Massage and Manual Therapy for Orthopedic Conditions.
|Publication:||Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 New Zealand Society of Physiotherapists ISSN: 0303-7193|
|Issue:||Date: July, 2011 Source Volume: 39 Source Issue: 2|
Massage and Manual Therapy for Orthopedic Conditions. Thomas
Hendrickson, Lippincott Williams & Wilkins, 2009, ISBN
978-0-7817-9574-6, 526 pages. RRP: $139.99
The aim of this text, authored by a chiropractor, is to advance massage and manual therapy techniques specialising in the management of musculoskeletal pain and dysfunction. Following the first edition, published in 2003, the second edition adds manual therapy techniques, defined as mobilisation of joints and soft tissue, including muscle energy techniques.
The techniques are based on the "Hendrickson Method" named after the author, emphasising manipulations in a transverse direction to the line of fiber, believed to realign the soft tissue. These sound very similar to techniques currently used by physiotherapists under the term "cross-frictions" and "specific soft tissue mobilisation techniques". Emphasis is placed in the text on body position of the therapist, providing suggestions for developing and using "internal energy" or "chi" in the massage strokes to improve physical efficiency.
The first part of the book provides a general theoretical overview for the treatment approach. A new paradigm in soft tissue therapy is introduced, namely that electromagnetic fields from molecular and intermolecular forces, the heartbeat, muscle contraction, gland sections and emotions can be focussed for healing. It is suggested that touch can transmit a focussed electromagnetic signal that may affect the entire body. This signal, in turn, may influence repair and regeneration. The approach emphasises four overall treatment goals: structural, neurological, psychological and energetic. The structural goals include improving mobility, alignment and extensibility, while the neurological goals focus on neuromuscular and proprioceptive reeducation, pain management and relaxation. Energetic goals are based on the hypothesis that massage and manual therapy have piezoelectrical and electromagnetic effects, contributing towards healing. These mechanisms and basic anatomy of musculoskeletal system are described in the first chapter.
Bascic principles for the Hendrickson techniques are described in the second chapter. A wave-like movement for the therapist is suggested, both for the whole body ("large wave of energy moving through the body") and for the hands. The text then continues with clinical applications, divided into different body segments. Each section describes common disorders, relating these to the anatomy of joints and soft tissue, including fascia and retinaculum. Good figures are used to illustrate these, as are comprehensive tables for muscle origins, insertions, action and common dysfunction. Detailed physical assessment is outlined, including observation checklists, assessment of active, passive and resisted movements, and palpation. Specific techniques are described for each main muscle (including fascia) and joint. Concepts of muscle balancing are incorporated, namely indicating which muscles tend to be inhibited and weak, or tight and short. Clinical case examples for acute and chronic injuries are give for each segment.
A limitation of the text is lack of sound research basis, although references are provided. Nevertheless, this book will be very useful for undergraduate students and for clinicians whose approach may have focussed mainly on assessment and treatment of "joint" techniques and rehabilitative exercises.
Combining soft tissue techniques, including fascia as a possible source of symptom in the clinical reasoning process, with prior knowledge and skills, will contribute towards a holistic approach to rehabilitation of patients with musculoskeletal disorders.
Gisela Sole, PhD, fnzcp
Senior Lecturer, School of Physiotherapy, University of Otago
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