Functional Soft Tissue Examination and Treatment by Manual Methods: The Extremities.

The purpose of this book is to present both a comprehensive evaluative approach to the soft tissues of the extremities and a conservative manual treatment approach (ie, friction massage, joint mobilization, muscle stretching, and myofascial treatment methods).

The first two chapters are dedicated to the understanding of the biology/physiology of soft tissue and the basic soft tissue examination. Credit is given to Dr James Cyriax for his contributions in Diagnosis of Soft Tissue Lesions, Volume 1 from his Textbook of Orthopedic Medicine. This is appropriate, as much of the framework for this book is based on an understanding of the work of Cyriax, from the differential diagnosis of passive and contractile tissue in evaluation to the use of friction massage in treatment of soft tissue maladies.

Part 2 of this text is an effective six chapters of evaluation techniques for the major joints of the extremities. Each chapter covers the anatomym biomechanics, functional examination, and lesions of the joint being examined. At the end of each chapter is a "Functional Diagnosis Chart" that summarizes the expected findings of the functional evaluation. The text is supplemented with diagrams, charts, and photographs that illustrate the anatomy and testing being described. Paragraphs on treatment also supplement the text. A thorough bibliography is included at the end of each chapter.

The third and finl section of the book provides six chapters on manual treatment options. John Mennell contributes a chapter on manipulation and the concept of joint play. If you have not studied Travell, the book provides a good overview of myofascial dysfunction. The concepts of Mennell and Cyriax are reviewed in the chapter entitled "Friction Massage." The final chapter basically provides a cookbook with recipes for suggested treatment regimens for each soft tissue clinical entity that was discussed in-depth earlier in the book.

Although the book relies heavily on other well-published authors--namely, Cyriax, Mennell, and Travell--the chapters on soft tissue evaluation are informative. The photos of testing maneuvers are well done, and the chart at the end of each chapter condenses a lot of information into a brief format.

This book is a good overview of soft tissue evaluation and treatment. If your library does not include the works of Mennell, Cyriax, and Travell, this book can provide you with these concepts in a very usable format.

Jim R Jones, PT Gallup Indian Medical Center Gallup, NM