Handbook of Sports Medicine: A Symptom-Oriented Approach.

Handbook of Sports Medicine: A Symptom-Oriented Approach Lillegard W, Butcher J, Rucker K. Woburn, MA 01801-2041, Butterworth-Heinemann, 1998, hardcover, 431 pp, illus, $65.

Sports medicine has increasingly become part of mainstream medicine. Exercise is now considered an essential part of healthy living rather than a luxury. As people become more athletic, certain risks also increase. Health care professionals can find it difficult to keep abreast of all the injuries and illnesses common to individuals who participate in athletic activities. The purpose of this book is to provide a ready reference that addresses both athletic injuries and medical problems in a systematic manner, including initial assessment, differential diagnosis, evaluation, the latest treatment advice, and a general guide to rehabilitation and return to sports.

This edition is an improvement over the first edition because of the addition of chapters on mass participation events and back pain in the young athlete and because of the book's enhanced graphics. In addition, more information on the pediatric athlete has been included in the other musculoskeletal chapters, and the shoulder and ankle injury chapter has been greatly expanded. The text is well organized and concise, making it quite useful as a quick reference.

The book is divided into 3 sections: "General Considerations," "Injuries," and "Medical Problems." Chapter 1, which covers preparticipation athletic exams, includes the most recent recommendations for conducting the exam and practical guidelines on qualification for participation. The examples of evaluation forms are easy to read (ie, full-page format) and very useful. The chapter on mass participation events is a must read for all medical personnel involved in this type of event. I have never seen this topic covered as well, as thoroughly, and as concisely. The weakest chapter in section 1 deals with modalities in rehabilitation because some of the information is outdated and incorrect. For example, the authors write that "ice massage is generally the most effective method of cryotherapy," although current research indicates otherwise.

Because the athlete generally presents a specific symptom, the sections devoted to injuries and medical problems, which constitute the bulk of the text, are based on these symptoms whenever possible. The text uses algorithms to help the practitioner form a quick differential diagnosis. For example, when examining an athlete reporting chronic anterior knee pain, the reader can refer to the section on knee injuries, look under anterior knee pain, and know immediately to look for patellar tracking, patellar bursitis, patellar tendinitis, patellofemoral dysfunction, patella partita, and Hoffa syndrome. Each of these entities is then discussed in terms of the pertinent anatomy, pathophysiology, clinical findings, radiographic assessment, and treatment.

The section on injuries contains generally better, more concise information than most similar textbooks. The chapter on shoulder injuries in particular has excellent illustrations of anatomy and manual tests. The section on medical problems contains 13 diverse chapters ranging from exercise-induced bronchospasms to special considerations for the female athlete. Even a chapter on sports oncology is included.

The quality of this book's content is generally excellent. All of the chapters are followed by a list of appropriate references. The chapters on injuries, however, would have been improved if rehabilitation specialists (ie, physical therapists) had Contributed to the rehabilitation and exercise portions. For example, no mention is made of the importance of early movement and mobilization of an injured joint. Also, a rotator cuff exercise program is presented without including scapular stabilization.

This book is designed to serve as a guide for team physicians, sports medicine specialists, and most primary care doctors, and it accomplishes this goal quite well. Physical therapists will find this test to be an excellent resource for evaluating injured athletes and patients with orthopedic injuries as well as a necessary addition to their library.

Gerry C Van Dyke, PT, ATC 

California Orthopedics and Sports Therapy Rehabilitation Services Inc (COAST)

Aptos, Calif

Mr Van Dyke is the owner of California Orthopedics and Sports Therapy (COAST) Rehabilitation Services Inc, which provides physical therapy and athletic training services to professional, collegiate, and high school athletes.