Mechanical Shoulder Disorders: Perspectives in Functional Anatomy.

Mechanical Shoulder Disorders: Perspectives in Functional Anatomy Porterfield JA, DeRosa C. St Louis, MO 63146, Saunders, 2004, hardcover (with DVD), 235 pp, illus, ISBN: 0-7216-9272-9, $69.95.

The authors have provided a focused, well-written text that discusses clinical anatomy and applied biomechanics and the clinical application of this information in the examination and treatment of shoulder injuries. The central theme of the text is to improve the reader's knowledge of the process of evaluation and treatment of shoulder pathology. A specific statement of intent is included in the early paragraphs of each chapter, which provides a broad learning objective for readers.

The text contains 6 chapters and begins with an overview titled, "Principles of Mechanical Shoulder Disorders" (chapter 1). Chapters 2 through 4 provide information on neuroanatomy, anatomy, and joint structure and function. Chapter 5 covers the assessment of shoulder girdle dysfunction in sufficient detail. The final chapter focuses on intervention and includes an extensive section containing 48 exercises, supplemented with photographs, instructions regarding technique, and sequencing of the exercise components.

The DVD included with the book provides more than 2 hours of information focusing on clinical anatomy and its application in the management of shoulder dysfunction. This additional feature makes Mechanical Shoulder Disorders a unique text and a useful resource for clinicians. Although the primary component of the DVD is the utilization of cadaveric prosections for discussion of clinical anatomy, the authors also effectively included fluoroscopy to emphasize applied biomechanics. This DVD is well done and can be useful for students, educators, practicing clinicians, and patient education.

In addition to the DVD, the book contains more than 200 illustrations that complement and add clarity to the written text. Another key component of this text is its incorporation of 48 specific exercises and accompanying photographs. The final chapter concludes with the authors' recommended treatment progression for various shoulder disorders.

Although this text provides a thorough review of clinical anatomy, I do not recommend it as a stand-alone reference for the examination and treatment of shoulder disorders. The authors touch on most shoulder diagnoses; however, the coverage is not always thorough. The inclusion of surgical conditions, procedures, and postoperative rehabilitation is limited. Each chapter concludes with references; however, the incorporation of evidence-based, peer-reviewed literature from the past decade to support the examination and interventions proposed in this book is limited. Although the DVD is a wonderful complement to the text, the inclusion of examination, treatment, and exercise techniques in the disk would have made this a more complete resource. Furthermore, although the authors briefly discuss the influence of the thoracic and cervical spine on the shoulder, there is little mention of the potential contribution of the lumbar spine, hip, and pelvic regions to shoulder dysfunction.

This is a clear, concise text that I believe would be most useful for students and educators. The accompanying DVD is an excellent resource for practicing clinicians and may be an effective tool for educating patients as well. Although the book is not explicitly aimed at a particular medical specialty, I would recommend it for students, educators, and practicing clinicians in physical therapy, occupational therapy, and athletic training.

Michael Rosenthal, PT, DSc, SCS, ECS, ATC 

Naval Special Warfare Center 

San Diego, Calif

Dr Rosenthal is the Director of Physical Therapy and specializes in the management of orthopedic and sports-related injuries.