Physical Therapies in Sport and Exercise.

Kolt GS, Snyder-Mackler L, eds. St Louis, MO 63146, Churchill Livingstone Inc, 2003, hardcover, 643 pp, illus, ISBN: 0-443-07154-3, $95.

Physical Therapies in Sport and Exercise is a multifaceted text that provides evidence-based information on the management of sports and exercise injuries. Forty-six international contributors from physical therapy, psychology, athletic training, orthopedics, pediatrics, radiology, biomechanics, and nursing contributed to this comprehensive text.

The book is organized into 5 sections. The first section reviews management principles for connective tissue, cover the areas of muscle, tendon, ligament, bone, and nerve. Adaptation of tissue to mechanical load and its response to injury, and healing are thoroughly discussed and provide the framework for musculoskeletal management. The clinician can use this section as a refresher of the basic structure and biomechanics of connective tissue.

The second section of this text is titled "Concepts in Managing Sport and Exercise Injuries" and contains 7 chapters that are important for comprehensive management of injuries. The first chapter of this section is dedicated to the theory and application of motor control and relearning. The next chapter focuses on mechanisms and theories of pain. Feedback strategies in management of pain and injury associated with sports activity also are discussed. This is followed by chapter 9, "Exercise-based Conditioning and Rehabilitation," a 21-page chapter" that presents evidence for strength/plyometric, interval, endurance, and stabilization training. Sample programs for clinical use are included for the reader. The next chapter offers a perspective on the psychology of injury and rehabilitation, an area often overlooked by clinicians. The 11th chapter is coauthored by 2 physicians who give detailed information on screening and provide criteria for determining clearance for sport and exercise. Outcome measures and the use of valid clinical measures and functional testing are discussed in chapter 12. The final chapter of this section covers the use of electrophysical agents in facilitating tissue healing. Efficacy studies are discussed for each modality, and I found this extremely helpful for clinical decision making.

Section 3 addresses injury management for regions of the body. Written by experts on each topic, these areas include the spine; shoulder; elbow; wrist and hand; pelvis, hip, and groin; thigh; knee; patellofemoral joint; leg; and foot and ankle. Each chapter discusses sport-specific applied anatomy and biomechanics, tests and measures, and interventions.

Four chapters on specific populations are covered in section 4. The first chapter details specific sports injuries related to children and adolescents and includes several radiographic figures. Older exercise participants are the focus of the next chapter. This chapter begins with the physiological effects of aging, and then discusses exercise and chronic illness. The active woman is the focus of chapter 26, which includes information on bone health b, the menstrual cycle and performance, the female athlete triad (disordered eating, amenorrhea, osteoporosis), and pregnancy and exercise. The chapter on athletes with disability rounds out this section, and it details the benefits of exercise and injury management for this special population.

The final section of this text is dedicated to medical considerations for the rehabilitation practitioner in a sport and exercise setting. Topics presented in this section are pharmacological agents and their effect on injury repair, performance-enhancing drugs, medical imaging, and medical emergencies. The chapter on medical imaging is very well organized and provides basic knowledge of various imaging techniques used in diagnosing sports- and exercise-related injuries.

I am not aware of another sports medicine text that is more comprehensive than this book. The evidence-based approach adds to the credibility of the information presented. The numerous, up-to-date references provide evidence for the effectiveness of the interventions described in the book. I would recommend this text to the practicing clinician who works with patients who are active.

Janice Loudon, PT, PhD, ATC 

University of Kansas Medical Center

Kansas City, Kan

Dr Loudon is Associate Professor in the Department of Physical Therapy and Rehabilitation Sciences where she teaches the classes "Applied Kinesiology and Biomechanics," "Evaluation Methods and Principles of Treatment of Musculoskeletal Disorders," and "Health Promotion." Her research interests are in pathomechanics related to injury in the athlete.