Women's Sports Medicine and Rehabilitation.

Women's Sports Medicine and Rehabilitation Swedan N, ed. Gaithersburg, MD 20878, Aspen Publishers Inc, 2001, hardcover, 447 pp, illus, ISBN: 0-8342-1731-7, $79.

The purpose of this book is to show health care professionals how to optimally examine, treat, and rehabilitate women who are involved in athletics at all levels. As the author states, most contributors to this project are women who are personally involved in athletics. Furthermore, the scope of the book is not limited to just "sports" activities, but it includes "nonsports" athletic activities as well (eg, walking, hiking, aerobics).

The introduction offers a history of the gradual emergence of women's sports, starting with the prohibitions on female exertion during the Victorian period and earlier historical periods. The prologue presents general rehabilitation concepts and attempts to illustrate gender differences within the categories of the kinetic chain, emotional and psychological considerations, and overtraining. The presentation of rehabilitation consists of 1- to 2-line summaries of exercise terminology and 1- to 2-paragraph summaries of common modalities and therapeutic techniques. The highlighted summary of information that appears in the prologue is continued throughout the book.

The 24 chapters are grouped into 4 sections. Part I, "Musculoskeletal Considerations," begins with a succinct but thorough chapter on gender differences in muscle morphology. The next several chapters (chapters 2-6) cover anatomy, gender differences, and musculoskeletal injuries for specific regions of the body. Except for the coverage of pelvic floor dysfunction in the chapter on pelvis and hip injuries (chapter 4), the contents of these chapters are summaries at best. The chapter on the knee contains recommended exercises and an appendix of rehabilitation protocols. Chapters on chronic injuries and on considerations for women with disabilities complete the first section.

Part II, "Across the Lifespan," contains an excellent chapter on the reproductive cycle and its effect on sports training and how sports training, in turn, affects the reproductive cycle. Other chapters in this section cover athletes who are young, pregnant, or aging. The initially informative presentation on the aging female athlete changes midway through the chapter to become a program of exercises.

"Medical Issues," part III, includes an interesting collection of chapters on medical challenges, cardiac issues, cancer, pain and headaches, breast health, bone metabolism, and the female athlete triad (disordered eating, amenorrhea, and osteoporosis). The chapter on bone metabolism is a superb presentation of bone remodeling and the effects of estrogen, nutrition, lactation, and exercise on bone. A clear discussion of osteoporosis, including secondary osteoporosis, is included along with trauma and stress fractures.

Part IV, "Health and Wellness," includes information on medical screenings, sports nutrition, psychology and the injured athlete, ergogenic aids, and recreational drugs. The chapter on ergogenic aids is a savvy presentation of related biochemical research and the effects of anabolic-androgenic steroids, creatine, growth hormone, blood doping, and caffeine. The International Olympic Committee (IOC) standard and method of screening is incorporated into each area.

The stated scope of the information to be included in this text has made this book an ambitious project. The collaborative nature of the effort without equally thorough editing has resulted in a book of uneven quality and depth. Some of the chapters are thorough and informative but these chapters contrast sharply with the superficial summarizing in others. Physical therapists will likely find the exercises in the book to be rudimentary and distracting. For these reasons, this book is not recommended for a health care professional's library but a dramatically edited second edition might be.

Debra Coglianese, PT, OCS, ATC
Beth Israel Deaconess Medical
  Center-Lexington
Lexington, Mass

Ms Coglianese adds her experience as a collegiate athletic trainer to 15 years experience in orthopedic physical therapy.