Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries
Thomas C. Michaud
Newton Biomechanics, 2013
In early 2012, Dr. Michaud had sent me a copy of the latest edition of his book, Human Locomotion: The Conservative Management of Gait-Related Disorders. Rich in both content and complementary illustrations, Human Locomotion is a book that I find myself frequently referring back to in order to improve my understanding of the evolution of human gait as well as both the pathophysiology and treatment of gait related-disorders. Admittedly though, I have yet to read the book cover to cover as I try to with most texts.
See review of Human Locomotion by Jason Brown, DC.
(Patrick Ward had also written a review but due to website security issues recently, the review can no longer be accessed)
As a follow-up to Human Locomotion, Dr. Michaud recently released his newest book, Injury-Free Running: How to Build Strength, Improve Form, and Treat/Prevent Injuries. Thanks to a heads up from Joe Heiler of SportsRehabExpert.com and a discount code, I purchased the book earlier this month and completed it within one week.
In contrast to the original, this book is targeted directly toward recreational runners. A condensed and easy to read version with a similar template, Injury-Free Running begins with a chapter introducing the anatomy of the human body not unlike one you would find in an introductory university-level anatomy course. Interestingly though, in addition to identifying muscles by their names in the illustrations, Michaud also provides the Greek/Latin origins of each to provide greater meaning and understanding.
Like Human Locomotion, a chapter on the evolution of running was integrated into this book. Although condensed and laid in a manner that is easy to both follow and remember, this chapter provides the reader with the "why" behind the "what". For example, why our ilia lies more sagittal in contrast to a more frontal orientation seen in our ancestors.
Chapters three, four and five discuss the biomechanics of walking and running as well as what Dr. Michaud considers the "perfect gaits" and risk factors for injuries of each. Finally, the final two chapters discuss how to select the "ideal" running shoe as well as self-management protocols for common running injuries.
Personally, I found this book to be a nice and simple resource that complements Human Locomotion. As a clinician who works extensively in the sport of athletics, I found Human Locomotion to be much more valuable to expanding my knowledge of this topic. However, again this book was targeted to the end user. That said, because of its simplicity, I found it to be a nice review particularly in regards to evolution and biomechanics.
So for those of you who are clinicians and are interested in learning more about running injuries, I do believe Injury-Free Running would be a nice introduction and/or review.
For more information about Dr. Michaud, please visit www.humanlocomotion.org.
Iced! The Illusionary Treatment Option
By Gary Reinl
"Easy to read, (potentially) difficult to digest" is how I would best describe this book.
Several years ago, I had contacted two well-respected colleagues and bluntly asked them what, in their experience, was the most effective method for improving recovery post-injury. After a short discussion it was made clear that I had to speak an individual named Gary Reinl. Well I did and today I can confidently say that I have a better understanding of the potential negative role that ice can play on post-injury healing and recovery.
Long thought to be the first and possibly most important protocol a therapist must apply to an injured athlete, icing is now seldom if at all pulled from my toolbox thanks to Gary.
For those of you who have yet to meet Mr. Reinl, watch his interview with Kelly Starrett, and/or are still frequently using ice and cryotherapy in the acute management of sports injuries, I highly suggest you read Iced!
As I mentioned above, this book was easy to read and for me, a nice break from most clinical textbooks. In fact, I was able to breeze through the book on my return flight to and from a recent to Portland (approximately 5 hours). As I also mentioned above, this book may potentially be difficult to digest for some. Again, traditional clinical wisdom tells us to use ice and cryotherapy post-injury but since inflammation is a critical early step in the healing process of muscle and tissue injuries, it is very important that we instead try to facilitate this natural process...and speed it up (again, the whole process) if necessary.
There is no question that Gary is a great story teller. And this book reflects exactly that. In a coherent and progressive manner, Gary uses a first person narrative to tell us why we started applying ice in the first place, how he came to the epiphany that icing may not be ideal, and how he directly and indirectly influenced the same thought processes of most North American professional teams' training staff.
Gary also devotes a chapter to the three phase healing process and summarizes the current state of the literature on the use of icing in injury. What is made clear is that there are actually no high level research studies that unequivocally conclude that icing speeds up the healing process and that some studies even state that icing can delay the healing process.
Rather than leaving the reader with no alternative to ice, Gary graciously provides us with examples of protocols that have anecdotally worked for him and his clients/athletes following injury. Now certainly, we would have to do some critical thinking ourselves, but his examples really make it simple for the reader to understand the rationale behind muscle contraction and injury recovery and subsequently apply similar principles.
With all that said, does it mean that icing and similar therapies are completely unnecessary? Gary does stress that in a life or death scenario (i.e. amputation, injury in the woods, etc) icing would certainly be a viable option. However, there has been some valid research with respect to the use of ice baths to upregulate the sympathetic system in hyperparasympathetic states. Remember though, such scenarios are separate from acute injuries.
In my opinion, I think this book would be relevant for all stakeholders in sport. From athletes and coaches to medical staff and front office personnel, Iced! is a welcomed myth-buster that in due time, will no doubt help athletes recover from injury in a more timely and efficient manner.
Athletic Development: The Art & Science of Functional Sports Conditioning
By Vern Gambetta
Human Kinetics, 2007
"The explosion of information is 'noise'. They...do not have the background to differentiate good information from fallacious information."
This book, purchased in 2008, was one of those books I have been meaning to read literally from cover to cover for quite some time. Like one of my more recent reviews, "Developing Sport Expertise", "Athletic Development: The Art and Science of Functional Sports Training" is one of a number of books that I admittedly had started but put down with the purchase of another. For some reason, it is now my objective for the rest of the year to go back and read all those books, and hopefully provide a little summary and/or review to give you a better insight into its contents and real world meaning.
The quote above, taken from "Athletic Development", sums up my feelings upon reading this book in its entirety. Although it was directed to coaches in the context of their athletes, with the current age of information "noise" is spreading like wildfire and its important for us as professionals in whatever field to respect sound principles and keep things simple.
"Athletic Development" does just that. It outlines the important principles of sports conditioning in a straightforward manner that is highly comprehensible for both the beginner and expert strength and sport coaches. For the sport medicine professional, it introduces and summarizes the necessary concepts of athletic development for those who may not (for example) be CSCS credentialed.
Common themes throughout the book seem to highlight what Gambetta likely considers as his foundational principles of coaching athletes. Namely, the importance of fundamental movement skills at all levels as well as the mutual relationship between the coach and athlete. Divided into two main sections, Part 1: Elements of a Training System provides the reader with a global understanding of the needs of a sound athletic development program. By breaking the whole into its progressive parts, Part 2: Physical Contributors to Performance provides the reader with a foundational understanding of the specific components important in any program.
Although the concluding chapter, "The future of functional conditioning", closes the book, it does so in such a manner that opens the gates to a "path" that many coaches can follow. His advice?
"There is no need to make things complex. The interplay between al the training variables will take care of the complexity."
"As a coach, you need to think of yourself as a tour guide, carefully leading athletes to their destination without being overbearing, but now allowing them to get lost. To accomplish this, you must look for familiar patterns and take advantage of the relationships that will appear. Learn to foster those relationships."
Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction
Chichester, England / Aptos, California
Lotus Publishing / On Target Publications, 2012
Over the last several years, a considerable percentage of my continuing education endeavours have come from the likes of Craig Liebenson, Gray Cook and Pavel Kolar. To many of you, this is no secret. And although I will often recommend "Rehabilitation of the Spine" and "Movement" to those asking for resources where further knowledge into the functional approach to rehabilitative exercise can be gained, I have always had difficulty locating a book to recommend to those unfamiliar that outlines the principles upon which the Dynamic Neuromuscular Stabilization approach lies. I am aware that Pavel Kolar will soon be releasing an English version of his text in the near future, but until now, the majority of information pertaining to the principles behind DNS seem to only be found in the literature, book chapters, blogs and websites. Having just read Evan Osar's new book, "Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction" I thankfully can now recommend a resource that introduces and incorporates principles inherent within DNS (amongst others) to many of my colleagues.
"Corrective Exercise Solutions" is divided into three parts; an introduction, identification/assessment, and corrective exercise solutions. Part 1, Introduction to Movement: The Functional Elements outlines the theoretical background behind functional movement. In addition to a contemporary rendition of biomechanics and kinesiology (contemporary meaning it is likely a different version than what you learned in school) Osar describes the ontogenesis (development from birth) of human movement, joint centration, and stabilization-dissociation (aka Joint-by-Joint). Part 2, Identifying and Assessing the Hip and Shoulder Complexes utilizes three chapters to describe, again from a contemporary viewpoint, normal hip and shoulder mechanics, dysfunctions, common injuries and finally, simple ways to assess each region. Lastly, Part 3, Corrective Movement and Exercise Progressions formed the second half of the book and introduced the theoretical rational to and foundation behind corrective exercise, as well as the key patterns and movement progressions for both the upper and lower extremities, naturally focusing on the shoulder and hip.
Throughout the book, three key principles formed an underlying theme that certainly will not go unnoticed regardless of whether this realm is novel to the reader or not. The principles, many of you will be familiar with, consist of:
Additionally, several other important sections throughout the book also warrant highlighting:
The book is rich with images, not dissimilar to Elphinston's "Stability, Sport, and Performance Movement", to ensure that the reader accurately conceptualizes the content within the written dialogue. Additionally, throughout the book, "Keys to Success" bolded text boxes provide the reader not only with summarized key points but also with related and clarified concepts that may just challenge the readers' traditionally held beliefs. And, although some of you may or may not use the exercises recommended in the text, you certainly will gain a better appreciation for the importance of ipsilateral and contralateral patterns when prescribing exercises.
Finally, I must be clear. This is not a book from Prague. It is also not a book containing DNS exercises. What this book is, however, is a resource that seems to hold DNS principles at its core combined with influential ingredients taken from the likes of Diane Lee & Linda-Joy Lee, Vladimir Janda, Shirley Sahrmann, Gray Cook, Mike Boyle and others. As many of you know, much of the content on this blog is influenced from a conglomeration of resources and therefore, "Corrective Exercise Solutions" resonated very well with me. For those of you that choose to read "Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction", my guess is that you also will likely take kindly to Dr. Osar's integrated approach as well.
Developing Sport Expertise
Edited by Farrow, Baker, and MacMahon
Abingdon, Oxon / New York, NY
This text, co-written by a colleague and mentor of mine, Joe Baker, is one of those hidden gems that should be in the library of any professional working with athletes. As the internet is littered with information pertaining to athletic development, it is easy for one to get lost in theoretical practice not founded by research. This particular text does the opposite and gathers the current available literature into a concise, easy to read, resource pertaining to athletic development and firmly grounded in scientific evidence...
Table of Contents
1. Introduction: Developing Expertise in Sport – How Research Can Inform Practice
Section 1: Developing Elite Athletes: From the Backyard to the Big Stage
2. Play, Practice and Athlete Development
3. Does Practice Make Perfect?: The Role of Training in Developing the Expert Athlete
4. The Motivation to Become an Expert Athlete: How Coaches can Promote Long-Term Commitment
5. Identifying and Developing Sporting Experts
Section 2: Designing Practice to Make Athletes Think – (But Not Too Much)!
6. Expert Coaches in Action
7. Skill Learning the Implicit Way: Say No More!
8. Performance Pressure and Paralysis by Analysis: Research and Implications
9. Organising Practice: The Interaction of Repetition and Cognitive Effort for Skill Performance
Section 3: Through the Eyes and Thoughts of an Expert
10. A Recipe for Expert Decision Making
11. Tactics: Using Knowledge to Enhance Sport Performance
12. The Sports Official in Research and Practice
13. The Past and Future of Applied Sport Expertise Research
Although I had read this book shortly following it's publication in late 2008, I recently re-read it in its entirety due to my increased interest in applied sports science from each of a coaching, strength and conditioning and sport medicine perspective. Reading this book provided me with a deeper insight into how sports experts ACTUALLY develop rather than how we may think they develop. Utilizing the evidence, the editors of this book called upon researchers and coaches from around the world to shed light on the successful and unsuccessful practices employed by scientists, coaches and athletes. Incorporating and comparing both theory and application, topics such as deliberate practice, the developmental model of sport participation (Cote), implicit skill learning, and paralysis by analysis were introduced and expanded upon to provide us (the reader) with a better understanding of how athletes become "sports experts".
Overall, I think this is an excellent book for any stakeholder involved in sport including coaches, sports scientists, athletes, policy makers and even sport medicine professionals. And although you may or may not directly work with elite athletes, it never hurts to gain better insight into why Bolt became Bolt and Tiger became Tiger.
Note: If this aspect of sports science and coaching interests you, I highly suggest another book titled "Talent Identification and Development in Sport: International Perspectives".
Talent Identification and Development in Sport: International Perspectives
Edited by Joseph Baker, Steve Cobley and Jorg Schorer
Abingdon, Oxon / New York, NY
A must read for all stakeholders in sport, "Talent Identification and Development: International Perspectives" takes a comprehensive examination at the variables involved along the pathway to sport expertise. Edited by Baker, Cobley and Schorer, the contents within this text cohesively summarizes much of the research performed to date across the globe in the field of talent identification and development.
This text is divided into two sections: Theoretical and conceptual models for understanding talent identification and development and International case studies of talent identification and development. As stated in its title, section one provides the reader with the theoretical background necessary for understanding the variables and mechanisms described in section two. Authored by many of the scientists performing today's research in this field, section two is comprised of a series of case studies from various nations and their respective sports detailing the processes by which, young athletes are identified and developed into international sports experts. From genetic influence to government involvement, the interaction amongst a wealth of variables are described in both their roles as limiting factors and promoters in achieving professional and international success.
For the professionals "in the trenches" of sport, it comes as no surprise that the identification and nurturing of young, talented individuals incorporates a wealth variables that are seemingly difficult to predict and administer. However the purpose of this book, "to provide a 'state of the science' overview of empirical and practical information", may enable the coach, exercise professional, administrator, or other to focus more on the interactors at play that have been grounded in science. Upon reading this text, you will dynamically be compelled to examine your own current practices and provided with conceptual frameworks of both successful and unsuccessful practices.
Although both the authors and editors understand that future research is necessary to solidify our understanding, their summaries provide us with the theoretical and practical knowledge to be able to critically examine modern day practice. It is clear to many that physiological, psychological, and sociological influences play a dynamically interactive role in the pathways to sport expertise but in reading this text, key variables within each certainly come to the forefront.
I have been fortunate to have had several students work with me over the past year. While most of these bright students have typically come from chiropractic colleges across the continent, Porter Brown is a graduating kinesiology student from the University of Alberta who will be entering his first year at CMCC this fall.
Aside from the daily assistance with my patients, Porter has been through many of the books on my bookshelf and many of the DVDs in my library. To say that he has saved several thousand dollars in the past 3 months is quite accurate.
Here is his unedited review of the book, "Movement."
Gray Cook, MSPT, OCS, CSCS with Dr. L. Burton, Dr. K. Kiesel, Dr. G. Rose & M.F. Bryant
Movement: Functional Movement Systems – Screening, Assessing, Corrective Strategies
On Target Publications
Aptos, CA. 2010
Hardcover, 407 pages
Movement is such a radical and ingenious book, that I am skeptical I can do it justice in just a few lines. Movement fills a gap in our knowledge about natural authentic movement that I never even knew existed. It proposes a paradigm shift is required for the way we view authentic movement patterns. Instead of dissecting human movement into individual parts (like our physiology, anatomy, chemistry classes taught us) we examine natural movement from a holistic perspective. With this new stance in mind, the author Gray Cook and his team, explain the lack of underlying principles for fundamental movement that exists in fitness and rehabilitation theory to date. Cook’s goal is to point out the lack of a standard operating procedure in existence for movement fundamentals and offer up the Functional Movement System to fill the void.
Gray Cook has his foot in the door for both the fitness (CSCS) and the rehabilitation (MSPT and OCS) fields; pairing these with years of experience makes him one of the leading minds in physical therapy and strength and conditioning theory.
Movement could be beneficial to everyone, but the intended audience are the health care and fitness industries. Professionals such as medical and chiropractic physicians, physical and athletic therapists, personal trainers, coaches, physical educators, and even people looking to become healthier (and not limited to this list) will gain the most from this read.
The organization of the book follows the same pattern as someone administering the functional movement system. It progresses from reasoning/explanations, to administering the screen/assessment, to creating and prescribing corrective exercises.
The book opens with a preface from Gray Cook, providing a hook that I’m afraid no one could resist, followed by chapters that are the meat and potatoes of Movement. This is where Cook presents the paradigm shift in the way of thinking. The ah-ha moment that sold me, occurred as Cook explained that the number one predictor for injury is previous injury, implying that something is drastically wrong with our current rehabilitation process. The process of looking at dysfunction, limitation, and asymmetry, as opposed to pain, was completely alien to me. I always believed that pain indicated where the problem is, but instead it’s the fire alarm going off telling us there’s a fire somewhere else in the body. Further, Cook’s explanation about the importance of breathing was so simplistic yet undeniably eye-opening. There is so much in these first chapters that one can read it over and over and take something away from it each time.
Movement progresses into explanations and instructions for administering the Functional Movement Screen (FMS) and the Selective Functional Movement Assessment (SFMA). The FMS is a screen for discovering faulty fundamental movement patterns in the absence of pain, which can be used to correct patterns to reduce the chance of future injury. The SFMA is systematic clinical approach to discovering which movement patterns are dysfunctional/functional when there is pain present, a concept known as regional interdependence. The appendix provides SFMA flowcharts to assist the clinician in mastering the assessment process.
The subsequent section provides an understanding of corrective strategies, ways to develop corrective exercises, and methods for recording exercises on a corrective framework checklist. This section is unique compared to the last because it isn’t a pre-constructed system. It provides the reader with principles to follow without strict guidelines (which is one of the strengths of the FMS/SFMA). This makes it applicable to real life, because as new and better exercises are developed, this section will allow one to check them against logical principles.
The undisputable theme of this book is quality over quantity, a phrase that Cook incorporates into his philosophy: “First move well, and then move often”. This theme is well supported throughout the book as it is one of the underlying principles to Functional Movement Systems. The purpose of these systems is to provide a standard operating procedure to ensure there is fundamental movement quality instilled before movement quantity is of concern.
One aspect that I had a tough time deciding whether to call a strength or weakness is Cook’s thoroughness/repetition with certain topics, such as the mobility before stability rule. Upon reflection, I realized that the only thing Cook is repetitive about is the very important principles he wants to engrain into our thinking. I decided to refer to it as a strength indicating that he is thorough almost to the point of repetition.
Cook is an excellent communicator, something that is easy to see in his writing. He reduces and simplifies complex ideas with a few sentences and examples. It’s uncanny how many times I was forming questions in my head, only to be answered in the next sentence. It’s things like this and his first person informal tone, that make it seem more like you’re having a conversation with the man than reading his 400 page textbook. Not only is it expertly written, the content is just as impressive.
Although I’m sure Cook can sell me the shirt off my back, he’s not just a sweet talker. After reading this book and stepping away, I’m amazed at the common sense of it all. How in a world where fundamentals are stressed in so many aspects of life, are they not stressed in movement patterns?
I believe the philosophy behind this book is invaluable to absolutely everyone; movement quality over quantity. However the book itself is indisputable in its value to the fitness and healthcare world. I would recommend it to anyone in those fields. I personally (having borrowed the book) am going to purchase it so I can read it again. It’s one of those books that has so much in it you have to keep reading it to catch things you missed. I have seen both the FMS and SFMA in use and can attest to its usefulness, I even plan to become certified in both systems once I graduate from Chiropractic College.
This is a different kind of review. For any clinician, this is a must read. But rather than providing you with my opinions on this book, which are beyond positive by the way, I thought I'd provide you with some pearls. Enjoy!
Manipulative Therapy: Musculoskeletal Medicine
Churchill Livingstone / Eselvier, 2010
(originally published in Czech - English title: "Manipulative therapy in rehabilitation of the locomotor system)
"We may ask why, when treating essentially the same disorders, preference is given sometimes to one method and sometimes to another. This...gives the impression that the choice of method depends on which treatment the practitioner is best able to perform, irrespective of actual suitability."
"As a rule a nociceptive stimulus produces somatic and autonomic changes. It is necessary to understand these changes in order to arrive at a rational, targeted course of treatment."
"The dysfunctions of the locomotor system..., together with the reflex changes they produce, may aptly be called the functional pathology of the locomotor system."
"The vast majority of cases of pain are not associated with demonstrable morphological changes in the locomotory system. In effect, therefore, these are patients with no diagnosis."
"Modern civilization brings with it very one-sided, unvaried posture and movement, causing muscular imbalance. Lack of movement together with static or postural overload are a characteristic feature of modern life. Disturbed movement patterns and static overload are probably the most frequent causes of reversible restrictions and of their occurrence and recurrence."
"It is important to realize...that not all vertebral segments have the same importance for the overall function. When performing a brief assessment we shoud therefore focus on key regions (craniocervical junction, cervicothoracic junction, middle thoracic spine, thoracolumbar junction, lumbosacroiliac joint, feet)."
"Faulty neurological and psychological control are among the factors involved in the pathogenesis and clinical signs and symptoms of locomotor dysfunctions. However, they are not identical with them."
"The locomotor system has to coordinate the specific function of respiratory movement with the function of locomotor activity...The most important issue here is the close link between respiration and postural function."
"Since movement is an outward effect of psychological activity, it is also true that psychological activity is a factor in motor function."
"Present-day knowledge of functional inter-relationships shows i to be essential to study the entire locomotor system at the initial examination."
"Dysfunctions should not simply be diagnosed by process of elimination...Instead, diagnosis should be based on characteristic symptoms."
"The greater the number of complaints a patient has...the greater the likelihood that these are indeed vertebrogenic dysfunctions."
"Almost any kind of trauma, even if it only affects the limbs, affects the spinal column."
"Function and its disturbances in the locomotor system are influenced by movement, load, posture, and position, especially if the position maintained is stressful. Therefore one of the most important points in recording the case history is to discover under what conditions the pain occurs."
"The soft tissues surround the muscular and articular structures everywhere, and need to move in harmony with them...For this reason, dysfunctions that are closely associated with the function of joints and muscles can be diagnosed in the soft tissue."
Advances in Functional Training
Santa Cruz, California
On Target Publications, 2010
Authored by one of North America's pioneers of strength and conditioning, Advances in Functional Training is a book written primarily for coaches, trainers, and athletes. With an obvious emphasis on function, one would be hard pressed to withhold this text from the rehabilitation professional as well, since many of the concepts discussed look at applied movement as it pertains to sport.
Advances in Functional Training is divided into eleven sections:
While many of the above chapters pertain specifically to strength training and athletic development, there is certainly no shortage of crossover to the field of sport medicine. Touching on specific topics such as core stability and sports hernias, among others, Boyle provides the reader with sound strategies for training around injuries. In fact, his "sports hernia" section really opened my eyes to effective rehabilitation and I've been treating hockey players for quite some time. Regardless, many of the training principles incorporated in this text can easily be applied in the rehab setting, even those principles surrounding periodization.
Now many of you in the field of sport medicine may be quick to ignore this text simply because of its title, but I can assure you that many of its concepts are relevant to your everyday practice. For those of you unaware, prior to full time strength training, Boyle previously worked an athletic trainer so he certainly understands the nature of injuries sustained in sport. Now I, myself, am a big believer of training heavy in rehabilitation but for those of you comfortable with yellow resistance bands and heat packs, you're more than welcome to forego this text. And for those of you interested in taking your rehabilitation skills to the next level, I highly suggest you get your hands on a copy. Think about it, how fun would it be to differentiate yourselves with the next clinic by using kettlebells, the TRX and valslides/slideboards in your practice? You really don't need much to rehab your patients effectively and efficiently and you certainly do not need a large budget for useless exercise machines that take up enormous amounts of space. If you are doubtful, just ask my interns.
But you do have a great opportunity to change the way your current rehabilitation programs are being implemented and Advances in Functional Training is but one important resource to help you do so. Better yet, get yourself a membership to strengthcoach.com
An oldie, but a goodie. This review pertains to McGill's Low Back Disorders (1st edition). It was written by Angela Regier Cubos, DC several years back, but worth the read.
Low Back Disorders: Evidence-Based Prevention and Rehabilitation
Human Kinetics Inc., 2002
This book attempts to give the reader a more in-depth understanding of the workings of the lumbar spine as it pertains to injury and rehabilitation. It is geared towards the more academically inclined individual, with a basic understanding of the anatomy and biomechanics of the low back. The author uses the most current and relevant scientific evidence to develop rehabilitation strategies for common low back pain, while highlighting common misconceptions that are often encountered in rehabilitation.
The book is divided into 3 distinct sections, each with its own focus. Part I provides a foundation for the remainder of the book by: giving an introduction to the issues surrounding low back disorders in society; highlighting the current knowledge regarding the epidemiology of low back pain; giving an in-depth description of the functional anatomy of the lumbar spine; as well as delving in to the mechanics of the lumbar spine, both in a normally functioning and injured state. Part II focuses on injury prevention strategies. Various guidelines for risk assessment are discussed that can be applied to both the occupational and/or athletic setting. The author then provides various strategies that should be employed by both the occupational worker as well as the athlete in order to reduce the occurrences of low back injuries, such as proper lifting techniques and training strategies. This section ends with an in-depth discussion of the use of back belts both in the workplace and for the athlete as a means of treating and preventing low back pain. Finally, Part III uses the foundational scientific knowledge gained in the preceding chapters to introduce rehabilitation strategies for low back disorders. This section explains how to properly assess each individual to determine the type of rehab strategies to employ, and then proceeds to explain the best exercises to use in order to train and strengthen the lumbar spine. The author provides exercises of varying degrees of difficulty in order to encompass a wide range of patients, up to, and including, the high-performance athlete. He demonstrates the need to include these exercises that provide maximal opportunity for strengthening, yet minimal opportunity for injury in any management program, and provides the research to support this.
Overall, McGill does an impeccable job of presenting the reader with a concise overview of the overwhelming topic of low back injury and rehabilitation. Tackling such an enormous issue in the scientific and thorough manner demonstrated here, reserves this book for those who already have a foundation in anatomy, biomechanics, and treatment strategies for the low back. Despite the plethora of charts and experimental data presented throughout the book, the reader feels well versed at the conclusion of the text to accurately assess the low back, as well as implement safe and effective rehabilitation strategies for a wide range of patients. This book is a must-read for any manual therapist who will be encountering the common complaint of low back pain in practice.
The more recent version of Low Back Disorders (2nd Edition) is available through my Amazon library by clicking on “Educational Resources” above.