Manipulative Therapy: Musculoskeletal Medicine

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
Karel Lewit
Churchill Livingstone / Eselvier, 2010
436 pages
(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."
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"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."

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