Manipulative Therapy: Musculoskeletal Medicine

Cover......Page 1
Dedication......Page 2
Copyright......Page 3
Foreword......Page 4
Preface......Page 5
Acknowledgements......Page 7
Abbreviations......Page 8
The history of manipulative therapy......Page 9
Nociceptive stimulation......Page 12
Choice of method......Page 14
The place of reflex therapy......Page 15
The significance of morphological changes......Page 17
Theoretical aspects of manipulation therapy......Page 18
The significance of functional disturbances......Page 20
The barrier......Page 21
Joint play and restriction......Page 22
Reflex changes in joint restriction......Page 23
The possible mechanism of restriction and manipulation......Page 24
The pathogenesis of restriction......Page 25
The spinal column as a functional unit......Page 27
Key regions of the spinal column in dysfunctions......Page 28
The importance of nervous control......Page 29
Dysfunctions of the spinal column in childhood......Page 32
Restrictions and their sequelae......Page 34
The significance of disturbed motor patterns (stereotypes)......Page 35
Straightening up from a forward-flexed position......Page 37
The effect of respiration on the locomotor system......Page 38
The significance of constitutional hypermobility......Page 41
Reflex processes in vertebrogenic dysfunctions......Page 42
Radicular pain......Page 44
The term ‘vertebrogenic’......Page 45
Conclusions......Page 46
Structural diagnosis......Page 47
Technique in functional diagnosis......Page 48
X-ray of the lumbar spine and the pelvis......Page 49
X-ray evaluation of lumbar spinal statics......Page 51
The pelvis......Page 57
The lumbar spine......Page 62
Functional anatomy......Page 66
X-ray anatomy of the thoracic spine......Page 67
Evaluating functional aspects......Page 68
X-ray technique......Page 70
Assessment of X-ray films......Page 71
Functional anatomy of the cervical spine......Page 73
X-ray anatomy of the cervical spine......Page 79
Evaluation with respect to functional implications......Page 82
Movement studies......Page 85
Morphological changes......Page 90
Diagnosis of dysfunctions of the locomotor system......Page 94
Course of the disease......Page 95
Load, posture, and position......Page 96
The inspection: posture......Page 97
The lateral aspect......Page 98
The ventral aspect......Page 99
Hyperalgesic zones......Page 100
Trigger points......Page 101
Radicular syndromes......Page 103
Passive mobility......Page 107
Screening examination......Page 108
Pelvic distortion......Page 109
Restriction of the sacroiliac joint......Page 110
The pelvic floor and coccygeus muscle......Page 113
Ligament pain......Page 114
Screening examination of active movement......Page 115
Examination of individual motion segments......Page 116
Screening examination of active movement......Page 119
Anteflexion......Page 120
Rotation......Page 121
Screening examination......Page 122
Screening examination......Page 123
Examination of passive mobility......Page 124
Examination of the motion segments......Page 125
Testing of mobility between occiput and atlas......Page 129
The shoulder......Page 131
The elbow......Page 133
The hip......Page 134
The knee......Page 135
The foot......Page 136
Examination of disturbances of balance......Page 137
General principles......Page 139
Examination of muscles with a tendency to weakness......Page 140
Examination of muscles with a tendency to shortening......Page 143
The spinal column......Page 147
The joints of the upper limb......Page 150
The joints of the lower limb......Page 151
Examination with the patient sitting......Page 152
Examination with the patient standing erect......Page 156
Movement patterns of respiration......Page 157
The lower crossed syndrome......Page 158
Stratification syndrome (according to Janda)......Page 159
Dysfunctions and the course of examination......Page 160
Adjusting our thinking to the functional approach......Page 161
Function and chain reactions......Page 162
Chain reactions in the light of developmental kinesiology......Page 164
The pathomechanisms of chain reactions......Page 166
The role of the diaphragm......Page 167
Analysis of chain reactions......Page 168
Problems......Page 169
Case studies......Page 170
Common differential diagnoses......Page 171
Conclusions......Page 172
Indications for and principles underlying individual treatment methods......Page 173
Indications......Page 174
Contraindications......Page 175
Traction......Page 176
Restoration of deep tissue mobility......Page 177
Massage......Page 178
Local anesthesia – needling......Page 179
Soft-tissue manipulation versus reflex therapy......Page 180
Remedial exercise......Page 181
Treatment of faulty statics......Page 182
Immobilization and supports......Page 183
Lifestyle......Page 184
The course of manipulative treatment......Page 185
Conclusions......Page 186
Therapeutic techniques......Page 187
General principles governing technical aspects......Page 188
Extremity joints......Page 193
The spinal column......Page 207
Johnston’s functional techniques......Page 229
Tactile perception and muscle tone......Page 231
Assessing altered tactile perception......Page 232
Altered superficial tactile perception following surgery (due to scarring)......Page 233
Self-treatment......Page 235
Stretching a connective tissue fold......Page 236
Shifting (stretching) the deep fascia......Page 237
Mutual shifting of metacarpal and metatarsal bones......Page 241
Self-mobilization......Page 242
Self-mobilization by stretching......Page 243
Self-mobilization of the lumbar spine......Page 244
Self-mobilization of the thoracic spine and ribs......Page 246
Self-mobilization of the cervicothoracic junction and first rib......Page 248
Self-mobilization of the cervical spine......Page 249
Self-mobilization of the extremity joints......Page 251
Basic principles......Page 252
Muscles of the head and neck......Page 254
Muscles of the upper extremity......Page 261
Muscles of the trunk......Page 267
Muscles of the hip region......Page 276
Muscles of the lower extremity......Page 278
Muscles of the trunk......Page 285
Standing on both feet......Page 291
Standing on one leg and walking......Page 292
Sitting......Page 293
Anteflexion......Page 295
Lifting the arms......Page 296
Carrying loads correctly......Page 298
Breathing......Page 299
The feet......Page 300
Supports......Page 302
Pelvic belt (Biedermann and Cyriax)......Page 303
Local anesthesia......Page 304
Clinical aspects of locomotor system dysfunction (vertebrogenic disorders)......Page 306
Pain in the lumbar spine and pelvic region......Page 307
Painful or tender coccyx......Page 308
Painful hip joint (coxalgia)......Page 310
Restrictions in the lumbar spine and sacroiliac joints......Page 311
Low-back pain due to disk herniation......Page 314
Forward-drawn posture......Page 316
Inflare and outflare (Greenman)......Page 318
The coccygeus and pelvic floor......Page 319
Low-back pain due to restricted trunk rotation......Page 320
Combined lesions......Page 321
Slipping rib......Page 322
Muscle imbalance......Page 323
Acute wry neck......Page 324
Referred pain and other pain types......Page 325
Entrapment syndromes......Page 330
Carpal tunnel syndrome......Page 331
Thoracic outlet syndrome......Page 332
Nocturnal meralgia paresthetica......Page 333
Headache......Page 334
Disturbances of equilibrium......Page 338
Diagnosis......Page 343
Basilar impression and spinal canal narrowing......Page 344
Radicular syndromes......Page 346
General principles......Page 353
The lungs and pleura......Page 354
The heart......Page 355
The stomach and duodenum......Page 356
Importance of the psoas major and rectus abdominis......Page 357
Gynecological disorders and low-back pain......Page 358
Cranial trauma......Page 359
The clinical picture of dysfunctions in individual motion segments......Page 362
Segments C3/C4–C5/C6......Page 363
Segment L3/L4......Page 364
The hip joint......Page 365
The foot and fibular head......Page 366
Importance and incidence of locomotor system dysfunctions......Page 367
Principles and goals of prevention......Page 368
Passive prevention......Page 369
Active prevention......Page 371
Manipulation as a prophylactic measure......Page 373
Assessment of (un)fitness for work......Page 375
Did an accident happen?......Page 377
Did the accident cause the symptoms?......Page 378
The place of manipulative therapy and its future......Page 380
Glossary......Page 384
Bibliography......Page 386
Further reading......Page 392
Index......Page 420