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Clinical application of neuromuscular techniques: volume 1 the upper body
  1. H Wajswelner

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    Edited by Leon Chaitow, Judith Walker DeLaney. Churchill Livingstone, 2000, £45.99, pp 469, hardcover. ISBN 0443062706

    As stated on page 2, imagine removing all the organs of the body, leaving only the connective tissue. What would remain would still resemble the human form, and its function could be readily appreciated, whereas doing the opposite would leave an unrecognisable collection of organs, devoid of form or function. Although there is little scientific evidence presented, such as controlled therapeutic trials, as to why these techniques are effective, this impressive first volume lights the way for practitioners of muscle energy techniques (METs), well known here in Australia, and neuro-muscular technique or NMT (Europe)/neuro-muscular therapy (America). It covers in great detail the entire background to the collection of manual techniques concerned with changes to the connective tissue, including fascia, muscle, joint, bone, and nerve, due to injury and disease. The first volume begins with chapters describing the function and dysfunction of the connective tissue and fascial system, muscles, reporting systems and the brain, patterns of dysfunction, myofascial trigger points, inflammation and pain, assessment, treatment and rehabilitation, modern NMT and associated modalities. Text boxes interspersed in the chapters summarise the broad range of previous authors’ work in these areas. This is followed by a regional consideration of clinical assessment and treatment techniques in the cervical region, cranium, shoulder/arm/hand, and thorax.

    NMT is described in both European (Lief’s techniques, which are fundamentally “manual application of specialised pressure and strokes…applied by finger or thumb contact”) and American versions (manual glides and pincer compression assessing for taut tissue bands and treatment using glides and flat or pincer compression).

    Associated modalities include myofascial release (MFR), MET, and other positional release techniques (PRTs), strain-counterstrain, proprioceptive neuromuscular facilitation (PNF) and other stretching, which have in common the concept of moving the limb or affected tissues “…away from the resistance barriers towards a position of comfort…” as follow up to the manual treatment.

    In the clinical applications chapters, the functional anatomy is described, as are common causes of dysfunction, such as whiplash. Every muscle of the region is described systematically in terms of attachments, innervation, muscle type, function, synergists, antagonists, trigger point locations, and patterns of complaint. This is followed by a description of NMT, MFR, and MET treatment options.

    There are very few good references on MET, Chaitow having written or co-written most of them previously, and this text helps to integrate MET with the other manual techniques in a logical way. Impossible to summarise in a book review because of its depth of detail and scope, this book could serve the neuro-musculo-skeletal practitioner as both a reference text and practical technique manual. It is formulaic in its approach, which makes it simple to use despite its size. Although there are few specific details on sports injury, sports medicine practitioners and physical therapists would be well advised to have this book in their professional library.

    Rating

    • Presentation 17/20

    • Comprehensiveness 18/20

    • Readability 15/20

    • Relevance 15/20

    • Evidence basis 8/20

    • Total 73/100

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