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Peripheral nerve injuries in the athlete
  1. P McCrory

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    Edited by J H Fienberg, N I Spielholz. Published by Human Kinetics, 2003, pp 280, £38.00, hardcover. ISBN 0736044906

    Increasingly it has been recognised that neurological problems, such as nerve entrapment syndromes, contribute to a variety of exercise related problems in athletes. This increased awareness is reflected by the large number of books as well as review articles currently available on the topic of nerve injuries. This new book by Fienberg and Spielholz is yet another addition to this area. The book reads as being written primarily by rehabilitation physicians or physiatrists rather than by neurologists or sports physicians. As such it is very strong in the rehabilitation area (which comprises almost half the book) as well as the understanding of radiculopathies and other spinal problems. The rehabilitation of nerve injuries is an area that is relevant not just to sports medicine but the wider church of physiotherapy, athletic trainers, and other providers of rehabilitation for athletes.

    The book is weakest in the clinical perspective of the myriad of peripheral nerve entrapments, where the majority are presented as theoretical constructs rather than giving the reader the impression that the authors of the various sections have actually seen the conditions first hand. One can contrast their approach to that of Pecina et al (Tunnel syndromes, 3rd edition, CRC Press, Boca Raton, FL, 2001) where the authors not only provide an understanding of the anatomical and aetiological basis of the various syndromes but also the clinical perspective, clearly bringing their own thoughts to the interpretation of the published literature.

    The other annoying aspect of the book by Fienberg and Spielholz is the dated references that are cited. There are few references from the last five years and surprisingly few citations from the non-US literature. The references that are cited are not classified by any evidence based approach. If readers are looking for a more thorough review of the literature on nerve entrapment syndromes, then they would do well to find the book Focal peripheral neuropathies by John Stewart (3rd edition, Lippincott Williams & Wilkins, Philadelphia, PA, 2000), which is the standard reference for neurologists in this field.

    In summary, this is a very frustrating book. Its weaknesses are in the syndromes it sets out to define. Fortunately, alternative and better references exist in this regard. Its strength is in the rehabilitation of these nerve injuries. This is the only book that I have seen in the sports neurology literature that discusses this topic in any depth. I cannot help thinking that the authors should have written the entire book on the subject of nerve injury rehabilitation, in which case it would have been a classic.

    • Presentation10/20
    • Comprehensiveness5/20
    • Readability8/20
    • Relevance8/20
    • Evidence basis0/20
    • Total31/100


    Edited by J H Fienberg, N I Spielholz. Published by Human Kinetics, 2003, pp 280, £38.00, hardcover. ISBN 0736044906

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