Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines

565 Pages·2010·66.36 MB·English

by  Shirley Sahrmann PT PhD FAPTA

MOVEMENT
SYSTEM
IMPAIRMENT
SYNDROMES
oft heE xtremities,
CervicaanldT horacSipci nes
ShirlSeayh ranmn andA ssociates
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WashingtUonni versSicthyo oolfM edicine
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ELSEVIER
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ELSEVIER
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MOVEMENT SYSTEMI MPAlRMENTS YNDROMES OF ISBN:9 78-0-323-05342-6
THE EXTREMITIESC,E RVICALA ND THORACIC SPINES
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Notices
K.nowledagned b esptr actiinct eh ifsi e,lHdec onstancthiayn giAnsgn .e wr esearacnhde xperience
broadeounr u nderstancdhianngg,ie nsr esearmceht hodpsr,o fessipornaaclt iocrem se,d ical
treatmmeanytb ecomnee cessary.
Practitiaonndre ersse arcmhuesrtas l waryesl oyn t heiorw ne xperieanncdke n owledigne
evaluatainndug s inagn yi nformatmieotnh,o dcso,m poundosre, x perimednetssc rihbeerde iInn.
using siuncfho rmatoirmo ent hods sthhoeuyl bdem indfouflt heiorw ns afeatnydt hes afeotfy
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besttr eatmfeonret a cihn divipdautaile ,nmtd,t ot akael alp proprsiaafteept rye cautions.
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liabinleigtlyi,g eonrco et ilerwoirfs reo,ma nyu seo ro peratoifoa nn ym ethodpsr,o ducts,
instructoiroi ndse,ac so ntaiinnet dh em aterihaelr ein.
LibraorfyC ongresCsa taloging-in-PubDlaitcaa tion
Movemensty steimm pairmseynntd romoefst hee xtremicteirevsi,ac nadlt ,h orascpiicn Ie [se ditbeyd]
ShirlAe.yS ahrmann.
p.; c m.
Includbeisb liograrpehfiecraelna cnedis n dex.
ISBN9 78-0-323-05(3h4a2r-d6c o:va elrkp.a per)
I. Movemendti sorders-Phtyhseircaapl2y ..C ervicvaelr tebrae-Diseases-Physical
therap3y..T horacviecr tebrae-Diseasest-hPehryaspi4yc..aE lx tremi(tAineast omy)-Diseases­
Physitchaelr ap1y. .S ahrmanSnh,i rley.
IDNLM: I. MovemenDti sorder2s.C. e n,jcVaelr tebrae-physiopa3t.Eh xotlroegmyi.t ies­
physiopatho4l.oT ghyo.r acViecr tebrae-physiopaWLth o3l9o0g]y .
RC376.56.9M42011
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DesiglMlaerrg:a ret Reid Working together to grow
libraries in developing countries
www.e1sevier.com I www.bookaid.org I www.sabre.org
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whhoa vmea dmeyl isfeso e chuarpefup,lfiy l,l aendpd,r oductive.
Yohua vmea dweh amta ncyo nsail diefreo twfio mrtekob e
instanea amda zliinfgje oluornnoegjfy o y.
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Contributors and Associates
Nancy Bloom, PT, DPT, MSOT Gregory W. Holtzman, PT, DPT
Assistant Professor Assistant Professor
Program in Physical Therapy and Department of Program in Physical Therapy and Department of
Orthopaedics Orthopaedics
Washington University School of Medicine Washington University School of Medicine
St. Louis, Missouri St. Louis, Missouri
Cheryl Caldwell, PT, DPT, CHT Renee Ivens, PT, DPT
Assistant Professor Assistant Professor
Program in Physical Therapy and Department of Program in Physical Therapy and Department of
Orthopaedics Orthopaedics
Washington University School of Medicine Washington University School of Medicine
St. Louis, Missouri St. Louis, Missouri
Suzy L. Cornbleet, PT, DPT Lynnette Khoo-Summers, PT, DPT
Assistant Professor Assistant Professor
Program in Physical Therapy and Department of Program in Physical Therapy and Department of
Orthopaedics Orthopaedics
Washington University School of Medicine Washington University School of Medicine
St. Louis, Missouri St. Louis, Missouri
Mary K. Hastings, PT, DPT, ATC Mary Kate McDonnell, PT, DPT, OCS
Assistant Professor Associate Director of Residencies and Fellowships
Program in Physical Therapy and Department of Assistant Professor
Orthopaedics Program in Physical Therapy and Department of
Washington University School of Medicine Orthopaedics
St. Louis, Missouri Washington University School of Medicine
St. Louis, Missouri
Marcie Harris-Hayes, PT, DPT, MSCI, OCS
Assistant Professor Theresa Spitznagle, PT, DPT, WCS
Program in Physical Therapy and Department of Assistant Professor
Orthopaedics Program in Physical Therapy and Obstetrics &
Washington University School of Medicine Gynecology
St. Louis, Missouri Coordinator of Clinical Residency in Women's Health
Washington University School of Medicine
St. Louis, Missouri
VII
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Foreword
Recentiy, I was sharing my enthusiasm with a nonmedical structural findings on imaging, the movement diagnosis
friend about attending a research meeting with Dr. is inlperative. Unfortunately, this later diagnosis is not
Shirley Sahrmann. I was trying to think of a way to always clarified and instead the patient is told "there is
describe the magnitude of her influence on the "world" nothing wrong" to "you're aging." As a result, movement
of musculoskeletal medicine. The single thing I carne up retraining opportunities are missed, and the patient may
witil was, "Her book has been published in seven differ­ go on to develop a chronic condition that could have
ent languages." My friend understood. I have been for­ been avoided.
tunate to work with and learn from an international rock Movement System Impairment Syndromes of the Extrenzi­
star and her band, the Program in Physical Therapy at ties, Cervical and Thoracic Spines provides musculoskeletal
Washington University School of Medicine. healthcare practitioners a detailed method of examina­
Movement is the activity that every patient with a mus­ tion to describe movement patterns and impairments in
culoskeletal impairment wants to resume without pain tile clinical setting. Further, tile spectrum of practitioners
and restriction. The assessment of movement has been at can benefit from reading and studying this work. Physical
the core of my own training. However, early on, I recog­ tilerapists that utilize the movement impairment system
nized tilat there were several theories of thought without to diagnose and treat patients daily now have a detailed
substantiation across the entire musculoskeletal system. It resource for examining and providing intervention for
was obvious that to pursue the idea of reliably describing tile cervical and thoracic spines and extremities. Other
specific movement patterns in a clinical setting would take healthcare providers, (physicians, chiropractors, nurse
at least an entire career. Fortunately, Dr. Sahrmann has practitioners, physician assistants, atilletic trainers, and
spent her career doing just that. Movement System Impai1'­ massage therapists) who provide musculoskeletal care can
ment Syndromes of the Extremities, Cervical and Thoracic benefit from studying the movement inlpairment method
Spines provides practitioners of musculoskeletal medicine of assessment. These latter practitioners may not have
with tile theory and pictorials to describe movement tile same level of experience as physical tilerapists, but all
impairments of the cervical and tiloracic spine and have a unique background that can utilize tilis method of
extremit ies. This book extends the work of her preceding assessment in some way. The specificity of the descrip­
text, Diagnosis and Treatment ofM ovement Impairment Syn­ tion of the impairment leads to one of the key factors for
dromes. Together the two books provide readers with a intervention, specificity. Patients bring unique factors to
base of information to describe movement impairments even common impairments. As a result, a specific inter­
across the entire musculoskeletal system. vention is essential to maximize outcome. The movement
A movement diagnosis is not a diagnosis that is uni­ impairment system of analysis provides that specificity.
formly established and then conveyed to the patient with Healthcare providers in musculoskeletal medicine
a musculoskeletal disorder. With the advancement of have been waiting for Movement System Impairment Syn­
technology and imaging, much attention is given to a dromes of the Extremities, Cervical and Thoracic Spines. The
structural injury or degenerative condition as the source contents are worthy of the anticipated arrival.
of dysfwlction and pain. Indeed, tilese advanced imaging Congratulations to Dr. Sahrmann and the faculty of
techniques have promoted musculoskeletal evaluation Washington University School of Medicine Program in
and interventions. However, most are static images. To Physical Therapy. You have advanced musculoskeletal
completely describe the patient witil a musculoskeletal medicine one step further.
disorder, several observations should be summarized to
determine tile diagnosis. These include the clinical dis­ Heidi Prather, DO
tribution and quality of symptoms, structural findings on Associate Professor
imaging, and the movement observations. Certainly, the Chief of Section, Physical Medicine and Rehabilitation
psychosocial setting in which all of tilese exist is impor­ Departments of Orthopaedic Surgery and Neurology
tant because the psychosocial attributes can affect any Washington University School of Medicine
and all of these observations. In the setting of normal St. Louis, Missouri
ix
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