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uccesrst ol)t her enowneMdan uaMle dicinDei:a gnosatnidcsM anuaMle dici·Inneer:a py.
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thirsi chillylt uarste.do glicaolrlgya nibzoeodk w.h ilcel inicoarlileyn tperde.s enbtost thh e
theoarnyd p ractoifct eh ee xpandifnige olfdm usculoskemleedtiacli Inteas.i mi st of ully
integraantdce o ordintahteree l ativyeoluynfi gr lodf m anuamle diciwniet chl asmseidci cal
scoholt eaching,o nbc ausrerde nL biomeacnhdae nviicdaeln ce-bkansoewdl edWgiet.h out
pleJudtihcebe o oki ncludtehsepo silalvsep ecotfos s teopaatnhdic ch iropraecxtaimci nation
andt reatment tpcwhintihqtihunee c onteoxfat f untcinoallmye aningmfuuslc uloskeletal
managpment approach.
Whlltt>h ep articeuxlaamri natainodrn e latterde atmteenhctn iqueasr ed escriibned de tail.
tilel ayour facblo1tiahtq autiec(cid:256)k ovearnvdis euwffi ciednett awJhie,n n eede.Td hea ccom
panyitnegx dte scriabnedcs o rrelaptoessbsl iep atholofgiincd inOgtsh.ec rh aptecrosvr et he
histoorfmy a nual miendeie, x aminatainodLn r eatmpernitn cipalnedts h.ea pplicaotfi on
biomechasna incdm usclpeh ysiolLoatg hyev arionlolns- surghiacnadls -aopnp roaches,
includmiynogf asctrigiagelr p ointtr eatmtEnmtp.h asiisgs i vetnoa natomidceaslc riptions
ofm uscslJ endt hepiarlp atorays semsesnta sw elals t echniqtuote rse asth ortemnuesdc les.
Thec onceopftm usclimeb aalncei sp resented.
Relationbsehtiwpesep na iann d specivfairci abalrejesu xtapdoJ snedg raphicraelplrye tseed.n
Raroinaltreatmenalp proacahreeds e Scri.br eadngifnrgo m" wait-andr-esceoem"m endations
tof urthmeerd ical woarnkd-i unpd icatfoiros nusr geSrpye.c imfuisCc uloskedliestoarldJ erres
reVeiwedi nd etla.i
Highlights:
Systematpirce sentaftrioomtn h,r ee-ednisimonaaln atomtyof unctiaondnp ain
•
Over1 00i0l lustradtisipoensnlsl.lw gi t[hh en eedf olre ngthtye xpta ssages
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LogICparle sentna otfsi poeCidfiics orders
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"Actio"np hotografoprhe sx aminatainodtn r eatment
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Full-color darnadpw hiontgosg rawpihtssh u perimpdo gsreaphicclse ardleyp icting
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lhjeo inatnsd a reaosfe acbho dyr egion
Physioclaoelgx iplanatainodfn usr threerq uiremseunbtsst anlitclhteuis neog f
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m;mipulatimveedc iine
Wel(cid:257)larragnede xaminattieocnh lllqfuoetrsh ee niterp erson
•
Muscu/oskeMlaenruaalMl e diciwnielb le i ndispenstaopb rloef essiwohnoat rlesa tth ep erson
witahc utaned c hronmiucs culoskellp ertoablepmrso,v idaicncge tsost heb roadepsosts ilbe
cumamentiaurmb asde ont odayk'nso wledagnedi nsights.
The Amercias Resotf W orld
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LibraorfCy o ngrCeastsa loging-in-DPuabtliais ac vaatiiloanb le Importannto teM:e diciinsea n ever-Chansgciinegn ucned ergoing
fromt hep ublisher. contindueavle lopmeRnets.e aracnhd c linical expercioenntcien are
ualleyx pandionugr k nowledgien.p articuoluarkr n owledgoef
propetrr eatmeanntdd rugt herapIyn.s ofaasrt hibso okm entions
anyd osagoera pplicatrieoand.em rasy r esats surtehda tth ea uthors.
editors.p uabnldi shhearvsem adee vereyf fotrote nsurteh astu ch
referenacrees a icnc ordawnicteth h es tatoefk nowledgaett het ime
ofp roductioofnt heb ook.
Neverthetlheisdsso .e nso ti nvolivmep.l oyr.e xpreasnsyg uaran
Partosft hibso oka rea na uthoriazneddr evisterda nslaotfit hoen5 th
teeo rr esponsiboinlt ihtepy a rotf t hep ublishienrr se spetcota ny
Germaen ditioofMn a nuelMleed iziDni:a gnosatnidtk h e3 rdG erman
dosagien structainodnf so rmosf a pplicatsitoantsei dnt heb ook.
editioofnM anuelMleed iziTnh:e rappiueb.l ishaendd c opyrighted
Everyu seri sr equestteode xamincea refultlhyem anufacturers'
1997b y GeorgT hiemVee rlaSgt.u ttgaGretr.m anyT.h isb ooka lso
leafleatcsc ompanyeiancghd ruga ndt oc hecki.fn ecessianrc yo n
includes raenvdiu spedda temda teritaalk efnr omt he1 s te ditioofn
sultatwiiotnah p hysicoiras np eciawlhiestth.e trh ed osagsec hedules
ManuaMle dicinTeh:e rapayn dt he2 nde ditioofMn a nuaMle dicine:
mentiontehde reoirnt hec ontraindicsattaitobenydst hem anufac
Diagnostics. paunbdcl oipsyhreidg h1t9e8d8a nd1 990r.e spectively.
turedris ffferro mt hes tatememnatdse i nt hep resent book Such
byG eorTgh iemVee rlaSgt.u ttgGaerrtm.a ny.
examinatiispo anr ticuilmaprolryt awnittd hr ugtsh aatr eei ther rarely
usedo rh aveb eenn ewlyr eleasoend t hem arketE.v erdyo sage
Thef ollowiimnagg easr et akefnr omS chuenkTeh.i emAet laosf scheduolree verfyo rmo fa pplicautsieodni se ntiraetlt yh eu ser's
AnatomVyo lI.G. e orTgh iemVee rlaSgt uttg·a Nretw York2.0 07. ownr isakn dr esponsibTihleai uttyh.o arnsd p ublishreerqsu eesvte ry
Illustrator Karl Wesker. Berli1n7.. 117G..e 5r9m.a ny: uFsiegrts o.r e3p.o4rt3to.t hep ublishaenrysd iscrepanocrii ensa ccuracies 17.60.
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toi nt hibso oka rei nf acrte gistterraedde maorrkp sr oprientaamreys
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IV
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LisotfC ontributors
HuberBta umgartnMeDr , CarGlr agnerM,D
FormeCrh ieoffR heumatology ProfesosfoR re habilitMaetdiiocni ne
SchulthCelsisn ic Univeirtsayt B uffalo
ZuricShw,i tzerland SchooolfM edicianned B iomediSccaile nces
ExecutDiivree ctor
DanieBlu ehler UniforDma taS ystefmo Mre dicaRle habilitation
Physiotherapist Amherst
FlunteHring hS chool SCpeornttse r New YorkU,S A
DepartmeonfPt h ysiotherapy
ZuricShw,i tzerland DietGerr obM,D
Professor
DouglCahsa ng, MD,P hD Heado fS pinSeu rgery
AssistParnotf essor SchulthCelsisn ic
ChiePfh,y siMceadli cianned R ehabilitation ZuricShw,i tzerland
DepartmeonftO rthopeSduircg ery
UniversoifCt ayl iforSnainDa i,e go NorbeGrstc hwenMdD,
San DieCgAo,U, S A ProfesasnodrF ormeCrh ieSfu rgeoann dC hairman
SchulthCelsisn ic
JilChlo miaMkD,, P hD ZuricShw,i tzerland
AssociPartoef essor
Heado fP ediatOrritch opeDdeipca rtment JocheFn.L oehMrD,, F RCSC
University HIoPsVpaZin td1a s ltM edical ProfesosfoO rr thopedics
FaculotfCy h arlUensi versity ENDO-Clinic
HospitNaaBl u lovce HamburgG,e rmany
PraguCez,e cRhe public
ChetaMna liMkB,B S
BeaDte junMgD,, P hD CliniIcnaslt ructor
PhysiaclM ediciSnpee cialist RehabilitMaetdiiocni ne
RehabilitaantdRi houenm atiDci seases DepartmeonfPt h ysicMaeld icianned R ehabilitation
FMHS wisMse dicAasls ociation Univeristy atB uffalo
WinterthSuwri,t zerland SchooolfM edicianned B iomeidcaSlc iences
UniforDma taS ystefmo rM edicRaelh abilitation
TomasD robnMyD, Amherst
OrthopeSduircg eoLno,w eErx tremity NewY orkU,S A
SchulthCelsisn ic
ZuricShw,i tzerland AnneF rancMeasn nioMnD,, P hD
Heado fD epartment
TonGir af-BaumaMnDn,P, h D ResearacnhdD evelopment
Professor SchultheCslsi nic
Managianngd S cientDiifriecc tor ZuricShw,i tzerland
GermaSno cieotfyM usculoskeMleedtiacli ne
ManagiDnigr ector UrsM unzingMeDr ,
GermaSno cieftoytr h eS tudoyf P ain OrthopeSduircg eoFnM H
GermaPna iSno ciety Heado fO rthopeSduircg erLyo.w eErx tremities
TeningGeenrm.a ny SChulthCelsisn ic
ZuricShw,i tzerland
v
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ManohaMr. P anjaPbhiD, WolfgaTnrga utmann
ProfesEsmoerr itus Physiotherapist
FormeDri rectBoiro mechanRiecsse arch DirectoofPr h ysiotherapy
YalUen iversSicthyo oolfM edicine SportMse dicaCle nteBre rn
NewH avenC,o nnectiUcSuAt , PermanenCclei nBiecr n-Hirslanden
BernS,w itzerland
BogdaPn.R adanoMvD,
Professor BeaWta elchMlDi,,D C
Heado fP aiCne nter PRISMSAp inSeu rgeZroyl lil<erberg
SchulthCelsisn ic Centefro Crh iropraZcutriicc h
ZuricShw,i tzerland ZollikerSbweirtgz,e rland
PascRailp psteMiDn , BarbaWreab erS chneidMeDr ,
ChairmoafnF ooatn dA nklDee partment DietliSkwoint,z erland
Schulthess Clinic
ZuricShw,i tzerland RichaDr.dW eissmanPTn,,O MT I
PhysiothePrraapcyt aincdeC linic
BeaRt. S immenM,D ,P hD Heado fF aculty
ChairmaUnp perE xtremiatnydH andS urgery DaviGd. S imonAsc ademy
SchulthCelsisn ic WinterthSuwri,t zerland
ZuricShw,i tzerland
Acknowledgements
Ase ditoorfsa textbowoikt ha histoorfy2 5y earasn da Int hirse spewcet t hanTkh iemPeu blishfeorras s signing
tracrke corodff iveed itioinnGs e rmaann dt woe ditioinns twos uchs killcfoulll abortaota osrssii sntt h ep rojefcrto m
EnglisJha,p anesSep,a nisahn,d I taliraens pectiwvee lyb,e ginnitnoeg n d.
haveb eens upportiendp ,a rticublyaM rr,.B rian ScanlaWne, wouldl ikteo t hantkh eS chulthCelsisnZ iucr icfho r
PresidoefnT th iemPeu blishTehresi .d eaan dc oncefpotr offeriintgsi nfrastrucItnu praer.t icuMlra.rA ,n dreas
thec urrencto,m pletely rewbooorkkM euds culoskeleLtia.li tshcehaedor f,t hed ocumentatcieonnt eorft heS chult
ManuaMle diciwnaes s trongsluyp portbeydt heE xecutivhee sCsl inwihco,s upportuessd i nc1e9 86a ndw hoc ontrib
DirectDorr.C, l iffBoerrdg mawnh,o sawt he advanotfa guet eidn a major iwnta hyep roductpiroonc ewshsi lceh ang
then ewc oncept. ingf romt hec lassisctayllt eo c ompledtieg itdaels ktop
Fusintgh ep reviotuwsob ookisn,t roducsienvge rnaelw publishTihnogs.we h o wentt hrougthh ep rocegsrse atly
chaptearnsde, n hancitnhgel ayoauntd p resentaotfit ohne apprecisautcehp rofessihoenlaplA. s pecitahla nks also
materiwaals q uitaen undertakiWen gw.o uldt hereforgeo est ot her esearacshs istfarnotmst heS chulthHeosssp i
likteo e xtenodu rs pecial tthoaM nrkss,A nnieH ollinst,a lM,r .D aveO 'RiordaanndM r.C harlMecsC ammonw,h o
EditorAisasli staanndtM ,s Elisable(tuhrP zr,o ductEidoin helpeuds w itht her eferencesc ooarnddi nactoendt acts
torf,r omT hiemPeu blishwehrosd ,i dm orei nt hec oursoef witha lolf t hec ollaborators.
thet ranslaatnidop nr oductoifotn h eb ookt hana nyone We,a se ditoerxsp,e rientcheadat p rojeocftt h insa ture
woulde xpecftr oma publishhionugs eB.o thl adineosw isn otj usatn i ndivideufaflo Irttr. e quirae tsr emendous
understatnhdec onceopftm usculoskemlaentuaalml e di amounotf t eamwortko p roducae t extbosoukc has t his.
cinaes t henyo to nlcyo ntributtote hde p roductoifot nh e
bookb uta lsuos edt heiirn tellecctaupaalc ittoyi dentify
ande liminmaitset aktehsa otc currientd h ef usiporno cessT.h eE ditors
VI
Copyrighted Material
Prefaocnet heO ccasioofnt he2 5thA nniversary
Thec urretnetx tboMouks culoskeMlaentuaaMlle dicihnaes , twoa uthoirnsf luenicmemde nsehloyw w e woullde artno
int ermosf m edicpaulb lishai lnogn,ag n di ntereshtiisngt hink about and naepwp rreosaecahr pcrho jectthsa t
toryA.l thoutghhi bso okh asa new formacto,m pletelwyo uldi nvestipgraitnec ipoflm eesc hanisamnsd h owt hey
reworkeadn dr eorganitzheedo ,r iginiadle apsr esenterde lattoec linisciagln asn ds ymptomTsh.i sr esultienda
25y earasg os tihloll td ruTeo. t hes urpriosfme a ny-both wonderffurli endsahnidpt houghtsfcuile ntcioflilca bora
withiann do utsitdheef ield-probnaoob tlhye bra ckp ain tioann,d n ear5l0yp aperisnp eer-revijeowuerdn als.
treatmeinntt erventhiaovnebs e ens tudiaesde xhaustivelyK nowintgh eq ualiotfyT hiemPeu blishweer psr,e sented
inb iomechansitcuadli aensd r andomizceldi nitcrailaa lss themw itohu rh and-madbeo okf ocro nsideraItni1 o9n8.3 ,
manuamle dicipnreo cedures. ThiemPeu blishceorusr ageopuusbllyi sahb eodo kw hicaht
Durintgh ep as2t5 y earisn,t erienst th ef iehlads s teadiltyh atti mea ppearteodb eq uitaen e xotpirco jetchte:f irst
increasbeodt,ho nt hep arotf t hep ublaincd p atienatnsd, German ediotfMi aonnu aMle dicine: DiaWgen otshtiinkc s.
ont hep arotf o rthodmoexd icinMea.n uamle dicihnaes thatth iism portadnetc isisoenr veedv eryowneel l.
gonef romh avinagn " outsidreorlt"eo b einag l ogical parSto ona ftetrh ef iresdti tiaonnd,b einegd ucatweidt hin
oft hea rmamentaroifut mo daym'uss culoskeplheytsail thef ramewoorfkt her athyeoru nSgw isMse dicAasls ocia
cian. Ahgiasitno,irs ay g oodt eacher. tiofno Mra nuaMle diciwnee v,i sitweedl l-estabeldiushed
Int hem id1 970csr,,M RIS,P Ecra,n dP ETs cancsa pablec ationianls titutoifoo sntse opatmheidci ciinnet heU SA
ofi nvestigsattriuncgt uarnedts i ssupeost entiraelslpyo nthaatl reahdeyl udn iverssittayt uassw ,e lals t hosceo lleges
sibfloepr rimasryym ptomssu cahs p aiann da ltersetdr ucofc hiropraacctcirce dibtyet dh eS wishse altshy stetmo
ture afnundc tiwoenr en ota vailatbopl aet iepnrtess entinegd ucatSew iscsh iropracTthoerc sl.o seex posuarned c ol
witmhu sculoskedliestoarld eHrosw.e vewri,t thh ei ncreaslaboratwiiotnhe xperotfso steopatmhaincu amle dicine
ingi nteriensa tn df ascinaotfai popnl icatoifto encsh nologsyu cha sP hilGirpe enmaMny,r onB eala,n dB obW arda,n d
inp atiecnatr et,h ep hysicihaann'dsas s a diagnosatnidc fromt hec hiroprapcrtoifce ssSicoontH,ta ldemanno,to nly
therapetuotoiwlce rec ommonlnye glectpeadr,t icuilna rloyf feruesdn ewd imensiaonnds aspoefcm tasn uamle dicine
thea ssessmoefns tu chm usculoskedliestoarld aesrs so buta lstoa ughutst or espeacntd c ollaboerqautael wliyt h
callneodn specoirfm iecc hanilcoawlb acka ndn eckp ain. doctoorfso steopatmheidci cianned d octoorfsc hiroprac
Int hel at1e9 70osu ra ttentwiaosna ttracbtyea d s mall tic.
grouopf S wispsh ysicisauncsc essfuuslilnmyga nuamle d WolfganGgi lliDaOr,,c urrenPtrloyf esastot rh eN ew
icinaep proachbeost,dh i agnostiacnadlt lhye rapeuticYaollrykC. o lleogfeO steopatMheidci cinoeft heN ew York
We became stuodfet nhteps r omineSnwti srsh eumatoloInstitoufTt eec hnolotgrya,n slattheebd o oka,n di tw as
gisDtr,M. a xS uttewrh,o t aughutso ne-on-ohnoew t ou se presentteotd h eE nglish-spemaakrikneigtn 1 984.
ourh andtso p alpattheec hangoefsd ifferent ttihses uesF oilnl owitnhgee xperience fgraoimno eudre xposutroe
human bodys ucha s thes kins,u bcutanetoiusss ueso,s teopaatnhdyc hiropraocnt tihce o ccasioofnt he7 th
muscleasn,d t endonTsh.e princiipdleeaw ast ot ryt o InternatCioonngarle osfst heF IMM( InternatFieodnearla
identitfhyea natomicsatlr uctuarnedsr elationsrheipst ioonf M anuaMle dicinienZ) u ricihn1 983w,e invittehde
sponsifbolrpe a iann da lterfeudn ctiionan j oinotrs pinall eadeirnts h eipra rticfuileatlrod w hati sn owk nowna st he
region. FischinCgoennf erenTchee.r wei,t hi1n w eek, ctohmem on
The firsttw o authortso,g ethweirt ht heo rthopedidce nominatoofrm sa nuamle dicinoes,t eopatahnydc, h iro
surgeoDnrT .o masD robnsye,t d ownt heierx periencesp roafc twiecr eo penlayn dc ollegidailslcyu ssWeed r.e alized
then earl3y- yeaerd ucatiopnraolc eisnst hef irGsetr man thamta nyo ft hed iagnosatnidct herapeuatpipcr oaches
editioofMn a nuaMle diciDniea:g nos(tMiacnsu eMleldei zin:a ppeasri miloardr e viaotnel syl ighftrloyme acho ther-as
Diagonstiwki)t,ah p rinrtu no fa t otoafl1 0c opioefsa b ook fara st heb iomechanmiocdaell i sc oncerned-tahnedi r
baseodn o uro wnh andc olorderda wintghses, t artpionign t approaacnhd a pplications may have atbl eeeans ts haped,
ofa longm edicajlo urneMya.n yo ft heo rigidnraalw ingsi np artb,yt heiprr ofessional ancdop nhtielxots ophy.
fromt hivse ryf iresdti tiionn1 980a res tiulsle di nt he Int he1 980rse lationbsehtiwpesee nx ponenotfms a nual
curretnetx tboonko,w redrawann df ollowian lga youtm edicianned c lassiocratlh odmoexd iciwneer es omewhat
thawta sc reateyde,sw ,i ths ophisticpautbeldi shtiencgh tensIen.o thewro rdst,r aditiuonniavle rsiattil eesa.si tn
nologAyt.t hatti mew e werea lreaidmyp ressbeydt he Europsee,e merda threerl ucttaoin ntt egrtahtede i agnostic
seminarle searpcahp erasn dt extbooonk clinibciaol and therapeutico fma asnpueaclmt esd iciwnie thitnh e
mechanibcysA ugustus WahnidMt aen ohar PaTnhjeasbei. f ramewoorfkw hatc oulbde b esmte dicparla ctiAcreo.u nd
VII
Copyrighted Material
Preface
theg lobet,h et renodf a ndc alflo re vidence-baapsedi nS witzerlwahnidc,oh f fepross tgradtueaatceh itnodg o c
proachbeesc ammeo rei mportannott,o nlyi na cademict orasn dp hysiotheraipnti hsetf si elodfm usculoskeletal
practibcueti nm edicaplr actailcet ogetIhnet rh.ir se gard,m anuamle dicine.
we receivqeudi tae s tronmge ssagfer omo neo ft hem ost Thec urrenEtn gliesdhi tioMnu,s culoskeMlaentuaall
promineanntd r espectpieodn eeirnss p inree searPcrho, Medicinhaes,b eenc ompleterleyw orkeadn di ntegrates
fessAolrNf a chemsofnr omG iitheboSrwge,d enA.f tesre ndthen ewest aspeccltisn ibocifao lm echancilcisn.i pcraalc
ingh imt hef iresdti tiooftn h eE nglibsoho lf<o rre viehwi,s ticaen.d e vidence-based aptpodr ioaagcnhoeassne dt reat
answewra ss wifatn dt ot hep oint":Iw ilnlo tr eady our musculoskeldeitsaolr decrosn servatiivnecllyu.d itnhge
boolu<n lesisth asb eens cientifpircoavlelnyO. u"r f irstp reventpirvoeg rams.
reactiwoans q uitheu man,b utg ivinDgr. Nachmeson's Fort hinse w bookw.e invitWeodl fganGgi lli(cid:180)aOr..
commentass econtdh oughwte, w erem arkedilnyf luencemde anwhile fcrlioesanend d e xponeonfto steopatmheidc
byt hema,s w aso urf urthdeerv elopmeTnhtef. i rasutt hor icinaen dw ell-knonwont o nlyi nt heU SAb uta lsion
returnferdo mc linipcraalc taincdes tartheidrs e sideinnc y Europteo.b ec oauthHoarv.i ntgr anslaotuerid n ittieaxlt s
neurolotgoyo btaiend ucatiaonnd p articulsacrileyn tif(iMca nual MedDiiciangen:o satnidcM sa nuaMle dicine: The/'
tooltsoi nvestiagnadtf eu lfNialc hemsorne'qsu esItnt. h is apy)b.e inagp hysiatarnidse tv.e irn teresitnfe udr therai ng
respetchte,c losceo llaborwaittihoM na nohaPra njaabnid meaningufnudle rstanodfip nrgi ncipalnedms e chanisms.
hisr eseartceha ma,s w elals t heo pportuntiotp ye rformh e developheidso wn personaaplp roaacnhd e xpertise
cadaveerxipce rimeinntt sh eh ighlsyo phisticlaatbeodr afromt hes tarHti.sc ontributtoit ohnen ewE ngliesdhi tion
toryo ft heM oriMsU lieIrn stitiuntB ee rnw asa lucky hasb eenm ajora ndt hee ditoarrse v eryt hankftuhla t
coincidetnotc hee a dvantaogfte h ed evelopmeonfMt u s Wolfgang acctehpeit nevdi tattoih oenl sph apaen ds ignifi
culoskeMlaentuaalMl e diciwnhei,c fhu rthceorn tributtoe dc ant lcyo ntribtuott hee c urrebnoto k.
ourp ersoniamlp rovemeonftu nderstandainndcg l inical Ase ditoarnsda uthowrse. a reh ighlsya tisfwiietdht he
skilWles r.e aliztehda,n ktsoN achemsohna'rsld e ssotnh,a t severeadli tioinnds i fferleanntg uagweist,ht hef irasntd
cliniceaxlp erience-wsheirlvei ng a agso ods tartincgu rreendti tion sp2a5ny neianrgTs h.e n ewe ditiwohni.c h
point-niost e nougha,n da ctuaclalryr iae rsi sokf b eing now hasb ecomea ne ntirenelwy bookr.e fleocutrsp er
ledi nt hew rongd irection. sonadle velopmeanspt h ysiciaanndsa .tt hes ame tiimse
Thes cientaipfpirco acwhh,i chw e asa uthorosft he witnetsost heg rowinagc ceptaonfct eh ifso rm moefd icine
currebnoto ki mplementientd h ef ramewoorfko urt hinkwithitnh em ediccaolm munitWye. r ealitzheib sr inwgist h
ingd,o minatoeudr n exstt epwsi tht hei ntenttioos ne archi tt her esponsibiwlei etdiietson rese dt ot akien taoc count
fore videnocfet hospeh enomenwah ichw e felbty u sing whenp resentnienwgt eachimnagt erial.
ourh andfso rd iagnoasnidst reatmeTnhte.e xposuarse Trultyh ibso okh asb ecomae " tranbso"o kt:r ansconti
actimveem berosf t hel eadisnpgi nseo cietsiuecsha st he nentaaln dt ransdisciplinary.n eiunrtoelgoUrgOay)t .i ng
InternatSioocniaelft oytr h eS tudoyf t heL umbaSrp inteh,e internmaeld ici(nVeO )p.h ysicmaeld icianned r ehabilita
CervicSapli nRee searScohc ieatnyd,t heS pinSeo cieotfy tio(nW G)r.h eumatol(oWgSy) s.p ormtesd ici(nHeS )a.n d
(TI).
Europael,s ion fluenocuerdd evelopmeanntd b,e incgo n physiotherapWyi tht hei nvaluaibnlpeuf tr oma ltlh e
frontewdit hs pinseu rgeriynp articuwlea rl,e arntth e contribuittio sro su.rs incewries ht hatth er eadeirss timu
limiotfsc onservaatpipvreo aicnhc ludtihnogs oef m anual latetdom oveb eyonpdr ofessiboonuanld arainedsl ooakt
medicinWee. r especttehdel imiatnsd w,h iluen derstandthe" souolf"t het opiacth and.
ingt heg reaatd vantaogfem so dersnp inseu rgerwye ,d is Thimsa yb ea topic-hopewfiutlhml oyr er esearrceh-
cusseadn dr ecommendseudr gicparlo cedutroeo su rp a suitisd.e alwliyt h oiwtnsn ew ideasf oarnmdos f i nves
tienwthse nn ecessatrory e ducpea inan di mprovfeu nctigatiionna - booki na noth2e5ry earfsr omn ow.
tion.
In1 997w e completreelwyo rkeadn dr estructtuhree d
bookasn di nvittehdr enee w editotrose nhancaen di m- JiffD vorak
provteh ef ifGtehr man Edition with their eVxapce/raDivve onracke and
expertise. WolfgaCnig/ liar
Int hifso rmt heb ookb ecamae m ajoerd ucatiotnoaoll WernerS chneider
withitnh eS wisMse dicAasls ociaotfiM oann uaMle dicineH,a ns Spring
oneo ft hem osts uccessafnudal c timveed icaasls ociatioTnhso mas Tritschler
VIII
Copyrighted Material
Contents
1 M anuaMle dicine-OAvne rvi.e.w. ....
SomatDiycs functainodTn e ndePro in.t s. . . .. .. 1.2 .6
HistorPiecraslp ec.t.i.v.e. .................
TheS pondylogReenfilcSe yxn dro.m.e. ......., . 127
Recent InterPneartsipoenca.tl.i .v.e. ..........
EffectivOeuntecsosm,e asn,dO penQ uestio.n.s. .., 2 7 T heS tructuarnadlF unctional
Neuro-MusculoskEexlaemtianla t.i.o.n 1 35
2 D efinitainodnP sr incipolfMe asn ual
Introduc.t .i o.n . . . . . . . . . . ... . 1.3 5. . . . . . . . .
MediciDniea gnosainsdT reatme.n.t. .. 4
Observat(i"oLnO OK." ). . . . . . . . . ... . 1.3 7. . . . . .
Palpat(i"oFnE EL." .) .. . . . . . . . . ... . 1.3 7.
. . . . . .
DefinitainodGn esn erParli nci.p.l.e.s. ......., . 4
Motion Testing .( ." M.O V.E ".) . . . . ... .1 .4 0.
. . . .
TreatmePnrti nciopflV easr ioMuasn uaMle dicine
FunctioEnxaalmi natoifto hne M uscles
Tehcniqu.e.s. ....................... . 16
andM yofascSitarlu ctu.r .e s. . . . . .. .. .1 4.2 .
. . .
ProvocaTteisvt.es . . . . . . . . . . .. .. .1 4.4 .
. . . . . .
3 B iomechanPlrcianlc ipolfte hse S pine
Rational Seolfte hceAt piporno priLaatbeo ratory
andJ Oin.t.s. ................. .4.1.
..andA djunctDiivaeg nosSttiucd i.e s.. . . . ... .1 .4 4.
GenerBailo mechanPircianlc i.p.l.e.s. ..........
41
CliniBciaolm echanoiftc hseS pi.n.e. ...........
41 8 RationSaell ectoifoA np propriate
Biomechaonfit chseU ppeCre rviScpailn jaoli nts
Low-RiTsrke atmeInntt ervent..i o..n . s145
(CO-C1-.C.2.). ..................... . 44
Introduc.t .i o.n . . . . . . . . . . ... . 1.4 5.
. . . . . . . .
Biomechaonfit chseL oweCre rviScpailn (eC 3-C.7.).. 54
ExaminatLieovne ilnsR elatiotnh eDt ioa gnosis
VertebArratle .r.y. ..................... . 61
andT reatmeonfMt u sculoskeletal .D i.s. .o. r d1e4r8s
.
Biomechaonfit chseT horacSipci n.e. ...........
64
Correlaotfit ohneV arioCulsi niPcaarla met.e r.s .. .. 149
Biomechanoiftc hseT horaaxn dR ib.s. .......... 65
Biomechanofit chseL umbaSrp in.e. ........... 66
Biomechanoift chseP elvGiicr d.l.e. ...........
69 9 IndicatianodnC so ntraindicaftoiro ns
JOiMnott ioann dB iomechanCiocrarle lations 78 Conditiwointsh P otentiIanlclyr eased
Risokf T reatme.n t. . . . . . . ... . 1.6 0.
. . . .
4 N europhysioolfot ghyeJ oints
DiagnosLiusm:b aDri sHke rniat.i .o n. . . . ... .1 6.0 . .
andM uscle.s. ................. .81. .
.Di agnosLiusm:b aSrp inSatle nosis
Neuropathophyosfit ohleAo pgoyp hysjeoailn .t.s. .. 81
(Centarnadl/ oFro ramiSntaeln os.i . s.) •. . . .. .. 161
DiagnosCiesr:v iDciaslHk e rniat.i .o n. . . . ... .1 .6 1.
.
ArticuNleaurr ol.o.g.y. .................. . 81
FunctioPnaatlh oloofgM yu sc.l.e. ............. 8
7 Diagnosis: CervSitceanlo. s Si.ps .i n.a l. . .. .. 1.6 .2 .
.
DiagnoAscius:t e Soft-Tistsotu hee C IenrjvuiSrcpyai ln e1 62
What'osn t heH oriz-oWnh enM anuaMle dicine
DiagnoCshirso:n Pihca soef S oft-TiIsnsjuuer y
andM olecuMleadri ciMneee t. .............. 98
tot heC erviScpailn .e . . . . . . . . ... . 1.6 3.
. . . . .
DiagnosCiesr:v icogVeenritci go
5 TheP harmacoloagnidPc s ychologic (Including MCiegrrvaiic.na el.) . . . . . ... .1 .6 3.
. .
TreatmeonftC hroniPca i.n. ......... 9.
9 DiagnosSipso:n dyloliwsitthSheps oinsd ylolysis
B.D .R adanov
int heL umbaSrp i.n e. . . . . . . . . ... . 1.6 4.
. . . . .
UnderstanPdaiinMnge chanis.m s.. . . . . .. .. .9 9. .D i.a gnosBiosny:M alformatoifot nhseV ertebCroallu mn,
PharmacolTorgeiact meonfCt h ronPiaci .n . . .. .. .1 0.2
Malformatoifot nhesS pinCaolr .d . . . . . ... .1 .6 4. .
PsycholAosgpiecc otfsP aiTnr eatm.e.n.t. ....."
110 DiagnosOisst:e opor(oistnih seP resenocfPe a thologic
VertebFrraalc tu.r e.s ). . . . . . . . ... . 1.6 4.
. . . . .
6 NonradicuPlaairnS :p ondylogenic DiagnosAinsk:y losSipnogn dyl(iBteicsh teDrieswe ase):
and MyofasPcaiiaSnly ndrom.e s. .. .. 1.1 3
AcutIen flammaCthoarny g.e s. . . . . . ... .1 .6 5.
. .
DiagnosAinsk:y losSipnogn dylitis (BDeicshetaesree)w
ReferrPeadi n.. . . . . . . . . . . . .. .. 1.1 .4 .
.w i.t .h oC.ul t.i n.iS c.ia glno sfA cutIen flammat"i .o.n. 165
MyofascPiaailSn y ndrom.e s. . . . . . . .. .. 1.1 .8 .
. . .
TheP ostuPrsaelu doradiScyunldarro m.e . . . .. .. 1.2 2.
IX
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