Positive Health Online

In its second edition, this is one of those superb books you wish you had discovered when it was first published. The book is subtitled ‘Integrating Science and Therapy’ and it achieves this goal extremely well and very efficiently. It is an ideal book for the practitioner of manual therapy who wants to gain a thorough and in-depth understanding of the causes, mechanics and exercise regimes for back pain or rather back instability.

The book combines information from several sources. The scientific information is taken from fields within both medicine (anatomy, physiology, and pathology) and sport (biomechanics, exercise physiology and motor skill training). All this is combined with the many years of experience the author has as a physiotherapist, an exercise professional and teacher.

In Part 1 of the book (Conceptual Foundation) the author presents information on the mechanisms of stability and discusses stability as part of an overall muscle balance approach, all backed by recent scientific findings. The concepts of functional training are also introduced in this section.

Part II of the book (Establishing Stability) deals with the basic skills required to develop stability. Assessment of posture and muscle are highlighted, and the author here introduces the foundation movements that can be taught to a patient. He describes in detail the teaching points that a practitioner can use to accurately prescribe an exercise movement to a patient. Furthermore, he guides the reader through the clinical decision making when determining which exercise is to be used and with which patient.
In Part III (Progressing Stability Training) the focus shifts from the treatment room to the rehabilitation room. Whilst working in a rehab room is not always feasible, this is still very useful information and the exercises can be adapted for the patient’s ease of use. In this section, the author uses progressive exercises and basic equipment to develop greater stability. As in the previous section, important teaching points are emphasized, and exercise modifications are used to enhance prescriptive precision.

Part IV (Building Back Fitness) the training is taken from the rehab room to a gym situation, where the focus is on abdominal training, resistance apparatus, speed and practical functional progression. Again, whilst it may be impractical for the practitioner to be in a gym with the patient, it is very important to have a good understanding of the concepts of the training involved at this level. Being well informed puts the practitioner in a good position to offer practical and sound advice to the patient.

Finally, in Part V, the author uses real-life patient examples to illustrate how to structure the full Back Stability programme stage by stage. He also includes tick lists that the practitioner can use with patients to make exercise prescription easier.

This book has many excellent points worthy of commendation. It is full of two-tone and black-and-white illustrations which are suitably placed and so fit in very well with the text. They are also big enough for the reader to see clearly what is being demonstrated. The structure of the text is well planned and takes the reader from the assessment stage right through the various steps to the gym level. The layout is extremely well presented with easy to follow chapters, headings, sub-headings, tables, diagrams, charts, key points, exercise markers, and summaries. The choice of exercises demonstrated in each chapter is extensive and provides good, effective and clear instructions for the practitioner.

All in all, this is an excellent book and a must for every practitioner of manual therapy. By integrating the science with the therapy, it guides the practitioner to recognise and assess inappropriate movement patterns, whether caused by injury or simple day-to-day activity, and to use a process of clinical decision making to determine which exercises to use in developing effective back care programmes. It presents an alternative method for the treatment of back pain, and provides each patient or client the opportunity to actively participate in recovery and maintenance. This is a book that is very likely to be well-thumbed and used extensively in the practice.

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