Positive Health Online

This book is written for the therapist, doctor or patient and athlete. While I am sure it will be of some interest to the patient or athlete I suspect that they would struggle with the terminology.

For me, as a practising osteopath this is an excellent revision tool, reference work and a fount of information regarding not only the basic science of the shoulder but also a practical manual drawn from the extensive experience, knowledge and high quality thinking of the author.

The anatomy is not limited to the shoulder but also includes the functional and clinical relationship the shoulder has to the rest of the body as well as to the health of the individual. This is illustrated for example in the section on differential diagnosis where shoulder pain can relate to organ pathology including gall bladder issues and cancer. This is, deliberately presented early on where the mind of the reader will be drawn to these relatively rare but critical presentations.

The academic nature of the subject is interspersed with anecdotes that illustrate the points being made. I do like the style of these stories that bring the information alive. Some of these refer to his own insight with these issues from his experience as a patient! Nothing gives a practitioner more empathy than to have experienced what the patient is suffering.

In viewing the functional anatomy of the shoulder complex, he explores how the area has a key two-way relationship with the pelvis, lower limb and cervical areas through the interaction of the neurological and musculoskeletal system forming composite functional units such as the posterior oblique sling. I was particularly taken by the description of the ability of the body to combine oblique and torsional compression, tensions and strains to store and release energy effectively and usefully via a synergy of these functional units in locomotion.

Evaluation of the relevant parts of the nervous system such as the myotome and dermatome systems is described and illustrated to aid the practitioner in determining the contribution that these systems have in the patient’s presentation. I enjoyed learning about the ‘regimental badge’ area in testing axillary nerve dysfunction.

The importance of the pelvis and the gluteus maximus is emphasized. Muscle testing is demonstrated with a clear introduction to Muscle Energy Technique (MET). He points out accurately that although many practitioners may have some training in MET, their ability to apply the technique does not take full advantage of the value that this method can bring. I shall certainly be using the clear explanation and illustrations to take my limited use of MET to a higher level.

Having said that he is not averse to pointing out design faults in the system, for example, the weakness that allows the shoulder to dislocate anteriorly via the gap in the ligaments known as the foramen of Weitbrecht. It is pointed out that the design of the shoulder displays a compromise between mobility and stability. I would further add that much of the musculoskeletal dysfunction that we see is not helped by the way we use our bodies in the modern world.

There is a chapter on Myofascial soft tissue treatment. It is explained that there are many variations on this approach. The author has been influenced by the writings and teachings of Ida Rolf; much of what is shown I am unfamiliar with. However, with the illustrations and instructions I think it will be useful to explore these techniques.

I am also unfamiliar with taping techniques and there is a chapter devoted to athletic and kinesiology taping. Again this is comprehensively explained and I notice that on his YouTube channel there are videos to illustrate this. I am looking forward to getting to grips with this.

The book is completed with a comprehensive, well-illustrated and clearly explained section on rehabilitation and exercise protocols. Some of these can be done with little or no equipment such as resistance bands and core balls.

There is a couple of appendices, one summarizing and tabulating dysfunction tests and the other as an illustrated shoulder stabilization exercise sheet.

Gibbons shows how the marriage of osteopathic principles and modern science can make a significant contribution to the care and rehabilitation of the shoulder patient whether the problem is the result of an accident or the by-product of an athletic lifestyle.

The personal style makes the material more accessible, readable, entertaining and engaging. His love of the subject and his desire to share his knowledge comes through strongly.

This tome will grace my shelves in the years to come and no doubt will acquire a certain dog-eardness as it is removed, referred to and replaced.

Further Information

Available from Amazon.co.uk, Amazon.com John Gibbons and Lotus Publishing