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Principles of Manual Therapy
© 2005, Deepak Sebastian
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2005
9788180615047
Typeset at JPBMP typesetting unit
Printed at Gopsons Paper Ltd, Noida
To
My parents
Dr S Snehalatha and Mr R Sebastian,
the Almighty,
and my profession
Prof Mary Chidambaram,
my first impression of a
physiotherapist
All my teachers in India and the
United States
6Acknowledgements
Behind every endeavor stand able and enthusiastic minds and sources of inspiration. I wish to thank Prof. Mary Chidambaram, Formerly Chief Physiotherapist, College of Physiotherapy, Chennai, for her dynamism as a clinician and teacher, which was indeed a great source of inspiration and her constant emphasis on the character of a clinician. I express gratitude to Prof. IS Shanmugam MBBS, Dorth, DPhys Med, Retd Director Govt Institute of Rehabilitation Medicine, KK Nagar, Chennai for giving me an opportunity in this profession and for his guidance and encouragement. My deepest gratitude to Prof. PVA Mohandas MB, D (Orth), MS, Mch (Orth), Professor of Orthopedic Surgery, MIOT, Chennai, for giving me an exposure to a new work culture, for his dynamic mentorship and his emphasis towards innovation. His ideology is followed and shared to this day. My heartfelt thanks to my teachers Dr George Ibrahim, PT, DO, Consultant, St Joseph Mercy Health System, Ann Arbor, Michigan and Dr Stanley V Paris, PhD, PT, Professor of Manipulative Therapy and President, University of St Augustine for Health Sciences, St Augustine, Florida, my very sources of motivation to specialize in manual therapy. I wish to thank Helen Smith, MSA, PT, Systems Manager, Department of Physical Therapy, St Joseph Mercy Health System, Ann Arbor, Michigan for her friendship and support through the early days of my career in the United States and Dr Peter Loubert, PhD, PT, ATC, Professor of Physical Therapy, Central Michigan University, Mount Pleasant, Michigan, for his valuable academic advice over the last decade. My immense gratitude to Dr MG Mokashi, PhD, PT, formerly head, Department of Physical Therapy, All India Institute of Physical Medicine and Rehabilitation, Mumbai, my first exposure to controlled research and critical enquiry.
Much is owed to my colleagues Raghu Chovvath, PT, OCS, (Dr PT) Ramesh Malladi, PT (Dr PT) and Toby Manimalethu, PT, at Alternative Rehab Inc, Livonia, Michigan, for their dedication and zealous enthusiasm despite their hectic work and family responsibilities. Their clinical and technical support has indeed made this book a possibility.
I wish to recognize and thank Nazir VM Ahmed, PT, MSc, Consultant, Henry Ford Health System, Detroit, Michigan, a friend and colleague, who dedicates most of his valuable time caring for patients who to him stand as his biggest priority.
Words cannot express the moral support that I received from my friends Salil Raje, BSc, MBA, MS, Kshitija Raje, PT, MSc, MS, GCS, Suvarna Aphale, PT, Sanjay Kulkarni, MD, PhD, Amit Mehta, PT (MBA), Smitha Mehta, PT, Sachin Desai, PT, MSc and Swapna Desai, PhD, whose genuine love and affection saw me through some very hard phases of my life as I was writing this book.
Lastly, but truly firstly, my parents, Dr S Snehalatha, MD, Professor of Pathology and formerly Vice Principal/Acting Dean, Madras Medical College and Mr R Sugumar Sebastian, retired Abrasive Consultant and Technical Director, who set an example and constantly instilled in me the value of education and the importance of persistent hard work. They, to this day, motivate me to move on.
7Preface
Manual therapy is a form of hands on treatment approach, which has evolved over time from an orthodox approach to a clinical science. Of all the clinical specialties, especially in India, hands on treatment are provided most by physical therapists. For the most part treatments of this sort are palliative and also for functional enhancement. However, manual therapy today has evolved into a clinical science, more intricate with regards to examination and treatment and most importantly an effective diagnostic tool. Rapidly developing in Europe, Australia and North America, institutions now have clinical residencies in manual therapy.
In India, physical therapists practise manual therapy in various forms. Some clinicians have the opportunity to travel abroad for training, which they share with the community by way of continuing education courses and conference presentations. Besides these fortunate few, other clinicians practise their philosophy by information gleamed from textbooks written by foreign authors. These textbooks often carry terminology that is difficult to understand and treatment strategies that may differ from a cultural perspective. The bigger handicap being, besides the availability of these textbooks being relatively remote, they are indeed expensive. A textbook for every clinician or student may not be a realistic expectation.
Hence, the goal of this endeavor is to address these deficits. First, to standardize the instruction of manual therapy with a standard text and offer structure to treatment concepts. Then to make possible the availability of an inexpensive book to every physical therapist and student to be used as a day-to-day reference manual, both for self-improvement, and the welfare of the patient. This book contains conceptual aspects and treatment techniques. They are categorized by regions of the body and carry a fairly extensive number of clinical photographs.
The target population are physical therapists and physical therapy students. This book, however, serves as a reference for any practitioner involved in the management of musculoskeletal dysfunction. There are now several hundreds of physical therapy colleges in India and very many practising physical therapists. Most colleges are now headed towards postgraduate education in physical therapy and this book, well taken, may be the need of the hour.
I sincerely hope and pray God that this endeavor offers physical therapists in India, more structure with regards to their manual therapeutic approaches.
The cover depicts four hands, two pairs working as a team, as no endeavor is completed alone. The signs are actually finger alphabets denoting the alphabets H, E, A and L and the entire logo signifies ‘hands on healing’. The depiction on the lower part of the signs are a concave and convex surface, a vertebra, and the sacrum.
Deepak Sebastian