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Osteopathic Athletic Health Care Principles and practice by W Llewellyn McKone. Chapman and Hall, London, 1996 (ISBN 0 4 12 59090 5). Illus. 394 pages. f24.99. Despite its title, this book is not a ‘how t o do it’ text. So if you are looking for a detailed text which describes the practice of osteopathic technique in the sports medicine field, then look elsewhere. If how- ever you are interested in some of the underlying principles of osteopathic medicine and the way that a holistic approach t o the care of.the athlete can be instituted, then there may be something of interest to you in this book.

While there are references to ‘athletic health care’ throughout the text, the basic theme is of explaining some of the underlying principles of osteopathic management. There is, however, a lack of technique description and application and this, together with a paucity of detail regarding specific athletic injuries, means that this text gives little insight into the practicalities of the subject.

The opening section deals with the history of osteopathy and this is covered comprehensively and touches on some of the differences between the osteopathic approach and the ‘orthodox’ medical app- roach. However, from the physio- therapy perspective there is one glaring inaccuracy, with reference being made to British physiothera- pists who are described as being only able to ‘work under medical supervision’.

The following section is entitled ‘Principles’ and i t covers a wide range of topics, some of which come under the broad title of ‘applied anatomy and physiology’. These include energy systems, body fat composition, body types, immunology and muscle structure and function. These topics are covered very briefly, often to the point of acknowledging a body of information without fully explaining its relevance to athletic health care.

In this chapter considerable space is devoted to discussing the ‘osteo- pathic lesion’. Most of this relates to aspects of neurophysiology and the final definition of such a ‘lesion’ is that it is a ‘facilitated segment of the spinal cord’. This makes for

thought-provoking reading and it echoes some of the views of certain contemporary physiother- apists working in the fields of neural pathodynamics and pain physiology.

Some osteopathic treatment tech- niques are described in this section but only briefly and with no illus- trations. Consequently it is difficult to appreciate fully their relevance to the osteopathic examination and treatment process.

In the chapter on ‘The athlete and trauma’ the ‘neuro-endocrine’ response to injury is considered and following this some aspects of first aid and taping are discussed. This is done with little reference to specific sports injury-related condi- tions.

Not surprisingly in a book with this title, one of the main chapters is given over t o ‘Regional trauma, dysfunction and treatment’. Unfor- tunately a great deal of space is devoted and consequently wasted in describing muscle anatomy, eg lists of muscles with their attachments and actions. Another disappoint- ment is the limited number of conditions and injuries that are dealt with. This is too small and

is not representative of a general athletic population.

The final chapter deals with ‘Prin- ciples of rehabilitation’. I t is very short and contains a minimum of information, with no mention being made of key factors such as speci- ficity of training or methods of exercise progression.

My first impressions of osteo- pathy, which were formulated many years ago (and which admit- tedly were based on second-hand experiences and encounters), were of a somewhat shadowy and myst- erious profession. However, over recent years I have come to ack- nowledge that there are probably more things in common between osteopathy and physiotherapy (at least of the manipulative variety) than there are differences. I am happy t o say that this book has confirmed this view.

So if YOU read this book with the intention of obtaining an insight into a fascinating medical philo- sophy, you should be satisfied. If, however, your aim is t o improve your sports medicine knowledge, then you will probably be disap- pointed.

Philip Newton MCSP

A Garden for You by Fred Walden. Disabled Living Founda- tion, 380-384 Harrow Road, London W9 2HU, 1997 (ISBN 0 901908 69 X). Illus. 7 10 pages. f5.95 including postage.

This is a very practical guide to gardening tools, equipment and design for older people and people with disabilities.

In his enthusiastic foreward, Dr Stefan Buczacki confesses himself deeply impressed by the common sense and insight shown in the book

and prophesies that ‘it will help thousands’.

Little information is provided on plants, because this is available elsewhere. Garden design is covered, and methods are up to date - an illustration shows layout being planned with a computer.

The bulk of the book is devoted to tools and equipment for all kinds of garden activity.

Both regular and adapted items are described, with their advantages and limitations, dimensions in metric measurements, and the types of disability to which they are most suited. A useful feature is that the weight of each tool is also stated.

An index, a comprehensive list of suppliers, and a few useful organi- sations complete this informative and well illustrated paperback.

JW

Physiotherapy, July 1997, vol83, no 7