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PREFACE

Today, one patient in four seeking medical aid does so solely with a locomotor system complaint. Many of the remaining three-quarters of all patients seeking medical aid primarily for other reasons also complain of stiffness, aches, and painful movement. The muscular-skeletal dis-orders of patients in these two categories comprise the greatest single cause of sick leave. The persons affected dominate the group of those who retire early on disability pensions. The socio-economic problems resulting from muscular-skeletal dis-orders are undoubtedly greater and morę wide-spread than indicated by any single statistic.

Years of research and experience in studying and treating locomotor system maladies have clearly proven the effectiveness of treatment through relaxation and stretching of shortened muscles and other related structures. The techniąues involved are basically therapeutic, but they may also be applied in preventative exercise at all levels of physical training programs, for persons of all ages.

Our research has been pragmatically oriented towards attaining results for a greater number of patients over longer periods of time. Hence we have not conducted double-blind tests, but instead have allowed our patients to function as their own Controls. Prolonged dysfunction, which diminishes dramatically after relaxation and stretching treatment, is morę than ample proof of treatment effectiveness, both for the therapist and for the patients involved.

This book is a compendium of therapeutic techniąues that we have used to successfully treat patients with reduced mobility caused by shortened structures. Treatments for the extremities and their associated joints are covered in Volume

I.    Treatments for the spine and the temporo-mandibular joint are covered in Volume II. Although the temporo-mandibular joint is anato-mically removed from the spine, it is therapeuti-cally recognized as being closely connected to the cervical spine and therefore is included in Volume

II.    Each of the two Volumes is arranged to be used as an independent clinical reference.

In this Volume I:

The generał principles of manuał therapy are outlined in Part 1, along with a guide to the organization of the therapy techniąues. The therapy techniąues are fully described in Part 2 and Part 3, one to a page. Each description consists of a drawing showing the muscles in-volved, two photos showing the starting and finał positions of the techniąue, and an explicit text giving positions, grips and procedures.

The Movement Restriction Tables and Index of Muscles of Part 4 list the muscles which may restrict movement and reference them to pages.

The two volumes of this book are intended primarily to be used as ready-reference clinical manuals and as texts on muscle stretching in manuał therapy. However, we hope that they will also provide physiotherapists and medical doctors with a fresh, comprehensive approach to the entire subject of muscle stretching in manuał therapy. Our underlying goal has been to contri-bute to improving the ąuality of the treatment of muscular-skeletal disorders, both for patients and for therapists. We will be pleased if the users of this manuał find it useful in realizing that goal.

Oslo, Norway and Alfta, Sweden August 1984

Olaf Evjenth and Jern Hamberg

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