On rare occasions, someone comes along who challenges the way we view our world. Professor Shirley Sahrmann is one of these individuals. Diagnosis and Treatment of Movement Impairment Syndromes is the result of many years spent simply observing and analyzing how the human body moves. Everyone who reads this text will understand the world of musculoskeletal medicine differently, and his or her world will be forever changed. I have frequently said to Dr. Sahrmann that she has given me “new eyes.” After many years of observing a wide variety of musculoskeletal problems, I am now understanding them differently. I once said this to a patient and was told that “the eye can only see what the brain knows.” This text will challenge its readers to observe their patients with movement system disorders with brains jammed full of new information that can be quickly incorporated into their practices. I have no doubt that perfecting the examination techniques and becoming adept at selecting and teaching the exercises outlined in this book will result in tremendous satisfaction both for the patient and the health care practitioner.
Like most of my contemporaries, I was taught assessment skills using the pathokinesiologic model. My skills were limited to telling patients what pathologic conditions they were experiencing and to hoping that they would go home happy once they knew their diagnoses. In actual fact, my patients wanted to know what caused their symptoms and pain problems. I often dismissed such requests with a perfunctory, “It is a result of overuse,” hoping no more questions would follow. My tremendous frustration resulted in the beginning of my quest to find the solutions to the limitations of this education model. I remember mentioning my dilemma at the Lillehammer Olympic Games. The chief therapist for the Canadian team suggested I attend one of Dr. Sahrmann’s muscle balance courses. I followed his advice and found that the assessment and treatment skills I learned and with the subsequent attendance at a number of courses perfectly met my needs. I continue to apply this knowledge with virtually every patient assessment in my practice.
Dr. Sahrmann is the first to categorize pain disorders logically into movement impairment categories. I quickly discovered that after using her assessment skills, the identical pathologic diagnosis is frequently not associated with the same movement impairment. Treating the specific impairment rather than the diagnostic label has been very rewarding in terms of outcomes. Diagnosis and Treatment of Movement Impairment Syndromes gives the clinician the necessary information to diagnose the various impairment syndromes with confidence. It also provides the researcher the grounding with which to perform the necessary investigations to expand the diagnostic categories and treatment protocols for the body regions not discussed in this book.
I hope this text will be followed by others from Dr. Sahrmann and her colleagues from the Washington University program in physical therapy. This information will serve as a stimulus for other researchers to test the theoretical concepts and further define the treatment protocols. The concepts have been tested by physical therapists around the world, but Dr. Sahrmann is to be commended for presenting her material in written form for all to see and evaluate, even though it remains largely a work in progress. Diagnosis and Treatment of Movement Impairment Syndromes has been a labor of love for Dr. Sahrmann. I, among many others, are very thankful for the years of effort it has taken to conceptualize, test, and document this information. It is an important body of work and one that will have significant effect on how we treat our patients with movement disorders. I hope all that read Diagnosis and Treatment of Movement Impairment Syndromes will find themselves saying, “I have seen this clinical scenario many times. With this knowledge, I now see it so differently.” Thank you, Dr. Sahrmann, for sharing your knowledge with me and for helping make working with patients such a joy!