Book Review: A Manual Therapist’s Guide to Movement

A Manual Therapist’s Guide to Movement
Gordon Browne. PT, GCFP
2006 Churchill Livingston Elsevier, Philadelphia, PA
ISBN: 0 443 10216 3

Gordon Browne’s “A Manual Therapist’s Guide to Movement” is a book that attempts to bridge the gap between traditional/objective/scientific thoughts on movements and exercise, and a more integrative/subjective/awareness based model. For Feldenkrais® practitioners reading this book, it should be noted that this book deals primarily with the movement aspect of the Feldenkrais Method. As noted in the title, Mr. Browne’s audience is primarily the physical therapist/manual therapist who works with an orthopedic clientele. Mr. Browne does not claim that this is the “whole” Feldenkrais Method or that this is a book that describes the Feldenkrais Method. The book can still be a tremendous resource for the Feldenkrais practitioner who is interested in an explanation for what might happen from anatomical, biomechanical, neurological, and/or motor learning aspects during lessons.

The book is divided into three sections and seven chapters. The sections and chapters build upon each other, but can also be used as freestanding chapters. Each chapter has a number of experiential lessons (short Awareness Through Movement? lessons) included that follow the general theme of each chapter. The movement lessons included in each chapter can also be found on a CD set that can be bought separately. The CD’s add enormous value to the book, since readers can do the lesson that pertains to the book section they just read. After doing the lesson, the reader can then go back to the book and read about some of the ideas and theories based on the central nervous system and biomechanics that pertain to the specific movements of the lesson. “A Manual Therapist’s Guide to Movement” is unique in the way it presents the lessons and then discusses possible mechanisms involved with each of the movement variations just described/performed by the reader.

The first section of “A Manual Therapist’s Guide to Movement” discusses the background of the book and concepts in motor learning and motor behavior. This section includes a brief sketch of the author, the author’s reasons for writing this book and a brief biographical sketch of Moshe Feldenkrais. The author goes on to discuss different factors influencing motor learning and motor behavior, including sections on development, injuries, avoidance, cultural/emotional factors, pattern specificity, gravity, effort and other factors that influence motor learning and motor behavior. While each section is short, the sections give enough background to make the reader familiar with the concepts, and provide enough references for the reader who wants to delve deeper into any of the aspects.
In section two, Mr. Browne goes on to introduce global patterns such as balance, trunk control and different ways to orient from the vertical. Throughout section two, the author introduces concepts such as skeletal weight bearing, baselines (scanning), constraints, comparing baselines and variations. These concepts are familiar to most Feldenkrais practitioners, but are not necessarily familiar concepts to manual therapists. Mr. Browne does a very nice job explaining these concepts to the reader, and the reason why these concepts are important. Feldenkrais practitioners can benefit from the authors’ explanations of how these concepts that Feldenkrais practitioners perform all the time are important from a proprioceptive/awareness, neurological standpoint.

The experiential lessons in section two follow a developmental/evolutionary pattern. From falling in different directions (flexion, extension, side bending and rotation), to orientation, balance, and finally a combination of orientation and balance, the lessons follow a sequence that is easy to follow and understand while doing the lessons and reading the explanations. The lessons focus on global patterns and do not introduce specific patterns, standing, walking or more developmentally advanced movement patterns.

Section three is divided into three chapters. The chapters follow a logical sequence that goes from connection of the legs to the pelvis, to the low back and finally to standing activities. Section three includes sections on standing, posture, walking and more specific sections on dysfunctions such as low back pain, lumbar stabilization, joint replacements, sprains, strains, etc. To many Feldenkrais practitioners, this might go against their belief that the Feldenkrais Method should not be used for specific dysfunctions, but, as the author points out in the preface, this book is primarily written for the physical therapist with an orthopedic clientele. Many people with various orthopedic dysfunctions come to Feldenkrais practitioners for pain relief and to find out how to improve their movements for better efficiency and performance, so the sections that deal with specific orthopedic conditions can be very helpful to deepen the Feldenkrais practitioner’s understanding of orthopedic conditions from a movement perspective.

The first chapter starts out by discussing posture, but quickly moves on to focus on the connection of the pelvis and the legs, and pushing through the legs to go from sitting to standing. The author uses several examples, in different positions, of how spinal and pelvic control is built from the ground up.

The second chapter in the third section discusses lumbar and pelvic stressors and stability. When discussing different types of stresses (flexion, extension, side bending/rotation), the author gives examples on how to identify the stressors, by observing people’s body types and movements. The author then moves on to the concept of stability. The experiential lessons in this section do a nice job of taking the reader through a series of lessons that puts progressively more and more demands on the stabilizers of the trunk. The lessons range from stability on the floor to stability in gait.

The third and last chapter in section three covers the organization of the lower extremity and how the lower extremities contribute to and influence lumbar and pelvic control, and our ability to move around with comfort and efficiency. Many of the experiential lessons in this chapter focus on awareness of the feet and ankles. Medial/lateral and heel/toe patterns are explored both in writing and lessons. The author clearly explains what happens in the feet, knees, ankles, hip and spine (lower extremity kinetic chain) when a person walks with the feet, knees and hips in different positions. At the end of this chapter, the author also discusses common conditions and muscles that can be influenced by a variety of lessons that have been presented in the book.

Overall this book does what the author set out to do for the intended audience. That is, to bridge between traditional/objective/scientific thoughts on movements and exercise, and a more integrative/subjective/awareness based model for the physical therapist/manual therapist who mainly works with an orthopedic clientele. Considering that many Feldenkrais practitioners work with the same clientele, many practitioners could benefit from reading this book to gain a deeper understanding of motor learning, biomechanical and/or neurological aspect of movements. Readers will get much more enjoyment out of the book if they buy the CD set that is sold separately from the book. The CD set will make it easier and more pleasurable to do the experiential lessons described and analyzed in the book.

Volume 2 of the “Manual Therapist’s Guide to Movement” is forthcoming and will cover the upper extremity and cervical spine. If the second volume is as complete and well written as Volume 1, then Feldenkrais practitioners and physical therapists/movement therapists have something to look forward to.

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