Book Review

Title:	Positional Release Therapy -- Assessment and Treatment of Musculoskeletal Dysfunction
Authors:	Kerry J. D'Ambrogio, PT, George B. Roth, DC, ND
Publisher:	Mosby-Yearbook, Inc., St. Louis, Missouri, 1997
Number of Pages:	259
Price:	$76.99
Part No:	T-184

Positional release therapy (PRT), the authors state, is a generic name for the strain-counterstrain technique originated by Lawrence H. Jones, DO, who published a book with the same title in 1981. I dug up my old copy of the Jones book and compared it with PRT. This "new edition" of strain-counterstrain includes better discussions on the scientific rationale of soft tissue dysfunction, plus an appendix of 145 strain-counterstrain terms and how they correspond to positional release therapy terminology. The technique illustrations which comprise the majority of both books are improved in both detail and layout in PRT. There is a short chapter and an appendix devoted to a recordkeeping system that is rather bulky and will probably be ignored by the majority of practitioners who purchase the text.

PRT or strain-counterstrain is a technique of reducing tender points in the soft tissues by passively placing the patient in a position where light digital pressure on the tender point is no longer painful, and then holding that position for approximately 90 seconds. After 90 seconds, the patient is slowly returned to neutral and reexamined (range-of-motion/palpation) for improvement.

The authors have similar stories which sparked their interest in strain-counterstrain. Kerry D'Ambrogio, suffering from chronic groin, hip flexor, and knee pain caused by athletic injuries, attended a seminar by Lawrence Jones. After one treatment by Dr. Jones, his improvement was so substantial that he eventually began working with Jones, teaching strain-counterstrain in seminars.

George Roth suffered from intermittent upper back pain caused by a childhood automobile accident and was in the midst of a three-month flare-up, which was also unresponsive to multiple types of treatment. His condition resolved after one treatment with the strain-counterstrain by a student of Dr. Jones.

The authors do state in more than one area that PRT is not a panacea (I can attest to that, because it did not help me when I had an acute case of lumbar discitis a few years ago). The authors further state that when PRT is performed correctly, significant results should be seen within three to five visits. They also recommend using PRT with other treatment modalities (manipulation, mobilization, exercises, and other soft tissue techniques) for maximum effectiveness.

It is this author's opinion that chiropractors who limit their practices to manipulation only will find it increasingly difficult to compete with DCs who incorporate other types of manual physical medicine procedures in their practices. PRT is well illustrated and easy to follow. Chiropractors who are interested in expanding their types of treatment and are looking for a soft tissue technique that is gentle and easy on the bodies of both doctor and patient should consider purchasing this text.

Dr. Andersen's Rating: 8

G. Douglas Andersen, DC