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Logo of brjsmedBritish Journal of Sports MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Br J Sports Med. 2007 August; 41(8): e1.
PMCID: PMC2465434

Soft tissue rheumatology

Reviewed by Alexander Scott

Edited by Brian Hazleman, Graham Riley, Cathy Speed. Oxford: Published by Oxford University Press, 2004, £115.00, pp 568. ISBN 0-19-263093-8

Graham Riley is without doubt one of the pre‐eminent tendon scientists. Cathy Speed and Brian Hazleman have published key papers in high‐impact journals including the BMJ and Rheumatology, respectively. Therefore, this tendinopathy monograph warrants close attention.

Given the focus of this issue of BJSM, it behoves us to ask, what tendon books are available? In chronological order, I have retrieved Curwin and Stanish's Tendinitis (1984), Kannus and Jozsa's Human tendons (1997), William Weintraub's Tendon & ligament healing: a new approach to sports and overuse injuries (2003), as well as the most recent offering by Maffulli, Renstrom and Leadbetter, Tendon injuries: basic science and clinical management (2005).

Soft tissue rheumatism, as the name implies, views a diverse group of musculoskeletal conditions from a rheumatological perspective. Two of the three editors are rheumatologists, as are a dozen of the contributors. As the authors note in their preface, many of the musculoskeletal problems that are difficult to manage are not primarily problems of the “hard tissues of the joint and are not associated with overt inflammation”. Much of the caseload comprises “multifarious” (I liked that!) disorders that include tendon, ligament, sheath, capsule, bursa, disc and meniscus—these are the target tissues of “soft tissue rheumatology”. The authors make a compelling case for the need to clarify the diagnostic challenges that beset this field.

The book begins with a strong scientific foundation that is well illustrated, authoritative and comprehensive. To me, a clinician–scientist, this was the highlight of the book and it provides a terrific vehicle for Drs Riley and Benjamin to share their wisdom in a way that scientific papers do not allow.

Section 2, relating to pain science, is very medical, which is appropriate for a book geared to rheumatologists and other doctors. Non‐pharmacological therapies are covered in one paragraph.

The introductory biomechanics chapter succeeds in outlining fundamental concepts in the field and discussing techniques; it is a nice overview of the field but is not geared specifically to tendon or ligament. These tissues warrant three paragraphs in the chapter. US surgeon Richard Brand provides the chapter on biomechanics and locomotion.

From there the book moves to its clinical section—the general principles and the management of specific conditions. Again a wealth of highly respected authors contributes comprehensive and reasonably well‐illustrated material across a wide range of tissues. It is helpful that fundamental material is included, such as the anatomy of the knee and how to examine the joint (with illustration),and yet the book also moves to providing advice on complex conditions. For example, the authors tackle complex issues such as fibromyalgia and myofascial pain, as well as chronic fatigue. These topics are rarely addressed and never previously with such authority in a text.

Thus, Soft Tissue Rheumatology makes a much‐appreciated foray into soft tissue issues for rheumatologists, the traditional non‐operative specialists in sports medicine. It will greatly benefit those clinicians who read it, and the scientific foundation of this book is worthwhile for all those who are interested in the field.


  • Presentation 18/20
  • Comprehensiveness 8/20
  • Readability 17/20
  • Relevance 18/20
  • Evidence basis 15/20
  • Total 86/100

Articles from British Journal of Sports Medicine are provided here courtesy of BMJ Publishing Group