Foreword

By HARVEY E. BILLIG, JR., M.D., F.I.C.S., F.A.C.S.M.
Director Billig Clinic, Los Angeles

The scientific announcement by Hench, Kendall, Slocumb and Polley of the Mayo Clinic concerning the importance of the steroid metabolic effect on rheumatoid arthritis focused clinical attention on the remarkable rapidity with which fibrous collagen tissue contrac-tures can be released to allow a restoration of range of joint motion.

A long and distinguished list of investigators must also be included among those who, from various approaches, have thrown light on the problem of fibrous collagen tissue contractural "stiffness" : e.g., Hisaw with studies on "relaxin," Chamberlain with studies on joint motility associated with the various metabolic phases in the estrus cycle, Meyer with studies concerning hyaluronic acid and hyaluronidase, Eigsti and Dustin reporting the colchicine inhibition of collagen fibers contraction, etc., etc.

A review of the basic biological characteristics of all protoplasm reminds us of "contractility" and "elasticity." Pertinent consideration of these ever present protoplasmic characteristics of contractility and elasticity for application in clinical thinking brings to mind the remarkably rapid rate that the fibrous sheathing (sarcolemma) of the muscle fibers of the muscles of the humming bird contract (contractility) and lengthen (elasticity) in coordination with the thinning in relaxation and broadening in contraction of the encased muscle fibers.

It is now understandable how the clinical methods of mechanical stretching traction, metabolic agents, heat and cold, etc. can result in recovery of range of motion by means of the fibrous collagen tissue elongation. The compartmentation and enveloping ramifications of the collagen fibrous tissue layer, sheathings and ligaments provide passageways for the distributing ramifications of the nerves, blood vessels and lymphatics. When fibrous contractural restriction of mobility ensues, the distributing nerves, blood vessels and lymphatics are hence constricted giving rise to clinical signs and symptoms.

Alleviation of such clinical signs and symptoms requires mobilization loosening of the fibrous contracture. James B. Mennell of St. Thomas Medical School in London has extensively researched the passive manipulative techniques necessary to progressively loosen the fibrous tissue contracture in order to mobilize joint stiffness. Harvey E. Billig has extensively researched the passive and active mobilization stretching traction exercises necessary to progressively loosen sheathing, fascial and ligamentous contractures.

In this book is described the means whereby, in industry and the home, "elongation" therapy provides the opportunity for release of fibrous contracture and hence alleviation of many of the stubborn back aches and peripheral nerve symptoms seen in clinical practice.

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