Massage Today Get the Latest News FASTER - View Digital Editions Now!
WEBINARS
 Massage Today dotted line
CONTACTSUBSCRIBEFIND A THERAPISTASK A THERAPISTCALENDAR
dotted line
Use Woman Who Is Suing To Your Advantage
You’ve probably seen ...
A New Chapter Begins
Today is the first day of ...
Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
I just got finished with a ...

quick links

CURRENT ISSUE PREVIOUS ISSUES NEWS INDUSTRY NEWS COLUMNISTS BROWSE EDITORIAL TOPICS WEBINARS

resources

ABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Alternative Health News
Prescription Rights: Be Careful What You Wish For (Part 2)
Some chiropractors hold the view that if given the authority to prescribe drugs, they would also have the right to counsel patients to modify or stop the use of at least some of the drugs prescribed by other professionals.
The Wellness Center Solution
Most of us didn't go to chiropractic school for the money. We did it because we genuinely wanted to be doctors. The dream of one day opening our own practice and having our own patients?
Exposing the Bias for Acupuncture
A pair of papers published recently in the Journal of Alternative and Complementary Medicine challenge the United Kingdom's NICE clinical practice guidelines for osteoarthritis of the knee, specifically the guideline's recommendation against the use of acupuncture as a treatment option for knee OA.
A Name Change Will Save Our Profession
When the art and science of chiropractic was established in 1895, the art and science of marketing, advertising and public relations was virtually nonexistent.
Kudos to Consumer Reports
A well-rounded discussion of back pain, the problems with traditional treatment and the benefits of conservative care including spinal manipulation – now wouldn't that be great?
University of Missouri Adds Chiropractic
The Missouri Orthopedic Institute, a branch of the University of Missouri (MU) Health Care System, has added chiropractic to its list of available services and named K. Jeffrey Miller, DC, MBA and Jose Ramirez, DC, MS, CCSP, assistant professors of chiropractic.
Complacency Can Be a Practice Killer
Master motivator Zig Ziglar frequently told audiences in his lectures how to cook frogs. "If you throw them in hot water, they quickly jump out," he explained. "If you place them in warm water and slowly heat them with a small candle, they relax and get cooked."
Canada Keeps Cutting Chiropractic
Manitoba is the only remaining Canadian province that covers a portion of chiropractic care for all residents, but a new funding formula effective June 1 cuts $4.8 million from Manitoba Health's annual subsidies for chiropractic.
The News Shaping Your Future
As Ferris Bueller said during his infamous "day off," "Life moves pretty fast. If you don't stop and look around once in a while, you could miss it." Such is the case with the most recent events shaping the role of chiropractic in America's health care.
Denied Care: The Art of the Appeal (Pt. 1)
One of my patients was involved in an accident that left him permanently disabled. Although he finds welcome relief through an evidence-based, integrated approach to his injuries, the managed care organization (MCO) denied his care.
Chronic LBP: New Study Suggests Orthotics Can Help
A new study touted as "the first large-scale clinical trial assessing orthotics for treatment of LBP" suggests custom orthotics are an effective treatment option, alone or in combination with chiropractic care, for relieving pain and improving function in patients with chronic low back pain.
Coming to a Hospital Near You: Acupuncture
Revised pain management assessment and management standards1 by The Joint Commission require accredited hospitals to "provide nonpharmacologic pain treatment modalities" as a necessary performance element.
Treating Gulf War Illness: The Lasting Effects of Desert Shield/Storm
Clinical and registry programs indicate that 25 percent of the 700,000 veterans of the first Gulf War (Operation Desert Shield/Storm, years 1990-1991), have been affected by clusters of symptoms, and co-morbid medical diagnoses.

Senior Care: Don't Forget the Feet
A number of significant health conditions begin to have a greater impact on our patients as they age. Some of these are not immediately symptomatic, and often patients are unaware of the deterioration until they develop a loss of functional capacity and independence.
A Better Way to Treat Back Pain
Eight out of 10 people will experience back pain at some point in their life.1 Lower back injuries are seen in patients who are sedentary or athletic or even those whose jobs require no sitting at all, including 37 percent of school-aged children.1
A Dangerous Cause of Upper Back and Chest Pain
I was scuba diving in the Gulf of Mexico with several other divers to spear lionfish. Our first dive was to 100 feet and proved uneventful. On the second dive, a pair of divers went first while we waited for them to return.

The Do's & Don'ts of Office Humor
The new patient was a young, athletic-looking male who towered over me. As I shook his hand, I judged he was at least 6'6" tall. Walking back to the consultation room with him, just to be friendly and warm things up, I said, "I promise not to ask you if you ever played basketball in school!"
AHPA is Taking the Lead: A Proactive Approach to Herbal Safety
The American Herbal Products Association (AHPA) and Chinese Herbal Products Committee (CHPC) has taken the lead when it comes to defining "Good Herbal Compounding and Dispensing Practices."

Integrative Healthcare: An East West Perspective
Acupuncture and Oriental medicine schools educate their students to understand that a patient's specific health concerns are important to understand, as well as the patient's more general concerns about elevating personal stress levels in navigating the health care system.

Coming to Grips With Our Professional Realities
As an American citizen, watching divisions in our society sharpen and grow more barbed and distinct over the past decade has been painful.
An Acupuncture Parallel in the Everyday
It was a breezy spring evening in San Francisco when I stepped out of the car in front of Quince restaurant. As I walked toward the front entrance, I could not help but notice the well-groomed trees, and neatly swept sidewalk.

Let's Restore Ilium Motion
If you are a practitioner who routinely evaluates sacroiliac function during standing hip flexion, you should notice the loss of sacroiliac motion on one or both sides following lumbar spinal injury, dysfunction or degeneration.
Coding for Maintenance Care
You are indeed correct that S8990 is indeed a code for maintenance for physical therapy or manipulation. It is a Health Care Common Procedure Coding System (HCPCS) code and not part of the CPT coding set. HCPCS is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and individuals enrolled in private health insurance programs.
The Yang of Stress & Fat: Hormones Worth Monitoring in Your Patients
There are many risks associated with obesity, some even severe enough to lead to death, such as a heart attack or stroke.

3 Reasons Patients Fire You
Any successful DC knows the secret to running a thriving practice involves having patients who return time and time again for your health-related services. But how do you get them to want to continue to walk in your door? You keep them satisfied.
Tackling the Opioid Crisis: Big Insurance Victory for Rhode Island DCs
Rhode Island Gov. Gina Raimondo has signed legislation requiring insurers to reimburse chiropractors for medically necessary non-opioid pain treatments.
News in Brief
National, Western States Forge CE Partnership; New Appointments at NYCC; Core Products Acquires Swede-O.
A Herbal Guide for Digestive Complaints
One of the most common presentations in the clinical setting is digestive complaints. Almost daily I see patients presenting with a wide array of digestive issues ranging from simple issues such as gas or bloating to complex issues such as IBS or chronic food allergies.

What's Causing That LBP? Facets vs. Discs vs. the SI Joint
Let's discuss some simple ways to differentiate the three major spinal joint sources of low back pain a chiropractor needs to address. Differential diagnosis is one of the keys to accuracy and success.
Penetrating the Myserious: Strange Diseases & Hidden Qi
Often the root of our problems come not from what we can identify and explain, but from a deeper, hidden place. This is true for both physical problems as well as mental-emotional issues.
Needling in Nepal: World Healing Exchange
In 2009 Acupuncturists Without Borders (AWB) traveled to Nepal for the first-ever "World Healing Exchange" trip. While they were there they visited rural villages, met with traditional healers of the region (particularly traditional Tibetan medicine healers), and got to know the acupuncture community.


 dotted line
Share |
  Forward PDF Version  
Massage Today
September, 2002, Vol. 02, Issue 09

Sharp Anterior Medial Knee Pain

By Ben Benjamin, PhD

Question: Where is the medial quadriceps expansion?

Answer: At the medial side of the patella.

The quadriceps muscles join together into the quadriceps tendon just above the patella.

The tendon then passes over the patella in the form of an aponeurosis (or flat-sheet structure) and envelops the kneecap, tucking slightly under the medial and lateral aspects of the patella, fitting like a shower cap. It then continues down to attach to the tibial tubercle. This section is called the patellar ligament.

Illustration of medial quadriceps expansion. - Copyright – Stock Photo / Register Mark Medial quadriceps expansion (arrow B). Most therapists have never heard of this important structure. It is the cause of frequent knee pain when negotiating stairs, walking up hills, or engaging in more vigorous activities such as running, biking or racket sports. The nature of the pain can be achy but is often very sharp, especially when the adhesive scar tissue is in the inferior medial corner.

Illustration of resisted extension of the knee. - Copyright – Stock Photo / Register Mark Resisted extension of the knee. Resisted extension of the knee is usually the assessment test that verifies the presence of this injury. However, because this tendon is so strong, this assessment test will often not show a positive result unless the activity that causes the pain is done immediately before the test is performed.

Treatment is usually fairly straightforward. With the client lying supine, the therapist forcefully pushes the patella medially with the thumb of one hand and applies friction therapy with the index finger of the other hand. The finger is placed under the medial side of the patella and pressure is applied anteriorly (toward the ceiling). The direction of the friction movement is from head to foot.

Click here for more information about Ben Benjamin, PhD.

 

Join the conversation
Comments are encouraged, but you must follow our User Agreement
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.
comments powered by Disqus
dotted line
To report inappropriate ads, click here.