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Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
August, 2003, Vol. 03, Issue 08
Injured Bursas in the Knee
By Ben Benjamin, PhD
Question: True or False?
The prepatellar bursa is located just superior to the kneecap.
Question: True or False?
The infrapatellar bursa is located inferior to the kneecap on the anterior surface of the patella ligament, right under the skin surface.
Question: True or False?
The suprapatellar bursa is located right on the anterior surface of the kneecap.
Answer: All three statements above are false.
All three of these bursas play a role in the smooth functioning of the knee joint.Knowing the exact locations of these bursas and being able to tell when they are injured will help you better evaluate clients that present with knee pain. Deep massage or friction therapy will either do nothing, or worsen the pain of a client suffering from bursitis in the knee. Therefore, it is very important to distinguish between a soft-tissue injury, where hands-on treatment is appropriate, and an injury that is not.
The prepatellar bursa, located just beneath the skin on the anterior surface of the patella, protects the bony surface of the patella. This bursa is usually injured by a high-impact fall. When injured, it swells like a balloon on top of the kneecap, and is red and painful when touched, even gently. Hands-on treatment is not effective for this injury.
The infrapatellar bursa is located inferior to the patella within the knee joint, posterior to the patella ligament. It cushions the patella ligament and is painful when kneeled upon. When swollen and inflamed, it is also difficult to bend the knee fully; however, it does not limit extension of the knee. This bursa is often injured along with the quadriceps mechanism above or below the patella. The suprapatellar bursa is located proximal to the patella at the base of the anterior thigh. When inflamed, it is usually hot, visibly swollen and painful to the touch. The swelling in the bursa limits the ability of the knee to fully flex.
Very little is definitively known about why a bursa becomes inflamed and swollen. Causes could range from impact trauma to subtle misalignments of the knee. My best guess is that excessive movement, caused by loose medial and lateral collateral ligaments and loose anterior and posterior cruciate ligaments, often causes the bursa to become irritated and inflamed.
Treatment options for bursitis are limited. If several months of rest do not eliminate the pain, anti-inflammatory injections are usually indicated and effective.
Click here for more information about Ben Benjamin, PhD.
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