Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Calculating Billable Units
I recently learned of an office that was audited based on the number of acupuncture sessions performed in one day. Is there a maximum number of sessions that can be performed in one day?
What Does Success Mean to You?
Recently, I was asked to speak to young, budding businesswomen about running a successful business — and at first I thought, "Me? You want me to speak to others about success?!"
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
The Nectar of Plants: Essential Oils and Chinese Medicine
Essential oils are a very hot topic these days, especially with the likes of the Ebola virus and the resurgence of measles lurking in our awareness, but when I first became interested in Chinese medicine, essential oils weren't on the radar screen for acupuncturists.
Our Biggest Challenges to Compete in Wellness Care
In the first article in this four-article series [May 1 DC], I made the case that chiropractors should either embrace offering lifestyle wellness in their practices or face the possibility of losing their place in the wellness care marketplace.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Breath: The Movement of Oxygen and Energy
I remember with surprising clarity the first time a patient started crying during an acupuncture treatment I was giving. This is now quite a long time ago, back in 1999, when I was a student.
How One Little Symbol (#) Gets You More Patients
Are you struggling to get more fans or followers for your acupuncture practice? Or are looking for ways to simply connect with your patients? Or do you just want to know how to keep them engaged (comments, retweeting, liking and sharing)?
The Source-Luo Point Combination
The luo collaterals are part of the acupuncture channel system presented in the Su Wen and the Ling Shu (The Nei Jing). The function and clinical application of the luo mai are primarily presented in chapter 10 of the Ling Shu, however, they are also found in others chapters in the Su Wen and the Ling Shu.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
TMF 2015 Scholarships
The Trudy McAlister Foundation (TMF), a nonprofit organization established to support students who are on track to make contributions either to clinical practice and/or to the understanding of the role of Traditional Oriental Medicine, has announced the 2015 scholarship recipients.
The Year to Make Things Happen
It is hard to believe that the Year of the Ram – 2015 is half over. Time seems to be moving especially fast. This is the year for things to happen for the acupuncture profession.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
Acupuncture in the U.K. Today: A Personal View
When asked to write a short piece on the current state of the U.K. acupuncture profession, my first response was to say it has all been relatively quiet.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients, in May 2014, researchers showed that drinking the equivalent of 2 to 4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
The Modern Acupuncturist
You studied ancient Chinese medicine, but I'll bet you don't practice it! Contrary to popular belief, our medicine has evolved A LOT over the years. Let's take a brief walk through history and discover the differences between ancient and modern acupuncturists.
Acupuncture and the Pulse
In 1991, I attended a martial arts workshop hosted coincidentally by Sung Baek, a martial artist and the head of his lineage as a Korean trained acupuncturist. I was enamored by the details Sung could attain from the pulse, as told to me by some of his apprentices.
Use Technology to Gain New Patients and Improve Efficiency
From the smartphone in your pocket to your microwave oven, advancements in technology have made almost every aspect of our lives easier.
Marijuana, Apathy and Chinese Medicine, Part 2
A talented young woman presented herself with emotional mood swings, which included being nervous, anxious and jittery.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
January, 2009, Vol. 09, Issue 01
Recognizing Baker's Cysts
By Whitney Lowe, LMT
The practice of massage therapy helps develop outstanding palpation skills for the practitioner. One of the great advantages of improved palpation skills is the ability to identify structural abnormalities under the skin before the client might be aware of a problem even existing. Many of these structural abnormalities may not even be painful. It is still important to be aware of those that are not painful because they may be an indication of an underlying pathology that could cause problems later on.
One such condition that may be evident during massage of the lower extremity is a fluid-filled cyst called a Baker's cyst or popliteal cyst that develops in the posterior knee region. Most Baker's cysts are benign, but they can cause pain and are frequently an indication of other pathologies so it is important to properly identify them.
Baker's cysts are the most common cysts found around the knee and the most common cysts lined with a synovial membrane anywhere in the body. They develop posterior to the knee joint and are usually found directly behind the medial femoral condyle between the medial head of the gastrocnemius muscle and the semimembranosus tendon. The cyst fills with fluid and becomes a palpable mass in the proximal posterior calf.
Baker's cysts may develop for a number of different reasons, but the cause is not always clear. There seems to be a correlation between the development of a Baker's cyst and the presence of other knee pathologies. For example, these cysts routinely occur after conditions such as osteoarthritis, rheumatoid arthritis, gout, meniscal tears, cruciate ligament tears, or osteochondritis dissecans have occurred in the knee. The reason they develop after these conditions is not entirely clear, but since the lining of the cyst is intimately connected with the joint capsule of the knee, irritation of the capsular tissues may have something to do with it.
The Baker's cyst has another interesting structural feature. Examination of the cyst reveals there is a one-way valve system that communicates between the capsule and the cyst. The cyst develops as a fluid-filled pouch of capsular tissue, but there is not a free exchange of fluid between the cyst and the internal knee structures. The one-way valve only lets fluid pass from the internal knee joint into the cyst. This is one reason for so much fluid accumulating in the area. As fluid develops within the cyst, it may press on other structures in the region and produce pain. Presence of the cyst behind the knee is also likely to prevent full flexion of the knee and may cause some discomfort or limitation to full extension.
There are a number of fluid-filled cysts that occur in different regions of the body, such as the ganglion cysts found around the wrist. A primary focus of treatment for these cysts is aspiration, or drawing the fluid out of the cyst. With Baker's cysts, aspiration is not performed because the fluid is much thicker and can't be drawn through the narrow diameter of a needle during aspiration. Treatment usually relies on conservative approaches such as rest from offending activities, thermal therapies including both ice and heat, and nonsteroidal anti-inflammatory medications (NSAIDS). The rationale for some of these approaches, such as heat or ice, is not entirely clear and is rarely given.
Since the Baker's cyst is often the result of some other pathology associated with the knee joint, it is important to address that underlying pathology. In many cases, the Baker's cyst will resolve on its own if the original problem can be resolved.
There is no benefit to treating a Baker's cyst with massage. Because it is a fluid-filled mass with a one-way valve, mechanical pressure on the cyst will not do anything to help the fluid move out of it and may, in fact, irritate the problem further. Most massage practitioners are cautious about pressure to the posterior knee region due to other delicate neurovascular structures in the region. This caution is warranted, as pressure behind the knee can damage these tissues.
Sometimes, more advanced practitioners may attempt treatment of some of the important muscles in this region, such as the popliteus and plantaris. Because the bellies of these muscles are only in the posterior knee region, they are difficult to treat in any other way. Putting further pressure on a Baker's cyst in this region could occur when attempting to treat one of these deeper knee muscles, and could aggravate the cyst. However, the palpatory skills of the massage practitioner frequently help to identify the tissue abnormality so the person can be referred to someone who can more accurately identify and treat the problem. Other conditions such as deep-vein thrombosis or popliteal aneurysms can also produce similar symptoms, and these problems are all serious enough to warrant referral to another specialist.
Click here for more information about Whitney Lowe, LMT.
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