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History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
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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