resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
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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