Pathology-Chapter 3, Musculoskeletal System Conditions

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Erythema migrans

A "bull's-eye" rash, usually seen as an early symptom of Lyme disease.

Chondroitin sulfate

An important component of cartilage, sometimes taken as a dietary supplement for joint health.

Subluxation

An incomplete dislocation.

Tonometer

An instrument for measuring pressure or tension.

Myotonia

Delayed relaxation of a muscle after a strong contraction.

Myelopathy

Disease or injury of the spinal cord.

Bursae

Fluid-filled sacs that reduce the friction where a muscle or tendon slides across bone. (singular: bursa)

Bruxism

Habitual teeth grinding, especially while sleeping.

Hips joint replacement

Hip joints are frequently replaced, either as a consequence of arthritis that wears away at the huge weight bearing joint or as a result of femoral trauma.

Proteoglycans

Large, negatively charged molecules that attract water.

Laxity

Looseness

Ligamentum flavum

One of the ligaments of the spinal column that connect the laminae of adjacent vertebrae. (Plural: ligamenta flava)

Meralgia Paresthetica

Paresthesia of the lateral thigh

SERMs

Selective Estrogen Receptor Modulators, a group of medications that reduce the risk of certain cancers as well as osteoporosis.

Viscosity

The degree to which a fluid resists flowing. Stickiness.

Lavage

The washing out of a hollow cavity.

Scheuermann disease

This is a type of hyperkyphosis that mostly affect young men.

while gout usually begins at a single joint, it doesn't usually stop there. Left untreated or incompletely treated, destructive uric acid deposits can accumulate at joints throughout the body, and eroded bones can fracture.

What are the complications of gout?

The incidence of myofascial pain syndrome is unknown, but it is reported equally among men and women.

What are the demographics for myofascial pain syndrome?

Massage offers many benefits to cancer patients, including improving mood, lessening anxiety and depression, promoting good-quality sleep, and decreasing the negative side effects of cancer treatments. All this must be done in coordination with the rest of the health care team, of course. A client who has fully recovered from osteosarcoma can enjoy the same benefits of bodywork as does the rest of the population.

What are the massage benefits for osteosarcoma?

The chronic low back pain, paraspinal spasm, and tightness in the psoas and hamstrings that many spondylolisthesis patients experience can all be addressed with massage. Bodywork won't correct structural problems with the vertebrae, but it can be an effective way to deal with the symptoms.

What are the massage benefits for spondylolisthesis?

In the absence of dystrophin the cell membrane degenerates, and muscle cells atrophy and die, to be replaced by fat and connective tissue.

What happens (etiology) with MD?

Two forces operate to maintain fluid balance within tight facial compartments, especially in the lower leg: tissue pressure (which is partly determined by the rate and volume of incoming fluid), and perfusion pressure (which describes the ratio of blood in the arteries compared to that in the veins within and enclosed space)

What happens when it comes to compartment syndrome?

muscle strains and other soft tissue injuries may arise from specific trauma, but they often develop in the context of chronic, cumulative overuse patterns with no specific onset.

What happens when you have a strain?

vapocoolant spray

a topical anesthetic aerosol spray.

Herniated disc

.bulge .Protrusion .extrusion . rupture

Fascicle

A band bundle of fibers. (Plural: fasciculi)

Diffuse Idiopathic Skeletal Hyperostosis (DISH)

A bony hardening of ligaments that attach to the spine.

Osteophyte

A bony outgrowth

Heberden nodes

A bulging at the distal interphalangeal joints caused by arthritis.

Chondrocyte

A cartilage cell.

Bisphosphonate

A class of drug used to restrict bone loss by reducing the number of bone-clearing cells.

RANK ligand inhibitors

A class of drugs used to treat osteoporosis by interfering with bone resorption.

Acetylcholine

A common neurotransmitter that is necessary for the nervous system to stimulate muscle movement.

Fibromatosis

A condition in which connective tissue cells multiply into tumors called fibromas. Usually not cancerous.

cauda equina syndrome

A condition in which the inferior part of the spinal cord is damaged, resulting in loss of function.

myofascial pain syndrome

A condition that is identified when a person develops trigger points: Pain-generating spots in muscles that are palpable as knots or taut bands.

Crepitus

A crackling sound, often created by joints.

Pain-spasm-ischemia cycle

A cycle traditionally thought to create trigger points: sensations of pain cause spasm, which limits blood flow, resulting in more pain, and so on.

Linea alba

A fibrous band that runs down the center of the abdomen. The name literally means "white line."

Collagenase

A group of enzymes that help to dissolve collagen.

Capsular ligament

A ligamentous sac that surrounds the articular cavity of a freely moveable joint.

Arthroscopy

A minimally invasive surgery in which the inside of a joint is examined using an arthroscope.

Needle aponeurotomy

A minimally invasive treatment for Dupuytren contracture, in which the offending band is weakened using microscopic punctures.

Botulinum toxin

A neurotoxic protein that interferes with acetylcholine activity to reduce muscle contraction.

Pseudogout

A painful joint disease with symptoms similar to gout, but which does not involve uric acid.

Dystrophin

A protein found in skeletal muscle tissue; it is missing in people with some forms of muscular dystrophy.

Proliferant

A substance that stimulates the growth of tissues, in this case, connective tissue.

fasciotomy

A surgical procedure to cut fascia in order to relieve internal pressure.

Extracorporeal shockwave lithotripsy

A treatment for kidney stones and gallbladder stones using focused ultrasound energy.

Reducible

Able to be reduced, or put back in proper position.

Dysplasia

Abnormal tissue growth.

Postural Deviations

Although it is tempting to think about the spine like a ship's mast, a column, or a tent pole held erect by muscular tension, it is actually much stronger than any of those. The curves in the cervical, thoracic, and lumbar regions give the spine many times the resistance it would have if it were straight. Sometimes these natural curves are overdeveloped though, which reduces resiliency and strength rather than enhancing it.

Adhesion

An abnormal connection between one layer of tissue and another. usually refers to the "gluing" of connective tissue layers.

Contracture

An abnormal contraction or shortening of a muscle. Can become permanent.

Stenosis

An abnormal narrowing of a tubular structure.

Paresthesia

An abnormal sensation such as burning, prickling, or tingling

Hyperuricemia

An abnormally high concentration of uric acid in the blood.

Counterirritant

An agent that causes mild irritation or inflammation of the skin on order to relieve symptoms of inflammation in deeper tissues.

Myofibroblasts

An atypical type of fibroblast with some qualities of smooth muscle cells.

Papain

An enzyme derived from papayas that is used to dissolve connective tissue. Also used as a meat tenderizer.

Fasciculation

An involuntary twitching contraction of fasciculi.

Radiculopathy

Any disorder of the spinal nerve roots.

other joints replacement surgery

Arthroplasty can be conducted on ankles, various carpometacarpal and interphalangeal joints, the saddle joint of the thumb, and the temporomandibular joint.

Shoulder joint replacement

Arthroplasty of the glenohumeral joint is done when the joint is no longer competent: trauma, ongoing damage to the rotator cuff, or bone spurs have made the head of the humerus and the glenoid fossa incompatible in shape.

Prostheses

Artificial body parts. (singular: prosthesis)

Exercise-associated muscle cramping

Athletes often report problems with muscles cramping at or near the end of vigorous work. Dehydration, electrolyte imbalance, and hyperthermia may all be contributing factors, but a neurological component appears to be present as well.

Nutrition

Calcium, potassium, and magnesium deficiencies can make one prone to cramping, especially in the feet. Other important substances for efficient muscle contraction include water, glucose, and sodium. If any of these are in short supply, muscles can't work to their best potential.

Post treatment Lyme disease syndrome

Chronic symptoms of pain and fatigue that may continue for months in some people after contracting Lyme disease.

Perineurium

Connective tissue wrapping around bundles of nerve fibers.

Tophi

Deposits of uric acid and urates in tissue around joints and other areas. often seen with gout. (singular: tophus)

Incarcerated

Describing a hernia that is entrapped to the degree that it cannot be repaired without surgery.

Involutional

Describing something that is entangled or turned inward on itself.

Hyaline

Describing translucent articular cartilage.

Joint Disruptions

Dislocations and associated ????? describe situations where the articulating bones of a joint are not in correct relationship. In a full dislocation, the surfaces have no contact and the joint cannot be used.

Bouchard nodes

Enlargement of the proximal interphlangeal joints due to bone spurs associated with osteoarthritis.

Apophysitis

Inflammation of a bony process or outgrowth.

Compartment Syndrome

Is a condition in which an injury or repetitive stress creates pressure inside a tight fascial compartment that can lead to the starvation and death of muscle and nerve cells. It usually happens in the lower leg, but it can develop elsewhere.

Adhesive Capsulitis (Frozen Shoulder)

Is a poorly understood condition in which the connective tissues that surround the glenohumeral joint become first inflammed and then thickened and restrictive. The process typically takes several months to fully develop, then it is stable for several months, and then for most patients it eventually spontaneously resolves, and most or all of the lost range of motion is restored. For some,it leads to a lifetime of limited range of motion at the affected shoulder.

Gout

Is a type of inflammatory arthritis that is relatively common in men between 40 and 50 years old and women who are postmenopausal. Its incidence appears to be increasing as baby boomers with long histories of problematic eating and drinking habits enter maturity. ????? is one of the oldest diseases in recorded medical history; treatment recommendations that are still in use date back to 580 A.D.

Arthroplasty

Joint replacement surgery

Knees joint replacement

Knees are unique in that they combine a large range of motion with strict limitation in direction-that is, they flex and extend only (unless the knee is bent, in which position it can slightly rotate). Consequently, knees are vulnerable to shearing forces that can damage their stabilizing ligaments and put the internal cartilage at risk for permanent damage.

Whiplash

Or CAD (cervical acceleration-deceleration) is a broad term used to refer to a mixture of injuries, including sprains, strains, and joint disruptions.

Impaired contractility

Scar tissue can impede the efficiency of uninjured muscle fibers. when the muscle cells try to contract, they bear the weight no only of their bony attachments, by also of the fibers that are disabled by the mass of collagen that binds them up.

Q angle

The angle formed by the line from the ASIS to the middle of the patella, and the line from the middle of the patella to the tibial tubercle.

Bone structure

The arrangement of living and nonliving material in bone is elegant and efficient.

Dislocation

The articulating bones are no longer touching; the shared surfaces have become disconnected, usually because of trauma. ???? are common for the shoulder, the fingers (especially the metacarpophalangeal joints), and the patella, although they can certainly occur elsewhere. A joint with a history of dislocation that is not surgically corrected is at increased risk for spontaneous dislocation in the future.

Subluxation

The bones are out of best alignment, but the joint capsule is intact. The joint is functional, but lacks a full range of motion. Joints that commonly subluxate include the intervertebral facet joints, the patellofemoral joint, and the radial head (this is sometimes called "nursemaid's elbow" from dangling a child by his or her forearm).

Osteopenia

The condition of low bone density, but not low enough to be considered osteoporosis.

Periosteum

The connective tissue membrane covering the outside surface of a bone.

Perimysium

The connective tissue membrane surrounding a bundle of muscle fibers.

Epimysium

The connective tissue membrane surrounding a skeletal muscle.

Endomysium

The connective tissue membrane surrounding individual muscle fibers.

Sarcomere

The contracting part of a myofibril.

ATP energy crisis

The cycle of involuntary muscle cell contraction that leads to an increased need for fuel and a decreased supply of blood.

Cortical bone

The dense outer layer of bone. also called compact bone.

Perfusion pressure

The gradient between arterial and venous pressure in a comparable location.

Endosteum

The layer of cells lining the inner surface of bone in the central medullary cavity of long bones.

Trabecular bone

The less dense bone tissue generally found at the ends of long bones and in the interior or vertebrae. Also called spongy bone.

Umbilicus

The navel.

Intervertebral foramina

The openings between adjacent vertebrae. Through each intervertebral foramen passes a single spinal nerve.

Ischemia

The pain-spasm-ischemia cycle presents one major theory behind involuntary muscle tightness. When a muscle, or part of a muscle, is suddenly or gradually deprived of oxygen, it can't function properly.

Pars interarticularis

The part of the vertebra between the superior and inferior articular process.

sarcolemma

The plasma membrane of a muscle fiber.

Tissue pressure

The pressure of interstitial tissue fluid in an enclosed space.

Debridement

The removal of dead tissue and foreign matter from a wound.

Synovium

The secreting membrane found between the joint capsule and the joint cavity of synovial joints.

Costoclavicular space

The space between the clavicle and the first rib.

Discectomy

The surgical removal of some or all of a vertebral disc.

Duchenne muscular dystrophy

The x-linked genetic anomaly is the most common and most severe variety of the disease. Boys with this condition cannot produce any dystrophin at all.

Dupuytren Contracture

This condition also called palmar fasciitis, is an idiopathic thickening and shrinking of the palmar fascia that limits the movement of the fingers. Its a type of fibromatosis: a benign soft tissue growth with a proliferation of fibroblasts and extracellular matrix.

Becker muscular dystrophy

This is a less common and less severe form of MD that also affects only boys. In this version some dystrophin is produced, but not enough for normal function.

Splinting

This is a reflexive reaction against injury consider an acute whiplash: the upraspinous and intertransverse ligaments have been severely wrenched, and the body senses a potentially dangerous instability in the cervical spine. The postural neck muscles contract in response; as far as they're concerned, they are keeping the head from falling off.

Myotonic Muscular Dystrophy

This is the most common form of adult-onset muscular dystrophy, and it affects both men and women. Its primary symptom is myotonia.

spreading problems in the spine, Nerve pain, secondary spasm, blood vessel pressure, and myelopathy

What are the complications for spondylosis?

A person with a history of dislocations may have permanently compromised ligaments, which can contribute to joint instability and an increase risk for both subluxation and osteoarthritis.

What are the complications of joint disruptions?

The possible complications that accompany any surgery are daunting. They include a reaction to anesthesia; arrhythmia; and the consequences of blood clots, including DVT, Pulmonary embolism, and circulatory shock. Hospital-borne pathogens may lead to an infection in the joint, urinary tract infection, or pneumonia.

What are the complications of joint replacement surgery?

is diagnosed about 400 times each year in this country. It is slightly more common in young men than young women, and the incidence is slightly higher among blacks than among whites.

What are the demographic for osteosarcoma?

is most common in people in their 50s and 60s. Women are slightly more likely to have it than are men.

What are the demographics for Adhesive Capsulitis?

These cysts are common in children, for whom the preferred treatment is to wait for them to resolve on their own.

What are the demographics for Baker cysts?

is most common among middleaged white men of Northern European descent.

What are the demographics for Dupuytren Contracture?

Hernias are common: about 5 million are diagnosed each year in this country, and about 1 million surgeries are conducted to correct them.

What are the demographics for Hernias?

Lyme disease has been reported in most states, but the highest concentrations are in the northeast and MId-Atlantic states, the upper midwest, and northern california. It is the most commonly reported vector-borne illness in the united states, with about 30,000 new cases reported each year, but the centers for disease control considers the true infection rate to be much higher.

What are the demographics for Lyme disease?

Occurs all over the world affecting all races.

What are the demographics for MD?

Adolescents are the prime demographic for OSD, especially those who engage in running and jumping sports.

What are the demographics for OSD?

PFPS is extremely common; it is the most frequently documented knee injury in runners and other athletes.

What are the demographics for PFS?

TMJ disorders occur mostly in people between 30 and 50 years of age, and women diagnosed with this disorder outnumber men about 4:1. Some estimates suggest that about 10 million people in the united states have some kind of TMJ disorder.

What are the demographics for TMJ disorder?

People who habitually carry heavy loads, who do a lot of repetitive movements with their arms and shoulders, and who spend a lot of time with their arms in the air (electricians, plumbers, painters, and so on) are more at risk for thoracic outlet syndrome than is the general population.

What are the demographics for Thoracic outlet syndrome?

The incidence of compartment syndrome is difficult to guess. Acute compartment syndrome is probably relatively rare, but it can occur as a complication of fractures (especially of the tibia) or crushing injury.

What are the demographics for compartment syndrome?

are found in women about three times more often than men. They are usually seen in children and young adults, with the exception of mucous cysts that often accompany osteoarthritis in older people.

What are the demographics for ganglion cysts?

About 6 million adults in the united states report having had gout at some point. Men between ages 40 and 50 are the most likely to develop this problem. Women can have gout, but it is rare before menopause.

What are the demographics for gout?

about a million joint replacement surgeries are conducted in this country each year. Most of these procedures are for knees, hips, and shoulders. The distribution between men and women is about equal, and most arthroplasty patients are over 40 years old.

What are the demographics for joint replacement surgery?

is the most common form of arthritis, affecting about 27 million people in the united states.

What are the demographics for osteoarthritis?

May get over used by athletic and sedentary people.

What are the demographics for plantar fasiitis?

Different types of sponylolisthesis are associated with different ages. Congenital or isthmic cases may show up in adolescence or young adulthood during growth spurts combined with athletic pursuits. Athletes who lift heavy weights or who twist and hyperextend their spine: gymnasts, wrestlers, rowers, weight lifters, javelin throwers, pole-vaulters, and football players have a particularly high risk.

What are the demographics for spondylolisthesis?

Cervical spondylosis is very common in mature people; about 90% of men over 50 years of age and women over 60 years of age have some evidence of degeneration in the cervical spine, although many do not have symptoms.

What are the demographics for spondylosis?

Are extremely common in the united states; it is estimated that over 20,000 happen each day, just to ankles; this doesn't account for knee, elbow, wrist, and finger sprains.

What are the demographics for sprains?

It is estimated that up to 80%of the population will experience low back pain at some point, and disc disease is a common contributor. sometimes happens with age.

What are the demographics of disc disease?

affects about 10 million Americans, but about 34 million others have a silent preosteoporotic condition called osteopenia. Women with osteoporosis out number men by about 4 to 1, for a variety of reasons.

What are the demographics of osteoporosis?

Gentle massage around the edges of new postoperative scars, and directly applied to older scars, and directly applied to older scars, may be helpful in scar tissue organization. successfully treated hernias makes it where they can get a normal massage.

What are the massage benefit for a hernia?

Manual therapies get generally good results with this condition, as long as care is taken not to exacerbate pain or inflammation. Physical therapy, exercise, and good self-care are often part of successful treatment plan as well. Muscles of the shoulder girdle are likely to be recruited to compensate for lost range of motion; massage therapists are in an excellent position to normalize muscle tone and posture as much as possible.

What are the massage benefits for Adhesive Capsulitis?

Massage that respects the limitations of acute inflammation is safe for clients with bursitis. Clients who have a history of bursitis can enjoy the same benefits of bodywork as does the rest of the population.

What are the massage benefits for Bursitis?

As long as sensation is intact, massage may be helpful in slowing the progression of Dupuytren Contracture or in supporting the growth of healthy functional scar tissue after surgery.

What are the massage benefits for Dupuytren Contracture?

As long as sensation is present and inflammation is not acute, a person with Lyme disease may enjoy the relaxation, relief from anxiety, and general sense of well-being that massage can offer.

What are the massage benefits for Lyme disease?

Lymphatic work may help resolve acute inflammation. in nonflared cases, massage with careful stretching of the quadriceps may ease pain, improve flexibility , and reduce tension in the quadriceps. All of this may allow young athletes to safely return to play sooner than without treatment.

What are the massage benefits for OSD?

Bodywork aimed specifically at the knee,but also systemically, can help to address the tension stiffness and chronic low-grade pain that many people with PFS experience.

What are the massage benefits for PFS?

Massage can help reduce muscle tone, resolve trigger points, and improve client awareness of bruxism and other habits, all of which can improve the outlook for a person with TMJ disorder.

What are the massage benefits for TMJ disorder?

Massage elsewhere than the affected area is safe and appropriate. clients who have successfully treated their baker cysts can enjoy the same benefits from massage as the rest of the population.

What are the massage benefits for baker cysts?

Massage won't reverse a bunion, but it can certainly improve the quality of the life for a person with this painful condition.

What are the massage benefits for bunions?

Chronic compartment syndrome in the lower leg may respond well to massage as a strategy to prevent or delay the onset of pain.

What are the massage benefits for compartment syndrome?

Massage therapy for low back pain in general is often successful for symptom management. Bodywork with the intent to create space for a disc to retreat and to reduce muscle spasm and inflammation (after the acute stage has passed) may be especially useful for clients with disc problems.

What are the massage benefits for disc disease?

Bodywork is not likely to improve a client's ganglion cyst, but massage elsewhere is sage and appropriate: these clients can enjoy the same benefits from massage as does the rest of the population.

What are the massage benefits for ganglion cysts?

When gout is not acute and is successfully treated, patients can enjoy the same benefits from massage as do the rest of the population.

What are the massage benefits for gout?

If a client's hammer toe is rigid, massage may have little immediate or local impact. However, if this situation is still passively malleable, massage may work along with taping, splints, or other devices and stretching to help restore balance between the musculotendinous forces in the foot.

What are the massage benefits for hammer toe?

Massage to the adjoining soft tissues around a weak or unstable joint may be helpful to manage pain, and to improve muscle and connective tissue function.

What are the massage benefits for joint disruptions?

Evidence suggests that massage can improve the symptoms of some kinds of arthritis, which may delay the need for a joint replacement surgery: a definite benefit. Massage can also reduce postsurgical pain and inflammation, and it can improve the quality of scar tissue for better mobility. For clients with older surgeries and no other complications, massage the respects their limited range of motion has the same benefits as it does for the rest of the population.

What are the massage benefits for joint replacement surgery?

Massage and physical therapy may be recommended to preserve function, ease pain, and slow the process of contractures in muscles that are antagonistic to those weakened by the disease. Because sensation is intact with MD, massage is safe as long as systemic weaknesses are recognized and respected. * Passive stretching to delay contractures and prolong muscle function is a key part of physical therapy for MD patients; this can be provided by a massage therapist as well.

What are the massage benefits for muscular dystrophy?

Careful massage can be effective to resolve MPS, by addressing the pain-spasm cycle and the ATP energy crisis that occurs where trigger points develop.

What are the massage benefits for myofascial pain syndrome?

Carefully performed massage, including general work that does not specifically focus on affected joints, has been seen to reduce pain and stiffness and to improve function in osteoarthritis patients.

What are the massage benefits for osteoarthritis?

Massage won't reverse osteoporosis, but it can be a powerful modality to help with pain and limited movement. Any work that respects a client's fragility while working for pain relief is welcome.

What are the massage benefits for osteoporosis?

Massage is often suggested both to decrease tension in nearby muscles and to have an organizing influence on collagen fibers within the plantar fascia itself.

What are the massage benefits for plantar fasciitis?

Carefully performed massage that targets the complicated tangles of soft stresses on the spine can be tremendously useful in addressing many postural deviations.

What are the massage benefits for postural deviations?

Mild muscle injury or periosteum irritation can respond well to massage, which may allow the client to return to pain-free activity sooner than otherwise.

What are the massage benefits for shin splints?

Cramping muscles can respond well to bodywork that is not at the muscle belly, and muscles that have been in spasm or cramp may benefit from the circulatory turnover that massage can provide. When a spasm that splints an injured area has outlived its usefulness, massage can help to reestablish efficient movement, but this is best done incrementally to avoid the risk of reinjury. Op: Acute muscle cramps can often be relieved through stretching and massage to their attachment sites. After the cramp releases and pain is resolved, rigorous massage is safe and useful for local circulatory turnover.

What are the massage benefits for spasms and cramps?

Massage can be extremely helpful for subacute or mature sprains. It can address poor-quality scar tissue and muscle holding around affected joints for improved local nutrition and efficiency of movement.

What are the massage benefits for sprains?

Carefully performed massage at the appropriate stages of healing can be an important contributor to the recovery from a simple muscle strain, turning a potentially painful and long-lasting injury into a relatively trivial event with a successful outcome.

What are the massage benefits for strains?

Various types of massage can contribute to the healing process for chronically irritated tendons. Whether that comes about because of impact on circulation, the mechanical impact of movement and stretching, or neurological soothing isn't clear, however.

What are the massage benefits for tendinopathies?

Massage along with postural and movement education can drastically improve TOS for a person with symptoms due to muscular imbalances. Even in cases where the impingement is not muscular, massage may be able to lessen fascial restrictions and lift the pressure from inflamed nerves in the arms, leading to improved function.

What are the massage benefits for thoracic outlet syndrome?

In the subacute and postacute phases of whiplash recovery, massage can be an excellent strategy to deal with pain, proprioception, muscle tone, movement patterns, and dysfunctional scar tissue. Massage in combination with bony manipulation can be an especially powerful combination.

What are the massage benefits for whiplash?

Acute bursitis can be exacerbated if deep specific massage is applied to the irritated area. Any infection must be resolved before bodywork is applied as well.

What are the massage risk for Bursitis?

If nerves have been damaged, sensation could be impaired in the hand, and this requires special care. Steroid injections may alter the strength of the fascia, which may require adjustments in the intensity of treatment.

What are the massage risk for Dupuytren Contracture?

Intrusive friction around the tibial tuberosity may exacerbate pain and inflammation during acute flares of OSD.

What are the massage risk for OSD?

Massage carries no particular risk for a person with patellofemoral Syndrome, but direct downward pressure on the patella may be irritating.

What are the massage risk for PFS?

Not all jaw pain is caused by TMJ disorder, and it is important to have an accurate diagnosis for the best outcome. Some of the disorders that mimic TMJ disorder contraindicate massage in certain circumstances.

What are the massage risk for TMJ disorder?

untreated hernias are local contraindications for specific massage, because the fascial wall is already compromised: any extra pressure or stretching would not be helpful.

What are the massage risk for a hernia?

Especially in the first "freezing" phase, adhesive capsulitis may be acutely painful and involve active inflammation. Direct and intense bodywork on and around the shoulder capsule at this time may only exacerbate symptoms. Furthermore, patients with adhesive capsulitis in its most painful presentation may be prescribed painkillers that mask important information. It is important that massage therapists don't overtreat this condition while symptoms are temporarily muffled.

What are the massage risk for adhesive capsulitis?

Symptomatic baker cysts present a local contraindication for massage, with the caution that it signs of thrombosis are present then medical intervention is called for.

What are the massage risk for baker cysts?

Acutely inflamed bunions locally contraindicate deep, specific massage, which may exacerbate swelling and pain.

What are the massage risk for bunions?

Acute compartment syndrome is a medical emergency and must be treated quickly to avoid potentially life-threatening complications. Any clients presenting with these signs needs to be referred out immediately. Chronic compartment syndrome may respond well to massage when it is not active or irritated, but when the client is in pain, manipulating affected tissues with anything but the lightest touch is likely simply to interfere with the body's ability to compensate for increasing compartmental pressure.

What are the massage risk for compartment syndrome?

While massage is unlikely to rupture a cyst, deep specific work in the area may be irritating. of course, undiagnosed bumps need to be evaluated by a primary provider.

What are the massage risk for ganglion cysts?

Acutely inflamed gouty joints at least locally contraindicate massage. This situation often involves fever and general malaise, which contraindicates all but the gentlest body work systemically. Any joints that have had multiple gout attacks may be permanently distorted and vulnerable to irritation with pressure or movement: these are local cautions even when the acute stage has passed. Some massage therapists talk about "grinding out uric acid crystals" in the feet. For a person with a history of gout, work of this pressure and intent is not appropriate. A client who complains of pain and shows extreme inflammation around a joint should consult a doctor before applying ice: if it is gout, ice will promote the crystallization of uric acid, making the condition worse.

What are the massage risk for gout?

If a client's foot is hot and inflamed, this is obviously a local caution for any but the lightest touch. otherwise as long as sensation is intact and work is not painful, hammer toe has no specific contraindictations for massage.

What are the massage risk for hammer toe?

Acute traumatic joint disruptions obviously contraindicate massage at least locally. For subacute or chronic problems, the practitioner must respect limitations in range of motion.

What are the massage risk for joint disruptions?

New joint replacements carry specific risks in relation to surgical complications. Older joint replacements must be carefully maneuvered to avoid stressing the joint and putting it at risk for loosening or failure. Always check with the client for limitations in range of motion.

What are the massage risk for joint replacement surgery?

The arthritic phase of lyme disease involves intermittenly severe and painful inflammation of joints; this contraindicates massage, at least locally. Lyme disease can also affect the nervous and circulatory systems, and because treatment can take a long time to take effect, it is especially important for massage therapists to operate as part of a client's health care team.

What are the massage risk for lyme disease?

A person with MD may have general fragility, in the area of muscle contractures. Advanced cases of serious forms of MD may involve heart or respiratory weakness; any bodywork must allow for this fragility. Further, the drug regimen used may alter massage choices; steroids and muscle relaxants have specific cautions for bodywork.

What are the massage risk for muscular dystrophy?

A person with many active trigger points not only experiences chronic pain, but may be easy to overtreat because of an abundance of pain-sensitizing chemicals in the tissues.

What are the massage risk for myofascial pain syndrome?

Acute inflammation contraindicates massage that may exacerbate symptoms, but this is rare in osteoarthritis. As long as bodywork is well tolerated, it carries few risks for osteoarthritis patients.

What are the massage risk for osteoarthritis?

The symptoms of osteosarcoma can look like growing pains or simple soft tissue injury. This may lead patients to seek massage rather than medical treatment, which can delay an important diagnosis. Once the cancer has been identified, care must be taken around the damaged bone, because fractures are a possibility. And of course any massage or bodywork strategy must accommodate for the challenges of cancer treatment, which in this situation involves surgery and chemotherapy at least.

What are the massage risk for osteosarcoma?

If a client has used cortisone injections to treat his or her PF, massage at the site should be avoided until the tissues have stabilized. Acute inflammation (which is rare) should be locally avoided in order to not exacerbate symptoms. Otherwise massage for PF is safe and appropriate.

What are the massage risk for plantar fasciitis?

Muscles that are chronically tight or cramping may not respond well to direct aggressive bodywork delivered to the muscle bellies. Underlying conditions or pathologies that contribute to involuntary contractions must be addressed if cramping is frequent occurrence. A client taking painkillers or muscle relaxants for muscle spasm will not be able to give accurate feedback to the massage therapist about pain or stretching limitations. When muscles are splinting a new injury has passed.

What are the massage risk for spasms and cramps?

When a client's back is acutely painful, massage therapists must be careful not to exacerbate pain or inflammation. Any instability in the low back must be addressed with careful positioning. If symptoms include areas of numbness or reduced sensation, that needs to be pursued with a neurologist.

What are the massage risk for spondylolisthesis?

The main risk for clients with spondylosis is that careless positioning may allow bone spurs to put pressure on nerves. Also, muscles that surround affected areas may be hypertonic for good reason: they could be protecting the spine from movement that may be painted.

What are the massage risk for spondylosis?

Massage other than lymphatic work is not appropriate in the area of an acute sprain. Sprains that are not significantly better within a few days may be complicated by a bone fracture; this must be pursued with another medical professional.

What are the massage risk for sprains?

Vigorous, intrusive massage to a new or acute injury may exacerbate inflammation and tissue damage.

What are the massage risk for strains?

Acute injuries locally contraindicate massage until the inflammation has begun to resolve, but lymphatic work during the phase may be helpful.

What are the massage risk for tendinopathies?

Some forms of TOS are related to anatomical anomalies, and massage Will not resolve this situation. Careful positioning and sensitive work are important to avoid exacerbating impingement of delicate nerves or blood vessels.

What are the massage risk for thoracic outlet syndrome?

The risk for exacerbating inflammation or inappropriately disrupting damaged tissues with vigorous massage during the acute phase of whiplash is important to respect. Further, because damage can affect the vertebrae, central nervous system, and structures of the anterior neck, it is important for a client with a recent neck trauma to be fully evaluated by a primary care provider before using bodywork as a treatment strategy.

What are the massage risk for whiplash?

The primary risk with osteoporosis who receives massage is that a fracture may occur because of undue pressure of problematic positioning on the table. It is important also to remember that elderly clients are unlikely to have only one pathology: this population that may have several problems in addition to osteoporosis that influence bodywork choices.

What are the massage risks for osteoporosis?

Any palpably hot or inflamed situation in the lower leg musculature requires medical attention before massage is appropriate. If a case of shin splints seems particularly long lasting, evaluation for a stress fracture is important.

What are the massage risks for shin splints?

occur when the spine's normal curvature is over exaggerated or moves out of normal planes.

What happens when a person has postural deviations?

Baker cysts form when the joint capsule or a bursa at the back of the knee develops a pouch at the posterior aspect.

What happens when it comes to Baker Cysts?

It is unclear exactly what triggers the facial changes seen with Dupuytren contracture, but it appears in three predictable stages.

What happens when it comes to Dupuytren Contracture?

The left and right sides cannot move independently, but the joint still has a wide range of motion, allowing the mandible to move up, down, forward, back, and side to side.

What happens when it comes to TMJ disorders?

the closer the vertebrae are, the looser and weaker the annulus is-this is what happens on the anterior side of the spine during flexion.

What happens when it comes to disc disease?

Uric acid is a naturally occurring by-product of digestion. Foods and liquids that are high in a substance called purine are particularly potent sources of uric acid. under normal circumstances, uric acid is extracted from the blood by the kidneys, and expelled through the urine. when the process is inefficient or overwhelmed hyperuricemia develops: this is a predisposing factor for gout

What happens when it comes to gout?

When the bones in a joint are not in their optimal relationship, joint function is impaired. This can happen because of specific trauma or because of a congenital problem with the shape of the bones, or it can be a slowly progressive chronic problem of instability without full dislocation.

What happens when it comes to joint disruptions?

synovial joints, especially knees and hips, put up with tremendous weight-bearing stress and repetitive movements; their design is a marvel of efficiency and durability. But the environment inside a joint capsule is precarious; any longlasting imbalance can have cumulative destructive impact.

What happens when it comes to osteoarthritis?

The section on osteoarthritis describes in some detail the changes that happen when damage occurs at the synovial joints. Spondylosis has some features in common with osteoarthritis, but some important differences distinguish the two conditions.

What happens when it comes to spondylosis?

injury to ligaments triggers an inflammatory response and the rapid production of new collagen fibers. These are laid down in a haphazard mass early in the healing process similar to the process discussed in muscle strains.

What happens when it comes to sprains?

Deer ticks and western black-legged ticks pick up the spiral bacterium B. burgdorferi from the blood of animal hosts, especially mice. If an infected tick subsequently bites a human, that bacterium may be transmitted to the human host. Immature nymphs and adults can both transmit the disease, but adults are easier to find and remove. Most human infections come from younger ticks.

What happens when someone has Lyme disease?

The etiology is not at all clear. some experts suggest that it always begins with an adhesion between the anterior aspect of the glenohumeral capsule to the head of the humerus; others propose that it begins in extracapsular tissues like local ligaments, the rotator cuff and biceps muscles, and the subacromial bursae; they suggest that the thickening that happens in the joint capsule is a secondary development.

What happens with Adhesive capsulitis?

The quadriceps group attaches at the tibial tuberosity, a bony landmark that doesn't fully calcify until late in adolescence. The structural weak spot is vulnerable to constant, repeated forceful contractions of the quadriceps that can lead to inflammation and injury.

What happens with OSD?

when the knee is bent or not it is bearing weight, the femur and the patella press together. The patella bone moves superiorly and inferiorly, but it can also move medially and laterally, and it can rotate or tip in any direction. Pressure must be evenly distributed across the back of the patella, or disruptions to the patellar cartilage can occur.

What happens with PFS?

is essentially a connective tissue pouch filled with a viscous fluid. Cysts may have a single chamber, but many have multiple lobes that are connected by tiny channels.

What happens with ganglion cysts?

and other toe problems are multifactoral conditions. They are seen most often in people with second toes that are longer than the great toe, and they occur frequently along with bunions and pes cavus.

What happens with hammer toe?

Abdominal hernias can be classified as fascial disorders because they involve weakness in the connective tissue layers that normally form strong containers.

What happens with hernias?

probably develop as a multifactorial process. Traditionally it was thought that they began as microscopic injuries to individual muscle fiber, and these fibers descend into a pain-spasm-ischemia cycle.

What happens with myofascial pain syndrome?

The turnover of mineral deposits happens constantly, but this activity occurs in trabecular bone at a higher rate than in cortical bone . Osteoporosis develops when calcium is withdrawn from bone tissue faster than it is deposited.

What happens with osteoporosis?

Cancer is the development of cells that replicate in a hyperactive and disorganized way. Osteosarcoma is relatively rare because bone tends not to grow quickly-except in children and young adults: these people are the most vulnerable to this condition, especially during growth spurts.

What happens with osteosarcoma?

Often occurs in conjunction with the growth of bone spurs on the calcaneus. While these spurs were once assumed to be the source of heel pain, that assumption is no longer taken for granted.

What happens with plantar Fasciitis?

It is not always clear muscles contract involuntarily: this phenomenon is suprisingly understudied.

What happens with spasms and cramps (etiology)?

The facet joints in healthy lumbar vertebrae occur on an essentially coronal plane. The superior facets of one lumbar vertebra contact the front sides of the inferior facets of its upstairs neighbor; this prevents the higher bone from sliding forward.

What happens with spondylolisthesis?

osteocyte

a bone cell.

Glucosamine

a compound found in connective tissue, sometimes taken as a dietary supplement for joint health.

purine

a compound found in some foods, which can form uric acid. Meat, organs, and seafood are high in ????

Cauda equina syndrome

a condition in which the inferior part of the spinal cord is damaged, resulting in loss of function.

Dysplasia

a congenital anomaly, ???? involves the formation of an abnormal acetabulum or femoral head. This can often be detected in early infancy, but if it causes no symptoms (usually this means it occurs bilaterally) it may require no treatment. Ultimately a person with hip dysplasia is has an increased risk for both subluxation and dislocation of the affected hip.

Adipocyte

a fat cell.

Myofiber

a muscle fiber

Hiatus

a natural opening

Podagra

a painful condition of the foot (usually the great toe) caused by gout.

Proprioceptor

a sensory neuron that conveys information about muscle tension and joint position.

Oculopharyngeal Muscular Dystrophy

affects the eyes and pharynx muscles first.

joint replacement surgery

also called arthroplasty, is a procedure designed to repair articulating surfaces within a synovial joint.

Bunions

are also known as hallux valgus, which means "laterally deviated big toe." The first phalanx of the great toe is distorted toward the lateral aspect of the foot.

Strains

are injuries to muscle fibers involving the tearing of myofibers and production of scar tissue. They are sometimes difficult to distinguish from tendon injuries, which are discussed in the section on tendinopathies later in the chapter.

Bursitis

are small closed sacs made of connective tissue. They are lined with synovial membrane and filled with synovial fluid.

Ganglion Cysts

are small connective tissue pouches filled with fluid that grow on joint capsules or tendinous sheaths. They usually appear on the wrist, the hand, or the top of the foot, but they have been found elsewhere as well.

Baker Cysts

are synovial cysts found in the popliteal fossa, usually on the medial side. They are also called popliteal cysts.

Sprains

are tears to ligaments, the fibrous connective tissue strapping tape that links bone to bone throughout the body.

Limb Girdle Muscular Dystrophy

begins in the shoulders, upper arms, and pelvic area.

Adhesions

collagen that is manufactured around an injury isn't laid down in perfect alignment with the muscle fibers: instead it is deposited quickly but in haphazard form. Randomly arranged collagen fibers tend to bind up different layers of tissue that are designed to be separate.

Chondral

having to do with cartilage.

Congenital Muscular Dystrophy

includes several rare varieties that are diagnosed at birth or in early infancy.

Sciatica

irritation of the sciatic nerve. often causes pain that radiates down the leg through the buttox.

Plantar Fasciitis

is a common condition involving pain at the plantar fascia, which stretches from the calcaneus to the proximal phalanges on the plantar surface of the foot.

spondylolisthesis

is a condition in which a structural problem in the lumbar spine allows one or more vertebral bodies to slip anteriorly. This can involve tiny or large bone fractures, and put pressure on nerve roots at the intervertebral foramina, or on the spinal cord itself in the spinal canal.

Osteoarthritis (OA)

is a condition in which synovial joints, especially weight-bearing joints, lose healthy cartilage. This condition is distinguished from other types of arthritis by being related to age and wear and tear, along with biomechanical factors and the consequences of inflammation. The etiology of ????? is restricted to synovial joints. Arthritis at the spine has some important differences, and is discussed in the section titled spondylosis.

Hammer toe

is a foot deformity that affects the lateral toes. The second toe is most commonly affected, especially when this digit is longer than the great toe.

Osteosarcoma

is a form of cancer that originates in bone tissue. It is most common in adolescents and young adults.

Spondylosis

is a form of degenerative arthritis, involving age related changes of the vertebrae, discs, joints, and ligaments of the spine. It happens most frequently and most severely at the neck.

Patellofemoral pain syndrome (PFS)

is a group of conditions in which the patellar cartilage becomes irritated as it contacts the femoral cartilage. This situation can be a precursor of osteoarthritis at the knee.

Muscle Dystrophy (MD)

is a group of several closely related neuromuscular diseases characterized by genetic anomalies that lead to the degeneration and wasting away of muscle tissue.

Thoracic Outlet Syndrome

is a neurovascular entrapment.

Scoliosis, rotoscoliosis

is a problem for approximately 1% to 2% of teenagers. It progresses in girls much more frequently than boys, and almost always involves a bend to the right.

Shin splints

is a term that refers to a variety of lower leg problems. Medial tibial stress syndrome is the injury most commonly associated with ?? ????.

Lyme Disease

is an infection with a spirochetal bacterium called Borrelia burgdorferi. This pathogen spreads through the bite of two species of ticks: deer ticks (Ixodes pacificus). These ticks are very small, especially in the nymph stage, when they most frequently affect humans. This can make it difficult to find them on the skin. An unfed deer tick nymph is about as big as a sesame seed.

Spasms, Cramps

is an involuntary contraction of a voluntary muscle.

Hyperlordosis

is an overdeveloped lumbar curve.

hyperkyphosis

is an overdeveloped thoracic curve.

Disc Disease

is an umbrella term referring to a collection of problems in which the nucleus pulposus and/or the anulus fibrosus of an intervertebral disc extends beyond its normal borders.

Tempromandibular joint Disorder

is an umbrella term that can refer to multitude of common problems in and around the jaw. This collection of signs and symptoms is usually associated with malocclusion (a dysfunctional bite), bruxism (teeth grinding), and loose ligaments surrounding the jaw.

Tendinopathies

is an umbrella term that covers injury and damage to tendons and tenosynovial sheaths. Longterm degeneration of tendon.

Osgood-Schlatter Disease (OSD)

is irritation and inflammation at the site of the quadriceps attachment on the tibia. It can also be called tibial tuberosity apophysitis. It occurs when the quadriceps muscles are vigorously used in combination with rapid growth of the leg bones, typically during an adolescent growth spurt in athletic children.

Osteoporosis

literally means "porous bones." In this condition, calcium is pulled off the bones faster than it is replaced, leaving them thin, brittle, and prone to injury.

Diaphysis

long bones its hollow, filled with red marrow in youth and yellow marrow in adulthood. (The shaft of a long bone)

Hernia

means "hole." A variety of ???? can occur in the body: muscles may herniate through fascial walls; vertebral discs may herniate; the brain may even herniate through the cranium.

Facioscapulohumeral muscular dystrophy

primarily affects the muscles of the face, shoulder, and upper arm.

Emery-Dreifuss Muscular Dystrophy

shows contractures of the Achilles tendon, elbow, and spine.

Contractility

the ability to contract

people with osteoporosis are prone to fractures with little or no cause; these are called spontaneous or pathological fractures.

what are the complications for osteoporosis?

Massage can help reduce pain and stiffness, and improve the general quality of life for clients with spondylosis-as long as general cautions for frailty and positioning are observed.

what are the massage benefits for spondylosis?

Disc problems can be complex and difficult to pin down: these are situations where massage therapist can benefit most by working as part of a health care team. Acute inflammation and muscle splinting to guard an unstable area call for bodywork that respects these processes rather than interfering with them.

what are the massage risk for disc disease?

Some postural deviations are the result of serious underlying conditions. These must be identified and accommodated as part of a massage therapy strategy. Of special note: hyperkyphosis may be related to osteoporosis and extremely brittle bones. Outside of these cautions, massage has few risks for a person with postural deviations that do not interfere with lung or cardiac function.

what are the massage risk for postural deviations?

The precipitating factor for most joint replacement surgeries is osteoarthritis, or "wear and tear" arthritis. Rheumatoid arthritis, avascular necrosis, or serious trauma (sometimes related to osteoporosis) may also contribute to reasons for an arthroplasty. In any case, this surgery is only conducted when all other options, including exercise, braces, anti-inflammatory medication, cortisone injections, and less invasive surgeries are no longer adequate interventions.

what happens when it comes to joint replacement surgery?


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