.JPG&w=300) In this glossary you will find an illustrative explanation of some keywords which are frequently used in research papers and, more general, in updated Orthopaedic Medicine Cyriax, as well as some summarized descriptions of certain clinical images and diagnostic procedures
General remark : sometimes I refer the reader to "Part I" and "Part II" for further information on that specific subject i.e. the two books "Orthopaedic Medicine Cyriax : updated value in daily practice, Part I and Part II "
I also refer to the interesting glossary of some other publications such as :
"Orthopaedic Medicine, a practical approach ; Kesson-Atkins, 2nd edition, Elsevier BH 2005" and
"The lumbar spine, mechanical diagnosis and therapy, volume one, McKenzie-May, Spinal publications New Zealand 2003"
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Macrofailure
Occurs when there is rupture of a structure and it is unable to sustain further load.
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Manipulation
We use different kinds of manipulation : in the extremities we use manipulations with a traction and rotational component in order to shift a loose body. In certain chronic lesions (e.g. after inversion trauma foot) manipulation can be used too in order to rupture the adhesions.
Manipulation under traction is also used for reduction of spinal disc protrusions.
The very specific indications and contraindications for spinal manipulation need to be respected.
(Part II, p5-73)
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McKenzie
For what is concerned diagnostics there is high degree of compatibility. Both methods are, after detailed study, even taking into account some contradictions, very compatible.
Treatment techniques are very similar, but the strategy is different, opening new perspectives.
I am convinced that a McKenzie therapist, without solid updated Cyriax basis, misses something and vice versa. The combination of both methods can increase the diagnostic and treatment efficiency.
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Mechanical pain
Pain that results from mechanical deformation of tissues is mechanical pain. This occurs with abnormal stresses on normal tissues, as in the postural syndrome, and normal stresses on abnormal tissues, such as in derangement and dysfunction.
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Mechanical response
Change in mechanical presentation, for instance an increase or decrease in ROM in response to a particular loading strategy.
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Medial collateral ligament
A sprain of the medial collateral ligament is a frequently seen lesion in the knee.
Diagnosis is not always abvious since, in the knee, after a trauma there can be a confusing, masking posttraumatic capsular reaction. History will provide important information.
In an acute, subacute and chronic stage we provide a specific treatment consisting of transverse friction massage and mobilisation.
In the medial collateral ligament, the lesion lies at one of the following three sites :
generally at the joint line.
Adhesions here cause a slight limitation of flexion. The clinical examination shows :
passive extension and passive lateral rotation are slightly painful
valgus strain markedly painful
slightly painful limitation of flexion (-5°,-10°)
the pain is felt medially.
This is the typical pattern of adhesions in the MCL.
The lesion can also lie at the femoral insertion or at the edge of the tibial condyle.
Adhesions at the femoral insertion do not cause limitation of range, making manipulation unnecessary (see further).
(Part I, p131-133 ; Part II, p29-30)
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Medical imaging
Can be helpful for differential diagnostic purposes, but don't consider the result of medical imaging as THE thruth ; it only offers part of the truth, being helpful for differential diagnostic purposes.
(Part I, p1)
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Mensical lesion
Besides the bucket handele meniscal lesion, there exist other more frequent types of meniscal lesion : when the first attacks occur after the age of 30, another type of meniscal lesion is suspected (posterior or horizontal). The symptoms are the result of too much loading on a degenerated disc and are often less acute and treatment is not always necessary.
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Microfailure
Occurs when a structure reaches its elastic limit with progressive failure of cross links and fibrils.
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Morton's metatarsalgia
Acute metatarsalgia (Morton)
Typical history : sudden sharp pain on walking (the pain lasts a few minutes, but the foot remains warm for several hours) ; long painfree episodes between the
attacks.
Negative clinical examination.
Cause : neuroma of the digital nerve between the metatarsal heads 4-5 (or 3-4).
Treatment : support under the 4th metatarsal head.
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