Body, Soul & Spirit - Nicolas Kindt, Med. Masseur EFA

14/12/2025

Spannend😉👍🏻

21/08/2025

Ich freue mich sehr Christian Sommavilla als neuen Mitarbeiter ab August 2025 bei mir in der Praxis Body, Soul & Spirit GmbH begrüssen zu dürfen.
Christian, schön bist Du da!

Nach 15 Jahren alleiniger Tätigkeit, ist dies ein grosser, nächster Schritt in eine tolle Zukunft, welcher ich voller Freude entgegenblicke.

Als Team sind wir gemeinsam für Dich da und freuen uns auf Deine Terminvereinbarung.

Besuch doch unsere neue Website um mehr zu erfahren:

https://lnkd.in/dUkkscwk

̈rtherapie@

17/12/2024

So true💪🏻🔥👍🏻😉

08/09/2024

Listen😉

15/10/2023

Bakercyste😉👍🏻

Baker’s Cyst 🦵 💡

ETIOLOGY

👉 A Baker´s Cyst, also known as a popliteal or parameniscal cyst, is a fluid-filled sac that forms in the posterior aspect of the knee, typically located between the semimembranosus and medial head of the gastrocnemius.

👉 The eponym “Baker’s cyst” honors British surgeon William Morant Baker’s, who wrote a description of 8 cases of popliteal cysts that he had seen. https://pubmed.ncbi.nlm.nih.gov/8119018/

👉 Baker's cysts are encountered most frequently in adults with a history of trauma (e.g., cartilage or meniscus tears, injury to the knee), in association with degenerative/co-existing knee joint disease (e.g., osteoarthritis, rheumatoid arthritis, infectious arthritis, pigmented villonodular synovitis, meniscal tears), or asymptomatically as an incidental finding. https://pubmed.ncbi.nlm.nih.gov/28007292/

PATHOPHYSIOLOGY

👉 A valvular opening of the posterior capsule, high up on the medial side and deep to the medial head of the gastrocnemius, is present in up to 40% to 54% of healthy adult knees, based on cadaveric studies. https://pubmed.ncbi.nlm.nih.gov/7436561/, https://pubmed.ncbi.nlm.nih.gov/4751777/

👉 Radiopaque dye has been injected into popliteal cysts, confirming that fluid flow is from the knee joint into the cyst, while reverse flow was not possible. https://pubmed.ncbi.nlm.nih.gov/4751777/

👉 It is thought that this 1-way valvular opening allows fluid to pass into the gastrocnemius-semimembranosus bursa. https://pubmed.ncbi.nlm.nih.gov/26137182/

👉 As an effusion is often present with intra-articular pathology, it is possible that the Baker’s cyst may provide a protective effect on the knee by decreasing the hydraulic pressure within the knee through the 1-way valve. https://pubmed.ncbi.nlm.nih.gov/4916772/

👉 This argument is strengthened by the finding that the volume of the popliteal cysts is associated with the size of the knee effusions. https://pubmed.ncbi.nlm.nih.gov/11409127/, https://pubmed.ncbi.nlm.nih.gov/10873212/

👉 This valvular opening allows flow during knee flexion, but it is compressed closed during knee extension due to tension in the semimembranosus and the medial head of gastrocnemius. https://pubmed.ncbi.nlm.nih.gov/7436561/

CLINICAL DIAGNOSIS

👉 A Baker's Cyst typically is diagnosed by having the patient stand and extend the knee full; this is when the mass should be most prominent and firm. When the knee is flexed to 45 degrees, the mass often either softens or fully disappears (this finding is commonly known as “Foucher sign” and is due to cyst compression between the medial head of the gastrocnemius and semimembranosus as they approximate each other and the joint capsule during knee extension, https://pubmed.ncbi.nlm.nih.gov/3579388/)

👉 It is useful for differentiating a Baker’s cyst from other popliteal masses, such as popliteal artery aneurysms, ganglia, adventitial cysts, and tumors, for which the palpation of the mass is unaffected by the knee position. https://pubmed.ncbi.nlm.nih.gov/3579388/

TREATMENT

👉 Treatment is not usually necessary for a Baker's Cyst unless the patient is symptomatic. https://pubmed.ncbi.nlm.nih.gov/30230249/, https://pubmed.ncbi.nlm.nih.gov/27468670/, https://pubmed.ncbi.nlm.nih.gov/27134018/

👉 Incidental findings in the asymptomatic patient are managed with observation and reassurance alone.

👉 The initial treatment for symptomatic popliteal cysts should be nonoperative for at least 6 weeks, unless vascular or neural compression is present and directed towards treatment of the underlying intra-articular lesions. During this time, rehabilitation focusing on maintenance of knee flexibility should be emphasized to avoid stiffness that can develop from pain occurring at terminal flexion and extension.

👉 Intra-articular corticosteroid injections have been found to decrease the size and symptoms of the cysts, and their use can be considered during conservative management. https://pubmed.ncbi.nlm.nih.gov/16547992/

👉 If the pain fails to resolve with this conservative approach, usually under 2 months, then surgical treatment may be considered directed to the intra-articular cause of the joint fluid production and not at the popliteal cyst unless it is unduly large and highly symptomatic. Surgical excision of the Baker’s cyst without treatment of any intra-articular lesions has been reported; however, the results have been disappointing because of the high rate of recurrence. https://pubmed.ncbi.nlm.nih.gov/5536022/, https://pubmed.ncbi.nlm.nih.gov/525326/

10/09/2023

Bitte unterstützen😉👍🏻💪🏻!

Die Physiotherapie leistet einen wichtigen Beitrag zur medizinischen Grundversorgung. Seit Jahren kämpfen Physiotherapeut:innen für einen kostendeckenden und zeigemässen Tarif. Doch jetzt will der Bundesrat mit seinem Vorschlag (https://www.physioswiss.ch/de/news/2023/tarifeingriff-klare-ablehnun...

06/09/2023

5⃣ Reasons Why Some Herniated Intervertebral Discs are Painless

👉 Despite clear findings of an herniated intervertebral disc (HIVD) on MRI or CT, many HIVDs do not cause pain. Jensen et al reported that only 36% of 98 asymptomatic patients had normal discs at all levels on MRI, with 52% showing a bulging disc at least at one level and 27% with a disc herniation. https://pubmed.ncbi.nlm.nih.gov/8208267/

💡 Shin & Chang propose five reasons why some HIVDs do not induce pain. https://www.dovepress.com/five-reasons-why-some-herniated-intervertebral-discs-are-painless-peer-reviewed-fulltext-article-JPR

1⃣ Chemical inflammation around the sinuvertebral nerve and nerve root is the main mechanism of pain in an HIVD, together with direct mechanical compression of these nociceptive nerves. https://pubmed.ncbi.nlm.nih.gov/12616153/. An HIVD can be painless if compression and inflammation are insufficient to cause pain.

2⃣ Although rare, motor weakness or sensory deficits without pain may develop following HIVDs. Painless weakness or sensory deficits following HIVDs suggest less of a transient, inflammatory component and more of an established mechanical component. Compression of nerve tissue in the absence of inflammation results in painless loss of motor or sensory function. https://www.sciencedirect.com/science/article/pii/S1040738315001008

3⃣ Secondary change in gene expression within the dorsal root ganglia (DRG) after HIVDs might be attributed to painless HIVDs. Gene expression within the DRG dynamically changes after an HIVD has developed, which alters the level of protein production of certain factors related to the inflammation process and nociception (ie pro-inflammatory, pro-apoptotic, and pro-nociceptive factors). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404509/ If gene expression within the DRG changes in a way that prevents persistent inflammation through natural adaptation processes or treatments, there may be no pain even in the presence of an HIVD.

4⃣ Reorganisation of neural circuits within laminae I–III of the spinal dorsal horn could be the cause of a painless HIVD. Inhibitory and excitatory interneurons in these laminae play an important role in the nociceptive signalling pathway through modulating the activity of wide dynamic range neurons and nociceptive-specific neurons in the spinal dorsal horn. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6703564/ During reorganisation because of neuroinflammation, when inhibitory synapses are greatly increased compared with excitatory synapses, the secretion of neurotransmitters involved in the transfer of nociceptive signals is significantly reduced. In such situations, patients may not experience pain, even in the presence of an HIVD.

5⃣ An HIVD can be painless in patients with an effective pain coping strategy. Pain is a complex sensory and emotional experience that involves both physiological and psychological factors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680716/ Coping strategies can influence pain perception and the level of pain experienced by patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957813/ Additionally, people with effective coping strategies may have a higher tolerance for pain, and their bodies may release pain-relieving chemicals that mask any discomfort from pain.

24/04/2023

🤗❤️

23/04/2023

😉

Bitte denkt auch an die Tiere des Waldes