Muscle Mice

[supasta]

Anyone ever hear of this term?

 

[Chyeah(:]

Nope! But I know what Joint Mice are.

 

[irishgreenc16]

Nope! But I know what Joint Mice are.

t102

I don't know what either are!

:

 

[Antonia]

What is joint mice???

 

[Khan]

Joint mice is a term to describe loose pieces of cartilage moving around the joint. It's called joint 'mice' because they move around and seem to appear and disappear. I've only been taught about it in relation to knee injuries.

 

[Real Deal CowGirl]

Did they teach anything on treating it, relieving it??? I have a client, he said muscle mice but I assume he was wrong and it is really joint mice. Its in the shoulder. I had looked it up and found nothing..... I thought he was making it up to mess with me!

 

[Aleisha]

Not that I'm aware of, it is caused by loose cartilage in the area so I don't know how massage could help. Sometimes they can cause the joint to lock up, but then they move and the joint is fine.

 

[J J]

This guy is locked up a lot. So doing ROM, will that get the mice to relocate or just irratate the situation, you think?

 

[flexcavano]

I don't think ROM would help out much and might just create another opportunity for his shoulder to lock up. But I really don't know b/c I've never worked on someone who had that problem.

There's a great group on yahoo.com called orthopedic_massage, it's run by Whitney Lowe and he or someone on there may be able answer your question.

 

[Mommylh]

muscle mice

I once read an article, possibly in Massage & Bodywork Magazine, that referred to "back mice". It was in referrence to those moveable lumps in the low back/sacral area that no amount of massage can get rid of. The author's explanation was that they are tears in the fascia that allow the underlying fatty layer to protrude, making a lump. They are usually very tender, and massage, especially deep, vigorous work, makes them More tender, which makes sense if they are actually underlying tissues protruding through a tear. The author didn't offer any treatments that I can remember. I would be interested to hear if anyone out there has found a treatment that reduces these things, as I have several clients who have them, and I have a couple myself!

 

[cmeduck]

muscle mice

I once read an article, possibly in Massage & Bodywork Magazine, that referred to "back mice". It was in referrence to those moveable lumps in the low back/sacral area that no amount of massage can get rid of. The author's explanation was that they are tears in the fascia that allow the underlying fatty layer to protrude, making a lump. They are usually very tender, and massage, especially deep, vigorous work, makes them More tender, which makes sense if they are actually underlying tissues protruding through a tear. The author didn't offer any treatments that I can remember. I would be interested to hear if anyone out there has found a treatment that reduces these things, as I have several clients who have them, and I have a couple myself!

http://www.massagetherapy.com/articles/index.php/article_id/602

The Problem With The Back Mouse
Diagnosing and Dealing with Episacroiliac Lipoma

Anyone who performs bodywork has encountered this situation at one time or another: The client presents with an episode of sharp, severe, low back pain.There may be a history of pain with lifting or prolonged sitting and the pain is usually greater on one side more than the other. The pain may radiate into the buttocks and sacrum and perhaps to the lateral thigh and into the lower extremity. The pain may worsen with extended sitting and with any forward flexion of the spine.

Medications may not be helpful and the client is usually unable to find a comfortable position. The client has tried everything, been everywhere and you are his last hope. When asked to point to the area of the greatest pain, he will invariably point just above and lateral to the natural "dimple" where the back and buttocks come together, near the multifidis triangle. When that area is palpated, the most marked finding is one or several firm, mobile 1-3 cm nodules that, when pressed, reproduce the client's complaints of back pain as well as the "sciatic" pain. The photos below map the location on two clients. Clients often exclaim, "That's it. That's where all my pain comes from!" You have just found the elusive "back mouse."


A Sensitive History
The term "back mouse" is a rather cute description for a very painful yet often overlooked problem, even by back pain specialists. Originally termed the "episacroiliac lipoma" by E. Ries in 1937,1 it was later labeled the "back mouse" by Peter Curtis in 1993.2

I first encountered the back mouse while learning various soft tissue techniques in chiropractic school. While palpating over the sacral region, I would feel these small, firm, fleshy yet moveable nodules. Firm pressure directly on the nodules would produce pain and tenderness, as well as local radiation into the sacrum and hip. Thinking that they were trigger point nodules, I would apply direct and deep ischemic compression, which only served to aggravate any pain. This however did not dissuade me from applying deeper pressure, as this was most certainly not bone and we were taught to apply trigger point therapy to soft tissue nodules. They appeared to be definite, moveable and encapsulated masses much like a subcutaneous lipoma and not at all like a band of skeletal muscle. Further-more, I had encountered many subcutaneous lipomas in the back region and they were always the same: Moveable, non-tender "speed bumps" that caused pain only when they compress the underlying soft tissue.

Subcutaneous lipomas are found all around the body, grow slowly over time and are only cosmetically important. The back mouse, though, is only found around the sacral region and is generally tender and at times painful. Also, the back mouse seems to suddenly appear following trauma to the back as in motor vehicle accidents or perhaps following a lifting injury.3 The size of the nodules does not change and they remain the same regardless of the administered soft tissue treatment, so they couldn't be muscular. But why would a lipoma be both tender and predictable in location?

Perhaps a more descriptive term than the back mouse is actually that of the "lumbar fascial fat herniation" as described by W. S. C. Copeman and W. L. Ackerman.4 Some other terms are: Episacral lipoma, iliac crest pain syndrome5 and multifidus triangle syndrome.6 A lumbar fascial fat herniation occurs when the lumbar subfascial fat layer (see Figure 1) herniates through the overlying thoraco-dorsal fascia (see Figure 2) and gets trapped and inflamed. The mechanism appears to be due to an anatomical defect or weakened area in the fascia, which, when there is increased internal pressure, allows the fat lobules to push through the fascia.7 Once herniated, the fat becomes trapped and as an expanded, inflamed, herniation in an otherwise unyielding fibrous capsule, this creates a focus of pain. Pressure on the lipoma does not push it back through to fascia but only inflames the torn fascia more. These herniations occur at predictable sites along the iliac crest and sacrum very close to the natural dimple area (see Figure 3). They also are approximately three times more prevalent in women, particularly in moderately obese women.8

Over the years I have also encountered many episacral lipomas and I am always amazed at the strength of the positive "doorbell" sign. It is a reliable sign in that firm pressure usually reproduces the exact complaint that the client relates in their symptomatology. Direct pressure even reproduces the sciatic or radicular-type pain without any stretching of the sciatic nerve and without any motion to the lumbar facetal or sacro-iliac joints. In this respect, it is similar to the active trigger point with a zone of referral. But if it is not purely a muscle problem, nor joint, nor nerve, then how do you conquer the back mouse?


Cycle of Pain
Unfortunately, typical "back mouse" clients have usually run the gamut of treatment protocols. They have seen and have had evaluations by multiple specialists including acupuncture, chiropractic, orthopedic, neurological, psychological, etc. They have perhaps been diagnosed as having myofascial pain syndrome, fibromyalgia, chronic low back pain strain or fibrositis as well as arthritis, disc herniations, etc. They may have had radiographs, MRI studies or nerve conduction studies, all with usually negative or minimal findings. Or they may have a minor disc bulge without nerve compression, yet the pain exactly mimics a disc herniation.

There appears to be a focus by back pain specialists upon the disc and nerves even though these lipomas are readily palpable. Many have had epidural injections without success. I have had clients who have had surgery for disc herniations yet who still point to the back mouse as a large perceneforum.xxxe of the post-surgical pain. It is perhaps considered diagnostic for the presence of a lumbar fascial fat herniation if a local infiltration of anesthetic takes away the pain. But many clients do not want to pay the $150 or so for a few hours relief. Many have gone through the pain pill merry-go-round, taking a cocktail of pain and anti-inflammatory medications even though the pain never truly goes away. There is a wealth of information to be gained through digital palpation, something at which massage and bodyworkers usually excel. A client with excruciating low back pain, the presence of the back mouse and pain reproduced at the site of the lipoma should lead the practitioner toward manual soft tissue therapy for a lumbar fascial fat herniation unless proven otherwise.


Avenues of Relief
If the back mouse fails to respond to conservative treatment, I recommend the client see his primary care physician, chiropractor or acupuncturist, and request further evaluation. A medical doctor can inject the back mouse with a local anesthetic, which may help temporarily. Dry needling techniques by acupuncturists may help reduce the tension in the fibrous capsule. Excellent results also may be obtained with local electrical stimulation. Perhaps the only permanent cure for the back mouse is its excision and removal. Those patients who are at the end of their proverbial rope, I send to a hernia repair specialist. Once the fat herniation is excised, the fascial tear is repaired and the client enjoys a more enduring and sometimes dramatic relief. One problem is that so many medical doctors fail to recognize this condition, they tend to discount its existence thereby limiting the treatment options.

The back mouse is a fairly common problem, which on first view may have a symptomatology similar to a disc herniation. It can be responsible for a significant degree of low back pain that's absent from positive diagnostic studies. The considerable level of pain may at first be daunting for the bodyworker. However, if the practitioner first recognizes the existence of a fascial fat herniation, palpation confirms the condition. Conservative treatment geared toward pain relief and treating the fascial tear rather than trigger point therapy on an inflamed, herniated and edematous fat lobule is most helpful. Changes in lifestyle and exercise may help to further alleviate the condition, and other treatment options are always available should the back mouse present itself.

 

[Jeff B]

Soothing the Back Mouse
For the past 10 years, I have been an advanced course instructor for the palpation and biomechanics classes at the Touch Therapy Massage Institute. In each class of 20 to 22 students, we find at least two to four individuals with tender episacral lipomas. I tell them that when I have a client with an obvious back mouse, I apply the following rules:

Do not apply deep pressure. Doing so may only serve to aggravate the herniation. Deep pressure may and should be applied to the surrounding paraspinal and hip musculature (as client comfort will allow), but avoid applying pressure directly on the lipoma. Since it is a fascial problem, I apply a fascial stretch to the thoraco-dorsal fascia. I apply trigger point therapy to the surrounding musculature and a sports massage to the low back, again excluding the lipoma itself.

Do not stretch the low back. Many clients feel they should stretch the low back, usually by touching their toes or by twisting. It is through an inherent fascial weakness or faulty biomechanics that this problem evolved and when the client puts additional pressure on the fibrous capsule, the inflammation may worsen. I do recommend stretching when the back pain improves above a 50 percent level, but not before. When stretching the hamstrings, I always have the client standing with the leg elevated on a chair -- or something of waist height.

Do not suggest exercise. Exercise tends to aggravate the problem at least until the client improves above the 50 percent pain level. Many clients I see actually aggravate the back mouse while doing some kind of exercise. They have the misconception that painful soft tissue needs exercise so they tend to overdo it. As they improve through treatment, some mild exercise should be added. I recommend tai chi, qigong or swimming as the best exercises for someone with a back mouse.

Apply ice. Since the back mouse results in inflammation, ice will tend to sedate the nerves and cool the heat. After a treatment, I tell the client to go home and apply ice for a few minutes at a time. As he improves, I tell him to start using heat as long as he does not fall asleep on the heating pad.

Avoid lying on a hard surface. Some clients have heard that for back pain, they should lie on a hard surface. This may be true for some conditions, but not for the back mouse. The pressure on the capsule may aggravate the condition and cause further inflammation.

Avoid prolonged sitting. Prolonged sitting and/or prolonged driving tends to aggravate the condition first by direct compression of the lipoma and then by deconditioning of the low back. The hamstrings tend to tighten and the abdominal muscles weaken. This will cause the low back musculature to tighten, further putting pressure on the fascia. If the client spends hours in traffic, a low back support pillow or rolled-up towel is helpful.

 

[GucciGirl]

I wanted to update this. His condition is joint mice. I actually did have some communication with Whitney Lowe on his board.

My sessions with him are Asian Bodywork. The best relief he says he had so far was the last session, I did cupping. It stayed in good shape for weeks. I also do gentle traction and shaking and limit the ROM.

He does need surgery. Apparently that was to happen or was discussed then he moved away from that area and started over. Also he told me the first doctor or maybe a PT suggested extreme heat/cold treatments. I asked him if he does that and he said no.

Hopefully this will help someone else.

 

[Lily<33]

The medical term is Osteochondritis Dissecans.

 

[sandy123]

I have mice too...on both side of lower back but more on the right. An infestation on the right and some stragglers or runts on the left it seems. It is very relieving to read that this is actually something identifiable, even if now as easily "curable" It has been long term for me too. Nobody medically seems to want to admit they don't have a clue what they are. Most take a guess that it's the nearest thing in the vicinity like a muscle attachment or something. It is not a muscle attachment issue! Oh no, and definitely those babies do not like or respond well to pressure. No way. And SI problems are horrid.

My suggestion for SI issues would be to go to someone certified in Mayan/Arvigo Technique Abdominal Massage. They do work on the abdomen, but a very large part of the massage is working with the hips and getting all of that in alignment using the soft tissue and releasing ligaments in the pelvis and stuff. I just went today for my first whole session. I took the self-care course that is required before you can take training to become a practitioner and got a mini-session and learned the self-care routine. But you need to have a good full-session to get in the hip work (which you can't really do on yourself!) It's very beneficial.

I've been going to chiropractors for over a year and I never get the twist in my pelvis and SI issues fully addressed, but the Abdominal Massage gets straight to the point when it comes to that. For myself a lot is soft tissue related and it's the soft tissue that hold the bones in place. Plus, its kind of hard to leave out the front of the body when you're addressing the back of the body...it's all connected...for everyone but especially women with all the stuff housed in our abdomen with the uterus and all the ligaments and stuff holding things in place. Anyway that's my spiel.

bonniebeegood I send my thoughts out to you. Omg, hypochondria! Ughhh! If I find anything else out about the mice or something to help with them I'll keep you informed. And if you find something out before I do I'd love to hear about it too! I guess we are on mouse patrol.

healingtime

 

[blackflamez951]

Thank you Stacia for posting the medical term.

Before I found this forum, when clients would ask what those spots were I would tell them I didn't know for sure, but it could be fatty deposits. I told them if the spots didn't bother them, not to worry about it. But, if the spots caused them pain, to get it checked by their doc. :undecided:

After finding this thread, I could then tell them I didn't know the medical term, but I have heard it referred to as Muscle Mice.

Then, the same day you posted the term Osteochondritis Dissecans, I had a client asking me about it. She used to be a RN and she was also thrilled to know what she is dealing with. Talk about synchronicity, huh?

Also, I personally have not applied deep pressure to these spots, or tried to work them out as trigger points. All clients with this have extreme sensitivity in the area, and just always seemed counterproductive to me.

I am so sorry, bonniebeegood, that you had therapists cause you pain and NOT respond by adjusting pressure or leaving the area. I have no respect for those therapists who don't respect their client's bodies. I wish you the best on your healing journey.

 

[Echo Kilo]

Just a note here, because it seems that this thread is talking about two totally different things and possibly some people could get confused.

• Laymans terms for Osteochondritis Dissecans = "Joint Mice"
  
• Laymans terms for Lipoma = "Muscle Mice", or at least that is how it appears from this thread. I have never personally heard of that laymans term for lipoma, but apparantly it exists.

Article from The Journal of Bone & Joint Surgery RE: Osteochondritis Dissecans aka "Joint Mice" -- OSTEOCHONDRITIS DISSECANS: CONCERNING ITS NATURE AND RELATION TO FORMATION OF JOINT MICE

Article on Lumbosacral Lipomas from the Journal of Neurology, Neurosurgery & Psychiatry -- Lumbosacral lipomas: critical survey of 26 cases submitted to laminectomy

And, here's an old 1975 article on Subcutaneous Lumbosacral Lipomas (pdf file of the same article is HERE)

 

[Avinash kumar]

I actually started this way back and what I believe my client has is joint mice though at the time he said muscle mice.

If anyone deals with joint mice, I would HIGHLY recommend cupping the joint and shu points on the back and small intestine points on the scapula.

 

[Barcode]

Back Mice

This is an awesome thread.

I've asked numerous doctors that I work for about these things and none of them have heard of it.

Thank you all that have contributed to this thread! Very informative!

 

[MississippiQueen]

Back Mice

I’ve also been very interested in this topic. In fact, I arrived at massageplanet through this thread, by way of an internet search for back mice, and this is my first post.

Yes, I too have these pesky and sometimes painful lumps, which I’m sure I’ve had for a very long time and only just figured out what they were.

Amazing that they didn’t mention them in massage school and no acupuncturist or LMT I’ve talked to has heard of them. And I know they’re quite common (the client I worked on last night had lots of them- but no pain).

For many years I’ve had very occasional flare-ups of mild lower back pain... but it didn’t feel like my discs were involved, and the pain would go away after a massage and/or emotional healing work- so I didn’t consider it a huge problem- until a couple of months ago when I was hit by a confluence of major life stressors. At the same time some mega internal healing was taking place (I’m an extreme abuse survivor) and my lower back started hurting so much that I could barely walk.

The pain sent me on a quest to figure out what the lumps were, which I finally did through the few articles on “back mice” found on the internet.

This thread though was the first place I found some reasonable and wholistic advice on what to do i.e. Mayan Abdominal Massage, which I tried. The therapist said that my uterus (yes I’m female) was tilted to one side and gently coaxed it (her) back to the center.

It was a lovely and powerful massage and when I got up off the table the pressure on my back was gone. The therapist taught me abdominal self-massage and I’ve since been doing it regularly.

The Mayan Abdominal Massage really helped, and I’d highly recommend this modality to anyone but… some level of pain did return (not nearly as bad as it was) and tends to flare up every few days. Therefore, I’m still working on healing it, which I’m hoping to do myself.

To me it seems that on a normal basis I co-exist quite well with these mice, but the pain comes when something makes them swell up. Also, if they are made of fat that has pushed up through a weakness in the fascia, maybe the fat can absorb back through.

In fact… check out this quote from an article I found on the website of a massage therapist in Ohio:

The Back Mouse can be soothed and eventually coaxed back down under the fascia layer with proper treatment…….. Over time, the fat eruption can be convinced to recede back under the fascia layer where it belongs.

Link to full article:

Low Back Pain? Consider the “Back Mouse.”

http://healthy-massage.com/?p=3

Anyway, I’m experimenting with “TRE” David Berceli’s exercises that release trauma stored in the body, particularly in the pelvic region by evoking tremoring. The exercises are amazing and seem to be helping. I’ll share more on this later.

Hi and thanks to everyone here. I’m so glad this thread exists.