Pandemic Fatigue: It's not all in your head

Pandemic Fatigue, or Quarantine Fatigue, it goes by many names. It's that underlying fatigue that we are all experiencing, regardless of how well we sleep. It is an emotional fatigue that has a very real, physical impact. It can feel like low level depression or dysphoria, lack of motivation, your "get up and go" has "got up and went."

Psychosomatic symptoms (psyche-mind, soma-body) are symptoms that are caused by the mind but experienced in the body. Many allopathic doctors use this term in a derogatory way, meaning, "it's all in your head, it's not real." Natural or Holistic doctors and practitioners see this as something very real, where what is happening in your head is causing physical symptoms; it is real and you should pay attention it.

In my acupuncture practice I see psychosomatic symptoms frequently, where long held emotions are causing physical pain and dysfunction. In Traditional Chinese Medicine (TCM), the mind and the body are interconnected, where each internal organ has an emotion that is related to it. The 5 main organs that we look at are Liver, Spleen, Lung, Kidneys and Heart. Each organ has a characteristic emotion. When you feel that emotion it affects that particular organ, and over time the emotion can create an imbalance in that organ, or an imbalanced organ can lead to a particular emotion:

• Liver--Anger, frustration, stress, unfulfilled desires, irritability, feeling emotionally stuck
• Spleen--Overthinking, worrying, ruminating/obsessing, compulsivity, depression where you can't get out of bed due to exhaustion
• Lung--Grief, sadness
• Kidneys--Fear, shock, fright, lack of motivation
• Heart--Feels all the emotions, joy, lack of joy, mania

It is normal, and human, to feel all of these emotions at some point. The problem is when you get stuck in these emotions, and are experiencing them chronically, the long term effects can translate into physical symptoms. Some examples:

• Anger/frustration damaging the Liver: Headaches, migraines, muscle tightness, frequent sighing
• Worrying damaging the Spleen/Stomach: Stomach aches, loose stools, foggy thinking, weakened immunity, fatigue/exhaustion, loss of appetite
• Grief damaging the Lungs: Chronic or recurring bronchitis, asthma, allergies, recurrent sinus infections, frequent colds
• Fear damaging the Kidneys: Lower back ache/instability, knee pain, bone pain, low libido
• Too much Joy or lack of Joy damaging the Heart: Mania, anxiety/panic attacks, having a flat affect, palpitations, unusual sweating

The fatigue that many people are experiencing right now during this pandemic is like a slow leak from a bucket. The constant fear or anxiety, even if it is at a low level, running in the background, is slowly draining your energy, like water leaking from a bucket. Over time, the water level in the bucket drops and you find yourself feeling really tired, even though overtly, nothing has really changed in your life (aside from having to wear a mask, staying away from people and washing your hands constantly). The worry is damaging your Spleen, the grief from missing people (and your pre-COVID life) is damaging your Lungs, the fear is damaging your Kidneys, the frustration is damaging your Liver and the Heart feels, and is affected by, all of the emotions. These are all very real and valid things to be feeling right now. Stepping up your self care is important so that the physical symptoms above don't start to creep in. 

Self-Care Ideas:

• Sleep--getting enough hours of good quality sleep
• Eating high quality, nutritional foods--vary your diet, include plenty of fruits and veggies and high quality protein
• Finding time to relax and recharge-- read a book, watch a movie, draw, paint, dance, be creative, anything that is quiet and allows you to recharge your batteries
• Exercise-- exercise should improve your energy. If you feel more tired after exercising, change things up a bit. Exercise should make you feel better, not worse. Maybe take it easy and just move your body, stretch, breathe, go for a walk. Anything to get out of your head and back into your body.
• Meditation-- even 3 minutes of meditation can improve your mindset and help you feel more centered. Just watch your breath; if your mind wanders, just start again. It's all part of the process.
• Journaling-- a great thing to do before bed. Dump out all of your worries and stressors onto the page so that you don't have them swirling around in your head while you are trying to sleep.
• Acupuncture-- it can help you sleep better, calm your anxiety, clear your foggy head and improve your energy and well-being.

All of these things will repair your leaky bucket and help you feel better in your daily life. Give them a try, let me know how it goes!

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6 Ways to Boost Your Immunity

With all of this talk about COVID-19, it is easy to get all worked up. Anxiety and generalized stress are at an all time high. Nothing brings on anxiety like the unknown: will I get sick? Will someone I know and love get sick? How bad will it be? Unfortunately, no one has these answers, but what we do know is that the #1 immune suppressant is STRESS.

Stress suppresses the immune system. Yes, you read that correctly. Originally it was a brilliant evolutionary design where in moments of stress, the Sympathetic Nervous System would up regulate, increasing the heart rate, tightening the muscles, increasing breathing so that you could escape from danger quickly. During that time the body would down regulate processes that were unnecessary for survival, i.e. digestion, fertility and immunity. Once the danger passed, we would move out of "fight or flight" and up regulate the Parasympathetic Nervous System, which would return us to the calmer state of "rest and digest."

In modern times, however, stress is no longer lasting for moments, but can be days, weeks, months, even years at a time. Right now, with everyone worried about getting sick, we are worrying ourselves out of our much needed immunity; we are weakening our own ability to fight off illness. So what do we do?

The best thing you can do (in addition to washing your hands, not touching your face and following recommendations by the CDC) is to manage your physical and mental/emotional stress. Here are 6 ways to do that:

1.) 5 Deep Breaths. This is something that costs nothing and is extremely effective in a period of stress to help you get back into balance. You can do it while working, driving, pretty much anytime during the day. Place your hands on your lower abdomen and inhale through your nose, filling the abdomen with breath; feel it expand under your hands like a balloon inflating. Exhale slowly through the nose for longer than you inhaled. This will slow the heart rate and slow the mind, getting you back in touch with the present moment.

2.) Mindfulness practices like mediation, yoga, T'ai Chi, etc. These practices teach you to be present. In this moment there is no stress, no anxiety, as anxiety lives in the future. It is the thought of "what if" or feeling like you have no control that gives you anxiety. You have the most control over the present. In the present you have choice and can act on that choice, so by practicing techniques that bring you back into the present, into a calmer state, on a regular basis, you will know what that feels like and can access that feeling more easily. Plus, activities like yoga and t'ai chi move your body to get you out of your head, where stress can start .

3.) Sleep. One thing that should be prioritized is sleep. If you are not giving yourself sufficient rest (7-9 hours per night) your body cannot heal itself properly and you will be in a state of physical stress. If you do get sick (colds, flu, other viruses) you won't recover as quickly without proper sleep, as it is during sleep when the body heals itself. Sleep deprivation causes the body to be stressed even if you don't feel emotionally stressed. Your body will still down regulate digestion, fertility and immunity. Sufficient, good quality sleep is essential for good health.

4.) Proper Diet. While there is no one-size-fits-all diet that works for everyone, eating a diet full of fresh fruits and vegetables, lean meats and drinking plenty of fresh water are a good place to start. Try to avoid processed foods, sugar, artificial sweeteners/colors/additives and instead choose foods that you recognize as food. If a 3rd grader can't pronounce an ingredient on the box, it probably isn't food and should be avoided.

5.) Exercise. Move your body a little every day. You don't need to go to the gym and punish yourself on the treadmill for an hour, just make sure that movement is part of your day. Moderate exercise is better than intense exercise which can cause more stress to the body, and it doesn't need to happen all at once. You can exercise for an hour, or do 3-6 10-minute increments throughout the day. Take a class, go for a walk, dance in your living room, roll out a yoga mat and just move your body for 20 minutes or more. Park further away from your destination and take the stairs instead of the elevator. There are lots of ways to put movement into your day if you are not a regular gym or studio goer. Moving your body is a great stress reliever.

6.) Acupuncture. Acupuncture can help you sleep better, improve your energy and calm the nervous system bringing you out of fight or flight and back into a state of calm and well-being. If you tend to run on the anxious side in general, acupuncture can help give your mind a break. Acupuncture increases activity in the para-sympathetic nervous system helping you "rest and digest." It can also improve the strength and efficacy of the immune system, making it easier for your body to fight off disease.

The best thing you can do for yourself right now is to take care of your health. The stronger and healthier you are, the more easily you will fight off whatever bug comes your way. Just do the best you can. That's all any of us can do.

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Why Movement Matters: A TCM Perspective

Most people know that exercise is beneficial to your health. If you are not quite convinced, a quick Google search (or clicking the links below) might give you some more reinforcement.

Exercise has been shown to help improve the quality of life and health for people with chronic disease and pain, depression and anxiety, osteoporosis, and can even improve your sex life! Any movement that you do will have a positive effect on your body, and you don't need to go to the gym to feel the benefits of movement.

One of the reasons that exercise is beneficial is that it increases the circulation of Blood, Fluids and Qi in the body. There is a saying in Chinese medicine:

"When there is pain, there is no free flow;
When there is free flow, there is no pain."

The Liver is in charge of the free flow of Qi in the body. When the Liver is imbalanced, it causes various types of pain in the body and mind. The Liver can be out of balance due to emotional reasons like stress, anger, frustration or unfulfilled desires, or due to physical lack of bodily movement. When the Qi doesn't flow well; we call this "Stagnation." Qi Stagnation can manifest as different symptoms:

• Musculoskeletal pain in the muscles and joints, muscle tightness, low range of motion, body stiffness
• Emotional pain, feeling stuck, depression, irritability, short temper
• Headaches, eye strain, menstrual pain (cramps, breast tenderness, lower back ache)
• Sighing, frequent yawning when you are not tired

Movement is something that you can do to unblock the stagnation and free up your internal flow, which will make you feel better.

Movement can be going for a walk in the woods, playing with your children, dancing, yoga, pilates, T'ai Chi, running, weight lifting, etc. but, what matters most is that you have fun doing it. If you dread moving your body, you won't do it. In order to lead a healthy life, movement needs to be part of your daily activities. That being said, you don't need to exercise for an hour every day, or at least not an hour in a row. Every little bit counts. 5 or 10 minutes here and there over the course of the day have the same or greater impact as exercising all at once.

Easy movement additions are park further away from your destination, or take the stairs rather than the elevator. Other ideas are, if you have a desk job, every hour stand up and stretch for 5 minutes, maybe walk around your office, maybe have a little mini dance party (this is best if you work from home, but if you have cooperative office mates, this might be a fun group activity). Get creative. Make it fun. Intentionally move your Qi! When you move what is stuck, you feel less pain and have improved mood, increased creativity, better balance and increased freedom of movement.

If you still need support with pain or with any of the above symptoms, acupuncture is a safe and effective treatment option. The needles improve the flow in the muscles, joints and fascia to improve how you feel physically, mentally and emotionally. 

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https://www.healthline.com/nutrition/10-benefits-of-exercise#section5

https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389

https://medlineplus.gov/benefitsofexercise.html

Acupuncture vs Dry Needling: What's the Difference?

What is Dry Needling (DN) and how does it differ from Acupuncture?

Acupuncture, as defined by The National Center for Complementary and Integrative Health "describes a family of procedures involving the stimulation of points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. Practiced in China and other Asian countries for thousands of years, acupuncture is on of the key components of traditional Chinese medicine."*  There are many forms of acupuncture (Chinese, Japanese, Korean, Orthopedic, 5 Element, to name a few) and each style is a bit different. Overall, acupuncture is used to create healing in the body for both acute and chronic problems due to injury or illness. It is a holistic form of medicine that has been used for thousands of years. Usually an acupuncture treatment is a comfortable, relaxing experience that leaves the patient with an overall sense of well being, and symptom relief either immediately or within 24-48 hours of treatment, depending on the issue.

Dry Needling (as opposed to the "wet" needling of injection therapy) is a form of acupuncture where an acupuncture needle is inserted into a trigger or motor point to elicit a twitch response. This twitch releases the muscle making it more relaxed to improve its function. This tends to be a more symptom based treatment dealing with musculo-skeletal problems, rather than internal problems, like insomnia, anxiety, IBS or hormonal regulation, which are better treated by acupuncture. The treatment can be a little uncomfortable, but the discomfort is short lived. After DN the patient should leave with an overall decrease in their pain levels.

There is an ongoing debate in the physical medicine world about Dry Needling. Physical Therapists and Chiropractors are treating their patients with DN for the purpose of healing symptoms and improving physical function, because needling the body is effective; this has been proven by Acupuncturists all over the world for millenia. So what's the problem?

The biggest problem is lack of proper training. A licensed acupuncturist has had 2-3 years of supervised needling training by the time they go into the student clinic to begin to treat patients and by graduation, 3-5 years. Most Dry Needling courses take place over the course of a weekend and typically have only about 10 hours of needle practice. The students are not being trained by Acupuncturists, who understand not only how to needle, but what and why to needle, they are being trained by other Chiropractors or PTs.

Would you go to see an acupuncturist to get your spine adjusted after (s)he took a weekend chiropractic course? I wouldn't. It's like calling a plumber to work on your electrical problem. Great skills, just the wrong set of skills for the job at hand.

My biggest concern is safety. PTs and Chiropractors have extensive training on how the physical body works: how to rehab a knee replacement, how to create strength and stability in the hips, how to realign the spine and pelvis, how dysfunction in one area can affect another, etc. What they don't have is extensive training in needling the body. Massaging a tight muscle and putting a needle into it are two different skill sets. With massage you don't need to worry as much about where blood vessels and nerves are, or how deep (or shallow) the Lungs or Intestines are relative to the surface. Acupuncturists have an entire semester course learning about acupuncture points, not only where they are located, but how deep and at what angle you should needle each point. Understanding these needling depths and angles (which are based on the anatomy beneath them), keeps a licensed Acupuncturist from creating a pneumothorax (puncturing a Lung) or hitting an artery. This course is separate from the course taken about the functions of each point. When DN is taught by someone not trained in depths and angles, this can be very dangerous for a patient. Even when a practitioner is not needling an acupuncture point per se, but perhaps a motor point or trigger point, there is still the underlying anatomy to consider. Acupuncturists needle acu-points (which are located along the 14 main meridians), "extra" points (not on the main meridians), "ashi" points (points when pressed there is a sore sensation, also not necessarily on main meridians), motor points (a point on a muscle that when stimulated causes the muscle to contract) and trigger points (a sore point that causes generalized muscle pain when over stimulated). There was a Dry Needling training video that circulated the Internet a few years ago where an instructor actually caused a pnuemothorax during the training because he used a needle that was too long and he went too deep into the upper back of a relatively thin person. He made this mistake due to not fully understanding how to properly needle that area, despite what he believed was taking proper precautions.

In my practice I have seen the sequelae of DN performed by well meaning, but insufficiently trained practitioners (like large swellings, increased inflammation, decreased range of motion, increased pain). Most of my patients know that if they need Dry Needling, they come to see me.

It is this lack of education that I believe is the biggest health risk when it comes to DN. Is it effective? Yes, but only when performed by a trained, Licensed Acupuncturist, or a health practitioner who has taken much more than just a weekend course.

* https://nccih.nih.gov/health/acupuncture

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Pelvic Floor Pain: How Acupuncture Can Help

When it comes to pain, not everyone thinks about acupuncture as the solution. With intense pelvic floor pain, the idea of needles anywhere near the pelvic floor can have you running in the other direction. You will be pleased to know that although it is possible to needle the muscles in the pelvic floor, it is not necessary to be able to address pelvic floor pain with acupuncture. One of the benefits of using acupuncture for pain is that there are many ways to treat the body, many ways to see the body and a seemingly indirect treatment can be the most powerful.

Case Study

59 year old female came to my office with her Chief Complaint as Pelvic Floor Pain that she had been experiencing 6 times per year for 15 years. The pain was intense, an 8-9 out of 10 and lasted at that intensity for 45-60 minutes. It usually appeared at night, waking her, but recently it had happened while at work or while driving. The pain was in the rectum as well as at the base of her spine and was a throbbing, pounding pain. The pain would start suddenly, then stop just as suddenly. The patient had seen multiple types of specialists, none of whom could do anything but give her pain killers for when she had the pain, and physical therapy hadn't helped; no one was able to help her with prevention, and could help only mildly with pain management. The pain was slightly better with NSAIDs and nitroglycerin but nothing prevented the pain from occuring; she just had to wait it out.

I first saw her in late February and the last episode of the pain had been late December.

Observing her posture, her rib cage was shifted to the left relative to her pelvis and her right Quadratus Lumborum (QL) was tight and contracted. Her left SI joint was jammed causing a medial shift when she lifted her knee. Her left psoas was tighter than her right and her right pubic bone was slightly deep relative to her left. There was no movement in her right ThoracoLumbar Fascia (TLF) or sacrum, which was jammed moving superiorly. The movement of her TLF and sacrum were detected by using a light touch to detect the body's various rhythms subtle movements.

I saw her weekly for 2 weeks, then every other week for 4 more treatments. After the first treatment her SI joints were moving properly and evenly, and her QL tightness had released. Her rib shift was also gone. As the acupuncture treatments progressed, I addressed imbalances in her piriformis and hamstrings and continued to address the sacrum which improved with every treatment. We were able to trace the problem back to her left foot which had had a seismoid bone resection many years before that affected her overall alignment, causing her to overuse her right side.

Typically the pain had occurred every 2 months for 15 years. During the 3 months that I saw this patient, she had no recurrence of the pain. Our last treatment was in May, so she had been pain free for 5 months.

I find that looking at the whole body, rather than just focusing on the one part in pain, it's the best way to get rid of pain more permanently. The body is a master at compensating and over time subtle, often unconscious shifts in posture and gait can lead to bigger problems down the road. By correcting the way a person moves through their life by correcting their imbalances, it can have a profound effect on how someone feels on a daily basis.

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Cupping for Athletes

Cupping is a hot topic among athletes these days, spurred on by the purple spots on competitors like Michael Phelps and Wang Qun at the Olympics and more and more celebrities and professional athletes across numerous sports. The Chinese (as well as Europeans) have been using cupping for thousands of years, for all sorts of muscle and joint pain, as well as for respiratory infections and digestive issues.

You can read about the basics of cupping in my previous post, "Cupping and Gua Sha: What are they and what are their benefits?" by clicking here. This post will focus on how cupping works to benefit athletic performance and recovery, as well as treating sports injuries.

Any athlete, whether a professional, an amateur or a weekend warrior, knows that soreness and injury is par for the course. Soreness is the build up of lactic acid and micro-tearing of tissue that when healed, creates a stronger muscle. With intense use, muscles can get tight or inflamed, and many people use ice to battle that inflammation. Unfortunately this practice is outdated and is actually interfering with the healing process. You can read more about that here. By restricting blood flow, you are actually impairing the body's ability to heal itself. It's like a fever: when you have a fever, the body has raised its temperature to kill off the virus or bacteria that is making you sick. When you reduce a fever, the body can't do its job as well (I am referring to fevers under 102.5 degrees; anything above is more serious and may require other interventions). Icing an acute injury delays the healing process by interrupting blood flow to the area. According to Traditional Chinese Medicine (TCM) you are infusing cold into the area which leads to a stagnation of energy, or Qi (pronounced Chee) and causes pain. Many times ice will numb the area, but won't actually get rid of the pain, since once the numbness wears off, the pain returns.

Practices like acupuncture and cupping are very helpful for recovery as they move the lactic acid out of the muscles, encouraging Qi and blood flow, helping the body recover. Cupping is great for muscle tightness, acting like a deep massage, to help release what is stuck and return the muscle to better functioning. Acupuncture encourages blood flow to the area so that the body can more efficiently heal the micro-tears and return the muscles to strength and stability. These two practices complement each other, but each can also stand alone when it comes to recovery.

In terms of healing injury, depending on the injury, acupuncture is my first go to, as it encourages blood flow to encourage healing. Moxa is another great modality for treating injury for the same reason. Our blood contains the nutrients that help us heal; encouraging blood flow encourages healing. Moving Qi and Blood can also reduce pain and swelling, often immediately after treatment.  Cupping can be helpful as long as there is no muscle tearing as part of the injury. It is great for muscle spasms or tightness, and can be helpful with scar healing, once the scar is stable and closed. Cupping (or Gua Sha, see the above link to the article "Cupping and Gua Sha: What are they and What are their Benefits"), can help the scar become more supple, prevent adhesions and help the body return to proper function.

Scars can be very problematic, post-surgery or otherwise, if they don't heal well. Puckered or tight scars can impair function not only of the affected area, but can also cause problems in other related areas, like nearby joints. I had a patient who had a lumpectomy and the scar was very deep and tight. She came to me because of a shoulder injury on that same side. Once I released the tension in the scar, her shoulder felt much better. Cupping, Gua Sha and acupuncture are all great ways to treat scars and encourage them to complete the healing process so you can return to the activities that you love.

https://www.usatoday.com/story/sports/olympics/rio-2016/2016/08/08/how-cupping-works-and-why-olympic-athletes-use/88410804/

https://www.independent.co.uk/news/world/americas/rio-2016-cupping-what-is-it-olympics-athletes-suction-cups-skin-marks-a7178731.html

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Musings of an Acupuncturist Treating Veterans

Musings of an acupuncturist treating veterans:

I love the vision of people, mostly men but some women, coming into the Veterans Acupuncture Care clinic,
a little nervous, a little unsure. Before they’ve been treated they don’t know what’s going to happen. Does it hurt?
How will I feel after? Does it hurt? What should I expect? Does it hurt?
They walk in, sign in and take a seat in one of of almost a dozen wing chair and couch seats. They sit down,
swab their ears with alcohol and await the needles. Within 5 minutes or so of receiving the needles, I see the peace
and calm wash over their faces. Soon the subtle sounds of gentle snoring mix with the flute music playing in the
background. They sit until they feel complete, for some it is 30 minutes, for some 90 minutes, for many it is
something in between. I take my cues from them. After the treatment, they arise, refreshed and ready to take on
whatever their life may bring. Initially the contentment may last only a few hours or a few days, but over time the
effects last longer and longer. The treatments build up in the system helping them hold on the more good feelings
than bad. Bodies have an amazing ability to heal themselves; I only facilitate that action. That’s why I do what I do.
I am an acupuncturist.

* * * * *

Everyone experiences stress in their lives, but after experiencing war and combat, the stress is a little different.
At first it may be subtle, like feeling irritable and isolated, or yelling at your spouse and children. Then it might be
more invasive, interrupting your sleep, causing nightmares and flashbacks, driving your desire to drink or behave
recklessly. PTSD, or Post-Traumatic Stress Disorder is not always immediately apparent to the person experiencing it.
If you or someone your love has been affected by a traumatic event in war or combat, know that help is available.
Veterans Acupuncture Care (VAC) Metrowest offers free acupuncture treatments specifically geared toward easing
your experience of your trauma and giving you a deep sense of peace and well-being.
For more information, please visit www.vacmetrowest.com.

What is Tui Na Massage?

Tui na (pronounced TWEE-nah) is a type of bodywork that falls under the Traditional Chinese Medicine (TCM) umbrella. TCM includes Acupuncture, Chinese herbal medicine, Chinese dietary Therapy, Moxibustion and Tuina.

Literally translated, Tui na means "pinch and pull" which doesn't sound particularly appealing, but it is a simultaneously relaxing and invigorating style of massage. It uses techniques like "rolling," "grasping," "kneading," "shaking" and "pressing" in order to encourage the Qi (pronounced "CHEE") to flow through the meridians, or energy channels. It has been around for thousands of years and follows TCM theory: "when there is pain, there is no free flow; when there is free flow, there is no pain." By encouraging the circulation of Qi and blood, the pain dissipates and the client feels better.

If you are looking for a Swedish style "mush your skin around" type of massage, this is not it. Tui na is, however, a highly therapeutic style of massage that is great for sports or other soft tissue injuries, general muscle tightness and relieving stress that is held in the body, causing symptoms such as headaches, TMJ, back pain, neck pain, etc. It is also helpful for preventing injuries with athletes or exercisers by releasing tight muscles that restrict movement and impair range of motion. By releasing this tension, athletes can perform better in their sport or activity of choice.

Tui na is done fully clothed in loose, comfortable clothing. It is often performed as an adjuctive technique to acupuncture or moxibustion, but also can be a stand-alone treatment. Like acupuncture and other TCM modalities, Tui na focuses on the whole body, in addition to the symptoms, so that the client feels a greater sense of well-being afterwards. The goal is to bring the body back into balance using manual techniques done by the practitioner's fingers, hands or elbows. Tui na is often referred to as "acupressure" where pressure is used instead of needles, but Tui na is not just an alternative or replacement for needles, it is its own form of Chinese medicine. Typical Tui na sessions last about 30 minutes.

Tui na is safe and can be used by people of all ages, from infants to seniors, and some techniques can be taught for use at home as self-care.

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Acupuncture and Working Out: How Acupuncture can Support your Fitness Goals

Fall is the most popular time of year for people to get back into the gym. Kids are back at school, the days are getting shorter and colder and many people are raring to get back into shape. Unfortunately, this is also the most popular time of year for people to hurt themselves by doing too much too fast. Going to the gym 7 days a week after sitting on the beach all summer is a recipe for injury.

Acupuncture is a great complement to your fitness routine by increasing your energy, improving your sleep and helping you recover and heal, both after workouts and after injury.

The first 2 items are very related-- when you don't sleep well, or enough, you won't have enough energy to work out properly. Coffee and other stimulants can work short term, but shouldn't be part of a long term health routine. Coffee and stimulants encourage the body to release adrenaline so that you have "more energy," but long term this strategy actually leaves you more tired and depleted than when you started. One true solution to having more energy is getting more, good quality sleep. For 7 tips for better sleep, click here.

Not only will good sleep give you more energy, but it will also help you recover more quickly after exercise. Sleep is when the body repairs itself, from injury, from illness and even from daily wear and tear. Exercise creates microtears in the muscles. When you are asleep, the body heals the microtears and you become stronger. Prolonged soreness after exercise (more than 2 or so days) is a sign that you either REALLY overdid it and you might be injured, or you are not getting sufficient sleep to heal your body.

When microtears become macrotears, that's when you know you've hurt yourself. Acupuncture, Cupping/Gua Sha and Moxibustion are all ways to encourage the body to heal itself. The healing nutrients in the body are in the blood stream, so by encouraging blood flow to the injured area, the healing process can begin and the pain subsides. There is a saying in Traditional Chinese Medicine: When there is pain, there is no free flow; when there is free flow, there is no pain. Acupuncture encourages the free flow of Qi, blood and fluids so that the body can heal itself. DO NOT ICE! Ice and NSAIDS (non-steriodal anti-inflammatories) actually slow the healing process by slowing blood flow and reducing inflammation. Inflammation is actually okay for an acute injury (chronic inflammation is something else) because it signals the brain that there is an injury that needs tending. Inflammation is similar to a fever in that way. A fever is your body's attempt at killing the virus or bacteria that is making you sick. When you reduce a fever (unless it is over 103.5 degrees F--always reduce high fevers), you are impairing the body's ability to fight off whatever illness is causing the fever. For more on Sports Injuries, click here.

Finally, good food is important to support your gym efforts. You can't exercise away a bad diet. Food should nourish your body and give you proper fuel to get through your day. Drinking enough water and eating sufficient protein is also important for repairing the body after exercise. "Dieting" is not a good way to lose weight; it typically restricts calories which slows metabolism and is temporary, creating temporary weight loss. Eating a balanced, whole food diet is the best way to feel good and get to a healthy weight for you. "Ripped" and "healthy" are not always the same. Setting goals that bring you toward health is the best way to help you feel better, for the long term, in your body and mind.

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Acupuncture for Veterans: Treating the Internal Wounds of War

Studies say that 1 in 5 soldiers comes back from combat suffering from Post Traumatic Stress Disorder, or PTSD. Many times they are not initially aware that there is anything wrong, it is their family members who notice first. Maybe they are depressed or anxious. Maybe they are having nightmares or trouble sleeping. Maybe they are self medicating with alcohol, drugs or even getting frequent speeding tickets. Maybe they are struggling to "fit back in" to their pre-combat lives. PTSD doesn't always show up in overtly recognizable ways, sometimes it is more subtle, something only a husband or wife would notice; their military spouse just seems "off" and "not themselves." Acupuncture is a treatment that helps reset the nervous system, getting you out of "fight or flight" and back to feeling calm and centered again.

At Veterans Acupuncture Care (VAC) Metrowest, we see veterans who have fought in every war or conflict ranging from WWII to the present and have varying degrees of emotional pain and scarring. We also treat family members because PTSD doesn't only affect the person in trauma, but everyone they interact with as well. Stress and anxiety are human emotions and can affect everyone, no matter how strong they are.

The men and women who come to our clinic often enter a bit agitated and chatty, then within minutes all the talk settles down and there is just quiet. Their eyes close, they lean back into the wing chairs and many fall asleep. You can see the release of all of the worries, turmoil and internal unrest as ease takes over their bodies. You can feel the deep relaxation in the room and see the peaceful expressions take over their faces. I am grateful that I possess the ability to give this gift to those who have given so much to our country in the name of freedom.

When we opened in 2008, our idea was to help the soldiers returning from Iraq and Afghanistan get back to their regular lives. The VA hospitals at the time (and now) were inundated with people looking for help but finding they would have to wait weeks, sometimes months, to see a mental health professional. As acupuncturists we had an effective treatment to offer right now. In 2010 we decided to open our doors to First Responders too (Police, Fire, EMT), both active and retired, because they are our local soldiers, fighting daily battles, not knowing what they are walking into each time they get a call.

Auricular Acupuncture is a simple way to treat internal wounds without the client needing to talk about or relive their experience. The acupuncturist places 5 needles in each ear for the purpose of balancing the nervous system and creating a deep sense of well being. All the client needs to do is receive the treatment. Initially the effects are short lived, maybe a few hours up to a few days, but with continued treatment the effects last longer and longer. Many people report an improvement in mood and an increased ability to cope better with daily life. Clients experience improved sleep, less teeth grinding, and much less anxiety through the week.

Our clinic is located at 3 Maple Street in Framingham, MA and is open every Saturday (excluding holidays) from 10am-12pm. All treatments are free, no appointments are necessary, just walk in. For more information about this clinic, go to www.vacmetrowest.com. To find other clinics around the country, go to www.acuwithoutborders.org.

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Natural and Non-Invasive Treatment for Varicose Veins

Varicose Veins can present in different ways for different reasons. According to the Mayo Clinic, varicose veins can be caused by age, where the veins lose elasticity and enlarge, or by pregnancy, where your overall blood volume increases, but not the flow of blood from your legs to your pelvis. Other factors include obesity, sex (females are more prone), family history, and standing for long periods of time. Unfortunately, most standard Western treatments involve some sort of surgery or "stripping the veins." Luckily there are other, less invasive options available from Eastern Medicine.

According to Traditional Chinese Medicine (TCM), Varicose Veins (which differ from Spider Veins) are due to an insufficiency of Spleen Qi, or Spleen energy, in the body. Each of our internal organs has particular jobs in our body; TCM theory sees the Spleen as much more important than it is typically considered in Western Medicine. With TCM, one of the Spleen's jobs is to hold things in their place. When the Spleen is too weak, you often see "Sinking Qi" symptoms, like organ prolapse, urinary or fecal incontinence/stress incontinence, a sinking sensation of the uterus, flooding uterine bleeding (usually during menstruation) and varicose veins. With all of these symptoms, the Spleen is too weak to hold things where they belong and they fall. With varicose veins, the Spleen is unable to hold the Blood in its vessels and they sag and expand. When there is also pain or dark blood associated with varicosities there is additional Stagnation, where the Qi and/or Blood isn't moving the way that it should. Here the Stagnation is also due to the insufficiency of Qi, where it doesn't have the "oomph" to keep flowing properly and it gets sluggish and stuck. 

This condition can be treated quite effectively with Acupuncture and Moxibustion.  The acupuncture, and sometimes Chinese herbal medicine, focuses on:

• Building and supplementing the Spleen Qi so that it can hold the blood in the veins
• Raising the Yang so that whatever has fallen (in this case the veins) can be lifted back up
• Moving the Qi and Blood to relieve the pain often associated with varicose veins.

Moxibustion is a warming treatment (see link above) that helps move the Qi and Blood and helps reduce the swelling and discomfort associated with varicosities. It is safe and non-invasive. Many times varicosities shrink, lighten and become less painful after a moxa treatment. While the varicose veins won't disappear after just one treatment, each treatment builds upon the one before, so over time you will see continuous shrinkage and lightening of the veins until they are no longer problematic. Because everyone is different, there is no way to predict how many treatments are needed; the more chronic the condition, the longer it takes to treat. For a relatively recent occurrance, it may take 4-6 treatments, for varicosities that have been around for years, it may take 3-4 months or more.

In the end, in addition to feeling less pain, you should have better energy and feel better in your daily life.

Sources:

http://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/dxc-20178128

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Natural Remedies to Ease a Sore Throat

Illnesses are rampant this time of year with colds, flu and flu-like viruses everywhere. The Corona virus is on everyone's mind as well, and like will all illnesses, prevention is key. Sleep, handwashing, supplementing with Vitamin D3, C and probiotics can be a bit help with supporting your immune system. Elderberry Extract Syrup has shown to be very effective to battle Flu and Flu-like viruses, as well as my favorite remedy, Oscillococcinum. This is a homeopathic remedy that should be taken at the very first signs of illness and, in my experience, can get you back to feeling healthy within a day or two.

Some of these nasty bugs can cause sore throats. Sore throats abound this time of year. Some are severe and require antibiotics, like with Strep (you don't want to mess around with Strep). Most sore throats, however, are relatively benign and are really just a symptom that you are fighting some sort of bug.

When Chinese medicine was developed thousands of years ago, the concept of pathogens like viruses, bacteria and fungi had yet to be discovered; doctors noticed how different illnesses caused different symptoms and would diagnose and treat patients according to how their symtpoms presented.  They would treat the body, rather than the illness.

Chinese doctors identified the different pathogens as invasions of the elements: Wind, Heat, Cold, Damp and Dry, and would treat each patient according to these "External Pathogenic Factors." Our immune system is referred to as Wei Qi, which is a superficial layer of Qi that acts like a force field around us, protecting us from pathogenic invasions. When we get sick, our Wei Qi rises to the surface and battles the invading pathogen(s), seen as various symtpoms (headaches, runny nose, cough, sneeze, fever, chills, etc.) A sore throat is caused usually by an invasion of Wind and/or Heat, although Cold and Dry are also possible; dry, scratchy throats are often due to Wind and red, painful sore throats are due to Heat. You can also have sore throats that are due to physical irritation, like with a cough caused by post-nasal drip, but you would still categorize it according to its quality, scratchy or raw. This type of sore throat would have a Damp (Phlegm) element to it, and you would see other accompanying symptoms, but the sore throat itself would be categorized according to Wind or Heat.

Acupuncture and Chinese herbal medicine treat all sorts of illnesses, including sinusitis, rhinitis, sinus infections, coughs, post-nasal drip, bronchitis and others, and sore throat is definitely on that list as well. Acupuncture treats the body, so whether you are fighting a virus or bacterial infection, it doesn't matter, what matters is how the symptoms present. By boosting the immune system and helping the body fight off Heat, Wind, Damp, Cold and/or Dry, the body is able to recover more quickly from the illness and you feel better sooner.

When you can't get in for an acupuncture treatment, doing acupressure on LU 10 can be a temporary help for sore throat. LU 10 is located on the hand, between the heel of the hand and the lowest thumb joint. along the inner edge the bone connecting the two joints (see the dot in the photo). Massaging this point (which might be sore if you really need it) releases heat from the throat and can help ease the pain, making you feel more comfortable. It can also be helpful with a scratchy throat, but is most effective against the heat of a sore throat.

My favorite home remedy for sore throat, or even hoarseness/loss of voice, is Hot water, juice of a 1/4 of a Lemon and a teaspoon to tablespoon of Raw Honey. You can drink this beverage all day long and it helps soothe the throat. The lemon has Vitamin C which can help you combat illness and is sour so can bring moisture into the throat. In addition to soothing a sore throat, honey can also ease a cough. While I usually encourage coughing, since it is your body attempting to get rid of phlegm and illness, at night when you are trying to sleep, coughing can interfere; when it comes to healing, sleep takes priority. A Tbsp of raw honey before bed can help calm your cough, soothe your throat and help you sleep better.

Sleep is essential for preventing or fighting any type of illness, major or minor. Sleep is when your body heals itself and repairs any damage. If you chronically have trouble sleeping, click here for some tips on how to get better sleep.

Proper hydration is also important for healing, especially if there is a fever and sweating. Dehydration is a common cause of sore throat, and sometimes just drinking enough water can be the solution.

If your sore throat persists more than 3 or 4 days, see your doctor to check for Strep; as I said, you don't want to mess with Strep.

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Acupuncture for Migraine Relief and Prevention

Migraines can be debilitating. Excrutiating pain, visual disturbances, nausea, vomiting, light and sound sensitivity are only some of the symptoms that can be associated with migraines. There are many pharmaceutical options, but unfortunately they often have side effects, including headaches, and can be toxic to the liver long term.

Acupuncture and Chinese herbal medicine are two effective ways to manage migraine pain when it comes on, as well as prevent the occurance in the first place. According to Chinese medical theory, "when there is pain, there is no free flow; when there is free flow, there is no pain." Acupuncture  encourages the Qi, or energy, to flow properly through the body, so that the symptoms go away. The reason acupuncture can be so effective, is because there is no "one size fits all" approach to migraine management; each person is treated according to their specific constellation of symptoms. Just like each person's experience of a migraine can be different (although there are often many common factors), each person's treatment will be tailored to them. This is the reason that certain medications work for some people and not others, and that people experience different side effects from the different medications.

There can be many different causes of migraines, such as hormonal fluxuations, dietary intolerances, muscular imbalances, barometric pressure changes or sinus problems. Knowing what causes your migraines can helpful, especially in terms of prevention, but not necessary to receive relief from acupuncture. If you know the cause then it can help build a picture of what is happening in your overall health that could be contributing to the migraines, but even without, the treatment is based on your symptoms, both related to your migraines as well as other aspects of your health. Balancing certain internal sensitivities can help your body cope better with the "insult" that is causing your migraines. For example, with sensitivity to barometric pressure changes, there is often an internal Dampness (with possible symptoms such as  heavy fatigue, sinus issues, loose bowel movments, achy joints) along with stagnation (stagnation = pain, discomfort, tightness both physical and/or emotional) that leaves the sufferer susceptible. With hormonal fluxuations, the patient usually has migraines before their menstrual cycle, during peri-menopause or even after menopause; by balancing the hormones, the migraines lessen in severity and frequency and eventually go away.

The biggest benefit of using acupuncture to treat migraines is that it works with your body to correct the imbalance that is causing the migraines in the first place. Once the imbalance is corrected, the body operates as it should and there are no migraines.

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To contact Janine directly, email jagoglia@integrativetherapeutics.com.

Food as Medicine: Top 5 Anti-Inflammatory Foods

"Inflammation" has become a big buzz word in the health community in the last few years. Inflammation can occur in the body in many ways and for many reasons, but not all of them are problematic. For example, inflammation after an injury is your body's way of trying to protect, then heal itself. Just like a fever raises your internal body temperature to kill off viruses and bacteria, localized inflammation, like with a  sprained ankle, is the way your body helps contain the injury and any pathogens that might be present, and prepare the body for tissue repair. When inflammation becomes chronic, that is when it stops being helpful and starts being harmful.

Chronic inflammation has been tied to many diseases, such as depression, heart disease, diabetes (Type 2), arthritis and allergies. Chronic inflammation is often tied to a poor diet (lacking fruits and vegetables, high in sugar, chemicals, processed foods, trans fats), chronic stress (which impairs the body's ability to regulate inflammation), poor sleep (raises stress) and incorrect exercise (too much or too little causes stress, therefore inflammation in the body).

Traditional Chinese Medicine doesn't recognize inflammation as a condition per se, TCM focuses instead on pain and the different types of pain that the body can feel. Pain is due to stagnation of energy (Qi), Blood and/or Body Fluids. When these substances get stuck and don't move, it is like pressure building up behind a clog in a pipe. The more the water tries to flow, the more pressure builds up (increasing sensation of pain). Once the clog is removed and the water can flow through the pipe again, the pressure returns to normal (no pain). Sometimes when Qi, Blood or Fluids stay stagnant for long periods, the constant attempt of Qi to move while impeded can create heat; this is similar to friction in an engine when you press the gas while the emergency brake is on. This type of heat is often seen with chronic inflammation in the musculo-skeletal system. Both inflammation and heat can also occur in other aspects of the body as well. Lung Heat might be related to bronchitis (inflammation of the bronchii), Heart Fire could be the cause of cardiac disease associated with high blood pressure, Liver Yang Rising might also relate to high blood pressure as well as headaches and dizziness with chronic lower back and/or knee pain. Each of these conditions could be attributed to inflammation and can be treated side-effect free with acupuncture, Chinese Herbal medicine and/or Dietary therapy.

Often times people think about NSAIDS (Non-Steroidal Anti-Inflammatories) for inflammation. Unfortunately long term, these can have some very negative side-effects including stomach upset, pain and damage, toxicity to the the heart, liver and kidneys and slowed healing of musculo-skeletal injuries.

Luckily, nature has provided many foods and spices that have excellent anti-inflammatory properties that can help ease your pain and heal your body from the inside, out.

1. Turmeric. By far, my favorite anti-inflammatory food, and many studies have shown it to be as effective as ibuprofen. It is best consumed with black pepper, as it makes the turmeric more bioavailable. There are many ways to consume turmeric, but just eating the occasional curry dish will not give you the medicinal doses needed for generalized inflammation. Golden Milk is a great way to consume it; it not only provides you with the anti-inflammatory qualities you are looking for, it is a soothing warm beverage that in and of itself offers some stress relief. There are many recipes for Golden Milk on the internet, but here is one of my favorites (I add a dash of black pepper and often leave out the ghee). For those of you who would rather take a supplement, there are many out there. Look for one that is either liquid, powder or a capsule as it will absorb better than a tablet. Take up to 2000mg daily, with food, for acute conditions, 1000-1500mg for chronic. Caution with pregnancy, nursing and for people on blood thinners. Talk to your doctor first if these apply to you.

2. Ginger. Often added to Golden Milk, ginger is a great anti-inflammatory. In Chinese medicine it is often used to heal the stomach, especially when nausea is present. It is a warming herb, so can be helpful with pain that is better with heat. You can also drink it as a tea; raw ginger is slightly less warming than dried ginger which is hotter in nature.

3. Tart Cherries/Tart Cherry Juice. This is a great alternative to Turmeric, especially for people on blood thinners. Drink about 8 oz. daily, either "straight" or diluted in water. It can have a very intense flavor, so spreading it out through the day is my recommendation, or you can add it to your favorite green smoothie recipe.

4. Pineapple. Like tart cherries, this is a great alternative to Turmeric, but diabetics should use it with caution since it does have a higher glycemic index rating.

5. Foods containing Omega-3 fatty acids. Foods like Salmon, anchovies, sardines, chia seeds, flax seeds, hemp seeds and walnuts all contain high levels of anti-inflammatory Omega-3 fatty acids. They are good for the joints and the brain as well.

If you tend toward inflammation, especially with the conditions listed above, these foods should be part of your daily diet. You don't need to eat everything on the list, but foods that you like should be consumed daily. Foods that cause inflammation (like sugar, artificial sweeteners, coffee, trans fats, factory farmed meats, nightshade vegetables) should be used sparingly if at all.

Health begins with prevention and diet is the key. Food is medicine.

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Herbs and Foods that Help Your Body Heal When You are Sick

Nobody likes to get sick. You feel terrible, you're tired, getting through your work day is so much harder, did I mention you feel terrible? Obviously prevention is important because if you don't get sick, you don't need to feel terrible and miss work or time with your family. Unfortunately, not every illness is preventable, but if you do get sick, there are some very simple things you can eat to help you feel better more quickly. 

But first: Prevention. The best ways to prevent illness are:

1. Eat real foods and manage sugar and caffeine intake. When you diet is filled with foods that nourish your body, your immune system has the support it needs to function properly. It can often fight off any cooties that come your way, without you even knowing you've been exposed. Sugar and caffeine can stress, and thereby suppress, your immune system, preventing it from functioning at capacity. The #1 thing that suppresses your immune system is stress.

2. Get sufficient, good quality sleep. Sleep is when the body repairs and restores itself. Without good quality sleep, your body feels stressed (even if your mind doesn't) and therefore suppresses your immune system. Without enough sleep, you don't give your body the time it needs to adequately restore and heal itself.

3. Manage your stress. When we are stressed, our blood pressure, heart rate and breathing increase, as does our muscle tightness. These are evolutionary reactions to stress that help us escape from danger. If you are running away from a bear, your body is shunting all of your energy toward the goal of survival; processes like digestion, fertility and immunity are significantly down-regulated which is why conditions like IBS, infertility and frequent colds or infections are often caused/exacerbated by stress.

4. Handwashing. Regular soap and water will do the trick. Anti-bacterial soaps typically contain triclosan, a chemical that is also a carcinogen and has no business being on the human body. You don't need to strip your hands of all bacteria, but washing them multiple times a day during cold and flu season is a must.

5. Avoid touching your face. The points of entry for germs are our mucus membranes (mouth, nose, eyes) so if you don't touch your face, the germs have a harder time getting in.

The biggest problem with over the counter cold medications is that they just suppress your symptoms, and don't actually get you better. Symptoms such as sneezing, coughing, fever, sore throat actually serve a purpose: these are some of your body's ways of getting rid of the viruses or bacteria that are making you sick. By suppressing a fever or preventing a cough, you are actually making it harder for your body to fight off the cold or flu, and many times you end up staying sick for longer.
Consuming herbs and foods that help your body improve it's ability to fight off illness is the best way to go.

1. Garlic--Garlic is a great remedy for colds, both for immune support and for breaking up congestion. Raw garlic is ideal as it has the most potent enzymes to support immune health, dried supplements tend to be weaker.  You can consume raw garlic in foods, such as salad dressing (olive oil, crushed raw garlic and some type of vinegar--I like balsamic), guacamole, hummus, salsa, on toast, etc. Here are some other suggestions. Make sure to crush the garlic first and let it sit for about 15 minutes before eating. This allows for the most potency. For garlic breath, eating parsley afterward can help.

2. Ginger--Ginger is a very common Chinese medicinal enjoyed for it's warming qualities. It is mostly known to help with nausea and unsettled stomachs. Dry Ginger is considered Hot, whereas Raw Ginger is Warm; if you tend to run cold or feel particularly cold, Dry ginger is a better option. Ginger is also a great anti-inflammatory and has anti-microbial properties to help with sore throats and fighting off viruses. I like it best in tea form. Heat water to just below boiling, then put in ginger and simmer for about 15 minutes over low heat. Remove from stove and add in the juice of 1/4-1/2 of a lemon and a tsp. of raw honey (or more if the ginger flavor is too strong). This remedy can be very soothing for a sore throat and cough.

3. Elderberry extract--This is my go-to remedy for flu and flu-like viruses. Taking 1-2 Tbsp 2-3 times daily can significantly shorten the duration of your illness as it has many anti-microbial properties. At the first signs of flu (sudden onset fever, chills, body aches, generally feeling run down), I like the homeopathic remedy Oscillococcinum. It is my experience that if you start taking it within 12-24 hours of initial symptoms, you can be back to health within 24-48 hours. If you miss that window, Elderberry can give you the support your body needs to get back into your life quickly.

4. Saurkraut or other fermented foods-- 70% of your immune system is in your gut, so having a healthy microbiome (having lots of good bacteria in your gut) is essential to getting and staying healthy. Fermented foods are a great source of a wide mix of probiotcs, while also containing pre-biotics which feed the bacteria to help them colonize in your gut. My favorite is saurkraut, but foods like pickled beets, kimchee, miso, kefir, coconut kefir and kombucha are also great sources. Making them part of your daily diet is a great way to prevent illness, but once you are sick, these foods can be really helpful to get you back to health. Ideally you should make your own saurkraut (there are a million recipes out there) to maintain all of the probiotics and vitamin c that is killed off when companies have to pasteurize their products to be sold in stores. But if you can't (or don't want to-- no judgement, I buy mine too), the best saurkraut/pickled products are in the refrigerated area of the produce section of the grocery store. My favorite brand is Real Pickles but there are a number of other great ones too.

5. Bone broth--Grandma's chicken soup has been a natural remedy for colds and illnesses for generations and it turns out she might have been right. The heat, salt and hydration that the soup supplies can be very beneficial for healing. Bone Broth, however, is a little different. Bone Broth draws out all of the nutrients from the animal bone, including collagen, protein and minerals. It is great support to the immune system and a great beverage to drink when you are feeling under the weather. I often recommend it to my cancer patients as it is easy to digest with nothing to chew (unless you add it in) but full of nutrition. Again, the best bone broth is made at home, and cooked for at least 24 hours (lots of recipes online). There are some pre-made bone broths, but they are often far inferior. If you know of a company that makes bone broth that you love, I'd love to hear about it!

Cold and flu season is on the horizon. Do what you can to stay healthy!

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Using Acupuncture to help heal Tennis Elbow

So many times, patients come to see me and say "my doctor says I have Tennis Elbow, but I don't even play tennis!" Tennis Elbow is a very common repetitive strain injury that can be caused by tennis, but can have numerous other sources as well.

What is it?

The Western medical term is Lateral Epicondylitis, which is inflammation of the small "bony knob" on the outer elbow and the surrounding tissue. Pain here can cause difficulty with lifting objects with one hand, like when you want to pour milk into your coffee (of course you are pouring coconut milk into your tea, but that's an exploration for another day) and can sometimes interfere with one's ability to twist open jars. In Chinese medical terms, there is Qi and/or Blood Stagnation in the elbow, often due to physical trauma (like overuse), Heat, Dampness, Cold or a combination. When Qi (often translated as energy) is not flowing properly (no matter what the cause), there is pain; by encouraging Qi flow, the pain goes away. Qi stagnation usually has an achy, dull quality to it, whereas Blood stagnation tends to be sharper and more stabbing pain; it is possible to have both simultaneously.

Why does my elbow hurt?

Even though the pain is in the elbow, my experience has found that that is rarely where the problem originates. There is a saying in the bodywork community that "pain is a liar;" the location of the pain is not always it's source. Sometimes people feel pain in their knee but the pain is really coming from their hamstrings, their IT band or sometimes it can be compensation from dysfunction in their foot. In terms of Tennis Elbow, usually the problem comes from tightness and restriction in the rotator cuff muscles (often Subscapularis or Infraspinatus). When you repeatedly hit a tennis ball with a racquet, the movement comes from the torso and shoulder, but the impact is often felt at the weakest joint, in this case, the elbow; the elbow is the "weak link" so that is where the pain refers. Even without the impact of a ball against a racquet, repetitive movements like typing, using a mouse or even lifting something with one hand that is a little too heavy can cause strain in the elbow in the same way.

How can acupuncture help?

When the restriction is released, the elbow pain decreases and disappears. Acupuncture needles work

to release the muscular tension and restriction in the body so that it functions properly. In this case, they go into the body typically in points along the Small Intestine and Large Intestine Meridians to encourage proper Qi and Blood circulation which reduces pain and encourages proper range of motion. "Small Intestine 9," or SI 9, is a point behind the shoulder, that when released often gives significant relief to the elbow. Additionally, acupuncture increases blood circulation. Our blood contains nutrients that help our body heal itself, so by increasing blood flow to the area, acupuncture encourages the body's natural healing process.

What else can help?

Sometimes the elbow can feel really "angry," by which I mean sensitive and irritated, and usually feels worse with movement and massage. In this case, the needles can make the pain worse instead of better, so I choose to treat the elbow with Moxa (read more about Moxa here). Moxa is a less invasive way to treat pain and inflammation. What is interesting is that even though Moxa is a heat therapy, it reduces inflammation, rather than increasing it.

Is there anything I can do on my own that will help?

Ideally you want to be treated by a professional, but between treatments or before you can get started, a tennis ball can be very handy to start working on the rotator cuff tension. Lie down on the floor or lean against a wall or chair back. Place the ball around SI 9 (see image above) and lean into it until you feel a strong sensation. Take some deep slow breaths and try to relax into the ball. Sometimes it helps to lie on your side with your arm extended and place the ball that position, but the sensation can be much more intense. Listen to your body and be kind to it. If you find a tennis ball isn't hard enough, you can use a lacrosse ball, but anything harder than that will only cause bruising and tissue damage. Please don't use the tennis ball on the elbow itself, you won't be happy with the results.

In terms of anti-inflammatories, I believe in using food as medicine. Turmeric (with black pepper), tart cherry juice, pineapple, ginger and anything containing Omega-3 Fatty Acids (chia, flax, hemp, salmon, sardines, walnuts) have anti-inflammatory properties. When taken in high enough doses they can make a huge difference in your pain levels and won't cause damage to your liver or kidneys like NSAIDS can. See your local natural health practitioner (acupuncturist, naturopath, functional medicine doc) for dosage suggestions.

*Picture above from www.natural-health-zone.com.

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Natural Solutions for Irritable Bowel Syndrome (IBS)

According to the International Foundation for Gastrointestinal Disorders, Irritable Bowel Syndrome (IBS) is defined as "A functional bowel disorder in which abdominal discomfort or pain is associated with a range of symptoms. Typically, these include intermittent abdominal pain accompanied by diarrhea, constipation, or alternating episodes of both." In my private practice, I've seen that this can be exacerbated by or caused by diet, stress or emotinoal upset and can be very frustrating for the sufferer.

According to Traditional Chinese Medicine (TCM), alternating constipation and diarrhea is a common symptom of Liver Qi Stagnation, which basically means your energy isn't flowing properly. An important Liver function (according to TCM) is to move energy (Qi) smoothly through the body. When the Liver becomes imbalanced, due to anger, frustration, resentment, stress, unfulfilled desires and/or improper diet or eating schedule, then the Qi doesn't flow smoothly and you can have symptoms such as:

• headaches
• TMJ
• Irritability
• Neck and shoulder tension
• Tight chest
• Chronic sighing
• Depression
• Premenstrual breast tenderness and lower abdominal or lower back cramping
• Irregular bowel movements

That last symptom is the topic of today's post.

IBS can show up differently for each person. Some people have chronic constipation, others chronic loose stools or diarrhea, and others have both. Stress usually accompanies these symptoms or can make them worse. IBS rarely happens without the concurrence of stress. Any symptom that is worse with stress is always due to Liver Qi Stagnation.

How do I fix this in the most natural way possible?

1. Regular life habits. The body likes to be on a schedule, which includes eating at regular intervals and at more or less the same time every day. Regular exercise that is moderate in nature (not too strenuous, but getting the body moving) is important to keep the Qi flowing well. You need adequate clean water intake, which is about half your body weight in ounces, more if you sweat a lot. Finally stress management using acupuncture, exercise, yoga, mediation, talk therapy, tai chi, etc.; there are many possibilities.

2. Speak your mind. When you "hold your tongue" you are preventing the free flow of energy and can build up as resentment, which will stagnate the Liver Qi. When resentment explodes outward (like when you lose your temper), it is a sudden release of that stagnation; you feel better but only temporarily, and often at the expense of others, leaving you with regret. Diarrhea behaves in this way, a sudden explosion. I'm not recommending that you be hurtful or rude when speaking your mind, just say what is true for you, whether out loud or in a journal. I find that writing letters to people can be very cathartic. These are letters that you don't send, but by writing down all of your feelings, whatever is making you angry, resentful, sad or hurt, you can process the feelings and let them go. When they fester, they cause problems, usually physical problems (see above list of symptoms). When you free yourself of these feelings, it encourages proper Qi flow and you feel better. With constipation, it is representation of one's inability to process and let things go.

3. To quote Michael Pollan from his book Food Rules, "eat food, mostly plants, not too much." When you eat actual food that is cultivated on a farm or found in the wild, you will be nourishing your body, giving it sustenance and nutritional building blocks to function properly. When you eat food-like substances that were created in a laboratory (like all packaged, processed "foods"), your brain and body doesn't receive the nutrients it needs to work right and you get irregular bowel movements, as well as other symptoms (e.g. weight gain, depression, ADHD, brain fog, lack of energy, irritability). Eating mostly plant foods with some meat and animal products (organic pasture-raised of course) will keep your bowels moving properly. Eating at regular, predictable times helps your body regulate itself. Fermented foods, like miso, saurkraut, pickled beets (pickled in brine, not vinegar), kimchee, kombucha, etc., are a great source of probiotics that can help regulate your bowel movments, for both constipation and diarrhea. If you can't see yourself eating ferments regularly, a good probiotic supplement can be helpful. Look for one that is enteric coated so that it will get to your intestines before breaking down. Each person has different requirements so play with your dosage and find what feels right for you. Alternatively see you local naturopath or functional medical doctor for some guidance. Some great bowel movers are chia seeds, prunes, figs, green leafy vegetables and healthy fats (olive or coconut oil, avocado, etc).

4. Abdominal self-massage can be an easy way to self treat. Lie down and place your palm on your belly. If you have diarrhea, you are going to rub your palm against your belly in a counter-clockwise direction, going against the natural flow of the Large Intestines. For constipation, go clockwise. It is a gentle superficial rubbing that you can do 30-60 times, multiple times a day. It feels good and can be very calming. Works great for bloating too (clockwise).

5. Acupuncture and Chinese herbal medicine can help you both manage your stress and your bowel movments. There is no "one size fits all" with TCM, your acupuncturist will do a complete health history to determine how best to treat your specific condition. Each treatment will be tailor made to fit you, not just your IBS. Typically you will feel better within 4-6 treatments, but the more chronic the condition, the longer it may take. Regular maintenance treatments (1-2 times per month) are often recommended to keep you feeling your best.

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If you would like to ask questions directly, email jagoglia@integrativetherapeutics.com. 

Acupuncture Solutions to TMJ and its Causes

Temporomandibular Joint (TMJ) issues are very common in our high stress society. TMJ symptoms can include tension in the jaw, clicking, pain and severe restriction with opening the mouth. TMJ can cause problems with eating, speaking and...other things. It can range from mildly uncomfortable to severely impairing. Aside from pain killers (which are temporary and can be addicting) allopathic medicine doesn't have a lot to offer. Acupuncture can not only treat the symptoms of TMJ, but can also address a common cause--stress.

Some forms of TMJ can be due to a misaligned jaw. If that is the case, then you should get checked out by a dentist who specializes in TMJ so that they can work to realign your jaw and how your teeth line up. However, even with this type of TMJ, acupuncture can help with pain management by releasing tension in the musculature of the jaw.

Many times TMJ is caused by emotional stress, especially in people who struggle with expressing their emotions.Teeth grinding and clenching when you are awake or asleep are signs that you have unexpressed stress. When you "hold your tongue," your feelings get trapped inside. Because emotions are a type of energy they need to go somewhere and often they get lodged in the jaw. This lack of expression causes Qi stagnation (stuck energy) where the Qi is no longer flowing properly through the mouth. According to Traditional Chinese Medical Theory, when Qi stagnates, you have pain. "When there is pain, there is no free flow; when there is free flow, there is no pain." Acupuncture uses tiny needles placed into specific points on face and jaw to relax the muscles and restore the flow of Qi and blood; this releases the stagnation and therefore reduces or eliminates the pain. Acupuncture is also known for its powerful effect on the nervous system which can reduce or eliminate your feelings of stress.

Another technique that will soothe a painful jaw is Moxibustion. This specialized heat therapy offers gentle, soothing, deeply penetrating heat to relax the tight jaw muscles, create more movement and less pain in the jaw. To read more about Moxibustion, click here.

Something you can do on your own to release jaw tension is a yoga technique called Simhasana, or Lion's Breath. It looks funny, but feels great. As you inhale squish up your face making it as tight as possible. As you exhale through your mouth making a "haaaa" sound, open your eyes and mouth and stick out your tongue as if you were trying to touch your chin with your tongue. If you'd like to see a picture of Lion's Breath, click here. Lion's Breath is a great release for the jaw and when practiced regularly is great for maintaining a more relaxed jaw.

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Treating Asthma with Acupuncture

Asthma has become more and more prevalent. Causes can range from air pollution, to food or other allergies, to illness to insufficient Vitamin D. Some asthma is temporary (like due to respiratory illness), but most asthma is chronic and can be life threatening if not properly controlled.

Acupuncturists have been treating asthma for thousands of years, and while I don't recommend giving up your rescue inhaler just yet, there are many ways that TCM (Traditional Chinese Medicine) can help you need it less often, if at all.

According to TCM, there are many types of asthma. The type typically associated with illness is usually an "excess" form, where there is too much phlegm in the Lungs for the body to get rid of and you have wheezing, coughing and tightness in the chest. Two other forms are due to "insufficiency" where either the Lungs or the Kidneys (or both) are too weak to properly move the air in and out of the body. According to Chinese medical theory, the Lungs take in the air (Kong Qi) and the Kidneys "grasp" the qi then send it back up to the Lungs for dissemination through the body. If the Kidneys are weak and fail to grasp the Qi you have asthma with difficulty inhaling. If the Lungs are weak and fail to disseminate, you have asthma with difficulty exhaling. Shortness of breath is also associated with the Lungs, as they are unable to pull the air in properly, but there is often a Kidney weakness present with that as well.

Asthma often appears first in childhood and can be due to any of the above causes. Any Kidney or Lung weakness is often congenital, passed down from parents with weak Kidneys or Lungs; the parents may or may not have asthma themselves, but might have symptoms like weak/injury prone lower back or knees, urinary frequency, long standing fear, trouble sleeping, poor stress management or salt cravings. Any imbalances that the parents have when the child is conceived will be passed on to the child, like DNA. Life choices, like diet, exercise, stress management will either improve or exacerbate the presentation of the passed on imbalances in the child.

Asthma can be exercise induced (often with vigorous exercise), where the strain of the exercise is taxing the Kidneys. As soon as the exercise ceases and the person recovers, the symptoms often disappear. Getting enough sleep and managing stress can often help prevent this type of asthma. Acupuncture can help support the Kidneys so that they can properly Grasp the Qi and withstand the strain of exercise.

Adult onset asthma, that is not caused by illness or environmental pollution, can sometimes be caused by long term grief. Grief and sadness affect the Lungs; while these are  normal emotions for humans to have, they are supposed to have a finite time span. When grief and sadness become chronic (like after the death of a loved one that you can't get past, or multiple losses in a short period of time), it can take its toll on the Lung Qi and can lead to asthma. People with this type of grief often stand with a sunken chest/ rounded shoulder type posture that makes it physically challenging to take a deep breath. Certain yoga poses that open up the chest can help improve breathing, like those in this blog post.

There are many Chinese herbs and herbal remedies that can be very helpful for controlling asthma, however you need to get a proper TCM diagnosis from an acupuncturist or Chinese herbalist to ensure that it is the right herbal remedy for you.

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