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TCM Spring Training

Almost Spring at Zilker Botanical Gardens, Aus...

Image by DigiDragon via Flickr

Spring is the season of the Wood element and is characterized by reawakening and outward expansion. It is associated with the Liver and Gallbladder energetic systems, which when balanced are known for Qi that flows smoothly, initiative and good decision-making. Physical associations manifest in the eyes, tendons, ligaments and sinews which are nourished and maintained by the Liver. Just as the expansiveness of Spring can be seen in nature, emotional and physical energies associated with the Liver can be directed outward. Just like a sprout beginning to rise, energy is still fragile and can easily be damaged. Outbursts or projections of excess energy can best be put to good use with activities or projects that can utilize it.

Climactically Spring is associated with wind. The wind which can carry other pathogens also tends to aggravate the wood element. In the body it can cause allergies, itchy skin and pain patterns that tend to move from place to place. Symptoms may present as fever, slight aversion to wind or cold, cough, or mild thirst with burning pain in local areas. Sensitive people should enjoy windy outdoor time in minimal doses.

Injuries may present as:

  • Wind:  marked by a decrease in range of motion and pain that changes location.
  • Heat:  local inflammation and/or redness in the joints or extremities, and may be aggravated by heat.
  • Damp:  fixed and intense pain with a feeling of heaviness, numb skin and muscles that wet conditions may aggravate.

Movement in the Spring
To prevent injuries and improve performance in the Spring, consider the following:

Warm up properly utilizing dynamic stabilization exercises to ensure that postural muscles are activated prior to regular training.

As a stand-alone program or as an adjunct to another endeavor or sport, take advantage of strength training with slower to moderate speed movements. Strength guidelines state using 70%-85% of your estimated 1 repetition maximum, at a moderate to high volume (up to 25 sets when your main activity is weight training), with up to 60 seconds rest between sets. Incorporate this into your program for about four to six weeks to allow ligamentous tissues, which have a poor circulatory system, time to adapt. The nervous system and muscles characteristically adapt more quickly, which is part of the strength continuum but does not take all tissues into consideration. Transitioning into ballistic movements too soon, especially after a lay off due to injury or from sedentary life will predispose a person to further injury. Beginners should spend more of their workout doing stability exercises with a strength component.

As part of a post workout cool down, emphasize static flexibility to bring the body back into a more parasympathetic (normal) state. This will allow tendons to relax and circulation of metabolites in the muscles to move more smoothly.

Proper maintenance such as Tui Na, bodywork, acupuncture and meditative movements assist in recovery from exercise and injuries and boost the immune system.

Spring Time Nutrition
Food that assists in balancing the nature of the Liver and Wood element should nourish, soothe and keep the Liver clean, tonify the Spleen, nourish Yin, & strengthen Yang. Enjoy plenty of young plants, fresh greens, sprouts, and yellow to red veggies nutrient-dense and low in calories. These include tomatoes, loquat, beets, mint, onion, green beans, broccoli, chives and leeks. Flavor meals sparingly with vinaigrettes and pickled foods.

Keep high-calorie, refined, greasy or fried foods, sugars and alcohol that overtax the Liver and Gallbladder to a minimum.

Fasting will over tax the Liver and create more disharmonies in the body. A better way to cleanse the Liver is via sound nutrition, herbs that support Liver function and simply sweating from exercise.

Seasonal Recipes:
Ju Hua (chrysanthemum) congee: 100g white rice, 50g chrysanthemum.
Soak chrysanthemum separately for 30 minutes. Then combine with rice over heat for 5 minutes. Soothes the Liver and brightens the eyes.

An Chun (‘animal ginseng,’ quail) dish: 100g quail, asparagus 100g, mushrooms 5g, cucumbers 15g, egg whites.
Slice quail and mix with egg whites then sauté. Add asparagus, cucumber & mushrooms later. Sea salt to taste. Nourishes and soothes Liver.

Spring Herbal Considerations
This year has brought much change in the world and continuous perceptions of disharmony which sound nutrition and lifestyle may not relieve quickly. Strong emotions may affect digestion, causing stomach butterflies or bloating, acid regurgitation diarrhea and/or stomach pain. A Chinese formula that has made its way into  Western use is called Xiao Yao San or “Free and Easy Wanderer”. This formula profoundly soothes the Liver, thereby reducing the effects of stress on the body and helps prevent digestive symptoms. For those with enteric brains, this is quite a find. (For a thorough diagnosis, consult a Licensed Acupuncturist (L.Ac.)

Climate and physiological change affect the natural tendency of the Liver to spread and grow. By nourishing and maintaining the Wood element, the outward momentum of Spring will segue nicely into the warmer months of Summer.

Read about the coming Summer

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Self Myofacial Release

Self Myofacial Release (SMR) is a technique used to assist in the alleviation of muscle, fascial and joint imbalances. Imbalances such as tightness, trigger points or muscular weakness or one-sided dominance tend to happen due to a multitude of reasons such as sitting or standing for prolonged periods of time, overuse, activities dominated by one side of the body and/or injury. They may eventually lead to complications and potentially pain or further injury. There are various tools used to prevent and treat imbalances in conjunction with proper form, stretches, bodywork and other therapies. Foam rollers, tennis or lacrosse balls and other specialty items are usually found in gyms, sports shops, yoga studios or therapist’s offices.

Utilize SMR techniques before and after your workouts. Pre-workout 5 to 10 total minutes is adequate while post-workout longer SMR sessions are beneficial.

SMR procedures:

  1. Place the area of concern over a foam roller or similar tool. Remember to incorporate appropriate posture even while lying on your side. Foam Roll
  2. Roll back and forth over the area to increase circulation and “feel for” tight spots.
  3. Some points will stand out as ‘tender’ or tight; allow your body to breath and sink onto the foam roller in those spots. Hold this position for 20 to 60 sec. (some conditions allow for 120 sec. under supervision). If it is too tender with direct pressure work above and below the area  of discomfort. [Remember this should not normally hurt but some areas may be more noticeable than others]
  4. Reassess the area you worked on. Repeat as necessary.
  5. ‘Roll’ on the opposite limb and compare.

Common areas that benefit from using this techniques include but are not limited to the calves, hip flexors (quads), iliotibial (IT) band, piriformis (glute area), paraspinals (parallel to the spine) latissimus dorsi (lats/”wings”…), rotator cuff and pectoral muscles.

Avoid rolling directly on joints, bones and especially your spine.

By regularly incorporating SMR techniques into your daily routine you will become more limber, recover from workouts more efficiently and reduce your chances of injuries due to tight fascia.

OM Winter: Journey Inward for Outward Movement

In Oriental Medicine (OM) winter is the time to turn inward with meditative thoughts and conserve one’s energy. The winter’s energetic system is found in the Kidneys and manifests physically in the ears, lumbar spine and knees. Positive energy in this season reflects in a calm ability to handle stress with consistent focus and moderate energy throughout the day. Hearing can be more acute in the winter months, but the lower back and knees may experience more discomfort than in other times of the year. Some aspects of the Chinese medicine Kidney energetic can be seen in the biomedical kidney’s water metabolism, adrenal, reproductive and excretory functions . Through self-neglect or from prolonged stressors, people may find themselves anxious, irritable, fatigued and in some ways fearful or insecure. Since the cold slows the flow of blood and warmth to our extremities, activity should maintain continued circulation of the body’s fluids and proper joint relationships, as well as build our resources rather than deplete them.

Beneficial activities include Qi Gong, Tai Chi, low intensity movement or corrective exercises. Pre-workout exercises designed to warm the body up should be done for longer duration than in the hotter times of the year. Outdoor activities should be during the warmer, sunnier parts of the day and kept at a shorter length of time.

The weather can creep into the body and aggravate old injuries, arthritis and other aches and pains. This is especially true for outdoor athletes such as runners, bikers and hikers who spend a lot of time exposed to the elements as well as our aging populations and younger children. Pain patterns manifest in different ways.

  • Wind:  marked by a decrease in range of motion and pain that changes location.
  • Cold: fixed stabbing pain with spasms that does not usually have inflammation, is aggravated by cold and relieved by warmth.
  • Damp: fixed and intense pain with a feeling of heaviness, numb skin and muscles that wet conditions may aggravate.
  • Heat: not so common in the winter; characterized by local inflammation and/or redness in the joints or extremities, and may be aggravated by heat.

The wind is a carrier of other pathogens such as cold and dampness. Adequate clothing or protection is imperative. The yang parts of the body where most external pathogens enter and cause problems, such as the back and nape, should be covered. Normally our immune system (wei qi) is ample protection but chronic exposure, poor food choices and weaker or overworked constitutions create susceptibility. Enjoy foods that nourish the Kidneys and warm the interior of the body. Choices should include nourishing soups, broths and stocks, moderate spices and congees or porridge.

  • Foods that nourish the Kidneys: black beans, grapes, bone broth, eel, quail, walnuts (hu tao ren), black sesame (hei zhi ma), Chinese yam (shan yao), goji berries (gou qi zi), seaweeds: sargassum (hai zao), kelp (kun bu) or other varieties
  • Warm foods:  lamb, deer, beef, chicken
  • Warm spices and herbs: mild peppers, cinnamon, cardamom, nutmeg, ginger (sheng jiang)
  • Although salt guides to and nourishes the Kidneys, it is unnecessary to add copious amounts to our modern diets. Instead utilize seaweed, which is rich in iodine, and sea salts for cooking.
  • Raw and cold foods make the body weaker by disrupting digestive processes. They include:  iced drinks, ice cream, and excessive raw vegetables and fruits.

Overtraining or overworking in the winter will greatly affect your performance in the following season. Be aware of early signs and adjust your activities accordingly. Signs include – but are not limited to – a higher resting heart rate, decreased focus, mental fatigue, insomnia, mood swings, chronic muscle soreness, frequent injuries, delayed recovery, sensitive digestion, and/or unwanted weight loss or gain. Athletes and exercise enthusiasts who continue through the colder months of the year should follow these guidelines.

  • Regular acupuncture and tui na treatments restore balance to the body and speed recovery.
  • Warm up sufficiently. Include the use of a foam roller and dynamic stretching.
  • Avoid prolonged static or deep stretching at the beginning of workouts as this will cool the body down further, increasing the chance of injury.
  • Stay hydrated and maintain adequate nutrition. The body sweats less in the cold and relies more on exhalation and urination to expel water and waste, which creates the illusion of hydration.
  • Rest and be aware of signs of over-training.

By conserving energy, exercising moderately and eating well you can enjoy the season and ready yourself for a smooth transition and expansion into Spring.

For other articles on winter, see Oriental Medicine Winter.

TCM Summer: Keeping Cool in Hot Times

Impact of water in a water-surface

Image via Wikipedia

In Traditional Chinese Medicine (TCM) the energetic organ systems associated with the summer includes the Heart, Small Intestine, Pericardium, and Triple Burner (san jiao). The Heart is associated with laughter, joy and the kinds of emotional activity we see in family gatherings and outdoor events.  Physically the Heart governs blood circulation and sweat is its fluid.

Heart Qi is at its peak in the summer, which makes it particularly susceptible to injury from heat at this time. Heart Qi and body fluid damage may manifest as temperature regulation problems, dry mouth, skin blemishes, poor digestion, darker urine, a rapid pulse, restlessness, insomnia, poor sleep, cold sores and/or manic behavior.

As temperatures here in Texas continue to rise, we have to acclimate ourselves in preparation for summer time outdoor fun. Gradually build up your tolerance to warm weather activities by starting with shorter duration outdoor workouts and hydrate regularly – even if you’re not thirsty. Avoid very cold or prolonged exposure to cold water (drinking or swimming), cold foods and air conditioning as all of these can reduce your ability to adapt to the season.

Activities
Outdoor athletes like boot campers, runners, bikers and hikers sweat more and are susceptible to heat injury. Indoor Bikram and other “hot” yogis should likewise take care. Profuse sweating injures the body’s Qi and yin. Qi and yin injury can manifest as anything from thirst,and irritability to fatigue, urinary tract infections and sun stroke. Try to do your activity early in the morning or late in the evening when it is coolest. Wear breathable fabrics that are light in color and weight and avoid prolonged exposure to the sun and heat. Hydrate by drinking fluids before, during and after activity.

Foods to Keep You Cool

  • Bamboo shoots
  • Bitter melon – cooked
  • Coconut water
  • Cucumbers
  • Green tea – slightly warm to alleviate excess thirst
  • Lotus seeds
  • Mint
  • Mung bean soup, sprouts or the juice of soaked and cooked mung beans
  • Oranges
  • Water
  • Watermelon

Avoid or Minimize

  • Cold drinks or foods – i.e. ice water, etc. – temporary fix
  • Ice cream and sweets – can cause thirst and tax digestion
  • Foods that may spoil easily – common in warm weather
  • Spicy foods – add to internal heat over time

Proper hydration is imperative. Athletes may lose three to four liters per hour and football players have been known to lose as much as 11 to 13 pounds in one day due to multiple workouts.

As a basic exercise & recovery optimizer follow these suggestions:

  • Drink 14 – 22 oz. of fluid 2 hours prior to exercise
  • Drink 6 – 12 oz. of fluid every 15 – 20 min. during exercise
  • Drink on schedule rather than relying on thirst
  • Drink during training as well as during competition
  • Replace weight lost during training

Feel free to stay up a little later to enjoy the season and time with friends but get enough sleep to wake up with the early light. Rest and recovery can be accelerated by acupuncture, tuina and meditative practices.

 

For other articles on summer, see TCM Summer.

Modern Feet

From bare foot times when we relied on agility and endurance for survival, to the present day when our command of language is what makes or breaks us, there have been few times in history during which our feet – or someone else’s – did not carry us.

High Heels

Foot Photo by Matilde Aamodt

Even though our feet are normally reliable and loyal we have a knack for ignoring and even abusing them. The brutal practice of foot binding, for example, created a deformity that certain cultures viewed as a mark of beauty. While foot binding died off with a refusal to tolerate the lifelong disabilities it caused, today’s high heels with their narrow toe boxes and sharp points might be considered just as punishing.

Consider this:  for every two inches of heel height the ankle must rotate by ~23.5 degrees, while it undergoes a 45-degree change in four-inch heels.

Feet are the foundation from which we move; problems in the feet can lead to compensatory patterns in the rest of the body. Structural changes can occur in the knee, hip or spine, and head placement and gait may be altered. This commonly results in ankle, knee, hip, low back and even neck pain. In heeled shoes, structures in the calf like the soleus and achilles shorten, the calcaneus bone lifts and the talonavicular (TN) joint drops. Over time, the mid-foot may even collapse. Ouch!

We began wearing shoes as necessary protection, but over time most shoes have decreased our proprioceptive awareness and changed the way we move – and not for the better. Technology provides arch support, motion control, attractive design and cushioning. Running shoes are purchased as slightly larger shoes assuming that the foot will eventually deform and fit them. Flip-flops allow us more freedom, but the foot tightens up in dorsiflexion and then slaps the ground as we move along and for some this lead to imbalance.

Common Foot Conditions Resulting From Modern Footwear

    • Plantar fasciitis
    • Bunions
    • Achilles tendonitis
    • Ankle sprains
    • Bone spurs
    • Excess pronation or supination

… all leading to compensation in the kinetic chain

Oriental medicine (OM) includes acupuncture and bodywork – including acupressure and reflexology – in its view of the foot as one of many microsystems representative of the rest of the body. It prevents and treats diseases by stimulating points (zones) on the foot to regulate zang-fu (yin-yang) organ function and soothe qi and blood in the channels.

There are 33 points found on the six basic meridians of each foot. Perhaps not-so-coincidentally there are 33 joints in each foot. All acupuncture/acupressure points on the feet can be used to treat local conditions, while many of them are the most powerful points for treating conditions affecting organ systems or pain in opposite limbs. The most distal (farthest away) points on a channel affect emotions, regulate temperature, strengthen the body and can relieve heaviness in the limbs and joint pain. The feet in particular can help with head and face conditions.

In the cortical homunculus, a sensory map, our brain views the feet, hands and mouth as being proportionally larger sense organs than the rest of the body. But allopathic medicine tends to use orthotics such as boots, arch supports, cortisone injections and surgery – all which serve to numb or restrict movement – as answers to every problem.

With so much potential, it is a wonder that we have come so far in desensitizing our feet.

There has been a recent movement to return to our barefoot nature with the introduction of the Vibram 5-Fingers and similar minimal concept shoes. More research and education about the benefits of going barefoot are giving us a greater understanding of how having healthy, functional feet affects the rest of our bodies.

When I attended the 2012 SCW Dallas Mania in August, I found Vibram Five Fingers fitness advisor Stacey Lei Krauss to be the highlight. She brought together years of experience and training working with and improving foot function. Her knowledge base and presentation skills made for informative and enjoyable seminars.

Krauss says that bare feet tend to have improved blood circulation and nerve reflex action, and that going barefoot or minimal will “wake up your feet.” Because “minimal” does not imply extra cushioning or support, Krauss suggests going barefoot on concrete first since we are less apt to stomp or run quickly over a hard surface. There is more reaction or proprioceptive awareness required of the feet on soft uneven surfaces such as sand and grass so these surfaces should be approached over time. Important points to remember for maximizing minimal shoes like Five Fingers as you re-learn how to run include foot strike, compliance (allowing the feet to relax), tempo, and posture.

Kraus offered a few starter protocols for care and strengthening of newly bare feet.

I. Self-Care
The feet house 250 sweat glands and can sweat up to one pint daily! Bacteria live better in your shoes than on a studio floor, so it’s essential that you clean and maintain your feet. Krauss says feet have the same stigma as other “private parts” but we tend to spend more time maintaining those parts than we do our feet. “It’s not enough to splash – wash!”

Self-Massage Sequence Before or after workouts and on non-workout days. ~3 minutes.

  • Apply oil or lotion.
  • Rub each toe, lengthen, split (forward, back and wide), toe fan.
  • Slide fingers between toes and move forward, back, sides and figure eights.
  • Thumbs on transverse arch (landing pad). Try to feel each metatarsal head.
  • Rub an elbow or knuckle along the arch (and plantar fascia).
  • Knuckle thump around heel.
  • With your thumb and first two fingers rub the achilles tendon up, down, across and around.
  • Use both hands to friction-rub  the ankle in a twisting motion.

I would recommend soaking feet in warm soapy water, or a warm herbal soak, for 10 minutes before following the sequence. Make sure water is deep enough to reach your ankle bones.

General Foot Strengthening and Lengthening  
Do this protocol for a minimum of two weeks to one month. Can be done pre- and post-run or workouts. Do each exercise a few times.

  • While standing barefoot raise the toes up, spread the toes.
  • With the toes up try thumb taps, pinky taps, back and forth.
  • Eversion (roll the foot out), inversion (roll in).
  • Grip the ground with toes, hold and release.
  • 1 heel up ankle circles.
  • 1 foot up dorsiflex (toes down), plantarflex (toes up). Grip floor with the other foot.
  • Split stance calf stretches – gastrocnemius (straight leg) and soleus (knee slightly bent).

Krauss says to start jogging at about 10 minutes max. Bring your regular running shoes with you and change before the long part of your run. Your feet (and ankles, and calves) will thank you. After reaching 10% of maximum weekly distance progress at no more than a 10% increase at each week. Expect tight calves and achilles complex at first. Always allow time for a foot-specific warm up and cool down.

Starting tempo runs at about 180 beats per minute is recommended for beginners. This sounds fast but it actually decreases the load and distance between each step.

Having done post-race massage for runners, I have met runners who used their minimal shoes for the first time during a race. A three-mile run in new minimalist shoes can create major tightness and discomfort post-run for the uninitiated. Remember you are waking up muscles and joints that have been lulled to sleep by restrictive and cushiony footwear for a long time. It’s going to take a while to re-educate these structures, but your patience will certainly pay off in less ankle, knee, hip and back pain overall.

Consider the information I have provided and continue to learn by utilizing good resources such as Vibrams’ website.

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