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

Oriental Medicine Winter

Winter, tree and birds

Image by mirsasha via Flickr

This year winter begins with the solstice, which is the shortest day and longest night of the year. In Oriental Medicine (OM), winter is the season associated with the water element and is yin in nature (dark, cold, moist and still). Just as nature is sleeping and resting in anticipation of warmer days, the season urges us to rest, conserve and replenish our energies until the coming spring. The change in season may bring about abundant allergies, while colds and flus take advantage of the stresses only the end of the year can bring. The emotion associated with the water element is fear and it contains the spirit of will power. An imbalanced water element may present as fearful, which depletes vital energies. Just as water provides fluidity for movement and lubricates every joint, the water element’s spirit guides us to smoothly overcome fear and difficulties.

By supporting positive qualities, the most stressful time of the year can be the most joyous time of the year. To make the most of this winter, enrich Kidney essence (jing) or constitution and maintain your immune system (wei qi) by following these lifestyle changes until spring.

1. Go to bed early and wake up later, stay warm and expend minimal amounts of energy.

2. Avoid raw or cold foods as they tend to cool the body further. Do consume warm foods such as soups, lamb, pork, chicken, peanuts, beans, walnuts (hu tao ren), Chinese dates (da zao), longan fruit (long yan rou), cinnamon (gui zhi), ginger (sheng jiang) and garlic (da suan).

3. Wear warmer clothing to protection your yin qi, but do not make your home or workplace so warm that your body does not adapt to the outside environment.

4. Continue to exercise to keep your pulse and qi strong, but do not exercise to the point of exhaustion.

5. As reinforcement of your lifestyle, acupuncture and Tuina relieve stress and improves digestion. Applied to specific areas such as the abdomen or Stomach 36 (Zu san li area on the lower leg), they  also boosts immunity by increasing white blood cell counts.

By adopting an OM lifestyle, embracing the change of season and nostalgia for the year gone by, we can fuel the energies to create new memories in the coming year.

To see how athletes can optimize their success in winter, see Journey Inward for Outward Movement.

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.

Autumn and Oriental Medicine

Autumn in Austin
Image by Andreanna Moya Photography via Flickr

Autumn begins at the equinox, where the day and night will seem to be equal in length. During this season harvesting and eliminating can be seen as crops are brought in and leaves change colors and float to the ground. Creatures in nature tend to become more dormant and focused on preserving energy. Yang Qi (warmth, vibrance) goes inward, & Ying Qi (combination of air/ da qi and food qi/ gu qi) starts to grow.

The fall corresponds to the “Metal element,” which has a quality of moving inward and represents the organs of the lungs, the large intestine, and the skin. The Lung and Large Intestine energies affect respiration, digestion, nutrient assimilation, and opening and closing of skin pores. They are also seen as the main organs for cleansing & detoxification. The Lung manifests in the nose and represents an entrance for clean air/ da qi into the body. The Large Intestine is seen as a segway for elimination of unwanted and unnecessary constituents from the body.

The metal elemental energy is associated with processing and grief, letting go of old attachments and emotional baggage. Autumn is a good time to assess what we value and determine what is needed. As we do this we realize who we are without constraints, in effect remaining positive and calm.

The Lungs are strong in the fall, but exercising less than the spring & summer is essential to store yang qi for the winter. This can be optimized by choosing exercises that do not require excessive sweating, focusing more on athletic skills & techniques, and practicing inward-directed movements such as Qi Gong, Tai Qi, Yoga and breathe work. In terms of recovery acupuncture, herbal medicine and tui na (Chinese clinical bodywork), accompanied by the philosophy of going to bed earlier and waking up later applies well in this season.

This is also an excellent time to rejuvenate the lungs and to cleanse and nourish the skin by avoiding extreme dryness.

Potential imbalances can be seen in the immune system/ wei qi, respiratory problems (allergies, shortness of breath & asthma), skin conditions and constipation.

Foods that will help balance the metal element, nourish and protect body fluids/ jin ye, should be warmer, sweeter and slightly sour. But not pungent, acrid or spicy as these can be too dispersing & may cause damage to body fluids.

Here is a general list of foods that can nourish  the body during autumn: pears, white fungus, onion, garlic, chive, ginger, turnips, daikon; yellow, orange vegetables like carrots, yams, sweet potatoes; dark leafy greens, such as mustards, kale, chard and spinach; and rice, quinoa, amaranth or oats.

This is an easy recipe that is beneficial to eat at the beginning of autumn or winter:

  • 1 pear – peeled, remove seeds
  • Fill with 30g Fritillaria bulb/ chuan bei mu (a licensed acupuncturist can provide this)
  • Steam 10-15 minutes, cut into 3 equal parts and add local bee honey/ feng mi.

This can also be cut into cubes, added to rice & water to make congee.

As the air becomes cooler and our environments become more still, we can learn from the world around us. Turning towards introspection, and nourishment via breath, food and Oriental Medicine, we can allow an opportunity for conserving strength and a renewal of energies/ Qi.

Irritable Bowel Syndrome (IBS) and Oriental Medicine

Irritable Bowel Syndrome (IBS), also known as spastic colitis, is the most frequent gastrointestinal (GI) disorder and accounts of 30 -50% of all referrals to gastroenterologists. In 10-20% of European and American populations it starts in late teens to early twenties occurring more often in women.

IBS is not classified as a disease, but as a syndrome. It is considered a functional GI disorder characterized by a variable combination of chronic and recurrent intestinal symptoms that are not explained by structural or biochemical abnormalities.

Symptoms may occur alone or in combination:  abdominal pain or discomfort with altered bowel function; abnormal frequency of bowel movements (BM); typically diarrhea, constipation or both; flatulence, bloating, loss of appetite, nausea, increased mucous production, painful BMs. Cramping, intermittent, lower abdominal pain does not usually occur at night nor interfere with sleep and most symptoms are commonly relieved by defecation.

Additional non-bowel symptoms may include heartburn, chest pain, headaches, fatigue, muscle pain, urologic dysfunction and gynecological symptoms, and often coincide with chronic fatigue syndrome. There is a Mind-Gut interaction where anxiety and/or depression frequently accompany IBS symptoms in varying degrees.

The cause of IBS is not clear. It is felt to be a “dysregulation” of intestinal motor and sensory functions of central nervous system (CNS) origin – thus the psychogenic component.  The gut produces 95% of serotonin in the body. If the gut is not functioning optimally this affects mood, thought processes and clarity of mind. There is strong evidence for disruption of balance between non-pathogenic flora and the immune system, while GI infections treated by antibiotics result in a higher chance of acquiring IBS.

Diagnosis follows the Rome III Criteria, which includes abdominal pain for at least three days per month for three months and is characterized by two out of the three following symptoms:  pain relieved with a BM; change in frequency of BM; and change in the consistency of BM.

Other causes should be ruled out such as lactose intolerance, drug-induced diarrhea, parasites, food sensitivity (may depend on combination) and food allergies.

Medications include the possible use of tricyclic antidepressants and symptomatic treatment for spasms, constipation and diarrhea. Antibiotics are often improperly prescribed because diarrhea is confused with infection. This leads to other gut problems such as poor gut flora.

Lifestyle: Eliminate offending foods such as common allergens:  wheat, dairy, corn and soy. Avoid gas-producing and diarrhea-producing foods:  beans, fermentable carbs, sweeteners, hydrogenated fats, brussel sprouts, cabbage, cauliflower, raw onions, grapes, plums, raisins, coffee, garlic, red wine and beer. Increase dietary fiber from non-wheat plant sources for constipation and foods that promote healthy flora in the gut such as beet fiber.

TRADITIONAL CHINESE MEDICINE (TCM) cannot be simplified without losing its essence. It seeks to find and understand the cause. TCM’s advantage in treating functional disease is holism and emphasis on various exterior functional activities of the human body.

TCM can’t live without the Spleen (SP); biomedicine does not consider its importance. In TCM the SP and Stomach (ST) energetic systems are paired. Together they receive food, assimilate it and send it to the rest of the organs and the body to be further processed. The SP ascends energetically while the ST descends. SP dysfunction may result in diarrhea, while ST dysfunction may result in nausea or vomiting.

The Small Intestine (SI) separates pure substances from the un-pure. It has the ability to absorb and distribute nutrients. There are few specific SI syndromes and SI qi deficiency can result in chronic diarrhea. Most SI diseases are referred to as SP problems. The Large Intestine (LI) has the ability to eliminate waste and its dysfunction is constipation.

Causes of IBS in TCM include:  irregular diet; emotional stress leading to qi stagnation and affecting the SP and ST; SP deficiency causing anxiety, depression and sleep disturbances; Qi, Blood, Yin or Yang deficiency after chronic disease or after delivery; or overuse of laxatives or purging supplements.

Differentiation follows the basic presentations such as diarrhea-predominant IBS, constipation-predominant IBS with abdominal pain and flatulence, abdominal pain-predominant and alternating between diarrhea and constipation. Subcategories go into further detail and include but are not limited to:

  • Excess presenting with abdominal distension and/or pain, red face, scanty and/or red urine, dry smelly mouth; may occur in heavier kids with less BMs due to lack of exercise.
  • Deficiency in older patients and weaker constitutions with diminished Yin essence from over-consumption of spicy food and irregular toilet habits. There may be weakness, no power to pass stool, might not be dry, may even be soft; sweaty, pale complexion, shortness of breath and/or fatigue. This is also common in women after giving birth due to blood loss.
  • Cold, in chronic conditions and older patients. Stools may not be dry, but difficult to pass or the patient may have no power to pass stool and present with a sallow or pale complexion, cold in the four limbs and lower abdomen and an aversion to cold with clear urine.

Acupuncture and Herbs seek to alleviate symptoms, address the cause and restore balance to the entire person by being highly modifiable based on patient presentation.  Some acupuncture points are near areas of discomfort while others are found on distal aspects of the body. Herbs are a way to safely treat the body internally.

Nutritional considerations follow an energetic standpoint that is synonymous with the TCM diagnosis. Foods are recommended that nourish and balance the body without aggravating the gut.

Both Western and Eastern medicine agree it is necessary to address the whole body to alleviate the IBS presentation. After being diagnosed it is imperative that consistent lifestyle changes are made to maintain and prevent reoccurrence of symptoms.

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