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Slow & Steady Heals the Shoulder

At the end of 2022 I tore my rotator cuff, not throwing a baseball for some important league game, not in some random construction accident nor act of heroism. Instead, one of my first favorite paternal pastimes was throwing my daughter as high as I could into the air then allowing her to crash down on to my palm, elbows flexed, held tight by my bicep’s insertion.

 

Everyone says the same thing: You blink and they’re all grown up! This isn’t exactly an example of that, but I definitely didn’t take adequate note that my favorite play toy had grown from 15 to 25 pounds, and as an acupuncture colleague who was treating me for the issue remarked: “Would you throw a 25-pound weight up and down and catch it in your palm?”

 

To which I replied: “It depends how adorable and joyful the weight was.”

 

Typical presentation of a torn supra-spinatous: Pain radiating into my deltoid, especially with my arm extended to the side and/or behind me—even worse with inward rotation (trying to pour water from pitcher into our filtration system). Occasional pain while lying on my shoulder at night, and I couldn’t throw a tennis ball, let alone a baby anymore. I had to find other ways to enjoy parenthood. I also got used to pouring water with my left arm, which was probably a temporarily decent brain exercise anyway.

 

My funny acupuncturist friend helped a bit—a lot of sports medicine, trigger points and gua sha techniques—though no classical points, and improvement was always temporary. For two years my intermittent, moderate pain continued, and I was terrified of the notion of surgery and determined as such to avoid it.

 

I continued to go for treatment, occasionally poked and cupped myself at home as much as I could (though the supraspinatous is located behind the shoulder, making local self-treatment relatively impossible), and got very diligent with my daily Qi Gong practice: Shoulder rotations, shoulder rolls, neck rolls and rotations, “silk reeling” exercises, which are great for creating unique notches of negative space around the joints for the corresponding breathwork’s oxygen to enter. “Qi moves the blood,” is one of our most ancient maxims, which means where oxygen goes, fluids follow. I couldn’t tell you when it happened any more than I could when my daughter jumped from 15 to 25 pounds, but somewhere between years 2 and 3 of my injury, enough fluids got to the tendon and joint for my pain to disappear!

 

Today I am unsure if the tear is still there—I’m 47, not 27, so my shoulder may never again be perfect. I continue to do my Qi Gong regularly, preventively, not only for my shoulder, but other vulnerable tendons and ligaments as well. Slow and steady heals the shoulder!

 

If you have chronic pain it is something that requires daily attention, an at home regiment, self-massage and gentle movement anywhere from 10-20 minutes 1-2 times a day, and patience, the “patient patient,” if you will. If you stop, if you half-ass it, or give up, you’ll likely be resigned to the “blue pill,” surgery and well… literal blue pills, either of which will eventually wear off. I often recommend tailored Qi Gong homework exercises to my patients with our sessions, but if you’d like local Qi Gong teacher referrals, please let me know—happy to refer!

Posted in Acupuncture, Arthritis, Dry Needling, ElectroAcupuncture, Pain, Pain Management, Sports injury | Comments Off on Slow & Steady Heals the Shoulder

Yin & Yang of Stomach Pang!

Not all bellies are created equal, nor therefore, is all belly pain.

Stomach pain on the left tends to have more to do with organ function, whereas (in women) the left side might pertain more to ovarian function. Generally, belly pain that occurs above the umbilicus pertains to two of the three “yang” systems of the body, either “Shao Yang” or “Yang Ming,” either of which because of their connection to our intestines and digestive enzymes, might be accompanied by thirst for cold drinks, insomnia or agitation (not only as a result of the stomach pain), constipation, chest tightness, blurred vision, or blockage of the ears.

“Yang stomach pain,” as it were, tends to be constant—the abdomen feels firm and hard, resistant to touch. Conversely, pain that occurs below the umbilicus pertains to any one of the three “yin” systems of the body—gastrointestinal, endocrine, and/or hematological, tends to be more intermittent. The abdomen is softer, still tender to the touch, but it occurs more often in people who are prone to diarrhea and sensitive to the cold.

Thirst may still be present, though it is more likely for small sips of warm water, not big gulps of cold. That is because thirst of yin pathologies is a result of the GI tract’s lack of healthy fluids, whereas thirst of yang pathologies is from excessive inflammatory heat. If the same medicine is prescribed to both patients, one will improve and the other will exacerbate.

Yang pathologies might find relief with sour and/or bitter foods and medicinal—those whose mechanism is to drain, purge, and emolliate the abdomen.

Yin pathologies might find relief with sweeter (not by American standards) and more acrid (not by Indian standards) foods—those whose mechanism is to imbue the organs with more energy.

Another great way to distinguish diagnosis is by learning how people find relief.

If passing gas provides relief it is more likely a yang pathology, whereas if a complete bowel movement is needed it is more likely yin. If a hot compress feels good this is DEFINITELY a yin pathology, just as if ice water does it is DEFINITELY yang. A patient suffering from gastrointestinal, hormonal, or hematological weakness wouldn’t wish ice water on their worst enemy! That’s probably not true. People suffering with chronic “yin pathologies” tend to be understandably irritable, henceforth would very likely wish this on their enemies.

Then again, wouldn’t you wish acupuncture on your worst enemy, to transform them into a healthier, happier person to ultimately convert from worst enemy to best friend, or at the least, tolerable human being?

Where is your stomach pain, or that of a loved one?

What makes it better?

What makes it worse?

The answers to these questions and more can help us ascertain an accurate pattern diagnosis!

Posted in Digestive Disorders, Herbal Medicine, Pain, Weight Loss | Comments Off on Yin & Yang of Stomach Pang!

Tyrese Haliburton’s Achilles & Voice!

As a Buddhist I feel guilty about the mixed emotions I had as a (resentful) Knicks fan when Tyrese Haliburton went down in Game 7 after re-injuring his torn calf muscle and probably his Achilles tendon, sidelining the Pacers’ star for the rest of the game. I’m sure once that happened the odds in Vegas went heavily in favor of OKC.

As a Chinese medicine clinician, I couldn’t help but wonder, in the interim since the original injury how much his trainers had iced it to “bring down inflammation” even though Chinese Medicine and Dr. Gabe Mirkin, the originator of the R.I.C.E. protocol, recommend against it due to its vasoconstrictive mechanism.

Ice should be limited to stage 1 of an injury, only if there is some local redness, and even then Chinese medicine has something better to offer, San Huang San plaster, for its extensively studied anti-inflammatory, analgesic, and blood circulating effects.

The vessel that runs from the Achilles heel up to the calf and in fact the entire back is named the “Foot Tai Yang,” or urinary bladder, which logically acquires its nutrients and blood via its complementary vessel, the “Hand Tai Yin,” the lung vessel.

I recalled a story from last year that Haliburton has an odd but presumptively harmless condition where his voice changes inflection frequently and without apparent cause or warning. He laughed about it after several press conferences, saying he’d never realized he had this condition, but noticed exactly what others had while listening to himself speak.

Our voice of course is dependent on proper pulmonary function, which is why everyone immediately understands what someone means by “smoker’s voice.” Smoking dries the fluids, which might also explain why cigarette smokers are three times more prone to bladder cancer.

The ancient Chinese understood this connection. For all their brilliance at what they do, it is unlikely that modern sports medicine physicians do. Their lens is to isolate and treat, whereas ours’ is to understand every piece of the puzzle, no matter how seemingly disconnected.

In the article I read on Haliburton, a voice specialist medical doctor cited the fact that athletes do have to use their voice quite a lot on the court when communicating, but probably not nearly as much as performers or teachers or several other professions, right? I don’t think athletes are generally more prone to dysphonia. Also, basketball players may be more prone to issues with Achilles tendons, ankles, and knees, but it is notable that the remaining starting nine players in the Finals were playing the same game on the same floors at the same pace, and did not tear their calves. Only the guy with the history of dysphonia did—in my opinion due to the physiological connection between Foot Tai Yang and Hand Tai Yin. So the next time you have shoulder pain, knee pain, or any pain, by all means go to the doctor and get assessed—then go to a (good) Chinese medicine clinician to understand what’s happening beneath the surface.

Congrats OKC!

Posted in Acupuncture, Back Pain, Dry Needling, ElectroAcupuncture, Meridians, Sports injury | Comments Off on Tyrese Haliburton’s Achilles & Voice!

Acupuncture & Chinese Medicine for Nightmares

I’m not sure if what my toddler experiences qualifies as nightmares—she’ll occasionally yell out in her sleep—defiant demands, such as: “I don’t want one! I want TWO!” or, “No, put me down!” which my wife and I imagine are healthy reenactments of infuriating boundaries one of us had to regularly and/or recently hold with her.

For most adults, with greater awareness, a resume of more hardship to induce greater fears, real traumas, and fabricated neuroses, nightmares can be much scarier than being limited to one cookie. Per usual, (in Chinese medicine) they can be the result of a variety of mechanisms (none of which are mutually exclusive to the obvious psychological aspect), however all with one end result: “(Jue Yin) Blood Deficiency.” What is “Jue Yin Blood Deficiency?”

Generally, this means a person is lacking in fluids, such as blood and organ fluids, as well as inhibitory hormones and/or neurotransmitters, such as melatonin, dopamine, or serotonin. Without ample inhibitory substances, excitatory substances have no anchor—they will flare, whether in the form of emotional dysregulation, insomnia, night sweats, or NIGHTMARES.

I read one small study that demonstrated that people who suffer with nightmares also have a blunted cortisol awakening response, which is to say they feel exhausted upon waking, even after a good night’s sleep. Another study showed that specifically ADHD patients are three times more likely to report nightmares. Both instances suggest neuroendocrine disruption due to a deficit of stimulatory hormones, which might seem counterintuitive, as we might suspect that someone in the throes of a nightmare must be overstimulated. In fact, Chinese medicine and modern neuroscience seem to agree that these patients are in fact under-stimulated.

Activating hormones and neurotransmitters do not only activate the mind—they also stimulate the organs, via the hypothalamic pituitary axis, to properly do their jobs, part of which is to produce more substances to harmonize chemical balance in the body.

Stress can dry out these substances, as can poor sleep habits or poor diet. If stress is the cause it is advisable to seek therapy and/or meditation or some kind of spiritual context to reframe one’s suffering. Acupuncture would likely revolve around the gallbladder, liver, stomach, and pancreas vessels. Herbal medicine might revolve around bupleurum, ginseng, licorice, and/or pinellia root.

If someone’s diet is lacking in proper fat or protein this can lead to hypoactivity. Acupuncture might revolve around the stomach, pancreas, and liver vessels, plus the kidney instead of the gallbladder. Herbs might revolve around red dates, rehmannia root, angelica, and/or aconite.

If someone’s diet is excessively fatty or rich, this obviously creates inflammation that suffocates the organs, which causes the illusion of hypoactivity—in fact the organs are working overtime, exhausted as a result. Acupuncture would definitely revolve around the gallbladder and stomach vessels, probably the large intestine, as well as points on the abdomen itself. Herbal medicines might revolve around coptis root, gardenia fruit, and bamboo paper. In call cases points along the scalp above the hypothalamus and/or amygdala can be helpful.

If you or someone you know deals with any kind of nightmares or sleep disturbances, Chinese medicine can absolutely help… unless you live on Elm St. Wishing everyone restful sleep!

Posted in Acupuncture, Emotional/Psychological Disorders, Traditional Chinese Medicine, What We Treat | Comments Off on Acupuncture & Chinese Medicine for Nightmares

What Should We Be Drinking?

How much water should we be drinking? Is cold water okay? Is coffee healthy or not, already? What about decaf? What about green tea? Green juices? Prune juices? Sparkling water??? Please tell me sparkling water is OK! It’s all I’ve got…

Across the generations (and mediums) there have been many hydration gurus, and I suppose in this blog I’m throwing my hat into the ring, albeit really as just a hopefully qualified echo of Chinese medicine’s biological perspective.

Sparkling water is OK, but can irritate the bladder—should be kept to 1/day.

Room temp water is best, ideally half of our weight in ounces each day. Cold drinks can impair digestion, but again, once a day outside the context of a meal is no big deal, imo.

Juice is worse than people think—green juice not quite as good as people think. Green juices, without the sugars of fruit inside them, are fine, but should not replace real meals where salivary amylase is generated, we actually eat, and chew whole (green) vegetables.

One coffee/day should be fine for most people, but obviously has an excitatory and diuretic effect, so if one suffers with a lot of heat or dryness symptoms, should be minimized. These can include everything from insomnia and irritability to bloating or lack of appetite (dryness of digestive enzymes).

Green tea is preferable in people with “heat patterns,” and/or after a night of eating red meat, which can generate heat in the intestines. Again, because of its bitterness, people who tend to nausea, diarrhea, or lack of appetite should steer clear of green tea, and reach instead for…

PU-ERH TEA! Probably the healthiest thing one can drink besides clean, room temperature water, pu-erh is a black tea known for its naturally occurring pre and probiotics that enhance digestive and gut barrier function, the latter of which gets compromised by stress, medications, or alcohol. And I don’t know anyone who doesn’t check off at least one of these. Best taken hot.

I try to limit myself to 2 caffeinated beverages/day (I think no one should have more than 3), which are routinely a cup of Purity black coffee, followed by a cup of pu-erh, from either ARBOR or YUNNAN SOURCING, both of which offer organic and fair trade, high quality products. Highly recommend!

Posted in Acupuncture, Blood Pressure, diabetes, Diet, Digestive Disorders, Herbal Medicine, kidney, Nutrition, Recipes, Weight Loss | Comments Off on What Should We Be Drinking?
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