Exercise
Is it Safe to Go Running Outside Now?
And suddenly it’s 70 degrees… The days are longer and next week everyone comes into the clinic with either sudden onset colds or aches and pains. Why?
Yesterday while driving around my South Orange/Maplewood community I saw so many runners out in the streets, I would have thought a local race was going on if I hadn’t known better. It’s nice to be hyped for the warmth and sunlight, but smart to also not be the guy/girl who can’t wait to shed layers of clothing and allow the cozy but still crisp air of March to penetrate their surface through open beads of perspiration, thereby getting trapped at the body’s immunological layer, finding its way most proximally either to the lungs or the muscles. About half the runners I saw had sweaty arms and/or shoulders exposed, and if they’re not sick or especially sore in the next few days, well… good for them.
Throughout winter our “Yang Qi,” or immunological substances and anti-inflammatory chemicals nest mostly at the surface of the body, warding off cold temperatures and strong winds, and making shoveling many pounds of snow that much more exhausting, as we generally feel more energized when it is our metabolic layer, not surface, that is replete with “Yang.”
While east coast temperatures are poetically as bipolar as the default psyche of its inhabitants, suddenly jumping from 20 to 60 degrees in the span of a few days, our Yang Qi doesn’t move so quickly, especially as we get up there in years. Instead, in response to consistently warm temperatures it moves gradually from the surface, luring us into the illusory feeling that summer, if not at least spring has arrived, and we can store all the scarves, hoodies, and jackets away for the foreseeable forecast. This is false.
When open sweat pores come into contact with a breeze, the breeze bypasses the dermis. In winter or on the heels of winter cool winds are met by the immunological substances that have been subleasing space there for quite some time. They recognize one another as the enemy and battle ensues. This battle may manifest as something as simple as suddenly unusual neck or shoulder pain, or worse, they choose the immune system’s favorite organ as a battle ground, and there is cough or congestion.
Chinese medicine’s most referential text, The Yellow Emperor’s Inner Classic, clearly outlines a physiological pattern of (cold) air penetrating open sweat pores, thereby trapping fluid retention at the surface layer, which spends years trying to escape, manifesting in yellow or oily sweat that consistently stains (white) clothing, then followed years later with arthritis or other joint pains. Often considered an “astragalus pattern,” it can be treated by various herbal formulas with astragalus, or “Huang Qi” as their chief ingredient, working by transporting functional gases from the microbiome to the surface with the intention of ridding the latter of said inflammation.
This doesn’t mean be ridiculous. Enjoy the week! No need for winter coats, hats, and gloves. But scarves are a good idea, as are sweatshirts if you can handle it, and other sweater weather type attire, even if the literal number on the map suggests otherwise.
To Morning Exercise or Not to Morning Exercise
Patients (and students) can be good teachers, and one recently reminded me of an important premise, as she reported feeling much better since beginning to exercise in the morning upon waking, before breakfast, before doing anything else. For her, this made sense. For approximately the other half of the population it would not.
Sunrise in Chinese medicine is Shao Yang time, the time of day that corresponds, logically, with the body’s pivot, that is the system whose responsibility it is to use cortisol to bring vital substances, such as immunological or hormonal, upwards in the body. For those of us whose cortisol spikes too quickly or too early, exercise is one way to temper this surge. Interestingly, healthy food is another way. While physical movement can clear some of the inflammatory heat associated with morning cortisol, a proper breakfast of protein, unrefined sugars, and/or healthy fats can also act as an anchor to prevent it from spiking so much in the first place. For the types of people more prone to insomnia, hyperactivity, and fast metabolisms, it seems a moderate morning workout shortly followed by breakfast might be ideal.
For the opposite body type, prone to hypersomnia, chronic fatigue, and/or weight gain, a better time to exercise might be the time of day associated with the most “yang qi,” or warmth, closer to 12 noon, as these people tend to be more lacking in cortisol, as well as other excitatory chemicals, and therefore will benefit more by moving in accord with the environmental nature around them.
For those of us with small children at home, who cannot exercise upon waking, or those with jobs that preclude us from exercising just before lunch, I recommend doing what you can. Everyone is busy, but if you can find 15-30 minutes/day to get in your preferred form of movement, almost every scientific study on the subject since the beginning of scientific studies corroborate the benefit.
Acupuncture Post-NYC Marathon
The NYC marathon was this past weekend, and approximately 55,000 people pursued an admirable goal, reached a self-defined mountaintop, and in the process may have caused some degree of irreparable damage to their knees and/or hearts.
Although running is not the most advisable form of exercise in Chinese medicine, it is my opinion that for most people in moderation its benefits outweigh its pitfalls, helping to improve stamina and cardiovascular health, promote circulation, and in most months out of the year a healthy, non-excessive amount of perspiration.
But just like too much perspiration ends up negating its benefit by leaching the anti-inflammatory molecules and neurotransmitters contained within it, too much running can cause more harm than good—excess sweat being just one form of it.
While I struggle to disidentify as anything but a metropolitan, I also know that humans were not intended to walk, let alone run, on cement. That concrete is an inorganic, manmade endeavor, a luxury but challenge of modern society—good for capitalism, bad for Daoism.
Repeated pounding on the knees depletes their synovial fluid, the cushioning between bones and lubrication around tendons and ligaments that keep them soft, pliable, protected. Two ways to mitigate this effect is through stretching, that is opening the vessels and collaterals that send fluids to the patellae, but also with treatment.
Local acupuncture where fluid is missing cannot offer very much, but local moxibustion can inhibit NF-kappa B (inflammatory) signaling pathways, thereby dilating local vessels enough to attract white blood cells and healthy fluids. What’s more, “sports medicine” treatment around the neuromuscular paths that surround the knees can have a similar effect. Rectus femoris, biceps femoris, vastus medialis and laterali—basically, invigorate the thighs to unburden the bones.
As for the heart, this is obviously a serious issue. Excess exercise is arguably just as hard on the body as no exercise. It is important that we all find our own unique sweet spot in the middle and engage with discipline each week. For the excess inflammatory type, who drips with sweat, whose face turns red during workouts, who over-indulges and over-extends, the best recovery formula after a marathon will likely be Bai Hu Jia Ren Shen Tang, or White Tiger and Ginseng Decoction, with gypsum stone to clear the inflammatory heat that can overstimulate the heart, plus ginseng, licorice, and that’s right, white rice, to prevent further heat from flaring.
For the more typical runner type, thin and pale, who gets easily cold and prone to getting sick or injured, a potential recovery formula is Gui Zhi jia Gui Tang, or Cinnamon Twig Decoction with licorice, ginger, red dates, and extra cinnamon to strengthen and warm the chest.
Wishing everyone a speedy recovery, whether from the madness of marathon running or that of trick-or-treating. Stay warm and take care, especially en route to the holidays!
The 4 Seasons of Each Day
While many people are preoccupied with what foods are good for them, what foods are “bad,” and which exercise is ideal, from a Chinese medical perspective it is easier to simplify: The more we live according to the Dao (the scientific way of nature), the less ailments we will have. The less we live with the Dao, the more ailments we will have.
One Daoist, and subsequently Chinese medical principle is that each individual day contains within it the same seasonal arc that we experience in each year. Obviously, this does not mean that every day in January and February around 12 noon the temperature visits 80 degrees (though wouldn’t that be nice? But confusing). The arc is relative.
The morning hours correspond with the mechanisms and principles of spring. Rise and shine. “Plant seeds” for the day, in the form of a healthy breakfast and possibly setting one’s intentions. If you truly don’t have time for a good breakfast during the week, try to have an earlier lunch and be sure to do so on weekends. Morning is a good time for exercise, but not as ideal as mid-day, nicknamed “Tai Yang,” most yang and/or high noon.
Mid-day corresponds with summer. It is when most people have the most energy, hence it is the time to be most physically active. Since Chinese medicine views most parts of the body from a “use it or lose it” perspective, the less disciplined we are about engaging in at least some movement during the Tai Yang hours (11am-3pm), the weaker we will become. Again, if this is challenging during the work week, I recommend finding and committing to 15-minute windows, then “realer” workouts on weekends.
Sunset to nighttime obviously equates with autumn and winter, hence regenerating and restoring, winding down until sleep. This parallel is the one with an apparent hole in logic, as we recommend eating more calories in the winter than summer, but more during the day than at night when the body is relatively more insulin resistant. My understanding is the premise is more applicable to activity than caloric consumption, and principles of relativity still apply. Eat smaller meals for dinner in summer than in winter and remain restful at this time during all seasons. If you enjoy going out and indulging with friends once or twice a week or once or twice a month, by all means do so, but follow a more Daoist schedule on all other days.
In my opinion, there is actually virtue to a lot of “gimmick diets,” abstinences, and new age health regiments. However, in thousands of years, neither the human body nor nature has changed very much. If it had our medicine would be rendered wholly ineffective. Follow the Dao.
Go to sleep at a healthy bedtime, eat a healthy breakfast, exercise at mid-day.
Eat cooler foods and less foods in summer—warmer and more foods in winter.
Minimize indulgences, stress, and reductionist medicines.
These Longest Days of the Year
Welcome to the Tai Yang time of year. Say that three times fast, and maybe add “Thank You,” to complete the trifecta, TYTYTY! “Tai Yang” means the most yang, as we enter the longest days of the year, leading up to the summer solstice next week, at which time days will begin to very gradually, grow shorter.
Until that time we might be more vulnerable to “yang pathogens,” exemplified by inflammatory heat and/or “external invasions,” which is probably why we see a minor uptick in Covid cases around this time each year, despite the warm weather which should mitigate such spread. More common are the former, symptoms of “heat rising,” a la insomnia, anxiety, palpitations, acid reflux, constipation, headaches, and ANGER!!! If you’ve noticed an exacerbation in any such signs within yourself, rest assured, it is normal for the time of year and relatively wane after June 21st. If it doesn’t, see a doctor, and/or myself.
Some of the things we can do to cool excessive yang rising include green tea in the mornings (after breakfast), then peppermint or chrysanthemum teas at night, snacking on watermelon, cucumbers, and celery, and minimizing spicy foods and alcohol. Most importantly, sweat!
In Chinese medicine we treat most “Tai Yang disease,” or viral pathogens through moderate sweating—underscore moderate for you high intensity athletes—and as the weather now is increasingly humid to begin with, it is important to sweat, just a bit every day.
The Tai Yang time of day is mid-day, around noon, which makes that window optimum for exercise—although as I often advise my busy patients, the truly best time to exercise is whenever you have time. ‘Tis better to do imperfectly than not do at all.
Although I am admittedly a slave to air conditioning for sleep, it is obviously manmade, unnatural, and ultimately not physiologically (or environmentally) beneficial. In the humid climate of summer, the contrived cold air traps pathogenic fluids at the exterior, or “Tai Yang layer” of the body, thereby exacerbating local inflammation, often inducing skin/joint conditions, and compromising immune function. I recommend using it as minimally as possible and/or wearing a scarf or long-sleeves while in offices or public transportation that insist on killing us slowly. And spend as much time outdoors as possible. We are all too deprived of it these days.
Happy Father’s Day!
