Just Breathe

Hello everyone! I apologize for not being as regular with my posts recently as I would like to be. I’m a little overwhelmed with my school workload at the moment, so my blog posts will probably be on the shorter side for the next few weeks.

I’ll be honest with you all. I’ve been a little stressed recently. I am really enjoying my doctoral course load, but at the moment, I’m taking four classes and maintaining my practice. It’s a lot. And it’s perfectly fine to admit that I’m feeling the pressure lately. In our modern world, stress is ubiquitous. Everyone is stressed pretty much all of the time. With technology making much of our work right at our fingertips, it’s hard to turn “off.” There’s always one more email to respond to, one more quick text to send, and one more task you can squeeze in before bed. Unfortunately, this constant stream of pressure can have negative consequences for our health. When we are constantly in a state of stress, our body gets stuck in the “fight or flight” mode. This means that our body is always ready for the next catastrophe, but this is not a good place for our body to be for any sustained amount of time. Stress has been linked to a huge number of health conditions, including headaches, digestive disorders, and cardiovascular issues.

So what do we do when we are stressed? There’s a million things you can do to reduce stress, but I want to focus on just one tool to manage stress in this post. It’s easy, free, and can be done anywhere. Curious yet?

It’s breathing.

I know, I know…this is ground breaking stuff here. “But Sarah!” you might say. “You are normally so wise and witty!  Breathing! For stress?! What a stupid statement from such a normally wonderful practitioner!”

Bear with me. Breathing is a fundamental part of Qi Gong, a system of mediation and movement that draws a lot from the philosophies of Traditional Chinese Medicine. Qi Gong combines different postures and breathing techniques in order to cultivate well-being.deep-breathing

So this is not just any breathing. Many people don’t breathe correctly. And again, you might be doubting my sanity here. But it’s true. Look at how a baby breathes (if you don’t have a baby for easy access, don’t ask to borrow one so you can watch it breathe. That way lies creepiness. Just trust me on this one). Their little tummies go all the way up and all the way down. They breathe all the way down into their abdomen. As adults, we forget how to do this. We hunch our shoulders up around our ears and take shallow breaths. We don’t use the full power of our diaphragm muscle to take full breaths in and release a deep breath back out.

Taking a few minutes to pause and re-set our method of breathing does a lot for us. It slows our heart rate, increases our oxygen consumption, and allows our mind to become more still and at ease.

This can be done through a simple breathing exercise that I will walk you through. This can be done either seated or lying down, whatever you prefer (if you lie down, this is not naptime…stay with me!).

Place your hands over your belly. I like to place them around the area of my umbilicus (belly button). Take a long slow deep breath in so that you feel your hands lifted up by your belly. Hold for a second at the fullest point of the inhale. Then exhale very slowly. Feel your hands fall back down as your belly flattens and air is expelled.

If you’d like, you can include mantras or mental imaging with the breathing. You can breathe in “Peace” and breathe out “Stress,” letting your negative emotions and thoughts leave with the exhale. You can picture a white light as you inhale, and exhale whatever color you associate with stress (red, black, grey are the most common ones). You can simply count slowly: inhale for “1…2…3.” Pause, and then exhale, “3…2…1.”

deep-breathing
Sounds pretty easy, right? This is a very simple method of reducing stress and allowing yourself a few minutes to rest, re-set, and get about the rest of your day. Give this a try this week, and let me know what you think! I hope everyone has a great rest of your Sunday and a wonderful week ahead. Be well!

What A Pain!

Hello everyone! I hope you all enjoyed the last few guest authors here, but today you are stuck with me 🙂 I’m going to talk about pain in this post. Pain is the most common reason that I see patients in my private practice, and it’s probably the most common reason why Americans seek out TCM services and acupuncture in general.

Pain can be divided into two types: acute and chronic. Everyone has experienced acute pain- you have a throbbing headache, you stubbed your toe, or you threw out your back. Acute pain is typically fairly short-lived and uncomplicated. Acupuncture works very well for these types of conditions (in fact, the sooner you come in to get treated, the better results we tend to see), but what I tend to see most often in practice is chronic pain. Chronic pain means pain that is sticking around for quite some time (usually either longer than three months or longer than six months , depending on who you ask), and it is often very difficult to manage effectively. Usually, people come to see me because whatever they have been trying to do to manage their pain either isn’t working, or it isn’t working as well as they would like.

When thinking about pain in TCM, we can pretty much boil everything down to a very fundamental statement of Chinese medicine:

If there is free flow, there is no pain. 

If there is no free flow, there is pain. 

Essentially what this means is that pain results from a stagnation of qi and blood in the body.  How exactly does the stagnation occur? This is where things can get a little complicated- as with almost anything in Chinese medicine, there are always lots of different etiologies or potential causes of a pathology. However, for our purposes here, it’s just enough to know that something happens to impede the free flow of qi and blood. This “something” can be an injury or accident, a structural issue with the body, a deficiency of qi and blood, an external pathogen like cold or damp, and even emotional factors like stress and anxiety. Once things stop moving and grooving like they should, you develop a symptom- pain.

The best analogy I have for this is to picture cars moving along on a highway. Suddenly, two cars collide and stop on the side of the road. Almost immediately, the flow of traffic on the road is altered. Cars slow down near the site of the accident and move sluggishly to get around the stopped cars. Traffic begins to back up behind the site of the accident and there’s not enough cars on the road ahead of the accident.

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The same thing happens along the acupuncture channels that cover the whole body. So what do we do to fix this problem? Treatment is going to address whatever caused the obstruction as well as help to get things moving as they should.

The insertion of acupuncture needles at specific points works like the emergency responders and tow trucks at the site of an accident- it helps to resolve the issues at the local area, direct traffic, and get things back to normal as quickly as possible. Tui Na (a form of Chinese medical massage) works in much the same way. Chinese herbal medicines (which can be used internally, topically, or both) also work to reduce pain and inflammation locally and to keep things moving freely in all the acupuncture channels. Once we get things back to moving smoothly, the pain resolves!

You can also do things at home to help manage pain conditions. Meditation, light stretching or exercises, and addressing lifestyle factors such as sleep habits and diet can all contribute towards pain management. Depending on what people are coming in for, I almost always send them home with some personalized recommendations for things that they can do at home until their next appointment.

Chronic pain can take a little longer to make progress on than acute pain. I usually give a gentle reminder that if you’ve had a painful condition for a long time, it can take a little while to get things better. Again, think about the traffic jam example- it’s a lot easier to clean up a fender-bender than it is to clean up a ten car pile up in a snowstorm. Once stagnation has settled in, other pathologies can develop, so it takes a little while to make things right. I always love when I’m conversing with someone and they say, “Oh yeah, acupuncture…I had that once. I had shoulder pain for three years so I tried it once. Didn’t work.” This is akin to licking the outside of an antibiotic pill and assuming it’s going to clear up a bacterial infection. Acupuncture works cumulatively- treatments build upon each other, so that your progress becomes a little more pronounced with each visit. I usually ask chronic pain patients to give me three to five visits before they call it quits- this gives a much better idea than just one visit if their condition is something we can address effectively. I can only think of a very small handful of patients who weren’t seeing progress after a few visits, and in most of those cases, there was some pretty significant structural issues that went beyond what I could fix.

One more quick note about pain…this is in regards to the use of ice for pain. Chinese medicine has a very different perspective on the use of ice than Western medicine does. It has become very common now to use ice packs, cooling patches, or other chilly therapies when you have a painful condition. I don’t mind the use of ice immediately following a trauma, especially if the area is red, swollen, or warm (of course, these signs also mean that you should be getting yourself to a medical provider). What I don’t like seeing is people still using ice eight months after an accident. In TCM terms, cold is said to constrict and contract. This means that it can cause hiccups in the free flow of qi- think of a stream that freezes in winter. Ice formation along the waterway means that the water can’t go where it should. Applying too many cooling treatments can do the same thing to our acupuncture channels.

For those who live in New England, this stagnation can happen in your gutters too...nothing like smashing an ice dam to get things moving!
For those who live in New England, this stagnation can happen in your gutters too…nothing like smashing an ice dam to get things moving!

What we can do instead of using ice is to use cool or cold formulas- these contain herbs that will reduce the redness and inflammation, but they also contain moving herbs to counteract the stagnating nature of cold. If ice is literally the only thing helping someone with their pain, I try to find a way to incorporate it into their treatment plan, but this has very rarely been the case…once we start to get things resolved, the need for ice usually becomes much less.

.I hope you’ve found this little explanation on pain to be helpful! Acupuncture and other TCM modalities are really great for pain, and they can be safely combined with most other treatments that people may be using (injections, most meds, PT,  pre- and post-surgical, etc.) Although I treat a lot of pain conditions, I never really get tired of working on them because it is so rewarding to help someone alleviate some of their suffering. I hope you all have a wonderful week, and as always, fell free to share this blog with anyone you think might enjoy it. Be well!

A Little Something Different (Feat. A Special Guest!)

Hello everyone! You lucky readers are getting spoiled this month, because I have another special guest coming in to help me out with today’s blog. Today’s post is a little different from my regular TCM musings, but I got to thinking about all of those people who wanted to try out some new fitness resolutions for the new year. I feel like the initial momentum of making positive changes can carry us through for about four to six weeks before real life gets in the way. So now we are just about at that point- it’s been awhile since you were all pumped up with that New Year’s energy and maybe now you are feeling sore, getting tired, or just aren’t sure if you like where things are headed. Plus this is prime PJs and wine season, so it can take some extra motivation to even get your rear in gear. I don’t want to frame exercise only in terms of weight loss (although obviously it can help with that), since there are so many other positive aspects to it. Among other things, exercise boosts your mood and promotes good self-esteem, strengthens your bones and promotes joint health, and makes your heart and lungs healthy and strong. So there are so many reasons to make sure you are getting some fitness into your daily routine.

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This is where my good buddy Ryan Yurista, CSCS, comes in. He is a very talented personal trainer based in Manchester, NH. He is a Certified Strength and Conditioning Coach as well as a Level 1 Precision Nutrition Coach. In addition to be an excellent coach and nutrition expert, he is one of the most genuinely positive people I have ever met and is dedicated to helping his clients achieve long-term, sustainable health goals. He recently wrote an awesome post on his blog where he talks about how to keep the momentum going after resolution season, so I asked him to contribute some thoughts on that subject here as well.

So I’ll turn things over to him and let the expert take the reins!

 From Ryan:

We are now well into the new year! Congrats, you made it!

Sometimes things can get a little crazy though, and it can be tough to continue your positive mindset moving forward when you have certain things land in your lap. That’s what we’re talking about today. With that said, we are talking about stuff that really just gets in the way. Real problems that everybody faces. Knowing how to overcome them can really help you be positive in the moment and figure out another path (even if it’s longer) to reaching your goals. 

1.) I got hurt.

Well, that just stinks. It’s okay though. You may be able to work around it, depending on the injury. If this is the case, simply don’t do things that hurt. Don’t ever feel like you should push through pain, but don’t be afraid to find a new way to explore an exercise. For example, many of my clients might say that squats hurt their knees. Well, there are ways to get around that. Instead, you can try to a squat to high box and limit your range of motion, or push your knees way out to emphasize the glutes in the movement. Find what your body likes and don’t be afraid to experiment.

On the other hand, if you are just incredibly sore after your workouts, you need to look at those other factors like nutrition, sleep quality, and overall exercise volume. Sometimes your body just needs to rest and repair itself. Many times your recovery is limited because you may not be eating enough for your exercise demands. So, either scale back the exercise a bit, or make sure you replenish your muscles with a solid meal after workouts.

Another thing here is what type of pain you are in and when to get it looked at. If you wake up one day and you are in agonizing pain, you should definitely find a professional to assess your injury and give you some guidance regarding the injury. Rule of thumb: If your daily activities are limited with a lingering injury, get yourself looked at. Some things do need the appropriate care, so you can get back to feeling your best!

2.) I am bored.

For someone as scatterbrained as me, I completely get this. You see new things on the internet, and say, “Hey, I want to do that!” But, consistency is important for getting results- so stick to your plan! Although you may be getting bored with your exercise program, each workout is another opportunity to get closer to mastering each exercise. Here are a few tips to get around this feeling:

Pick a new skill and try to get better at it. We are more likely to be engaged if we are part of a learning process. Find a new lift or activity, and learn everything you can about it. Then, try and throw it into your routine and continue to work on it! This can be something as simple as using a new piece of equipment or learning a new mobility routine.

Take some classes. If your gym doesn’t have small group training classes, there is usually somewhere around town that you can pay a drop in fee. It’s always great to have someone else pushing you a little bit more, as well as having the community of the group sweating with you. Maybe you’ll be able to pick up a new tip that will help your form. There are tons of Spin studios, Barre, Pilates, climbing, and other training facilities that offer some pretty cool and unique experiences.

3.) I am frustrated with the progress I’m making.

Sound familiar? Everybody experiences this! The best advice I can give you is to think of your health like your bank account. There are no get rich quick schemes. You have to earn your accomplishments and deserve your results. Whatever your goals, be ready to fight for them. You can, however, continue to make small tweaks here and there to discover where you feel your best and get the most from yourself.

For starters, work on your warm up routine. Most people that I encounter are more on the side of, “Wait, I should warm up?” Here’s why it’s important: You won’t be wasting your time warming up for your workout- during your workout. Exercise is as much of a mental habit as it is physical, so if your mind isn’t ready, neither is your body. Come up with an easy routine that includes some foam rolling in those trouble areas that tend to get stiff, as well as a full body warm up that helps to get your heart rate up and loosen up those cranky joints. It could be as simple as foam rolling your hips, followed by jumping jacks, and a hip stretch for a few times around. This will ensure you are putting in the most effort you can while you are crushing your workout.

Secondly, I would also recommend that when you get “stuck,” you take a hard look at your routine and simply make some small adjustments to get the wheels going again. Don’t scrap the whole thing, just mix it up to add variety (no, this is not a reference to “muscle confusion,” whatever that is). Think about the days or parts of your workout that you really just… don’t enjoy, for lack of another PG term. Determine which parts you can live without, and keep the ones that you know you are progressing with and enjoy doing.

It’s all about getting your mind engaged again. So, you focus on new areas that interest you. Maybe it’s a particular detail of your exercise plan. Maybe you try and focus on your exercise as time for yourself, and keep your phone in your locker. Maybe you spend more time just playing and exploring what your body can do. Maybe it’s getting outside once a week. The possibilities really are endless, but that’s the point. You are in charge.

4.) I don’t know how I can keep it going.

Life is tough. It’s hard. It’s supposed to be. If it were easy, everyone would have millions of dollars, 8 pack abs, and live until we are 150 years old. But, it doesn’t work like that.

People work hard to make a living for themselves and build the body that they want. The key to making it all work is balance in your approach. Managing your lifestyle stressors is massive in building sustainable success for reaching goals. Seriously! When you aren’t on top of this, the first thing to go will be your awesome workouts and healthy eats! So chill out!

Do you best to not take yourself too seriously, and have fun with the process of growing on your fitness adventure. Just understand, sometimes you will miss workouts. Sometimes you will want to dominate cheesecake (maybe that’s just me). It’s okay, just get right back on track. You’ll be fine if you limit your stress and try making yourself better 90 percent of the time.

Get to it!

With that said, now you should be ready to conquer anything that comes your way. The New Year is an exciting time for everyone, and having ways to push through your struggles is key. I think someone smart said Rome wasn’t built in a day. That’s kind of the way I look at creating the best version of your own self. Be willing to keep growing on each day’s successes and eventually things will start to click.

A big thanks for Ryan for his expert advice this week. I think these are issues that many of us struggle with, so I am so thrilled that he was able to lend his perspective here for us. We’ll be back to our regularly scheduled programming next week, and I hope everyone has a great week until then! Be well. 

Ginger For Me, Please!

Hello there! Today’s post is another short and sweet one. I hope you all enjoyed last week’s post on seasonal eating. This week is also food-related, but I’m actually going to be talking about an important Chinese herb- ginger! Some of our commonly used Chinese herbs are also foods or spices that we eat regularly, and I think the best example of this is ginger.

When I talk about Traditional Chinese Medicine (TCM), usually acupuncture is the big buzzword that people associate with it. However, acupuncture is just one small part of our Chinese medical toolbox. The practice of Chinese herbology (yes, friends, I did indeed study herbology…just like Harry Potter) is one that actually extends back even further through Chinese history than acupuncture does. There are hundreds and hundreds of medicinals in the repertoire of Chinese herbal medicine- plant leaves, roots, berries/fruits, barks, minerals, animal products, and even some particularly gnarly ingredients like scorpions, snakes, and bugs. However, today I’m just going to focus on one very important Chinese herb- the humble, yet delicious, ginger root. Herbs are very rarely used by themselves in TCM, but ginger is one that we can use just as a single herb.Ginger-rootGinger is called Sheng Jiang in Chinese and zingiberis rhizoma in Latin. It is considered part of the category of herbs that is said to “release the exterior.” That is a fancy way of saying that these herbs are used to treat conditions that attack us from the outside (remember my scarf post? Those types of pathogens). This means that this category of herbs is really good at treating a cold when it is just starting to show up- chills/fever, muscle aches, stiff neck, headache, coughing, etc. Ginger can be used at the first signs of a cold to help give those pathogens the heave-ho and send them on their way. It’s also good for treating coughs once they have settled in to stay.

Ginger is also very good at treating upset stomachs. I’m sure many of you have heard this as a folk remedy for nausea, and I’m here to tell you that it’s good advice! Ginger helps what we refer to as the “middle burner” in TCM, which essentially means it’s a good herb to help with our digestive system. Ginger can be used to treat nausea, vomiting, and any garden-variety stomach ickiness (including that general bleh feeling you can get after eating something that doesn’t seem to be sitting so well).

A ton of ginger root drying out in a neighborhood in China- this picture is from when I did an internship in Beijing in 2011
A ton of ginger root drying out in a neighborhood in China- this picture is from when I did an internship in Beijing in 2011.

There’s a couple of easy ways to enjoy ginger. I love ginger tea when you feel like you are getting a cold. You can buy ginger tea bags and let those steep, or you can just slice up some fresh ginger and boil it in some hot water for a couple minutes. I also like to add a little honey to ginger tea when I’m feeling under the weather, especially if I am coughing a lot.

You can also find ginger chews, hard candies, and crystallized ginger in most grocery stores. I like the products by The Ginger People company since they tend to have a pretty clean ingredient list (I’m actually eating one of their hard candies as I write this!). You can also add ginger to most things you cook- I personally love it with broccoli (sounds weird, tastes delicious). It’s great in stir-frys with pretty much any protein, and it can add a spicy kick to stews, curries, smoothies, and soups. Ginger also keeps really well in the freezer, so if you buy a knob and are worried about using it all up, just wrap up what you don’t use and throw it in the freezer. When I take it out of the freezer, I’ll usually just grate what I need when it’s still frozen and not stress about cutting off the skin, but feel free to thaw and peel if you’d like.

Obviously, too much of anything becomes not a good thing. Ginger is a pretty safe ingredient, as is evidenced by its easy accessibility. However, it is considered a warm herb, and too much consumption of a warm herb over time will eventually create pathological heat in the body. So add it to your diet in moderation. Plus, an ancient Chinese medical doctor said that too much ginger would drain the will and intelligence, so better to be safe than sorry (sometimes historical Chinese medical advice is straight-up bonkers, as evidenced here. I love it.). Obviously, if you have an underlying medical condition or are pregnant, it’s always a good idea to run any dietary changes or herbal supplements by your regular physician or Chinese medical practitioner.

Let me know your favorite way to eat ginger! And if you know The Ginger People and can ask them to send me many ginger items, I like the chews best 🙂 I hope you have a wonderful week, and be well.

All herbal information comes from: Chinese Herbal Medicine Materia Medica (3rd. ed) by D. Bensky, S. Clavey, E. Stöger, & A. Gamble (Eastland Press, 2004).