This week, join me in this week’s Moov Better Mobility WOD 1 as I focus on opening the ankle joint and relieving plantar fasciitis and achilles pain. The feet, achilles, anterior tibialis, and calves provide a solid foundation for most of the functional movements we do in our daily lives.
How does a chiropractor prescribe shoulder care? Read on…
A 63-year-old female presents to Enhanced Movements Chiropractic with complaints of shoulder pain and restrictions. She has had some shoulder issues in the past, but never this frequent or intense. She has been doing CrossFit for nearly 6 months and the pain has progressively been getting worse. She has pain when lifting her arms overhead as well as doing any pressing overhead.
The prescribed treatment plan included restricting any painful positions until inflammation and pain sensitivity went down, while introducing myofascial release techniques to the shoulder complex. Her first visit improved her pain significantly as well as increased shoulder range of motion. During the second visit the myofascial release techniques were continued, while starting to incorporate new movements to improve shoulder range of motion with tools such as kettlebells and Indian Clubs.
Here is a simple video that shows one of the shoulder opening exercises we used:
Let’s face it, as a culture we are stressed out. Stress isn’t just bad for our mental health. When something stressful happens, hormones are released from the adrenal glands and travel all around the body. These stress hormones are designed to help get us out of a dangerous situation, e.g. run from the saber tooth tiger. Then we should relax and let the hormones fade away. For most of us, however, being on time to work, heavy traffic, or our jobs in general, are stressful events that increase those hormones on a daily basis.
Managing stress can feel like a full time job.
High levels of stress hormones can cause a wide range of negative health effects such as:
- impaired mental functioning
- trouble sleeping
- increased blood pressure
- dampened immune system
- increase in abdominal weight gain
- decreased muscle mass
Managing stress can feel like a full time job. Fortunately, there are ways to get your body out of this vicious cycle. As we discussed in Part 2: How Does Acupuncture Work?, Acupuncture excels in its ability to balance the body. The nervous system is no exception. Acupuncture treatment takes the body out of the fight or flight state (sympathetic nervous system) and back to the rest and digest state (parasympathetic nervous system). This transition is what’s responsible for the deep state of relaxation patients feel during and after an acupuncture treatment; practitioners call the feeling “acubliss” or being in “the acuzone”.
Anxiety and Depression
Balancing the nervous system isn’t just for stress management. Acupuncture can also be a valuable treatment for anxiety and depression. A study by the University of York in the UK found that acupuncture treatments helped combat depression. After 3 months of treatment, patients experienced improvement in their depression symptoms and were able to decrease their prescription antidepressant usage! Check back to Part 1: How Does Acupuncture Work? to learn more about how emotional health and pain correlate through the stimulated release of endorphins.
Chinese medicine stresses the importance of balancing your emotions, because of this, we have many methods of stress reduction to help you. Qi Gong, Tai Chi, and meditation are some of the classical therapies that connect mind to body and help decrease stress but there are many more. If you’d like to learn more about how acupuncture and Chinese Medicine can help you feel calmer and fortified in the face of stress, click here to contact me to schedule an appointment and learn more. We can all benefit from increased resilience to stressful situations!
According to the Institute of Medicine nearly 100 million Americans suffer from chronic pain, that’s around 1 in every 3 people. Western medical treatment for chronic pain is fairly limited. Many of these patients take unnecessary prescription medications daily in order to manage their pain. Recently, there has been extensive news coverage on the opioid epidemic in America. Frustrated patients and doctors are looking for other options. Fortunately, there is another solution; acupuncture excels at the treatment of chronic pain! A review of 31 clinical trials, which included nearly 18,000 patients, found that acupuncture was effective in the treatment of chronic back, neck, shoulder, headache, and osteoarthritis pain, and this is just the tip of the iceberg.
Many [people] take unnecessary prescription medications daily in order to manage their pain.
In 2015, the University of Pittsburgh published a study on the use of auricular (ear) acupressure for chronic low back pain. These researchers found that in 4 weeks of treatment patients experienced a significant reduction in pain and an increase in their physical functioning. They also discovered that pro-inflammatory blood markers (the substances that increase inflammation) declined while anti-inflammatory substances in the blood increased. These results show that acupuncture and acupressure change more than just the perception of pain; these therapies actually change the physical environment in a way that promotes healing1)Vickers, A. J., Cronin, A. M., & Maschino, A. C. et al. (2012, October 22). Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Archives of Internal Medicine, 172(19), 1444-1453. doi:10.1001/archinternmed.2012.3654.
In Parts 1 and 2 of How Does Acupuncture Work? I highlighted some of the important mechanisms that explain how acupuncture helps ease pain. In any type of chronic pain, I work to balance the nervous system and increase circulation while at the same time supporting the body so it has the strength to recover properly. Long term use of pain medications has many risks and only masks the pain. Acupuncture and Chinese medicine go deeper to relieve muscle spasms, ease pain, and stimulate healing naturally.
Stay tuned for Part 5: How does acupuncture work? To learn how acupuncture can help you become less stressed and HAPPIER!
|1.||↑||Vickers, A. J., Cronin, A. M., & Maschino, A. C. et al. (2012, October 22). Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Archives of Internal Medicine, 172(19), 1444-1453. doi:10.1001/archinternmed.2012.3654|
The thing I remember most about my first weeks in school for Chinese medicine was thinking to myself “This makes so much sense!” I was certainly already a proponent of Chinese medicine, having been a patient for many years, but getting the inside scoop on how it all works was mind blowing. At its core, Acupuncture and Chinese Medicine are based on a system of principles that are highly logical. Once you begin “speaking the language” it all starts to make perfect sense.
4 Basic Ideas
The fever is external; it’s caused by something (a virus or bacteria) coming into the body…
Every symptom can be broken down and evaluated using 4 basic ideas:
- Is it caused by something internal or external?
- Is there an element of heat or cold?
- Is it yin or yang in nature?
- Is it caused by excess or deficiency?
This is the ground level of where we begin with each patient. Take a sudden onset of a high fever for example, we can break it down using the following principles.
1) Internal or external? The fever is external; it’s caused by something (a virus or bacteria) coming into the body and stirring up trouble. Early Chinese doctors did not have germ theory but they understood it wasn’t something that just happened in the body.
2) Hot or cold? This one is easy, a fever is hot.
3) Yin or yang? The concept of yin and yang is a little more complicated. Yin is classically described as the dark side of a mountain. It is cool, quiet, and without much activity. It’s the support and frame that allows for yang to take shape. Yang is the bright side of the mountain. It is bright, warm and bustling with vibrant life and activity. By describing it as two sides of a mountain, it reminds us that they are intimately connected and one does not exist without the other…So back to the fever. A high fever could best be described as yang, the body is full of warmth and is actively fighting to battle the sickness.
4) Excess or deficient? A high fever is excess. It’s caused by something coming into the body. Deficient is for things like fatigue or a weakened immune system that is the result of long term deterioration. When things are excess they need to be cleared from the body. When something is deficient, we need to use acupuncture and herbal medicine to support the body to help regain strength.
All these ideas can be summed up in one word: Balance. The goal of every treatment is to encourage the body back to a state of balance.
Movement vs. Stagnation
Another piece of the puzzle that doesn’t fall under these 4 basic principles is the idea of movement versus stagnation. All parts of the body need to move well on their own and in relation to one another. Think of a river, when there are no obstacles or blockages, the river moves smoothly down its path. The water is clean and clear. Any debris that gets into the river is naturally washed away. If there is an obstruction in the flow of the river, the water gets murky and muddy. Debris build up. This idea can be reflected in the body. Areas of pain are often the result of obstruction from injury to the tissue. Instead of everything moving the way it should, gunk gets backed up. In western terms, the body cannot clean up the damaged areas because the clean healthy blood and lymph cannot get to the area and even if it could get there, the obstruction would prevent it from getting cleared out. As athletes we are intimately aware of what it means to stop moving. When you’re sore and you stop moving, things get tighter and more painful. We know that the best recovery from a hard workout is to keep things moving. This is why active recovery is so important.
So what does this mean for treatment with Chinese Medicine? Every time you are treated with acupuncture and Chinese medicine, your practitioner will evaluate how your symptoms stack up using these principles. If there is heat, we work to cool the body. If there is cold, we warm it up with techniques such as acupuncture and moxibustion. If something is obstructed and causing pain, we work to increase movement through the area with acupuncture, cupping, gua sha, or herbs. If you have an external invasion, like a cold or a flu, we give herbs that push the pathogen out of the body. Through western research, many of these herbs have been shown to be antiviral and antibacterial. If there is a system that is deficient, we use acupuncture, moxibustion, and herbs to support it so that the body is able to regain its innate strength.
Acupuncture channels or meridians are groups of related points that cross over the body. This is what sets acupuncture apart from some other types of therapies such as trigger point injections or dry needling. Modern Acupuncture is based thousands of years of empirical evidence. With this knowledge, ancient practitioners studied the effects of stimulating different areas. They learned which points would boost the immune system and which would calm nausea through careful and dedicated study of their patients.
Having a better understanding of some of these basic principles, you can start to see that the possibilities for acupuncture and Chinese medicine are essentially endless. Following these patterns, acupuncture can benefit nearly all symptoms and ease most conditions; it’s not just about pain. Chinese medicine can help you sleep better and have a brighter mood. It can strengthen your body’s ability to digest foods and eliminate toxins. It can also help you work out harder and keep you healthier in all aspects of your life.
As an acupuncturist the most frequent question I get from my patients is, “How does acupuncture work?” This is a simple question that requires much more than a simple answer.
Acupuncture is amazing because it doesn’t just work in one way. It stimulates many systems in the body and can help treat everything from pain to anxiety and depression to a weakened immune system.
When these areas are stimulated by a needle, strong messages get sent to the brain, which then affect the whole body.
I usually begin with the western science terminology, since it is what most of us are most familiar with. The body is made up of bones and muscles, nerves and blood vessels, all interconnected with tissue and governed by our organs. Acupuncture points are located in specific places, for distinct reasons. Anatomically, most acupuncture points are located in areas near large nerve bundles or concentrated nerve endings. That means that when these areas are stimulated by a needle, strong messages get sent to the brain, which then affect the whole body. Through their connection with the brain, some points then have secondary effects on the internal organs and can lead to decreased pain and/or changes in how the cells are working. Acupuncture points also increase white blood cells to give your immune system greater fighting power. Inserting a needle into the skin creates a response in that area which increases blood flow and lymph circulation. Lymph is the fluid between cells that contains white blood cells and nutrients to bath the tissue. Lymph plays a vital role in delivering these nutrients to damaged tissues for repair and then clearing out the damaged products1)Inanç, B. B. (2015). A New Theory on the Evaluation of Traditional Chinese Acupuncture Mechanisms from the Latest Medical Scientific Point of View. Acupunc Electro-Therapeut Res Acupuncture & Electro-Therapeutics Research, 40(3), 189-204. doi:10.3727/036012915×14473562232987.
Acupuncture has been shown to increase levels of endorphins in the body. Endorphins are the molecules responsible for the “runner’s high”, but they are also a critically important substance for blocking pain stimuli. Not only does an acupuncture treatment leave you with less pain, but you’ll have the added emotional benefit of increased endorphins. Increased endorphins combat anxiety, depression and balance mood swings. Endorphins are the reason we love exercise. Though some days seem like a grueling battle to get to the end of the workout, the flush of endorphins we receive at the end is the body’s way of thanking you for your hard work. A consistent schedule of exercise (CrossFit) and Acupuncture are two of the best ways to take care of your mind and body!
Different rotations of the needle have been shown to have varying effects on the connective tissue
A crucial part of any acupuncture treatment is how the needles are inserted into the body. There are many different techniques of inserting and simulating the needles. Some techniques such as “burning the mountain” or “cooling the sky” use rotational movements of the needle to affect the body. There is much more to these techniques than fun names; different rotations of the needle have been shown to have varying effects on the connective tissue (the part of our bodies that surrounds and supports our cells and connects all the pieces together). When the there is tension on the connective tissue, cells up to several centimeters away start responding to the stimulus to help decrease pain and relieve areas of tension((Langevin, H. M., Bouffard, N. A., Churchill, D. L., & Badger, G. J. (2007). Connective Tissue Fibroblast Response to Acupuncture: Dose-Dependent Effect of Bidirectional Needle Rotation. The Journal of Alternative and Complementary Medicine, 13(3), 355-360. doi:10.1089/acm.2007.6351).
Acupuncture is often referred to as “alternative medicine”, but more and more research is showing that it has efficacy and results that parallel other more western treatment modalities. These are just the highlights of a few ways in which acupuncture provides very observable effects on the body. As you think about the ways in which you want to better your overall health, consider acupuncture among your treatment options.
Stay tuned for Part 2, where I will explain the basics of acupuncture from the perspective of Chinese Medicine and enumerate even more ways that acupuncture can help you lead a happier, healthier life…
|1.||↑||Inanç, B. B. (2015). A New Theory on the Evaluation of Traditional Chinese Acupuncture Mechanisms from the Latest Medical Scientific Point of View. Acupunc Electro-Therapeut Res Acupuncture & Electro-Therapeutics Research, 40(3), 189-204. doi:10.3727/036012915×14473562232987|
In this short video, Steph Duininck, MSOM, L.Ac. explains what cupping is and it’s many benefits.
- Eases pain
- Loosens tension in the muscles and fascia
- Promotes healing by increasing blood flow to a particular area
Schedule a 30-minute cupping session with Steph.
Besides feeling great, regular massage is an ideal recovery method for CrossFit athletes. Getting a massage once a month or more helps to reduce muscle soreness and risk of injury, all while increasing mobility, so you can perform better. Not only that, but massage actually improves muscle tone.
“Massage is perhaps the oldest and simplest (yet deeply effective) of all medical treatments.”
By blending ancient and modern techniques from both eastern and western heritage, massage is able to address both long term and short term aches and pains. This helps athletes live more comfortably in their day to day lives, providing a more solid base for bigger and better workouts. The blend of techniques includes: trigger point therapy, deep tissue massage, myofascial release, passive movement and stretching, meridian theory, energetic balancing, and Reiki1)The Book of Massage pg 6, Gaia Books Ltd. 1984.
Every treatment session is as unique as the athlete themselves. By using skilled assessment techniques, a treatment is developed specifically to address the client’s needs. As the client’s needs change during a session, the treatment evolves. The goal is to bring the client into the highest state of comfort and physical ability as possible. Regular massage helps keep muscles soft and flexible, meaning that workouts take less recovery time.
“When part of the body is energy-deficient, and not pulling its weight, other areas of the body must overexert to pick up the slack.”
Shiatsu aims to re-balance the use of muscles and energy to achieve better movement and liveliness. By looking at the body as a whole system, where each body part affects the state of the rest of the body, Shiatsu and Massage provide balanced whole body treatments2)http://www.zenshiatsuchicago.org/clinic/shiatsu/.
“Research shows that soreness is reduced and muscles heal at a faster rate after being massaged. This is because massage reduces the body’s production of cytokines, which contribute to inflammation, and stimulate mitochondria, which aid in the repair process.”
Some benefits of massage include:
- faster muscle recovery
- lymph movement
- increased circulation
- greater range of motion
- muscle elasticity
- myofascial release3)http://www.massageheights.com/blog/how-massage-therapy-can-benefit-crossfitters#sthash.KoaIDCI3.dpuf
The best times to get a massage
An ideal time for a restorative massage is between 30-45 minutes after you have completed your WOD for the day, or after other intense activity. For a therapeutic massage, the ideal time is during planned recovery periods, i.e. rest days or de-load weeks.
When planning for a competition or event, 3-4 days before the competition or race will help improve your range of motion and mobility. Then, after a competition or race to help you recover quickly.
How to maximize the benefits of a massage
Use these tips to get the most out of your massage:
- Drink a LOT of extra water before and after your massage
- Shower immediately after to rinse the skin of any toxins
- Take a nap or go to sleep early
- Avoid strenuous activity to keep muscles supple
- Deep stretching and static mobility work
|1.||↑||The Book of Massage pg 6, Gaia Books Ltd. 1984|
On May 30, 2016, Memorial Day, myself and several fellow Moovers embarked on an eight-week journey to complete Murph every week.
What is Murph? For those unfamiliar with CrossFit, Murph is the following workout:
1 Mile Run
300 Air squats
1 Mile Run
Partition the pull-ups, push-ups, and squats as needed. If you have a 20 lb. weight vest, wear it.
Why would I do such a thing? I got the original idea from Jerrod Moon at EO3 after I saw his post on Reddit. Except he’s doing it for a year… But I wanted to see if I began to get similar results. Murph has always been a daunting workout for me, as I have always put this workout on a pedestal. It has always made me nervous. I wanted to overcome that feeling and start viewing Murph as just another 30-60 minute workout.
Below are my overall results week to week. The ups and downs are marked by a change in method (chipper vs. broken sets, no vest vs. 20 lb. vest), but within a specific method, I saw improvements every single week.
Below is a week-by-week synopsis of how I improved and what I learned over these eight weeks.
Weeks 1, 2, 4: Reps Partitioned as Desired
|Week 1||Week 2||Week 4|
|Rep scheme:||20 Rounds of: 5-10-15||25 Rounds of: 4-8-12||25 Rounds of: 4-8-12|
It had been a full year, since the last Memorial Day, that I had done Murph. Although that performance was a new best time by about 6 minutes, it wasn’t a life-time PR. This one did not feel good. My alcohol consumption the day before was more than normal with the long weekend, so that definitely played a role.
Week two, I changed the strategy up a bit after a few conversations around the gym. Instead of 20 rounds of Cindy (5 pull-ups, 10 push-ups, 15 squats), I partitioned it into 25 sets of 4-8-12. This allowed me to barrel through the push-ups without stopping; interesting how sets of 10 push-ups over time is just over my threshold.
In Week 4, I performed my best by a long shot in this method. 29:30. I never, ever, would have guessed that I would go sub-30:00 on this workout no matter how I broke it up. There were two of us this day, and my workout partner edged my time by about 12 seconds. We definitely pushed each other on this one.
Weeks 3 and 5: Chipper Style (100 | 200 | 300), No Weight Vest
|Week 3||Week 5|
These two weeks were basically a warm-up for the weighted vest. I had never done Murph chipper-style before this, so I had no idea what to expect. Week 3 push-ups caught be by surprise, and I started out doing way to many reps in each set (10-15) and died quickly to sets of 3 about halfway through. The air squats I did not pace as well as I should have, and it cost me on the run.
Week 5, I learned my lesson a little and did smaller sets on the push-ups (sets of 7), but they still caught up to me. I improved by almost 5 minutes here, but a lot of that was on the run.
Weeks 6, 7, and 8: Chipper Style With a Weight Vest
|WEEK 6||WEEK 7||WEEK 8|
Week 6 was my first Murph every with a weighted vest. It hurt. The vest I used wasn’t great either, and came off twice during the pull-ups so I lost a bit of time re-adjusting.
Week 7, my time improved for the sole reason that my strategy improved. Nearly 8 minutes by simply partitioning my push-ups better (sets of 3), doing more pull-ups at a time (5-7), and going a little hard on the first run.
Finally, week 8 saw a big improvement because I knew exactly what to expect every step of the way. My squats felt sluggish so I definitely lost some time there (doing sets of 15), but otherwise I stuck to my strategy of 10 sets of 10 pull-ups, and sets of 3 push-ups with quick rests. Going under 50:00 with a vest, chipper style, to me is a huge accomplishment and felt great.
Some are not surprising, others very surprising. Below are a few improvements that occurred in other areas. I do not attribute some of these solely to Murph, as we did just come off of a very well planned strength macrocycle as well.
1 mile run time, -11 seconds to 5:54
Back squat, +5 lbs. to 285
Deadlift, +20 lbs. to 365
400 meter run, -7 seconds to :56
Bench Press, +5 lbs. to 225
Split Jerk, +15 lbs. to 235
General Synopsis and Conclusion
When partitioning your reps, if you fatigue at all on the push-ups, then 25 sets of 4|8|12 is definitely the way to go over Cindy-style of 20 sets of 5|10|15. It really allowed me to keep a solid pace throughout. I really don’t think I could go much faster here than I did in week 4 except maybe push harder on the runs.
PUSH the last run. Too many people treat the last mile run as a victory lap. If you really want to improve your time, push this segment. At this point, the legs are jello for sure, but if you can suck it up, it’s over relatively quickly.
Take care of your hands. They will get torn up, especially with a weight vest on.
Overall, this workout went from intimidating as hell to just another Sunday exercise. Mentally, I overcame what I set out to do, and my overall fitness improved quite a bit. Will I still get butterflies when I do it again next Memorial Day? Yeah, probably.
Proper posture is not fixed overnight and it is usually not just one correction. Use this as a guide to correct posture long term.
Let’s talk about how to position the ribs and pelvis to reduce strain on the abdomen.
Rib and pelvis positioning: Posture is important for many problems that can occur in the human body and this is true of diastasis recti as well. Commonly the problem of the unnatural distancing of the right and left halves of the rectus abdominis is partially due to the stressors placed on the abdomen through rib and pelvic positioning.
Your rib cage should be down and back, not up and forward like we often see in our society. The pelvis should not be tucked, nor hyperextended and should instead be in a neutral position. Check out the video, below, to gain a further understanding of positioning and how to correct your posture for the long term.
Video credit: Enhanced Movements