Arnica for bruises, sprains, strains

I generally don’t use topical stuff or supplements. Even when I have a good remedy, I have a bad tendency to forget to use it. Arnica is my big exception. Arnica montana is an herb that has natural anti-inflammatory properties. It makes a terrific topical oil for bruises, sprains, and strains. It’s fantastic for reducing inflammation in the area and speeding up healing.

arnicaoilI have a source for organic, locally-grown, hand-picked, hand-processed Arnica oil. It also contains a little St. Johns Wort for antibacterial and anti-inflammatory effects, and olive oil so it soaks into the skin. I prefer topical application to the pills, because it puts the medication where you need it, rather than spreading it out over the entire body, and because in high doses, taken internally, it can be toxic.

In all my years of martial arts, personal training, and running an acupuncture clinic (not to mention my own boo-boos), this is easily the best preparation I have found. It’s far superior to the multitude of diluted oils, creams and homeopathic pills generally available (most contain only small amounts of arnica), and that’s why it’s the only product I carry. I have bottles for $15 – swing by and pick one up! Use on unbroken skin only, please, and of course discontinue if your skin is irritated.

 

The Shoulder

Front view of the bones of the shoulder joint.

We can do amazing things with our arms. Lift them overhead, cross our chests, even link our hands at our spines. In fact, the shoulder is the most mobile joint in our bodies, thanks to its “ball and socket” configuration. See how the head of the humerus (upper arm bone) fits into the scapula (that triangular bone in your upper back) like a baseball into a glove? It can spin on the smooth, round surface to provide a spectacular range of motion.

The posterior (back) view of the shoulder.

Just as with national politics, there’s a trade-off between freedom and stability. The complexity of this joint makes it prone to a variety of injuries. Cartilage lines the articulating joint surfaces to create a smooth track for movement. If torn, it takes a long time to heal and may require surgery. There’s the bursa, a fluid-filled sac that provides cushioning. Inflammation here, called bursitis, can be very painful. Rest, ice, anti-inflammatory drugs, and acupuncture are the best treatments (of course an anti-inflammatory diet will help, too). The well-known rotator cuff is actually a set of four deep muscles that stabilize the joint and work to rotate the humerus. Three (supraspinatus, infraspinatus, and teres minor) can be seen in the drawing of the back view of the shoulder. The fourth, subscapularis, attaches to the front of the scapula and goes to the front of the humerus and the joint capsule. If torn, they will require rest and then specialized exercises to repair.

Overtop the rotator cuff is a layer of larger muscles, such as the latissimus dorsi & teres major (back), and the pectoralis muscles (front), and the deltoid (that roundy bit at the corner). These are your heavy duty movers. Ironically, since the lats and pecs both attach to the front of the humerus, unbalanced exercising can lead to an internally rotated (palms towards the back) shoulder, or “ape” posture. This is a great example of the importance of an intelligent, balanced workout plan. Then of course there are all the muscles that continue down the arm to control the elbow, including the triceps and biceps.*

If any of these muscles are dysfunctional, the bursa is irritated, or the cartilage is torn, you can have shoulder pain and loss of range of motion. Connective tissue can adhere, and scar tissue builds up over time. In extreme cases, you can develop Frozen Shoulder, which is exactly what it sounds like. It just won’t move. There are other causes of shoulder pain, too, ranging from nerves being pinched at the neck to gallbladder disease, but these musculoskeletal problems are the most common.
Acupuncture can reduce inflammation, increase bloodflow, relax tight muscles, and speed healing. I can also perform Osteopathic medical massage to break up scar tissue, release myofascial adhesions, and retrain the neurological system. This allows chronically tight muscles to return to normal. In most cases, therapeutic exercise is important for complete healing.

*Please note that I’m simplifying the anatomy quite a bit  for the purposes of this article. If you’re interested in all the marvelous details of our bodies, I highly recommend Netter’s Atlas.

The Knee

Let’s talk about the knee joint. It’s not quite as complicated as the shoulder, because it doesn’t move in as many directions. Having that kind of mobility with all of our body weight on top of it… well, that would be a recipe for disaster.  Instead, we have a modified hinge joint. The knee folds, but it also twists a little bit. The trick is keeping this twist under control.

Front view of the knee joint.

Collateral ligaments run along each side, and the cruciate ligaments (named so because they form a cross) inside the joint create stability. Strong quadriceps (a set of 4 muscles on the front of thigh), hamstrings (three muscles in back of thigh), adductors (inside) and abductors (outside) also support the knee. Slick cartilage lines the surfaces where bones meet. The meniscus, a pair of special horseshoe-shaped cartilage structures, help absorb shock and guide the movement of the femur. And there’s a bursa on top of the patella (kneecap) to provide some extra cushioning. Pretty neat design, huh?

Sp-9 treats the knee, and drains Damp (a concept in Traditional Chinese Medicine).

If your gait is off, it can affect your knees and eventually your hips and back. Good shoes are important for knee health. Avoid heels as much as possible. If you have flat feet, use shoes with good arch support. To prevent injury, frequent light workouts are best. If you are a bigger person or have joint issues, try to reduce impact: walking or using an elliptical trainer is better than running, and staying on grass or a rubber track is better than concrete.

 

 
    Did you know that babies are born without kneecaps? They have a cartilage wedge but it doesn’t ossify (turn to bone) until about 3 yrs old. Lucky for them – It makes crawling around on a hard floor much more comfortable.
Acupuncture can reduce inflammation, increase blood flow, relax tight muscles, and speed healing. I can also do Osteopathic medical massage to break up scar tissue, release myofascial adhesions, and retrain the neurological system. This allows chronically tight muscles to return to normal. In most cases, therapeutic exercise is important for complete healing.

Acupressure you can do at home: LV-3

*Please note that I’m simplifying the anatomy quite a bit  for the purposes of this newsletter. If you’re interested in all the marvelous details of our bodies, I highly recommend Netter’s Atlas.

LI-4 (headache, arm or facial pain, infection, hot flashes)

LI-4: Hegu. This point is astonishingly useful for a wide variety of complaints, but don’t use it if your patient is pregnant!

Large Intestine 4 is the acupoint most well-known by the general public. I first had it taught to me by a riding instructor when I was a kid living in rural Virginia. The name for this point is Hegu, “Joining Valley,” which is a reference to its anatomical location on the back of your hand, in that fleshy area between the thumb and forefinger. Feel around – it’ll be tender if you need it – but the easiest way to find it is to squeeze your thumb against your hand. The highest point of the muscle is where you want to press. Use firm, gentle pressure for 10-20 seconds with a healing intention. Try both sides.

Hegu, or Joining Valley, is a tremendously useful point. It moves stagnation, so you can use it to clear pain and stiffness anywhere in the upper body. Hegu will be particularly effective along the LI channel, which runs from the nail of the forefinger, along the forearm to the lateral (outside) elbow, up the arm and across the shoulder, eventually crossing the upper lip to end at the opposite side of the nose. Shoulder and elbow pain, carpal tunnel, and (of course) headaches are common uses. It’s specifically the Ruler of the Face, so it’s doubly powerful for frontal headaches, eye pain, sinus blockage, and tooth pain. It also releases heat and is part of a point combination for fighting viral or bacterial infections. If  you are prone to hot flashes, this point could be your new best friend. Also use LI-11, pictured here, to clear heat.

And by the way… the leading cause of headache is dehydration. Drink a glass of water!

WARNING: Because Hegu is a moving point, DO NOT use it if you are pregnant or bleeding. It can induce a miscarriage or increase blood loss. On the other hand, if you are overdue and want to evict your baby, this is a great way to do so, along with some other points (assuming everyone is healthy and it’s not a complicated pregnancy!). It will usually increase menstrual flow if the patient is having her period. If you have a severe headache paired with sudden loss of motor control or speech, get to a hospital immediately. DO NOT use LI-4 until you are sure you are not having a hemorrhagic stroke (bleeding inside the brain). This goes for head injuries, too!

 

Unexplained pain & its various causes

There are many reasons your body can hurt. It’s really frustrating when you don’t understand why, but often unexplained pain just means it doesn’t fit into a nice diagnostic box. We’re all familiar with muscle strain/sprain, fatigue, inflammation, and arthritis… you probably already know that acupuncture can help with these. Less understood by the general public are these causes of pain:

Viscero-somatic referral (Viscero= organ, Somatic=relating to the body): In this case your brain misreads a distress signal, so an organ problem feels like a muscular problem. The most famous example is the heart attack that creates an aching arm or jaw, or bone cancer masquerading as a back strain. Pain that doesn’t respond to treatment needs to be assessed by a medical professional to rule out dangerous causes.

Chronic spasticity: Healthy muscles are constantly changing their level of tension. They work with constant feedback from the cerebellum (part of the brain) to make tiny adjustments. This is how we keep our balance and perform tasks smoothly. When a muscle is tight for a long period of time, however, its setpoint changes. It thinks being tight is normal – this is called spasticity. It leads to stiffness, pain, and misalignment of bones as they are pulled out of place. Blood flow is blocked, creating painful ischemia. Tight muscles and misaligned bones can pinch nerves causing “electric shocks,” tingling, or numbness. This is what I see most often when people come in with unexplained pain. There’s nothing to show up on an X-ray or MRI, because the problem is functional, not structural. Massage is a great temporary relief, but to really fix it you need to treat the cause of the problem, the neurological setpoint. Acupuncture and Osteopathic-type medical massage remind the nerve controlling the muscle how it’s supposed to behave. Once the muscle relaxes, bones return easily to their proper place, and the body can heal itself.

Fascial adhesions: Each muscle fiber has connective tissue, called fascia, surrounding it like a layer of Saran wrap.

Connective tissue (white) and muscle fibers. When fascial adhesions form, it can cause unexplained pain.

Connective tissue (white) and muscle fibers

It may help to picture a muscle fiber as a drinking straw in a paper wrapper (sheath of fascial connective tissue). At each end, that fascia becomes our tendons. These sheaths are supposed to slide past each other as muscles move. With long periods of no movement, if the muscles are spastic, or if there’s an injury, they can stick together and form a fascial adhesion. When your muscles are shrink-wrapped together, it can cause muscle stiffness and unexplained pain. Some people like to get in and dig the adhesions apart, deep-tissue massage style. That works well in the short term, but it also causes inflammation… which causes scar tissue… so the adhesions reform.

Myofascial release can help with unexplained pain.Myofascial release, a type of medical massage, uses a more subtle approach to slide the layers apart. I love doing this type of work because the result is immediate freedom of movement with no pain and no boomerang side-effects.

Emotional causes of pain: Sometimes the pain of an injury lasts far longer than it logically should. This usually points to an emotional attachment. The brain literally links the muscular dysfunction with the memory, and the unresolved post-traumatic stress around the incident will actually prevent the body from completely healing. This can happen with gradual, cumulative injuries too: Imagine a tight neck from a job you hate. Patients will frequently have an emotional release when we start working on the physical site. They may start crying, get angry, or suddenly find themselves terrified “for no reason.” Once we get those remaining feelings flushed out, the muscles and tendons often recover rapidly. If you feel something emotional happening during a session, let it out! Releasing pent-up emotions is therapeutic for your body as well as your soul.

Doctors used to blow off psychosomatic illnesses as “all in your head” and not worth treating. The medical community now has a better understanding of the interplay between the mind and body. It’s a two-way street, and they affect each other profoundly. Chronic pain will screw up your neurotransmitters (chemicals in your brain) and temporarily change your personality. Likewise, an overthinking, worried mind can trigger digestive troubles like IBS (Irritable Bowel Syndrome).

If you have a chronic injury that isn’t healing, it’s worth reflecting for a few minutes. Is there anything your body is trying to tell you? If so, consider talking it out with a therapist or a good friend. Acupuncture can help balance your emotional life, but there may be some work needed on your part, too. Of course you’re welcome to discuss anything in our sessions, and your confidentiality is always assured.

 

 

Anti-inflammatory Diet & Nightshades

If you have osteo-arthritis or an inflammatory disease (Fibromyalgia, IBS, etc), listen up: There are ways to alter your diet that will help decrease your pain! It’s also very helpful when you want to reduce inflammation after an injury.

1) Avoid sugar. This includes soda* and high-glycemic foods that will break down quickly into sugars. White bread, pasta, and starches will all contribute to inflammation.
2) Avoid fried foods. Enough said.
3) Grain-fed red meat is a problem for some people. Grass-fed meat is less inflammatory, since the fat structure is different.
4) You can counteract pain by eating ANTI-inflammatory foods. Dark leafy greens like kale and spinach will help a lot. Berries (except for goji and blueberries), turmeric, garlic, celery, pineapple, cocoa, ginger, and foods containing good fats (extra-virgin olive oil, avocado, salmon, nuts) are great, too. If you are sensitive to oxalates, however, be careful not to overdose on the dark leafy greens.

5) Foods your body doesn’t like. Some people are sensitive to dairy or wheat, for example. If you know you react badly to something, avoid it when you are in pain.

6) The Nightshade (Solanaceae) plants contain a small amount of an alkaloid toxin called solanine. Some people aren’t bothered by it. Other people, especially those with auto-immune issues & arthritis, tend to be sensitive to this family of plants. Most are unaware of the pain they are causing themselves, because they eat them so often, and because the inflammation & ache are delayed up to 24 hrs.

Tomatoes
Potatoes (Sweet potatoes and yams are ok)
Peppers, including spicy, chili, and bell peppers, and paprika (Black, white, and green pepper is ok- it’s actually a peppercorn. Long pepper is ok, too.)
Eggplant
Tobacco

Although less well known, Goji berries are nightshades, too.

Note: Blueberries, huckleberries, artichokes, and okra are not in the Nightshade family, but they also contain solanine.

The good news: It’s very easy to find out if you are Nightshade sensitive. Simply remove all of them from your diet for two weeks. Then have a big dose of tomatoes, potatoes, or drink a V8. See how you feel that evening and the next day. If within 24 hrs your pain is worse, you are Nightshade-sensitive. Wherever you have inflammation, that’s where it will show up. If not, congrats – you can go back to all the tomatoes you want.

The alkaloid is degraded by heat. Raw Nightshades are more toxic than cooked, and the extreme heat of deep-frying is even better … but fried foods are inflammatory for other reasons, so don’t get too excited. I will eat a small amount of potato chips on a special occasion because they are fried all the way through, but not french fries, since they are still squishy in the middle.

The combination of Nightshades and sugar is a doozy. I can get away with a small amount of tomato paste, but even a tiny squirt of ketchup will make my hands ache the next day.

Following an anti-inflammatory diet is a relatively simple way to decrease your pain and make a real difference in your quality of life. Some people have inflammatory reactions to dairy or wheat, and that may be worth testing the same way as the Nightshades. You don’t have to be perfect all the time – just pick your battles, okay?

Here’s a nightshade-free curry recipe and one for non nightshade Mexican. Substitute either cauliflower or sweet potatoes for regular potatoes. Pizza and pasta are great with pesto sauce. There’s even a “No-Mato” marinara sauce I just found online (OMG SO GOOD!!!! I used the higher levels of spice for everything and loved it!).

UPDATE 4/29/16: Now that I’ve been Nightshade-free for a decade, I’ve found that I can get away with cheating once in a while. There seems to be a cumulative effect. By staying away 99% of the time, and preventing a build-up of inflammation, I can enjoy the occasional indiscretion. 

*Diet soda is bad too. While it doesn’t contain sugar, the artificial sweeteners cause their own problems, including triggering the body to start storing more calories as fat.