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It is almost humorous that one of the easiest home care methods is also one of the most controversial in its application. From the standard R.I.C.E. to “Ice is for dead people” there are a lot of opinions on whether or not the application of cold for pain and injury is beneficial or just bad advice. In my own education, my opinions have changed over the years (as they should when science says to). That being said, there is still a lot of misinformation out there. The goal here is to present evidence- based information to help you decide whether or not to reach for that ice pack. 

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It is very common for people to say that ice is useful for acute injuries, but not for chronic ones. A 2017 study by Singh et al., used rats to test the tissue response to ice application following acute injuries. Results showed that after 3 days, the rats that were using sham ice had healed more tissue than that of the rats that received ice. The conclusion of the authors however, was that icing delayed the infiltration of inflammatory cells, but did not necessarily decrease actual healing time or quality. They also noted further research was need to assess if icing the injury more frequently changed the outcome. These results do not necessarily bode well for icing, but does not entirely discredit it either. 

 

A 2012 A 2012 meta-analysis by Van den Bekerom et al, looked at the use of R.I.C.E. (rest, ice, compression, and elevation) in ankle sprains. Once again research showed to be inconclusive on the effects of ice. Authors reviewed 24 studies and noted that none of them sufficiently showed that ice was effective for the use of R.I.C.E. as a treatment for ankle sprain. Instead they found that the recommendation as a treatment should be made on a case by case basis by licensed professionals. That statement, while indecisive, does have validity in the sense that treating a patient as they come in is important.  

Another study on different icing protocols in acute ankle sprain was published in the British Journal of Sports Medicine. This study showed that the use of intermittent icing lead to a better decrease in pain over a ‘standard protocol’. The ‘standard protocol’ in the study was defined as icing for 20 mins, whereas the intermittent protocol involved icing for 10 minutes, not icing for 10 minutes, then 10 minutes icing again. Results showed there was still not a shortening of healing time from this treatment. So, what can we conclude from all of these studies together? 

Untitled design (1)The argument of ice effectiveness is an ongoing discussion that will take longer to truly identify. Will icing be harmful to an injury? It appears that is unlikely. It also appears that it is unlikely that ice will expedite healing time. Should ice be used at all? I tend to agree with the conclusions of Van Den Bekerom et al, that it all depends on the case. Many people want nothing to do with ice and I happily encourage them to avoid it. If a patient really leans towards icing injuries, perhaps the best advice is to use the intermittent protocol and note that it may help with pain.  

The next big question is, what about using contrast hydrotherapy or ice baths as preventative care? Recovery from exercise is perhaps as popular a topic as how to best treat injuries. So, what does research say about immersion? Check back next week to find out!  

 

References:

Singh et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339266/ 

Van den Bekerom https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/ 

BMJ https://bjsm.bmj.com/content/bjsports/40/8/700.full.pdf 

Frozen shoulder is a common shoulder pathology that can cause pain, decreased range of motion, disrupted sleep, and a decreased ability to perform basic daily activities. It is a frustrating complaint that has few treatment options from the standard care approach. As an acupuncturist focusing on shoulder pain, I have heard everything from “wait two years, it will just go away” to aggressive procedures that include anesthesia and manual manipulation of the shoulder to quickly reintroduce full range of motion. From my experience, people generally don’t like being told to sit around and do nothing and aren’t fans of unreliable aggressive and painful procedures. So, what can be done to help?

Unfortunately, there is no one shot cure all approach. There are however, options to try that may be very beneficial both at home, or with a professional. It is the health care professional’s duty to meet every patient where they are at when they walk through the door. Recognizing what works for one patient may worsen symptoms of another in regards to movement, is pivotal. That being said, we want to talk about home care options here and only briefly offer options for health care providers.

Frozen shoulder occurs in three stages: freezing, frozen, and thawing. Each of these stages comes with a separate focus. Generally speaking, the freezing stage is painful, the frozen stage is when the least mobility is available, and the thawing stage is the recovery period. Throughout each stage, tolerable movement is key. It is commonly thought that the frequency of tolerable range of motion is useful at increasing speed of healing. So, what are methods of tolerable range of motion?

Initially speaking, exercises to work on include both a wall walk and a pendulum exercise. These exercises don not require any special equipment and can be performed in a pain free manner by most people. The wall walk exercise can be performed in two separate directions, which makes it useful for range of motion. The video below discusses and demonstrates both of these exercises and how you can make them most effective.

 

If the above exercises worked well or are to easy, then it is time to test out the movements in the video below! You can use a dowel, broom stick, or perhaps a friend to try out these movements. In practice, these are often referred to as proprioceptive neuromuscular facilitation (PNF for short). If these can be performed correctly and pain free, you will note marked improvement in range of motion immediately. It is important to be consistent with the exercises to try and keep progressing. The video below demonstrates how to use this style of stretching with a stick. It is possible to use a home pulley system in a similar fashion as well.

Outside of these exercises, there are other methods of homecare that can be used. Self massage can be very helpful at decreasing pain and increasing range of motion temporarily. Good target muscles to “roll out” include the pectoral muscles and infraspinatus. The videos break down the details on how to perform these easy homecare options, but it is important to note that this should be done in a tolerable manner in regards to pain. These techniques can be performed before and after exercises, but do not go overboard on it beforehand. Utilize quick and light massage techniques to loosen the fascia up versus really working deep into those trigger points when doing before an exercise. Stronger and longer compressions can be used at the end of homecare exercises. If you find self massage to be really helpful, you can consider investing in a ‘Theragun’ or similar machine. They are not an inexpensive investment, but for the patient that really values trigger point work, ‘Theraguns’ provide easy homecare relief. Many local running stores have the option to test them out if your health care practitioner doesn’t have one.

Another excellent homecare option is taping. Taping takes a willing partner, but can be useful at mitigating related pain, aiding in muscle firing during exercise, and temporarily increasing range of motion. There are many different options when it comes to purchasing tapem, but my personal preference is Rock Tape. In the video below, I demonstrate a great approach to taping the shoulder that can be followed along at home!

If you decided to try any of these methods above,  let me know how they go by dropping a comment below. If you are inclined to try alternative treatments for your care, Trigger Point Acupuncture can be a very effective method of providing relief and increasing range of motion when combined with the other treatment options discussed above. Obviously, a blog post is not made to be a replacement for seeing professional that can identify your personal needs. Please discuss these options with a licensed health care professional before trying them on your own. Happy healing!

 

 

BY CELESTE HOUVENER LAC.

Here is a brief overview of a few key points for maintaining the immune system at an optimal level. The first three are ones you may already know, I have elaborated and provided some insight into these. The final point relates to my area of expertise and may be new or mysterious to most. There is great depth to each of these key immune boosting tips to be elaborated upon. Please enjoy this overview and do not hesitate to ask questions of book an online or in person consultation for your personal health concerns.

 

Daily stressors can accumulate . . . that weakens our body’s defenses over time

  1. Deep Breathing

You can help maintain and strengthen your immune system by taking full breaths from the belly. Daily stressors can accumulate and cause a tendency toward shallow and rapid breathing, that weakens our body’s defenses over time. The more we intentionally practice proper breathing techniques the more we maintain full breath throughout the day.

Try this technique for at least five minutes three times a day for a week. You will notice your breath, and therefore your life benefit. Keep mind and shoulders relaxed throughout exercise:

-Inhale slowly and evenly via the nose, aim for the inhale to last 7+ seconds

-Let your breath expand your belly and ribcage out in all directions

-Sip in a bit more breath into your belly than usual, feeling the oxygen reaching your entire body

-Hold breath in for as long as you comfortably can at max capacity, this may start at a second or two and build to between 5-7 seconds.

-Exhale slowly and evenly via nose, for 9+ seconds

-Completely empty lungs and again hold for as long as you comfortably can at minimum capacity in the same way you did at maximum capacity

-Repeat this at least 5minutes 3x a day

-After completing this exercise and throughout the day, notice your breath without judgment or effort to change. By bringing more awareness to your breath, regulate and bring you into a clearer state of being.

* Remember to keep your mind and shoulders relaxed throughout this exercise

If your nasal passage is blocked in anyway, don’t let it stop you from this practice. This exercise is especially helpful for you. You can start by breathing through your mouth and imagine your sinuses opening with each breath. Attempt partial mouth with partial nose inhales and exhales. Exhaling through the nose will help bring movement to stuck sinuses. Imagine all congestion draining downward bit by bit with each breath. You may need a few tissues during your exhale!

Stay tuned to my Celeste the Rose site for more in-depth breathing articles and breath exercise videos coming soon. Become a sponsor of more breathing education materials by clicking here: . Also feel free to submit your breathing technique video requests in the contact form.

2. Moderate Exercise

Physical exercise is key in maintaining general health. Moderate exercise is especially useful if your body is fighting any pathogens. Ideally, induce a light sweat for 20-40 minutes, 3-6 times a week with your favorite activities. You will raise your core temperature, encouraging healthy circulation throughout your body, and activate your body’s natural detoxification processes.

While I do have my preferred exercise modalities, its best to find something you personally enjoy. Any sweat-inducing physical activity that you have a good time doing will do wonders for your health. Pick something you can find enjoyment in over what you feel like you “should” do. This will keep you inspired and coming back for more movement each day. Enjoyable activities also help elevate your mood, and that will help regulate stress. Choosing exercises that you enjoy will also encourage you to actually get moving consistently, which is key.

Sometimes we get so caught up in what we should do that we forget what we actually like to do. So meet yourself where you are genuinely at and start exploring. Do not let excuses and old stories bog you down, everyone can pick up somewhere. Prioritize regular exercise in your schedule and you will see how you have the clarity and energy to actually do what is on your to do list.

Enjoyable exercise may look like a brisk jaunt through a beautiful park or participating in your favorite sport or fitness class. Some great activities to induce a light sweat are dancing, martial arts, mid to high-intensity yoga, Pilates, aerial arts, acrobatics, hiking, biking, swimming, cross-country skiing, rowing, vigorous yard work, stair climbing, jumping jacks, jump rope, and so many more! Your options are vast; you can choose a few to keep it fresh.

If you have decided at some point in your life that you hate exercise all together, there is still opportunity for you to get moving. You could tune out to your favorite TV show while you ride your stationary bike, treatmill, or better yet hula hoop! Get creative, make opportunity, &/or even trick yourself into getting a sweat on if you have to. Ideally, you can ditch the TV and bring mindfulness into your exercise. You know what you need to do to bring some movement into your day.

If you are suffering from pain or injury, listen to your body so that you help and do not hinder your condition. You can find ways to achieve an intense workout that does not cause acute pain to your condition. Find ways to keep moving even if you are injured. For instance, if you usually play tennis and broke your hand, try brisk walking or stair stepping while your hand repairs. Consult a professional if you need help with this. Injury repair and pain management is a major field treated within the scope of acupuncture, herbology, and qi gong. Don’t cover up your pain; use it as a guide to bring you into a more balanced state of strength!

If you have suffered extreme injury and are unable to find a suitable exercise to induce a light sweat for a time period, there is hope. Soak in an Epsom salt bath 30+ minutes throughout the week as need be. This will help with circulation, tissue repair, mood, and more. These baths can in this way provide some of these benefits until you are ready for therapeutic exercises and beyond.

If you are immune-compromised, make sure to wear light protective layers when exposed to cold and wind. Especially if you are sweating, the pores are more open for pathogenic invasion. This means covering your skin, especially around the neck, core, and joints. Give yourself time to cleanse and dry before going about your day after sweating.

Be on the lookout for more in-depth fitness articles and exercise videos my Celeste the Rose site. Become a sponsor of more physical fitness education materials by clicking here: . Also feel free to submit your fitness exercise video requests in the contact form.

  1. Proper Sleep

A good night sleep is key to maintaining a healthy immune system. Do not skip out on precious sleeping hours, as you need this time to help restore and replenish all of your mental and bodily capacities. Sleep is something you need each and every day, and not something that you can “catch up on” in the future. Amongst a society that idolizes an “all work, no sleep” mentality- you need to individually stand for you and your body’s need for proper rest.

Perhaps you have early mornings ahead? Setting a bedtime alarm for yourself can ensure you can get plenty of rest. Schedule at least 8-10 hours of intentional rest and relaxation. If you lead a high-intensity life, you may need a few hours of intentional winding down before you are able to fall asleep.

Get in touch with your circadian rhythm. Shut off artificial light sources and all stimulating mental, emotional, and physical triggers. Set your devices to filter out blue-light when the sun sets with night mode or apps like Flux for your computer. Set your phone to “do not disturb” mode. You will be more prepared to face the day’s issues if you allow yourself to fully refuel. For myself, this can be easier said than done with all of the fun things that start later in the evening. Yet when I align with the natural rhythms, my balanced and nourish mind and body thank me greatly! It is worth it to get my work and fun priorities in during the day so I am ready to sleep at night.

In Traditional Chinese Medicine (TCM) 11pm-1am are the hours where the Liver and Gallbladder do their best work. If you are out of balance you may feel this as a creative and productive surge coming to the surface. Yet in the long run following this urge to work or play late into the night will leave your body depleted. Aim to be winding down as the sunsets and in a deep sleep by the liver nourishing times. Your body will naturally cleanse and nourish your blood while you sleep.

Proper restoration takes time and intention. Allow yourself time to prepare yourself for sleep so you can truly relax. Perhaps this means tidying your space, preparing your things for the coming day, practicing meditation and yin yoga, taking a hot shower or bath, &/or whatever you need to get yourself in the right space to let go of the days concerns and rejuvenate. Leave the worries of the day behind and enjoy the calm inner state within yourself no matter what is going on around you.

Poor sleep can become a major issue that weakens the immune system. This can be inability to fall asleep, inability to sleep a full night into the morning, light sleep, dream-disturbed sleep, or even too much sleep with difficulty waking up. There are many things you can do to improve your sleep on your own. When in need of extra help, TCM provides many treatment options for various underlying causes of poor sleep. Feel free to book an online consultation or in-person session to seek treatment for poor sleep.

If there are aspects in your life that prevent you from sleeping, such as motherhood or graveyard shifts- do not panic. Realize a goal of sleeping at night for sometime in the near future. In the meantime find supplementary practices and treatments to help support your daily rest and restoration.

Educate yourself deeper on the fascinating importance of sleep and let me know what you discover!

  1. Acupuncture, Herbology, and Medical Qi Gong

Acupuncture, herbology, and medical qi gong are excellent ways to help build and maintain excellent immune functions. Treatments are effective preventatively as well as during and after acute immune dysfunction. You can receive treatments, learn exercises, and find herbal supplements customized to help your circumstance. Effective treatment to help clear head and nasal passageways, pacify fever, strengthen immune system, and much more!

Traditional Chinese Medicine offers preventative, acute, post-acute recovery, and ongoing care for pathogenic invasions. Treatments are aimed at balancing the body to its most natural state of wellbeing. When treating an illness, diagnosis of the pathogenic factor is taken into consideration to develop a balancing treatment. The external influences we face are broken into six encompassing categories: cold, heat, fire, damp, wind, and dryness. These become pathogenic factors when in excess, and are then considered to as the “Six Evils” or “Six Pathogenic Factors”.

The Six Pathogenic Factors can enter from the external environment into one’s body. The Six Pathogens have Six Levels of invasion into one’s body, as stated in the TCM classic text Shang Han Lun (220 CE). These are six levels to the depths of your body. They are can offer protection if the body is resilient, as well as invasion if the body’s immune system compromised. The pathogenic factors usually enter more superficially and can develop deeper into the body. This can look like a bacteria entering your lungs and developing an infection that spreads throughout your body. In some cases pathogenic factors can enter into the deeper layers from the get go, such as a toxic materials that enter through the digestion or bloodstream.

In TCM treatment, we aim to skillfully keep the body free of the invading pathogenic factor. Ideally, we can do so before a pathogen enters the body. If a pathogenic invasion is present, we aim to prevent it from developing deeper into the body. Whether the invasion is slowed, stopped, or reversed- there are many possibilities with proper treatment.

Our immune systems utilize mass amounts of energy when fighting off or pathogens to bring the body back into balance. The more we fortify our body and mind we become less vulnerable to pathogenic factors. Treating any physical, emotional, &/or mental condition with acupuncture will simultaneously increase your bodies resilience toward pathogens.

Onto some specifics about each TCM treatment modality:

Acupuncture treatments

There are individual and groups of acupuncture points in traditional Chinese medicine that can treat acute and chronic immune illnesses. If you have an acute cold, you can receive a series of treatment to help minimize and eliminate symptoms. For individuals with a systemic tendency towards sickness, you can build immune system resilience with regular acupuncture. If you are wishing regulate and strengthen immune and respiratory systems, find out more about how acupuncture can assist your efforts.

Herbal Prescriptions

Herbs can access your body internally, absorbing into your bloodstream to reach your organs and blood stream directly. They can treat specifically and are very useful to prevent, reduce, &/or eliminate pathogen invasions. Herbs can also build resilience to weak areas and systems within the body to increase your body’s resilience. You can take home herbal formulas to administer throughout the day depending on the prescription, which ensures you are receiving the treatment you need between sessions.

Medical Qi Gong

There are specific exercises in medical qi gong to help stimulate immune function in the body. You can increase your core energy and resilience through regular and proper practice of qi gong. Qi Gong essentially means “energy skill”. The practice utilizes breath, physical postures, and focus of the mind. The synergy of these pillars enables you to directly accomplish the objective of the various exercises. You can increase lung capacity, clear your respiratory channels, and build your core energy to stay your healthiest through any immune-compromising times.

Qi gong exercises are tangibly beneficial to all of your bodily systems. You can feel your inner power activating and bringing vitality to the various focus areas of each exercise. Depending on what issues you are experiencing, you will be prescribed specific exercises for your condition. Medical qi gong centralizes in exercises that build your core strength and defense systems. When your internal systems and external defenses are reinforced, no pathogen stands a chance against your fortress!

In life and in qi gong, “your energy goes where your mind goes”. This has huge implications in life, as what we focus on is what we will move towards. The mindfulness aspect of the qi gong exercises brings your focus to your breath and body. This in turn will increase your sense of bodily and energetic awareness. This means you will increase your abilities to access different areas of your body with your mind.

There are many types of qi gong, it is best to find one that works for you. Most qi gong does have medical benefit, yet specific qi gong exercises can be chosen for specific medical purposes. I prescribe specific exercises for my patients depending on their condition.

In closing, I hope these tips and bits of information are of help to you. Keep in mind, they are tips of an iceberg and up to your own discretion how you utilize them. Each of the individual suggestions could be elaborated on greatly and would benefit from professional consultation. If you would like to hear more, do not hesitate to ask questions or book an online or in person consultation. I am happy to help you integrate these tips into your life in the most effective way for you.

 

When patients receive trigger point needling for the first time it is often a significantly different experience then acupuncture treatments they have had in the past. The world of acupuncture is quite diverse with those practicing and favoring a variety of techniques based on their own clinical experience. Many patients that have experience with acupuncture are only familiar with distal needling practices so when they first experience local needling it can require adequate patient communication.

With distal needling, depending on style, the needling method may be pain free or focus on attaining “De Qi”. This can be very different than a twitch response elicited when a trigger point is directly needled. When I first see a patient, I always ask about previous needling experience. If they have had acupuncture before, I am sure to ask about the experience and whether they felt a twitch response. Often patients have also experienced needling from physical therapists, chiropractors, or physicians, which I also inquire more about as these providers treatment approaches can vary greatly as well.

I personally feel that the experience of Trigger Point Needling is separate enough from Distal or Constitutional styles that it even can have different home care recommendations and expectations. Not every practitioner may agree with this, but here is what I find most effective for my patients:

Move the day you are treated

This doesn’t mean have your most intense training session or compete right after needling. What this does mean however, is do not get a treatment and go rest all day. Taking a walk, going for a swim, doing a light work out or performing recommended exercises can all be beneficial movements. When we treat trigger points, we are increasing blood flow with needling and if the patient gets the blood moving it is even more beneficial.

Avoid NSAIDs

                This is a tricky one. I encourage patients to avoid NSAIDs as long as it does not counteract direct advice from their Physician. When we needle trigger points, we are somewhat reliant on micro trauma to create a positive healing cascade and NSAIDs are not going to help this process. In my opinion, if the patient can avoid anything that interferes with the healing cascade I recommend it. Movement, heat, and self massage can help instead. Ice is a topic onto its own. Qualified practitioners should be well educated on the topic to apply their knowledge to their patient’s specific needs.

Self massage is good in small doses

                Foam rolling, lacrosse balls and other methods of self massage are very common among well-informed patients these days. While I encourage my patients to utilize these techniques, I also give some time restrictions and try to limit overdoing it. A little bit can go a long way with these techniques. Use of these self care techniques for too long or too frequently can exacerbate symptoms and in my experience prolong the healing process.

Common occurrences

The other point I note to patients post treatment is common “side effects” and what to watch for. Obviously, the most common post treatment occurrences are bruising and temporary soreness. I think it is important to note that the bruises are not usually tender and the soreness should be brief but paid attention to (see the needle intensity blog for more). Fatigue can occur in some patients as well, but is not something I see often. Temporary exacerbation of symptoms also occurs occasionally enough to be called common, so being informative about this point can be very helpful to patients.

Want more tips and tricks for Trigger Point Acupuncture? Check out the Trigger Point Acupuncture facebook group!

 

Type “paleo diet” into google and you’ll find countless threads talking about it and most have a very strong opinion towards it. Some of these sites quite literally say it is the “healthiest way to eat,” while others talk as if it poison for every ounce of your being. Very few of these sites present pro’s and con’s and an informational approach. Hence my approach, an attempt at an unbiased review pointing out pros and cons so that the reader can decide and not be told the answer. Of course to do this, we have to first decide what the paleo diet is.

The concept of paleo from a branding standpoint is to mimic the diet of the caveman. Now of course, there is heavy branding going on and getting caught up in the specifics of this is missing the point. Essentially the diet is based on eliminating processed foods, grains, and dairy. It is a high protein, low carb diet attaining protein mostly from animal sources. Veggies, oils, nuts and some fruits are included in the diet. For the purpose of this article, we will leave it at that as getting too in depth with specifics will only cause arguments. Based off this definition, let us look further at some of the pros and cons.

Essentially the diet is based on eliminating processed foods, grains, and dairy.

Essentially the diet is based on eliminating processed foods, grains, and dairy.

Pros:

  1. Focusing on food- this diet gets you to pay attention to what you are putting in your body on a daily basis. It provides accountability and a map for eating. It encourages the avoidance of processed foods and aims for whole, organic foods. This is definitely a step up from the SAD (Standard American Diet) that is prevalent today. If everyone in the country took this step we would be a much healthier country.
  2. High Protein Low Carb- Want to cut weight? High protein low carbohydrate is the way to do it fast and effectively. Most athletes will follow that simple concept in sports nutrition at some point and be successful in certain ratios.
  3. Great Option for certain health conditions- Lactose intolerant? Celiac’s Disease? Gluten Sensitivity? Paleo has you covered as you are not eating Dairy or Gluten.
  4. Not your standard diet- I love that there is no calorie counting and Paleo is a sustainable dietary lifestyle versus a “diet”. It is something a person can embrace without having the likelihood of huge ebbs and flows due to difficulty of food choice availability.
  5. Group Mentality- The CrossFit community has really embraced Paleo. It practically comes packaged in some Boxes (CrossFit Gyms). Have a community supporting diet and lifestyle can be a very good thing and making it easier to stay on track.

Cons:

  1. Inflammation- High animal protein equals elevated inflammation in the body, period. There is no way around it, no arguing it. If you eat a diet that is high in animal protein you will increase inflammation via arachadonic acid pathways.
  2. Dehydration- With a high protein diet you will need more water. Drinking lots and lots of water can help with this, but more often than not, markers will show up on a blood panel such as an elevated ESR (inflammatory marker).
  3. Global Impact- High animal protein equals a heavy impact on the planet. It is estimated that about 18% of human caused green house gases come from live stock production. That is a huge global aspect to think about when you are considering eating meat with every meal.
  4. Not for everyone- There is the obvious, Vegans and Vegetarians will not be on board with this diet. There are also health conditions that would not benefit from a Paleo diet. People with inflammatory conditions such as arthritis, rheumatoid arthritis, lupus, ect or those with heart conditions. There are much better options for these individuals. This directly counteracts number 3 of the pros so I would say it is pretty balanced in this case.
  5. Excuse to indulge on meat- As a health care practitioner I have seen many patients that operate under the theory that Paleo means eat bacon all day, every day. They will look at paleo as a solid reason to offset any hope for a balanced diet. This can be argued for other diets as well (in fact I made a similar argument in a vegan diet blog). Balance is key with food.
  6. Elevated Cholesterol- Eating a diet where often every meal contains animal protein can have a negative effect on cholesterol. Many Paleo eaters find themselves on a high protein, high fat, low carb diet which can lead to an increase in LDL, decrease in HDL and increase in total cholesterol. In the event that an annual blood panel shows a negative increase in cholesterol, perhaps the Paleo diet should be reconsidered, especially in those with a genetic predisposition to elevated cholesterol. Interestingly, there are some studies performed that show people that switch to the Paleo diet actually have an improvement in Cholesterol levels. One study showed a decrease in LDL of up to 22%. The reason this is in the “con” section is it also shows the inconsistency of the diet standards. The Paleo diet can vary so much as to what is eaten, therefore sometimes having a positive effect and sometimes having a negative one. As mentioned in number 5, if the Paleo Diet is not well balanced, then is can be hazardous (as is the case with many other diets).

There is a brief synopsis of Paleo pros and cons. Part 2 coming soon will be a look at the Paleo diet from an East Asian Medical perspective. Don’t forget to subscribe if you want to check it out! What are your thoughts regarding the Paleo diet? Sound off below!

1)      Make a habit of not taking the easy route: Most people will wait for someone to pull out of that front spot in a a parking lot so they can take it and get into the store as quick as possible. Don’t be that person. Park further away and get a quick walk into your location. Same thing goes with elevators. There is no good reason (assuming capability) that you should take an elevator up one floor. Take the stairs! Another idea is, if you can use a hand basket instead of a cart while shopping, go for it!

The mind set of training over working out is highly beneficial.

The mind set of training over working out is highly beneficial.

2)     Don’t think exercise, think training: Mindset is extremely important. When someone asks me, “how often do you work out”, I say rarely, if ever. However, I do “train” about 6 days a week. Of course it is just a play on words, but there is some meaning behind it. People often think of “working out” as an activity done specifically to lose weight or get six pack abs and personally I never do that. I set goals and work daily to achieve them. The healthy management of weight and gain of lean muscle mass is just a cool side effect. For example, the goal I achieved to the right took a really long time to reach! Setting goals gives you something to focus on and create “work outs” around. Maybe you want to run a 5k? Or maybe you want to achieve a specific movement like a strict pull up? If you build your training schedule to achieve these specific goals, you will increase fitness levels while achieving these new skills.

3)      Get a partner or join a group: Some people love fitness groups to get motivated. For example, CrossFit or Yoga are large group fitness classes. Classes usually have around 10-40 people and this can create a great environment to encourage fitness.  A group or partner setting can easily be applied to any fitness situation. Training partners not only encourage you to reach fitness goals, but also can hold you responsible on those days where sleeping in or hitting the couch instead of training sounds good.

Go For a Hike4)      Find active activities you enjoy:  It’s no big surprise that not everyone enjoys the daily grind on a treadmill or hitting the weight room. In fact I’m that guy too! That is completely okay, but find something active you can enjoy. Don’t like a treadmill? What about hiking? Or golfing (walk the course!). Finding hobbies that are active will provide you exercise outside of hitting the gym. Who knows you may even find an activity that lets you look at gym time as training.

 

 

5)      Avoid negative reinforcements:  Becoming healthy is all about lifestyle changes and not temporary fitness and diet trends. Part of that can be making changes to habits that reinforce behaviors that won’t help you reach your goals. One example is “happy hour”.  Red wine in low amounts can be good for the heart and have antioxidant value, but more often than not, happy hour means cheap beer or high sugar beverages along with calorie laden appetizers. Hate to break it to you but they aren’t helping your heart or your fitness goals! Skip happy hour and grab a friend for a walk, run, or dance class instead!

6)      Don’t be afraid to get your hands dirty: Not many of us like chores but, they can be a good way to stay active. Mowing the lawn, tending the garden, and even doing laundry can play a part in your fitness. Yard work is hard work!

7)      Don’t sit all day: It is all too easy to get stuck at the desk staring at a computer for hours on end. We are all guilty of it. It is important to take time once an hour to get up and walk around. It is the perfect time to go to refill that water bottle you have been using to stay hydrated (see what I did there?). Another great idea is don’t have lunch at your desk. Take 30-60 minutes and go for a short walk. Eat outside if the weather allows. Getting that extra movement will also help recharge you for the second half of the work day without needing a pick me up.

8)      Create a routine: And stick to it! This can be huge for developing great fitness. You don’t have to go Type A about it, a broad routine is okay. For example, I make a point of going hiking at least once a week. Sometimes it is a whole day, sometimes it is just an hour or two but, I get out there for a good hike.  Even if I only have one day off that week, I carve the time out of that day to do this activity and make it a priority. You can do the same. You can also be more specific with a training plan and come up with an agenda that you want to go to the gym 5 days a week, three days cardio and two days strength training.  The routine is up to you, but make sure you can commit to it. Start with a realistic and attainable plan. It will feel better to be able to commit to your routine and even be able to surpass it rather than feel like you are falling short because it is too much.  Remember the importance of mind set!

9)      Cook at home: When you make meals at home you have total control about what is in them. When you eat out all the time you don’t always know what is snuck in there to get that rich flavor. Ever wonder why when you attempt to recreate a meal it doesn’t turn out the same as the restaurant? To be honest you may not want to know. Limit eating out and you may find success in the kitchen!

10)   Have your health team in line: Those who are really fit usually have a health team in order. Look at a professional athlete. These individuals have athletic trainers, coaches, physical therapists, acupuncturists, massage therapists, nutritionists, and chiropractors depending on what they find most useful. They do not just go to the doctor when something goes wrong, they see health care practitioners to prevent something from going wrong and to stay their best!

What kind of things do you do to keep active and fit? Leave a comment below! And don’t forget to subscribe to our blog and follow us on Facebook for lots of other great tips!

Getting an extra boost is always desirable for a workout. Whether you are looking for an edge on a big day or just dragging a bit and need a pick me up, energy drinks have become a quick grab for both the athlete and those trying to get through the work day. As always, it comes down to what is in the energy drink that should be considered. Obviously, the number one “pick me up” ingredient is caffeine. Now there isn’t anything wrong with utilizing some caffeine, but overuse will decrease its usefulness and have a negative impact on your body.

                Caffeine is a stimulant. That means it will give you energy, but it does not mean it does not come with side effects. For example, caffeine may cause an increase in heart rate, blood pressure, and body temperature. In that effect it is similar to a basic warm up before exercise; it will get our body temperature up, get the blood flowing, and prepare body for the actual workout. From that stand point, it isn’t the worst thing. Personally, when I climb mountains, I will have Cliff Blocks with caffeine handy because the extra energy and calories work great when I am at an altitude where the last thing I want to do is eat. These would not be as useful if I used them all the time though, as tolerance to caffeine also occurs. Unfortunately so does addiction.

                It is one thing to use caffeine for an occasional workout, but it is completely different thing to use caffeine all day. The more one uses caffeine, the less effective, more addictive and worse the side effects become. I mentioned some of the side effects and can reason how they would be good for exercise, but let’s think of those effects during times of rest or at least physical rest.  An example is 2 cups of coffee sitting in rush hour traffic. The caffeine can cause restlessness and perhaps anxiety. Coffee with breakfast, energy drink for your morning workout, mid afternoon iced coffee to get through the day, and then a soda with dinner now you’re in trouble!  Another fun side effect of caffeine is the increased excretion of calcium. Now that useful occasional drug has the potential to cause lasting side effects to the body including decreased bone health. So what do we do for energy instead?

                I don’t necessarily recommend stopping a single daily cup of tea or coffee. The increased antioxidants are a great benefit and the amount of caffeine isn’t going to send you on a downward spiral. I do encourage people to consider the thought behind the extra pick me up. Do you need a boost or do you need more rest? Caffeine can stay in the system for 6 hours, so that night cap is affecting your sleep whether you want to admit it or not. Realistically, you want caffeine, but you need water and electrolytes. Dehydration has a profound effect on energy levels. We recommend drinking half of your bodyweight in ounces of clear filtered water per day.  To gain electrolytes you can be sure to eat a balanced diet. What about energy for the everyday workout?

                If you are dropping back to a max one cup a day of tea/coffee and you are a multiple cup drinker per day, the first week will be tough. Nervousness, irritability, and headaches are not uncommon. Once that is done what are options for energy? A pre-workout energy shot can be useful and does not have to contain enough caffeine to turn a slug into a cheetah. My personal favorite is Elevate Shots by Thorne. It contains minimal caffeine (2mg per serving), which means the pick up is more gradual and thankfully the crash is non-existent. It works off a proprietary herbal blend to give adaptogenic support (think balancing more than stimulating). Using Elevate before longer workouts is awesome and you will experience great stamina. They are portable, single dose and even tasty. If you want to learn more about these, come into the clinic and check them out.  The other amazing and simple way to help maintain natural energy without overloading on caffeine is a homemade sports drink. Below is a great and simple recipe for one that I got from my colleague at Source Naturopathic Dr. Robert McElroy.

Home Made Sports Drink

An amazing and simple way to help maintain natural energy without overloading on caffeine is a homemade sports drink.

 

                This is just one of many options for creating a homemade sports drink. It is also significantly lower in cost than picking up a Gatorade (with way too much sugar) or an energy drink (with way too much caffeine) at your local store. It also allows you to pay closer attention to what your body actually requires in regards to nutrients. With adequate hydration (water and electrolytes) and the occasional use of adaptogenic herbs (see your natural health care provider first!), a high caffeine intake will no longer be as appealing. If it is, seeing a health care practitioner for a screening would be a great idea. Have questions? Please feel free to comment below or contact us directly. If you liked it please remember to share this with your friends! Thanks for reading.

False Grip Gymnastics Rings

I work with CrossFit enthusiasts regularly to help them improve specific gymnastic skills

 

As a hand balancing instructor, I work with CrossFit enthusiasts regularly to help them improve specific gymnastic skills. As a Bellevue acupuncturist, I see CrossFit enthusiasts with injuries some avoidable, some not.   Regardless of my relationship with the athlete, I’ve learned they enjoy taking their health and fitness seriously and want to reach their full potential. To help do that, I have compiled my top 3 tips for the Crossfit athlete.

Prehab– CrossFit can be very hard on the shoulders. In order to continue to train injury and pain free, consider a prehab routine. In the case of Crossfit, strengthening the core, rotator cuff and periscapular muscles should be considered.  Check out the video to see some great exercises that can help keep shoulders healthy and prepared for the stress that a good WOD can put on them.

Periodization– Creating a cycle of intensity in your exercise program helps achieve goals and improve the overall quality of said program. This is especially true if you compete in any CrossFit competitions, but works great for every CrossFit enthusiast. If you look at any professional athlete’s training program you will clearly see periodization.  It is an annual plan to layout goals, how to achieve them, and how to do so without getting avoidably injured. It is not written in stone and can be modified to meet an athlete’s individual needs. If you take baseball as an example, these athletes have a clear off season. This does not mean they sit on the couch and eat chips though. The professional athlete will utilize the off season to work on specific skills and to maintain overall health. During spring training season, they take sport specific time to get ready for serious competition. As spring training comes to the end, official season begins. This is when there is constant training and a high level competition occurring. This shows a clear annual training plan for these athletes and it keeps them at their best.  So how would this look for a CrossFit competitor?

If we break down skills of CrossFit into three aspects; gymnastics skills, weight lifting, and high intensity cardio, then periodization will be easier to implement. Most CrossFitters I work with tend to have a preference for a specific area, which from a competitors stand point can come back to bite them. Having a planned approach can all skills will be addressed to be well rounded. A good plan can also prepare the athlete for a competition. For example, take a certain competition, say the CrossFit Open, and make it the main event of the year. Planning that time to be a physical peak would be great to focus on. Divide the rest of the year into cycles where skills are focused on in divided sections. An example is to focus on gymnastic skills such as muscle ups and handstand walks for a few weeks, then switch to a focus on weight lifting for a few weeks followed by cardio skills (i.e. double unders). When working on specific skills, it doesn’t mean that is the only thing you do during this time, just that these skills will be the focus. Continue to rotate these during your off season. Perhaps two months before the Open, enter your own “spring training” where you begin to combine the skills you work on in a way that directly mimics how the Open competition will be. This is a good time to even check out other local competitions or encourage your gym to have an in-house competition. As the Open gets closer (about a week before,) taper the workouts down and take some rest days. The skills have been trained, mimicking of real life challenge has been performed, so taking some time to ease off will be very beneficial. Rest, prevent injuries, and prepare mentally. This will allow you to enter the Open fresh, trained and ready to PR!

Recovery– I could probably write an entire book on recovery, but some important aspects to ensuring an adequate recovery are:

Stretch– All too often people want to get in and get out with a workout. They will slam out a new personal record on the WOD, then get out of the gym to get on with their day. Taking just a few minutes to work on flexibility will not only help with recovery, but improve one’s overall skill level.

Sleep– Something people often neglect is rest. The body needs adequate sleep to work on recovery. When we sleep, we enter a parasympathetic state (rest and digest). The body gets a chance to relax and focus on repairing the day’s work. Personally, before sleeping is when I like to take my herbs and supplements tailored to recovery. I tend to think of sleep as my time to prepare so that tomorrow’s work out can be even better than today’s.

Nutrition– The best way to ensure the body recovers, is to make sure it is adequately nourished. This can be accomplished with a combination of good whole foods and quality supplementation. If you look back at our blog about supplements for athletes, it will give you a small intro into recovery supplementation. As far as diet goes, one simple tip is to be sure to get protein within 30 minutes after a workout. Protein is the building block for muscles. Feed the body protein and it will get to work on healing everything that is torn down during a workout.

Health Team– There is a reason they are called health care professionals. Take the time to have a team that is familiar with your health goals. This can be a Naturopath focusing in the nutritional aspects, an acupuncturist that focuses on sports (like the one’s at Pins and Needles!) helping manage pain and keeping muscles healthy, and a massage therapist to keep the kinks out.

 

Implementing these three tips into your life can really help improve athletic ability within CrossFit. Be sure to take the time to speak with professionals (health care and coaches) to reach your specific goals. If you have specific questions please feel free to leave a comment or contact us! And don’t forget to subscribe to our blog for more great tips!

                Sports nutrition is often designed without the vegan lifestyle in mind. To be honest, many sports nutrition diets are designed without long term health in mind. That is the difference between a diet and a lifestyle, the latter is sustainable while the former is a temporary approach. That doesn’t mean temporary dieting is bad, done with periodization of training, it is very effective for competitive athletes. The lifestyle approach to food is what is done the rest of the time. For a vegan athlete, there are some concerns when attempting to maintain a high level of activity with a healthy diet. Some are more common misconceptions, while others are valid concerns. The following are 5 of the most common issues a vegan athlete may come across.

Vegetarian Trap- The dietary issue with the vegan lifestyle I come across as a health care practitioner is, what I refer to as, the vegetarian trap. It is similar to that of the omnivore’s great failing… too much processed high sodium foods. Many vegans ‘go vegan’ and think that means frozen readymade meals and pasta at every meal. This equates to excess salt, hydrogenated fats and way too many carbohydrates. It will undoubtedly offset the vegan athlete’s dietary goals. Vegans turn vegan for different reasons. Sometimes the reason is about animal rights or a personal belief and other times it is to become “healthier”. The best way to be a vegan athlete is to truly embrace a plant based diet. This should mean fresh, organic, unprocessed foods.

 B12 Deficiency– This is definitely a valid concern. The highest sources of B12 come in the form of meat products. If a person chooses to not eat meat they can usually be health conscious enough to get adequate B12 via fortified foods and not become ill from a deficiency. Just because you are achieving the bare minimum, does not mean you are achieving enough. As an athlete you are striving to be at your best, not to scrape by. This means the Vegan athlete will most likely need to supplement B12 to become as efficient as possible. There are many products on the market that claim to provide B12. If oral B12 is being taken it is often best absorbed in a sublingual form rather than a pressed pill. More often than not we would recommend an intramuscular injection of B12 to maintain a high performance level for an athlete. B12 shots are inexpensive, sustainable and easily put the vegan athlete on par with if not above the omnivore athlete in regards to B12. Intramuscular B12 injections are the number one method of absorbing this vitamin. To learn about B12 shots, contact your friendly neighborhood Naturopath (like the one at Pins and Needles!)

Vegan Athlete

The best way to be a vegan athlete is to truly embrace a plant based diet.

Protein Insufficiency– I personally believe this is more of a mythical threat as long as you don’t fall into the Vegetarian trap. There is more than enough protein available in a plant based diet to achieve optimal amounts. The trick is to not rely on one source of protein. As discussed in our last blog (check it out here), protein powders are wonderful for athletes. The problem with protein powders and the Vegan Athlete is finding a source that provides a balances complete protein. Our tip is to mix up the sources of protein in protein powders. This is the same tip we have for gaining protein through foods, be sure to mix it up! Examples of high protein vegan foods are tofu, seitan, tempeh, dark leafy greens (kale, spinach), almonds, and beans.

Calcium– We are more or less bred in North America to think dairy is how we get calcium. In fact I would give major kudos to the dairy marketing industry for having the capability to practically brainwash an entire population into thinking this is a legitimate fact. It isn’t true. The next big lie marketing campaigns came up with was, you need to get extra calcium via “calcium chews”. Again amazing campaign with a heavy impact to create desire for a product, that is usually junk. In fact, many Calcium products use Calcium Carbonate which has potential for worsening bone health by creating osteophytes. Attaining calcium without calcium chews or a cows milk product is actually pretty easy!  While we often recommend a calcium/magnesium supplement to patients, we always strongly encourage the majority of calcium to be obtained via food sources. Oddly enough, this is almost always accomplished from non dairy sources! Did you know that 1cup of cows milk contains 305 mg of calcium and 1 cup of collard greens has 357mg? Nice!

Iron– Along with B12 deficiency, Iron deficiency can be common in vegans. However, with a strong focus on incorporating dark leafy greens, it is less of a concern. There was a reason Popeye ate his spinach! If the vegan athlete embraces a plant based diet and avoids the vegetarian trap, iron deficiency would be less likely than that of a lacto/ova vegetarian. Some of our favorite vegan Iron sources include spinach, quinoa and lentils.

A vegan lifestyle will require frequent shopping to assure fresh foods. Below is an example of a vegan menu for a day that contains balanced nutrients to fit an athlete training for one to two hours a day:

Breakfast: (Steel cut)Oatmeal with ground flax

Snack: Trail mix/ nuts and fruit

Lunch: Salad including a Spinach and Kale base, garbanzo beans, shredded carrots, broccoli, oil and vinegar

Snack: Homemade granola bar

Dinner: Tempeh “steak” on a bed of lentils with edamame and chard

Pre Training- Apple with almond butter 30 minutes before workout

Post Training- Protein shake (pea and rice protein mix) and a banana within 30 minutes after exercise

                Of course this only an example and it can easily be modified to suit individual tastes. The vegan athlete definitely needs to do a great deal of research or seek out a health care practitioner that can help to provide a diet that helps achieve an optimal diet. The above only briefly covers some of the considerations for a sports diet.

If you have any questions please feel free to post in the comment section or contact us. Thank you for reading!

 

If you are an athlete of any kind then you have probably been inundated with suggestions on what supplements will get you to become the best athlete you can. From claims of magical pills to drinks containing vitamins (that you will never absorb), the market is full of options. A very large portion of them are unnecessary and essentially junk. In fact, one of the first things I like to do with my athlete patients is have them bring in supplements to the clinic. In doing so, we can go over all of the ingredients and figure out what is working for them and what they should add into their regimen. While everybody is different here are  a few items that should grace the cabinet of every athlete whether professional, amateur, or weekend warrior.

Weight lifters often treat this like it is a precious as gold, which to the body it can be.

1)      Protein Powder- Weight lifters often treat this like it is a precious as gold, which to the body it can be. Protein isn’t just for people trying to bulk up. Whenever we perform athletic activities we are breaking down muscle to some degree. Protein is what helps build that muscle back up. From a nutritional standpoint, protein is also great to have before a work out to assure adequate nourishment. The question is what kind of protein powder is best.

  • Whey Protein Isolate- Definitely one of the most popular. Whey is a milk based protein and is considered a complete protein (contains all the necessary amino acids). The thing to watch for is what other junk have they put with it and is if it is truly a Whey protein isolate. Quick tip to avoid junk: always read “extra ingredients” and look at the carb/protein/fat content. You don’t want a protein packed with carbs or fats. The only aspect where whey protein fails is that it is obviously not a vegan product and not so friendly to those that are lactose intolerant. Also, milk is very mucous producing so congestion/phlegm may be an undesirable side effect.
  • Pea Protein- An excellent option for those sensitive to dairy or concerned about welfare of animals. Pea protein is considered a hypoallergenic, vegan protein that is easily digested. The con of Pea Protein is that a Vegan athlete would need to consider integrating other sources of protein as well to assure an adequate balance of amino acids is achieved.
  • Hemp/Soy/Rice- Other powdered proteins include Hemp, Soy, and Rice. The most common complaint I hear about hemp is the flavor and that it is more limited at stores than Soy, Pea, or Whey. Soy protein is an acceptable option in moderation, although it is becoming a very common food allergy for people because it is quietly added in many of our foods. Also, finding an organic source may be more difficult and most Soy is not GMO free. Rice protein is a great option and is also easily digestible.

Whenever looking for a protein powder, stay away from ones that add sugar.

2) Daily Multiple- If you are an athlete you are using up more nutrients than an average person and you need to replenish these. Choosing a daily vitamin can be tricky. Check out our previous blog article about choosing a proper daily vitamin here.

3) Ca+Mg- Calcium and Magnesium in combination is an excellent step in recovery. While it is important for an athlete to consider products that will improve athletic ability, the ability to recover is just as important. Calcium and magnesium need each other in the body, so it is great to take them together. Ca+Mg taken in small doses at night can act like an all natural muscle relaxer due to the magnesium content.

4) Fish Oil- Continuing along the lines of recovery, fish oil is anti-inflammatory. Like all supplements, all fish oils are not created equal. There are also many ‘types’ of fish oil, depending on the content and ratios of the ingredients. One fish oil recommended for an athlete would be different than one recommended for cognitive health or during maternity. For pain, choose a high grade, pure triglyceride form fish oil with high grade eicosapentaenoic acid (EPA) over a high level of DHA (docosahexaenoic acid). Ratios of EPA and DHA can important in tailoring the treatment for different conditions. The benefit of supplementing with Fish oil over just eating fish is twofold. Often, people cannot eat enough fish to attain a therapeutic dose and there is also concern of mercury content, especially if certain fish are eaten. The downside of fish oil is obvious; it is not for the vegan athlete. Vegans often utilize flax seed instead, but this provides ALA (Alpha-lionlenic Acid) which may not provide the same therapeutic effect.  As a vegan athlete it is difficult to attain the benefits of EPA directly leaving ALA as main option. Other considerations before starting a fish oil would be to consider current medications and avoid with some medical procedures. As with everything in this article, it is best to discuss individual needs with a medical professional before starting supplementation.

5) Chinese Herbs- This is a very broad statement. Chinese herbal medicine has an apothecary of hundreds of herbs. Almost always, herbs are combined together rather than used alone because TCM (Traditional Chinese Medicine) is all about balance. It would be necessary to see an East Asian Medicine Practitioner to find out what herbs would be best for each athlete. For an example however, one commonly used formula for athletes is Yu Peng Feng San Wan. Because training can be very draining and tax the immune system, supplementing short term with this formula can be very beneficial to help burn out or prevent what is called a “Wind Invasion” in TCM. While this is only one example, there are many other uses for a patient to take Chinese herbs such as pain, digestive upset, or even fatigue.

For athletes, considering any or all of these products is a great idea. Whether a weekend warrior or a serious competitor, every athlete deserves to get the best performance they can.  If you enjoyed this information please subscribe to our blog and for more great tips follow us on Facebook!

*The preceding is not intended to diagnose or treat and is for informational purposes only.

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