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Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
March, 2003, Vol. 03, Issue 03
Yin and Yang Deficiency, Part VI
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
This is the last of the series of articles on yin and yang deficiency, By now, you should have a pretty good idea of the primary organs involved and how to differentiate between the two conditions.
Always remember: Before looking at details, go back to the larger picture.Yin is cool, dark, relaxed, quiet, reflective and receptive; yang is warm, light, restless, exciting, outgoing and relatively more aggressive. When comparing the two, yin has a more substantive nature, whereas yang is more energetic. Yin and yang are relative terms; neither exists in isolation. They are in constant dynamic balance.
So, if you keep that in mind, all you are doing when treating yin or yang deficiency is readjusting the relative balance of yin and yang in the body, which is more important than quantity. Depending on the time of day or the season, we all feel different yin or yang qualities, but sometimes we get noticeably out of whack. In the case of a yin deficiency, the opposite back to the body, and determining how yang became so depleted in the first place.
Characteristics of yin are present, i.e., a relative excess of yang. In the case of yang deficiency, look for symptoms you might consider yin, but are actually representative of a relative lack of yang. A person might feel cold day and night, summer and winter, not because of an excess of cool/yin, but because, for some reason, his or her yang has been depleted or damaged. In this case, the treatment plan would have to include adding yang.
Let's start by discussing how to treat yang deficiency with Asian bodywork therapy (ABT); Later on, we'll address lifestyle, diet and environmental changes. I find ABT is often better than acupuncture in the case of deficiencies, because it can be extremely nourishing, tonifying and relaxing. Often, needles can be depleting if overstimulated and left in too long.
General Yang Deficiency Treatment
Anytime there is a yang deficiency, the primary treatment principle involves using moxa or a TDP lamp to tonify and warm yang. Make sure you are correct in your assessment, because you don't want to do this if the person has any excess heat! I don't use heating pads, hot water bottles or hot rocks, because they have no herbal penetrating energetic quality.
A TDP lamp is a strange, expensive device I call a "Chinese magic lamp." I don't think the lamp actually has supernatural powers, and I really don't know why it works - but it does. And every Chinese acupuncturist that I respect uses one. It's a heating lamp made with mineral plates that have the same penetrating action as moxa. It actually adds something into the body energetically that other therapies don't. You can get TDP lamps at any acupuncture supply store, but shop around, because they can be pricy.
To use a TDP lamp, heat it up first, then place it over the point you want tonified. For any yang deficiency, I would place it over Du 4 and Ren 6 for at least 15 minutes each. Make sure not to put it too close for too long, or you will burn the patient. If he or she gets a headache afterward, or if sensory feedback is compromised in any way, stop using it. Common sense rules.
The same goes with moxa. I would caution you not to use any kind of moxa unless you have been properly trained. You can cause serious burns or misgauge treatment, which is not only bad for business, it's not great for your karma or your client's health, either.
A moxa box is easiest, but it's also the smokiest, which can be a problem if you are sensitive to smoke or share your office, particularly since it smells a bit like marijuana. People give me side glances after using it, and I have had police come to my door inquiring about the strange smell. It is a box with no bottom but a screen in the center. You fill it with crude moxa, light it, and set it over an area such as the abdomen or lower back.
A moxa pole is also fairly easy to use. You gently circle over the point, visualizing spiraling the energy into the person's body. Don't overheat it; we are talking tonification here, so, as you know from my previous articles, be gentle, gentle, gentle, like you are petting a cat. Encourage the qi to come to the area.
I am not crazy about big, fat cone moxa that you knock off when it is too hot. It's fine if you like that technique and are good at it, but try to remove the cone before the patient starts screaming.
Since I was trained in Japan, I prefer another way of using direct moxa. I use an ointment called shiunko: a sesame- to rice-grain-sized, super-refined gold moxa cone, lit with incense and burned down to the ointment. It is somewhat labor-intensive, particularly compared to a TDP lamp, but it is quite effective once you know what you are doing.
You can use any of these techniques to warm Ren 6 and Du 4. Using either the pole or direct moxa, warm all of the Du points from Du 2 to Du 14, going up the spine, repeating a few times (general back treatment protocol). This is a powerful technique for tonifying yang; people will jump off the table warm and full of energy. As the Sea of Yang, the Du meridian is the best place to start to access the yang of the body. Warming Du 4, Ren 6 and Du 14 are general ways to tonify and warm yang. Utilize them in any session in which you are using that treatment principle, adding the specific treatment protocols below.
Kidney Yang Deficiency
Start the session with the back protocol above. Po Sum On is an herbal ointment you can rub on the client's lower back and sacrum before hand so the warm feeling lasts longer. Moxa Ki 3, Ki 7 and Bl 52, while the patient is face-down, gently and repeatedly warming each point. Next, hold the lower back area at the level of Bl 23 and Bl 52 with your fingers and heel of your hand, in a "bye-bye" squeeze. As you are holding, gently thumb press up each Kidney meridian on the legs, concentrating on Ki 3 and Ki 7. I suppose you could do this on the table, but the way I do it is on the floor, sitting between the client's knees, supporting their leg up on my knee, working one leg at a time. Obviously, this is not a position you would use unless the client is fully clothed! When the person is supine, moxa Ren 6. At the end of the session, reach under and cup both Bl 23s as you hold both Ki 27s with thumb and forefinger for a few minutes (mu-shu combo).
Spleen Yang Deficiency
Start the session with the general back treatment protocol. Use bilateral thumb pressure on Bl 20, 21 and 22, gently sinking in and holding each point. When your client is face-up, you can use a moxa box or TDP lamp on Ren 6 while you moxa Sp 3, Sp 6, Sp 9 and St 36. If you are using pole or direct moxa, continue up to Ren 9, Ren 12 and St 28, then gently thumb press up the Spleen meridian, one leg at a time, focusing and lingering at Sp 3, Sp 6, Sp 9, using your mother hand on Ren 6. Hold St 36 with firm thumb pressure as you hold Ren 9, Ren 12 and then St 28 bilaterally. Do the same with the other side. End the treatment by cupping your fingers and the heel of your hand under the patient's back, holding Bl 20 and 21 with one hand and Ren 12 with the top hand. Hold for a few minutes. Keeping your bottom hand in place, holding each Lv 13. Again, by doing this, you are holding the Spleen and Stomach shu and mu points simultaneously.
Heart Yang Deficiency
With the client prone, moxa up the Du meridian, as noted in the general back protocol. Go back and moxa both Bl 14s and 15s. Repeat moxa on Du 14, as it is particularly indicated for Heart Yang Deficiency. With the client's palms up, moxa Ht 5 and Pc 6 on each side. Hold Ht 5 with your thumb as the "mother thumb," press up the Heart meridian, ending at Bl 15s, holding Ht 5 with Bl 15s for a few minutes. Go back and hold Pc 6 with your mother thumb, then gently press up the Pericardium meridian as far as you can go, ending as Bl 14s and holding this combination for a few minutes. Repeat these two meridians on the other side. When the person is supine, moxa Ren 6 and Ren 17. Palm press the yin aspect of the arms while holding Ren 17.
It's always a good idea to suggest ways clients can support their health between sessions. For example, if they repeatedly expose themselves to cold weather, yang deficiency may persist. Make sure you tell your clients to bundle warmly, particularly around the waist. In Japan, they wear haramakis, which means "belly wrap-ups," to protect against cold.
The exercise you might recommend for yang deficiency would be any self-cultivation techniques, such as qigong or taiqi. Either one is gently tonifying and warming. If the client has lower back pain caused by yang deficiency, recommend exercises, in addition to stretching, to strengthen the back. If the client participates in more vigorous exercises, such as aerobics or running, and feel tired afterwards, suggest that he or she think about cutting down, stopping or switching to a more gentle form of exercise. Yoga is great if done properly. Again, if the client feels awful afterward, he or she is probably overdoing it. It's not about how great you feel while in class, or how far you can stretch; it's about how good it can help you feel in your everyday life.
Besides exercise, challenges and accomplishments tonify yang. This is one reason many people who retire start to become yang-deficient soonafter. They need to find something else that gives themselves purpose and adds meaning to their lives. Having goals, outside stimulation and activity nourishes yang.
Having sex too often also can deplete yang, especially that of the Kidney; however, Felice Dunas notes that being sexually rejected repeatedly over a period of time will also deplete yang. Continuous rejection can decrease sexual desire to the point of impotency or frigidity, which are symptoms of yang deficiency. When I see a client with a pronounced yang deficiency, I ask if he or she (or the partner) is depressed, and if so, if it has affected their sex life. If either is the case, I highly recommend they seek counseling.
Feng Shui is sometimes referred to as "acupressure for the home." Hope Karan Gerecht, author of Healing Design, says:
Diet is a factor in yang deficiency. Repeatedly eating cold foods inhibits our body's warming function, eventually depleting yang. This includes ice cream and other frozen foods, iced drinks and an excess of raw foods and fruit. Antibiotics are also considered cold and can be damaging if taken over a long period of time.
According to Daverick Leggett, author of Helping Ourselves: A Guide to Chinese Food Energetics, cooking food longer will increase its warming function and will encourage the heat to penetrate deeper into the body. Don't make the mistake of thinking "the hotter, the better," however. Food that is too spicy will cause us to sweat and we will begin to cool off, illustrating how yin and yang transform into their opposite in extreme situations.
Yang tonics tend to be sweet, pungent and warming. Choose foods such as: basil; garlic; lamb; sage; cinnamon; dried ginger; lobster; raspberry; thyme; chestnut; clove; kidney; nutmeg; rosemary; shrimp; and walnut.
Finally, encourage your clients not to rely heavily on stimulants to create the fiery yang vitality in their lives. Eventually, their body's ability to generate yang will be depleted. It's hard to keep going and keep pace with the demands of life. Bringing balance into our lives with self-awareness and self-care allows us to rise to life's challenges when needed ... and take a well-deserved rest afterward!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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