Olympic Athletes Benefit from Cupping Therapy

Marks from cupping

Marks from cupping

You may have seen pictures of athletes at the 2016 Rio Olympics with large red circles on their backs or arms. These red or sometimes purple bruises are signs that show that these athletes have benefited from cupping therapy. Examples include the Chinese Swimming team, the swimmer Michael Phelps (winner of 19 Gold Medals) and gymnasts Alex Naddour and Chris Brooks. Keenan Robinson, Phelps’ longtime strength-and-conditioning coach, says he first introduced him to cupping in 2014, having seen that Chinese Swimmers were using cupping as a recovery method. In 2015, Phelps increased the number of his workouts and their intensity in order to prepare for Rio. For him finding a rapid way of recovering and relaxing his muscles was a high priority.

"That’s been the secret that I have had through this year that keeps me healthy," Naddour told USA Today about the therapy. "It's been better than any money I’ve spent on anything else. Our bodies are going to hurt after doing this for so long,” said Naddour. “It’s the best thing that I’ve ever had. “It has saved me from a lot of pain.” Fellow gymnast Chris Brookshas needed multiple surgeries on his forearm, shoulder, thumb, hand and ankles due to the wear and tear on his body. For him, cupping is one of many therapies he relies on at the Olympic Training Center, in Colorado Springs.

Athletes report that they are using it to ease aches and pains, and to help with recovery from the physical toil of constant training and competing. Cupping is an ancient Chinese Therapy practiced by acupuncturists and is a therapy I offer at the Hale Clinic.

Suction Cupping

Suction Cupping

What is cupping?

Bamboo, glass, plastic or earthen cups can be used for cupping. Glass cups are used in Fire Cupping where a partial vacuum is created by a flame in the cups. The cups are put on the body where they can loosen and relax muscle and improve blood flow to the area. Suction cupping is similar but instead of using a flame a pump is used to evacuate some of the air from the plastic cups. Cupping is not painful, and the red marks left on the skin are caused by blood being drawn to the surface and small capillaries rupturing. In terms of Chinese Medicine cupping is used to move Qi and Blood in the Channels and to expel Pathogenic Factors. Moving Qi and Blood can be thought of improving blood circulation. Expelling Pathogenic Factors is another way of describing fighting infection. Diseases have entered the body and so it is beneficial to bring them to the surface and expel them from the body. Cupping is also used to treat other conditions such as herpes, headache, sciatica, asthma and acute and chronic back pain.

Evidence for Cupping

A review of the evidence for cupping (by Huijuan Cao et al) was published in the BMC Complementary and Alternative Medicine journal in 2010.  Most of the clinical trials showed positive results on therapeutic effect of cupping therapy but further evidence was required to show clinical significance for particular diseases. A review of cupping trials (Huijaun Cao et al, 2012) "showed that cupping has potential effect in the treatment of herpes zoster, acne, facial paralysis, and cervical spondylosis." Again further trials are required but there is the issue of blinding, "which continues to be a challenge for studies involving manual healing therapies, such as acupuncture, massage, and cupping therapy."

References

http://www.usatoday.com/story/sports/olympics/rio-2016/2016/08/06/usa-mens-gymnastics-cupping-game-ready-jake-dalton-sam-mikaluk/88336190/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289625/

http://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-10-70

http://time.com/4443581/michael-phelps-cupping-olympics/

 

 

The Water Element in Chinese Medicine

Reservoir

There are five elements in Chinese Medicine: Wood, Fire, Earth, Metal and Water. Five element acupuncturists use this system to determine which element in a person requires most support. Working on that element helps to bring balance to the person. The Water Element in Chinese Medicine relates to Winter, to cold, to the colour blue/black, to groaning and to fear (Hicks et al, 2004). Water is the most yin of all elements. It takes the shape of it's container such as a reservoir or a river bed. The Bladder and Kidney meridians are related to the Water Element. The Spirit of the Kidneys is called the Zhi. It gives us the drive and motivation to get things done.

On a physical level the excess and deficiency of the Water Element can cause problems. This can be seen in floods and drought. Water controls Fire. A fireman will use water to put out a fire. The power of Water is storage. Animals store food so the can hibernate over Winter. On an emotional level the Water Element relates to fear. Our response to fearful stimuli is how it manifests. When the Water Element is in balance we can use our fear to avoid dangerous situations like predators, cliff edges and fire. Such a person should be able to respond positively to reassurance. A lack of fear may lead us to engage in extreme sports. An excess of fear may lead to agitation of the mind body and spirit.

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone

Drinking Water

Water

Your body comprises of more than two thirds water. Water is uses to process waste, regulate body temperature, lubricate and cushion the joints. It is lost through breathing sweating and digestion. The Institute of Medicine recommends that men drink 13 cups (3 liters) of total beverages a day and women drink 9 cups (2.2 liters) of total beverages a day.

What is the optimal time to drink water?

1) In the morning

It is advisable to drink two glasses of water upon waking to re-hydrate.

2) Before a meal
Drink one glass of water 30 minutes before a meal to help digestion.  Drinking too much water with your meal will dilute the digestive juices. If you do drink at meal time only drink a small amount and make sure it's room temperature. Leave an hour after a meal before you drink again (Pitchford, 2002).

3) Before sleep
Drink one glass of water an hour before bedtime will help you to stay hydrated.

The American Heart Association says "Keeping the body hydrated helps the heart more easily pump blood through the blood vessels to the muscles. And, it helps the muscles remove waste so that they can work efficiently."

“If you’re well hydrated, your heart doesn't have to work as hard,”  says John Batson, M.D, a sports medicine physician.

 

 

Acupuncture treatment of Frozen Shoulder

Approximately 5% of the UK population will suffer from frozen shoulder at some point in their life. Frozen shoulder (adhesive capsulitis) is an extremely painful and sometimes disabling condition in which the movement of the shoulder is restricted. It can last for months or years. The symptoms include pain, stiffness, redness and contraction.

Cause

The NHS describes frozen shoulder as being caused by the inflammation and thickening of the flexible tissue that surrounds the shoulder joint, known as the capsule. Factors which increase the likelihood of developing a frozen shoulder include:

  • a previous shoulder injury or shoulder surgery
  • diabetes due to the reduced micro circulation
  • Dupuytren's contracture (a progressive painless thickening and tightening of the tissue of the hands and fingers)
  • other health conditions, e.g. high cholesterol, heart disease and stroke

The Shoulder Joint

The shoulder joint is normally flexible and elastic. The humerus, the scapula and the clavicle form the shoulder joint. The synovial fluid in the joint lubricates it. The four muscles of the rotator cuff allow the shoulder to rotate and help keep it in place. The subscapularis allows the arm to rotate medially (inwards). The Teres minor and the Infraspinatus externally rotates the arm. The Supraspinatus abducts the arm (brings it closer to the body.)

Treatment

The joint is assessed to ascertain the range of motion and any painful points. Frozen shoulder is treated by a combination of acupuncture and massage. Massage helps to improve blood flow to the area. Acupuncture helps with the pain, reduces inflammation, enhancing local micro-circulation and stimulating nerves located in muscles and other tissues, leading to release of endorphins the body's painkillers. Moxa on a needle can also help to bring warmth to the affected area. Advice is also given on gentle stretching exercises which gradually increase the range of motion of the shoulder.

Shoulder Exercises

Shoulder Exercises

Adjust your posture

You can help to reduce subscapularis-related shoulder pain by adjusting your posture—while awake and sleeping.

When sitting in front of a computer avoid slumping forward because this forces the arms to rotate into an uncomfortable position, which trigger pain in the subscapularis muscle. When sat at your desk, keep moving your arms. Reaching the arm up and behind the head will help to stretch the subscapularis muscle.

When walking allow your arms to swing freely. 

Sleep with a pillow

An extra pillow can help. If you’re sleeping on the painful side, place the pillow between your elbow and the side of the body. This helps to move the arm away from the body, which stretches the subscapularis muscle. If you sleep on the pain-free side, put the pillow in front of you so that the painful arm can rest on it.

Acupuncture Treats Drug Addiction

Pain Pathways

Pain Pathways

Acupuncture has been shown to treat drug addiction. Clinical trials are taking place to determine the how effective it is. Previous studies including a study in the Lancet (August, 2003)  showed that suppressed the clinical features of heroin withdrawal. The mechanisms by which acupuncture works in a Western Medical context are still poorly understood. Additional research using animal models is helping to do this. Long term exposure to drugs of abuse produces a withdrawal state. This state is characterized by the increases in brain reward thresholds. The acute administration of the drug produces opposite effects. The difference in the short term and long term effects of the drug may be a causal factor in the intense drug craving experienced by addicts.

Dopamine Pathways  

Dopamine Pathways

 

There are four major dopaminergic tracts in the brain. The reinforcing effects of drugs have been linked to central dopamine activity in the mesolimbic dopaminergic tract which runs from the ventral tegmental area to many components of the limbic system. Dopamine is a catecholamine transmitter in the Central Nervous System (CNS), which plays a major role in reward-motivated behavior. Research has shown that  acupuncture directly or indirectly affects the mesolimbic dopamine system. This suggests that acupuncture helps to maintain the balance between excitatory and inhibitory processes involved in drug addiction. The results also suggests that the regulation of neurotransmitters in the CNS may be one of the therapeutic modes of action of acupuncture. Further studies are required to demonstrate if acupuncture effects any of the other neurotransmitters that regulate dopamine release.

Acupuncture treats alcohol addiction

Alcoholism dependence is a chronic relapsing disorder that constitutes the third leading cause of morbidity and mortality worldwide. Craving is one of the most important symptoms of alcohol dependence and is a predictor of relapse (Lee et al, 2015)

Acupuncture reduces alcohol cravings in alcoholics (Bullock et al, 2001). In a large randomized placebo controlled study of auricular acupuncture for alcohol dependence 49% of subjects reported acupuncture reduced their desire for alcohol. The results of a study (Bullock et al 1987) suggest that acupuncture may be able to interdict the cycle of alcoholic recidivism. Karst et al, 2002 studied ear and body acupuncture in the treatment of alcohol withdrawal symptoms. Analysis of the results using the Clinical Institute Withdrawal Assessment (CIWA-Ar-scale) data showed that patients assigned to acupuncture had a general tendency towards better outcome results and significantly fewer withdrawal symptoms on day 14.  Other researchers note that acupuncture is both safe and effective for reducing cravings in alcohol dependent patients. They add that acupuncture is an inexpensive modality of care for the treatment of alcoholism and “produces significant results.”

Lee et al 2015 studied the effect of Zhubin (KI9) in reducing alcohol cravings in patients with alcohol dependence. This study breaks from other research on this topic. Prior research focused on National Acupuncture Detoxification Association (NADA) acupuncture point prescriptions for addiction. This typically involved use of auricular acupuncture points including Kidney, Sympathetic, Shenmen, Liver and Lung. However, this study used only one acupuncture point that is located on the lower leg. The researchers note of this acupuncture point, “Traditionally, it has been used as an acupoint for detoxification.”  “The results showed that the acupuncture treated group had a significant craving reduction compared with the control group. Acupuncture treatment on Zhubin (KI9) was effective from the 1st week of treatment and its effect lasted through the 4 weeks.”

What’s the Point?
The acupuncture point investigated in the research is Zhubin (KI9) that is translated as “guest house.” It is located on the medial aspect of the lower leg and is 5 cun superior to KI3. It is approximately 1 cun posterior to the medial border of the tibia at the lower end of the gastrocnemius muscle. It is placed on a line drawn between KI3 and KI10.

KI9 is the Xi Cleft point of the Yinwei (Yin linking) vessel. This is the channel that connects the yin meridians of the hand and foot to the Conception channel. The Yinwei vessel may also be accessed by acupoint PC6, the confluent point of the Yinwei vessel. To achieve this, PC6 is often paired with SP4, its paired confluent point for the treatment of heart, chest and stomach disorders.

This study used only KI9, whose Yinwei vessel connection makes it especially suitable for the treatment of heart issues. In particular, this point benefits patients with heart shen (spirit) issues due to phlegm and phlegm-fire. This includes the treatment of mania, raving, bipolar disorder (manic depression) and other forms of severe mental illness. Here, there is a logical consistency with the application of KI9 for the treatment of alcohol cravings given alcoholism’s propensity for causing phlegm-fire in the heart.

Auricular Acupuncture Points
Kidney - (MA-SC)

Location: Superior Cymba Concha where is meets the wall of the inferior Crus of the antihelix

Functions: Supplement kidney and boost essence; strengthen

lumbus and invigorate bones.

Indications: Disorders of urinary and reproductive systems such

as nephritis, cystitis, impotence, seminal emission; dysmenor-

rhea, amenorrhea; deafness, tinnitus, retardation of hearing,

loss of hair; disorders of the nervous system such as poor

development of the brain, headache, spinal retrograde degenera-

tion, pain in lumbus, rheumatoid arthritis, chronic diarrhea,

frequent urination at night, bedwetting.

Sympathetic

Location: Hidden from view, at the junction of the Inferior Crus of the Antihelix and the Helix

Functions: Regulates functions of the sympathetic and parasympathetic nerves, relaxes spasm of the smooth muscle and relieves pain. Improves blood circulation and soothes irregular or rapid heartbeats.

Shenmen
Location: In the tip of the triangular fossa, but slightly superior

Functions: Calms mind. Connects with Spirit. Relieves spasm, pain, inflammation and itching. Reduces fever and coughs. Eases tension, anxiety and depression. Also helps insomnia, dreeam disturbed sleep and hypertension.

Liver - (MA-SC5)

Location: Posterior portion of the lower aspect of the superior

concha, anterior to Chest (MA-AH11) and superior to Spleen

(MA-IC).

Functions: Course the liver and rectify qû; brighten the eyes and

extinguish wind.

Indications: Acute or chronic hepatitis, cholecystitis, cholelithi-

asis, distention and pain in the upper abdomen, belching, acid

regurgitation; dizziness, convulsion, hemiparesis; myopia, sty,

and acute conjunctivitis.

Heart

Functions: For palpitations, strengthens heart.

Acupuncture and low back pain

Low Back Pain

Low Back Pain

Do you suffer from back pain? Well you are not alone. Back pain is a common problem that affects most people at some point in their life. According to a 1994 study found in the New England Journal of Medicine, 31 million Americans are experiencing back pain at any given time. Low back pain is the single leading cause of disability world wide. The NHS lists a number of causes of back pain:

  • bending awkwardly or for long periods
  • lifting, carrying, pushing or pulling heavy objects
  • slouching in chairs
  • twisting awkwardly
  • overstretching
  • driving or sitting in a hunched position or for long periods without taking a break
  • overusing the muscles – for example, during sport or repetitive movements

A recent study published in the British Medical Journal concludes that paracetamol is no better than placebo for low back pain (http://www.bmj.com/content/350/bmj.h1225.) The NHS recommends acupuncture for long term back pain and states that it has been shown to help reduce lower back pain. It also recommends exercise classes. Pilates is a good choice of exercise for this condition since it gentle and encourages spine flexibility. The NHS also recommends manual therapies such as massage for back pain. I offer Chinese, Sports and Thai massage. I have found that a combination of massage and acupuncture is particularly effective in the treatment of back pain. This treatment technique works quickly and brings relief to the majority of patients within 24 hours. Several follow ups may be necessary depending on the severity of the pain and if it is more chronic or acute in nature.

The Fire Element in Chinese Medicine

Fire

Fire

There are five elements in Chinese Medicine: Wood, Fire, Earth, Metal and Water. Five element acupuncturists use this system to determine which element in a person requires most support. Working on that element helps to bring balance to the person. The Fire Element in Chinese Medicine relates to Summer, to heat, to the colour red, to laughing and to joy. The Sun is the Fire Element in nature. The following meridians are all related to the Fire Element: Heart, Small Intestine, Pericardium and Triple Burner.  The Spirit of the Heart is called the Shen. The Shen can be seen in the sparkle in a persons eyes.

On a physical level the Fire Element relates to a persons sensitivity to hot and cold. On an emotional level it relates to joy. Communication with others is how it manifests. When the Fire Element is in balance we can communicate freely and effectively with others. We will laugh and smile at appropriate moments. We will be able to recall pleasurable moments. When Fire is in excess we may become over exuberant,we may laugh at inappropriate moments.  Manic behaviour can harm the Fire Element. When the Fire Element is deficient we may be discouraged from human contact. We may not be able to join in the joy of a group and may feel isolated. When Fire is deficient people may display joy but it will lack warmth and not feel genuine. Lack of human contact can be detrimental to the Fire Element.

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone

The Wood Element in Chinese Medicine

In Chinese Medicine Spring is related to the Wood element. The nature of Wood is expansive. It pushes upwards and outwards. You can imagine seeds growing upwards out of the ground towards the light and warmth. The Wood Element encompasses all forms of vegetation from grasses and flowers to trees. The Power of Wood is birth. Spring time is also lambing time. Many animals give birth to their young in Spring time. The Wood element relates to the Liver and Gall Bladder. In terms of Chinese Medicine the Liver is the General that makes the plans and the Gall Bladder is the decision maker. The spirit of the Liver is the Hun. This represents the spiritual aspect of the Liver Meridian. It is involved with thinking, sleeping and consciousness. It is easily upset by drugs and alcohol. When a person uses "astral travel" it is their Hun that leaves their body.

The Wood Element  

The Wood Element

 

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone

Diet in Chinese Medicine

Proportions

A good nutritious diet is high in fiber, minerals and vitamins, moderate in unsaturated fat and low in saturated fat. People who eat these diets live longer and are less prone to cancer and heart disease. According to Healing with Whole Foods (Pitchford) it should contain the following proportions:

35-60% Grains such as whole grains and cereals

20-25% Vegetables starchy and non starchy, seaweeds, microalgi

5-15% Legumes: including beans, peas and lentils

5-15% Fruits, nuts and seeds

0-10% Animal Products: meat, dairy, eggs and fish

Breakfast

There is a saying "Breakfast like a King, Lunch like a Prince, and Dine like a Pauper..." and another saying "Breakfast is the most important meal of the day." This makes sense in terms of Chinese Medicine. The digestive system is strongest between 7 and 9am and between 7 and 9pm. So breakfast is the best time to eat a hearty meal and we should be eating sparingly in the evening. In the West this advice is not always followed. Many people skip breakfast and eat a sandwich in front of their computer. 

Fiber and protein slow the transfer of sugar into the blood and should definitely be included at breakfast time. Oats are a good food for a slow release of energy throughout the day. The setting for meals is just as important as the food itself. "When eating just eat" is a good saying. Your body's energies should be concentrated on digesting your food. Rather than rushing your breakfast or arguing with your family take the time to chew your food so that it is digested properly and avoid distractions like mobile phones and TV when you are eating.

Lunch

 Often we must eat lunch at work. Take this time to eat and socialize rather than hunching over your computer, laptop or mobile phone. A warm meal works wonders in Autumn and Winter. If your work offers warm meals you should take advantage of them. In summer months a salad makes more sense.

Tea/Supper

     The evening meal should be more simple. There is little point preparing a full meal if your body does not have the energy to digest one.  Soup fits the bill nicely. After 9pm we should avoid eating. If we must snack then fruit is a good choice as it is easy to digest. We should avoid caffeine or alcohol if we wish to have a good nights sleep.

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone

 

 

Winter

Blencathra in Winter

Blencathra in Winter

Winter

In Chinese Medicine Winter is the season relating to the Water element and the Kidneys. Winter is the time of year where everything slows down. Water freezes and becomes ice. The stillness of ice represents this season. Animals hibernate and seeds lay dormant.  In Winter we are advised to go to bed early and slow down our activity to preserve our resources.

Chinese Character for Water

Chinese Character for Water

Diet

In terms of diet Winter is a good time for salty and bitter foods which aid the bodies capacity for storage. Examples of bitter foods are oats, rye, carrot top and quinoa. Seaweed, millet and barley are salty foods. It is advisable to avoid salads at this time of year as they are cooling in nature.

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone

 

 

 

The Metal Element

In Chinese Medicine the character for Metal (Jin) 金represents something precious deep in the earth. It includes the character for Earth (see below). The Metal character has a sloping roof on top, representing something covered over. You could imagine it as a mine with nuggets of gold buried deep within the earth. Metal can be thought of like minerals in the body. Small but essential. In the body the Metal Element consists of the Lungs and Large Intestine. The Lungs take in air. In Chinese Medicine they take in the Qi from the Heavens. The Large Intestine lets go of waste material. On a more emotional level it's important to be able to freely accept gifts and compliments. To appreciate beauty in the world. It's also important to let go of things we no longer need. The Dhammapada (sayings of the Buddha) states "For see how the Jasmine flower releases and lets fall its withered flowers." So we must release the parts of us that no longer serve us rather than clinging to them.

Recently I had the chance to go potholing with Lancashire Walking Group. We hiked up towards Ingleborough. Gaping Gill is part way up the hill. It is a huge cave with the longest unbroken waterfall in the country. You had to be winched down into it. It was really impressive. I have also recently visited Poole Caver in Buxton. It made me appreciate the nature of the Metal element.

Gaping Gill
Gaping Gill

Gaping Gill

Character for Metal  

Character for Metal

 

References

Hicks, Hicks and Mole, 2004, Five Element Constitutional Acupuncture, Churchill Livingstone