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[post_content] => In this video, Dr. Peter Borten explains why he's seen neck pain become so prevalent in the last decade, and shares some really effective and easy ways you can treat (and avoid) your own neck pain at home.
Do you have tips for combatting neck pain? Please share with us in the comments below!
[post_title] => Talking Wellness with Peter: Treating Neck Pain
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[post_content] => A patient last week told me a story I’ve heard many times in many forms. She started experiencing chest pain that radiated down her left arm. She went to the hospital. There was nothing wrong with her that any test could reveal. She wasn’t having panic attacks and her heart was fine. She went from practitioner to practitioner before someone finally figured it out: it was muscular. In other forms of this story the symptom is abdominal pain, or diarrhea, or sinus congestion, or painful intercourse, or ear ringing, or acid reflux, but the common thread is that multiple doctors failed to consider that the origin was structural.
Often, these mystery symptoms – along with most cases of muscle pain – are caused by a phenomenon known as “myofascial trigger points,” and I believe everyone should know what they are and how they work. I’ve written about trigger points in the past, but I feel moved to explain some of the basics again because this concept remains largely unknown to both practitioners and laypeople. It’s not exactly a fringe idea either – it was developed primarily by President Kennedy’s personal doctor, Janet Travell (the first female White House physician, by the way), whom he credited with saving his political career after she cured his back pain. Her first journal article on the subject was published over 60 years ago.
What exactly is a “myofascial trigger point” anyway? Basically, a trigger point is a small, irritable region in a muscle (or the surrounding connective tissue – “fascia”) that stays stuck in a contracted state and can produce pain, other sensory changes, tightness, and dysfunction. A unique property of trigger points is that they’re able to produce symptoms in other parts of the body – from a few inches to a couple feet away. One of the most valuable contributions of Travell’s work was to map out hundreds common locations of trigger points and their referral patterns – i.e., where they produce symptoms.
If you know where to look for trigger points that could be implicated in an issue, it’s usually pretty quick and straightforward to determine if this is the cause. And if so, you can often fix them yourself.
How do trigger points form?
There are a handful of mechanisms that can promote trigger point formation, such as irritation of nerves, chronic organ problems, nutritional deficiencies, and autoimmune disorders. More often, though, the cause is trauma to our connective tissue. When a muscle is strained by being worked too hard, too fast, or beyond its natural range, there is frequently a sort of “recoil” that occurs as segments of the muscle fibers bunch up and remain that way. This is common in people who work out without warming up, or who suddenly do a very ambitious workout after having not exercised for a year. Even more commonly, the trauma is a form of “postural stress” that’s demanding on muscles in a way that’s difficult to perceive at the time – such as doing the same relatively motionless activity (like sitting at a desk or driving) for hours, days, months, or years.
A muscle contracts through the action of nerve impulses – electrical signals that deliver the command to shorten. These impulses stream into the muscle for as long as we wish to hold this contraction. The impulses aren’t distributed throughout the muscle in an even way, though, and the muscle “belly” (the bulky contractile part) becomes slightly twisted during each contraction.
This isn’t usually a problem if we’re doing repeated isotonic contractions. Isotonic contractions are where the muscle causes movement and it alternately shortens and lengthens, working and relaxing. The issue lies more in prolonged isometric contraction or “static” contraction. That’s where a muscle stays contracted without movement – like the way you hold your arms up for hours while typing or driving. The muscle is under constant pressure and the continuous stream of nerve impulses produces a sustained deformation of the muscle belly.
I need a little more science to explain what happens next, so get ready. Over time, the ongoing tension and twisting of the muscle fibers causes an elevation in the resting muscle tone – that is, eventually, the muscle never completely relaxes. It’s always a bit contracted, meaning a bit shortened, and therefore a bit taut. This tightness causes local vasoconstriction – the blood vessels are constricted – and this translates to local ischemia – inadequate blood supply to the tissue (the same thing that happens to heart muscle in a heart attack). The arteries can’t bring in enough fresh blood and oxygen, the veins and lymphatic vessels can’t adequately drain waste and deoxygenated blood. The tissue pH changes, local metabolism is impaired, and fluid and waste products build up in the area.
This combination of factors ultimately activates pain receptors – it starts to hurt – and when this happens you use the affected muscle less. Instead, you overload “synergists” – nearby helper muscles. The body makes the surrounding musculature tense as a protective mechanism. Meanwhile, there’s a disruption of the balance between the affected muscles and their “antagonists” – those muscles that lengthen when the primary muscles shorten and vice-versa (for example, the triceps is an antagonist of the biceps). Altogether, this restricts natural movement of the original muscle, which just perpetuates the imbalance.
Over time, this situation results in the development of trigger points. A muscle is composed of numerous parallel fibers and each fiber consists of many end-to-end contractile segments called sarcomeres. When they’re working correctly, they all shorten together when you contract the muscle and then return to their resting length when you relax. But trigger points involve a collection of sarcomeres that remain in a shortened, irritable state, which makes them bulge (often causing a palpable “knot”) and causing their muscle fibers to feel taut and stringy. Finally, with longstanding trigger points, the body deposits gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
Ok, enough with the big words.
The point is, there are tons of resources in print and online to help you locate trigger points and show you the kinds of problems they can cause. As for getting rid of them, the most basic method is to simply press and hold an active trigger point when you find one. After about 30 seconds, you’ll usually feel it soften. You can also press down the trigger point (with a thumb, fingers, or a tool) and then move the tissue, as if deliberately intending to re-lengthen this shortened part of the muscle.
Acupuncture is really excellent at releasing trigger points. Dr. Travell injected various agents into trigger points to cause them to deactivate, but later in her career, she began to realize that the most effective part of this process was simply jabbing the trigger point with the end of a needle. There wasn’t a need to inject any liquid; thus, this method became known as “dry needling.” She worked with an osteopath acupuncturist named Dr. Mark Seem who developed an acupuncture-based methodology for releasing trigger points in a holistic way – that is, while supporting the body as a whole to restore balance. (If you’re interested in trying dry needling, I strongly recommend you receive it from an acupuncturist rather than a physical therapist, since acupuncturists have an exponentially greater amount of needle training and a more sophisticated understanding of how to treat the big picture.)
If all of this sounds interesting and relevant to you, I encourage you to do a little research. It might well be the end of a problem you thought had no solution. And if you need more guidance, check out my online course, Live Pain Free, where I go deeper into trigger points and much, much more to help people get out of pain of all kinds.
Be well,
Dr. Peter Borten
[post_title] => The Science Behind Wonky Body Things that Suck
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Lots of people are anxious about this illness – and the impact of mass hysteria – so I want to share some rational advice on what you can do to stay well in both body and mind, including some specific supplements that may help. I’ll also explain what we’re doing at our spas to make them a safe place for you and our employees.
It is our mission to create a more peaceful world through more peaceful individuals. In order to give you and our staff the best chance at peace of mind, we will be temporarily closing the Spa until further notice. We will be monitoring COVID-19 the situation closely and plan on reassessing each day with plans on reopening as soon as possible.
We invite you to join us on our Facebook group, Dragontree Community and Conversations. There, you will find community, connection, and on-going wisdom from our Founders, Dr. Peter and Briana Borten.
You can find our online community here: thedragontree.com/community
Here is a replay of our Facebook Live where we share more details on each of these points for our community.
[embed]https://www.facebook.com/TheDragontree/videos/211888856841144/[/embed]
Here are my top recommendations for staying peaceful and healthy:
- Keep Breathing. Any time you feel stressed, bring your attention back to your breath. The breath is a built-in mindfulness tool. You watch your breath come in and go out and instantly you’re in the present – rather than letting your mind run away with you. Besides simply bringing your attention to your breath throughout the day, you can also practice making your exhale very long, and as you breathe out, imagine you’re releasing tension and fear. The Vietnamese monk, Thích Nhất Hạnh, has written that many of his fellow monks lived through atrocities during the Vietnam War, but were able to maintain their sanity and inner peace through Buddhist mindfulness practices. Another reason to practice breathing is to keep your lungs strong and resilient. All day long we fall into the habit of shallow breathing. Our lungs have a capacity of about 6 liters of air, but we usually take breaths of only half a liter in size! Imagine as you inhale that you’re filling up the bowl of your pelvis, that your breath goes so deep that you can feel your hips expanding from the inside as your belly expands.
- Avoid Lung Pollutants. If you’re interested in healthy lungs, it’s a good time to stop smoking, wear a mask while doing sanding or painting or other dusty activities, and quit toxic air fresheners and cleaners. It has been theorized that the high mortality rate in China is due in part to air pollution and smoking.
- Maintain Healthy Digestion. In Traditional Chinese Medicine (TCM), the digestive system is considered to support the respiratory system (in TCM terminology, “Earth is the mother of Metal”). It’s why we find that so many kids with asthma and allergies have digestive problems, and why so many food sensitivities cause respiratory symptoms. In biomedicine, there’s a growing understanding that the lining - or epithelium - of the digestive tract, especially the intestines, has a relationship with other epithelial tissues - like the lining of the lungs. A healthy digestive tract goes hand-in-hand with healthy lungs. For this reason it’s always a good idea to follow good nutritional practices (if you don’t know what these are, check out my online course, How to Eat), including frequent consumption of fermented foods like sauerkraut and/or occasionally taking probiotics.
- Exercise. Exercise tones virtually all systems of the body, including the respiratory tract and the immune system. I recommend getting exercise of an intensity that makes your breathing labored, and ideally not doing it in frigid or polluted air. Just don’t overdo it - ideally, you’re exercising enough to build energy, not exhaust yourself.
- Avoid Sugar. Eat Nutrient Dense Foods. Sugar can increase inflammation and suppress immune function. Besides, it’s just empty calories. Many times I’ve had patients tell me about how an infection worsened dramatically after they ate a big dessert. Instead, why not make this an opportunity to eat super nourishing foods?
- Wash Your Hands and Don’t Touch Your Face. You know this, of course. Just make a rule with yourself that you don’t touch your face unless you’ve just washed your hands. And you don’t need hand sanitizer - soap and water work better. Be sure to get under your nails. Also, if you’re finding - like me - that your hands are getting dry and irritated from all this hand washing (!!) use lotion. We happen to make some that you might like.
- Get Enough Sleep. Nothing supports the immune system like a good night’s sleep. If we could all go to bed at the first inkling of sickness, much of the time we wouldn’t even get sick.
- Keep Playing and Connecting. Play has a singular value in reminding us how to be lighthearted. Even in the midst of hoarding and hysteria, we must take time to play and to connect with our loved ones and the natural world. It grounds us. It pacifies our hearts. It gives us perspective. Even if we can’t touch, we can still be connected.
- Take Supportive Nutrients and Herbs. Authorities discourage saying that anything helps the coronavirus, but there are a number of supplements that I trust as immune enhancers. I take them myself, I recommend them to my patients, and I give them to my family. I can’t promise that it will prevent or mitigate the coronavirus, but you can do your own research and decide for yourself.
- Selenium. Adequate dietary selenium helps us fight RNA viruses like COVID-19, but many parts of the country have minimal selenium in the soil, leading to crops with minimal selenium. That said, unless you’re eating everything from local farms, the selenium status of soils in your area might not say much about your selenium status. You can get selenium capsules in the form of selenomethionine. 200 micrograms a day is plenty (half that is probably enough for most people). A single Brazil nut contains about 75 micrograms of selenium, so you could also skip the pill and eat just two nuts a day.
- Jade Wind Screen. This Chinese herbal formula was first recorded in a text in 1481, so it’s been in use for 539 years. The name comes from the idea that it is a screen against “wind” - i.e., airborne pathogens. It’s intended to simultaneously strengthen the lungs and digestive system while simultaneously promoting the circulation of “defensive Qi” (superficial immune cells), and it is generally taken as a preventive supplement rather than as a treatment for sickness. TCM physicians in Wuhan have had considerable success in treating patients with COVID-19 with herbal formulas. They have developed protocols for each stage of the illness and a modified version of this formula is their basic “preventative” formula. You can find Jade Wind Screen in liquid or pill form through numerous companies. I am in the process of making a large batch of the formula as a tincture, with my own additions based roughly on the Wuhan variation. We will have it available for sale soon (at our usual tincture prices). We can’t claim that it cures or prevents COVID-19, but I have my whole family taking it, and it means something to me that TCM has a millennia-long history of treating epidemic diseases.
- Vitamin D. Blood levels of vitamin D are directly correlated with immune function, and deficiency is common, especially in the winter. I recommend - with or without the threat of coronavirus - that people take at least 35 units of vitamin D per pound of body weight per day (e.g., a 100-pound person can take 3500 IU’s of vitamin D a day).
- Vitamin C. Besides its ability to enhance immune function, vitamin C may help prevent the progression of lung infections to pneumonia and may also help to clear fluid from the lungs in active pneumonia. If you get sick, I believe vitamin C works best for infections when consumed almost to “bowel tolerance” - that is, just below the quantity that causes diarrhea. Any vitamin C is fine, but I particularly like the “liposomal” or fat-bound forms of vitamin C - they seem to be more active and have less effect on digestion.
- Vitamin A. Vitamin A enhances immune function also. I usually take a high dose of 100,000 to 200,000 units per day for the first few days of an infection and often that stops it in its tracks. Because there are reports of liver toxicity with very high doses of vitamin A for prolonged periods, I generally don’t recommend using these kinds of doses for more than a week. If you have liver problems, you should skip it. Also, large amounts of vitamin A are a bad idea for pregnant women – it can cause birth defects. (Beta carotene, which is converted by the body to vitamin A as needed, is safe for pregnant women.)
- Rhodiola. Rhodiola rosea is a mountainous herb with adaptogenic and calming properties. Taken over time, it improves our ability to adapt to stresses of all kinds. It reduces fatigue and builds resilience.
- Mushrooms. Virtually all mushrooms help improve immune function. Some of my favorites are ganoderma (reishi), maitake (grifola), agaricus blazeii, chaga, and cordyceps. Many companies now make mushroom extracts for immune support. I like Host Defense because their founder, Paul Stamets, is an expert and pioneer in the world of medicinal mushrooms.
- Sang Ju Yin. This TCM formula (also known as Mulberry Leaf and Chrysanthemum Decoction) is used by Wuhan doctors for the very earliest stage of infection - especially when there’s a dry cough, fever, and maybe a sore throat. It’s available from many companies in liquid and pill form. If you can’t procure any, a practitioner of Chinese Medicine may be able to make you some. Otherwise, our Cold & Flu Formula is a reasonable substitute.
- Lactoferrin. Lactoferrin is a protein that occurs naturally in the human body, especially in human milk (particularly the first milk, known as colostrum), saliva, tears, and other fluids. It can also be extracted from cow’s milk. It’s a powerful component of our immune system, exhibiting anti-viral, anti-fungal, and anti-bacterial activity. It’s specifically been shown to help prevent viruses like COVID-19 from entering our cells.
- If You Feel Sick, Act Fast. Whether it’s one of the supplements above or something else, have it with you at all times so that you can take it at the very first feeling that you’re unwell. Then take a nap and when you wake up, take some more! This ensures the best chance of effectiveness. Meanwhile, do the right thing and stay home until you know you’re well.
- Meditate. Meditation has a unique value in times of turmoil. It opens up space in our consciousness which helps us to not be run by our minds. We see that we’re not our thoughts, and further, that we don’t even need to believe our thoughts. We receive insights. We reset our nervous system. And we reconnect with a Self that’s more authentic, more consistent, more honest, more loving and ever-present than the unbalanced ego we’ve been giving all our attention. Meditation is the antidote to hysteria. (If you feel you need additional mood support, you might benefit from our Anxiety Herbal Formula and check out this Anxiety White Paper I wrote.)
Finally, let’s all Stay Rational. People are often talking about fatality rates of COVID-19 rather than survival rates. And for most healthy adults, your chances of surviving an infection with this virus is 99% or better. Raging and freaking out won’t help, and may even compound the stress on your system. (Forgive yourself.) Keep looking for the silver linings. Stay in touch with your community. This too shall pass!
Love,
Dr. Peter Borten
[1] How COVID-19 (2019-nCoV) is Currently Treated in China with TCM
[2] Vitamin C may affect lung infections
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