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When I was in grad school for Chinese Medicine, I’d often see students hanging around campus engaged in related ancient Chinese arts, such as tai chi, qi gong, calligraphy, studying Chinese astrology or feng shui. It was also common to see a group of students hitting themselves and each other.
They were training in the toughening exercises of martial arts, which I had never witnessed before. This entailed repeatedly knocking the edges of their shins or forearms against each other, or whacking their bodies with a thick bundle of metal wires (called an “iron bundle” or tetsutaba). As I tentatively tried hitting myself with this implement, one of them told me, “You really want to feel your bones rattle when you do it.” Needless to say, they had lots of bruises.
They finished every session by taking out a jug of some pungent brown liquid and rubbing it all over the impacted parts of their bodies. As an herbalist, this was the most interesting part for me. Each guy actually had his own jug of brown stuff, and they often argued about whose was the best.
The brown stuff was called dit da jow (AKA die da jiu) which means something like “hit fall wine” and it’s sometimes just called a hit formula or training formula by martial artists. The purpose of the stuff is to help one recover faster after taking a bunch of kicks and punches. It’s made from a variety of herbs, resins, and minerals that have been soaked in alcohol for about a month. Famous teachers and martial arts schools often have their own recipes, many of which have been in continuous use for centuries and are often held in great secrecy.
Over years of begging and pleading with my fighter friends and hunting down obscure texts, I managed to procure about a dozen different recipes, then proceeded to spend more years studying them. I had hundreds of jars of my own “brown liquids,” made out of countless combinations and permutations of these formulas. Since most of my patients weren’t fighters I expanded the application to include the various ways we’re battered by modern life – athletics, poor posture, sitting for way too long at a desk, carrying kids around, using backpacks, sleeping on a crappy bed, standing on hard floors, wearing heels, etc.
By tracking people’s responses, I gradually moved toward what would eventually be our Muscle Melt liniment. It features a gigantic number of ingredients, but every one is in there for a reason. My high-performance athlete patients regularly tell me that it makes it possible for them to do a super intense workout and be back in action the next day with minimal downtime. If you’re feeling beat up by life, give it a try and tell me what you think.
Be well,
Dr. Peter Borten
[post_title] => Dit Da Jow: Healing Elixir or Ancient Myth?
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A couple weeks ago, I wrote about the differences between acupuncture and “dry needling” to alleviate pain, and in that article I explained a bit about the phenomenon of myofascial trigger points. After I said I believe these are the cause of most of the physical pain humans experience, a number of readers asked me to explain more. For the science lovers out there, I’m going to dive deeper this week.
Besides the most common forms of pain, like lower back and headaches, I’ve had patients with digestive problems, sinus congestion, chest pain, ear ringing, numb hands, painful intercourse, acid reflux, vision changes, and other health issues that were eventually discovered to be due to myofascial trigger points. I believe everyone should know about them and how they work – it could save us a lot of time and worry.
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, making the muscle fibers taut. This can cause reduced muscle strength and range of motion, pain, numbness, itching, and other forms of dysfunction. Sometimes a trigger point feels like a palpable nodule or “knot,” but to untrained fingers they’re often tricky to find.
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. For instance, there’s a trigger point that can form in the soleus muscle of the calf that’s capable of producing pain in the lower back. For this reason, the work of Janet Travell, MD and her colleague David Simons, MD, was groundbreaking. For each muscle in the body, they mapped where trigger points tend to form and what kinds of symptoms they cause.
If you were experiencing pain along the outside of your leg, you might assume that something was wrong with that part of your leg, perhaps with the often-tight iliotibial band (IT band). But this diagram might be helpful. The X’s show where trigger points can occur in a muscle called gluteus minimus above the hip socket. The red shading shows the potential areas of pain that can result. You might not suspect this muscle because, as you can see, there’s no pain at the site of the problem!
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. Most 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 especially common when someone works out without warming up; when someone does a very ambitious workout after not having exercised for a long time; when someone makes a sudden movement (like reaching out to catch something or trying to stop oneself from falling); and especially when someone does any of the above when in a state of diminished resilience (e.g, when stressed, upset, sleep deprived, eating poorly, etc.).
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. One possible mechanism is known as the “Cinderella hypothesis.” During static muscle exertion – holding a position for a long time, as dentists, musicians, typists, and others engaged in precision handwork do – the body tends to engage a certain group of small muscle fibers, called Cinderella fibers because they’re put to work first and are the last to be disengaged. Even though they’re not doing heavy lifting, these muscle fibers (often in the neck, shoulders, back, and forearms) are continually activated and overworked, which makes them susceptible to trigger point formation.
Whatever the cause, the result is that eventually the muscle never completely relaxes. Muscles are composed of numerous parallel fibers that work together to shorten (contraction of the muscle) and lengthen (the return of the muscle to its relaxed state). Within each of these fibers are many end-to-end contractile units called sarcomeres, and in the case of a trigger point, a group of sarcomeres gets “stuck” in a shortened state. This makes the affected fibers taut and often “stringy” feeling.
To make matters worse, the contracted region clamps down on tiny blood vessels causing local ischemia (inadequate blood supply), reducing in-flow of fresh, oxygenated blood and out-flow of toxins. This leads to a localized hypoxic state (not enough oxygen). The tissue pH changes, local metabolism is impaired, and fluid and waste products tend to 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. Finally, with longstanding trigger points, the body may deposit gooey lubricant compounds called glycosaminoglycans (GAGs) between these triggered muscle fibers, resulting in a gummy lump called a “myogelosis.”
The good news is that there are now books, charts, online tools, and practitioners that can help track down likely trigger points that may be implicated in your discomfort. I have such a tool in my online pain relief course, Live Pain Free, and I teach many approaches for deactivating trigger points.
The most basic methods involve simple mechanical disruption of this holding pattern. First, drink some water if you’re not well hydrated. Second, you or a friend can methodically feel around (ideally guided by a trigger point chart) for points that are sore, and ideally that reproduce the very sensation you’ve been experiencing. Third, maintain firm pressure on the epicenter of the point (with a finger, elbow, ball, or other tool) for about half a minute, consciously breathing into the area and intending to let it go, until there’s a palpable release. Then move on to all the other nearby points that are tight and tender and do the same.
This approach is called ischemic compression. By compressing the tissue enough to block blood flow, the body responds with reflex vasodilation, meaning it opens these vessels and flushes the tissue with a dramatic increase of blood. This will usually produce a significant improvement in the pain or dysfunction, though it will typically return sooner or later. These points tend to go from being active trigger points to “latent” trigger points, which have a certain “memory” (not the good kind of muscle memory) and are capable of getting reactivated. For this reason, persistence is important. The best results come from working on a trigger point consistently – usually from one to several short sessions per day (or less frequent if the sessions are intense) – and continuing for a while even after everything seems better.
As I said, this is a most basic approach, and while it’s often effective, sometimes a more nuanced intervention is required. There are many techniques that build on compression. We can replace fixed pressure with slow, deep strokes in the direction of the muscle fiber, as if re-lengthening this segment. We can work the trigger point back and forth across the direction of the muscle fibers. We can combine pressure on the trigger point with engagement of the affected muscle or antagonistic muscles. We can combine manual work on trigger points with topical herbs and/or internal herbs and nutrients that improve circulation and reduce inflammation. We can utilize release points on the same acupuncture meridian as where the trigger point occurs - or complementary points on other parts of the body. And more.
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.
While I said I believe trigger points are the cause of most of our physical pain, I think it’s worth mentioning there are usually even deeper causes, such as stress and withheld emotions, poor body mechanics, dehydration, and an inflammatory diet. Holistically addressing these issues will lead to a more complete resolution of the condition. Always look at the big picture.
Be well,
Dr. Peter Borten
[post_title] => The Science Behind Our Pain: Inquiring Minds Want to Know
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Unbeknownst to most Americans, the world is full of animists. According to Professor Stephen Asma of Columbia College Chicago, “Pretty much everywhere except Western Europe, the Middle East, and North America” is dominated by animistic cultures. Animism is the belief that everything has a soul or spiritual essence; not just living things, but also mountains, fire, the sky, the sea, and sometimes even words and human-made objects.
In practice, though, it’s more than just a belief. It’s a sensibility, a way of experiencing and interacting with the world. Animists relate to their surroundings with a certain intentionality, as if constantly among old friends.
To people in the developed world, such beliefs might seem primitive and superstitious. After all, who needs a world full of spirits when we have science? Science has given us explanations and inventions that have alleviated many hardships and dispelled so much fear.
But it hasn’t made us invincible or immune to fear. We’re still afraid of death, suffering, being alone, poverty, public humiliation, paper cuts, and so on. There’s little solace in science from these bugaboos.
Its other major shortcoming is that science has sucked the spirituality out of life. By reducing everything to cells and atoms, electromagnetic waves and neurotransmitters, it puts the whole phenomenal world beneath us. This promotes a certain feeling of ownership over the world – rather than a sense of belonging to it. If we put all our eggs into the science basket, life can seem random, lacking meaning and soul.
Science and Spirit aren’t mutually exclusive. But ever since early anthropologists looked down their noses at animistic cultures – seeing them as too dumb to know the difference between living and nonliving things, and giving their leaders justification to colonize and oppress them – the developed world has favored science as the ultimate authority. As we seek to right such wrongs, perhaps it’s worth considering not just what indigenous cultures lost, but what the oppressors also lost.
To an animist, the scientist is missing out on an entire plane of reality that’s beneath the surface and accessible only through an expansion of consciousness. To a scientist, the subjective reality of the animist’s consciousness is unmeasurable, untestable, unprovable, and therefore unscientific and even unreal.
What would be possible if we stopped using science to dominate or invalidate what we don’t understand? Can we concede – scientists included – that not everything is a scientific matter? This applies foremost to consciousness itself, which is entirely beyond the grasp of science, and arguably the only thing we know for certain to be real. We also know that humans yearn for a connection that’s beyond the ability of science to explain or provide.
You don’t need to be anti-science to be open to a spiritual reality. I say this as a scientist and animist.
If you’re open to it, I have a simple assignment for you to try this week. Consider this: how might your life be different if you treated your surroundings as if you were in relationship with them? Make it a lighthearted game.
What happens when you express gratitude to your bed, sheets, and pillow upon waking? What happens when you allow yourself to be in awe of the shimmering water that flows, as if by magic, from your showerhead? How does it feel to thank it for invigorating and purifying you? Does it feel any different to bless your food before eating it and thank it for giving itself to nourish you?
What is it like to thank your home for keeping you safe and comfortable? When you step outside, what happens when you experience the earth as the ever-present stability beneath your feet, supporting you and nurturing everything that grows upon it? What do you notice when you give names to the familiar trees or rocks in your neighborhood? How does it feel different to think of the sky as a beautiful, conscious dome over you versus your usual way? What changes when you think of all the animals you encounter as non-human people, each with an equally valid reason to be here as the human people you see?
And what happens when you listen and feel as if all these aspects of the world have something to communicate back to you?
When I say, “What happens?” I’m not (necessarily) asking, “Does your pillow respond, ‘Thanks for finally saying something! It was a pleasure to cradle your head all night!’?” More importantly, I’m asking, how does it make you feel to relate to the world in this way in comparison to your usual way? And if the answer is, “good” or “better” or “playful,” then keep going with it.
Be well,
Dr. Peter Borten
[post_title] => What if You Were Always Surrounded by Friends?
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When I was in grad school for Chinese Medicine, I’d often see students hanging around campus engaged in related ancient Chinese arts, such as tai chi, qi gong, calligraphy, studying Chinese astrology or feng shui. It was also common to see a group of students hitting themselves and each other.
They were training in the toughening exercises of martial arts, which I had never witnessed before. This entailed repeatedly knocking the edges of their shins or forearms against each other, or whacking their bodies with a thick bundle of metal wires (called an “iron bundle” or tetsutaba). As I tentatively tried hitting myself with this implement, one of them told me, “You really want to feel your bones rattle when you do it.” Needless to say, they had lots of bruises.
They finished every session by taking out a jug of some pungent brown liquid and rubbing it all over the impacted parts of their bodies. As an herbalist, this was the most interesting part for me. Each guy actually had his own jug of brown stuff, and they often argued about whose was the best.
The brown stuff was called dit da jow (AKA die da jiu) which means something like “hit fall wine” and it’s sometimes just called a hit formula or training formula by martial artists. The purpose of the stuff is to help one recover faster after taking a bunch of kicks and punches. It’s made from a variety of herbs, resins, and minerals that have been soaked in alcohol for about a month. Famous teachers and martial arts schools often have their own recipes, many of which have been in continuous use for centuries and are often held in great secrecy.
Over years of begging and pleading with my fighter friends and hunting down obscure texts, I managed to procure about a dozen different recipes, then proceeded to spend more years studying them. I had hundreds of jars of my own “brown liquids,” made out of countless combinations and permutations of these formulas. Since most of my patients weren’t fighters I expanded the application to include the various ways we’re battered by modern life – athletics, poor posture, sitting for way too long at a desk, carrying kids around, using backpacks, sleeping on a crappy bed, standing on hard floors, wearing heels, etc.
By tracking people’s responses, I gradually moved toward what would eventually be our Muscle Melt liniment. It features a gigantic number of ingredients, but every one is in there for a reason. My high-performance athlete patients regularly tell me that it makes it possible for them to do a super intense workout and be back in action the next day with minimal downtime. If you’re feeling beat up by life, give it a try and tell me what you think.
Be well,
Dr. Peter Borten
[post_title] => Dit Da Jow: Healing Elixir or Ancient Myth?
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