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After two years of studying plant and soil sciences, my favorite professor, Dr. Barker, offered me a job on the University of Massachusetts farm. Whereas my previous jobs had been things like bagging groceries and washing dishes, this was the first time I was getting paid to do something I was interested in, and under the supervision of someone I looked up to.
I was nervous when I showed up at Bowditch Hall on my first day. Dr. Barker, a white-haired man with a country drawl, introduced me to his assistant, Kathy. Then he handed me the keys to a faded old, blue truck and asked me, “Ever driven a three-on-the-tree?” I had never driven any kind of truck before, much less one with the gearshift on the steering column, but I learned quickly as I drove the three of us – with lots of jerking and stalling – out to the farm.
Standing at the edge of a freshly plowed field, Dr. Barker explained that we were going to use stakes and twine to mark out rows for planting seeds. Kathy and I got to work while he watched. The only trouble was, while I had stakes, a mallet, and a ball of twine, I didn’t have anything to cut the twine with. I thought maybe I had spaced out when someone explained where to find a knife or scissors. Or maybe the professor had told me to bring my own knife and I had forgotten. I was too uncomfortable to say anything.
Wondering if there was some way I could proceed with my task without a cutting tool, I pounded the first stake into the ground. I tied one end of the twine around it, walked the length of the field, pounded in another stake, wrapped the twine around that stake, pulled it taut, and then I just squatted there for a few moments. I considered trying to gnaw through it with my teeth, but dismissed the idea as totally unprofessional. Finally, at the risk of appearing unprepared, I called out to Kathy, who was a dozen paces away, “Do you have a knife?”
“Huh?” she turned around and squinted at me in the bright sun. “Oh.” She ambled over, fished around in her pocket, and passed me a pink disposable lighter.
I interpreted this unexpected response to mean, “I don’t have a knife, but I can see what you need there. You’re going to have to burn through the twine with this. At the ends of every row.” She gave me the lighter in such a matter-of-fact way that I thought it would be too weird to ask for a different explanation.
So, feeling like I didn’t have enough hands, I held the twine straight out from the stake, positioned the flame beneath it, and tried to shield it from the wind with my leg. It blew out a couple times, but I eventually managed to burn through it. Meanwhile Dr. Barker had wandered over to observe me and remarked, “That is the strangest way of doing that I have ever seen.”
“Um. I didn’t have a knife,” I said sheepishly.
“Well, I’ve got a knife you can use.”
“Me too,” offered Kathy.
And that’s how, on the first day of my first important job, I believed I must have convinced my boss that I was an absolute idiot. By the way, if you’re wondering why Kathy handed me that lighter, these were the days when smoking was still quite common. She was a smoker and must have thought I said, “Do you have a light?”
The whole thing turned out to be a good lesson for me. By avoiding an uncomfortable conversation, I ended up in even more discomfort.
I resolved to speak up and break through the tension of misunderstanding in the future. I can’t say I’ve always done this, because it takes bravery, and sometimes I chose to stay in my (dis-)comfort zone. But I can say that I’ve never regretted it. Usually there’s an immediate diffusion of tension, and even when there isn’t, at least the truth is out and there’s an opening for resolution. This is especially true when we bring an attitude of curiosity and aim to understand the other person.
Is there anywhere in your life where you’ve left something unsaid because of your resistance to the discomfort of speaking those words and the feelings that may follow? I want to challenge you to make a communication this week that takes you a bit outside your comfort zone. Even if you have to say, “I’m really nervous about saying this” or you have to hold a friend’s hand while doing it, it’s worth it.
Be well,
Peter
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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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I recently came across this statement on the U.S. Department of Agriculture website: “About 90% of Americans do not get enough dairy.”1 A review of dairy consumption by country shows that the United States ranks 17th in the world with an average intake of 560 pounds per person per year.2 In comparison, the average Japanese person consumes about 158 pounds annually, ranking Japan 109th on this list. Meanwhile, Japan ranks first in the world for life expectancy. The United States is 54th.3 If a country that consumes 28% as much dairy as we do outlives us by an average of eight years, is it accurate to say, “90% of Americans don’t get enough dairy”? Who defines “enough”?
It's questions like these that inspired me to create a new kind of course in nutrition – one that teaches people how to think critically, listen to their bodies, and develop a healthy relationship with food. In How to Eat, I explain how to achieve your optimal weight without counting calories or eating in a totally unnatural way. I lead students to a way of eating that promotes abundant energy and a clear mind without having to wade through all the contradictory information out there. Through a combination of modern science, psychology, and a strong foundation in traditional Eastern systems of medicine, I’ll teach you that it’s not just what you eat, but how you eat that matters.
For today I want to offer you just one simple piece of nutrition advice: stay conscious while eating.
We all tend to think about things other than the act we’re currently engaged in, and this is an especially bad habit while eating. We daydream, we work, we read, we watch TV, we talk, we drive, we play on our phone. This causes us to miss out on many of the benefits of eating, and it also makes us more likely to eat in ways that aren’t healthy.
There are three good things that happen when we stay conscious (i.e., mindful):
- The eating process tends to work better. We're relaxed, we consume at a healthier pace, the body assimilates it better, and I believe we probably derive more nutritional value from the food.
- We notice and can respond to the subtle (or not-so-subtle) messages our body is giving us, such as, “I’m not hungry anymore” or “This food is not compatible with me” or “Slow down.” You can learn virtually everything you need to know about how to best feed yourself – both the specific foods and the ideal time and manner to eat them – just by giving all of your attention to the act of eating.
- We have an amazing opportunity. Truly. I believe that most people may never experience just how profound the act of eating is. This profundity is only available when we give it our full attention. Then we start to get an inkling of it . . .
. . . the complexity of colors, textures, flavors, and nutrients in the food
. . . the incredible sophistication and intelligence of the human body; its ability to extract what it needs from the food and turn it into energy, blood, muscle, bone, and the capacity to remain conscious and sharp
. . . the whole ecology we’re part of – the sun and the almost magical ability of plant cells to turn its light into biological energy; the constructive roles of soil and water; the human labor and the care that was taken to cultivate this food; and the lineage of thousands of generations of plants and animals that were intentionally chosen for the purpose of nourishing us.
When we have an experience of just how special this is, eating is no longer just about making the hungry feeling go away or getting a good taste in your mouth. It can be calming and centering. It can be a beautiful spiritual practice. It unites us with our environment.
If you’re ready for a new way of relating to food and how you feed yourself, check out my course, How to Eat. It’s on sale for 60% off right now.
Be well,
Peter
1. https://www.myplate.gov/eat-healthy/dairy
2. https://en.wikipedia.org/wiki/List_of_countries_by_milk_consumption_per_capita
3. https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
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After two years of studying plant and soil sciences, my favorite professor, Dr. Barker, offered me a job on the University of Massachusetts farm. Whereas my previous jobs had been things like bagging groceries and washing dishes, this was the first time I was getting paid to do something I was interested in, and under the supervision of someone I looked up to.
I was nervous when I showed up at Bowditch Hall on my first day. Dr. Barker, a white-haired man with a country drawl, introduced me to his assistant, Kathy. Then he handed me the keys to a faded old, blue truck and asked me, “Ever driven a three-on-the-tree?” I had never driven any kind of truck before, much less one with the gearshift on the steering column, but I learned quickly as I drove the three of us – with lots of jerking and stalling – out to the farm.
Standing at the edge of a freshly plowed field, Dr. Barker explained that we were going to use stakes and twine to mark out rows for planting seeds. Kathy and I got to work while he watched. The only trouble was, while I had stakes, a mallet, and a ball of twine, I didn’t have anything to cut the twine with. I thought maybe I had spaced out when someone explained where to find a knife or scissors. Or maybe the professor had told me to bring my own knife and I had forgotten. I was too uncomfortable to say anything.
Wondering if there was some way I could proceed with my task without a cutting tool, I pounded the first stake into the ground. I tied one end of the twine around it, walked the length of the field, pounded in another stake, wrapped the twine around that stake, pulled it taut, and then I just squatted there for a few moments. I considered trying to gnaw through it with my teeth, but dismissed the idea as totally unprofessional. Finally, at the risk of appearing unprepared, I called out to Kathy, who was a dozen paces away, “Do you have a knife?”
“Huh?” she turned around and squinted at me in the bright sun. “Oh.” She ambled over, fished around in her pocket, and passed me a pink disposable lighter.
I interpreted this unexpected response to mean, “I don’t have a knife, but I can see what you need there. You’re going to have to burn through the twine with this. At the ends of every row.” She gave me the lighter in such a matter-of-fact way that I thought it would be too weird to ask for a different explanation.
So, feeling like I didn’t have enough hands, I held the twine straight out from the stake, positioned the flame beneath it, and tried to shield it from the wind with my leg. It blew out a couple times, but I eventually managed to burn through it. Meanwhile Dr. Barker had wandered over to observe me and remarked, “That is the strangest way of doing that I have ever seen.”
“Um. I didn’t have a knife,” I said sheepishly.
“Well, I’ve got a knife you can use.”
“Me too,” offered Kathy.
And that’s how, on the first day of my first important job, I believed I must have convinced my boss that I was an absolute idiot. By the way, if you’re wondering why Kathy handed me that lighter, these were the days when smoking was still quite common. She was a smoker and must have thought I said, “Do you have a light?”
The whole thing turned out to be a good lesson for me. By avoiding an uncomfortable conversation, I ended up in even more discomfort.
I resolved to speak up and break through the tension of misunderstanding in the future. I can’t say I’ve always done this, because it takes bravery, and sometimes I chose to stay in my (dis-)comfort zone. But I can say that I’ve never regretted it. Usually there’s an immediate diffusion of tension, and even when there isn’t, at least the truth is out and there’s an opening for resolution. This is especially true when we bring an attitude of curiosity and aim to understand the other person.
Is there anywhere in your life where you’ve left something unsaid because of your resistance to the discomfort of speaking those words and the feelings that may follow? I want to challenge you to make a communication this week that takes you a bit outside your comfort zone. Even if you have to say, “I’m really nervous about saying this” or you have to hold a friend’s hand while doing it, it’s worth it.
Be well,
Peter
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[0] => query_vars_hash
[1] => query_vars_changed
)
[compat_methods:WP_Query:private] => Array
(
[0] => init_query_flags
[1] => parse_tax_query
)
)