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In previous articles we looked at ways to see more dimensions of an issue in order to facilitate its resolution. After sitting a few times with spiritual teacher Leslie Temple-Thurston about 20 years ago, I learned this “squares” approach in her book The Marriage of Spirit and have used it and expanded on it ever since. Rather than seeing “two sides of the coin,” we’d do well to look at (at least) four interconnected aspects to any challenging pattern. While our attachment to one positions tends to keep us stuck, when we see that we contain all of these aspects, this quickly dissipates the intense “charge” around the issue and we can let it go.
Since issues around money and abundance are so prevalent, I thought I’d share a square on the dualities of attraction and aversion intersected with scarcity versus abundance. It’s easy for most people to feel into the attraction to abundance (upper right quadrant) and the aversion to scarcity (lower left quadrant).
What about the aversion to abundance and the attraction to scarcity? It may seem incomprehensible that you’d be drawn toward scarcity (upper left), but it’s within all of us. Maybe when you’re poor it makes you feel you’re more “real,” more relatable, more connected to the common person, or more right about the belief that life is unfair.
It may also seem incomprehensible that you’d be averse to abundance (lower right), but perhaps you have fears about a truly abundant life: maybe it will be harder, maybe it will be unfamiliar, maybe you’ll have no excuse not to be happy. Maybe you think abundance would change you in negative way. Maybe you think people would expect you to support them.
If you feel challenged by abundance and scarcity, I encourage you to spend time visiting with each of these four states. Write freely about each one, acknowledging that all four are within you. See what arises in your body as you steep in each zone. If you have our book, Freedom, you can use that body-centered releasing process to neutralize the feelings that come up. As you make peace with the whole complex, you’ll feel less “baggage” around the idea of having an abundant life.
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
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As we approach spring, it’s a good time to discuss seasonal junctions. Both Ayurvedic and Chinese systems of medicine see the changes of seasons as times when we are more susceptible to being thrown out of balance as our body is challenged to adapt to the shift. Ayurveda has a saying that “diseases are generated at the junctions of the seasons.”
Other junctions are also challenging, with the challenge generally proportional to the magnitude of change. Ayurvedic teacher Robert Svoboda writes, “Ovulation and menstruation are the ‘joints’ of the menstrual cycle, dawn and dusk are the joints of day and night, and adolescence and menopause are the junctions of life.” If you have kids, you know that the “joints” of the day are the times you’re likely to have trouble, and if you’re clever, you find ways to make these transitions easy, such as the ever-popular “five more minutes until we’re leaving.”
Depending on where you live and your personal constitution, different seasons and junctions will be challenging for different people. For example, because spring tends to be wet, moving into this season means taking on more of what Traditional Chinese Medicine (TCM) calls dampness, or in Ayurveda an increase in kapha (“kaap-ha”). This will be most difficult for those who already have constitutional kapha or an accumulation of dampness in their system. Some of the signs and symptoms include: being overweight, having loose, sticky, or incomplete stools, a wide or coated tongue, feeling heavy and tired, finding it hard to wake up in the morning, and a tendency to be phlegmy.
Ayurveda might prescribe some therapeutic vomiting for such a condition, but these days, especially in the West, we prefer more pleasant medicine, ideally in gummy form, and we engage in therapeutic vomiting only after an excess of margaritas. Luckily, there are gentler ways to restore balance, and when it comes to management of the seasonal junctions, the most natural is to be aware of vulnerability during seasonal transitions and treat yourself with extra care. For someone with a delicate constitution or pre-existing health problems, this may be prudent at every season change. For others, only certain season changes may be troublesome. In any case, it’s a good idea to get extra sleep and to eat with greater care during the transition month.
If you have a personal challenge with the transition to spring, here are some more specific recommendations for this time.
- Eat more warm, cooked foods. Soups and stews are great. An ideal one is kitchari, made from rice and mung beans (there are lots of recipes online). If you have some of the kapha / damp challenges described above, you can add plenty of warming spices, including ginger, turmeric, cumin, coriander, turmeric, cinnamon, fenugreek, caraway, nutmeg, and black pepper. As the world gets warmer, start incorporating more fresh local produce.
- Avoid heavy, cold, and sweetened foods. These all tend to be cloying. Also, stop eating before you’re full, and let yourself get hungry between meals (don’t snack).
- Do some movement every day. Kapha / dampness tends to congeal in us when we’re immobile, sometimes making us feel achy, heavy, phlegmy, or groggy in the morning, after we’ve been horizontal for several hours. Daily movement, ideally with enough vigor to break a sweat, will help.
- Try a dry sauna. If you have access to a dry sauna, it can help counteract the effects of a damp environment. It doesn’t need to be too hot. You shouldn’t be pouring sweat. More sustainable is to have longer sessions in which your skin is just glistening.
- If you tend to get spring allergies, this is the time to prepare by babying your digestive system (eat slowly, deliberately, and only easily-digested foods) and taking some things to stabilize your immune system. Some of my favorites are quercetin (500mg twice a day), nettles (pick and steam your own if you can), local bee pollen, and homeopathic preparations of the things you’re allergic to. As for this last item, it’s akin to the old-school method of desensitization. There are companies that make super-dilute tinctures common allergens, such as tree pollen, grass pollen, animal hair, mold, dust, etc. I’ve had good experiences with ones made by a company called BioAllers.
For everyone – including those who have no particular challenge with the transition to spring – it’s worthwhile to pay attention to what’s happening in nature. Be fascinated by the return of new life. Notice the boisterous energy in the flowers and birds. Admire the vigor in the shoots that push their way through the crusted soil. The rising energy and lengthening days make it the ideal time for: planning, visualizing, cleansing, and shedding.
Wishing you a harmonious junction and beyond,
Peter
[post_title] => How to Optimize the Transition to Spring
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In previous articles we looked at ways to see more dimensions of an issue in order to facilitate its resolution. After sitting a few times with spiritual teacher Leslie Temple-Thurston about 20 years ago, I learned this “squares” approach in her book The Marriage of Spirit and have used it and expanded on it ever since. Rather than seeing “two sides of the coin,” we’d do well to look at (at least) four interconnected aspects to any challenging pattern. While our attachment to one positions tends to keep us stuck, when we see that we contain all of these aspects, this quickly dissipates the intense “charge” around the issue and we can let it go.
Since issues around money and abundance are so prevalent, I thought I’d share a square on the dualities of attraction and aversion intersected with scarcity versus abundance. It’s easy for most people to feel into the attraction to abundance (upper right quadrant) and the aversion to scarcity (lower left quadrant).
What about the aversion to abundance and the attraction to scarcity? It may seem incomprehensible that you’d be drawn toward scarcity (upper left), but it’s within all of us. Maybe when you’re poor it makes you feel you’re more “real,” more relatable, more connected to the common person, or more right about the belief that life is unfair.
It may also seem incomprehensible that you’d be averse to abundance (lower right), but perhaps you have fears about a truly abundant life: maybe it will be harder, maybe it will be unfamiliar, maybe you’ll have no excuse not to be happy. Maybe you think abundance would change you in negative way. Maybe you think people would expect you to support them.
If you feel challenged by abundance and scarcity, I encourage you to spend time visiting with each of these four states. Write freely about each one, acknowledging that all four are within you. See what arises in your body as you steep in each zone. If you have our book, Freedom, you can use that body-centered releasing process to neutralize the feelings that come up. As you make peace with the whole complex, you’ll feel less “baggage” around the idea of having an abundant life.
Be well,
Peter
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