Topics in Muscles Bones and Joints

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Chinese dietary therapy often recommends that people limit or eliminate dairy products from their diet. In Traditional Chinese Medicine, dairy is considered a cold food that leads to damp accumulation, particularly in people who have a weakness in their Spleen energy. Symptoms of dampness include lethargy, loose stools, feelings of heaviness, cloudy thinking, excess sputum(particularly in the sinuses), certain types of headaches, and accumulations such as cysts and tumors. The concern for some who want to follow this dietary advice, is whether they will be able to get adequate amounts of calcium from a dairy-free diet. This is certainly a concern as most adults require around 1,000 mg of calcium a day to maintain bone, muscular, vascular and hormonal health. There is disagreement about the exact quantities of calcium in foods, but if a person were avoiding milk, increasing the amounts of the following foods should provide enough calcium for most individuals.

Nuts and Seeds

Sesame seeds (most sources list the calcium content of 1 oz of these to contain more calcium than one 8oz glass of milk)

Sunflower seeds (also high in iron)





Sesame tahini


Beans (garbonzo, pinto, soy, canellini)

Tofu (especially calcium-treated)

Dark Leafy Greens



turnip greens

dandelion greens

mustard greens



chicory (curly endive)



Bok Choy

Acorn squash


Figs, dried

Orange juice, calcium-fortified



Cereal (calcium-fortified)


Brown rice


Corn tortillas

Fish and Seafood

Oysters, raw

Salmon (canned with bones)

Sardines (canned with bones)



Blackstrap Molasses (also high in iron)

Greek yogurt (although dairy, this is not considered a damp-producing food)



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“It’s 5am and I’m sitting at the airport and am in complete amazement! I woke up with a full range of motion in my neck and not an ounce of pain. I haven’t even taken any advil yet.  I can hardly believe it! I am one happy girl.”

That is an email I received from a patient who had come in the day before with acute neck pain. Because she was flying the following day, she was desperate to get some relief from pain and the limited range of motion in her neck which had been plagueing her for 3 days. Advil took the edge off, but wasn’t giving her complete relief, and was doing nothing for her inability to turn her head to the right.

Upon palpation I found several very tight areas between her spine and her scapula on the right side, and also in the muscles on the right side of her neck. I did acupuncture locally, and also used a combination of points on her wrists and ankles on the acupuncture channels that traverse the upper back and neck.

The acupuncture certainly contributed to her quick recovery, but I think the key to treatment success in this case was the gua sha which I applied to her upper back following the acupuncture.

Gua sha is an ancient technique in which a smooth-edged tool, usually a ceramic soup spoon, is scraped along the skin in one area repeatedly. The technique stimulates blood flow and produces heat which releases toxins and helps muscles to relax. The feeling is one of a strong massage, and can leave reddish marks referred to as “petichiae”. Using gua sha on the muscles of my patient’s neck and upper back were the key to her relief from pain and return to normal range of motion. I use gua sha quite a bit in the spring when neck pain and spasm are a common phenomenon.

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If you’ve ever wondered what Liver Qi Stagnation felt like, all you have to do is get in your car in a big city at rush hour in stop and go traffic. Add to that a hot summer day in August and no air conditioning. Maybe to really experience it, throw in a broken sound system that only plays am stations. That frustration, that desire, or really, that NEED to move but being unable to, THAT is what Liver Qi Stagnation feels like. Being stuck is the essence of this pattern. When the qi cannot move, the blood also stagnates. We get frustrated, we get hot and our muscles get tense. Maybe our jaw clenches, our head pounds, and our shoulders can be found by our ears. We loose patience easily, maybe we yell out or throw some inapproriate hand gestures.

Sufjan Stevens is a young artist, mainly a musician, who has created a movie and musical score based on this sensation of sitting in traffic, specifically on the Brooklyn-Queens Expressway, or the BQE. Sufjan may not know anything about Liver Qi Stagnation (or maybe he does, I don’t really know) but he describes the sensation, and also his personal transformation beyond it after 9 months of driving on the BQE in an interview with Steve Inskeep on NPR’s Morning Edition. I encourage you to listen to the interview, check out the trailer for the film and maybe this about your own flow of qi while driving in traffic.

One of my favorite parts about the film is his use of hoola hoopers (is that a real term?) His reasons may not have anything to do with qi flow, but one of the BEST ways to get your Liver Qi moving is to move your body, and anyone who has spent any time with a hoola hoop can tell you that nothing gets the Qi flowing, and possibly the laughter as well, like a hoola hoop!!

The interview:

The movie trailer:



The main reason that fish and fish oils are so important is because they contain two fatty acids that do not occur naturally in any foods other than fish.

These fatty acids are called EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Together with ALA (alpha linolenic acid), they are known as omega-3 fatty acids.

They are highest in oily fish such as mackerel, herring, sardine, tuna and salmon.

The average intake of EPA/DHA in the US diet is only 11-20% of the recommended amount.

These two fatty acids from fish oil have been shown in hundreds of studies to be beneficial in a wide spectrum of human health including:

Heart Health

including all types of cardiovascular disease by reducing triglycerides (fat levels) in the blood, reducing VLDL (bad) cholesterol and raising HDL (good) cholesterol, Reducing inflammatory markers, which are now known to be very important in the progression of cardiovascular diseases, and by regulating (smoothing out) the rhythmic beat of the heart.

Arthritis, inflammation and allergy

including rheumatoid arthritis, Crohns disease, seasonal and food allergies, and eczema.

Child Development

both before and after birth. DHA and another fatty acid (arachidonic acid) are essential for the correct development of the fetal brain and mental ability. Neural development and eye function may be adversely affected by inadequate supply. 11% of the weight of the brain is the fatty acid DHA. Supplementing DHA in breast fed or formula fed infants has been shown to increase cognitive function including vocabulary and comprehension in 18 month olds.

Mental alertness, cognitive function and mood

due to the fact that EPA and DHA are the building blocks of neural cells. Those suffering from depression have significantly lower levels of DHA and other omega-3 fatty acids. Populations with higher consumption of fish have lower rates of depression than those with lower consumption. Studies have shown that Alzheimer’s disease in the elderly is more common in people with low blood levels of DHA.

So eat your wild caught fish!! Wild caught fish have a significantly lower levels of metals and other contaminants than farm raised fish. If wild fish is unavailable, or unappealing to you, take a fish oil supplement daily. Be sure you get your oil from a reputable source to ensure purity and high potency. High quality oils are tested for mercury, other heavy metals and PCBs. Consider a fish oil with the addition of the fat soluable vitamins A, D and E.

Since Copper River Salmon is in season right now, I highly recommend splurging and treating yourself to a delicious meal. I made this recipe last night from and found it to be outstanding!!

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Vitamin D is often referred to as the “Sunshine Vitamin” due to the fact that it is manufactured in the skin with UV rays from the sun.  Here in the Pacific Northwest we see such a small amount of sunlight that most people are at least somewhat, if not extremely, deficient in vitamin D. Most milk is fortified with vitamin D, but many people do not drink milk, either due to a dairy sensitivity or possibly because their natural medicine practitioner told them they are too “damp” to tolerate much dairy. Vitamin D is easy to supplement, and is even manufactured in a simple one-a-day chewable.

What does a Vitamin D deficiency look like?

The most obvious sign of deficiency is Rickets, or a bowing of the legs. This level of deficiency is uncommon, but more common problems linked at least in part to vitamin D deficiency include:

Spinal curvature, osteomalacia or osteoporosis

Sciatic Pain

Muscle Spasms, tingling or weakness

Poor tooth structure or Periodontal Disease

Nearsightedness or cataracts

Hearing loss

Depression or Seasonal Affective Disorder

Chronic Pain

High Blood Pressure and Coronary Disease



Autoimmune diseases such as Multiple Sclerosis


What are the sources of Vitamin D?


15 minutes of sunshine a day without the use of sunscreen

Animal products such as liver, butter, egg yolks, and fortified milk

Fish liver oils or oily fish such as salmon, mackerel, sardines, and herring

Veggies such as mushrooms and green leafies


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In Traditional Chinese Medicine (TCM), arthritis is called “Bi Syndrome” which is translated as “painful obstructive syndrome”. The theory of Bi Syndrome is that it initially occurs at a time when our defenses are low and we are exposed to “the three evil pathogenic factors” of wind, dampness, and cold. These factors are said to enter our bodies and obstruct the normal flow of Qi and blood, thus causing inflammation and pain.

Wind Bi is characterized by symptoms that move from one area of the body to another, affecting multiple joints. Sudden changes in weather and exposure to wind are likely to exacerbate the condition.

Damp Bi symptoms include a feeling of heaviness, numbness, and swelling. Damp Bi will worsen with exposure to damp weather or living in a damp environment. 

 Cold Bi manifests in a fixed, contracting type of pain and is also aggravated by exposure to cold. In the Northwest we are commonly exposed to wind, cold, and dampness, although our body type, dietary habits, and lifestyle can also be contributing factors in arthritis.

The treatment principle for arthritis with Chinese medicine is to invigorate the flow of Qi and blood, strengthen the body’s defenses, and to expel the wind, cold, and damp factors. How is this done? First, start with prevention. It is especially important when the season changes from summer to fall and from winter to spring to dress warmly, get plenty of rest and exercise, and keep a regular, balanced diet. For arthritis with fixed pain that is worse with exposure to cold, tea made of fresh or dried ginger, cinnamon bark and twig tea, and cayenne will help to warm the meridians and expel cold. For arthritis that is worse with exposure to damp weather, a diet low in fatty, greasy foods, sugar, dairy, and cold or frozen foods (including ice) will help. Include barley, soy, rice, and eat all meals warm or cooked. 

Acupuncture and Chinese herbal medicine have also been proven effective in increasing circulation, strengthening the immune system, and reducing inflammation and pain associated with arthritis. 

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