Something that really grinds my gears is how dismissive the average human has become of their pain. It’s almost universally accepted that “getting older” is a scapegoat for physical pain and creating limitations on your life. I will accept that our body changes as we age, and that can invite new obstacles into our lives, but that doesn’t mean we can’t overcome them. 
Aging doesn’t require you to start groaning when getting into or out of a chair, but to many people it has become the standard. It also doesn't require you to stop doing the things you love because “I’m in my 30s/40s/50s/60s” or whatever age. If you want to continue living the life you love, I have news for you…..It’s possible. 
Yes our bodies change, but with the right tools we can do it gracefully. Quality sleep, resistance training, and recovery tools can be your best friend and a great asset at any age. Resistance Training alone has shown to lower all cause mortality by 15%! (https://pubmed.ncbi.nlm.nih.gov/35599175/) 
Here are some things I think could change your life for the better: 

• Move Daily - Walk, jog, swim, ride your bike, or whatever else your like.
• Hydration! - Water does so many things for the body, so make sure it has enough. (every person is different, but a general starting point is ½ oz. for each 1 lb. of bodyweight) 
• Quality Sleep - Sleep is a major regulator of hormones in the body. It’s when our body gets to rest and repair. It can be a major factor in stress and healing. 
• Resistance training - You don't have to e “clanging and banging” at your local powerlifting gym. Bodyweight exercises, band exercise, light weights, kettlebells, etc. can all get you the basics. Pick what you like and stay consistent. including some basic strength training can have a huge impact on quality and quantity of life.
• Recovery tools - We already covered sleep which should be at the top of your list, but things like dynamic stretching, sauna, massage therapy, acupuncture, etc. are great ways to check in with the nervous system and encourage healing and recovery. 

Remember consistency is the most important thing. If you aren’t currently doing these things, don’t stress yourself out by trying to do everything at once. Pick 1 thing and do it consistently and slowly build from there. Don’t let your age dictate your life! Acknowledge those aches and pains and build a life that curbs them. 
If you would like support incorporating these things in your life, I would love to help!

Recently I had an old injury flare up. It was getting progressively worse, and quickly snowballing into something that was difficult to maintain with self care. It began to interfere with daily activities, so I scheduled an appointment with a friend and fellow acupuncturist. During the appointment I got some acupuncture and bodywork that worked wonders in managing my pain, but that isn’t what had the biggest impact on my physical health during that appointment. Talking to someone about my regular self-care was a game changer. I take pride in my self care routine. I exercise regularly and use self massage techniques daily, but when life gets busy or stress gets introduced to our lives, our routines are shifted. During my treatment I was reminded of the breathing practice that had faded into the background and my yoga/recovery sessions that gradually became less frequent between strength sessions. It’s ok to evolve your practices and skills, but we shouldn’t disregard the things that are working for us. 
This is why it's important to keep regular appointments. They keep you accountable for your health. I talk to patients all the time about how important the time BETWEEN appointments is to your health. As practitioners, we do the best we can to give your body the best treatment we can when you are in the clinic room, but that time is only a small fraction of your day, week, month, etc. The care you take between sessions is the real game changer. Regular appointments are important to keep you engaged with and reminded of the skills you have to manage your own physical health. They can also highlight areas that may be overlooked, or practices that may be most beneficial or the best use of your time. My advice is to pick a frequency that works best for you. It can be weekly, monthly, bi-monthly, etc. Use those visits to make sure you are staying on track with your physical health. Ask questions, get new ideas, remember old ideas that had an impact. Don’t let your health be something that just happens to you. 

I’ve talked about the joint by joint approach in a previous blog. Now, let’s explore the ankle specifically. The ankle is a hugely important joint. When missing adequate range of motion and stability, it can derail your movement throughout the entire body. Dysfunctional ankle motion can affect your running, walking, and other basic movements like squatting. It can also lead to pain not only in the ankle, but in your knees, hips and back. I’m going to discuss some ways to assess this issue, and a few ways to address this issue. 
First let’s talk about the basic movements of the ankle:
Ankle inversion: This is when the ankle rolls inward and the bottom of your foot faces towards the midline of your body. 
Ankle eversion: This is when the ankle rolls outward and the bottom of your foot faces away from the midline of your body. ​

Plantarflexion: This is when your toes point downward. (i.e walking on your tiptoes)
Dorsiflexion : This is when you flex your ankle upward (i.e point your toes towards your nose).
Restriction to any of these movements can lead to dysfunction in movement patterns, but I want to focus on the common restriction that affects most lower body patterns, and that is Dorsiflexion. ​

Tendonitis is a term that you may have heard before, and is a fairly common injury. A tendon is  the connection between the muscle and the bone, and tendonitis is inflammation or irritation of a tendon. This injury is typically caused by overuse or repetitive action. While it can occur in any tendon in the body, it occurs in some areas more often than others, giving the injuries to those areas their own names. Golfer’s elbows, tennis elbow, swimmer’s shoulder, jumper’s knee, etc. all fall into the tendonitis category. Left unaddressed tendonitis can progress into tendonosis. Tendinosis is a chronic condition that leads to degeneration of the inflamed tendon. Tendinosis is more severe than tendonitis and more difficult to treat.
The goal is to avoid either of these conditions from occurring in the first place, but if you do end up experiencing tendonitis here are some things to think about. Tendonitis is inflammation of a tendon. Inflammation is commonly defined as a reddened, hot, swollen, and often painful or stiff area of the body. This is true as a description of what inflammation looks like, BUT also remember that inflammation is a bodily process controlled by your immune system. The body is trying to repair or heal itself. Keep this in mind while recovering for several reasons. One, you want to eliminate what is triggering the inflammation if possible. In a repetitive motion or overuse injuries this can be addressed by assessing movement patterns and posture. Second, you don’t want to stifle the inflammation process itself, this is how the body heals. 
Once the tendonitis occurs, it's time to start focusing on healing. Kelly Starrett said in a training I attended “There are no fast healers. You either heal at the rate of a human being… or slower.” It’s something I think about for myself and treating patients. There are alot of great tools and treatment modalities in the work, but nothing is going to bypass the body's healing process. However we can optimize it! Let’s talk about some ways to do that. 
As I mentioned, inflammation is a necessary part of the healing process that should not be blocked, but it should also not be left unmanaged. When an injury happens in the body, white blood cells are sent to the area as part of the healing process. Fluid from the blood cells leaks into the area which causes the signs of inflammation (redness, swelling, pain). We can manage this by encouraging circulation to the area. Increased circulation can help flush the area and decongest the tissue. This can be done with manual techniques, such as massage, acupuncture or electro-acupuncture, as well as movement. If the area is painful to touch, body work on an area above the injury could also be beneficial in improving blood flow to the injury. For example, massage or electrostimulation to the thigh could be beneficial in treating achilles tendonitis. Will acupuncture “fix” tendonitis? No, it will not magically repair the tendon, but it can help optimize your recovery by helping your body do its job more efficiently.
Now let’s talk about self-care. Yes, going to a professionally trained healthcare provider is very important for assessment and treatment, BUT the treatment should not stop there. Realistically, how often are you going to be in that treatment room? Once, maybe twice a week for an hour. What about all those other hours during the days and weeks you are recovering? Don’t put your healing on hold and only optimize your healing for the time you are in the office. There are plenty of things you can do at home or work throughout the day to keep that road to recovery from growing longer. (This is a very basic and abbreviated list)

1. Get enough sleep. This is when our body does its best recovery/healing work. 
2. Stay hydrated. Dehydration thickens your blood, which is not ideal when you are looking to increase blood flow to an area. 
3. Foam roll/Mobility tools. A great option for self massage to keep that blood moving. 
4. Voodoo floss. Voodoo floss is a tool that can be used for a brief period of compression which allows for a rush of blood to the area when released. (please talk to a professional before trying this on your own.) 
5. Stretch.  I would recommend active stretching over passive stretching. 

The more frequently you practice these techniques the quicker your body will be able to repair your injury. Bonus! These tools can also be used for prevention. 

On a final note, you may have noticed I didn’t mention icing the injury. This wasn’t a mistake. Ice is something I rarely if ever recommend for an injury. If you are interested in learning why, check out this article here.

The American College of Sports Medicine defines Delayed Onset Muscle Soreness, or DOMS, as pain that develops 12-24 hours after exercise with the greatest pain between 24-72 hours after exercise. If you have spent anytime in the gym you have likely experienced this at some point in your life. DOMS can occur when the body is adapting when you are new to exercise or raising the intensity of a workout. Along with high intensity workouts, eccentric exercise has been linked to higher instances of DOMS. Eccentric exercise is when the muscle is tense during lengthening. i.e running down hill puts tension on the quads as they are lengthening and absorbing the impact from the ground. It’s important to note that DOMS occur AFTER the workout. If you are having pain during a workout. If you are having pain during a workout, that is something that should be investigated further to prevent injury. Delayed onset muscle soreness is exactly that…..soreness, but it isn't only that. It can present as tenderness to touch, stiffness and slight swelling. This part of muscle repair. When you are strength training/exercise you are causing tears and breaking down the muscle, as the body repairs the muscle it grows bigger/stronger. Because DOMS is the result of muscle repair, many people have a “no pain, no gain” mentality and believe that soreness after a workout is the sign of a good workout. I don’t subscribe to this line of thinking. It is possible to build muscle with a moderate intensity workout. Unless you are brand new to exercise (and sometimes even if you are brand new) DOMS in my opinion can be a sign the intensity was a little too much. 
Here are some methods I use to prevent DOMS from occuring in the first place:

1. Soft tissue work pre workout. This is generally 5-10 minutes of some foam rolling and mobility work to help prepare the body for exercise. 
2. Active stretching pre workout. Again 5 minutes or so here. Working through some basic stretches opening up some range of motion for full range exercise. 
3. Warmup. Get the body warm and prepared for activity. There are many ways to do this, but the key is to get the body warm before you start the meat of the workout. 
4. Lastly, moderate your workout. If you are new to working out, your body will go through an adaptation period and you are likely to experience some DOMS. As you progress, your body continues to adapt and the DOMS will become less frequent. 
   If you are already regularly working out, avoid major jumps and progression when possible. Calculated moderate progressions in intensity will be less likely to cause DOMS. 

Ok, so you went really hard in the gym and ended up with DOMS, now what? As I mentioned earlier DOMS is the body healing the muscle from the workout, so let’s talk about some good ways to manage that inflammation and recover. I took a course with Kelly Starret and The Ready State and he said something along the lines of there’s no magic bullet to healing, the body heals at the rate of the natural healing process or slower. Basically there is an intervention that will magically heal the body, but there are some that optimize the process rather than slow it down. Here’s a list for recovery. 

1. Keep moving! The body needs to get blood and fluids to that sore area and a great way to do that is with light movement. Active stretching, going for a walk, some gentle yoga. When you activate those muscles they squeeze the circulatory system and keep things moving. 
2. Speaking of fluids…HYDRATE! Water is my go to hear, but coconut water can also help you replenish and keep things flowing smoothly. When you are dehydrated you lose blood volume and will cause your blood to become thicker. Which is not optimal for the healing process. 
3. Another great way to help flush those muscles and keep your blood moving is bodywork. Massage has been shown in studies to improve recovery time. This can be done at home with a foam roller or you can schedule with a professional. If you are doing this as self care at home, I would do this as frequently as necessary. If scheduling with a professional massage therapist, studies suggest 48 hours post workout is the best timeframe. Acupuncture has some studies that show improvement in recovery time and some that show no change. “Tender point” acupuncture seems to be the most effective for this issue. 

These are general measures that can be applied to prevent and recover from DOMS. Please note that DOMS is not the only thing that causes pain post exercise. If you are unsure about your pain or your symptoms do not improve, please reach out to a professional. 
I'm always available for questions. 
Thanks for reading!

Whether you have personally used one or not, you have probably seen a foam roller at some point in your life. They are in most gyms and common in rehab facilities, but a question I often get is, do they even work? The short answer is yes, but not in the way most people think.
Foam rollers, or the dozens of other tools used for mobility work, are often explained as literally rolling out muscle “knots” or “adhesions”, inferring that we are in some way physically ironing out or flattening our muscles with these tools. This isn’t really the case. Foam rollers can release muscle tension and increase mobility, but it’s a neurological response that gets us the results. Foam rollers and all of those other tools help us communicate with our bodies and send signals to our brain, which causes a physiological response in the body that will release an area of tension. It’s important that we check in with our bodies regularly, and a foam roller is a great way to do that. I personally keep mine in the living room and use it daily, even if it's only for 5-10 minutes. 
​Now, let’s talk about some guidelines. First, we want to stay off of any bony areas. You want to be in the meaty areas of the muscles. I.e, stay away from elbows, knees, rolling directly on the spine, etc. 
Next, more isn’t always better. Remember we are not trying to physically crush those “knots” in our muscles, that’s a misconception that has led to using more force than our bodies can handle. We only need to use enough pressure to elicit a response from our nervous system. This means we should be able to breathe throughout the practice. If you find yourself holding your breath and bearing down, you are using too much pressure. You want to get close to that line, but not cross it. 
The goal should be to improve to the point that this process is not painful. Tissue should not be painful with moderate compression. If you work consistently over time, you should be able to achieve this. 
Finally, I want to emphasize that using a foam roller is not the be all and end all of self care for muscular health. Does foam rolling work? Yes. Can it help increase mobility and range of motion? Yes. Does it help decrease pain caused by muscular tension? Yes. Should it be the only self care practice used for improving or maintaining mobility, muscular tension and body health? Absolutely not. 
Foam rolling has its place in the selfcare world. It is a great introduction to self care because it can be done in small doses, give you great results, gives your body feedback, and help you build consistency, but it should be paired with other modalities. Active stretching and strength training should be incorporated to help reinforce the progress made with your foam roller. Once we gain that range of motion and mobility, we have to use it or lose it.
Thanks for reading! If you have any questions, please don’t hesitate to reach out.