acupuncture
Today on the Health and Wellness Show, we interview Doctors of acupuncture and Traditional Chinese Medicine Linnéa Snyder (L.Ac. MSTCM) and James Lovinsky (L.Ac. MSTCM).

Linnéa currently practices in the state of Rhode Island. She was first drawn to acupuncture after receiving it as a teenager and noticing its widespread effects. Most notably, she loves the way it balances one's nervous-system and can clear emotional build-up without the necessity of attaching or sharing about the feelings or pain. Linnéa is interested in women's health, psycho-emotional disorders and stress induced illnesses. James came upon acupuncture during a very stressful period in his life. After trying several modalities to treat his own stress-induced health concerns, he settled on acupuncture. Upon changing his career and beginning acupuncture school he realized that Chinese medicine offered many treatments that could give patients an alternative to drugs and surgery. James is interested in pain management, digestive disorders and psycho-emotional health.

Linnéa and James met on their first day of acupuncture school. Both received their training in Boston at the New England School of Acupuncture and in San Francisco at the American College of Traditional Chinese Medicine. In addition to acupuncture, their training includes herbal medicine, nutrition, and treatment modalities like cupping, moxabustion and massage. Recently they learned the M-Test somatic response technique developed by Dr. Yoshito Mukaino, MD.

Join us for a fascinating discussion about acupuncture, Chinese medicine and somatic therapy.

Running Time: 01:50:52

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Here's the transcript of the show:

Jonathan: Welcome to the Health and Wellness Show everybody. Today is Friday, October 20th. My name is Jonathan. I will be your host for today. Joining me in our virtual studio from all over the planet we have Doug, Elliot and Erica. Hi guys.

All: Hellos.

Jonathan: And we have a very special couple of guests today. We are going to be interviewing doctors of acupuncture and traditional Chinese medicine Linnéa Snyder and James Lovinsky. Hi Linnéa and James.

Linnéa: Hello.

James: Hello.

Jonathan: Good. Linnéa and James both received their training in Boston at the New England School of Acupuncture and in San Francisco at the American College of Traditional Chinese Medicine. Their training includes herbal medicine, nutrition and treatment modalities like cupping, moxibustion and massage. Did I say that correctly? Moxibustion.

James: Yes, moxibustion. It doesn't matter.

Jonathan: Awesome. So we're also going to get into some really interesting stuff about a somatic response technique developed by Dr. Yoshito Mukaino so there's a lot of really interesting stuff there. I think it's going to be a great show. Just to start off, we have a little bio in our show description but in lieu of having this discussion, you guys just tell us what got you into acupuncture. It's an ancient discipline but it's not widely known. What got you interested in it in the first place?

Linnéa: For me was that I connected with a woman who was an acupuncturist and I went in for a treatment with her. It was my first time trying acupuncture. I already knew her somewhat personally and had a certain level of trust going in, but as I experienced the treatment I noticed a lot of my awareness of my body changing and different parts of my body felt like they were opening up. Partway through the treatment I had what I would explain as an emotional release. I wasn't experiencing pain from the needles but the way that my body was opening up, I was able to cry and when I left the treatment room I felt so much lighter. I felt like I was walking differently and I was really fascinated with it.

In college I actually ended up developing my own major based partly on Peter Levine's work, philosophy, psychology and somatics. So I'm very interested in how our bodies store emotions and trauma and pain and how acupuncture can treat that.

Jonathan: Cool. That's the interesting part of this, right? I find that crossover really fascinating and I think that that's something that would connect a lot of people to acupuncture, for the layperson. Sure a lot of people think "Oh they just stick needles in you" but I think on the average people think "Yeah, I heard it works. Okay, hitting meridians, that makes a kind of sense." But they think of it as a strictly physical kind of thing.

Linnéa: Right.

Jonathan: I think that connection with the emotional release is really fascinating.

Linnéa: Yeah, definitely.

Jonathan: James, I totally cut you off. Please give us your backstory if you don't mind.

James: No sweat. I think when I was a kid I used to get car sick. I got pretty bad motion sickness when I sat in the back of the car and I don't know if you guys have ever seen these things called C-bands, but it's like a little elastic wrist band that has a little knob on it and you put it on your wrist. It's like an acupressure thing so it pushes on an important acupuncture point that is well studied and for a lot of people it relieves nausea. So that worked really well for me. It was a lot better than Dramamine because I could just put these wrist bands on and I didn't get carsick and I didn't have to take Dramamine and get sleepy. If it was a long trip I still did it sometimes, take a snooze.

So that was when I was a kid and then in college I found a book on acupressure and I was pretty interested in meditation already at this point so the book was really interesting. It gave me an introduction to more acupuncture points and meridians. It had some basic protocols for headache or stress or what have you. Fast forward a little bit further, I get out of college and was trying to figure my way out in the world and was going through a stressful time in my life. This was probably about six years ago or so. For whatever reason, one morning I fainted. I think I was just really stressed out and it caught up to me and I fainted and I ended up in the hospital and didn't know what was wrong with me.

A barrage of tests were done and there were no conclusive findings or diagnoses so I started exploring alternatives and one of the people I went to see was a chiropractor and in Vermont chiropractors can practice acupuncture under their licence. So he didn't have a lot of training in acupuncture but he knew enough to do some basic stress management protocols. He did a lot of other things but the acupuncture was something that really helped me. At the time I had been thinking about going back to school to study psychology, so I actually have similar interests as Linnéa but because of the experience I had with this chiropractor I started talking to him. We were kind of friends at this point and he encouraged me to look into acupuncture school.

So I went and interviewed and signed up and the rest is history, as they say.

Doug: Very cool.

James: Once I got started and started doing classes I really just got hooked more and more.

Jonathan: The acupressure you mentioned, I've had that done once. I've never had puncture and I should, I need to. But I have had the pressure done with the seeds. I don't remember the name of the seeds, but the acupuncturist was Liz Ross who was on our show before and she put them on my ear in a number of different places and taped them down and then if I got some soreness - it was mainly for my neck and back - then I could press on that seed. It was pretty noticeable. It would hurt real bad for a second and then it would kind of wash out and relax.

James: That's a pretty common therapy. Your acupuncture was actually developed by a French doctor, Nogier (I'm probably not pronouncing that correctly) but I think he was inspired by and the acupuncturists in China might disagree with me on this, but I think there's some disagreement. When you look back at the ancient texts you can see it but in modern times this doctor was inspired I think by the Chinese medicine idea of micro-systems which is related to reflexology in the foot which I'm sure most of our listeners are familiar with.

So he had this idea that the ear could be a micro-system for the whole body and he worked out this theory testing different points on the ears and basically mapped out all these points, this area of the ear relates to the stomach and this area relates to the neck, etc. So it works pretty well for a lot of people, especially for nervous system disorders. It feeds back into the nervous system. So we use it a lot. It's also easy access. It's very safe. You can use needles or you can use the little seeds.

Doug: I find it very interesting, whether you say discovered or reintroduced, by a French person. Acupuncture has this long history in Asia, China specifically so I can see why that would be controversial and the Chinese wouldn't like that so much, crediting this French guy with it.

James: The idea of traditional Chinese medicine is kind of a brand, it's almost like marketing, traditional Chinese medicine, that term TCM. There's acupuncture from Korea and acupuncture from Japan and the Worsley School from England that does five element acupuncture. So there's a lot of different streams of thought and because the history is so long, the streams diverge and then they're brought back together at different times in history. In the 1950s during the time of Mao was really a time where they were trying to combine acupuncture and herbal medicine...

Linnéa: Streamline it.

James: Yeah, streamline the system.

Linnéa: Standardize it so that they could make a school.

James: And it had a lot to do with the healthcare needs of that country, trying to be efficient. They didn't have enough doctors so they were trying to make a system that was streamlined and made sense and was scientific and that they could test.

Doug: And that's what's known as TCM today?

James: Yes.

Doug: Okay. I'm sure you could get very detailed on this answer, but what are the differences between Chinese acupuncture or Japanese acupuncture, Korean? Is there a lot of difference.

Linnéa: I would say there's a pretty big difference between the Japanese and the Chinese styles. At our school in Boston we did study a little bit of the Japanese style and they use a lot of alternative methods for diagnosing so they'll use the abdomen and abdominal palpation and also pulse which the Chinese use, but they focus more on that and the needling is very, very superficial and it's very gentle whereas with the Chinese it's more of a "no pain, no gain" approach.

Doug: Yeah. Hammer in the needles.

Linnéa: Yeah. So in this sense, later when we talk with M-test with Dr. Mukaino, he's coming very much out of that Japanese style where the skin is part of the nervous system and you can affect the whole fascial system through the skin alone.

Jonathan: Sure. Elliot, you can speak to this, the validity of this, but that the fascia is actually a communication system and that there's some research coming out that it's not necessarily always the impulses coming from your brain throughout the nervous system; it's actually the fascia that has this instant communication. So it would make sense that you're dealing with currents at that level.

Linnéa: Yes.

Jonathan: A lot of people I think, if we can go back and forth speaking to the lay people, I think people can grok that there are benefits to acupuncture but James you had said that you had this real relief from nausea with the acupressure. I think that's an interesting thing for people to see results, to see anecdotal evidence, not that it has to always be super dramatic. So I don't want to be melodramatic but I'm curious. What is the most dramatic case of recovery that you guys have seen in your practice or maybe in school or in hearing accounts.

James: We actually were just talking about that the other day. Linnéa might have seen different cases than me. The most dramatic case that I can remember was that we had a classmate who had an acute condition. She thought that she had appendicitis. She had most of the classic symptoms of appendicitis, doubled over in pain in her abdomen. I can't remember, did she have rebound tenderness?

Linnéa: Yes. And you could tell watching her lying on the table how uncomfortable she was and the doctor who was supervising us - we were interns in the clinic - when he did the palpation she was jumping with the pain.

James: Yeah, she was jumping off the table. And she went to the hospital and she said that there was one doctor and he palpated her and he said "I don't think it's appendicitis but I'm not sure what it is". So he called in another doctor and then another doctor. She said pretty soon there were half a dozen or eight different people had pressed on her abdomen which really hurt. I think she got imaging done and some tests and they said "Well you don't have appendicitis. We don't know what it is."

Linnéa: "Everything's normal."

James: "Everything's normal." {laughter} So being in acupuncture school, she was one of our classmates. She made an appointment in the clinic. She was in a lot of classes with us but I think it was on a Saturday and she came in after having been at the hospital I think all night. So our supervisor did a short intake and then he did a little bit of palpation of her abdomen and then from the location of the pain on the abdomen he started checking down her leg, down the acupuncture meridians.

Linnéa: He did channel palpation along the gall bladder channel which is on the lateral side of the leg. It goes all the way down the legs and the side of the body.

James: He found a really tender spot and he put a needle in it. I think maybe he did two points.

Linnéa: It might have been stomach and gallbladder channels.

James: Yeah, I'm not sure exactly. The points he found were empirical points or what
acupuncturists call ashur points which means that you palpate and you find the tender point in the muscle. So it's not necessarily...

Linnéa: In my memory a couple were ashur points which means that they were very, very sensitive to the touch and one of them specifically was the point for Dan Nang Xue.

James: So that's the point...

Linnéa: ...which is the appendicitis point and it's an empirical point.

James: Anyway, so with the first needle that he put in, you could see her visibly start to relax a little bit and I think he put two or three needles in her leg and the pain just stopped immediately. She was totally amazed and we were totally amazed. So he explained it as some kind of blockage in the meridian system, that's the Chinese medicine idea of it, and the pain never came back. So she was really impressed obviously and wanted to get into his clinic immediately. I think that was the last semester that he was supervising there. He was an old school doctor.

Linnéa: His approach was that he palpated along the channel and then he ordered in terms of most sensitive to least sensitive and he started at the least sensitive point and worked his way towards the very most sensitive point.

James: That's a good point, that a common treatment method or idea, especially for certain schools, is that you start with the least invasive treatment. So you might treat the local area last. So in this case he found points on her leg that relieved the pain so he didn't even treat locally.

Doug: Wow! And that's something that seems really counterintuitive and one thing that I find really fascinating about acupuncture. Somebody would think "Well I have a headache, therefore I have to do something to my head to get rid of it." Or "There's a problem with a tendon in my arm therefore I have to have a treatment on my arm" so the idea that there would be something going on in her abdomen and he would press along the acupuncture channels on the leg and find the points where that related to that, is counterintuitive but it seems very effective.

James: Yeah, absolutely. If you think about what Elliot was saying about the fascial system being a conveyer of information or a communication system in the body then it starts to make a little bit more sense.

Elliot: So from the perspective of an acupuncturist, in that particular case, if someone were to ask you what happened, how did that work, from your perspective how would you try to explain that? What do you think happened in that instance which allowed her symptoms to disappear?

Linnéa: I would say that he progressively opened up the channel in a way that her body wasn't going to have this response of re-clenching or protecting the area of pain. It was still a sensitive point that he started with but it was the least sensitive point and he sort of invited her body to be available to open up and then progressively went towards the most tender point. So from an acupuncture perspective, the way we think about it is that by opening that channel he then allowed the body to correct the flow of chi in her abdominal area so that the pain was no longer there and things were circulating better and the chi was moving properly through the channel.

Jonathan: That's a really fascinating aspect of this. Do you think that a lot of people might get turned off just by hearing the word chi?

Linnéa: Yeah, sure.

Doug: Absolutely.

Jonathan: Is it possible to frame it in a way of actual flow of electricity in the body where somebody who's super sceptical you might be able to say "Okay, look at it from the point of wiring."

Linnéa: Yeah. Even in Chinese medicine theory, the lungs govern the chi. If you think about taking a breath and it oxygenates your blood, so it's a very real form of energy that's moving through your blood and your body.

James: The Chinese character for chi relates to the steam rising from a bowl of rice that's been cooked and the way that the Chinese physiology and the way that they describe how chi is manufactured in the body, you eat food, it combines with the air and produces chi. So it's an analog for ATP, the body's energy.

Linnéa: Both food and oxygen.

James: So you're asking specifically in this case how would we explain how this student got relief, in scientific terms?

Elliot: Well I guess any case, really. It could be in this specific case. I'm just wondering for the layman, someone comes into your clinic and they don't really know anything about chi, they don't really know anything about physiology. Is there any sort of backing in what you might call mainstream science, for what you're talking about, or is it completely separate from that?

Linnéa: I think it's tricky. You definitely have to go back and forth and it's interesting because I notice sometimes that I assume someone wants to hear the biomedical version and you just see their eyes glaze over when you're explaining in the clinic and they want to know "Wait, in Chinese medicine what does that relate to?" And "What's the emotion associated with the liver?" They're hungry for this other language and this other way of understanding the body. So it is an interesting path that we walk where you want them to understand and it's also can be a mystifying way of talking about it. I think James has probably done more research on how to talk about it, but it's a very important thing to learn how to talk about it with patients, for sure and patient education is really crucial.

James: I think there's - sorry, go ahead Jonathan.

Jonathan: When you said it was representative of ATP that was kind of a mind-blower for me in that moment. That makes so much sense.

Linnéa: Yeah.

James: So my personal opinion - and this is not necessarily approved by all acupuncturists - but my personal opinion is that with Chinese medicine, the language is very different because the originating theories were developed a long time ago, at least two-to-three thousand years ago are the texts that they draw from. So the language is very naturalistic and sounds very simplistic or because of the biases of the 1800s with anthropology, we have this cultural bias to look down on naturalistic language as being primitive.

But actually I think that the ancient people who developed this system were very keen observers and they were describing the same physiology that we describe with modern science but they were using the tools that they had at the time, which was their eyes and their nose and their sense of touch. So when they were talking about chi and blood, they were talking about physical blood that they saw going through the body but at the time in China there was a very extensive canal system that they used for agriculture. So the theory that they came up with was that the blood vessels were like canals in the body. So the acupuncture needles were like a lock in a canal to shift water from one canal to another.

Doug: Oh!

James: And they have different language. For example if there's a blockage in the meridian like what happened with our friend - I say meridian channels interchangeably but they're imperfect translations from Chinese of course. She had a blockage. If you use the canal analogy, then the sediments are building up at the bottom of the canal and the water can't flow through the canal correctly. So by dredging the canal and clearing the blockage then that allows the chi and blood to move, improving circulation. So one theory about how acupuncture works locally is that it improves circulation and it also stimulates the release of the body's natural painkilling hormones, endorphins. I'm sure most people have heard of endorphins these days. It's kind of a common term.

So there's a local response with the endorphin release but there's also a systemic cascade that has been studied somewhat. There's a theory that basically you're blocking the nerves. So in simple terms, the local area is sending pain to the brain and there's a pain signal going to the brain and the brain is sending signals back. So for this woman, she had pain in her abdomen and the brain is sending back signals so that she's guarding her abdomen. So there's this pain loop going on; the signal's going from her abdomen, it's going up to her brain and then guarding back. If she doesn't have appendicitis, we're not sure exactly what caused it. Maybe she ate something that disagreed with her and she had a cramp in her large intestine or something and this pain loop gets stuck.

So the points that our supervisor put in her leg or if you were using ear acupuncture like the lady who came on before Jonathan, you're interjecting another signal into the system to break the pain loop. So that's another theory. It blocks the pain for a certain amount of time and typically that effect will last anywhere from a couple of hours to maybe 36 hours on average for the first treatment. That's a couple of theories about how it works and I might think of some more later.

Elliot: This is one of the reasons why acupuncture so fascinates me because there's just so many theories that seem to all have their merit. It seems like it's working on so many different levels. I was wondering if you guys had ever heard of a researcher. She died a couple of years ago. Her name was Dr. Mae-Wan Ho.

James: No, not offhand.

Linnéa: No.

Elliot: Okay. She's not involved in acupuncture or anything but she's done a lot of research. She's a biophysicist and she did a lot of research on water and things. She actually recently came out with a theory. I'll send you the paper later.

James: That'd be great.

Elliot: It was talking about the acupuncture points and she claims that her research has identified many of the main meridian systems as bundles of collagen. So apparently they've measured it by putting the acupuncture needle into this collagen bundle or bundle of fibers. There's this whole electrical property to it as well, almost like it induces some sort of charge and how that can almost affect the system as well. So it seems to be working on all of these different levels. I don't think anyone really knows how it works but it's good nonetheless.

Linnéa: What you just said also reminds me of moxibustion because one theory, even in Chinese medicine - or it's not even a theory necessarily, it was just how they treated - but there are certain places where you might put a needle and it creates a conduit or a place for heat to leave the body, where there might be too much heat. Then also they would put moxi balls on top of the needle to send warmth into the body through the needle, so it acts as a way to direct the energy into the body or to pull heat out of the body where there's too much.

Doug: And it's something that they actually put on the needle and ignite it.

Linnéa: Yes.

Doug: Okay.

James: It's a species of mugwort that's prepared. There's a traditional way of preparing it but it ends up being almost like a fuzzy wool. It's quite sticky depending on the grade and you can roll it into a ball or a cone or a little piece of rice or something like that. People who have had acupuncture, especially Japanese acupuncture, have probably experienced it. So you burn it. It's like infrared therapy basically. There's probably some therapeutic value from the smoke too, the same way that you would burn sage or tobacco to clean a room and that's been studied.

Linnéa: I know there was a study specifically on the wavelength from burning moxa and it was a very specific therapeutic wavelength that was quite penetrating. They took a spectrogram or something and showed photos going several hours later after the moxa to show that the heat was still present in the system.

Doug: Wow!

Jonathan: Cool. I go to chiropractic pretty often and one of the diagnostic tests is a heat scan of your spine and it shows where it's hot or where it's not hot and that allows him to target in on the inflammation because heat is a product of inflammation, right?

Linnéa: Definitely.

Jonathan: If I could get meta for a second, it's interesting to me from the perspective of the guy who developed Standard Process vitamins, he had this theory of what he called protomorphogens. This is not scientifically established per se, but his theory was that like treats like. So if you have problems with your liver you can eat raw liver and then your liver will use those cells to regenerate itself.

Linnéa: Right.

Jonathan: There are cases of cancer of the eye being treated with raw eyeball. You can heal your teeth by ingesting ground up bovine teeth. It's kind of fascinating. It makes sense that you would treat heat with heat. So it's kind of a high-level view but it was interesting to me from that perspective and it keeps coming up as you look at traditional modes of medicine and treatment, this like-treats-like philosophy seems to go throughout.

Doug: I was going to ask also...

Erica: I also...

Doug: Oh, go ahead Erica.

Erica: Okay. I wanted to ask you folks, so you've been doing this for a little bit of time, do you notice that most of the people who come are coming for pain? It seems there's a lot of information out there about how acupuncture now is helping pain. What do you see across the board as far as clients that are coming to you or do you notice that pain seems to be a big target for what they want to deal with?

James: That's a good question. Pain is definitely one of the things that acupuncture is most well known for, pain management and it has been studied a lot for pain management. I think recently in the US there are recommendations for treating back pain. I don't think it's the AMA. Sorry my mind's kind of blanking, but recommendation for doctors, standard of care for back pain. In the US we have the opioid epidemic so they're trying to find ways of treating pain without prescribing opioids and they recently changed the standard of care so that doctors refer their patients to a chiropractic, acupuncture or massage before they prescribe painkillers and before they do surgery.

So a lot of patients come for pain. And actually people started coming for fertility treatments before the studies were done because it was just one of those things where it worked and it was a word-of-mouth thing. Fertility and women's health is a really big and important area that we treat that a lot of people come for, especially depending on what part of the country you're in. I'm sure you guys are familiar with studies that on the east coast and the west coast of the US women tend to wait longer to have children because they have careers. So there are more women who need help getting pregnant.

There was a ground-breaking study a few years ago by an MD who came to our school in Boston when we were there. He was a fertility doctor and he met an acupuncturist and she convinced him that acupuncture could help with the work he was doing. I think they did a study together and they found that the acupuncture improved the outcome of the pregnancies. I think it helps people get pregnant and even more, it helps them carry the baby to term. Chinese herbs also help a lot. That's a big area in Chinese medicine as women's health.

Those are two really main things. Then you have breakdowns of low back pain, knee pain, migraines. Of course in scientific terms we want to break it down and study each thing. I think that treating nausea is a big thing.

Linnéa: Especially with chemotherapy.

James: Yeah, so chemotherapy patients is a place where acupuncturists can really help, is helping them mitigate the side effects of chemotherapy and radiation, some of the fatigue, nausea and lack of appetite and pain. So that's another big area.

Linnéa: I would agree that I see a lot of referrals for fertility and pain. If you're looking for a percentage I would say maybe 40% of the patients in my experience of treating in the last couple of years, have been pain.

James: It's probably a little bit higher for me but I studied Chinese massage Tui Na so to some extent the patients that you see depend on...

Linnéa: Who you are and what your interests are.

Doug: You mentioned the reason for you getting into acupuncture was having an emotional release type of thing. Have you actually encountered that with any of the people you've been treating? Does anybody come to you because of that? Because they've had some kind of traumatic experience and want to deal with it?

Linnéa: Definitely. I've treated two cases specifically that stand out. One was a trauma victim and one was a patient who had really severe anxiety attacks. I saw especially good results with the anxiety patient but I saw great results with both. The anxiety patient I did use a combination of herbal and acupuncture and it did get to the point where there was a specific person who especially triggered her anxiety attacks and I got to the point where she was able to actually interact with that person and not have an anxiety attack.

Doug: Wow!

Linnéa: So I was pretty happy.

James: And it was a short period of time too, wasn't it?

Linnéa: Yes, she only came in for four or five treatments and she was very diligent about the herbs and came in week after week. It wasn't a long spread of time between treatments. So I think it effectively was able to change the balance in her nervous system and with the herbs she was able to take those daily so it really helped carry over the effect of the treatments.

Doug: That's amazing.

Linnéa: Yeah.

Doug: And what about actually having emotional releases on the table?

Linnéa: Oh sure.

Doug: Even accidentally or if the person didn't even come in for an emotional issue but just by treating them they have that issue?

Linnéa: I've only had one or two people actually weep a little bit on the table about something, that you can see it coming up in their chest and they start breathing differently. But often I'll hear about people after the treatment. Something comes up for them to process, that kind of thing.

Doug: That's fascinating.

James: There are specific treatments that one of our professors in San Francisco specializes in and he has worked out a system - or he uses a system, I'm not sure if it's his or not - but it's designed to work on emotional release and releasing trauma, releasing attachments, that sort of thing. So there's a progression of treatments that he worked through, external dragons, internal dragons.

Linnéa: So this is called the eight extraordinary vessels and that's what you treat typically for an emotional issue. So they're more deeply seated in the body whereas the meridians and channels are more on the surface and there are certain vessels. So there are combinations of points that help you treat those vessels in the body.

James: So that's much more esoteric and if you think about the meridians that everyone knows about as canals of water going out into the fields, then the extraordinary vessels are like the reservoirs of the body. There's one guy who tried to work it out materialistically and he said "Oh yeah, okay, so the sea of blood, Chong Mai, that's the aorta and the Ren Mai is the vena cava going back to the heart". Maybe when they worked out this theory and then they saw the guy on the battlefield, and they were like "Oh yeah, look at the big main thoroughfare of blood". But I think they're more about spiritual issues. There's a whole set of symptoms that are attached to them that you look for; "okay, this person has something going on with their Ren Mai because they have these symptoms."

Doug: That's pretty fascinating.

James: Yeah.

Jonathan: That probably has something to do with the wall that's between the esoteric and the practical/scientific.

Linnéa: Yes.

Jonathan: Some of these things you don't have a good database explanation for it necessarily.

Linnéa: Oh definitely. There's so much mystery and I think that part of what happened with the standardization of the medicine and becoming TCM was that anything that seemed either superstitious or spiritual was taken out of the medicine mostly. You can find some people who focus on that or in our case we had one teacher in San Francisco whose specialty was doing extraordinary vessel treatments but it's not super common.

Jonathan: Do you guys find that it dovetails with chiropractic at all? I know for me, aside from the obvious not wanting to be inflamed, it's very important for me to keep my inflammation down because if it goes up then it will irritate subluxations that I have and push things back out of place. My question to you, if I can put this clearly, do you think that in more cases acupuncture would lead somebody into chiropractic and allow that adjustment to be more effective? Or have you ever noticed that you give somebody an acupuncture treatment and let's say they have a vertebra, or maybe their shoulder is a little out of place and the body will actually put it back into place because now it's communicating correctly with itself?

James: I would say yes.

Linnéa: Yes. I've had that experience personally too where I've had a treatment and then I've adjusted myself, moving after the treatment.

James: Yeah, I think it's kind of both. Traditionally there's a lot more to Chinese medicine than acupuncture. That's what's most well known in the west and this is still the same way in China. One of our supervisors at school used an orthopedic surgeon, he did acupuncture, he was also trained in the Chinese sports massage Tui Na and he did chiropractic manipulations and what they call bone setting, and herbs. He was trained in herbal medicine. So you'd get the whole package from him.

So if went in and you had a knee problem he might start with herbs and give you some corrective exercises like physical therapy and do some massage and see if he could work on it that way and then progressively work up to knee surgery. So I think that acupuncture works more on the soft tissues. So the way you described with the shoulder, if you had things going on with your back, oftentimes we can palpate and find those areas the way that a chiropractor would, but instead of doing an adjustment we would try needles and try to relax the soft tissues and like you said, see if it goes back into place. The needles, because they improve circulation can help raise inflammation, trigger a healing response.

So oftentimes, especially in San Francisco, a chiropractor will usually have an acupuncturist in their office. And they're starting to be more and offices where there will be a chiropractor and an acupuncturist and a naturopath or a nutritionist or a dietician or something like that, or a nurse to do blood draws and that sort of thing. But we refer back and forth a lot with chiropractors and it's really a complimentary system I think in a lot of ways.

Linnéa: I think with more chronic conditions they're really complimentary. In my case because I have a yoga practice, I'm a little bit more flexible, my joints tend actually toward hypermobility and I have to work on strengthening. It's easier for me to have an adjustment just from acupuncture, whereas someone who has a chronic condition and has a much more deeply held muscle pattern and it's harder to release that and have an adjustment. So if an acupuncturist can help open up the soft tissues then the chiropractor's work is easier and is more likely to hold.

Doug: That's a really nice way to put it.

Elliot: What you were just saying about how in some cases maybe just having an acupuncture treatment can essentially correct the issue, that's just amazing because I guess the way that it comes across to me is that the body has its own innate sense of intelligence. It knows what it needs to do and sometimes it just needs a little push and perhaps by increasing the flow of information, the flow of energy, I guess that would translate the flow of oxygen and the flow of nutrients and detoxification of metabolic waste and stuff, if you can provide that little push then I guess the body knows what it needs to do, yeah? Sometimes that can be sufficient. I just think that's amazing.

Jonathan: It really is.

James: At M-Test seminar that we were at last weekend with Dr. Mukaino, somebody asked a question, "Okay, what do you do when somebody has a really chronic issue and you're not getting quick results?" He said that the body compensates for things and it tries to protect itself and the longer and more chronic the problem is, it affects deeper and deeper levels and layers in the body. So when you're first injured it might be more like on a skin level and then it starts to affect the muscles. So there are muscular compensation patterns and maybe they're just in the extremities at first but then they move into the spine and the hips.

Then you see people who have hip imbalance and they say "One leg is shorter than the other". Usually the legs are actually the same length if you measure them but they appear to be different lengths because the hips are misaligned and typically if the hips are off and the spine is off and the shoulders are off, at that point it's in the joints and the bones. He said that chiropractic can be very helpful for that because you're going directly to the place where the body is compensating at the deep level and that when you're doing the soft tissue manipulations like what we were just talking about and the way you so elegantly described it Elliot, it also affects it indirectly. He said he thinks it's safer when it takes a little more time but it can be safer unless you're a really good chiropractor, and many are very good.

Linnéa: It's safer to start with the soft tissue and then go to the bone.

James: Exactly. So for someone like us obviously, who's not trained that way, it's a lot safer.

Jonathan: Sure.

Linnéa: And some chiropractors are trained to manipulate the soft tissue somewhat. I think personally for me that's the kind of chiropractor that I gravitate towards because I know that I really need that softening before I can receive an adjustment.

Jonathan: I think it's a big problem. I completely am onboard with chiropractic, acupuncture, with all these therapies, but there are a lot of people who may practice recklessly or carelessly.

Linnéa: Sure.

Jonathan: You hear stories about such and such a guy went to the chiropractor and then had an embolism in the parking lot.

Doug: Yeah.

Linnéa: Totally.

Jonathan: So it is something to be careful about. There's careless medical doctors too.

Linnéa: Yeah.

James: Yeah, absolutely.

Jonathan: Like you said, it's important to audit somebody that you're going to go see and make sure that they're very knowledgeable. But I don't want to divert too much into chiropractic. You had mentioned the M-Test therapy, the somatic response technique. Can we get into that because it sounds really fascinating.

Linnéa: Sure.

Jonathan: If you could just give us an overview of what it is.

Linnéa: Sure, I'll start. Dr. Mukaino developed a system of stretches and there are groups of stretches that stretch each meridian consecutively. So you move through them. First there's a series for the lung and large intestine. So you stretch the upper body portion of the lung and large intestine channels. Actually with that channel you only use the upper body. There are stretches of the arms, the neck, the legs and as you're going you have the person rate their pain.

So if a stretch causes them pain it actually doesn't matter where the pain is located. What matters is that stretching that particular meridian causes pain so that would indicate that somewhere along that meridian there's some kind of blockage or sticky tissue. Something is not moving and gliding properly in the body. So then we would treat that meridian not based on where the pain is, but based on the meridian that's being stretched and therefore is causing pain somewhere in the body.

James: I'll just jump in and add that Dr. Mukaino and Japanese acupuncture, I think we've mentioned earlier, is much more worked on the skin level, so he's an MD and he's really a scientist. They've done a lot of studies at the university where he works. The way that he explained it to us through a translator, is that the skin has a really important role to play in the body's movement patterns, proprioception, that felt sense and sense of balance. So the system that he developed, the M-Test is based on all of the traditional acupuncture ideas of meridians and acupuncture points and it incorporates ear acupuncture and scalp acupuncture if it's needed and works along the spine. But the really interesting and novel idea that he developed, in my opinion, is this movement-based diagnostic and treatment system that Linnéa was describing.

It dovetails pretty nicely into western orthopaedic tests. The movements are pretty similar. You're moving joints through the typical planes of movement; testing the front of the body, testing the back of the body, testing the sides of the body with bending and twisting motions and he actually developed it by working with athletes. So he wasn't even working with people who necessarily had pain. Some of them had injuries and they were like, "Can you fix me so that I can run in the race in an hour or tomorrow?" So he needed to come up with something that could get quick results.

Athletes are totally obsessed with performance so they teach all of the athletes at their school how to self-diagnose and treat with this system so before they run a race or swim in a meet, they run through these 30 movements and check for restrictions or asymmetries in their body. They don't necessarily have pain but maybe the range of motion in the right shoulder is different than their left shoulder, so they say "Well which part of my body is affected by this? I'm raising over my head so it's the back of my arm" and they can work along the acupuncture meridian, work along the muscles and stretch it and improve their movement so that they can perform better at their sport.

Linnéa: From there he came up with the order that he likes people to use. So they find their problem area, say you're raising your arm above your head, you find restriction in the back of your arm. He recommends starting with the large muscle groups. So it would probably be the tricep in this case. So he would recommend that you palpate your tricep and you look for a very tender area or where it feels sticky or where there's a nodule that doesn't feel really good when you press on it. "How can I help that to soften?"

It might be a rolling between the fingers or some kind of massaging and then you pinpoint the sensitive, tender area and try raising your arm again to see if there's any change. On top of that, after you've identified where in the large muscle group there's an issue, there are combination of points that you would test that are based on the channel. We would have to get into detail about acupuncture theory a little bit here because they're called mother and son points and you check the mother point and you check the son point and you see which one works better.

James: So there's a lot of comparing. There's a lot of test and retest and it's instant results. If it works you know right away. It's kind of a no bullshit system. Then you progress through a series of possible treatments and you keep testing the movement and hoping for results. He actually cautioned us against over-treating people. So if try to do too much - and this actually happened at the conference the other day. Somebody got over-treated one day and they came back the next day and said "Oh man, during the ..."

Linnéa: His whole back went into spasm.

James: Right.

Linnéa: He was lying in bed and couldn't fall asleep because he'd been over-treated and his body was just trying to protect itself because it was opening up...

James: Just trying to incorporate it.

Linnéa: And it was too much all at once. So it's very subtle on the one hand and at the same time all of these subtle adjustments add up and the body can freak out if you go too far. So typically if someone comes in and their pain is an eight out of ten and it's very painful to move, if it went down to a four you would probably stop there because their pain cut in half. That's a significant amount of reduction and you wouldn't want to keep chasing the pain down until you get to a one.

James: It's safer to change it over time.

Jonathan: The spasms that you mentioned, I realize that you may not know the intimate details of that case, but do you think that was just giving the body too much information to deal with or do you think there was possibly some kind of a tear or something that happened that would cause that?

Linnéa: No.

James: I think it was too much information.

Linnéa: Exactly.

Jonathan: Okay. So it's trying too hard to fix itself essentially.

Linnéa: Yeah.

James: Yeah. Or if you think about it...

Linnéa: Or rebounding because too much happened at once.

Jonathan: Sure.

James: And pain sometimes can be caused from hypertonicity in the muscles, so the muscles are too tense for a long period of time. They build up metabolites, lactic acid and so forth and it hurts because the muscle is tense all the time so if you think about somebody who has left-to-right imbalances, let's say, they walk in a certain way; maybe they sprained their ankle when they were 10 years old - everybody has sprained their ankle or broken their ankle or something like that - so maybe they broke their ankle and while their ankle was healing they were limping or they were on crutches and it changed their gait.

Then their hips are aligned differently after that and because of that the soft tissues work to hold this unnatural alignment, so then if you work with the person and you work with their skin which is part of the nervous system and you just touch the acupuncture points and there are these tiny band-aid stickers that you put on the points and you're showing the body how to move differently by giving it feedback through this information in the skin and the acupuncture meridians.

So you're showing it to move differently and if you go too far and you get all of these muscles to relax and open the body all the way up and it's too fast then they go home and they're like "Wow, I feel great!" and maybe this guy walked back to his hotel because he felt so good, he walked a little too far and because some of those muscles that are not used to being used in this new way, he overdid it and then they just tighten back up, or maybe they tired easily because they're not used to being used that way. It's not that it's necessarily dangerous I don't think.

Linnéa: Our bodies need a certain amount of tension to do our daily lives and the goal isn't necessarily to be completely tension-free, it's having the balance.

Elliot: This technique, if I understand correctly what you say, sounds really interesting because it seems from what you've said that it can be individualized for each different person.

Linnéa: Yes.

Elliot: You said about going through the different stages of the feedback and I guess in western medicine doctors traditionally will look at someone's condition and then they will go to a book which tells them exactly which protocol that person must follow. There's practically zero room for individuality.

Linnéa: Right.

Elliot: So I think it's cool that this doctor has come up with a method whereby you can see what works by testing it and continuing to test until you can refine it to such a point where you can maybe be confident that that is going to help that person, rather than potentially wasting their time or potentially causing harm.

Linnéa: Right. It was actually amazing to watch Dr. Mukaino. He is an older doctor and he still has so much curiosity about "Okay, is this going to work or is this going to work?" He's so into solving the puzzle of each person's individual body and very open to trying a different point once he has exhausted the points that he typically uses and figuring out crossing patterns and it's very subtle. But even in my experience I haven't treated a lot of patients with M-Test but I did treat a few.

In a case that worked really well for me I put my finger on the point, and you use pretty gentle pressure, but you can already feel as you press on the skin layer, as the person initiates the movement to do the stretch it almost feels like when the point is going to work, the patient moves in a different way right from the beginning. You can tell the muscle is either engaging in a different way or from a different place or it's originating in a different part of the body and the arm lifts and they either have better range of motion or they start smiling and they're pain-free.

Doug: You guys should tell the story about the pitchers, the example about the pitchers because I thought that was really interesting.

Linnéa: The graphics.

James: Dr. Mukaino works at a university. Of course they have sports teams and one of the studies they did that's in his book was with baseball pitchers. They were studying how they could improve performance with this M-Test system by fine-tuning the person's movement. I think it's called EEG, when you measure the electrical activity of the muscles?

Elliot: Yeah.

Doug: EKG or EEG?

James: I think EKG is with the heart.

Doug: Yeah, you're right.

James: So they put these sensors on biceps, triceps, the different heads of the deltoids which are in the shoulders, the triangular muscle. Biceps are the front of your arm. Triceps are in the back of your arm. I think the trapezius which is the muscle that goes from your shoulder up your neck and I think that's it; so basically the muscles in your shoulder and upper arm. They had a baseline they did with the pitcher, just a preliminary study. They had a baseline study where the pitcher went in, got the sensors on and went through his usual warm-up routine. They measured the pitching speed and they showed us these graphs and you could see that he starts out at a slow pitching speed and over the course of the 60 or 100 pitch session the speed of the pitches gradually comes up and then tops off. Most of the shoulder muscle activity is all over the place, pitch-to-pitch.

But the activity in his arm is really interesting because in the deltoids and the biceps there's initially a lot of activity when the pitching is slow and as the pitcher warms up and the pitch speed comes up it correlates with the deltoid and bicep activity dropping off. So as the pitcher warms up, his arm is getting out of the way, it's just transferring the force from his spine and his big muscles in his biceps and shoulders and it's whipping through and the pitch is coming out.

So that's the baseline. If anyone's interested in this I'd be happy to try to find the study. So the follow-up day, ran them through the M-Test and then did the same thing. What they found is that from the first pitch, his first pitch was as fast as the fastest pitch in the previous session.

Linnéa: After he had warmed up however many times.

James: Exactly. And his bicep and tricep activity was at the bottom from the get-go. So he didn't have to warm up. The M-Test took the place of the warm-up and he could just jump right into full speed pitching.

Linnéa: It was interesting because you're looking at this graph and the points are really all over the place initially and then with the M-Test they all come together, which signifies that there's less antagonist motion in the muscles, so they're working more efficiently.

James: The whole system is more coherent and it's communicating better. He told us another story about a swim meet, some kind of intercollegiate event. It's like the Olympics. I don't really understand it because I wasn't a college athlete, but it sounds like there are different sports teams from different countries that come to Japan to compete so there are Japanese teams from his university, there are American teams there, people from Europe. It was a swim-meet I think. One of the athletes was from a South American country and she came by herself. She didn't have trainers with her and the Americans and some of these other teams had these athletic trainers with them.

So one of his students volunteered to work with this swimmer as her trainer and the way he did it was to do M-Test and he taught her how to do it on herself, to self treat and he helped her through it. She apparently in the qualifying round she placed 5th and it was the best time she had ever swum. It was her best time ever. And then in the actual race she placed second and again, broke her own record and beat all the Americans, blew everybody out of the water. It's an anecdotal result but she was thrilled and they were thrilled and very proud.

Linnéa: One last thing I'll say about M-Test that I think is very interesting that James was just starting to touch on is that in terms of the self-care, what they'll do is if you have a stretch that causes pain and you can identify which channel is being stretched, then you can use other stretches that don't cause pain but also stretch that channel. So you can help the body help that channel to open without repeating the painful movement and that's something you can take home with you and do these stretches to help open that restricted channel.

James: That's another nice thing about the system that I like, is being able to teach people and give them something to be able to help themselves.

Linnéa: Have their own tools.

Jonathan: That's great. We do have a question from one of our chatters. She asks "Have the guests heard of inserting acupuncture needles into trigger points rather than acupuncture points?" Does that make sense to you guys?

Linnéa: Yes.

James: Yeah! Absolutely.

Linnéa: A pretty classic example is there's a trigger point on the top of the trapezius and it corresponds with an acupuncture point, gallbladder 21. I would say that often when an acupuncturist needles the point they wouldn't necessarily be trying to trigger the muscle but it's quite easy to manipulate the needle in such a way that you do trigger the muscle and you can feel the fasciculation and release. The muscle will clench and then relax.

James: Basically jumps and twitches.

Jonathan: Yeah. I think I've experienced it. It's like a wobble almost.

Linnéa: Yeah.

Jonathan: A trigger point then is something that stimulates that whereas an acupuncture point is more associated with the meridian and the energy flow?

James: There is some correspondence I think. Trigger points are different than motor points. Muscles have motor points which is where the nerve innervates the muscle and if you stimulate that point then it can make the muscle jump. I think the concept of trigger points was developed by a doctor named Janet Travell, if my mind is cooperating with me. She initially used hypodermic needles I think.

Jonathan: Oh my!

James: And she would inject saline solution or lidocaine into these trigger points. A trigger point - I haven't studied a lot but my understanding is that trigger points happen in muscles. Again, it's these long standing holding patterns. So there can be an emotional correlation; there can be trauma stored in it. Or it could be structural for some people. But basically what happens is that the muscle fibres get bound up and stuck and it creates a nodule in the muscle. Sometimes they're quite small. Sometimes they can be larger and there's usually a referral pain pattern. So if you have a trigger point in your neck or your upper back it can refer up onto your head for instance, and cause headaches.

So finding these trigger points and using an acupuncture needle - acupuncture needles are much thinner than a hypodermic needle. Sometimes you can treat it with acupressure but needling into the little nodule can cause it to release. When you needle a motor point it can jump and release. So those are the ashur points, what Japanese acupuncturists would call ashur points. You feel around for a nodule or tender point. It's based on modern anatomy. We did learn some trigger point needling and some motor point needling. With the motor points it's a similar idea; the muscle is overworked, it's hypertonic, stuck in this super tense state which all of us have probably experienced, in the upper back and neck from sitting at a computer or driving too much. You start getting that forward head posture and your shoulders start creeping up around your ears. {laughter} You know what I'm talking about?

Doug: Yeah.

James: And you just can't relax your shoulders. Sometimes you can tense it and pull your shoulders up and tense and then let them down and relax and that's another way of treating it. So you're putting even more tension into the system and then relaxing it.

Linnéa: I think that's actually what the needle can do too; the muscle is already really tight and then it tenses even more and then it can't actually tense anymore so it has to go somewhere and it actually has to relax.

Jonathan: I've heard that technique for stretching before and I can't remember the name of the guy who said this, but when you're doing regular stretching, not even yoga, just stretching on the floor, that when you reach a certain point where it feels like you've gone as far as you can without hurting yourself of course, you actually tense that muscle for 30 seconds and then relax again...

Linnéa: Yeah.

Jonathan: ...and you find you get more motions for that.

Linnéa: I've experimented with that. I think it's very effective.

James: I can't remember the scientific name for it right now.

Jonathan: You may have been about to answer my question. I was just going to ask, would you say generally that acupuncture points are set? They're in this spot and that's where that point is? And trigger points can move and shift, depending on the tension of the muscles?

James: Yes. An acupuncture point is where you put an acupuncture needle.

Linnéa: But also an acupuncture point will really vary depending on the area of the body we're talking about. For example, there's an acupuncture point, spleen 10, which is on the thigh, the quad muscle on the inside of the thigh...

James: Vastus medialis.

Linnéa: Vastus medialis. And the area is probably the size of a quarter, maybe a little bit bigger and then if you look at the wrist, for instance heart 7 when it's a really, really fine area and you have to be medial to this tendon and you don't want to needle the vein, we're talking about a tiny, tiny pinpoint of an area.

James: The most well known, traditional system of acupuncture with the 12 channels, lung meridian, large intestine meridian, stomach meridian, those locations are all fairly fixed. There's variation from person-to-person as with any anatomical system. So any model that we have is a set model but when you apply it to a living person the model never fits exactly. There are alternative systems of acupuncture points that are mapped out. The Master Tung system for instance, is a totally different tradition than the acupuncture points that made it into TCM and acupuncture for a long time was family systems and it was secret and really closely guarded.

If you have a system with acupuncture points like this M-Test for instance, if you worked out that M-Test system and you could offer people instantaneous relief and improvement and range of motion, you could get quite famous and make a lot of money if people would be coming to see you. So you wouldn't want to just tell everybody about it necessary, so you would keep it kind of secret. So there were a lot of different family systems that have acupuncture points in different places and this other system Master Tung, which is actually quite popular among a lot of acupuncturists. It adds more points. There are more points over the place. So those are all fixed.

Then depending on the acupuncturist, many acupuncturists will use some of the fixed points and then some of these ashur points which are empirical points that you find on the patient through palpation. There's a lot of palpation that goes on with acupuncture and with a good acupuncturist. You really get used to almost seeing with your fingers. You can feel down into the body and you start to be able to feel areas where the connective tissue is inflamed. It feels sticky or gummy or ropy. There are these specific kinds of feelings that you can start to know. There's also the times when you press on a point and the person winces obviously.

So there is some correspondence with the motor points and there is some correspondence with trigger points as well. I think there are common places where trigger points occur in muscles. Some muscles are more likely to get them and they're more likely to occur in certain places. Dr. Travell and other people who have followed her line of thought have mapped them out, like acupuncture meridian maps, where 'this is where you look for trigger points in these muscles and this is the kind of pain referral pattern that it has'. So if the person is having headaches on their temples then check in their trapezius and look for these nodules.

Actually in some ways that's pretty similar to acupuncture because some of the channel palpation and diagnosis systems like our supervisor used on the young lady with the abdominal pain that we talked about earlier, he knew to look on her lower leg, on the front of her shin because that's a traditional area where you look for painful points when somebody has that specific type of abdominal pain.

So trigger points are new in that they're based on modern anatomical knowledge and it's a different system than they teach in acupuncture school but there are some similarities and overlap. So I hope I answered your question with that kind of long rambling.

Jonathan: Totally. The reason I asked - and I don't want to make this about my own issues - but maybe anecdotal evidence and case and some listeners might have a similar thing. I have these spots along my spine where if you just barely touch it on either side my whole back will twitch, almost jump, but it's not painful. There's literally no pain involved. It's very strange, just a contraction without pain. That's the reason I asked because they seem to move. It will be here one day and there the next and I wondered if that was probably more related to the inflammatory response to whatever trigger points might be developed from that.

James: That makes sense.

Jonathan: Of course I'm not asking you to diagnose me over the air. {laughter}

Doug: You're going to have to go down to Rhode Island.

Jonathan: Yeah, I know. It's really fascinating. Speaking to the theory behind the M-Test, have you guys ever tried or are you familiar with hanging? Just hanging by your arms?

Linnéa: Yes.

Jonathan: Okay because that seems to help me a lot.

Linnéa: Oh, hanging by your arms! I know of inversion therapy type of hanging, but hanging by your arms I'm not very familiar with.

Jonathan: It was suggested to me by my chiropractor to just hang for a few minutes at a time and it's incredible. It's my new thing that I'm obsessed with.

James: Oh cool.

Linnéa: Just from personal experience I think it feels really great. It can relieve the pressure, especially if you've been sitting a lot on your sacrum area and open up your back and open up your shoulders.

James: Is it kind of like a Monty Python scene where they strap you in and then raise you up and play some sort of music? {laughter}

Jonathan: You've got to be able to get out of it of course. I have one of those chin-up bars that rigs up to the top of a doorway and then I have a set of these really long exercise elastic bands that are two inches thick and I'll run one of those bands through the chin-up bar and then loop my hands through either end of the band and then just let myself come down until my butt hits the floor. I can still stand up from that position but I can also relax and allow the pressure to come onto my arms and shoulders.
If I do that for a few minutes I can feel muscles moving and working themselves out. It's pretty wild.

James: Yeah, that sounds great.

Jonathan: And I've heard that it can be used to treat bursitis and other shoulder conditions. The evolutionary theory behind it - if you give credence to that - that chimpanzees are swinging and using their arms as their primary mode and method of moving around and taking force and that now we are, like you said, sitting in front of computers or sitting in cars and just generally being less active, that we're not getting that - for lack of a better phrase - evolutionary requirement for force on our shoulders. I don't know much more about it than that but I will say it seems to help me.

James: It sounds like fun too.

Jonathan: Yeah, it can be fun. Like you said with the M-Test, you'll start to hang and letting pressure onto the arms and the back and then it's like fire, like somebody stuck a needle in your back. So I'll hold that for a minute and I can feel it loosen and then I feel that wobble in the muscle. It twitches back and forth and then it lets go. It's an interesting process.

Linnéa: It sounds like a great self-treatment.

Jonathan: It seems to work so far. We'll find out. So when you said inversion therapy, my brother-in-law does the inversion table thing and he finds that helps him a lot. Do you guys use that in your treatment at all, or have you ever done it?

Linnéa: Oh I use it more in my life as a yoga teacher and practitioner. I have what's called an OmGym and I can hang upside down in it and I can do certain stretches and I really enjoy that.

James: I tried one of those inversion tables one time and I didn't know how to use it and strapped my feet in and went upside down and then I couldn't figure out how to get out. {laughter} My friend thought it was hilarious and just left me there, walked out of the room. So I was stuck there for a few minutes and that's my only experience with it. But I did feel great when I got up because of all the blood rushing to my head. So sometimes I do just legs up against the wall, especially at the end of a long day, been on your feet all day or something like that, just lay down, put your butt up against the wall and get your feet up the wall. Because of the way our veins work, it's really a great way to drain the blood and lymph fluid out of your feet and legs and get more oxygen into your brain and give all those veins in your legs a break for a few minutes. And you feel good when you get up.

Jonathan: That's interesting. So to get the blood moving through your legs walking is beneficial, get out for a walk, but you would also want to do this, where you're letting the blood come out of the legs in that sense.

James: So anatomically the veins in your leg have valves every so often. They're one-way valves, these flaps because your veins have to fight against gravity. Your heart is kind of a pump and it regulates the circulation in your body. Every time your heart beats all of the arteries, the muscles, contract to narrow the flow to help move the blood. So basically your heart and all of your arteries and everything work together and then the veins in your leg have to fight against gravity. So they have these one-way valves to help get the blood back up your legs and up into your abdomen and to your heart.

So by going upside down it makes it a lot easier and gives those one-way valves a break. Also, we have to move in order to move the lymph fluid through our body. Because blood's really easy to see. The veins and arteries are really easy to see so the circulatory system has been studied very thoroughly whereas the lymph system, because the fluid is more clear the lymph is kind of mysterious. It lives in the interstitial spaces and in the connective tissue. It's kind of like the fascia. People are just starting to study it. Lymph fluid relies on muscular contraction and movement in order to flow properly through the body. So by flipping upside down, you're helping out by letting gravity do some work. Anyway, that's my line of thinking with it.

Jonathan: I've also heard that just jumping on one of those small four-foot diameter trampoline for a few minutes a day is good for that.

Doug: Yeah, the rebounders.

James: You're really speaking Linnéa's language now. {laughter}

Jonathan: That seems like fun too.

James: Yeah, she'll jump on the trampoline then get in her OmGym and flip around on the ceiling and do some yoga and I'll just be laying on the floor with my feet up the wall the whole time. {laughter} Trying to figure out how I can read a book upside down.

Jonathan: What do you guys think about other self-treatment tools? Are you familiar with the backnobber? It's an S-shaped, very hard plastic tool that you can use to find a pressure point in your back and then put pressure with this little ball on the end.

Doug: I didn't know it was called that.

Jonathan: It's maybe a brand of it. I'm not sure what the type of tool is called. But my curiosity is, would you recommend that for people or try to get a diagnosis from somebody else before you try that so that you're maybe not hitting the wrong places or doing something that's damaging your tissue on accident.

Linnéa: My opinion is that nothing replaces human touch, but definitely I think that that can also be really useful for people and if they can find relief from using it and it's helpful, awesome! Keep doing it and at the same time if it's something that keeps cropping up and is really causing a problem I think there's no replacement for having someone else look and evaluate what's going on because there are definitely things that we can't see, especially on your own back it's difficult.

James: There are lots of things like that, self-massagers. There's the back knobby thing. I think we have one and we've played around with it a little bit.

Linnéa: Yeah, I liked it.

James: Little massage tools. You can use a tennis ball or a lacrosse ball, roll around on it. That's something that I made. I taped two lacrosse balls together, so you make a peanut shape and then you can put it so one ball is on either side of your spine, roll along the floor.

Linnéa: I like the Miracle Ball even better. I don't know if you've heard of that.

James: The Miracle Ball is really great. There are these mats that are about 2-foot by 4-foot and have all these tiny spikes all over them.

Doug: Oh yeah, I've got one of those.

James: It looks almost like a torture device but you lay on it and it stimulates your skin and all the acupuncture points. We actually have experimented with lots of devices like that because it's fun and it's a good way to explore your body and also because we want to know what works for what and what to recommend to people for self-care. So I think that those kind of things are great. My main advice to people would be to be careful not to overdo it. It's easy with that backnobber thing to start wailing on your back and give yourself a bruise or something like that, which is fine. That's the main thing; start slow and try to approach it with curiosity and ease into it and don't overdo it.

Linnéa: That's coming from someone who sometimes overdoes it. {laughter}

James: This is something I've had to learn, yeah. It's a hard lesson.

Doug: Speaking of devices, there is a question in the chat here, "Do you guys use cupping therapy?"

Linnéa: Yes! Definitely. I love cupping therapy. I love receiving it and I love giving it. I'm not sure if you're curious about how it works.

Doug: Sure.

Jonathan: Yeah.

Linnéa: The short way that I describe it to people is that it's like a reverse massage. If you think about massage putting pressure into the muscle, this is pulling and creating suction. It's also a way to pull up - we've been talking about metabolites and sticky tissues. In Chinese medicine it's very important to have good blood flow so when blood stagnates or when there's blood stasis in the tissues and things aren't moving well the cupping will create a very dark, what looks like a bruise and it can almost get towards purplish when it has been stuck for a long period of time. Then slowly as the therapy does its work the marks will get lighter and lighter and tend more towards red and pink.

This can actually show how severe the blood stagnation is in the area and usually more blood stagnation will mean more pain. On people who have a really severe case, the cupping will actually hurt, especially if it's moving cupping. So we'll use oil, we'll create the suction and then we'll slide the cup back and forth, usually the back is a common place.
I've had people have it really hurt and you have to do it pretty lightly to start if they have a lot of stagnation. But on people who don't have so much stagnation it can feel really good. It can prevent stagnation from building up.

James: I really love it. It's very safe and it feels really good to me. People have different pain tolerances. Go ahead Linnéa.

Linnéa: I was just going to add it stimulates the body to heal the area too. So if you think about a bruise, your body sends in all kinds of - I don't know exactly what, I'd have to look at all the scientific names - but cleans up the blood, brings in fresh blood and heals the bruise. So it stimulates a healing response and that's part of the therapeutic effect.

James: Traditionally it's kind of a home remedy in China. A lot of people know how to do cupping. There's another therapy called gua sha or scraping. There has been some more modern research done; it's really good because it pulls these metabolites out of the muscles and into the space between the muscles and the skin. It helps the body to eliminate them more easily. It's lactic acid and other things as well. So we commonly do it on our backs a lot because of a Chinese medical theory that environmental pathogens invade through the back more commonly. But I think in modern times we hold a lot of tension in our backs because we sit so much and the muscles have to hold a lot. They're tense most of the time so there's a build up over time of lactic acid and other metabolites from the muscle contraction.

So the cupping both pulls the skin layer away from the muscle which is good if you have adhesions between the skin and the muscle. Ideally you want the skin to be able to slide over the muscle layer easily and, going back to the M-test, that has a lot to do with the theory behind the M-test. Ideally we have freedom of movement because the skin is like the sheath that moves over the muscles and the muscles move under the skin and if there are places where the skin is stuck to the muscle layer below it, that causes a restriction that can interfere with movement. So the cupping loosens the skin layer from the muscle and also pulls all the stuff up from the muscles into that space and then it makes it a lot easier for the body to remove it.
Nowadays you see a lot of athletes using it. For anybody who watched the Olympics you probably saw Michael Phelps use it and a lot of the Chinese athletes. For many years they've had these round purple things.

They look like they got attacked by a giant octopus or something. {laughter} They do it to speed recovery. They're in the pool all day swimming and they get out of the pool at night and maybe something is sore and they get a massage and they put the cups on to pull the stuff out of their muscles so that their muscles can recover faster.

You can learn how to do it at home. I don't want to put any acupuncturists out of a job. If you do have an acupuncturist you can ask them about this, but they do sell pretty basic, simple cupping sets on Amazon and there are videos on YouTube. Like lots of things it's not something that's regulated by any kind of laws that I'm aware of.

Linnéa: At least not the pump cups or the silicon cups.

James: There are several different kinds.

Linnéa: We're trained to do fire cupping in acupuncture school which is a little bit more involved and also it creates a warming effect when you're doing it but it's not necessary to have the warming effect, but it's nice.

James: So if you want to try it at home I would say you can get a set of cups on Amazon or somewhere. There are pump cups where there's a pump gun and they're plastic or glass and you put the cup on and pump the gun and it sucks the air out.

Linnéa: And they have silicon ones you can squeeze, put down and then let go.

James: Yeah, you press it down on the body surface. So it's the same kind of thing with the other self-treatment tools. In this case you probably need help. Do your research, start slowly.

Linnéa: I have one patient who does cupping on herself regularly as a self-care between treatments.

James: It's almost started to be a cool thing actually. When we were at the airport I think, on the way over here, we saw somebody who had cupping marks on her back. Who knows why, but I thought "Oh." They're really easy to spot because they're circular.

Doug: Guys, we actually have a call. Do you want to take a question?

James: Sure!

Linnéa: Sure.

Doug: Hello caller. You're on the air.

Jenn: Hello, my name is (noise).

Doug: You need to turn your volume down.

Jenn: On my microphone?

Doug: No, on the speaker.

Jenn: Is that better?

Jonathan: Do you have headphones?

Jenn: Yeah. I've got headphones. Hang on a sec.

Jonathan: We'll make it work.

Doug: Yeah.

Jenn: Can you hear me now?

Jonathan: Yes.

Doug: Much better. No echo.

Jenn: Hello. Basically I wanted to give some sort of anecdotal evidence for cupping. I did a quick course about six months ago and then I bought a set of pump cups and sometimes I do care work so I'm often over-stretching, over-reaching, bending down to pick things up. It wasn't like a major injury, but I felt like I just overstretched and my shoulder was aching and it was going up into my neck. So I asked my partner to put all these cups all over my back and give a quick massage first and they went very dark in colour and they were quite, not sore, but they were tender for the day after but then after that the pain in my shoulder and neck had completely gone. So I was just amazed, I really was.

Linnéa: Wonderful!

Jenn: So that was it really.

James: Well thanks a lot for calling and sharing your story. That's awesome.

Jenn: Thank you guys for doing this show.

Jonathan: Thanks for sharing. I had a similar experience. We've also got a set of those little silicone push-button cups and we'll rub coconut oil on the skin and do that, so the suction is better and then you can move it around. But the first time I did it, it hurt like - insert expletive here - and it left really black circles so I'm sure there was a lot of badness in there. But subsequently since then it's gotten better and better and now I can do it where there's no pain and it'll just create a reddish/pinkish circle. So I can totally attest to that.

Linnéa: Yeah, that's a very typical progression. That's great. You've done it long enough to see the changes.

James: For anyone out there who's never tried cupping and you're thinking about trying it, you don't have to do a no pain-no gain approach.

Linnéa: No, no.

James: You can always ease off on the suction a little bit.

Linnéa: I just had a patient last week in Rhode Island where it was very painful. She was "ugggh", off the table. She couldn't bear it and it was very easy for me to lighten the pressure and then she enjoyed it more. It's easy to work your way up and do it that way.

Elliot: I find with the cupping - just to quickly give my experience - I really like the pain aspect of it. {laughter} Sometimes when I'm laying on the table and we've got the pump cups and on the little sheet that comes with the cups it says that you shouldn't use any more than two pumps but sometimes I like to have three pumps. {laughter} Like in the small of my back. {laughter} But I go there and it really hurts, but sometimes it feels like an elephant on my back and I leave it there for 10 or 15 minutes, but it's just utterly bliss. It's absolutely amazing. There's no way that I think I could ever get that from a standard massage.

Linnéa: Oh totally.

Elliot: Because it's just a completely crazy sensation and there's nothing quite like it. So I'm a massive proponent of that. I think it's really good that you guys incorporate that into your practice.

Linnéa: Totally! I definitely encourage people to push their edge a little bit because you will see more results when you get that little bit of "uuuggghhh, it feels uncomfortable".

Jonathan: Yeah, I've been doing that with hanging too, where I put it out, do five minutes, then do 10 and then maybe just put on a podcast or something and see how long it can go. Yeah, it's fascinating.

Doug: With that said Jonathan, you are a guy who has a history of maybe overdoing things a little bit.

Jonathan: Yeah, James, you and I are kindred spirits in that regard.

James: Yeah, I think we're comrades there. {laughter} I have to slowly teach myself, "Okay, my body actually likes it better if I make small, incremental changes instead of 'I think I'll go to Crossfit twice tomorrow and twice the day after that'."

Jonathan: Yeah.

James: Then I can't walk for two weeks.

Jonathan: More is always better, right?

James: Exactly. {laughter} If cupping is good then I should have cups on my back all the time. {laughter} And pumps.

Jonathan: Do you guys have anything that you'd like to promote? Your practice or a website or anything that you would recommend that our listeners check out?

Linnéa: I wish I had my website out but it's still in progress. I do have an Instagram account that I keep up. It's called moontime medicine and I do enjoy posting there and there are little bits of information about my practice or about things that I'm experimenting with or that I find useful or self-care practices, that kind of thing, that I post there. I am currently working at Keystone Family Acupuncture in Rhode Island. So that's it for me for now, but more to come.

Jonathan: Awesome.

James: I was at...

Jonathan: Sorry. Was it Moontime Medicine?

Linnéa: Yeah. Moon Time Medicine. I've been kind of focused on women's health and so Moontime is a way to refer to menstrual period and I've diverged from that. It's not completely focused on that so it's great for men and women, but maybe a third of the posts are about remedies for menstrual cramps or other women's health-related topics.

James: You also talk about Chinese herbs and formulas and other things too.

Linnéa: Yeah.

James: Gua sha. That was one of your most popular posts so far.

Linnéa: That one went viral.

James: I did gua sha on Linnéa and took a picture of it and she picked up 30 followers or something. I have a personal website that I'm ashamed to say I haven't updated for a long time, jameslovinsky.com that I need to update and I have some other projects I'm working on. But I don't have anything to promote right now. Maybe in the future. I have some leads in Rhode Island, so I'll probably be setting up shop soon.

Linnéa: Eventually we're hoping to open a clinic together. So we're getting a couple of years experience in separate clinics and seeing what we like and don't like and then we'll move forward from there. James is working on a website too that's for hair mineral analysis which is also something interesting, a totally different topic, but there may be some kind of link or posting about that on his website in the near future.

Jonathan: Cool. James, what was your site again?

James: jameslovinsky.com.

Linnéa: Lovinsky is l-o-v-i-n-s-k-y.

James: Yeah, people are going to go on there {laughter} and see a couple of old posts about acupuncture and there's an updated RSS feed for SOTT.net at the bottom and a weird picture of me because I haven't updated it with my professional photos yet.

Jonathan: Maybe we can motivate you to...

James: Yeah. I'm motivated now.

Linnéa: It's good motivation.

James: Next week when I get home I'm definitely going to update it. So wait until next week to look at it.

Linnéa: Thank you very much.

James: Thanks a lot for asking Jonathan.

Jonathan: I think we're at a good place to wrap it up. It's been a great show. Thank you guys very much. It was really fascinating.

Linnéa: Thank you.

James: Thanks a lot. You guys really asked great questions.

Doug: You guys are very well informed so it's good to pick your brains about stuff.

Jonathan: I've been thinking for some time that I really needed to actually start acupuncture in earnest and so this is probably the turning point for me.

Linnéa: The motivation for you too.

Doug: Yeah.

Linnéa: We'll get our websites running. {laughter}

James: So one parting piece of advice is that just like you would if you were going to start psychotherapy or see a therapist, you'd want to take your time and find somebody that you jive with. Try out a couple of people. If you're more into cognitive behavioural therapy approach or Jungian approach, take your time. If you have options, shop around a little bit because it matters a lot who the therapist is. I'm sure you know that.

Jonathan: Are there any credentials that you'd recommend keeping an eye out for, or specific schools?

James: Yes. Ask where they went to school if you're in the United States.

Linnéa: How much training. Some people take weekend courses or 30 hour courses, that kind of thing.

James: If they're in the United States and they're a licensed acupuncturist, then they have a lot of training. There's a national accrediting body called NCCAOM (National Certification Commission for Acupuncture and Oriental Medicine). On their website there's a "find a practitioner" page. You can look on that website. If you find them through that website then they'll be very well trained and credentialed. If you search for acupuncture Michigan then there's probably an acupuncture association in Michigan or email or call them and they could recommend someone in your area.

Jonathan: Sure. Liz Ross who was on our show before...

James: Of course.

Jonathan: ...actually lives in the same area. So I've got that nailed down.

James: You're all set.

Jonathan: But for our listeners, I'm sure a lot of them live closer to a metro area and probably have a lot of options available. I don't know what a lot is, 20, 30, 40 acupuncturists in places like Houston or Los Angeles. Or more.

Linnéa: Sure. Definitely it varies by state.

James: Yeah, how to choose. I would pick a couple and call and see what the front desk person is like, drop by the shop.

Linnéa: Some people will offer a free initial 30 minute consult to get to know whether there's a fit. But not all good practitioners necessarily offer that.

James: I think in countries besides the United States, like in the UK for instance, it's not regulated the same way. So it would be more important to ask what kind of training they've had and where they went to school, that kind of stuff. In the US you have to get a licence from the state so just make sure they're licensed I guess. That's the main credential.

Jonathan: Right, and commonsense.

James: Yeah, exactly.

Linnéa: And then follow your gut.

James: And if you have a bad experience of if the treatment they give you doesn't work for you, it doesn't mean that acupuncture doesn't work. It means that that person didn't work for you. So give it 5 or 10 treatments before you give up on it, I would say.

Jonathan: Cool. Alright guys. I think that's it. Thanks again. Let's wrap it up. I hope everybody has a really good weekend and thank you for participating in the chat, those who did. And be sure to tune into the SOTT Radio Show on Sunday, noon eastern time. Go to radio.sott.net for your local air time. Bye.

All: Byes.