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Climate change and TCM

Whether climate change is an acute crisis brought about through human behavior or an as yet little understood natural cycle there will be implications for our health, even the fear of  it can have an effect. The prospect of tropical diseases becoming  active in previously sub-tropical environments is one of the more obvious possibilities not only for people but for plants and animals too, whatever effects our agriculture impacts on us . If we were to properly study how our attempts to control our own environments impacted on our health we may be surprised, air conditioning is a good case in point. Even though air conditioning has been with us for decades now we still have not come up with a system that can be kept germ free past the twenty year mark, keeping hospital infection rates down is difficult for this reason alone. How ironic it was when CFC’s in our refrigerators and airconditioners were found to be effecting our ozone layer.

Long distance air travel often exposes us to sudden climatic change too, perhaps some of what we experience as jet lag may be a bit of climate shock effecting the body in a weakened state from body clock interruption. Climatisation is thought to usually take a healthy adult about two weeks when they travel to a place with a different climate to home. When a person  lives in a cold climate they acquire better immunity (all other things being equal), but lose their extra natural resistance after several weeks in a warmer climate.

In Traditional Chinese Medicine (TCM) the last two weeks of the current season and first two weeks of the next is called “doyo”, doyo is considered to be like a lunar year (one callender month) of transition from one season to the next. Many herbal, acupuncture and even chi gong practices are oriented to not only observe the current season but the next also, in all five seasons- summer, autumn, winter, spring and doyo* (in four parts).

There are no doubt other traditional medicine practices around the globe that innovatively and effectively deal with severe weather, in Russia for instance kindergarten children are marched bare foot in circles through tubs of icy water just  before winter hits and few children seem to get colds later on.

Maybe too many of us urban dwellers just don’t go outside enough anymore, we now know that not everybody gets enough vitamin D from sunlight so in a sense climate induced disease (and the fear of it) is already with us but we are only starting to notice it. Some urban and city environments because of the orientation of their streets and buildings create some very unpleasant wind tunnel effects and not much sunlight falls to the ground in high rise areas in winter time, making them fashionable climate ghettoes.

I have never had a client ask me to tune them up for the next season with acupuncture but I treat plenty whose problems are in some way connected to climatic factors, even the wind entering your car window on a still day creates a very localised wind that your body can react to, weather is not what it used to be for many reasons.

Climate, Health and TCM III

Heat, whether it comes in the form of an unseasonably hot day in a cooler month, during normal summer weather or as a result of a hot  artificial environments has  health significance in TCM. People are considered to be more accident prone, have headaches more often, suffer “hot-blood” conditions like psoriasis, suffer more from cardiac conditions, febrile diseases and insomnia, when exposed to heat and hot weather.

Psychological illness can be exacerbated in the heat too, people tend to be more manic and excitable when it is hot and crime waves have been known to correspond with heat waves. Many become reckless in the pursuit of having a good time in summer, in TCM summer is the season of accidents. Just as the heat can quicken your pulse, so too do “heat causing” food and drink like alcohol, coffee, chilli, chocolate and drugs that rev you up like ice and speed. In Summer time people are more sociable, venture  into nature and celebrate alot. In Australia more babies are born in August and Serptember than in the other months of the year, in TCM Summer is the season of joy.

People who dislike the heat often have a tendency to suffer from the energy states listed above just as people who prefer summer to winter often find that things like their osteo arthritis and blood circulation worse when it is cold. There is a feature of perceived heat in TCM too, where a “full heat” condition like heat stroke, hyperthyroidism or malaria does raise your body temperature, “empty heat” often does not.

In TCM empty heat is viewed as a condition caused by deficient body fluids rather than a fever, in my time as a nurse I encountered quite a few elderly people who would kick their blankets off and complain of feeling too hot even when the air temperature was not particularly warm.  These poor souls often looked emaciated (due to chronic dehydration) and were flushed across the nose and cheeks (malar flush). They even looked dried out  but would rarely drink water when it was offered, much to the frustrations of the nurses and doctors looking after them.

Empty heat (Yin deficiency) can be experienced by younger people too in the form of AIDS and Lupus. Whether heat is full or empty when you suffer from it it makes it hard to properly relax and be still. Burn out from living a frantic life style for too long is regarded as a heat condition in TCM also.

The five pernicious climates (cold, damp, dryness, wind and heat) interact with each other, heat and damp cause “hot damp” conditions- high humidity during monsoon can literally drive people mad who are not acclimatised to it because the moisture in the air will not allow your sweat to dry and cool you. When cold and wind combine the cold and flu season starts and wind dryness plays havoc with allergy sufferers.

In TCM so long as the transition from one season to the next is gradual rather than sudden and weather extremes do not occur we adapt and are less susceptible to illness.

Sprains and Strains

The main difference between a sprain and a strain is that strains are injuries that are confined to the muscle and sprains effect the other soft tissues around the joint as well as the muscle.

Both can be painful but strains do not effect the stability of the joint where sprains do. A strain can tear a muscle and cause restricted movement but fortunately muscles have a rich supply of  blood and therefore oxygen which means they heal faster than sprains do.

Sprains by definition can not only tear muscle but also damage the ligament, tendon and cartilege, these tissues have a poorer supply of oxygen and take longer to heal. Muscle is red because it has alot of blood inside it, ligament, tendon and cartilege are white because they contain less blood.

Sprains are graded according to the severity of the damage done, a grade 3 sprain is a complete disruption of stability of the joint where the ligament is torn away completely, when this happens to your knee good early splinting may be enough to set it on it’s course to healing but if this doesn’t work surgery may be the best option. A grade one sprain on the other hand does not disrupt the ligament and can be indistinguishable from a strain. Grade 2 spraining is in between one and three, partial ligament damage causes slight instability and if you are careful not to re-injure yourself will generally not require surgery.

Sprains to the ankle are one of  the most common and although they can be severe you have a better chance of avoiding surgery than an equivalent knee sprain.

Ice packs to your freshly sprained joint or strained muscle is usually good first aid, anti-inflammatories can help too just remember that though the pain is diminished the damage is still there so an immediate return to the activity that caused it is unadvisable.

Interferential, ultrasond and laser acupuncture directly to the injured area can be effective treatment. Massage, acupuncture, osteopathy, physio and chiropractic can be used on the injury site when the inflammation fades (when redness, swelling and touch sensitivity subsides) and can be used to contain the problem in the short to medium term.

Ignoring sprains and strains will not make them go away unless it is only mild damage,  when you are limping and favouring one side the other leg joints on both sides of your body are used more and in a lop sided way. If your knee, hip or lower back starts to inexplicably become stiff or painful weeks or even months after your sprain or strain there is a good chance it could be related.

No matter what therapy you choose a practitioner who takes a “global” approach protecting your other leg joints will help you most.


The bursae are small fleshy sacks filled with fluid that help our joints move smoothly and absorb shock. If you think of bursa as a zip lock bag with a small amount of oil inside and no air and then rub it between your hands, your hands will easily slide against each other and this is how bursa work. There are about 160 individual bursa in your body and they are found near your joints where muscle and tendon slide against each other and over your bones, without bursa your joints would creek and grate within.

Like many other musculo-skeletal problems in the body bursitis is often age related and seems to effect women more often than men. The symptoms of bursitis may include swelling and inflammation in your joint but the main one is pain that is made worse when you press against it. Bursitis is not like that “good pain” feeling that you get when a stiff muscle is rubbed, it is aversive to the touch. Bursitis may feel like arthritis but strictly speaking it is not because it does not primarily effect the joint capsule.

Because bursitis can be age related it may manifest with other musculo-skeletal diseases, so if you doctor has told you that you have it but your symptoms are slightly different from those described here that might be why.

Bursitis is caused by repetative strain injuries, cumulative muscle micro trauma, having one leg shorter than the other, arthritis, standing for long periods, accidental trauma and poor posture. Good old fashion neglect won’t help you either, being generally unfit will not help your bursitis nor will poor water consumption.

When your bursitis is very acute doing any exercise may be painful but when you are in your normal day to day living with bursitis routine, regular stretching exercise is a great idea. Ultra-sound, friction massage, ice packs (4-5 times a day), rest and anti-inflammatories can all help relieve the symptoms of bursitis.

In serious cases of bursitis that do not respond well to other measures, fluid may be aspirated via a needle to relieve pressure inside your effected joint. This type of therapy can be effective  thougfh a little on the uncomfortable side, if you try the gentler options first aspiration may be unnecessary.

I have always found massage to be effective on bursitis (Self Massage too), not so much on where the bursitis pain is actually felt but the muscle attached to the particular tendon that the bursae is cushioning. For instance when a person has hip bursitis you will find thigh muscles not far from the pain site that need to be loosened and stretched. Bursitis usually results from the over use of particular muscles.

Shin splints

Shin splints is a painful condition that does, as it’s name suggests, effect our shins. In the early stages of shin splints you may only notice a sporadic discomfort when you walk or run but as it worsens the frequency and intensity of the pain increases until it becomes impossible to ignore. The pain is felt along the edges of your shin bone (tibia) and your fibula the smaller bone in your lower leg. Shin splints have three different causes.

* Flat feet (collapsed arches)

* Running on hard surfaces like the road (and worse still if your running shoes are worn or of poor quality)

*Tight calf muscles (which can also cause plantar fasceitis on your soles)

Shin splints are a form of cumulative muscle micro trauma that effects where the muscles attached to  the fibula and tibia and the fibrous tissue joining these two bones (called your interosseus membrane),  become traumatised and inflamed. Shin splints can also effect the bones themselves.

Shin splints are common in long distance runners and in  other high impact exercise that works your lower legs hard, like aerobics and netball. With each stride you take when you run the muscles in your lower legs can absorb 2 to 3 times the force of your normal body weight because the muscles absorb the force of your downward momentum. This is a type of negative contraction, negative contractions can strengthen your muscles quickly but do so at a cost to your body. Running down hills and rapid changes in the distances you run and even in the surfaces you run on can also make you more susceptible to shin splints.

Shin splints are more likely to happen if you allow your leg muscles to tighten through an absence of good quality stretching and never getting soft tissue therapy such as massage.

Rest, ice packs and anti-inflammatories within the first 48 hours of injury will lessen the symptoms, after this time therapies such as ultrasound passive mobilization, stretching and manipulation will help you recover. If the cause of your shin splints is flat feet (foot pronation or collapsed arches) foot orthotics continuously worn in your shoes will help with your structural problem.

Your calf muscles (gastrocnemius, soleus,  tibialis, peronius) do alot of work, whenever you walk, run, climb or dance these muscles are constantly engaged and tend to suffer from neglect. It is rare for people getting a general massage to ask to have their calves worked along with their neck and back, even though their calves do more work than most other skeletal muscle in the body. Some people dont like having their calves worked because they get too sensitive, if you are having a massage and the pressure that the masseur or masseuse is using is too hard for your calves ask them to go softer rather than completely avoid them altogether, because they are sore for a reason and need attention.

If you Self Massage it is completely up to you how much pressure you use.

When the shock absorbers on your car wear out you replace them, you cannot do this to your body’s shock absorbers.