Tag Archives: Acupuncture malpractice Insurance

Tibial Stress Syndromes (Shin Splints) – Callison/Lau

“…we’re from ACU Sport Education and the Sports Medicine Acupuncture Certification Program. Um, we’re going to talk today about tibial stress syndrome.”

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello everyone. Welcome to our sports acupuncture webinar. My name is Matt Callison. I am Brian Lau. We want to thank the American Acupuncture Council for sponsoring our, our sport, our sports acupuncture webinar here. Uh, we’re from ACU Sport Education and the Sports Medicine Acupuncture Certification Program. Um, we’re going to talk today about tibial stress syndrome. So let’s go to the first slide please.

So since spring has sprung and we’re quickly approaching summer, we’ll start to see patients that are coming in with a tibial stress syndrome or the layman term for this being shin splints. Uh, people are trying to be able to get in shape. And so this is a common, very common overuse injury. So, uh, Brian, we’re chatting just last week. We, uh, we just published our module three lower extremity online recordings through net of knowledge. And we were talking about what we could actually grab from that since it’s so fresh in our minds and tibial stress syndrome was, was the first thing that we thought about. And so this is actually a, uh, it’s a fun topic because it is something that most of us most acupuncturist to see clinically. And there are some techniques that we have found work extremely well for this. So, uh, before we jump into the first slide there, Brian, do you want to say anything or do you want to go right into medial stress syndrome?

Uh, I’ll say something simple and that is, uh, this particular topic is one that I’ve dealt with, uh, not for a long time, but when I was in high school, I was a wrestler and we used to do a lot of drills on a hard floor running drills and these wrestling shoes that had zero support. Um, they’re not, you know, they’re designed to be on a mat, right? Not on, uh, not for running shoes, but sometimes being young and stupid. We were lazy and just wore the same shoes as we went out and did running drills and exercises and sass. I remember at the high school, this was, uh, something that I didn’t have horribly, or it stopped me that it was quite painful. So I know this one personally, uh, fortunately I haven’t dealt with it for, uh, most of my adult life

Midnight. And then that I’m ready to roll. All right. So should we go to the next slide and Brian, you want to take it away?

Sure.

As Matt mentioned, that student’s lens is kind of the layman term, uh, for medial and anterior tibial stress syndrome, I’m going to start the discussion talking about medial tibial stress syndrome. So that’ll affect the, the sort of medial side of the tibia, and we’ll look at the anatomy and kind of mechanism of injury for that. Um, and then, uh, I think Matt will take it, uh, from anterior

Tibial stress syndrome, but collectively people refer to these as shin splints. Um, it’s an overuse injury inflammatory condition that involves micro tears and either the myofascial origin. So the tibialis anterior that would be for the anterior tibial stress syndrome or the tibialis posterior for the medial tibial stress syndrome. Uh, those muscles are along the shaft of the tibia. So let’s, uh, go to the next slide and we’ll jump into medial tibial stress syndrome. So immediate tibial stress syndrome, uh, the pain and tenderness is found on the medial really at the posterior medial aspect of the tibia, you know, on the sort of the yin channel side of the leg. Um, so on the medial portion of the tibia, just really on that most posterior aspect. So that would be along the liver channel. Um, and we’ll talk a little bit about the channels on this slide, but, um, it’ll be usually the pain is, is level with the area between spleen eight and spleen six.

That can be a little less than that. It can go beyond those boundaries, but that’s the typical region that it covers. Uh, so that’s the area that people will tend to have pain that they’ll, um, they’ll be complaining about, um, in terms of channels. When we get later in the presentation, we’re going to be looking at a myofascial release technique. We’re gonna be looking at an acupuncture, of course, but then we’ll also look at the myofascia release technique. And in that, uh, particular associated technique, it will be in reference to the spleen, send you a channel. So this injury and the pain is a long that distribution of the liver channel, but the channels, aren’t just a line along the body. You know, they’re not only on the surface, so to speak, you know, we’re taking a needle or we’re penetrating the skin and where that needle goes can be, they’re either more deep or superficial.

So if we were just to glance at this image from mats, a text, a sports medicine acupuncture, um, and look at the arrows, the arrows are pointing to the tibialis posterior muscle, which is what attaches to the posterior surface of the tibia. And that’s, what’s going to pull excessively, or when it does pull excessively on the tibia and you create little micro tears there, that’s going to be what contributes to the medial tibial stress syndrome. But if we look at where those arrowheads sit, not what they’re pointing to, they’re pointing to tibialis posterior, but where do they sit? There’d be another muscle there. Um, that’s not shown in this illustration because it’s, it’s highlighting the relevant anatomy of the tibialis posterior, but that muscle that’s just medial to the tibial. The tibialis posterior would be the flexor digitorum longest. And then if we go lateral on the other side and the lateral side of tibialis posterior, it would have flexor hallucis longest.

But if we come back to that medial side where those arrow had CIT, uh, that would be flexor digitorum longest, that’s actually part of, as we define it in sports medicine, acupuncture, part of liver sinew channel, whereas the tibialis posterior a little bit more anterior, um, and a little bit more in the middle part of the tibia, you know, lateral to the flexor digitorum longest is the tibialis posterior as part of the spleen sinew channel. So depending on the depth that the needle is reaching, uh, we’ll also determine really which at least from a sinew channel perspective, what, uh, uh, channels being, uh, affected. Uh, so we’ll look at, at that aspect as we’re doing the myofascial release technique and we’ll discuss it, um, also, uh, in terms of the channels when we get to the acupuncture portion, but just a heads up, and I’ll re refresh that when we get back to the myofascial release techniques, but this one’s talking about the anatomy and that’s the tibialis posterior, that’s what the arrows are pointing to note that the tibialis posterior comes down, the leg becomes a little bit more medial around spleen six, and then look at how it attaches onto the foot and how much of a support mechanism it creates on the arch of the foot.

It’s really the Keystone muscle for that. Uh, at least from an extrinsic, from the muscles that are in the leg for creating arts apart in the foot. Uh, so I kind of think about the aspect of how the spleen can lift and this a spleen sinew channel muscle is really a prime lifter of the medial arch. And I, I see that as one of the spleen functions to have lifting, you know, in this case of the foot. So if we can go onto the next slide

[inaudible]

So a medial tibial stress syndrome, like we said, involves the tibialis posterior muscle commonly occurs, uh, occurs in individuals who are moderately to severely over pronated. Um, because of that line, Nepal, that we were just looking at how much that, um, tibialis posterior influences the lifting of the arch, when you’re going to the weight bearing and the foot hits the ground, there’s a normal pronation, you know, the foot, the arch is going to drop and that tibialis posterior is going to be elongated, but there’s normal. And then there’s, overpronation where it’s just like a flat tire. And that Tim posterior, it gets pulled really excessively long, probably a little bit in a more of a charring standpoint. So it doesn’t have that normal elongation where there’s a little tone there and it kind of checks, it keeps that, that, um, pronation and check, it keeps it from going too far out of the boundaries in this case, it just flattens.

So if you were to look at these images here and just glance at the runners, if we can see from the waist down, uh, notice which one of those, you know, they’re not all hitting, they’re not all in the, in the weight-bearing part of the gate, but some of them are which ones do you notice, or which one do you notice that really highlights that collapse of the medial arch? I’ll give you a second just to glance at that, but you can look at the front person, you know, th the, the weights falling to the medial arch that’s normal probation, but if you look at the person just behind him, right in the middle of the shot, um, it looks like I can’t tell what the number is 71 possibly, uh, with delusional shorts on yeah. Blue shorts. Um, you can see how much farther that person’s going into pronation and imagine that dropping of the medial arch and how accessibly that would be pulling on the tibialis posterior. Um, so people with foot overpronation is going to be a really key thing that you’re going to notice. That’s going to affect things like a medial tibial stress syndrome. Um, it’s very common with runners that accounts for approximately 13 to 17% of all running related injuries. So it’s a pretty big one. You’ll see it as the prime complaint, or at least a secondary complaint in your practice. Um, you know, frequently, if you haven’t already anything you wanted to add to this format.

Yeah. Brian, I just want to reiterate what you’re talking about with the spleen function being, lifting the tibialis posterior, or this is something that we talked about in December webinars through the American acupuncture council. It will be spoken about it has planets and the number of different injuries that can actually occur from that. And we actually spent a bit of time asking practitioners to look for, um, any time of earth signs and symptoms, spleen and stomach that may be actually contributing to some of the musculoskeletal pain, because with any muscle skeletal injury, there’s always going to be some kind of [inaudible] component, either that the organ and the channel has directly effected that or that the organ systems are deficient and not controlling inflammation very well. So there’s always some kind of [inaudible] component for the TCM practitioner to take a look at that. So that was the December, uh, webinars, something that you, you guys may want to check out on PEs planus, uh, Brian talk right now, but the tibialis post here. But if we look at that person with the blue shorts as well with the tibialis anterior, that will also end up being elongated with overpronation. So we’ll talk about the tibialis anterior, just a little bit, Brian, back to you.

Yeah. Yeah. And just the foreshadow that that’s going to be the stomach Cindia channel. So now we’re talking about spleen stomach and, and often how those correlate again, from a Zong Fu perspective, how frequently those, those two organs are so integrated, you know, that compared to other internal, external parents, those two are just like really functioned quite often together. And their disharmonies are often associated, um, both from a musculoskeletal, but even from his own food perspective. So I’m curious Matt, about the, the, um, long food perspective. I feel, you know, doing Chicano practice Tai Chi can be really any physical activity. If you take time to strengthen the arch in my mind, I feel like, and I see this to some extent play out though. It’s a little hard to, to test for, but, um, but I feel like you’re strengthening this lean channel. Sure. You know, at least the component that’s related to the foot, but I feel like that’s, that’s strengthening and calling on extra blood flow to that area, more communication with the nervous that that starts to be, you know, at least a component of, of strengthening tone to find the spleen. So even from his own food perspective, that, that, um, improvement of health for the floods can also have a, um, uh, regulatory effect on the whole system.

Yeah. And that’s through any channel, right? I mean, if you have a, um, excess gallbladder or excess excess liver and deficiency in gallbladder by exercising, the hip AB doctors and 80 doctors, it does help to balance that particular aspect. In fact, you can, you can feel the pulse prior to the exercises and feel maybe a sharp edge to a pulse. Some people would call that a winery recalls and then have the person do hip AB duction, 80, the options, and it softens the pulse. And that’s just one example. We could also talk about subscapularis and Terry’s minor, you know, again, but, but Brian’s point here is that how important it is to be able to prescribe exercises to your patient. And these are more webinars, isn’t it actually, how important is to prescribe exercises to be able to compliment your acupuncture treatment based on your differential diagnosis for TCM differential diagnosis? Sorry, Brian,

That’s good. Yeah, I think we’re ready to jump ahead. Next slide. All right. So some differentiation, because there’s more than one thing, uh, you know, fortunately, or unfortunately, fortunately, because it makes us put our detective hats on and makes life more interesting. Uh, there’s more than one thing that can cause pain in this region. Um, so if anytime, somebody comes in with pain and we just like, ah, medial tibial stress syndrome, uh, we’ll get it sometimes. And we’ll miss it other times because sometimes it’s not medial tibial stress syndrome and a common very, very close. I mean, you know, within probably less than an inch, uh, of, uh, uh, posterior to this where there’s going to be pain would be a solely a strain. So just off, you know, not up against the bone, but just off the, uh, the bone just posterior, um, there’s going to be a, uh, painful when there’s a solely a strain cause the soleus is a pretty wide muscle and it covers a lot more territory, both medial and lateral than the gastrocnemius.

So this would be, again, this is, uh, channels are a little odd in the, in the leg compared to the rest of the body because it’s along the spleen channel, but the soleus, again, as we have it defined and, and a sports medicine acupuncture would be part of the kidneys in new channel, but we’re on, you know, in this case, the pain that often is going to be apparent is really pretty close to that. Um, kind of most medial edge of the solely, as you know, this only has covers that whole posterior portion of the leg. So it’s a big muscle. And, uh, the bulk of that solely is really, it would be the kidney sinew channel, but the distribution of the pain is going to be really along more of this spleen channel, just posterior to the, um, often again in that region of spleen eight, but that through spleen seven, it’s probably not going to go down as low as spleen six. Um, so something to be aware of, you know, if you’re palpating to help confirm the pain and not so painful right up against the bone, but you back off, uh, what would you say Matt, about half an inch, an inch at the most? Yeah, yeah.

A quarter of an inch sometimes.

Yeah. And then that’s where, Oh, you know, that’s where the pain is. That’s you, you have your fingers right on it. That starts indicating more of a soleus, uh, uh, strain. And, um, it’s pretty close, pretty close in terms of their description of where it’s going to be. So something to look for, uh, uh, that can help differentiate the pain and that’s going to be a different channel correspondence. It’s going to be different, uh, uh, treatment. We’re going to stay with medial tibial stress syndrome for today, but it’s good to differentiate. Can I add something to that, right? Absolutely. Please. Yeah.

So we can use, this is something that we’ve talked about in the past before where we talk about it quite a bit actually is, um, acupuncture as an assessment. This would be when you’re in your assessment. Uh, part of the, um, treat of the clinic, uh, patient visits are for the patient visit and you’re trying to figure out, okay, this is a solely extreme, it seems like it’s going to be more painful. And it’s bound up in that mild fascial tissue about a quarter of an inch away from the bone. Um, we’re saying that it’s more of the kidney, mild fascial gene, Jen, but it’s also the spleen primary channel. Okay. So where’s the stagnation. Is it in the primary channel or is it in the soleus, mild fascial tissue? Um, in the kidney, what we could do is maybe needle kidney three, we can needle maybe kidney four as part of the assessment, and then go back to that soleus and feel if it’s quite a bit softer, is there less pain without patient to the patient?

If not, maybe we could needle spleen three and spleen four and see if that moves cheat within this plain channel and go back and out pate. That solely is, um, from my experience, it’s usually going to end up being kidney three, kidney four, and sometimes even kidney five that starts to take pain away from that solely us. But it’s nice to be able to at least put your detective hat on as Brian was saying and figure out actually, where is that stagnation? Is it more in the spleen primary channel or is it in the kidney gene, Jen?

Yeah, maybe we could just throw in an ashy point, uh, or if you’re a little more, have a little more finesse, maybe a motor point if you know the location for the soleus motor point and you’re going to get resolved, but you’re going to increase those results. If you link it with the channel and it start building a comprehensive picture and Madden this image, you can actually kind of see it. You know, we, we highlight this in our cadaver, um, classes, uh, uh, we look at it on a, on a cadaver specimen and you can really see that. Um, but this even just in the image here, you can see it quite well because if you follow the soleus through the Achilles tendon and look at its attachment on the Achilles tendon, um, I can tell you that the solely as partial portion has a much stronger connection into the medial side of the calcaneum attendant onto the calcaneus.

But then, uh, in this particular model, you can see how that links through the fascia of the calcaneus and right into the abductor hallucis, which we dropped straight down from, uh, could be six. There’s a pretty prominent abductor hallucis muscle. That’s, that’s visible, um, here. So, you know, that whole chain is, is really, uh, um, all part of the same myofascial plane of tissue. And, and as Matt was saying, like, give me five, such a strong point. Other other kidney points might be the ones that are really, um, indicated kidney two is the motor point for the abductor hallucis. So there was a lot of pronation that might be willing to consider too. Yeah. A lot of good choices for this, but that’s kind of deviating from the topic of the, of the day. So anything else,

Because we go in a lot more detail on that module three in the anatomy cadaver lab, and talking about that with different slides such and how I’m really how important that is, and trying to be able to balance out that calcaneus with any kind of, of ankle injuries or these technology and such are going to keep moving and we’re going to take all day. Yeah.

Uh, so the second differentiation to, to consider is a tibial stress fracture. It’s it’s, um, often as a gradual onset, it’s a progression of tibial stress syndrome. So, um, uh, the, the, um, when the tibia is excessively pulling and you’re getting these micro tears, especially if the person’s really powering through it and controlling it with then sets is, uh, um, is that a common dynamic, um, to kind of deal with the pain and they keep on working with it that can progress into a tibial stress syndrome where there’s a lot of, uh, starting with a lot of extra osteoblast, the plastic cellular activity, um, that can sometimes show up on a x-ray, uh, frequently can show up on an x-ray. And, um, you can kind of see that little cloudy area where the arrows are pointing to, and that can progress into a tibial stress fracture.

So with that, there’s going to be a really exquisite tenderness at a point specific region on the tibia. So if it’s not responding to treatment there, that that area is, um, exquisitely tender, where you’re palpating, um, even sometimes a very light pressure. This is something to consider and getting some imaging would be the way to go. And I think the next slide shows a little bit more on this map, but if you want to add anything here before we move on, maybe after the next slide. Yeah. Okay. So the next slide. Yep. So that doesn’t always show up on the x-ray because some of that osteoblastic activity is maybe a relatively new, and it hasn’t reached the level where it’s going to show up on an x-ray. So you can’t really rule it out with a negative x-ray MRI will show a little bit more. Um, but, uh, it, again, it’s really, I, I, we, I see it as if it’s not responding and there’s that, you know, points specific exquisite tenderness, that’s the indications that I’d be looking for, uh, that you would want to consider this to be real, uh, stress fracture method. You are going to add something. I think, uh, the GDV, but I think is another good one. Yeah, go ahead. Yep.

Both of these x-rays were from a patients of mine. Um, and when you are suspecting an osteopath increase osteoblastic activity, or even as it progresses into even a cortical stress fracture, um, like Brian was saying, it is exquisitely tender as you’re palpating along the tibia, and you find that spot, there’ll be a fluid within the tissue. We call that chia DEMA. Um, and it just the gentlest of pressure for the patient. It hurts quite a bit. Um, so just know this is trying to go and get some imaging. If it doesn’t show up on an x-ray, then you want to request a bone scan or even an MRI, but a bone scan is usually the gold standard for that kind of thing. If it’s not going to show up on an x-ray, you want to catch that you want to be the acupuncturist that catches this. Um, and, and because this will come into an acupuncturist office, if you are treating musculoskeletal injuries, uh, it’s just something to be able to make sure that you’re aware of anything else be. Nope. All right.

Okay. So now we’re going into a anterior tibial stress syndrome. So this is going to be affecting the tibialis anterior, which is responsible for 80% of dorsi flection. And it’s an incredibly strong decelerator for plantar flection. So you can see this runner, who’s running down an incline, he’s got heel strike. And so his foot is going into plantar flection. So that tibialis anterior is slowing down the ankle and the foot. So it’s, ecentric CLI lengthening. It’s a contraction. So therefore with overused, just like the tibialis posterior, it can have micro tearing some of the fascial attachments or the muscle fibers microscopically can start to tear away a little bit from that bone thing causing pain. Now the pain just like tibials poster syndrome is going to be on the bone. So you want to palpate medial to the stomach channel on the aspect of where the tibialis anterior attaches to the tibia bone.

That area will be tender if it’s going to end up being a shin splints of involving the tibialis anterior. So let’s go to the next slide and you’ll see the common areas to pop it for. This is usually around stomach 37, generally speaking. I don’t think I’ve ever seen it go all the way up to stomach 36 reasons. It’s usually more toward the muscle belly of it. Um, uh, stomach 37 and even just below stomach 39. So again, I just want to reiterate, it’s not on the stomach channel. That’s a different injury. That would be a tibialis anterior strain. So if you palpated on the stomach channel and you feel a fast cycle of tissue, that’s really quite hardened and that’s causing more pain than when you palpate on the edge of the bone where the tibialis anterior, it comes close to, right? So then therefore it’s going to be more of a tibialis, anterior strain.

Why is it important? It’s going to be different needle techniques, same channel that you’re working with, same channel correspondences that you can work with. But yet if it’s the tibialis anterior strain, we’re going to be needling the motor points. Um, and not necessarily the, um, the technique that we’re going to be showing you for shin splints. Now there’s something that we should all be aware of. And maybe you already know about this, but if not, make sure that if the person is talk is, is complaining about anterior pain when running it gets worse during activity, and then starts to go away. When you look at the front of the leg, that anterior, there may be a certain shine to the tissue, let’s go to the next slide.

It could be chronic exertional compartment syndrome. Now this is a pretty serious condition that often requires surgery. Um, I’ve seen this quite a few times at UCS D the treatments that we applied helped with the person, but as soon as they actually started going back into activity, it came right back. Surgery is in my mind, the better way of going with this, uh, chronic exertional compartment syndrome is usually occurring with people that are increasing their training or they’re changing their running terrain. Something of that nature could also usually be brand new shoes, but they’re starting to develop shin splints, anterior shin splints, but yet the pain is going to be more in the tibialis. Anterior is going to be a long, the bone. It’s going to be a accompany, usually with a burning or an aching or a pressure sensation. And a big note here, it’s often bilateral 70 to 80% of the time you’ll have this as bilateral.

So remember that one, that’s a key. All right. And then also with this burning aching and pressure and possible numbness as well, is that it usually will start to go away 30 minutes, 15 minutes or 30 minutes after they actually stopped their activity. What happens is that the muscle tissue starts to hypertrophy from the increased training or from changing the random terrain and at a very rapid rate. And so the fascia tightens quite a bit, and with that increased pressure within that answer your compartment. And now this kind of chronic exertional compartment syndrome can happen to any compartment of the lower leg, but it’s most common in the anterior compartment. So this is why I can kind of mimic this tibialis anterior stress syndrome or the shins anterior shin splints. Is that the, so like I was saying is that muscle will start to hypertrophy.

You’ll get the fascia starting to type, it starts to compress. You’ll have a decrease of the venous return. So therefore there’ll be increase of the interstitial fluid. That’s going to put pressure on the neurovascular structures. Um, it starts to get a lot of compression within that region. Again, you’re going to start pressing against the anterior tibial nerve and the deep peroneal nerve, um, getting the signs and symptoms of burning aching pressure numbness. If you do have a patient with that, you want to refer them out, continue to treat them because you’re going to, you can still help them, but refer them out for further diagnostics with this. Now it can be a very serious condition if you’re going to be decreasing the amount of blood to the area, uh, let’s go to the next slide. This is something that I think is really quite viable valuables to feel the dorsal Punal pulse, which is right next to stomach 42, right?

So this is going to be a collateral branch off of the anterior tibial artery. So if you go just lateral to the extensor, hallucis longus tendon, and just medial to the extensor, digitorum, longus tendon, you want to feel for that pulse, right? So it’s pretty common. Make sure you compare sides, even if you feel the pulse on the same side of the possible exertional syndrome, if it is decreased compared to the opposite side, we think of that as being a symptom, right? So as a pop, sorry, as a possible sign here. So, um, feel the dorsal pudo pulse in these kinds of cases, it’s going to be pretty valuable information for you. All right. So what else do we have? Let’s go next.

Can I say something real quickly about that? Matt is, um, some people, some folks are aware of both of these, uh, situation, uh, conditions, but, um, uh, maybe not. So it’s worth mentioning, you know, compartment syndrome, uh, for those who might be aware of like more of an, uh, traumatic compartment syndrome, where you have something call on your legs, some kind of a weight or something like that, you know, an earthquakes and stuff like that. You’ll see these with people. That’s a much more trauma-based, uh, uh, condition where you get that swelling and that can be an emergency, a really severe emergency condition. Um, this is like that it has the same components in that it’s, it’s, um, it’s, uh, restricting and putting pressure on those neurovascular bundles, but it’s not from, you know, impact like a trauma, like something falling on the leg or something like that. But a lot of people are aware of, of compartment syndrome, and this is notice the difference of chronic exertional compartment syndrome. So just that,

Well, there won’t be blood vessel rupturing or bruising with case. Cool. All right. Thanks, Pete. All right. So let’s, um, start to get into the treatment techniques with this. Um, at UCS, I started an externship for Pacific college of Oriental medicine, which is now called Pacific college of health sciences. Um, this was, gosh, I’ve been doing this for 20 years now and it still is ongoing. So we take the interns from Pacific college and we treat the UCF athletes and, uh, shin splints is extremely common, um, there, so we have plenty of experience, uh, to, to practice a number of different techniques to see what works and what actually doesn’t work. And so, um, I developed the study and it’s, again, it was just a very small study. It was only a three week study. We only had 45 people in the pool. Um, there was three groups in the study.

One was an acupuncture, only study. One was a sports medicine only group. And then there was also a group that was a combination between acupuncture and sports medicine. Now, the protocols for sports medicine was ice stretching and strengthening, and also ultrasound. They were using actually both ultrasound and ice in this case, depending on the patient. So they were doing it using those four things. Then the sports medicine group, um, with the acupuncture sports medicine, we applied the techniques that were about to go over the accuracy techniques in addition to the sports medicine protocols. And then we also had the acupuncture group of suggest acupuncture in that sense. Um, so what we found was that at the end of the three weeks, Oh, there’s one important note is that almost each one of these athletes were taking a lot of assets and they’re taking it, um, during and before, and also after the events, because they really need to be able to compete or they’re going to lose their position on that team.

So, um, and says was, was gobbled down like candy. And so one of the questions that we had with this particular study was that they could go ahead and decrease the amount of end sets if they wanted to voluntary voluntarily. So, um, this was something that we found in the study that, that in the acupuncture group, people were actually not taking the sets and just coming in twice a week for the acupuncture, which was not statistically significant in the other two groups. Uh, so in this article, uh, printed in the journal, Chinese medicine, 2002, so way back when, um, it does show that the acupuncture group was actually far superior and the other two groups, um, really didn’t match up very well as far as getting results. Now, again, this was only a three week study. There was only 45 participants in this. If we made it an eight or a 10 week study, I would think that the other two groups would actually start coming up. But I think there was actually enough evidence to show that these needle techniques that we’re about to get into, um, actually work pretty darn well. Um, and this is something that, um, I continue to use and have been teaching in the SPAC program Ford smack program for a good 20 years now. And, um, so we’re getting a lot of good results with it. So let’s take a look at the next slide.

All right. So the key with this with medial tibial stress syndrome is to palpate where the top of the pain is on the tibia. And then also where’s the lower range, the lower end on the tibia. So you’re going to start your needling at the top, just above the painful area. And you’re going to thread a number of different needles could be eight, could be 12. It could be more depending on how long the area of pain is. So each needle will

Actually,

And we’ll go in and the other one we’ll actually go right on top of it. So there’ll be continuous needles all along that edge. Now it’s going to be shallow needling, right? And that’s going to be very important. You don’t want to go deep when we did go deep. It actually aggravated the condition. So it’s a transverse needle technique, no more than 15 degrees, right? You want to thread that needle right along the edge of the tip yet, as if it is scraping the tibia, you don’t want it to go too much into the soft tissue. You want it in the crevice, just off of the edge and on that edge of that bone, right along that liver channel, just like on liver five, how we try to be able to scrape the bone fat, think about that with these particular needles, uh, you don’t want the needle at 30 degrees.

You wanted at 15 degrees, 10 to 15 degrees, and then thread that. So they overlap all the way down to low the area of pain. Now match this needle technique with your constitutional treatment. You can also go ahead and treat other points with this. For example, we were talking, um, spleen points because the tibialis posterior is associated with the spleen gene, Jen. So we want to treat spleen points in this case, of course, we want to probably treat stomach 36 for the patient, which is also nice. Cause that’s the motor point, one of the motor points for the tibialis anterior. So to reiterate this needle technique is not the only thing that we do, but this is a successful needle technique for helping to decrease pain. When you are helping to treat this patient now for the anterior tibial stress syndrome, which is the next slide.

It’s the same type of needle technique is the exact same idea. And, but you’re threading in different areas, obviously. So it’s right on the edge of that tibia and medial to the tibialis anterior in this case. So again, this is going to be something that you want to go ahead and treat the person constitutionally with it. And also you want to apply the myofascial techniques that we’re going to be getting into just next, I believe. Um, one important note, if the patient does have foot overpronation that this, these needle techniques will help decrease the pain, but the foot overpronation will need to be corrected or helped. And one way or another through exercises treatment, maybe, maybe the foot is prone is so much that you actually need to be able to get inserts. And that’s something that we actually talked about in that webinar in December. So the foot overpronation does need to be addressed for long-term clinical success. Brian was saying, um, no, I think it’s good. All right. You want to get into the mob passionate techniques? Yeah, sure.

So, um, I guess we go to the next slide. So we have, uh, one, one slide and a video for, um, demand terrier. And for tip posterior, we’ll start with tip posterior. Uh, we have videos for these because as Matt mentioned, um, we pick the subjects that we’ve recently presented on it, and it’s now live on the Neta knowledge, uh, for some of our classes, for the sports medicine acupuncture program. Um, and we recorded, uh, some acupuncture, more distal points for treatment of things in the assessment and treatment of the sinew channel class. But we have a lot of myofascial release techniques in those classes. So we have videos for them, for presenting at the webinars, um, uh, just cause we had better camera angles. We can, we can plan it a little bit better. Unfortunately, we don’t have videos for the acupuncture part cause we we’re, we’re reserving those classes for live classes, just so there’s more oversight.

Um, especially certain techniques require a little bit more oversight where there might be. Um, it might cause damage if people aren’t doing them correctly, we’ve, we’ve reserved those for post COVID, um, to do a in-person. Um, but some of the other classes, we were able to do a online webinar form during this time of COVID. So unfortunately that videos for them, it’s not to say that these are more important than the acupuncture. It just happens that we have videos for them. So let’s use them. Um, so this one, uh, we’re going to be working just sinking deep, uh, behind the tibia. And the goal is to kind of move the tissue posterior to soften those connections of the tibialis posterior, uh, from the tibia, uh, with the caveat that if there’s extreme discomfort for this, you have to use less pressure or maybe start using this technique as the, um, a few sessions in, as the acupuncture starts improving the condition.

So if the person is retreating from you on the table, either soften the pressure or uh, hold this one in reserve for down the road, but it’s usually, uh, able, you’re usually able to do it. It’s a slow technique you’re giving the time, uh, the tissue time to sort of soften and melt a little bit and connected tissue to sort of, um, become a little bit more soluble to go from that more gelatinous, hard state to a more soluble state. So it’s, it’s often applicable, but, um, you might have to modify pressure, especially on this medial surface that could be quite tender. So you’re going be sinking, a soft fingers sink in, take your time. And then slowly moving the tissue posterior as the person does a range of motion with the foot, if it’s too much of a range of motion that can push you out. So, so it has to be a small plantar flection, dorsal flection, very slowly. You’ll see that on the video. So let’s go ahead and look at the video and it’ll highlight that

This is a compliment to the tibialis, anterior myofascial release the technique. Again, it could be one that’s done along with that one, or it can be done separately. There’s various clinical reasons why you might do one or the other. Um, but the same idea exists is I want to move the tissue from the deep posterior compartment from lower down around spleen six in particular, it’ll be over tibialis posterior. I want to move that tissue away from the tibia. And I want to angle my direction down into that deep posterior compartment, multiple muscles there. But my goal is thinking about influencing the tibialis posterior and moving that most anterior most muscle away from the bone and giving more space along the spleen channel and spleen send you a channel. So I’m going to enter in just posterior to the tibia. Spleen six would be a really good starting point to consider.

So we’ll go in the region of spleen six, angling posterior, I’m going to have the patient’s door selection and plantar flection. This one, especially as I get higher up, it might be a smaller if I can get away with a little bit more, well, that might get to the point where it feels like his musculature is pushing you out out of that little Valley, which has all minimize the movement. Reposition slightly superior, six strays towards the table, and then ankle dorsiflexion thinkers. It could be the flat of the failings, same thing. As I dropped behind the tibia, I sink down towards the table and a slide traction, posterior, they’re going to do it ankle doors to flection. That’s almost pushing me out, but I’m going to do it to see if I can open up that tissue a little bit and relax, good up singing down traction, posterior slightly, just enough to give a drag on the tissue call for movement. Could you even consider using the flat on my elbow, but I’d have to be very mindful of depth because this tissue can be very sensitive.

One more

Sink down, traction, posterior call for movement. That’s enough right there. Yep. Too much. And we’ll push you out. So you might have to minimize the movement. Let’s do one final pass. Might be a little bit more on the solely as two, but that’s okay. It’s still opening up that same space behind the tibia. All right. An excellent technique for tibialis posterior syndrome. As the other technique on the stomach channel would be for tibialis anterior syndrome. It’s excellent to open up the ankle dorsi, flection and working on any condition that would be affecting the foot, uh, especially PEs planus. And we can look at a modified technique for past planters specifically.

I think we can probably move on, uh, to the next slide. Uh, that one I think was most relevant for tibialis posterior stress syndrome. Um, and I know we have not unlimited time. So, uh, this is a similar technique and we’re on the stomach. I send you a channel on the tibialis, anterior, very similar idea. I’m going to sink into the tissue. There’s a little bit more meat of the tissue to sink into. We have such a narrow space for tip posterior. You’re buying the tibia to get to that deep posterior compartment, but the anterior compartment we’re really having a little bit more direct access to. And another difference with this one is the tin posterior. I’m just kind of angling and stretching away, but I’m not gliding through the tissue so much because then I would just be gliding through the soleus. So it’s, it’s more of a traction. Whereas this one I’m going to actually glide through the tip anterior, but at the same goal to help soften those connections to the tibia. So let’s go ahead and look at this one.

We’re looking at a specific myofascial release technique for the tibialis anterior muscle and especially cases and especially useful in cases where it feels like the tibialis anterior. Is it here to the tibia and another condition where you might feel a little bit of a loss of a ballet dance, rigid, tibialis, anterior, and glued and stuck to the tibia. So we’re going to come in with a fist loose fist. My knuckles are going to be right up against the tibia and not driving into the tibia tibial crest, but right up against the tibia as close as I can get to it, I’m going to angle directly down. I’m going to go planning through the muscle, but I don’t want to think about it as a round technique where it pulls the leg into external rotation. I want to think that I’m going straight down to the table and it’ll actually squeeze the leg, push it a little bit into medial rotation, or at least it will influence it towards medial direction.

So again, this way around the leg will pull it into lateral rotation this way, straight down into the table, we’ll push it into medial rotation. So I’m going to contact sync perpendicular into the tissue, ask the patient to do some divorce, deflection toe extension plantar, flection to reflection. Sometimes it’s a little bit faster of a technique, but this tissue feels very stuck here. So I’m going to take my time and let it soften and melt and back out. It’s not uncommon to see some little tracks where your fingers, where it’s a little finger tracks. I can move down a fist length. I can sing stray towards the table, ask for movement and falling at that flood into dorsiflexion and plantar reflection. Again, even if I take my hand away, it actually pushes the leg more into medial rotation because my intention is just straight down. One more pass. You don’t want to go too far down because it can get a little nervy at about mid leg is good. It’s a one Margo plantar flection, and I’m going to do one more pass on the coming back up. You don’t have to do it this way every time, but this tissue felt particularly congested, uh, ankle, Doris deflection, total extension, and then down.

All right, that’s great. So, um, just to reiterate on some of the first technique for the medial side, if the patient is experiencing what you are thinking of osteoblastic activity, where there’s a dime-sized spot that is exquisitely tender, you can perform the technique above and below. It just let pain be your guide. I mean, these techniques are actually very, very useful after the acupuncture technique, um, to help free up that area and increase the circulation. Uh, Brian, anything you want to say before we jump into the exercise now, I think, uh, we’re ready for that. So with the exercise, this is ankle rotation. This is coming from our postural assessment and corrective exercise class in module three. This is a go-to exercise for shin splints. This is something that’s always going to be in. The protocol will be the only exercise. It all depends on the patient’s posture.

Like for example, if they do have food, overpronation, there’ll be a number of different exercises that we teach to be able to, um, use with that. But this would be one exercise we would throw into that protocol because it does exercise all of this in new channels, the yin and the yang sinew new channels with the lower leg. Um, this is an exercise that actually requires quite a bit of concentration. Those because people start to kind of have it, their mind is wandering or the dog comes and licks the patient’s face because they’re on the floor. You know, you have to really concentrate with this exercise. Now in this photo, what you’re seeing is the model, bring the hip into 90 degrees of hip flection, and then supporting that leg so that the tib and the fib are going to pair be parallel with the table.

I’m parallel with the floor. Then you go into ankle dorsi, flection from ankle dorsi flection. You’re going to ask the person to make a full range of motion as if you’re drawing. And Oh, you do that 10 or 15 times in one direction. And then you do 10 or 15 times in the opposite direction. Now to work the opposite side, you’ll notice that the model has Dorsey flection. So this is going to be an exercise that you want to work on both sides. You know, the person’s going to be having shin splints on one side exercise, both sides because there is going to be a crossover neurologically and also with the channels. So this is a really great exercise to really, um, before running and also after running helps really loosen up that lower leg quite a bit, um, before the run. And it helps to, uh, loosen up the leg quite a bit after the run as well. Brian, anything you want to add to that? Yeah.

Yeah. You know, when they’re doing the exercise, I know this is my hand. So you just have to use a little imagination here, but if the person has e-version and they’re already, you know, you can look at the, the video, uh, the webinar we did on PEs planus, we go into it a little bit more than I have time here, but if there are any version of their ankle and foot position is such that it’s going to encourage that, that turning out, um, whether they’re pointing the foot down in the planet reflection or up into door selection, and they have a much harder time going up and in or down and in, which is going to engage, tip anterior and tip posterior. Um, when they do this, they sometimes cheat a little bit, or they’re like a little, uh, a little iffy on the both, uh, down and in and up and end portion of it. But they’re very strong on the up and out, down and out portion of it. You really have to coach them to make sure they’re there fully getting that foot turned in, in both directions, whether they’re going clockwise or counterclockwise. So don’t let them just kind of like, you know, bully it into one direction. It kind of like, eh, not quite there at the other direction, you have to give them a little bit of incentive or kind of bring that to their attention

At least. Yeah. That’s a good point watching your patient, perform the exercise before they go home and do it. And a lot of concentration each time, making sure they’re going into the complete range of motion. If the mind starts to wander, it’s going to be really easy just to kind of flap it around a little bit, which is not really doing very much. It’s not really exercising this. Um, this is also called shin burners. And after doing it 10 or 15 times yourself, you’ll understand why it’s also called shin burners. It’s a difficult exercise. It’s a fantastic exercise, especially for shin splints. Anything else there, Brian? No, I think we are good. All right. So here’s some contact information. You guys, um, uh, thank you so much for attending. It looks like we really went over time with this. And so for you guys that hung out the whole time, thank you very much. Uh, we wanted to thank the American Acupuncture Council again for having us with this sports acupuncture webinar. Um, Brian, it’s always a pleasure hanging out with you and we should say, Oh yes, next week, make sure that you are back for Lorne Brown. He’s going to be discussing some topics, whatever Lorne is going to be talking about. It’s always excellent. He’s got that unique ability to be an amazing clinician and a real, quite an academic as well. So, um, Lauren is a great guy and somebody to be able to listen to.

All right. Thanks. You guys very much. Appreciate it. Yeah. Thank you.

Continuing Education Issues in the World of Covid

…the Kongress is so well organized and so fun, you know, I think, Oh, they’re just going to be listening to lectures all day, but there are, but there’s great teachers from around the world. And there’s also wonderful social events…

Click here to download the transcript.

Hi, I’m Virginia Duran. And this week’s host for another edition of, to the point, very generously, really produced by the American Acupuncture Council. And, uh, today we’re going to be talking about issues around continuing education in this new COVID world and where we might be going in the future and the pros and cons of online learning and issues that are specific to our field when it comes to continuing education. And so I thought who would have more experience with this then? Julia Stier, uh, Julia is the Kongress chair, woman of the international TCM Congress in Rosenberg, Germany, uh, which has been running for 52 years. And I think of it as the, the largest and most prestigious acupuncture conference in the world or in the Western world. I should say. I don’t, I’m not sure what’s done in the East, but, um, she’s very, very capable and has had to pivot last year, uh, in, in, in a couple of weeks time to putting everything online. And so she’s been dealing with these larger issues around the new continuing education sphere. And so I would like to introduce you to Julia and, um, have her tell us about, uh, how we might, um, proceed and solve some of these. So, Julia, thank you so much for taking time to be here. Cause I know you have another Congress coming up in a few weeks and uh, time is already precious.

So thank you. Can you tell us how

You, how you got into the field?

Um, yeah. Yeah. Oh, well, um, my mother is from Taiwan, I’m half Taiwanese. So, um, in my family or no family, the some Chinese doctors already. And so, um, I sort of grew up with Chinese medicine and it was normal and, um, at all plays and, um, when I was, um, um, a young girl at 17 or 18, I, um, had some, um, chronical condition that came up and up again and I had to take a lot of antibiotics and then I went to see a Chinese doctor and she treated me a couple of times and it sort of, it never occurred again. So, um, I was completely convinced and I, um, started learning, um, uh, Chinese medicine. Um, a couple of years later I have, um, studied, um, medicine also. And, um, also I have been working in, um, um, I’ve been, uh, an event manager, um, lots of years. So, um, when this position at the Congress, um, was free, um, I, it sort of everything came together. Everything just fell into place. And so, um, it was, um, sort of, it was supposed to be, I guess, especially well

Having, you know, knowledge of both worlds, uh, you know, some people don’t have the organizational skills to do something like this, but the, the Kongress is so well organized and so fun, you know, I think, Oh, they’re just going to be listening to lectures all day, but there are, but there’s great teachers from around the world. And there’s also wonderful social events where you’re dancing with your, your heroes or your DCM heroes thing. It’s it’s um, it’s and it’s so well balanced with you have things on nutrition, she gung and tie cheese sessions, uh, herbs, a little, you know, there’s some Western, uh, style acupuncture. There’s classical, there’s Japanese, Korean. I don’t know about Taiwanese, but we should have it if we don’t, you don’t, there’s just, it’s so well balanced to really reflect all the aspects of the medicine that I’m, uh, you know, I feel so fortunate to have, uh, presented there a few times and to just even attend. Um, so we do want to know though how you’ve managed to bridge this gap, uh, or, you know, uh, pivot on, you know, how you’ve been doing it and how you have to do it now and love to hear your thoughts about what it might be like in the future. Yeah.

Oh, well, um, last year it was, um, sort of a surprise in Europe. Um, racial, um, became real, um, in, in March I think. And, um, we had the first, um, lockdown light in Germany from middle of March and the Congress was only two months later. So, um, we really didn’t have a lot of time to think, um, or to make plans. So, um, we just decided to take everything online, um, because we thought this was the only possibility something could happen and, you know, tickets were sold already. Everything was booked, everything was planned. And so, um, yeah, we just went straight ahead. We found, um, a partner in net of knowledge. Um, they are a Canadian company, they have this educational platform already and they program, they set us up, um, um, well, um, a site in there on their educational platform. And so, uh, we could start from there and actually most of our speakers, um, were really, really, um, brave too.

They just, and then said, yeah, let’s go. And we try. And, um, some courses, of course, some lectures, um, some workshops, especially the practical clinical workshops. We couldn’t take online. Um, like the palpation based work. It was, we couldn’t really think of any way at that time. And, um, but most of my questions is how do you, how do you accommodate the, these challenges with the, uh, clinical style workshop? Yeah, well, um, what really worked out well is, um, we had, for example, we had, um, this, uh, Japanese speaker, um, he is, um, in his practice in, um, in Japan and he had, we had two lays with them and the translator, um, with him in the translator and, um, he had patients coming in and, um, so, um, all participants, they could watch online. Um, it was all live. Um, they could watch online.

Um, they had a view directly in the practice. Um, the speaker, um, he quit, um, talk to them directly and he could, you know, treat the patient and, um, do the theoretical part before. And then, um, we could just, um, what should him, how he handles things and he could tell, you know, he could demonstrate a lot on the patients and participants always had the possibility to ask questions. And so it was a really interactive, um, way of teaching. Um, although it was only online. Um, but, um, it was not, it was not only, you know, sitting in front of the screen and watching for seven hours a day and not really being able to do something other than just listening. Um, but you could, uh, really actively taking parts, um, and the demonstration of learning. So, um, that was really good. Um, and also, uh, there was this, um, speaker from Italy and she had, um, trainer, baby, um, uh, workshop. So the participants, um, the babies, um, enter the class and, um, they could, um, turn on the cameras. And so, um, the speaker could, uh, you know, uh, the extra, she could watch them the treat their babies and, um, still comment on how they, how they were treating and how they were, you know, doing what they were taught to. So, um, this was, this was really, um, this was really good way of bridging this gap for us.

Yeah. I think it’s very clever your solution. Yeah. One question I had was, uh, how do you manage, um, intellectual property issues? Because it seems to be a kind of epidemic in the field, at least in the U S and, uh, but I shouldn’t say cause every country I teach in within six months, somebody’s teaching my stuff. So it’s not unique to the U S it may be worse here, but, um, it, it, it’s hard with something where a lot of what we’re teaching is in the public domain, but, you know, material or, uh, you know, with an online platform, how do you protect it with this protector on that issue?

Yeah, well, of course, um, we have, uh, um, w we have them, well, we have not, everybody can just come in, you have to, we have only the participants who could, who get the code, um, uh, to get into the workshops. And, uh, we have people actually watching closely and controlling that, not nobody’s in there who doesn’t belong there. And, um, so it’s, it’s, um, similar to, to a live event really. Um, and there’s these controls. And then of course we mock all the, all the slides, all the slides are being marked from the speakers. Um, Mark does theirs and then, um, well in the end, um, it’s really like an, a live course. You also, you will also always have participants there who take photos or, um, make audios or, um, or video recordings. And, um, we have an eye on that and, uh, of course there are certain rules which people have to follow.

And, um, actually of course, um, some of our speakers put their handouts up, uh, upload the handouts before. So participants can, you know, prepare and Donald before, but some of us, because I’m also, uh, you know, fear that the slides or the material, um, will be taken. So, um, they only provide the material to the participants who leave their email address, and maybe they, um, send out the slides after the, um, after the lecture backs. Um, there will always be a small gap. You can’t close at the end. You can’t really well, um, be a hundred percent safe. Um, but we, and what we can all do is, um, have an eye on everything that is going on. And so, um, in Germany that is not, that’s not re re a lot if someone teaches us what, um, uh, material that is known from somewhere else that has been already taught by somewhere else by somebody else, or is really somebody else’s method that they involved. Um, somebody will see it as somebody will always realize.

Yeah, yeah, no, I’m always so impressed how you have such wonderful teachers and, you know, from all over the world, I mean, from Japan and China and Korea and Australia, North America, all over Europe, and probably some places I’m missing, how, how do you there’s, so there’s so much talent, but how do you choose? Um, and, you know, do you have, you have themes, I think yearly themes for the Congress that have a certain topic you want to promote then, then, um, and then you have, you know, people teaching other things too, but it must be a tough decision.

Oh, yes, yes. Oh, there’s so many really good teachers out there. And of course we have, um, we have a lot teachers who, uh, were already, um, um, part of the Congress many, many times, and you know, who we can really rely on and who always, who we, who we know will be sort of a Garand to, you know, um, to, to do a really, really good lecture that is entertaining and still, you know, really well, they have a lot to say. And, um, and then, um, I’m reading a lot of journalists and I’m visiting other congresses. And then of course, I always have an open ear to suggestions such as sun shins. So, um, many people, um, keep, um, send in their proposals and many people have some, you know, some teachers that they propose to us that they say what you might like, and then there’s, um, there’s also a thing of online learning.

Um, there’s this, um, a lot of material on YouTube and other channels, um, nowadays, so I can get a better impression of, um, what the speaker has already been doing. Um, it’s, um, it’s not, um, it’s not taught to find new speakers that are really a lot new challenges. Um, it’s just, yeah, but it’s hard to decide because we only have, you know, we have like, uh, sometimes some years we have 60 speakers, which is a lot, but, um, there are a lot more who we, who couldn’t speak. So yes, it’s a tough to show

Or, and, and with, you know, uh, if you’re, um, also providing the videos afterwards where people who couldn’t attend or people who just, you know, want to, you know, get it all, then you don’t have to worry about like missing, you know, your favorite speaker cause they were at the same time. So there, there are some advantages to the online viewing of the class.

Yes, yes, yes they are. I mean, nothing can, you know, there’s, uh, that the personal it’s it’s missing, of course I’m the person I’m meeting and the dancing, the, you know, social, but, um, what really is a plus a big plus is that you, you buy a day ticket and you don’t only get to see one workshop. Um, you can, and this is something that actually a lot, a lot of people did last year. You can, during the day you can jump between the lectures and you know, what, you don’t have to stay in one lecture all day. And, um, uh, we upload the recordings of the days, um, for a couple of months afterwards. And so, and until the 1st of September, September of this year, you have time. Um, what if you booked? So, um, at 10 days we will get the chance to see 10 courses, 10 lectures, instead of one.

Can you tell us, um, a little bit about the theme and some of the speakers this year and how they can help people can find out more information about it?

Oh yes. Do you find, um, the whole program on a TCM hyphen Congress for the key dot and D E is also an English language, of course. And, um, uh, the thing, well, this year it’s, um, expressions of the metal element. Can you see this? Yeah, very appropriate because of the metal element and it’s about a physical and mental manifestations of skin and respiratory diseases. Um, we have, um, a lot about topic, but also really, um, on, on any other topic you can imagine. And, um, we have learned a lot from last year things that worked really well and we left out things that maybe didn’t work out so well. And, um, all for example, this year we have, um, a live cooking class. So, um, there’s in the handout and there’s a sort of a stopping list and you can go and, um, do your groceries before. And then, um, on the day, um, you can, you can be actually cooking with our teacher. She does this. And then, um, and this is also something we couldn’t do live in an, in an actual kitchen because you can’t put hundred cooks into a kitchen, especially

Okay.

When everybody can do this from their homes and they’re connected.

Well, that’s a great idea. Yeah. Yeah. We’ll miss some of the interacting with your colleagues from all over the world, but you know, that’ll come in the future. And of course it’s really about the, uh, the content of the Kongress. So, um, is there anything else you wanted to say before we close? Yeah.

Um, because you mentioned the, like the interaction we have, um, we have some social gathering, um, um, also online, like, um, um, the fantastic finale, for example, it’s always on, it’s a concert on Saturday nights, um, which is, um, done mostly by us because, and, uh, we did that last year and we have that this year too. Um, it was really nice, you know, it’s, it’s sort of, uh, the same feeling

Yeah. Whoever wants to can turn on the cameras. And we had a long, long chat after the concert and it was hot woman, really, it was nice to see everyone and, you know, at least that for a while. So, um, yes, everyone who was interested can just check out the program and be sure, um, it will, there will be a social interaction to not only, you know, learning on a high level, but also, um, meeting each other in some way.

So everything, but the 2:00 AM drinking with your teachers. We try, maybe that goes lunch. Okay. Well, thank you so much for, uh, being part of the show and we’re so grateful and next week for those that can tune in, we have Matt Callison and Brian Lau as hosts. So, um, really, uh, again,

This is Virginia Duran of luminous beauty.com signing off and thanks to the American Acupuncture Council again, see you soon.

5-Step Checklist To Simplify Your Marketing – Jeffrey Grossman

“…you’ve got to figure out ways to consistently attract new patients and systematically, keep them in care and to have them really understand what you do and what you offer and how you could help benefit and support their life and wellbeing.”

Click here to download the transcript.

Hi folks, Jeffrey Grossman here, and thanks to the American Acupuncture Council, once again for inviting me here to share with you some insights about marketing and growing your practice. Our main focus when we are an acupuncture school is to learn about the theories, to learn about the points, to learn about the cupping and the GWAS shop. And we hardly get the foundations of what we really need in order to build a successful and thriving practice. And it doesn’t matter if you are the best diagnostician or the pulse finder or the most amazing wash Shaw giver. But, you know, you’ve got to figure out ways to consistently attract new patients and systematically, keep them in care and to have them really understand what you do and what you offer and how you could help benefit and support their life and wellbeing. And this is the reason why I’m excited to be hosting this web class today, which is called the five step checklist to simplify your marketing.

So welcome. My name is Jeffrey Grossman. For those of you that haven’t met me before doing videos. I’m the founder of acupuncture media works and Acu perfect websites. We’ve been creating patient education and marketing materials for acupuncturists since 2002 building websites for acupuncturists since 2010. And I started my practice in 98 and I had incredible struggles and trials and tribulations like many of you have had and may be having right now. And I had no business savvy or no marketing knowledge. I had to start from scratch. So there was a big problem. I realized that I wasn’t given the tools to really properly educate, communicate, overcome objectives, market my practice, close the sale and, and all those things aren’t involved with creating a really successful business these days. So I decided to start the companies that I have now to help other practitioners build their businesses and to help you understand what it takes to actually create a successful acupuncture practice.

We are healers. We change lives. People need us every single day, especially now, but many people don’t really know about our services let alone that you even exist, right? So I want to help you change all that I want to help you get more people on your table. I want to help you be seen and be heard and to ultimately to bring people into your practice so you can make more money, help more people, and even have more free time in your life. So I want to remind you that you’re never alone. Then I’m here for you. My team is here for you. And at the end of today’s talk. If you feel like that, you need help getting set up or becoming focused. You need a little more motivation. Please feel free to reach out to me. Uh, I reach out into the comments below this video.

I will respond to those comments or you can reach me at Jeffrey, J E F F R E Y at acupuncture, media works.com. Um, and one last thing is, um, I put together a detailed report for what’s working now with the recommendations and how you can make it work for you for your practice to get more people on your treatment table. It’s a 15 page resource that you’ll find invaluable. And I’m going to give you the link at the end of today’s training, because if I give it to you, now I’ll lose your attention. You’ll go get it. And that’s it. So just one or two things from this ebook that I put together that you put into practice can actually change your practice and make all the difference. So let’s just jump in right now to the five step checklist to simplify your marketing.

And the first thing I want to get across to you is that no matter how large your business is no matter how great their product is, it can always fail these days. It’s not enough that you just have a great product or a huge business. What truly matters is that you have a consistent way to attract and convert prospects into patients, right? So tell me if this sounds familiar, you hang your shingle and you hope that patients pour in, nothing happens. You offer great services and you hope patients continue care. They fall out of care. You help people, you help them get well. And you hope that they refer others and no referrals happen. And unfortunately, many practitioners think that their service and their care and their clinic can simply magically sell itself. And that’s not true in order to be successful these days, you need to have a, what is called an effective funnel, right?

And this is set up with three different stages for building patient relations. And that’s what you’ve got to do in your marketing is to build these relationships. The first stage is curiosity. The second stage is enlightenment and the third stage is commitment. And I’m going to briefly review those before we jump into the checklist with you. And it’s important to understand this process because the goal of any funnel, the goal of any sales process is to walk patients through each of these phases, to peak their curiosity about you, to enlighten them. So they want to learn more about you and then to get them to take the next step and make a commitment to begin care with you. So let’s just dive into that real fast, um, stage one, the curious curiosity stage, and this begins with a subconscious process that identifies whether or not, um, you know, P you are able to enhance a prospect’s life.

It’s basically a snap decision that Selah makes about a product or a service or a brand, and how people, how you, your services are viewed to help people survive and thrive. Right? This is the stage where people are making one of two choices, right? They want to learn more about you to take the next steps, or they’re going to ignore you and walk over wet way. It’s like sorting through your mail, right? You scan through thousands of collateral every day in your mailbox, in your inbox. And the majority of that gets discarded, right? And these, and some materials go into the key file. Some materials go into let’s review this for later on. So you either keep what appeals to you or you discard what doesn’t. And for us, the goal is to get people to want to learn more about you, as opposed to just walk away, right?

When it comes to marketing, there’s a number of ways that you can peak people’s interest and entice them to want to learn more about you. And when it comes to marketing, it’s your headline on your website? It’s the subject line of your email? It’s the title of your lead magnet? It’s your elevator pitch and a thousand other things that you need to express how you can help people immediately. They want to know what’s in it for me. So, you know, they want to know, um, you know, um, what’s in it for them in order to take the next steps in starting and building this relationship with you. And the point is that if you don’t tell someone how you can help them survive and thrive and overcome their problems right off the bat, on your headline, your email, your subject line, whatever that is, they’re going to discard you and walk away.

So curiosity is what gets a person to start to notice you, and to begin to pay attention with what you have to offer. And this can be a one-liner on your website, titles of your posts, titles of, of, of your email address of your emails and things like that. So this is where people get their, you get their attention. And then the next step is to get them to learn more about you, which is the enlightenment stage. And curiosity. Again, people are paying attention to you. Enlightenment invites them into a relationship. And this is where you begin to build trust. This is where people begin to take you up on your offer. This is when they realize that you have the solution for them and think about this, right? How do, how does what you offer solve? The problem that your prospects and patients have?

You can sell a treatment to resolve stress, but how does it work? You can sell a cure for menopausal symptoms, but how this is when you enlighten them as to how, what you do works and can help them alleviate their biggest problem, which is the reason why they come and seek you out for care. When you enlighten people, you help them to see clearly how you and your services can help solve their problems. So there’s a number of ways that you can enlighten your prospects. You could have enlightened them through a lead magnet or a live or online event, or a trading, a long form sales letter, or landing pages and email secrets, or even in video. Okay. So ask yourself is your marketing campaign, piquing, your prospects, curiosity, right? Getting them curious about you, and then in lightening them as to how you can solve their problems, right?

And how you can help them thrive and improve their lives. So now that you’ve built the trusted relationship by stimulating curiosity, and then lightening them, you then have to ask for their commitment and getting patients to commit to care. This is the Holy grail, right? And it’s relatively easy to get patients in, but it’s a whole different story when it comes to getting them to commit to care plans. And there’s two reasons why prospects may not commit to care and why they fall out of care too easily. One is that you may have asked for their commitment to early in the relationship, right? This happens when it’s clearly too early. When, you know, before you’ve really laid the other foundations out there before you’ve gone through the curiosity and enlightenment stages. And we’re all guilty of asking our patients to pay us for care before we get them to recognize and interest us with their care.

It’s like asking someone to get married after you meet them once or twice, right. It takes time to properly cultivate the relationship before you are all in. And second reason why patients don’t commit is simple. You just don’t ask for the sale, right? And this is all too common in my friends asking for the sale feels too smarmy for many of us introverted types, right? But the sale will never happen if you don’t ask for it. And I’m very familiar with this scenario from working with hundreds of practitioners over the years, the majority of them felt uncomfortable asking for the sale, asking patients to commit to long-term care. And I get it. I did the same thing. It was hard for me to ask for this LTU because I didn’t want to get rejected. I didn’t want to come off as, as salesy and pushy.

And I understand where you’re coming from. If that’s relates to you, but peaking our prospect’s curiosity and gradually enlightening them to, uh, to them greatly increases the chance that they will commit to care with you. So you have to invite them to commit at the pace that feels natural for any healthy relationship in order for it to form properly. So people don’t want to be enlightened about something until they’re curious about it. And until they are enlightened about how you can help them survive and thrive and overcome their problems, they will never commit. So you’ve got to progress them through each stage in the correct order. And here’s a couple of examples of getting, um, uh, commitment. Okay. So one, you can ask people, you meet at a health screening to come in for stress reduction treatment, or having a schedule now button on your website, or a call now button on your website or asking for their commitment straight.

When you deliver your patient’s report of findings to them, sales, email campaigns. And even there are specific conversion tactics that you can employ to get people to commit to care all this information. It can be found in a really great book that I came across, uh, by Donald Miller called marketing made simple. It’s a great book. If you haven’t seen this book or came across this book, check it out. Um, it can really enlighten you, um, about different stages of growing your practice and different aspects of moving patients through these, this, this curiosity, enlightenment and, um, and commitment phase. Okay. So as we move forward, there’s four things that I want you to keep in mind. Okay. And these, if you don’t get anything out of today’s training, just ask yourself these questions. Does your website or your emails or your conversation with patients peak their curiosity.

Okay. Are you earning your prospects and patients trust by enlightening them about how you solve their problems and how you help them thrive? Not somebody else down the street, how you can do that. And are you inviting prospects to take the next steps to schedule a call with you? Okay. So keep those in mind. I think I said there were four of them. There’s actually three of those. So if you know, hopefully you have answers for those three questions. I just put out to you. If you don’t feel free to reach out, I’d love to help you formulate some answers and some conclusions about that. So let’s talk about the, um, the, the five pieces of your, uh, your, the five checklist to help simplify your marketing. But this should really be called the five pieces of your marketing funnel. And I knew that if I called it a funnel, many of you don’t even know what a funnel is, except something that you could use for baking or cooking or pouring liquids into things.

But, um, I want to enlighten you about this because there’s five parts of, of, of, of, of a simple marketing funnel. And they all incorporate that curiosity, that enlightenment and that commitment phase. So, um, the five components that I’m going to briefly talk about here are a one-liner part of your website, lead magnets, nurture email campaigns, and sale email campaigns, and all of these elements work together to guide that potential prospect through the relationship phases that we just talked about. So your one-liner is what starts to build curiosity, right? And then you move that potential prospect through this enlightenment phase, um, onto your website, your lead magnet, or your nurture mails. And finally, you’ll ask them for a commitment using a sales and email sequence. So checklist number one is to create your one-liner okay. And there’s a couple of parts to creating your one-liner.

And this is a concise statement that clearly explains what you offer. And this is a powerful tool that you can use to make potential prospects curious about your practice. And it’s composed of three parts it’s composed of the problem, your solution, and the result. So part one is the problem, right? You always have to start by describing the problem that your product or service solves a clearly stated problem creates curiosity in what you have to offer. And it’s what helps potential prospects decide whether or not that you could help them survive and thrive and overcome their problems. So, for instance, the problem is that people are in pain, or they want to start a family, or they are wanting to get be less stressed or have a more robust immune system. And these are problems that your prospects may be contemplating and dealing with. And the first thing that you need to do is to identify the main problems that your prospects may be suffering from and are seeking relief for.

And this is usually done when you develop your ideal patient profile. So what kind of problems can you solve to help alleviate the pain points that your patients are feeling and experiencing? Okay. Part two is the solution. Once you define the problem, you’ve got to connect the problem with your solution. For instance, if you’re going after people who are looking to get out of pain, what is the solution that you offer to get them out of pain that somebody else does not right? Is it the special lasers that you use? Is it a Dr. Tan treatment that you offer? Or can it be the herbs or the poultices or the topicals that you use? What is your solution to help them achieve the solution that they are looking for? Okay. And your solution needs to be different and distinct from the acupuncturist down the street, right?

This is your unique selling proposition. This is what sets you apart from your competition. Okay. Part three is the result, right? This is where you have to explain the benefit or the outcome that your prospects will receive during using your services. Right? You need to get crystal clear on how the prospect’s life will be improved when they use your solution. When they choose you, when they choose your services, right? Will they be able to pick up their child? Pain-free um, you know, because there are no longer, they no longer hurt, right? Will they ever be able to avoid COVID or the common cold, because they’re receiving special immune boosting treatments from you, will they be able to finish their next triathlon because they’re need no longer hurts? What result will you be offering? Can you provide that? Another practitioner can not. Okay. So together part one through three that we just talked about, help you define your one-liner.

And here’s a couple of quick examples. Um, most couples trying to have a child are stressed. When you think about fertility treatment at Joe’s acupuncture, fertility clinic, our fun and welcoming clinic puts at ease. So they aren’t stressed, enjoy their treatments and create happy and stress-free families. And another example is many practitioners feel overwhelmed when starting or growing their practice. Acupuncture media works. We dispense hopeful advice, proven tactics and successful marketing strategies. So you can confidently take action to move your practice forward. So once you refine your one-liner use it everywhere, put it on your business card, um, front and center on your website, uh, as your email signature printed on your wall of your clinic, you know, use it in your profile descriptions on your social media accounts, anywhere you come up with, put your one-liner okay. Check list. Number two is to wireframe your website.

Once a prospect is curious about your solution, they need an opportunity to learn more about you, right? So these, these days, the best place for people to do that is your website, right? If you’re lucky enough to have a landing pages on your website, which are powerful tools, could, that could be used to enlighten prospects on how you can help them. So this is, is when you enlighten them, how you solve their most pressing problems, right? This is where that enlightenment part comes in. This is where that, that light of, Oh, I see how Jeffrey can help me with my headaches clicks on and patients. And they begin moving down that path towards trust, towards commitment, because you enlighten them a little more. So there’s, um, there’s a couple areas on, uh, you know, aside from this one liner at the top of, you know, your website and everywhere else that you could put it, it’s gotta be highly visible.

There’s no set order for these sections. And, um, uh, you, you know, but you’ve got to just make sure that you express them somewhere when somebody hits your website, that they can see that, okay, check list, number three, build a lead magnet. And most people that visit your website are unlikely to return if they don’t take an action step right away. So a lot of them will quickly forget about your practice and when you have to offer. So it’s essential that you have a mechanism for capturing contact information and prospects. Most visitors don’t want to share their email address. So you’ve got to come up with like a strong incentive or a bribe that we call it in the industry. Something, um, you know, that will get them to, if they’re not ready to schedule or call right away, that, that it take, gets them to take action in a free guide or a PDF or a video series about acupressure or some product samples are really good.

The magnets. Okay. So a couple ideas around lead magnets are like five mistakes. People make trying to boost their immune system, seven things to get right before you start your fertility treatments, learn the three most powerful acupressure points to eliminate headaches for good, et cetera. So those are some ideas, um, the different types of lead magnets that you could start employing in your practice. And once you create a lead magnet and you need to start promoting it, okay. So consider creating an advertising budget on Facebook and just driving traffic there. Checklist number four, four is to create a nurture campaign and this nurture campaign nurture all the leads and all your prospects that have opted into your funnel, right? It delivers continuous value and fosters a deep relationship with your prospects over time, right? Maybe they’re not ready to schedule right away, but, uh, but they are reading your emails or they’re aware that you can help with this condition and that condition because you send them an email or content around that.

So, um, you know, so that’s important to have a specific email nurture campaign in place that helps stimulate awareness and the talks about the depth and the breadth as to what you can do and how you can help your prospects. Okay. And checklist number five is to make sure that you have a plug in sales camp and a sales campaign basically closes the deal, right? So you, you, you, you, it’s what you, the nurture campaign adds value as content builds trust, but a sales campaign is focused on getting people to schedule. Okay. And that’s all it really is. It’s simply about getting clear on your product or your services that you’re trying to sell and creating a campaign and emails, literally emails around that, that go out that are asking to get people to commit to care or asking them to actually literally come in, are actually asking them to call you.

So, the first thing to do is to set up your lead magnet. So you can start attracting, interested, interested prospects, write out your nurture campaign to nurture them on the backend, and then keep continuing with them ways to add value and insight and inspiration, and then wrap it up with a good, um, good sales emails that really speak to them in the language that you’ve been talking to them about. Um, and, um, and can help solve their problems. So, um, couple of things, before I go is keep this in mind. Right? What problems do you solve for your prospects and patients, right? What will your prospect’s life look like after they come see you? How would their life be different? How are their life be better? What will their, um, you know, what will their life look like if they didn’t come see you? And what does somebody need to do next in order to take the next steps with you, right.

Schedule or call and so on. So those four questions are really important to consider. Okay. So thanks for joining me. Thank you, AAC for inviting me back here. If you guys, hopefully you guys received some inspiration, some insights today, uh, courage you to reevaluate your plans and make some actual strategies and yeah. And get out there and make marketing happen. Okay. The world needs more practitioners like you. And if you’re interested in sending up like free 15 minute mentoring and discovery, call shoot an email at Jeffrey, J E F F R E Y at acupuncture, media works.com and say, you know, free mentoring discovery call. I’ll get back to you as soon as possible. Um, and for those of you that are interested in the ebook that I put together called the, um, resetting your practice for 2021 and how to get more patients on your table, you can go to Acumedia, A C U M E D I A.US/reset2021.

So it’s www.Acumedia.US/reset2021. I will take that link and put that below here. And you guys are awesome. You know, the world needs you. And I just want to leave you with this one, thought that on the tip of every single insertion you do, and every single needle you do, there’s an angel. So you are changing lives for the better with those angels on the tips of your needles. And that was something that one of my teachers said to me back in the day and still resonates with me. So stay beautiful. You guys are awesome. And thank you so much for the AAC for inviting me back here to discuss yet some more marketing materials with you.

The Yin and Yang Balance of Sleep Tsao-Lin Moy

Today I’m going to be talking about the importance of sleep and using it as a way of improving health for your patients. People are not getting enough sleep, and this was an issue that was happening even before the pandemic.

Click here to download the transcript.

Click here to download the slides.

Hello and welcome. My name is Tsao-Lin Moy, and I am an alternative medicine acupuncturist and Chinese medicine practitioner. And I want to thank the American Acupuncture Council for hosting these Facebook live events. Um, today I’m going to be talking about the importance of sleep and using it as a way of improving health for your patients. Uh, so, uh, let’s go to the slide.

Okay.

So one of the, uh, problems that we are facing in these times is that, uh, people are not getting enough sleep, and this was an issue that was happening even before the pandemic, um, that, uh, we have a situation that is really a crisis, um, about a hundred million Americans, which is one-third of the population are sleep deprived. And that means getting less than six hours of sleep per night. And poor sleep has been linked to many chronic illnesses, such as diabetes, heart disease, obesity, dementia, and chronic pain. And the studies actually show that if you miss one night of sleep, I means like, stay up, do an all-nighter that you, um, you build up a protein called beta amyloid at two, as much as 5%. And this is, uh, a linked to impaired brain function. And it’s also associated with Alzheimer’s disease. And this is where these beta, the beta amyloid proteins actually clump together and create those plaques.

So lack of sleep, it’s also linked to increased emotional disorders, including things like anger. And later on, I’m going to actually talk a little bit about it, like how it works with the season, right? So seasonal, emotional issues can be linked back to sleep. Uh, what we know is poor sleep has been a problem for weight gain, uh, hormone imbalances in fertility for male and female lowered immune function because of the, the cytokines, which are the inflammatory process and also premature aging. So, uh, many of you, if you have children or have been home and may have been experiencing this, uh, uh, problems, getting sleep, uh, being stuck at home, right? Uh, so what I am going to talk about is, uh, as you, as practitioners, understand the yin and yang, and really what I’m going to do is relate it to sleep because the, of yin and yang play a major role in sleep.

Restorative sleep is governed by the body’s circadian rhythm and the sleep and wake homeostasis. So circadian rhythm is that internal biological clock that regulates wakefulness, metabolism, body temperature, and hormones, and synchronizes with environmental factors, such as temperature and light. And this is also true of the seasons. Uh, what’s interesting is that it also closely relates to the Chinese medicine organ clock. So here’s a picture of the Oregon clock, right? We all, this is a foundations in Chinese medicine. And as you know, if you are a practitioner of, uh, Dr. Tang, that you might also, you look at the clock is how you’re going to treat the different meridians systems, right. Um, okay. So yin, if we look at yin is considered the hormone of darkness or the hormone of darkness we should say would be yet. Um, this is the circadian in the part of the biological clock that signals the release of melatonin.

So melatonin is called the hormone of darkness because it gets triggered when the light is lowered. And so when the sun begins to set, we have melatonin that starts to build up and it signals the body to start to move into a yin phase, which helps you to, to slowly go into a sleep phase. So following these movements and rhythm of the day and nighttime in the evening, the body is going to naturally move towards a yin phase. And that parasympathetic, which is the rest and digest, this is what Phyllis, uh, facilitates, you know, restorative and restful sleep. And so studies show that actually people that work night hours that combat that natural rest period, uh, in terms of light, um, they cause a misalignment of their circadian rhythm. And what happens is they suffer more cognitive problems and they’re at higher risk also for developing diabetes.

Uh, so somebody who drives a truck or is, uh, just, you know, staying has like the night shift clearly related to, um, higher health problems. Um, so it’s important also what time you go to sleep versus not just the, not only the quality, but you look at the time because there is an, and there’s also like how much the quantity we really need at least seven to eight hours of sleep. Now, the thing is, is what we need is really restful sleep. So here’s a little bit of the, the nighttime, uh, the, the yin time. And we see the moon so related in time is related to

Pink. Yup.

We’re looking at is more sunshine and vitamin D. And so in the morning when the sun rises, we actually are entering into that young phase and become wakeful. And this also relates to the circadian rhythm. Sunlight will actually pause that melatonin production, and it’ll also help the body to produce vitamin D. And that also helps with mood and other metabolic functions. So if we don’t get the restful sleep, it will manifest in being tired and wired. And that could also be related that you’re not getting enough sunlight. Right. Um, so, and just as a side note, every cell in our body has vitamin D receptors. And if we look at many of the people that had a severe COVID from had lowered levels of vitamin D, uh, in the U S we have a lot of lowered levels of vitamin D even before, uh, since we spend a lot of time indoors in front of our computers, uh, watching zooms, uh, this is, you know, exhausted. We don’t, we just don’t get out. And we also see with children, they don’t run around and play so much anymore. They are really stuck in doors doing activities. Uh, so what’s really important is for children to actually get out there into the sun and, and play, and also as adults too, we really need to get outside and move around. Okay. So here we go. This is exactly, yeah. Fantastic. Would it feels like to be a kid running around in the sunlight, uh, enjoying, enjoying themselves.

So what causes this imbalance or to this a yin and yang out of balance? Well, as I said, you spoke about it a little earlier. The problem of modern life is that we also tend to ignore and override the body’s inclination for rest. And this can result in like racing thoughts when it’s time to sleep. And I’m sure a lot of your patients report, they can’t get to sleep. They, you know, they keep thinking about what they need to do. So this is really an example of this young energy when it’s really time for the yin to quiet down, or we see people staying up all night long and then sleeping during the day. And that’s really when they are out of alignment, really out of alignment with the Nat, the natural cycle. And what happens is, is that when you do that, your body is, is actually fighting with the, the rotation of the earth, right.

Going and moving towards sunlight. And you’re going down trying to go down and all of the forces of nature are pulling you back up. So what happens is you get very tired and wired. Um, and so really studies they’ve shown that people that work night shifts also have greater health issues. Um, even if they’re getting the hours of sleep, that they need the number of hours so that they there’s more, that has to be looked into. Uh, another thing is also people say like, Oh, I catch up on my sleep on the weekend and you cannot catch up on your sleep. It doesn’t so not getting enough sleep. You create something called a sleep debt, right. And that negatively impacts the, the, the health. So things such as stress, fear, and anxiety, which are like being in that fight or flight mode very young, um, that is often one of the complaints that people have, especially when it’s time to rest.

Uh, so just sitting and relaxing, their mind is still going, which means there’s this disconnection of the mind and body. So not going into calm, being relaxed and stable, which is more of that yin time. So there’s not enough time for recovery. So what we see is is that there may be too much of activity. And then the body just doesn’t get that TA like the focus time to relax. So then we start to have this thing where it, uh, the adrenals get involved and the people are unable to actually rest and relax. They just can’t go into it. And that’s like kicks into their nervous system, right? So when we’re looking at this, we’re looking at the illness is coming, comes from being out of balance with nature, our environment, and how it affects our biology. And so this yin and young balance is reflected.

It shows up in the quality and the quantity of our stuff sleep. Um, so, you know, why are we talking about this? Well, this is addressing sleep as a strategy for your patients. So no matter what they’re coming in with focusing on the quality of their sleep is going to be really, really a good key to helping them to heal. It’s also telling you that something else is going on, right? So most people don’t consider sleep as a wellness or self care practice. They don’t think of it as an activity because they think like, well, I’m just lying there. I’m not doing anything. But the fact is, is that there’s a lot that’s happening when you’re sleeping and you really need to get that quality sleep just as you’re preparing for your day. You know, this is an activity that, you know, during the daytime, very young, you’re very aware of the activities that you’re doing when you’re sleeping.

You don’t need to be aware of those things in your sleep. You need to come that part of your brain down and let that your body take over. So most patients, when they come in with the chief complaint, we know that there’s an imbalance in Ian and young. We can look at the meridians, we can look at digestion, we look at the emotions, right? And then the key is like, well, what can we look at that is really gonna give us, uh, an indication, because it’s really not yin or yang, it’s yin and yang. So that problem that they’re coming in with, there’s gotta be the other side of it. And so this is where we can look at sleep. So if somebody is not getting restful and restorative sleep, their body, you know, their, their body needs to heal if they are getting the sleep.

So even if they report that they get great sleep, um, that there’s a pro you know, sleep is going to be something that’s involved in, cannot be perfect balance if young is out of balance because they’re interconnected. So if someone has a problem, then we know that there’s also going to be the other side in, in the yin aspect. Um, so, and the other, again, I said, you can’t catch up on your sleep, right? We have the sleep debt, and that’s like an, I, those are one of those myths that people are like, Oh yeah, I sleep on the weekend. It’s not. And in fact, if you sleep too much, that you also can cause a problem like the, the, uh, the metabolic waste builds up and toxicity. So sleep quality we’re looking at. So what happens when you have a good night’s sleep, you release growth, hormone growth hormone is what helps maintain healthy body tissue.

It promotes healthy metabolism and is important for maintaining bones. 75% of growth hormone is released during sleep. And it helps to restore your body and muscles from stress experience during the day. So this is really key. If you don’t get into that restful state, this is not happening. And so that is going to be a real clue. If your patients are not healing, right, better mood and positive outlook, sleeping well means you’re regulating the autonomic nervous system to be in a state of rest and digest your body. And mind are able to repair and recover and balance brain chemicals. Poor sleep is correlated with depression, deep restorative sleep results in a more positive outlook on life. So anybody who has depression, you’re going to notice that they probably sleep a lot, but it’s not restful. So that’s where you there. That’s one of the clues of, yeah, well, I get a lot of sleep, but it’s not restful.

And so that means that there’s some other imbalance that’s going on. So immune function studies show that sleep quality and immune function are linked to better health outcomes. So getting deep and restful sleep, you are able to reset and remove that metabolic waste that builds up from stress and in turn reduces systemic formation. So we also know that children require a lot of sleep. Why is that? Whatever they’re learning, they’re growing and learning and their body and their brain needs to be able to integrate and do its functions, right? So this is true for us, even as adults. And, and when people are not healing, we can look at that. They’re probably not getting restful sleep. So you’re, we’re looking at the four seasons, right? The spring, summer, fall, and winter now seasons and patterns of sleep right now, we’re in the spring time. So all in all things, we can see that there’s a dynamic interplay of nature and seasons that are a microcosm of the cycle of life.

So we are influenced, this is, it goes back to the circadian rhythm, right? That we are also, uh, relates, you know, our health is also related to the environment. Uh, so if you look in certain countries where they have like four hours of light, when they’re in the winter, or they have, you know, forever a day, they tend to have a lot more emotional, um, problems. Right. Um, so understanding that the yin and yang of our body is what connects our biology for the need of sleep daytime and nighttime. So that we’re in sync with the movement of the sun and the moon, as well as the seasons where the amount of light will change. So being in rhythm with nature is going to help us with the flow of our own internal clock. So that’s resetting the circadian rhythm and the body’s ability to maintain homeostasis.

So this also applies in the change of seasons because we start to look at people having more health issues at certain seasons. So important to bear in mind that people’s energy will shift depending on those seasons and can show up in pulses and different types of illness. Right? So we always expect in the spring time that you’re going to have a little bit of a winery pulse, and that’s going to be normal in the spring time. Right. Cause your with the seasons, um, we got a little winter, okay. Winter, for example, is considered the most UN time of the year for looking at union young. Um, it’s cooler, there’s less light. Uh, it naturally influences the process of slowing down animals naturally go into hibernation to conserve their energy. And that’s true of us. We tend to feel more sleepy. We gain a little more weight, may not have so much energy.

You want to go and, and, and, you know, sleep. Uh, and so it’s during this sleep that the body temperature actually lowers. So this is something that we, you know, going into a sleep phase, we actually, our body temperature lowers. So we go towards the end, which is why, you know, the first days that are cooler after hot summer people have fantastic sleep. So people are also, uh, sensitive to the seasonal change, right? Experiencing the winter blues, the seasonal, sad, um, their relationship of their internal balance becomes upset by the external changes of the season. And in this case, something like sad in the winter, they may sleep excessively, withdraw, feel like hibernating and experienced depression. Also people with low vitamin D have a higher chance of developing seasonal depression. Uh, so treatments such as light therapy, acupuncture, exercise, and vitamin D have been found to help.

Now, if you’ve been indoors all summer, as winter comes around, what happens is, is that you have lowered vitamin D and you can become more, you know, have, uh, feelings of melancholy and depression, right? And so here is we’re looking at the young time. This is summer, right? So this is the most young time of the year. And so the warmth of the sunlight makes people feel a lot happier, right? We have more energy because we’re getting the energy and here there is a propensity to stay out later. So this is one of the things and get less sleep. Uh, the additional time in the sun is where people also get vitamin D and some of it can be stored in the body, right? That’s what kids do. They run around outside, and, uh, get a lot of sunlight in, in certain cultures where they’re working in the fields, they’re out there getting vitamin D and, uh, they don’t have to take the supplements, right?

Historically we didn’t have supplements, uh, in the summer, but we need them. Now, when you do need them now, uh, for many other reasons, environmental factors that cause us to lose, uh, also, um, important, uh, vitamins and minerals, uh, in summer months, some people experience more anxiety though, and agitation and even mania, right? So that’s that heart energy not sleeping, right. If they’re out all the time, they can actually trip into, uh, having more mania. So summer insomnia, they call it where, uh, that can be very frustrating. And that we see in, uh, in climates where people have like forever song, uh, long days of sunlight, you know, closer to the North. So maintaining a sleep schedule and cooling the environment and, uh, darkness for sleeping is something that can help. So this is where someone has to get really disciplined in the summertime, right?

Because that is actually kicking in their natural propensity for being very up, right? So they need things to do to help, to balance it out. So this is like seasonal illnesses and getting sleep, uh, getting good sleep in the spring is especially helpful for the emotion of anger, right. Uh, we’ve been seeing a lot of outbursts and a lot of stuff going on, at least here in New York city, where I am, you see people, you know, very angry and agitated. Uh, and of course the, the formula of choice is the shallow song to kind of help, uh, to unwind the liver and smooth out the emotions. So this is like that liver young energy people get very agitated as also as the season shifts. So it was at, to look at when there is a shift in season that we’re going to have liver energy is going to be involved to a certain degree.

So not getting sleep is also going to mean the blood’s not stored during the night and results in irritability and angry outbursts, also allergies and itchy skin fall, poor sleep. You can have more worry and anxiety, digestive problems, gas, and bloating, and then you get colds and sinuses and more melancholy, you can get lack of sleep is going to magnify any of these seasonal influences. And also it’s going to magnify the imbalances that are part of that patient’s constitution. So this is a place where when you look at their constitution and look at what’s going on in the season and how it’s relating to their sleep, like what’s happening. And that’s like a, like a, I won’t say a no brainer, but it’s a good start because what happens is people’s symptoms are all over the place and you start to chase them. And so you’re going to know if they’re having emotional problems, that there’s going to be some liver involvement, and you’ve got to look at whatever liver energy involvement and look at whatever else is going on with the season and their sleep, right.

So really to help your patients to cultivate better health. Um, if you’re, you know, diet is going to make a difference, right. With sleep, um, exercise, making sure to move the cheese in blood. And definitely during the, you know, outside, uh, meditation for mindfulness acupuncture is going to definitely help, right. With regulating the nervous system. Um, we’re looking at herbs supplements. They may need support with, like I mentioned, you know, shallow sawn in the, in the spring. Uh, but if you’re a new Yorker that is like, uh, you know, that’s the, the first formula you might think of. Cause new Yorkers tend to get very irritable and cranky and agitated, um, get some bodywork, cause touch is also going to help, right? Uh, again, there’s something when I, I love is the environment with Feng Shui, I’m going to quickly do something with that and spending some time in nature so that you’re able to really take advantage of, you know, the, the earth.

So here are some tips for better sleep, for something that you can do with your patients, mind, body harmony. So worrying and overthinking those racing thoughts are very young and it makes it very difficult to fall asleep and have a restful sleep. So powering down the mind is just as important as lying in bed, a relaxation, meditation, and breathing exercise can help bring the body back into a parasympathetic or you’re a yin phase. Now most, if somebody is very agitated, it’s very hard for them to meditate, right? I’m sure you have patients that say, I can’t do it. Oh my God. My mind races. Um, so what there is instead is there’s that four, seven, eight relaxing breath. Um, and it’s an exercise it’s really simple to do. Um, uh, there’s a link to it in here. And later on, if anybody wants the slides, uh, they can have the slides, right? It’s a, it’s a method of helping to calm you down. You can use it anywhere. You know, it helps with anxiety and actually helped to shift the nervous system. Breathing is also going to help with oxygenating the body and moving the energy, right. With each breath, we know that the cheese is going to move like five soon, right? And, and if we’re, our energy is stuck, we need to be

Great

In time promoting deeper sleep. So in time getting to bed before 10, right? The, the, the Oregon clock, right. We want to make sure we’re in bed before 10. So sleep can occur during the most yin time between 11 and 1:00 AM. So that’s taking advantage of the circadian rhythm and the movement of the earth. So when you’re in rhythm with your own biological clock, as well as with the plan, and then we’re looking hormone of darkness, you some heavy curtains on the windows, block out the light and the noise to help keep your biological clock for you to have a produce the melatonin and the rest will sleep. Right. So this is the thing in studies. If you’re, you’re looking at your, your computer or your TV or your smartphone, they found the people that, uh, expose themselves to room light before bedtime actually suppressed the synthesis of their melatonin. Right? So it means you got to put your phone down probably a couple hours before, at least, um, in temperature, you know, studies also show that the best temperature for sleep is 65 to 70 degrees. So your body will naturally lower its temperature and stay cool while staying asleep. So your body actually does do that.

Good.

So, um, young and moving energy, get outside and do a little bit of exercise. Um, this helps the body to synchronize, uh, with the movements of the earth. Uh, we see that, you know, looking at nature, um, here doing a little exercise in the early morning to move the Chi and gather that energy from the sun, uh, and then tips for functions way, you know, removing clutter, uh, distract, like that creates a mental distraction and chaos, um, that can actually interfere.

I got nice thing.

And then here, you know, preparing the sleep environment, you want to lower the lights again, you know, for the melatonin, no TV screens or computers, make sure you have those heavy curtains really make it a ritual for sleeping. Right. And, uh, again, uh, so this is, uh, I’m gonna stop sharing my screen here. Uh, if you, again, if you need copies, uh, you can, or you missed part of this, uh, this is going to be, uh, available to you. Uh, you can, I guess you can email or text, uh, you can get copies of the recording, uh, and, uh, yeah, for a copy of the transcript, you’re going to need to, you can text needle, uh, to the, the number (714) 332-6926. And, uh, I hope this was, uh, informative for you and please join us next week. Uh, when we’re going to have Jeffrey Grossman, who’s going to be hosting, uh, these, this, um, uh, American acupuncture council, uh, Facebook live. And, uh, so I want to thank you all for listening, and please comment. If you have any questions, you can always get in touch with me. And, uh, again, uh, this, uh, you can, uh, get the transcript and I think there’s going to be a replay too. Thank you.

#1 Practical Tip to Increase Retention – Chen Yen

Click here to download the transcript.

Do you feel like you give great clinical care, but then sometimes patients don’t end up sticking with care and it feels really frustrating because you feel like, Oh, I could so help them if they only stuck with care. So welcome. This is Chen Yen, six and seven figure practice make-over mentor at introvertedvisionary.com. Your host for our AAC live show here today. And so let me give you the number one most practical tip that you can use to help with retention, whether with your own patients or your associates practices, because maybe you’re, you’re actually pretty busy, but then you have an associate and you would like them to stay busy. Have you ever thought about this with, with retention? That if you are actually, um, if your patients don’t really understand why they should stick with it and they drop off care, it’s almost like, like, uh, not helping them fully.

It’s also, uh, something where if you’re feeling like I’m not consistent enough with patients, then it’s a leak. It’s like you bring in patients on Linden and then on the other end, they end up not coming back to the extent that you could really help them. So this is a number one practical tip that you can use right away is to think about these three key things. Number one is that patients need, and then I’m going to give you a specific strategy you could use in, in specific, um, thing that even a template that you could, you could use right away in your practice to increase retention. So then, um, three things. Number one is that patients need to understand if they’re not actually understanding why the care is helpful for them and why to stick with it, especially with the number of treatments many times with, with acupuncture could take, then they’re not going to actually stick with it as well. The second thing is to remind them, because even if they do understand, and they’re not reminded of it, they might not actually understand it fully because for you, it’s, it’s something that

Jen we’ll be right back. She has a little internet issue going on. We’ll fix that in a second. So hang in there, she’ll usually come back very quickly here. She comes

For you. It’s something that is, uh, you know, you get, get it clinically. But then for someone who, who is brand new to what you’re doing for them, they don’t really, uh, always understand things clinically. So it’s up to you to remind them and educate, continue to educate in each visit so that they will actually, uh, understand what you’re, how you’re helping them and why it’s important to come back. The number three to think about is to make it really easy to book an appointment. Again, I can’t tell you how many times I’ve heard from acupuncturist where it’s like, Oh, would you like to book it your next appointment? And then if someone says, no, I’ll just wait until next time. Well then they don’t end up booking, right? I mean, I’ll just wait until I, I fig figure out my schedule and then I’ll call you and then do they have ended up calling?

Sometimes they do. Sometimes they don’t. So how can you make it easy for them to book, for example, what are you saying right then? And there at the end of the appointment, are you actually saying, let’s get you scheduled notice. Even the tone of that is different than would you like to get book your next appointment? When would, when would you like to book your next appointment? Like that is not taking leadership of, of recommending what, what would be best for them? Because people are looking up to you for guidance. People are looking up to you as their acupuncturist to, to tell them what would be best for them. So those are three quick things to think about. Now, let me share with you specific strategy that my clients have used that have helped them double the retention rate in this Cub. So this, this retention piece comes from the fifth step of the consistent patients formula for introverts.

So as far as the, uh, practical tip related to this is one at the beginning of the visit, what do you do? Uh, do you always have an, a short, a very short intake form that they fill out very brief, just literally three questions and that, and what are they? So the first question is something more about, um, what what’s been happening since the last visit and the reason why you would want them to, to actually take a moment and write this down. Cause I, I hear from some acupuncture loads, do I really need to do this? I ask these things during the visit, or I, I actually diagnosed them during the visit and, and they it’s pretty obvious. And then I’d talked to them about it. There’s something about, um, patients taking that moment and writing down, reflecting on the progress that they’ve made.

Have you ever had people who, who have actually made great progress and they don’t seem to remember it? So this is why it’s important to do this. So the first question is the first thing is describe what’s been happening since your last visit. Um, and then with, with what you originally came in for, by the way, I’ll make sure that you get this template. If you want to just PM me and I’ll make sure you get this progress assessment form template. So the second, um, thing to have on there, actually. So I mentioned having three things, I’m gonna give you four things, but, um, the, the second one kind of ties into the first one. So the, the second one is to share any improvements you’ve noticed. So first they describe what’s been happening since the last visit. And then the second thing they share is, is the improvements that you’ve noticed.

Then the third thing is something that measures their, um, feeling of progress, right? So for example, if it is pain level, then, then you could say, what is your X level on a scale of one through 10? So what’s your, what’s your pain level on a scale of one through 10, and then they actually read it. Then the fourth question is, and this is the most powerful question. What it, what, what are your top three most frustrating health issues right now? What are your top three most frustrating health issues right now? And why is this so powerful? Because have you ever had people who came to you for one thing, but they didn’t even realize you could help them with other things? Well, this helps them have a moment to write down those things that are actually bothering them right now in this moment. And some of those things, they might not even have thought that you could even help them with.

So then during the visit, you can bring this up, you can say, okay, I noticed that this has been happening for you. And then you’ve mentioned that you’ve been having these issues. Tell me more about that. So that helps you to be able to have, um, a conversation with them about what’s most pressing for them right now. And again, you know, I get the question well, uh, from acupuncture sometimes like, well, do I really need to have them fill this out ahead of time? And the answer is yes, because, um, they w that’s where you end up having that opportunity to,

Oh, she’s coming back, ladies and gentlemen, hang on, Chad. I believe you’re muted. I don’t know if you could hear me, but you’re muted. Nope. You hold on. Okay. Wait, try it again. Let me hear you talk, talk, talk. Okay, there we go. There we go. Good. Keep speaking. Nope. Oh, wait a second. I hold on a second here. We’re sorry for these technical difficulties. Let me see if I can bring chin. Can you hear me? I can’t hear you. You must have muted yourself up and she’s gone again, ladies and gentlemen, um, we’ll make sure that you get a copy of this. Um, uh, here she comes.

So they need to be able to have that moment to actually reflect on their progress. And literally, how can these this be done logistically? Is that before they actually have their visit with you, they would actually fill this out, just this, you know, three or four quick questions out in the waiting area, like on a half sheet of paper, or if you are doing this in EHR, you could end up having, um, like a, a kind of like an iPod thing and iPod iPad, and then have them fill out the answers to this. And, uh, the finally the final tip I wanted to give you is that at the end of the visit, are you also giving context and also same thing at the beginning of the visit? So perhaps you could say, okay, last time we worked on this, this time we’re going to work on this or this I’m going to focus more on this.

And then at the end of the visit, acknowledge the progress they’ve made. For example, I have, um, a craniosacral therapist I’ve seen and, uh, she’s so good at this. You know, after every visit, she says, what got you? Or what some version of this, right? Like, Oh, you look like you’re glowing. You look so vibrant. You know? So then I feel really good at the end of the visit. Right? And she reinforces that for me. So if you see visibly that your patients look more relaxed or they just seem more, more like they’re in the flow or in a goal, it glowing, then, then recognize them for that. And then say, this time we focused on this and next time we’re going to work on this, you know, something like that. Right. So, uh, and I know that as, as a clinician, as an acupuncturist, you are already good with diagnosing things and you feel like, Oh, I don’t, you know, I probably don’t need this thing.

It’s not like I need them to tell me that this such and such is wrong. Sometimes, you know, you do a pulse, I’ll tell him and you, you know, exactly what’s going on. But when patients are bought into the idea of what you’re doing for them, when they understand, when they can actually see that they’re making progress, when they are actually feeling better and you are acknowledging that they are feeling better, they feel more excited about their care and they’re going to actually stick with it. And they see a context to, okay, this is what I need to do. Um, like continue on. And this is, this is what you’re going to do for me next time. And then as a quick reminder at the end of the appointment then mentioned, okay, let’s get you in the calendar for the next appointment. Let me see here.

I have such and such a for such and such date. Right? So, so there’s none of this, this kind of thing like, Oh, would you like to book an appointment, the right kind of tone, but rather an assertive, a tone of you knowing what’s best for the patient and you’re in terms of your recommendation and then giving it confidently and getting it on the calendar. So with that, I love to see you comment below. What did you find helpful most helpful about this? What’s one practical tip that you can use. And then go ahead and PME, go ahead and click on my name there and then private message me. And I’m more than happy to give you that template that, um, that I gave you in terms of the progress assessment form. There’s also a script that goes along with it in terms of what to say to, so that way you can actually benefit and help your patients get to the best outcomes as possible when they stick with care.

And they’ll appreciate you for it also when, when they get better care. And then when they’re also actually getting better results as a result of that, then they’re going to refer more to, and your practice will be full, or your practice we’ll get into more of the snowball effect and you’re going to help more and more people. So with that for more six and seven figure, practice, makeover tips, go to introverted, visionary.com. And if you’re struggling right now and feeling like you’re at a plateau, um, you, and you just know you’re capable of so much more, you’re meant to help people who, who really need you then feel free to reach out on our website and happy to give you insight into your situation, how it can help you. So that till next time.

Acupuncture Sports Medicine with Whitfield Reaves

His experience includes the 1984 Los Angeles Olympic games, as well as numerous track and fields cycling events nationally for the last four decades, Whitfield is the author of the well-known practitioner’s manual, the acupuncture handbook for sports injuries and pain, which one of the few texts integrating traditional Chinese medicine, acupuncture, orthopedics, and sports medicine.

Click here to download the transcript.

Hi, welcome to this week’s American Acupuncture Council’s Live uh, Facebook podcast show. I’m your host Poney Chiang of neuromeridian.net from Toronto Canada. Joining us today is our special guest Whitfield Reaves who is joining us from the central coast of California and he will be relocating into Santa Fe. I’d like to begin by giving you a biographical description of, uh, uh, Dr. Reaves. Uh, Whitfield Reaves is one of the leading practitioners in the field of acupuncture sports medicine. He began clinical practice in 1981 as specialized in the field of orthopedic and sports acupuncture for 40 years. He is licensed in California and his earned doctorate Oriental medicine degree in 1983, his thesis acupuncture and the treatment of common running injuries demonstrated that TCM could address many clinical issues in sports medicine. His experience includes the 1984 Los Angeles Olympic games, as well as numerous tracking fields cycling, either events nationally of the last four decades, we feel is the author of the well-known practitioners manual, the acupuncture handbook for sports injuries and pain, which one of the few texts integrating traditional Chinese medicine, acupuncture, orthopedics, and sports medicine. He’s also the director of the acupuncturist sports medicine apprenticeship program. Thank you very much for joining me. We feel it is an absolute honor,

And it’s a pleasure for me, Poney. It’s great to see you.

Um, I have, um, uh, some questions for you today and, um, uh, I want to keep it pretty relaxed and casual. Um, mostly wanted to hear about your experience, um, in sports medicine and you know, your clinical experience, especially, I was wondering if, um, you can tell us how you ended up specializing in the field of sports medicine.

Well, I started practice in 1981 in February of 1982. I had a marathon runner out for run run in my office and he had Achilles tendonitis and he asked me, you know, can you, can you help? And I said, of course, and of course I had never treated Achilles tendonitis. I had never had a teacher that taught me how to treat the Achilles tendonitis, but that was, you know, I was new in practice. It seemed like the logical thing to say. So I treated them. I was back from China. So I treated them China style, little bit Wednesday, Thursday, Friday, Saturday. And then on Sunday he ran the mission Bay marathon. He won the race. I had no idea. I didn’t even know him. You know, like, well, how fast do you run your splits? And what’s your personal best? And what are you training on this? I didn’t know any of that stuff, you know? And so that was Sunday and this was 1982. This was two years before the Olympics in San Diego. This was in San Diego, California, San Diego was filled with Olympians training, trying not to be in Los Angeles, but to be close Monday morning, he brought in busloads of athletes, you know,

From, and

Literally I became a sports acupuncturist overnight and it was of that moment. I didn’t choose it. I was always athletic. I love sports. And it just happened. And really looking back, I didn’t know anything as, you know, the education for graduation to be an Lac in 1981, included nothing very precise about sports acupuncture. So what happened? And I had to teach myself while we went.

That’s a fantastic story. So I guess it’s all, all word of mouth from a high-performance athlete from there. Yeah, that was it. Yeah. Um, well, unfortunately it’s sad to say even to this day, there is still not very more sports medicine curriculum, your average Chinese medicine school. Uh, so, uh, so unfortunately that it has changed, but thankfully we have, uh, mentors and masters such as yourself, which can help us pre-state yet. Now I wanna, um, um, uh, kind of put you on the spot a little bit. Um, I want you to tell us what do you find you get the most consistent results and when it comes to sports medicine now, what do you find? It’s one of the more complicated, more difficult, uh, conditions for you to treat

Well? Um, I would say consistent results for me come with the shoulder, come with tendonitis, infraspinatus, uh, the acromioclavicular joint, much of the shoulder. I find that I can just do really well with the techniques that I’ve learned and, and put together over the years that, I mean, unless you have greater than a 50%, all the way up to a full thickness tear of a, of a rotator cuff tendon, you can get great results in better than any other tradition. I know better than anything PTs can do or, or, or exercise signs or anything. Cause we can get into those discover chromium space area effectively with the needle. So I’d say that’s my favorite.

This has been great and reassuring to hear because for a lot of practitioners, they are afraid of shoulder. I have an associate in my clinic whenever a shoulder case, just like she gives it to me. So I’m very happy to hear that you, um, at that, that is possible to become really, really good to get great results in the shoulder. Cause I know a lot of people lacking that confidence because sorry to interrupt you, please continue

The worst. The things that I don’t like are places that are hard to needle. I don’t like an inguinal hernia or inguinal strain. I don’t like the groin. I don’t like need doctors and I don’t, and I don’t like the armpits, you know, the awareness, you know, I would prefer to send them out for manual therapy. Uh, and so as I would prefer to send out for manual therapy and those are conditions that I think acupuncture does, you can’t get precise access. Cause my needling is all about precision, you know? And you just can’t be precise, kneeling into an armpit, you know, or what have you. So, uh, that being said, there are people who can needle the subscap pretty effectively. I don’t like I don’t teach it. I don’t like it.

So I see. Yeah. Um, well I, I can relate, um, those places definitely are trickier. And of course you just, sometimes you have a deal with like, uh, you know, body hair and things like that. It’s, uh, it can get a little messy. Um, um, and yeah, I, I have found, uh, you know, growing issues to be, uh, relatively difficult to, you know, I’d rather treat, um, at least tendonitis than deal with the growing street. Um, you shared us with it as a great story.

Okay. I got to tell you that you became my hero.

Well that’s

When, what, when I use this technique of using needling small intestine nine, uh, with three-inch deep, deep, you know, all along the act below the axle and I use it for shoulder joint dysfunction, and I never could understand we’re not really going into the infraspinatus or the Terry’s minor. And I would do a corresponding point on the anterior side and I never really knew why they worked cause we weren’t really going into a muscle. And when I was looking at one of your webinars and you showed that branch of the nerve here that goes into the shoulder capsule, can’t remember if it was the anterior, the posterior or both. I went, that’s why it works. It’s a neural explanation and you became my hero. So,

So that means a lot. It means a lot. Uh, I was not expecting that at all. I mean, you know, I, I, you’re definitely a giant the field and I, you know, I, I studied your work very in depth and uh, so it’s actually a great, tremendous provision for me to, to have you on my show today. And, uh, so I really I’m just floored by your, by your generous words. Thank you very much. Um, no. So you shared it with us a really awesome story about how you got into, uh, the field of sports medicine. Would you mind telling us, um, a recent success story to something that was especially memorable that you can, um, chose, inspire our fellow listeners?

I’ll go back to the shoulder. Uh, I had this boy who had had a pretty severe motor vehicle accident 10 years ago, and she’d had a fracture and humorous, uh, up the proximal end and, and, uh, so they dealt with the fracture and, and, but the opposite shoulder had always heard her and it never got any attention because of the fractured side and the opposite shoulder was, uh, the seatbelt and shoulder. So something had happened in there and I, uh, I evaluated it. She had a positive arc of pain, so it with a D AB duction, she had impingement right into here and she was going and she had weakness on resistant AB duction. She had a weak, uh, turned off, right, inhibited supraspinatus with a positive impingement test. So something was going on inside of here, uh, with the 10 men and what have you.

And it just smoldered for 10 years and nobody had paid attention to it. She was leaving in two weeks to go to the Caribbean, uh, to, to, uh, take, uh, uh, uh, to sail. And she was going to be the captain, you know, ahead of the boat. And she needed to get her arms up like this for the wheel and for the lines and all that. And, and, and I said, well, two weeks, you’ve had this for 10 years. So she said, give me everything you got. So I went in at L I 1645 degrees of bleak, lateral and threaded under into the subacromial space needle and kind of toward [inaudible] superficial to the supraspinatus tendon, deep to the S to the boney, you know, a, a chromium. And I felt it going through these layers of scar tissue. I could just feel the springiness and I pushed through, and we, and we had maybe five mechanical strikes of, of scar tissue and fibrosis underneath here. She aggravated for, for seven, eight, nine days. I couldn’t treat her because it was so aggravated. She came back. Finally, we had three days left ago, she had no positive and, uh, impingement test. And the only thing that was left was that her muscle was still inhibited. We needled small intestine, 12, the motor point of, or the muscle belly of the supraspinatus. And she was seated. I got the needle in, into the muscle and, and within five seconds she turned green and

Yeah, that’s definitely a very memorable story.

Oh my God. Well, so we brought her up and we got her all fixed and then I’ve retested, it turned off five seconds of needle into the supers place. It turned on that muscle and she was 100% fixed for the rest of the time that I knew her, you know, and the second treatment was a five second stimulus to small intestine 12 and it just went, wow. So I didn’t need to put that needle in there for 30 minutes and do all this stuff fixed. So that was good.

That’s very, very cool. Um, and I like the fact that you’re not afraid to share some of these, um, slightly, you know, less than perfect stories. Right. She aggravated her, but sometimes as a healing response, she passed out, but you know, things like that happen. Right. So, um, yeah. So all of them are respect to you for, for, um, sharing these, uh, sort of less than perfect stories. But I think, um, mature practitioners without experience, understand that this part that’s part of the, you know, part of the day-to-day bread and butter, and that is, uh, amazing. Okay. And of course she won the race as well. Right? All your patients in races, right.

And it pricked the boat and they didn’t die. If practitioners will take the point of view that there is no such thing as a wrong needle, you might put a needle in and it might not go to where you want it, but it, but it tells you, okay, I need to direct this over here, or I need to needle it over there. Or I’m not on the band. I didn’t get a [inaudible] or whatever your criteria is. If you, if you, if you, there’s no such thing as a bad needle, there’s just some needles that just guide you to a better placement. Then, then you’re not always feeling like you’re a failure. You use those failures to get you more precise and it’s, it’s a much more positive relationship to the experience. So, yeah.

Yeah. What you’re, you’re, you’re saying is very profound when I have to kind of digest it and reflected about it. I’m sure it’s like, it’s not just going over my head right now. And there’s no such thing as, as a wrong needle. I have to, I have to think about that. Uh, but I appreciate that. Um, now I have the, because I, you know, I’m also interested in neurology, neurology and orthopedic aspects, and I encountered this with, um, you know, uh, new learners quite a bit. And some of them are, uh, hesitant to, to embark on a path to become great, uh, good at treating sports issues. Um, and, and it doesn’t have to be sports. It orthopedic issues right now, but it’s she’s athletes, but everybody, you know, um, everybody is, uh, has some repetitive chronic pain and due to repetitive strain. And so there’s sometimes a lot of overlap between the high-performing athlete and your typical sedentary type of desktop, uh, desk workers. Um, but I encountered some people are afraid to go into the field. I wonder if there’s any advice or words of encouragement. Um, I know you didn’t seek out to go into it, but it has turned out to be very rewarding for you, right? Any, any advice about people that are afraid or hesitant about going into this wonderful field?

Well, I, I think being afraid and hesitant is a really very beneficial emotion to take a look at because, because you’re not going to be very good knowing what you probably know already, uh, Meridian acupuncture is of very little value in treating orthopedics. Zang Fu is of almost no value in treating orthopedic and sports injuries. So you have to learn a new headset, a new way to think, you know, about what you’re doing, but it’s all doable. You can learn this. And there are plenty of teachers and you can, you don’t have to have one teacher. You could do a little bit from a number of places, learn from your neuroanatomy, uh, webinars. Learn from me, learn from that. Talisen, there’s just so many ways to get the information. So the, your fear should only be a guide to tell you you’re going to have to work.

You’re going to have to retrain yourself. You know, I had an occupier, I had a patient that came in and she said, I’ve got Achilles tendonitis. My family general practitioner takes care of all our, our coughs and colds takes care of the kids and all that six times nothing happened. So the patient came in, I said, okay, you have Achilles tendonitis. So when you get up in the morning, your Achilles tendon is stiff. And your first steps are difficult that as we know is a keynote symptom of Achilles tendonitis. It has to act that way to be Achilles tendonitis. And he said, Oh, no, I get up in the morning. And I feel great. It’s at the end of the day, that it’s a problem I want, okay, 99% chance, you don’t have Achilles tendonitis. You got the wrong diagnosis. This guy was a 1500 meter masters runner with the most beautiful body, 1500 meter runners just they’re gorgeous.

Right? They’re just beautiful bodies. You know, they’re not so bolt up as a, as a sprint or they’re not so lean as a marathoner. They’re just like, perfect, beautiful. So, so, uh, I did a pinch test of the Achilles and the pain was all the way down at the attachment at the Achilles bursa. He had Achilles bursitis. So I needled, uh, instead of the tendon, I needle down into the area of the burst. I’ve got some techniques for that. He came back five days later, he was 80, 90% better with one treatment. And the first thing he said to me, he said, there’s a difference between a general practitioner and someone who specializes in sports medicine. He just said that to me. And it made me feel so good because that is what we, that’s what we need to communicate. There is a difference. You know, you don’t go have brain surgery from your, your GP.

Doesn’t do brain surgery on you. You go to a brain neurosurgeon, you know, so the specialty is a beautiful, wonderful specialty. And if you’re drawn to it, you got to learn that you got to learn the language and you have to understand there’s orthopedics, but the next step over is their sports acupuncture. When you’re getting into sports medicine, you have to learn about the psyche of the patient, of the athlete. You have to have more, more attention to how they think and feel, and of course how they train, whereas with the PDX, you can get away without knowing a lot of that stuff. But there are similar the basis of orthopedic and sports acupuncture. The basis is similar with that emphasis of really trying to figure out what makes them do this and why are they doing this? And so, but it’s a wonderful field and it’s totally open. There’s no obstructions, there’s no barriers to entering. You can, you can, you can do fantastically in this field. So you’re welcome to come and join.

Thank you very much for that. Um, just to finish off with our interview session today, I was wondering if you can share with us your favorite acupuncture point, if there is possible to identify one of your favorite, one of your favorite points and how would you, uh, how do you recommend that we use it? Well, I think, you know what I’m going to say.

My favorite point, if I had only one point to do would be the extraordinary point. Jen claw, J I a N qua qua, uh, the claw, the is the, is the thigh and the glutes, the lower mid section five of the bodies, not just the thigh, but it’s, you know, probably includes the, the gluteus Maximus and all of that gen means strengthened. So the translation is strengthened the thigh or strengthened the block. Uh, this is in the muscle belly of the gluteus, medius it from the greater trocanter halfway, but from the greater toe canter to the iliac crest, along the shallow young line, take the mid axillary line, go straight on down to the Raider trow candor halfway between there and the iliac crest is Jen qua it’s post Steria to gallbladder 29. And it’s right on the, in the muscle belly of the gluteus medius, gluteus medius is what stabilizes the pelvis to keep that tilt from going and is crucial to establishing order in the lumbar vertebral segments of the body.

So that when I treat low back pain, I don’t treat Thai young. I treat shaliach. I go in from the side and treat the gluteus medius and deeper, of course, it’s the gluteus minimus. So you have two muscles with differing functions to get, bring about stability in the pelvis, so that the rest of the pair of spinal muscles have some consistency in their experience. They don’t have to be compensating because everything is moving because the gluteus medius inhibits from prolonged sitting. And we all sit too long for reflection along city, the gluteus medius, no matter how big and health, how well, you know, function, this is inhibits. And that big muscle just turns off and all you gotta do is needle it, turn it back on everything changes. So that’s my absolute favorite point that would, that would go up and affect everything up to the shoulder, posture, the neck, it wouldn’t go down and affect heel strike. And, and your whole cadence as a Walker or runner could theoretically correct everything from, from plantar fasciitis up to, you know, neck and head pain. I don’t know.

Wonderful. I didn’t know. I knew it was one of your favorite points, but I didn’t know it was such bright applications for it and the entire spine as well. And it makes a lot of sense that it, the smile has to compensate, you know, that you can have bad problems, they problems, right. And that all comes from having a nice stable, um, pelvis, pelvic bone. Cause after all the, where does the vertebrae sit on this, this other sacrum, which is rooted in the pelvis. Right. Wonderful. Um, so unfortunately this is, um, uh, we’re coming to the end to our, about our interview here. I was wondering if, um, people wanted to learn more about your curriculum or learn or study with you, um, are there some resources or some new information, a website or something that they can do to get in touch, get in touch with you?

Probably the easiest thing to do is go to my website, which is my name, Whitfield Reaves, not com. You got to make sure you spell it right. Wood field.com. There you can order my book there. You can see the links to my most current webinar program called mastering the treatment of injury and pain. It’s 40 hours. I just completed this right before the lockdown last year of all, it’s just all of my work put in 40 hours of webinars. Uh, and we also have some three hour modules of little special segments or portions of the body that we’re teaching still during this COVID era. Uh, and we’re actually starting to schedule some live stuff in the fall. So you can find all of that on my website, on the calendar page. Um, and, uh, and you can email me if you’ve got questions, email me, there’s a contact button. I’m happy to, to give you advice if you need some advice on how to proceed. So, yeah.

Okay. Thank you so much with, um, unfortunately I wish we have more time. I’m sure we can just talk on for hours and I can just, I mean, for me, I guess I can just listen to your stories for hours. Okay. Um, but, uh, I’ve always, that’s all the time you have today. So I thank you very much for joining, joining us. I think all the listeners for joining with joining us today, and don’t forget to join us next week posted next week is Chen Yen. And I’m sure she’ll have some wonderful information to share with everybody. Thank you and have a lovely rest of the weekend

Seal. Thanks for listening.