Flexibility and Stretching -- Not Helpful?

Here is a surprising piece of research:

The best runners were the least flexible. PubMed

The study is from a group of physiologists at Nebraska Wesleyan University. They found that the tightest muscles were the most efficient, both for men and women.

In fact, the latest science suggests that extremely loose muscles and tendons are generally unnecessary (unless you aspire to join a gymnastics squad), may be undesirable and are, for the most part, unachievable, anyway. “To a large degree, flexibility is genetic,” says Dr. Malachy McHugh, the director of research for the Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital in New York and an expert on flexibility. You’re born stretchy or not. “Some small portion” of each person’s flexibility “is adaptable,” McHugh adds, “but it takes a long time and a lot of work to get even that small adaptation. It’s a bit depressing, really.” How Necessary Is Stretching?

As someone who has always had tight hamstrings and very poor flexibility, I can agree with that last sentiment: It is a bit depressing. Nearly a decade of daily martial arts training increased my flexibility greatly (considering where I started), but never to the extent I wished. I'm just not a stretchy person, and never will be. And, just as this study suggests, a decline in my daily practice led to a decrease in flexibility -- though I will disagree with their sentiments to extent of saying that I did experience a significant change in flexibility, but it took a lot of work. The payoff for inflexibility seems to be more efficient use of muscles and greater stamina. Certainly, the genetic aspect seems to be borne out by my experience. In general, Asian martial artists tend to be more flexible than their American counterparts and some adaption of techniques and warm-up exercises seems appropriate for different body types. Please note that extreme flexibility, while impressive in some techniques, may make the athlete more vulnerable to injury.

For the casual athlete, the goal has to be avoiding injury.

If, on the other hand, “you can’t get anywhere near your toes, and the lower part of your back is practically pointing backward” as you reach, then you might need to try to increase your hamstring flexibility, Dr. Knudson says, to avoid injuring yourself while running, cycling or otherwise exercising. You can find multiple hamstring stretches on YouTube, although you should consult with a physical therapist before replicating them at home; proper technique is important to avoid injury. “You won’t get a lot of change,” Dr. Knudson says, ” but a little may be all you need.”

But, what about those athletes -- such as gymnasts and ballet dancers -- who really do need more flexibility? Can acupuncture help? In my acupuncture practice, the most effective technique I've found has been shallow needling into the muscle sheaths and micro-current electric stimulation. Simple daily stretching seems to be necessary, but not sufficient for a significant change in flexibility. Both from personal experience and from the experience of my patients, I have found herbal formulas featuring San Qi, to be helpful.

Byron Russell

Exercise Makes You Less Anxious

I see this regularly with patients who come in for depression, fatigue, anxiety -- if I can talk them into regular exercise, their symptoms improve. Of course, I'm doing acupuncture and herbs at the same time. But, therapeutic movement really seems to speed the treatment. The flip side of this is that over-training, pushing the body too hard -- especially without adequate nutrition and rest -- can cause anxiety.

This article looks at scientific research to explain why exercise reduces anxiety. In a nutshell, it seems to be that exercise induces the growth of new neurons that are less reactive to the hormonal and neurotransmitter effects of stress. It takes at least three weeks for these changes in the brain to begin to appear.

“Something happened between three and six weeks,” says Benjamin Greenwood, a research associate in the Department of Integrative Physiology at the University of Colorado, who helped conduct the experiments. Dr. Greenwood added that it was “not clear how that translates” into an exercise prescription for humans. We may require more weeks of working out, or maybe less. And no one has yet studied how intense the exercise needs to be. But the lesson, Dr. Greenwood says, is “don’t quit.” Keep running or cycling or swimming. (Animal experiments have focused exclusively on aerobic, endurance-type activities.) You may not feel a magical reduction of stress after your first jog, if you haven’t been exercising. But the molecular biochemical changes will begin, Dr. Greenwood says. And eventually, he says, they become “profound.”

Byron Russell

Exercise Makes You Less Anxious

I see this regularly with patients who come in for depression, fatigue, anxiety -- if I can talk them into regular exercise, their symptoms improve. Of course, I'm doing acupuncture and herbs at the same time. But, therapeutic movement really seems to speed the treatment. The flip side of this is that over-training, pushing the body too hard -- especially without adequate nutrition and rest -- can cause anxiety. This latter result isn't talked about but Chinese Medicine is very clear on the topic. Moderation in activities along with adequate rest and recovery time is crucial for health benefits.


This study reported in the NYTimes Blog looks at scientific research to explain why exercise reduces anxiety. In a nutshell, it seems to be that exercise induces the growth of new neurons that are less reactive to the hormonal and neurotransmitter effects of stress. And, it takes three to six weeks for these changes in the brain to begin to appear.

“Something happened between three and six weeks,” says Benjamin Greenwood, a research associate in the Department of Integrative Physiology at the University of Colorado, who helped conduct the experiments. Dr. Greenwood added that it was “not clear how that translates” into an exercise prescription for humans. We may require more weeks of working out, or maybe less. And no one has yet studied how intense the exercise needs to be. But the lesson, Dr. Greenwood says, is “don’t quit.” Keep running or cycling or swimming. (Animal experiments have focused exclusively on aerobic, endurance-type activities.) You may not feel a magical reduction of stress after your first jog, if you haven’t been exercising. But the molecular biochemical changes will begin, Dr. Greenwood says. And eventually, he says, they become “profound.”

Byron Russell

Moderate Exercise to Boost Immunity

Here's an an article from the New York Times describing research on the effects of exercise on the immune system. The main study involved exposing different groups of mice to the flu virus. One group had no exercise, one group moderate, and one group pushed to exercise intensely. The moderate exercise group did well, and the intense exercise group did very poorly. The results tell us about mice, but we can guess that it works the same way in people -- and certainly, I recommend only moderate exercise for my patients who are simply interested in maintaining health.

When you are an athlete in competitive training, you need to take these effects into account -- especially in focusing on having adequate recovery time and adequate nutrition to support you body's training. And, also, to note that the studies describe the negative effects of 'intense exercise' on immunity. That definition is very flexible and will depend on the person doing the exercise. If you have trained well, your capacity for healthy exercise will be greater.

The key finding in this study:

The bulk of the new research, including the mouse studies mentioned, reinforce a theory that physiologists advanced some years ago, about what they call “a J-shaped curve” involving exercise and immunity. In this model, the risk both of catching a cold or the flu and of having a particularly severe form of the infection “drop if you exercise moderately,” says Mary P. Miles, PhD, an associate professor of exercise sciences at Montana State University and the author of an editorial about exercise and immunity published in the most recent edition of the journal Exercise and Sport Sciences Review. But the risk both of catching an illness and of becoming especially sick when you do “jump right back up” if you exercise intensely or for a prolonged period of time, surpassing the risks among the sedentary. (Although definitions of intense exercise vary among researchers, most define it as a workout or race of an hour or more during which your heart rate and respiration soar and you feel as if you are working hard.)

Chinese medicine has a number of herbs that help with stamina and immunity -- like Ginseng and Reishi Mushroom. Supporting the immune system before and especially after competitive events is a great idea.


Byron Russell

Best Exercise for Healthy Bones

Bone density and bone loss becomes a concern for the majority of Americans who live past the age of 50 -- that's currently about 44 million people who experience mobility problems and increased mortality. Even in less severe cases there is definitely a reduction in quality of life and the kind of exercise you can do. If you are or plan to live past 65, osteoporosis and hip fractures are a serious problem (JAMA Report). The NY Times just did an article summarizing recent studies:

Although the number of hip fractures has declined in recent decades, the study found that the 12-month mortality rate associated with the injury still hovers at more than 20 percent, meaning that, in the year after fracturing a hip, about one in five people over age 65 will die.

Exercise has long been thought one of the best ways to prevent bone loss, but recent studies show not all exercise is beneficial. Swimming, competitive cycling, and weight-lifting don't seem to help and may even hurt. No one knows exactly why, but one possibility for finding bone loss in swimmers and cyclists is the intensity of their training. Long, high-intensity training sessions could result in lowered blood calcium levels due to calcium loss through sweating. This makes calcium supplementation very important to endurance athletes along with Vitamin D.

So, what does work? JUMP UP AND DOWN.

The bones apparently need a strong, fast impact to signal for increased bone development. Brisk walking is one of he best choices for older people whose bones are more delicate. For those wishing to maintain their bone density levels, jumping up and down is the simple answer. And, you don't need to do it for long -- 20-30 times.

Byron Russell

Walking Healthy

Here is an interesting statement from a Psychology Today article:

Biking and rowing may get your heart racing, but a low-intensity stroll in the park 5-6 times a week is actually more effective in preventing obesity and eliminating heart risk factors including insulin sensitivity, total cholesterol, and blood pressure. Walkers trimmed their waistlines more and shed more weight.

The author recommends taking faster small steps, pushing off the back foot, and swinging the arms to set the pace.

I recommend walking and taking the stairs to all my patients -- both for easy stress reduction and for general health. Even for athletes, adding some meditative walking time can be helpful. Serious training is often stressful both to the mind and certainly to the body. Balancing that with easy walking and a quiet mind can be helpful.

Byron Russell

Cordyceps and Ginseng to Boost Endurance

There are numerous herbs that boost endurance and stamina. Two of the best known are Ginseng and Cordyceps. Lots of research has been done on each of these. Ginseng has been around (in differing forms) for thousands of years and used as an anti-aging herb and Qi (energy) tonic. It is also famous for promoting virility. The variety called "American Ginseng" is highly prized because it is a balanced herb that isn't too fiery hot and safely boosts energy and stamina for almost anyone. The root of the plant is used medicinally and large, mature, wild-crafted roots can cost hundreds or thousands of dollars, but it is also raised on herb farms, making the supply more reliable.


Standard descriptions of Ginseng call it an 'adaptogen' -- an herb that strengthens the body and helps it return to normal after prolonged stress. It is going to be especially useful for someone doing prolonged sports training -- as in marathons or bike races.

A more unusual herb is Cordyceps. The description of this one sounds especially unappetizing -- it is a fungus that grows on silkworms. I always wonder how anyone ever decided to try this as a medicine, though it sounds better if you call it a mushroom. It has been around since at least the 15th Century.

Here is a quote from Wikipedia on the subject:


Outside the East, the world was largely unaware of cordyceps. This changed when the fungus caught the world's attention due to three female Chinese athletes, Wang Junxia, Qu Yunxia, and Zhang Linli. These athletes broke 5 world records for 1,500, 3,000 and 10,000 meters in 1993 at the National Games in Beijing, China. The amount of new world records being set at a single track event caused much attention and suspicion. Following the races, the women were expected by some to fail drug tests for anabolic steroids. However, the athletes' tests revealed no illegal substances, and coach Ma Junren told reporters that the runners were taking Cordyceps at his request.

I use a formula based on this herb regularly myself and recommend it to many patients. If you are an endurance athlete, it is definitely worth giving this a try.

Byron Russell

Running in Sandals

Here's an interesting article from the New York Times, suggesting that human bodies are made for long-distance running and that high-tech shoes could be causing injuries by encouraging bad running form. One interesting comment was that our bodies are made for running down large prey over long distances -- for instance, on a hot day, a human can outrun a horse over 26 miles. Based on the book 'Born to Run' by Christopher McDougal.

The Human Body Is Built for Distance



Byron Russell

Performance Enhancement Herbs: SAN QI

Herbal medicine is a great supplement to any sports training program. It is simple to take a few extra pills each day, and the results can be amazing.

One of the first uses is for pain and bruising. There is a long tradition in martial arts for using herbs. If you walk into a martial arts studio (and many locker rooms), one of the first things you'll notice is the smell of sweat combined with camphor and menthol from all the lineaments, pads and sprays used externally to combat pain and bruising. These work a lot like BenGay -- but have the addition of an important herb that strongly moves blood and reduces inflammation and pain: San Qi or Tian Qi. Formulas based on San Qi are sometimes called 'Hit Formulas.' For external use, they come in the form of herbal pads, sprays, and lineaments, and they are effective for most traumatic injuries -- including those that are self-inflicted from heavy training. I use these a lot in my office. Here's a picture of the San Qi plant and that's the raw medicinal form of the herb above.


You can also use this herb in pill form and it is a great find for anyone who is training really hard. Taken daily, it can prevent or reduce feelings of muscle soreness and pain, and speed recovery time: meaning, you can train harder and suffer less afterward, with less off time between training sessions. Of course, the internal formulas are better known for their use after serious injury for speeding healing. Besides their preventative use in sports, I recommend these formulas for patients who have been in car accidents, who are recovering from surgery or other kinds of physical injuries such as sprains and strains. In fact, San Qi is known for helping almost any traumatic injury.

Byron Russell

Reader Question: Can Acupuncture help Tennis Elbow?

This is a great question since Tennis Elbow, or lateral epicondylitis, is one of the most common injuries seen in sports. Some people call it an irritation of the muscles and tendons in the forearm. The main symptom is pain -- especially when cocking the wrist back or lifting objects. Tension around the elbow along with weakness in the arms and hands are usually seen as well. The explanation for this is inflammation thought to be caused by micro-tears in the tendon and muscle tissue. This happens in a lot of conditions, including plantar fasciitis and many repetitive stress injuries.

This is definitely a problem for any sport that involves using the arms. In my clinic I've seen many early stage cases that involve only the warning symptoms of stiffness, some minor weakness, and an uncomfortable awareness of the elbow and forearm. In more severe cases, patients come in wearing braces and often have already had cortisone shots and spent time in physical therapy, but are still experiencing pain, especially after any exercise.

So, what can acupuncture do for this? Reduce pain, relieve inflammation, encourage blood circulation and speed healing. The results are particularly noticeable in a situation like this involving damaged tendons where there is limited blood circulation.

Dr. Peter Dorsher, an MD with acupuncture training, presented a great study on this at the annual meeting of the American Academy of Physical Medicine and Rehabilitation in 2001. He treated 22 patients and found that the symptoms were relieved after 4 treatments. Eight and half months later, 77% still had no symptoms and had regained full use of their arms. He noted that some of these patients had had symptoms for months and tried many different therapies before acupuncture without success.

The techniques use for treatment include needles around the affected area, microcurrent electric stimulation, moxa (the application of heat), cupping (suction to bring stagnant blood out of the area), and therapeutic exercise.


Figuring out why the irritation occurred in the first place is also very important. Preventing injury and preventing RE-injury is better than treatment. I always ask patients WHY this is happening NOW. Have they changed their technique or experienced general changes in health? Higher stress in other areas of your life can lead to chronic muscle tension which makes the tendons more vulnerable to tearing. We also look at the condition of the Blood and Liver Qi. Blood (particularly Liver Blood) bathes and nourishes the muscles and tendons. If the Blood and Qi (energy) become blocked, you are more vulnerable to stress damage.

Thanks for the question! By the way, Sania Mirza and Gael Monfils are two prominent tennis players who have talked about using acupuncture in their training. And check out the link to Tennis Times for more information on using acupuncture in tennis.

The Tennis Times

Byron Russell

What can TCM do for an athlete?

I guess that is question number one. What can TCM (Traditional Chinese Medicine) -- that is mainly Acupuncture and Chinese Herbs -- do for an athlete today? What can it do for you?

It's a big question that touches on what acupuncture is, what proof there is that it works, and what kind of problems it is most helpful for. I want to address all these questions over the next few weeks, but let's start with a couple of prominent examples. Health care is (and should be) private -- so, I never discuss my patients without specific permission. Fortunately, a number of famous athletes have discussed using TCM in the press.


A great example is Kerri Walsh (Olympic Gold Medalist in Volleyball). She used acupuncture to resolve pain and speed healing after Rotator Cuff Surgery. This is something I see a lot in my practice -- and it isn't just for athletes. Once of the benefits of acupuncture and herbs is that it helps to reduce swelling, inflammation and pain, and speeds healing. I also think it works well for reducing the formation of scar tissue. For a high performance athlete, this is particularly important in reducing time out from training, and in regaining the full use of the injured part of the body.


Another is Yao Ming (Houston Rockets Basketball All-Star), who suffered a stress fracture in his left foot and had surgery to install a screw to stabilize the bone, again with acupuncture and Chinese herbs as part of his aggressive rehabilitation program -- to speed his recovery. This is a type of injury I've seen a number of times in my practice -- recently with a couple of triathletes and skiers. It can be a tough surgery to recover from, but I've seen great results - a good surgeon is the first step, then acupuncture and herbs to reduce the swelling, pain, and scar tissue. I also use Electric Acupuncture (Microcurrent Electric Stim) and infrasound treatments. This type of surgery and rehabilitation also helps people with severe bunions and foot pain.

So, one answer I will suggest is that TCM helps with post-surgery rehabilitation, with the goal of reducing swelling, pain, inflammation and restoring full function as quickly as possible. Next is a discussion with more specifics of what the treatment entails.

Byron Russell