Chinese medicine and physical exercise
Lately, I’ve been considering any holes I can find in my Classical Chinese Medicine education here at NCNM. Amazingly, there aren’t many. It’s hard to put together a top notch program in any topic, much less one as complicated as Chinese medicine. One place I have found myself without much to go on is in understanding the role of physical exercise in health according to this medicine. I’ve learned things here and there, both in class and in my own study, but the information is confusing and definitely conflicts with my own experience in places. In this article, I’d like to briefly discuss what I feel I have learned and the problems I’ve found therein. I hope that you will add your input in the comments. Some of what I write below will be in explicit TCM terms, as most of the docs I’ve talked to about this subject know that system best.
What I’ve learned about physical exercise since starting school in Chinese Medicine:
- In general, vigorous exercise is not recommended. This is particularly the case when the exercise is productive of lots of sweat. The thought is that the discharge of so much sweat inevitably damages Heart Yang, given that Heart Yang is used to expel sweat from the pores. Instead, gentler forms such as Qigong, Taiji and sometimes Yoga are recommended. These are said to build the body from the inside in a way that does not damage any vital substance of the body.
- Many of our doctors mention of how overwork can be very bad for the muscles and tendons and deplete both the Blood and the Qi. This is often mentioned mostly with relation to labor, but also non-working exercise. We are frequently asked to consider the lot of laboring people worldwide. They are often physically strong, but become ill easily and have shortened life.
- Much of the negative information we get about exercise concerns specific habits. For instance, showering or soaking in water directly after being very sweaty (with open pores). It is said that this (common) practice pulls dampness into the body and creates conditions of damp and hot damp in the middle jiao. Lifting very heavy weights over long periods of time are widely regarded (by most medicine) to be difficult for the joints, tendons and even bones. Another commonly mentioned problem is the tendency for many weight lifters to be building a sort of “muscle shell” that only conceals a hollow interior. Their muscles are very strong, very impressive, but the person is ultimately weak on a number of levels.
- There are often discussions about the importance of protecting the Heart. We often hear worry about making the Heart work so hard and wasting its precious Qi and Yang. Sometimes we will discuss various spiritual theories about the length of a person’s life being determined by a pre-determined number of heartbeats or breaths. I don’t think this information is regarded very seriously, we simply discuss it as something intriguing to consider.
I can understand much of this. For instance, it is certainly important that we don’t overwork ourselves. I see many people exercising in the name of health who seem to be making gains (losing weight, gaining muscle) but possibly at the expense of their longevity because of heavy wear on the joints and Heart. Further, the practice of being hot and sweaty and immediately going into the sauna or hot shower has always made me cringe a little.
On the other hand, we need to be mindful of the current state of most Americans. Another thing that we hear railed about at school is the danger of being overweight - leading a sedentary lifestyle. So, while exercising too much is certainly a bad thing and we can advise our patients to avoid it, we do need to help our overweight and out of shape patients! It seems that most Chinese medicine doctors would have us just eat a moderate diet, sleep well and do gentle movement in order to stay healthy. This sounds fantastic, but it doesn’t seem to work for everyone. It also makes one wonder what to do with a person who comes in already suffering from an overweight condition. Often overweight conditions are helped with dampness draining formulas and SP rectification, but again, this doesn’t seem to work for everyone. Some of the work seems to need to come from the person themselves.
Anciently, of course, most people were doing hard labor. In many of the Qigong forms we use, we visualize doing various kinds of labor (grinding the millstone, for instance). So, there is obviously some kind of recognition of the physical benefit of hard work. But, again, as explained above - it’s clear to anyone that too much hard physical labor is not great for a person.
I’m interested in this topic for two reasons. First, I expect to have plenty of fitness-challenged patients walking through my door in just over a year’s time. I want to know how to talk to them in a way that makes sense, will help them understand a course of action and yet also be rooted in Classical Chinese Medical principles. Second, as part of my revised Year of Sagely Living goal, I plan to engage in a program of focused physical exercise to help achieve a more optimal physique. Why do this? Well, by anyone’s measure I do need it and also I find that the process (exercise, focusing on what’s going on with my body) is very pleasurable and gives me lots of energy in a way that doesn’t feel at all jittery or strange.
I’m interested to hear others’ thoughts and experiences with this topic. What have you learned? What have you rejected? Please comment!
Note: For the record, my current plan is to balance my physical cultivation through a combination of walking/bike-riding, weight lifting, gardening, Qigong and yoga. I am also doing some work with diet, but mostly just watching portion sizes and eating until I am about 3/4 full. This seems to work the best for me. I’ll probably track my progress on the YSL page, if you’re interested. I will be watching, particularly, my experience of some of this information listed above and monitoring my energy levels very carefully.
Eric
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Tags: exercise, human physiology, Year of Sagely Living
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Overweight - purge through sweating. Exercise within capacity can be measured by being able to speak while doing aerobic exercise or monitoring on a scale of 1 to 10). 1 is lying down and 10 is running flat out.
Then there is strengthening the spleen and removing damp from it (my major challenge).
The other dimension is the emotions - wood invading earth often enough. In the traditional way this was handled through meditation and directions about what to meditate on. Psychotherapy, affirmations and much else can fit here. Most of us in modern societies know the information on eating well. It is not information and rationality that is at issue - the reasons for overweight are other than this.
The one simple thing I’ve found most helpful in change is to keep a log. It helps to keep it in my mind all day - even if I only write in it once a day (or even when I forget).
Welcome back to blogging. Looking forward to how you go with this.
Eric, this is a great topic. I get a great many inquiries about whether acupuncture can help you loose weight and I think other practitioners do as well.
The older I get, the more yoga I do and I love it.I think it’s particularly good for me as a deficient person.
I still need to work out and sweat some from time to time. I find that this works best for me when I am feeling very stagnant — which for me means also being very damp. When I just can’t get myself to move for awhile, very often I will make myself get on the treadmill and just run flat out for about 30 seconds and then walk for a couple of minutes to cool down and then repeat until I get bored or tired. This does break a BIG sweat. I don’t shower right after–I do a pretty long cool down. I like walking normally. Often this will get some of that damp, stagnant UGH I just don’t want to move moving and I can get back into a more regular routine.
I was just talking to a friend about the topic of water. That wasn’t something that was very closely covered in our schooling either. I feel like when I drink lots of water (I’ll do 3 liters plus my herbal teas and such in a day) I feel much more energetic and I sleep better (waking rested). I will notice a difference within a week. Water can be a big issue when people are trying to loose weight and by and large we don’t get enough. Do you have any thoughts on that?
In the words of Dr. Shen, “If you can make a rule about it, it is not Chinese medicine.” I think it’s important to remember that the body, when pushed past its current comfort level, the body responds by changing its structure to match, whether we’re talking about organ function or muscular function. The amount of course is very dependent on the person we’re talking about. For example, my dad has been bodybuilding as his form of exercise for many years. Excepting a recent arrhythmia problem (which I would attribute more to some recent non-exercise related difficulties)not only is he healthy as an ox from any diagnostic POV I threw at him (including pulse) has less muscular tension in the typical American locations (UB/GB channels) than anyone I know, despite working a sedentary job.
Xingyiquan, despite having the reputation as being a “gentler” exercise, certainly doesn’t feel very gentle. In fact, it feels like it’s going to kill you. Yet, it has very strong changing effects on all parts of the body like Yi Jin Jing practice (which is also not an exercise I’d call particularly restful).
Yang family TJQ (from the Yang Cheng Fu/Yang Shou Zhong lineage) puts a pretty significant muscular and tendon strain on you in the early going. You have to be strong to do the form-often in places you aren’t used to using-and you’re going to be really sore until such time as your body catches up to what’s required of it. it’s not as bad as XYQ is of course, but its a lot more taxing than the Qi hugger YMCA TJQ you normally see.
Also I would add that (FWIW) Yang Jwing Ming theorizes that mechanical stress on the bones causes creation of bioelectricity.
Um, right, my point…physiology differs from person to person, patient to patient. Since we can’t hand out a universal herbal formula, diet food, or point prescription, neither can we make gross generalizations about exercise and expect them to be accurate. Now obviously there are BAD practices that you shouldn’t be doing (I want to get my hands on the pulse of a population sample of everyone in Orlando with “26.2″ bumper stickers)which you’ll see by the results on the people who do them. Otherwise, I support a certain amount of limit-pushing balanced with recovery time/methods and balance elsewhere.
I know I don’t know much yet — anyway, I think it all depends on the person. Some people are more frail while others are more muscular physically. Shouldn’t different types of exercise apply for these different types than others?
I am prone to bouts of hyperactivity if I don’t get some kind of tough exercise. Most of the qigong I’ve done hasn’t been enough for me. Ashtanga yoga will often work, but running, jumping jacks, hula hooping, long uphill bike rides and dancing all seem to work well. I come from a long line of farmers who were used to working from sun-up till sun-down, and now I’m stuck in the city where life is just really different.
I have also been really confused about the talk in school with ‘gentle exercise.’ I think that with our patients, in this city, we will have to keep in mind that there are great things that we can recommend for them. This is a very bike friendly city with lots of resources for people who have never biked before. We can become aware of the different cooperatives in town that offer free classes and bike repair help and recommend that our patients start biking to work or school, or wherever they need to go during their days.
Walking is also a major deal — I think I read somewhere that the average New Yorker walks 9 miles a day. This is a great way to commute or shop if our patients are living within the city limits. If not, maybe they could start a routine walk during the day just for the hell of it. It’s possible to get walking odometers that will track the number of miles walked every day, and that might be another thing we could recommend to over-weight or under-exercised patients.
I’m not sure what Chinese medicine says about swimming, but it’s certainly one of my favorite activites. It’s low impact but still aerobic, so I wonder what the idea is in terms of how it’s affecting the heart?? The community centers in town have low-cost memberships and many of them have pools. It’s an affordable exercise option. It’s also really nice at Mt. Scott pool during the winter time, when it seems as if the sun has completely disappeared, because they have the massive skylights over the pool.
One of the options I’ve been thinking about is just training well in qigong/yoga and then teaching classes at my office for my patients. I think this is a really great way to be a doctor as teacher.
Thanks for starting this! It’s something I’ve been trying to think about too.
Interesting. Weight loss is such a hot-button topic in the media and I think the general public is realizing that western medicine and self-deprivation don’t have the right answers for everyone. Seeking balance of our life force and harmony in our lives should be the goals, but popular culture instead pushes an “ideal body type” which is not only unrealistic, but dangerously unhealthy as well.
I wonder how many studies have been done to determine how mentally/emotionally/physically/spiritually well people feel after going to such extremes to lose weight? How many souls are not living thier lives to the fullest because they feel “imperfect” by societies body-type standards?
Keep spreading the word that there is a better way to live, Eric, I love reading your blog - it gives me hope. –Christie
Hi Eric,
This is a loaded issue for sure. In my experience, patients who are ‘avid’ exercisers are not nearly as healthy as they think. There are a few reasons for this, but we must always think about what Dr. Hammer teaches regarding stress versus terrain. Individuals come in all different shapes, sizes and constitutions, with differing histories, etc. And, like everything in Chinese medicine, our therapies, diet and exercises must be individually tailored. What may be too much exercise for me, may not be for you, etc. We must always base the discussion within this background.
Luckily, the pulse and a detailed understanding of each person’s uniqueness can guide us in figuring out what is suitable for them.
At the same time, however, I think we can make some general statements without making any hard and fast rules. Too much aerobic activity puts a strain on the Heart. What is too much, however, is what differs from individual to individual. So, we need to be clear in figuring out for each patient what is moderate.
Of course, this isn’t the most efficient way as most individuals out there know nothing of Chinese medicine, and don’t get acupuncture, and I would even go as far as saying that they are not in touch with their bodies, nor do they have a paradigm that encompasses any of these concepts. Herein lies a tremendous problem. Education, education, education. We have such a responsibility (can feel like a burden at time) to educate and inform the public and it seems like a losing battle in the fast-food, fast-paced, more is better kind of world we are living in.
But there are some guidelines we can use. How steady is one’s energy; how well are we sleeping; what is the pulse rate; how much pounding do we feel on the pulse; how stable is the rhythm of the pulse and the intensity/amplitude of the wave; how stable is the left distal position; how does one find oneself emotionally: are there ups and downs in their moods, fluctuating all the time like a roller coaster; how much do they sweat when they exercise; does one feel rejuvenated after exercising or depleted; do they feel that ‘high’ from exercising (which suggests a general lack of oxygenation creating an almost addictive desire to exercise); how do the proximal pulse positions feel (are they deficient, Deep, Reduced Substance, etc.); does the person ‘crave’ exercise; do they dread it and push themselves because they think it is ‘healthy’, etc.
Sorry to say there is no one answer to fit everyone, but the foregoing issues to be aware of go for everyone.
Same goes for diet. Many obese patients don’t do so well with draining dampness. Often they get worse. Typically, what I find, what many need is to nourish their yin. We see this often in the type 2 diabetic who is overweight yet has tight to wiry pulse qualities in the left proximal and middle positions. Their bodies due to such a depletion of yin, hold on to water and fat in the form of dampness as a way of rectifying the situation. Without this understanding, and we try to drain their damp, they get significantly worse.
So, we are back to the beginning. An individualized medicine (for better or for worse :))
Ross gets the “can o’ worms” award. :D
Thank you, all of you, for the wonderful comments. Certainly the refrain seems to be “different regimes for different people” which certainly is one of the deepest truths of our medicine.
A few specific replies:
Evan: I think the idea of keeping a log or journal or whatever is a great one. It’s something I’ve long been doing, and it has helped me in a number of ways.
Bonnie: The issue with water is, of course, probably the same as the rest of these issues. For some people, drinking even 64 ounces of water a day is going to leave them bogged down and bloated, and for others twice that doesn’t seem enough. I think I would probably want to look at the health of the Earth and Fire, the whole water metabolism system as well as the remainder of their diet to understand their water requirements. That being said, I think the vast majority of people don’t drink enough water and I’ve certainly noticed what you’ve noticed - when I drink at least 60-80 ounces of fresh water a day I feel WAY better. So… *shrug*
Mike: Martial arts in general (I don’t know enough to say anything to the specific forms you’ve mentioned) are certainly a great contributor to anyone’s routine. They exemplify in many ways the “strong within”philosophy that I think it probably the best way to go. Also, what is 26.2???
Bex: Great comments… I’m interested also in swimming. Very vigorous swimming, particularly. I mean, the activity certainly opens your pores - and then you’re IN the water. I’d guess that the constructedness of your surface plays a role in the likelihood of disease in this case. If you have a very weak surface, I’d guess that you would quickly develop a dampness condition if you were swimming a lot… what do you think?
Christina: I certainly agree that the obsession with a perfect body type is a terrible thing. On the other hand, I’ve seen many folks who also agree with this philosophy use it as an excuse to pay precious little attention to their body at all. A middle way is doubtless needed. Thank you so much for your kind words - your comment gives ME hope. :D
Ross: Mike is right - can of worms award to you. :) Education is definitely vital, and I think it’s one of the great powers of Internet communication. If we can get great information on the Internet, as well as giving it to our patients through various means and lecturing to the general public, writing books, etc… well, things can’t HELP but get better, right?
Eric
26.2=26.2 miles, as in the marathon. Marathons are BIG here. Everywhere you go there’s either someone with an oval 26.2 sticker on their car, or one of those license plate holders that says “I do 26.2.” There’s even starting to be a half-marathon fad (yes, with 11.3 stickers).
Hi Eric,
Education is vital. But so is structural change.
Feng Shui for the modern world: co-housing and eco-villages?
“I’d guess that the constructedness of your surface plays a role in the likelihood of disease in this case. If you have a very weak surface, I’d guess that you would quickly develop a dampness condition if you were swimming a lot… what do you think?”
Hmm…well, I think that where you’re swimming matters a lot. When I was in Hawaii, it certainly felt a lot healthier to swim in the warm ocean than it does here at one of the chlorinated community center pools. Even so, I think it all comes down to the moderation aspect as well as your constitution and whether or not you are going to stress out about the chemicals, or if you can be pretty mellow about the whole thing.
As far as the dampness, I don’t know. I’m pretty new at this whole CM thing, so tell me what you think: As far as what Jun Zhang seemed to be saying, these different qi (like the damp, wind, etc…) aren’t necessarily literal, but symbolic. I might be understanding this incorrectly, but I thought that dampness was a symbol of invasive qualities that are descending, sticky, coagulating/clotting, stinky, etc…, as well as the symptoms that pernicious qi might cause in a person. If this is correct, then swimming wouldn’t necessarily be putting one at risk for a dampness condition and could in fact be working against one.
Anyway, I’m going to think about this some more. It seems complicated!
Hi Bex,
The use of real things as metaphors and symbols does get complicated. I think that often the thing that ties them together are the internal sensations.
It helps me to remember that the chinese ‘alphabet’ is pictures.
Wow, great article. I was once a body builder and I was sick all the time and even though I looked great I never really felt great. Now with less time I still get exercise but I don’t try to make huge muscle gains and I feel much better. Maybe there is something to this!
I’ve been getting acupuncture since I was seventeen and the doctor always told me that it was in my best interest to go out and exercise as much as possible. Sweat often helps get certain toxins out of your body and muscle growth and losing fat would often make it easier for a heart to function one would think. but hey, your the Chinese medical student.
Hi Condo tremblant,
Yes, that type of thinking is inconsistent with classical Chinese medicine theory that we learn at school and by studying the classics. The heart is emperor, and we must always protect and serve the emperor of the organ systems. Sweat is the fluid of the heart, and we think of sweating frequently and too much as a bad thing b/c it depletes the heart yang/qi as well as the yin/fluids leading to a state of deficiency over time. Sounds like your practitioner’s philosophy is not rooted in the classics. Chinese medicine does not usually promote vigorous activity like running, but rather more subtle exercise like qigong. People can certainly die from overworking the heart and losing too many fluids, no matter how fit.
-Delli
Hi Mr. Eric, nice and interesting information about how our Chinese brothers connect their kind of medicine with body exercises. Albeit I am a bit concerned about heavy types of exercises not being recommended. Does weight training for under this categoery?
It’s been a while (if ever) that I posted a comment here but I check in and like reading your articles.
I highly agree that every patient is different and while the classics might point in a direction of no vigorous exercise, that was written at a time where people did more physical exercise on a daily basis. In a day and age when walking miles for food/water, handwashing, building your homes, taking care of farms and animals, ect.. compared to now?
Vigorous exercise might be called for in some patients but I have seen a trend of over-exercising in an almost manic pace. “Why does this hurt?? I exercise all the time??” Blown out knees from running excessively, spine issues from lifting extreme weights. The physical body can only take so much.
I recommend swimming to many patients. Mostly they are to addicted to their personal activity. :)
Tiffany
I tend to agree that vigorous exercise is not the best way when it comes to healthy physical exercise. In many cases we do not really see the consequences of our activities. Classical medicine generally has a simplified and purely atomistic view of the human body and its processes. Unfortunately, it cannot really see and understand the underlying forces and energies. Therefore, I think you are totally right when you opt for gentler forms of exercise. I have done Yoga and Qigong, and both work just fine with me.
Hi Sunny,
I have to say I am perplexed by your response. Could you please explain what you mean by “Classical medicine has a purely atomistic view of human body and its processes. Unfortunately, it cannot really see and understand the underlying forces and energies.”
Are you refering to Western medicine, Chinese medicine, something else, or both? I am not sure how you are using the term classical here. No matter which way I think about it, I still can’t see any validity in this statement. Generally speaking, ancient medicine, be it from East or West, has a better understanding of formative forces and energy, in my opinion. Today, medicine is often viewed from an atomistic view, but ancient cultures didn’t know what an atom was, because the concept was not in existence since atoms were not discovered until fairly recently in history.
Please help me out if I have misunderstood your comment or if you just said it backwards so we all can have some clarity on this thought.
Thanks,
Delli
Sorry for the confusion I might have brought with my comment. Instead of classical medicine I should have used the term Western contemporary medicine. Indeed, I agree with you, that ancient medicine, be it from east of west, had a better understanding of the formative forces and energies. As a matter of fact, this was exactly the point I was trying to make. Thanks for helping me clarify my thoughts.
Hi Eric
You’ve really chosen a toughie! There’s almost no info on TCM and challenging exercise, and pretty much none of it is postive.
At university they just told us that running is bad for you - it damages your Kidney Jing. Now I’m trying to write an article on the effect of long distance running on TCM physiology and there is not much for me to go on but my own observations of my patients.
When I did the London Marathon I’d had a bad back for two days, but I’d read an Osteopath’s article than running is good for your back, and even though I had to run slowly (5:10) my back felt great afterwards!! This does not exactly tie in with Kidney-Jing depletion.
However, my friend really pushed himself (ran it in 2.56) and went green and was vomiting for ages afterwards.
In a nutshell, it’s probably how hard you push yourself that makes exercise detrimental as opposed to beneficial. In terms of running this is (I think) mostly down to whether you’re in a relaxed fat-burning state or a “forced” sugar-burning state. Slow Burn is a good book to read regarding this.
I don’t know if this has helped! I’ll probably have more info after I finish my article!!!
I forgot to mention the book Chi Running, which is a pretty good guide to running incorporating Tai Chi theory to avoid injury.
So, we talked about this in dietetics a little yesterday, and some of what she said made sense: If you have qi stagnation (generally), then running, basketball, swimming, and other highly aerobic exercises can get your qi moving. However, if you have qi deficiency, those exercises shouldn’t be prescribed. Rather, you should be doing gentle yoga, gentle qigong and simple walking to try and rebuild your qi reserves. It makes sense that we’ve got to look at each patient differently, and each exercise as going with a different energetic quality of the Wuxing. To me, it seems like running goes with the pungent flavor type energetics because it is dispersing and moving (though I would have originally placed it in the summery categor), and so maybe goes with the Fall-time energy and the lung. If we could somehow find a place in ourselves where we can match the energetics of exercises to the wuxing classifications, we could then prescribe them the same way that we would with foods or herbs? Or, maybe that is just too simplistic?
Oh yeah — and when I say “fall-time energy,” I don’t meant that running matches that energy, but just that the pungent/dispersing quality goes with that season, so I’m thinking so would that exercise. Would that work?
One other thing I though of yesterday that I want to mention is that qigong can also be done at different levels of intensity. Just watch a teacher or master doing qigong with students, and it is easy to tell who is the teacher an who are the students b/c the teacher has the most focus and intensity.
The linneage we belong to at NCNM is very unique in that we do shaking to start every form. It is in the shaking part that we are releasing stagnation and evil qi from the body, so that we can empty our vessel to receive nourishment from the Heavenly and Earthly qi during the rest of the form. The shaking can be a gentle movement exteriorly with focus internally, or you can do a more vigorous shaking and focus more on the physical aspect of your body to really get the qi moving and start sweating to expel pathogens. I have done some really intense shaking that is comparable to running or playing sports if my body needs it on that particular day.
Our linneage is associated with Wood and Gallbladder since it focuses on really working the connective tissue. We are encouraged to really stretch out tendons and ligaments and exert ourselves physically as much as possible, but most students do it too lightly from my observation. We are actually trying to work our body hard in qigong, but most people don’t realize this or do not know how to do it correctly. Qigong students should seek to take every opportunity to fully exerty themselves during the movement so that they feel numb while stretching out fully. The numb feeling is actually the qi being stirred up in the channels. This is how we actually make changes and strengthen the body through qigong. Of course, this is just one aspect of qigong. The breathing and mental focus must also be part of a healthy qigong practice, not just the physical body.
Anyone who doesn’t believe qi exists or has never felt it should do 20 straight minutes of intense shaking and then slowly decrease outside movement until the the physical body is still. At that moment you will feel a strong tingling sensation throughout the whole body. This is qi. Go try it if you don’t believe me!
Also, I feel that sports are fine for kids and teens that are still growing, and thus have lots of yang. It is when we reach adulthood that we must really be careful to safeguard our qi and jing, and so depending on the individual, it might be a good idea to either stop strenuous exercise all together or do it less frequently once we reach our late 20’s.
Wow! I don’t think I can catch up with all of these great comments. Maybe I will have to think a while about what has been written and write a follow-up. I really like how folks have been thinking further about this issue - my main point was that it’s not really addressed in our education and the way it is addressed is a bit… unsatisfying.
Thanks everyone,
e
These comments are great! I shall definitely consider what you said, Bex, when I write this article.
I think something that’s very important is that the adaptation of the body to exercise is not considered at all. For example - if my Mum ran for a mile now - it could almost use up her kidney-jing in one go (and she definitely wouldn’t forgive me for making her do it!!)
But my boyfriend ran 37 miles yesterday morning and is perfectly fine. So I don’t think we increase our Kidney Jing through exercise, but rather make our use of it much more efficient. I wonder if that’s why endurance exercise can have such a positive effect on bone density, fertility, life span, brain function etc… ie. have the opposite “sypmtoms” to Kidney-deficiency - as long as we increase slowly.
Hi. I think it’s an interesting point regarding conditioning and the more efficient use/depletion of qi. But I also think that it’s important to consider a few things:
1. not all are created equal in terms of constitution or body condition
2. all work consumes qi and eventually jing. every organ system has qi and any work consumes it. if you work more than you rest or replenish, you deplete oneself. if you push a system hard, you will deplete its qi reserves faster
3. no matter what kind of car you drive, you use gas. whether it’s a sports car or SUV that guzzles it, or an energy efficient car that uses it more slowly. this depends on ‘body’ condition. but everyone has their breaking point. no matter who you are, if you push too hard, you will break.
So, to run 37 miles in a day can be done by one with strong constitution and conditioning, but at what cost? This is taxing no matter how one frames it. Is he strong enough to handle it, perhaps. Especially if he rests properly etc. But that doesn’t mean that significant qi wasn’t consumed here, just that he has a strong supply of it. Doing this regularly will deplete qi rapidly. I have treated many athletes in my career, marathon runners, triathletes, etc. and this always proves true.
And this is not just a question of KI qi-jing, but HT qi as well.
And this is specifically not a question of being fine right after exercise or taxing oneself. We are looking at future impact based on present taxation and even cycles of 7 and 8.
These must be evaluated from more objective means such as pulse.
Ross
I also wonder about the Shaoyin conformation — in terms of the relationship between the Kidney and the Heart, when we talk about these long term, hefty amounts of exercise, especially running:
“Last October, in the American Journal of Cardiology, Siegel published two concurrent studies linking increased risk of heart-damaging events with long-distance running. Between 1996 and 2001, Siegel drew blood from 80 middle-aged male runners before, immediately following, and a day after the marathon. His findings showed that 24 hours after the race, the men, none of whom had any history of heart disease, exhibited early-stage signs of cardiac damage similar to those that appear during a heart attack.”
To me, Jing is a lot like the petroleum in the earth — it just keeps flowing, until it’s gone, so it’s hard to tell how much is actually left down there until it’s not there any more. On the other hand, we can look at the burning of the Jing really impacting the Heart…and the heat manifesting there can be devastating to the body.
A point I’d like to weigh in with, though I’m certainly not pointing this particular finger at anyone here:
It is my opinion that CM doctors and students are overly conservative by nature and we tend to push that “Chinacon” attitude onto everyone around us. Because the focus of our work requires so much time in figuring out mechanisms of health and disease, how to conserve Qi and Jing, how to repair damage and inefficiency, a lot of us get bogged down in the fallacy that your health is the only thing in the world that matters. This is simply untrue. Our model, taken to an irrational extreme, ends with everyone having the “Buddha Pulse” and no one doing anything that could get categorized as an “above and beyond” effort in their lives. No one would stay up late, no one would put forth unusual effort in the pursuit of projects, fun, or even necessity. There’d be quite a shortage of things that add the color and texture to the mural of our lives. Everyone would be quite healthy and, well, mediocre.
The point is, Jing should be viewed like a bank account. When it’s gone, it’s gone, but it is very much up to the conscience, will, and imagination of the individual how that is spent. As someone who currently lives on the depleted side of the tracks, I personally am unwilling to leave the doing of great things to those who were born constitutionally more gifted than I, or who have met with less illness in their lives. I’m only going to be here once and there’s things that need doing. It would be well to remember that a lot of our patients feel this way as well.
It would also be well to remember the philosophical underpinnings of the value system CM is imbued with, and by that I mean how Confucianism viewed the uses of the people. In a society where individual aims are largely subjugated to the support of the state, it is in the best interests of the state for the individual to maintain a consistent level of health and therefore a consistent level of work. In the Confucian model, the farmer who produces his allotted load of produce consistently for 20 years is of significantly more use than the one who has seven lean years but creates a new kind of crop in 13 good ones, as someone is going to have to make up for that lack.
At any rate, conservation of the Jing and maintenance of the health cannot be the primary principle that people follow at the expense of everything else. People should be made aware that from a longevity standpoint, marathons are not a good idea. However, when faced with the fact that competing in marathons is the primary source of joy in a patient’s life and they feel it to be their calling, it is our job to support them as we may with the understanding that we’re all here once and once only and everyone has to choose according to their conscience and inspiration how that time is spent.
Bex, I would love a citation on that article if you have it.
M. Reynolds, I think that is a great point that you bring up, and it needed to be voiced. What a boring world indeed we would live in if individuals could not and did not make these choices you describe. All of our traumas, belief systems, etc make us who we are. The goal is to live our lives as we envision it. To do that we need to understand the dynamics of this entire thread. If one thinks running marathons often and overtraining is good for them, it will in the not too distant future deprive them of what they love. So the knowledge is key. Then choice prevails.
Ross-perfectly stated.
Dammit. This thing just ate my reply.
Anyway, here’s the article:
http://thebostonphoenix.com/boston/news_features/other_stories/multipage/documents/02229150.htm
But money isn’t vitality and jing is. Which is maybe the point of the comment about a healthy way to use the bank account.
I think the point about the values is important too. Preserving health at all costs leads to shells of people on life support forever.
As was suggested I think we need to be clear about our values and help others be clear about theirs. As someone said asking people about why they like marathons.