Five Elements of Traditional Chinese Medicine

What Are the Five Elements of Traditional Chinese Medicine?

Everyone experiences life differently. One of the fundamental teachings of Traditional Chinese Medicine is that each individual has a unique response to a disease based on their constitution and the energy balance of their organs. Traditional Chinese Medicine explains energy balance in terms of five elements that are balanced or imbalanced in those five organs.

The five elements are water, wood, fire, earth, and metal. They can be used to classify every aspect of a person’s physical, emotional, and spiritual health. The five elements generate and control each other. Water generates wood. Wood feeds fire. Fire creates ashes, or earth. Earth condenses into metal. Metal releases water. Water controls fire. Wood controls earth. Fire controls metal. Earth controls water. Metal controls wood. But how is this ancient scheme useful to modern, scientific people?

Modern people can use the five elements to understand how they respond to health and disease. Each of the elements is a metaphor for the way people feel. A “fire” person tends to exhibit anxiety. A” metal “person tends to experience grief and a sense of lacking purpose. A “water” person may live in a flood of emotions.

Each element describes a way of thinking, a lifestyle, or everyday health habit that is useful in moderation but toxic in excess. Each imbalance generates symptoms, but it also points to the kinds of changes in thinking, lifestyle, and habits that will bring health back into balance. Your herbalist can deal with the physical aspects of the five elements. You can deal with lifestyle changes in terms of the five elements to enjoy good health. Let’s look at examples for each element.


The Water Element

In your physical body, the water element refers to a set of processes that focus on the kidney and bladder. In your emotional life, the water element refers to hidden power and deep emotions.

Water holds hidden power. In the United States, the Colorado River is at places so shallow it is possible to wade across. But that same river has carved out a Grand Canyon that is over 1500 meters deep.

Water is the power that holds the mysteries of our lives. The kidneys house the essence called Jing, which holds the key not just to physical reproduction but also to parenthood in a spiritual sense. The body’s water element holds in the right place in the flow of life. We find our place in the flow of life by practicing stillness. When we aren’t still often enough, our lives float out of place, and our physical bodies generate the diseases associated with imbalances in the water element, such as kidney disease, bladder problems, diabetes, difficulties in having good sex, infertility, and diabetes.

At a deeper level, the water element allows us to create our lives, to manifest our dreams and insights. This power is called Zhi Wang. It is our water element that enables us to hold to our desires and achieve our goals, and it is also our connection to family and history.

Disease Caused by Imbalances of the Water Element

The Zhi Wang gives us our ability to project our will into the world, but the Jing gives us an inheritance from our ancestors. Both are functions of the water element. Just as what your grandfather and grandmother ate could have activated genes that were passed down to you, the Jing can endow you with your ancestors’ trauma. These traumas interfere with your ability to project your will and they cause diseases associated with the kidneys. As you overcome these physical diseases, you also overcome the emotional trauma that came to you on the streams of life, and vice versa. What we do echoes in our lives and in future generations, both through changes in our genes, and in the mysterious set of energies and experiences that make up the water element.

The Wood Element


The wood element is that set of physical and emotional energies, knowledge and spirit that enables adventure. The wood energy fuels adventure. Wood people are doers, usually to the point that other people regard them as pushy. They are organised. They are assertive. They get things done.

Wood is fed by water. Water is released by the force of metal, and gathered in pools by calm reflection. When “wood” people don’t spend enough time gathering their energies and making wise decisions, their energies burst out in anger and fire.

Traditional Chinese Medicine associates the wood element with the liver and gallbladder. It also associates “fiery” conditions with imbalances of the liver. Emotions that spill over into headaches and eye aches and breast pain all relate to imbalances of the liver, and treating with liver herbs and needling liver points, cures them.

Inverted Wood

“Wood” people often suffer anxiety, headaches, and outbursts of emotion when their natural need to be active and growing is thwarted. When people with this kind of temperament are faced with lifes difficulties and decide to “ride it out,” their bodies rebel. The problem is even worse if they don’t exercise. The wood energies have to be expressed of the liver’s natural flow, both physically and energetically becomes blocked.

At a deeper level, the wood element relates the ethereal soul, the Hun. A healthy Hun gives the individual power to act as needed. Action relieves emotional distress—and diseases of the physical liver. The Hun, or “liver mind,” gives the individual the ability to make accurate assessments of the situation. A wood person might naturally be the one to burst into a burning building to save a baby. The Hun gives that person the ability to look for the safest entry and exit; both hero and baby will escape the fire. Similarly, the Hun gives the wood person the ability to move around and away from emotional trauma, to live a life unencumbered by situations that cannot be changed.

The Fire Element

Every textbook of Traditional Chinese Medicine will tell you that the fire element is associated with the heart, pericardium, and small intestine, as well as the energy channel connecting them. What usually gets lost in translation is that the fire element, and the organs with which it is associated, are powered by fun.

Fire embodies movement, enjoyment, and play. “Fire” people aren’t angry people. They are naturally bubbly and spontaneous. But when they have difficulty accepting their spontaneous, playful nature, the fire element within them, they can feel shamed for being a dreamer or are told they are comedians not to be taken seriously, they can achieve healing through the realization that they can be the spark even if they aren’t the fire. They don’t have to achieve their dreams by themselves. They can be the inspiration.

The Heart As Mirror

But how can fire people be an inspiration to the world? Traditional Chinese Medicine teaches that the heart is a mirror, or more precisely, a reflecting pool. Fire people provide the reflecting pool through which other people understand themselves. However, fire people can also generate a ripple in the pool, so that other people can imagine themselves to be something new. The heart person’s joyful, playful, fun emotions create the healthy ripple that stirs the pool.

Just as the physical heart sends blood throughout the body, the spiritual heart can send joy throughout the universe. However, in some people, the heart is captured by trauma. Post-traumatic stress causes the reflecting pool of the heart to replay unhappy, unresolved traumatic memories over and over again. Water transmits shock, not joy. The energy heart is healed by making wise choices between allowing the pool to be stirred and seeking to achieve a calm, reflecting pool. When people stretch themselves to control the reflecting pool, they develop shen, the ability to reach out from their trauma to the good of themselves, their neighbors, and the world.

The Earth Element

The earth organs are the stomach and spleen. They provide “homeliness” for the spirit. They “hug” the rest of the energy body. They are the reason we have so many warm feelings associated with meals for special occasions and why we enjoy comfort food.

This emotional comfort is necessary for rationality. The Yi of the spleen organizes rational thought. Conversely, smoothly rational thinking tonifies the stomach and spleen. When we cease to be grounded, we lose touch with our emotional home and let our emotions overpower rationality, our stomach and spleen suffer. Worry, confusion, and a lack of direction lead to cravings for comforting foods, and nausea, indigestion, excessive appetite or deficient appetite, fatigue, and bowel problems.

Rumination Causes Imbalances in the Earth Element

Ruminants are animals like cows that chew their cud. They eat grass, chew it, send it to one stomach for digestion, up-chuck it for a little more chewing, send to a different stomach for digestion, and then chew it some more.

Rumination in human beings can be the process of questioning things that have already been decided. It can be a long process of second-guessing. And it can lead to imbalances of the stomach and spleen energies that lead to actual disease of the stomach and spleen. The cure for both physical and metaphysical problems of the stomach and spleen is always to re-establish the normal flow. Well-timed rational thought, in addition to acupuncture and herbs, will help resolve stomach problems.

The Metal Element

The metal organs are the lung and large intestine. Together they balance Yin and Yang. Centuries before theory of quantum entanglement, Traditional Chinese Medicine theorised that they also process tiny bits of rock and metals from the air, water, and food that link us with all that has gone before. Metal expands, and the metal organs expand our connections with the universe into our bodies and into the world.

All of this connecting with universe makes “metal” people emotionally sensitive. They get physically sick when they cannot let go of the connections they receive. The large intestine becomes constipated. The lungs become congested. People who are constantly starting over, never able to move on from what they have received from the universe, develop problems in their lungs and large intestine.

Curing Imbalances of the Metal Element

In modern terms, the lifestyle changes that help to resolve energy imbalances of the metal element that manifest themselves in the lungs and large intestine is setting boundaries. Setting emotional limits strengthens the energy called Po. And healing physical problems of the lungs and large intestine also strengthens the limiting energy called Po.

What the Five Elements Mean for You

The five elements are a metaphor. They are symbolic representations for five aspects of our spiritual and emotional lives.

The five elements are also mnemonic. They stand for physical functions that, in a mysterious way, tie into five aspects of our life choices and life experiences.

But the five elements also provide the music of our lives. As the sage Lao Zi said, “That the musical notes and tones become harmonious through the relation to another, before and behind gives the idea of following another.”

The five elements lead each other but they also follow each other. They  drive the cycles of human experience and human health. Keeping them in balance and in motion is the foundation of a healthy life.


He Huan Pi : Cortex Albiziae

He Huan Pi is a traditional Chinese herb prepared from the bark of the mimosa tree, Albizia julibrissin.  Although this tree is native to China and Korea, it is a favorite ornamental plant in the Southwestern United States because of its feathery red and pink flowers that bloom all summer. Also known as Albizia or Cortex Albizae, this herb is in the general category of “herbs that calm the spirit.” Traditional Chinese Medicine used He Huan Pi as a “sweet” herb to make emotions sweeter. It was said to release constrained emotions that cause bad temper, and to release pain and swelling in fractures and abscesses.

Described in the Shen Nong (The Divine Husbandman’s Guide to the Materia Medica) over 1800 years ago, He Huan Pi became known as the “Tree of Happiness” for people who suffered emotional pain.Modern practitioners of Traditional Chinese Medicine, as well as many conventionally trained doctors in China, most often include He Huan Pi in herbal prescriptions for insomnia.[1] It’s also used in herbal formulas for treating anxiety, memory loss, confusion, and depression. The American herbalist Michael Tierra goes so far as to describe He Huan PI as “herbal Prozac.” But surely there’s no scientific evidence that this herb has any functions analogous to its understanding in ancient herbal medicine—or is there?

He Huan Pi May Stop the Spread of Cancerous Tumors

He Huan Pi is a “Yin” herb. It helps the body restain and redirect fluids, tissues, and energies that might go astray. One of the things He Huan Pi might restrain and redirect is cancer.

Angiogenesis, the formation of new blood vessels, is an important step in the spread of cancer. Cancerous tumors have to build new capillaries to provide them nutrients and oxygen, as well as to form a path for cancer cells to travel to other locations in the body.  He Huan Pi, the whole herb, not just a single chemical found in the herb, stops angiogenesis in laboratory tests.[2] A single chemical found in the herb called julibroside J(21) kills cancer cells inside the tumor.[3]

He Huan Pi Is Mildly Sedative

Laboratory studies confirm that He Huan Pi causes mild sedation and sleepiness.[4] It’s the kind of herb that you might take when you wanted sleep without the grogginess the next morning or the risk of sleepwalking at night. The problem is that the combination of He Huan Pi and any of the following medications for insomnia might be too much: Ambien (zolpidem), Ativan (lorazepam), Klonipin (clorazepam), or Seconal (secobarbital). It’s probably also a good idea not to combine He Huan Pi with calamus, California poppy, hops, kava, or St. John’s wort.

He Huan Pi Fights Aging and Anxiety

Scientists In Hong Kong obtained lab rats with a metabolic condition similar to type 2 diabetes in humans .When they fed the animals small doses of He Huan Pi , they noticed that the rats did not lose their whiskers as they got older. They also noticed that the rats did not lose their ability to run through several different kinds of three-dimensional mazes to get food. When they killed the rats and examined their brains, they found that He Huan Pi had an antioxidant effect that protected against the kinds of protein tangles that occur in Alzheimer’s disease. And not surprisingly, given that a large part of what rats do with their lives is to hunt for food, the ability to find food in a three-dimensional maze greatly reduced signs of anxiety.[5]

A laboratory experiment with rats is never proof that an herb or medicine works in humans. However, we’ll never have experiments that put people in three-dimensional mazes to see if they can remember the path to lunch. And it’s utterly unethical and illegal to examine human brains in this kind of experiment. However, these experiments hint that He Huan Pi might have anti-aging effects in people, especially in people who have type 2 diabetes.

So is He Huan Pi something you need to track down at the natural products store? The truth is, no one needs to take an He Huan Pi supplement. But when it is given to you by a physician or an herbalist trained in Traditional Chinese medicine, you can be sure that it is safe and it is supportive of your good health.


[1] Chen FP, Jong MS, Chen YC, Kung YY, Chen TJ, Chen FJ, Hwang SJ. Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan during 2002. Evid Based Complement Alternat Med. 2011;2011:236341. doi: 10.1093/ecam/nep018. Epub 2010 Oct 20. PMID: 19339485.

[2] Cai W, Li Y, Yi Q, Xie F, Du B, Feng L, Qiu L. Total saponins from Albizia julibrissin inhibit vascular endothelial growth factor-mediated angiogenesis in vitro and in vivo. Mol Med Rep. 2015 May;11(5):3405-13. doi: 10.3892/mmr.2015.3228. Epub 2015 Jan 20. PMID: 25607254.

[3] Zou K, Zhao YY, Zhang RY. A cytotoxic saponin from Albizia julibrissin. Chem Pharm Bull (Tokyo). 2006 Aug;54(8):1211-2. PMID: 16880673.

[4] Kang, T. H., Jeong, S. J., Kim, N. Y., Higuchi, R., and Kim, Y. C. Sedative activity of two flavonol glycosides isolated from the flowers of Albizzia julibrissin Durazz. J Ethnopharmacol 2000;71(1-2):321-323.

[5] Li R, Chan W, Mat W, Ho Y, Yeung RK, Tsang S, Xue H. Antiaging and Anxiolytic Effects of Combinatory Formulas Based on Four Medicinal Herbs. Evid Based Complement Alternat Med. 2017;2017:4624069. doi: 10.1155/2017/4624069. Epub 2017 Mar 28. PMID: 28458714.


The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient’s own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

Thanks and graduate for reading this blog if you would like to discuss your individual needs, please feel free to email or 02 8213 2888. 

Sydney Acupuncture & Sydney Chinese Herbal Medicine

Dang Gui – Angelica Sinensis

Dang Gui – Angelica Sinensisdang gui

Some people speak of the traditional Chinese herb Dang Gui (Dong quai) as if it had mystical properties. And in Traditional Chinese Medicine, it does.

Dang Gui, which is the root of a plant known to botanists as Angelica sinensis, was considered in traditional herbal medicine to be a Yin herb. It helps the body contain energies that otherwise would be misdirected. As a treatment for hot flashes, for example, it helps the body channel the energy that otherwise would be used to generate unwanted heat. As a “sweet” herb, it adds a measure of sweetness to emotions and the experience of life. As an “acrid” herb, it wakes up the senses, but in a way that enlightens rather than upsets. And as a warming herb, it helps energies and blood move up in body when they naturally sag down. It redirects the vital energy known as Qi and blood flow back to the heart and brain and away from frivolous uses in the torso.

The legendary applications of Dang Gui have corresponding actions in modern medicine, but how would a pharmacologist look at the herb?

Dang Gui Modifies the Body’s Use of Estrogen

Dang Gui isn’t really a “plant estrogen.” There are plants that make actual estrogen, but Dang Gui is not one of them. Instead, this herb is more “estrogenic” than “estrogen.” The ferulic acid in estrogen occupies some of the same receptor sites as estrogen on the outer membranes of cells in the breast and uterus. It activates these cells in the same way as estrogen, even when there isn’t actual estrogen in circulation.[1] However, it can also activate cells in the breast and uterus that don’t have estrogen receptors.[2] In this way, the ferulic acid in Dang Gui is a kind of “super estrogen” that counteracts some of the effects of menopause. This property also means, however, that it should not be used by women who have breast or uterine cancer, whether or not their cancers are estrogen-receptor positive.

Dang Gui Has a Unique Effect on the Immune System

There are complex sugars (polysaccharides) in Dang Gui that modulate the immune system without necessarily stimulating or suppressing it. These polysaccharides fit into different kinds of receptor sites on white blood cells to activate them to fight infection. This effect occurs specifically in T cells. It’s known to occur when dong quai is brewed into a hot-water tea.[3]

However, Dang Gui also contains compounds that keep specialized mast cells from breaking open to release histamine. In this way one compound in Dang Gui  activates the immune system to fight infection, but another compound in Dang Gui stops allergies.[4]

Dang Gui Relaxes Breathingdang gui 2

About 1-1/2% of the total weight of dong quai is a compound called ligustilide. This chemical relaxes the smooth muscles around the bronchial passages.[5] It relieves asthma, although this makes dong quai an herb you don’t want to take if you have COPD.

Modern Science Confirms Dang Gui’s Use as a “Detoxifier”

Traditional Chinese Medicine uses Dang Gui in tonics to “purify” the blood. What actually happens is that complex carbohydrates, the previously mentioned polysaccharides, lock on to receptor sites on a set of white blood cells known as macrophages. These are large white blood cells that can surround and “eat” germs. They patrol the body looking for bacteria and other microorganisms. Dang Gui polysaccharides stimulate them to patrol more of the body to look in more places for germs.[6]

Dang Gui also plays a role In “liver tonics.” Some plant chemicals in the herb activate the Kuppfer cells, which are the liver’s immune system.[7] Other plant chemicals in the herb prevent the process of apoptosis, also known as cell suicide, when liver tissue is exposed to toxins. They keep the liver alive even when it’s been shocked by exposure to a poison. It’s the whole herb, not a chemical extract, that has this protective effective on the liver, and it’s the whole herb soaked in beverage alcohol (wine in Traditional Chinese Medicine) that helps the liver recover after toxic exposure.[8]

Dang Gui Has Anti-Ulcer Effects

One of the modern uses of Dang Gui formulas in China is the treatment of ulcerative colitis. The herb doesn’t stop the process of ulcer formation, but it accelerates tissue repair.[9] This is a benefit that would be noticed after taking an herbal tea.

Dang Gui Is Helpful for Some Men, Too

Traditional Korean herbal remedies for premature ejaculation usually focus on dang gui. It contains phytochemicals that raise the “vibratory threshold” for ejaculation, so that sex has to last longer and has to be more vigorous for the man to climax.[10]

The Best Known Use of Dang Gui Is In an Herbal Formula

Clinical researchers in universities as far apart as China and Texas have done extensive studies of a traditional formula that combines dong quai with other ingredients, especially white peony root. This Dang Gui and Peony Decoction, also known as Dang Gui Shao Yao San, or Toki-shakuyaku-san (TJ-23) in Japan, or Dangguijakyak-san (DJS) in Korea, or Tang-Kuei and Peony in most English-speaking countries, is showing considerable promise as a treatment for Alzheimer’s.

Researchers at the University of Texas noticed that when they gave elderly women this formula for hormone-related problems, they became mentally sharper and their memories improved. This led to a series of clinical trials all over the world involving both men and women to see if the formula could be a treatment for Alzheimer’s disease.[11]

Japanese clinical trials have found that Dang Gui  and Peony Decoction can be used to prevent the onset of Alzheimer’s and cognitive impairment caused by multiple-infarct dementia.[12] It may also prevent dementia and memory loss In Parkinson’s disease.[13]

And this formula may stop the Alzheimer’s-like complications of “type 3” diabetes. Dang Gui and Peony Decoction counteracts the effects of harmful free radicals, like those that are released when blood sugar levels are too high. [14]

The benefits of Dang Gui for the brain are not obtained from the use of Dang Gui by itself. It has to be combined with the other herbs of the traditional Chinese formula. These herbs act synergistically with Dang Gui for the formula’s combined effects.[15] But this profound effect of an unpatented, ancient, traditional herbal medicine may provide more benefits for Alzheimer’s patients that any other pharmaceutical treatments.

Dang Gui Isn’t a Miracle Herb, But…

angelica sinensis dang gui

Dang Gui is an especially useful herb, but that doesn’t mean it’s a cure-all. It’s very useful for treating women’s problems that are caused by a lack of estrogen. It can be very helpful for men who are concerned about premature ejaculation. And it’s a possible wonder-drug for preventing Alzheimer’s and the dementia that follows tiny blood clots in the brain.

Just don’t give up on traditional medicine to use Dang Gui. All herbs are best used with the best medicines your doctor can prescribe. Herbs don’t replace medicine. Be honest and open with an honest and open-minded doctor to get the best results from using Dang Gui or any other herb.


[1] Eagon PK, Elm MS, Hunter DS, et al. Medicinal herbs: modulation of estrogen action. Era of Hope Mtg, Dept Defense; Breast Cancer Res Prog, Atlanta, GA 2000;Jun 8-11.

[2] Lau CBS, Ho TCY, Chan TWL, Kim SCF. Use of dong quai (Angelica sinensis) to treat peri- and postmenopausal symptoms in women with breast cancer: is it appropriate? Menopause 2005;12:734-40.

[3] Kumazawa, Y., Nakatsuru, Y., Fujisawa, H., Nishimura, C., Mizunoe, K., Otsuka, Y., and Nomoto, K. Lymphocyte activation by a polysaccharide fraction separated from hot water extracts of Angelica acutiloba Kitagawa. J Pharmacobiodyn. 1985;8(6):417-424.

[4] Wei-An Mao, Yuan-Yuan Sun, Jing-Yi Mao, et al. Inhibitory Effects of Angelica Polysaccharide on Activation of Mast Cells. Evid Based Complement Alternat Med 2016;2016:6063475 doi:10.1155/2016/6063475.

[5] Zhao KJ, Dong TT, Tu PF, et al. Molecular genetic and chemical assessment of radix Angelica (Danggui) in China. J Agric Food Chem 2003;51:2576-83.

[6] Wang, Y. and Zhu, B. [The effect of angelica polysaccharide on proliferation and differentiation of hematopoietic progenitor cell]. Zhonghua Yi Xue.Za Zhi 1996;76(5):363-366.

[7] Wang J, Xia XY, Peng RX, Chen X. [Activation of the immunologic function of rat Kupffer cells by the polysaccharides of Angelica sinensis]. Yao Xue Xue Bao. 2004 Mar;39(3):168-71. Chinese.

PMID: 15171648.

[8] Niu C, Wang J, Ji L, Wang Z. Protection of Angelica sinensis (Oliv) Diels against hepatotoxicity induced by Dioscorea bulbifera L. and its mechanism. Biosci Trends. 2014 Oct;8(5):253-9. PMID: 25382441.

[9] 48430 Cho, C. H., Mei, Q. B., Shang, P., Lee, S. S., So, H. L., Guo, X., and Li, Y. Study of the gastrointestinal protective effects of polysaccharides from Angelica sinensis in rats. Planta Med 2000;66(4):348-351.

[10] Choi HK, Jung GW, Moon KH, et al. Clinical study of SS-Cream in patients with lifelong premature ejaculation. Urology 2000;55:257-61.

[11] Fu X, Wang Q, Wang Z, Kuang H, Jiang P. Danggui-Shaoyao-San: New Hope for Alzheimer’s Disease.

Aging Dis. 2015 Dec 20;7(4):502-13. doi: 10.14336/AD.2015.1220. eCollection 2016 Aug. Review.

PMID: 27493835.

[12] Kitabayashi Y, Shibata K, Nakamae T, Narumoto J, Fukui K (2007). Effect of traditional Japanese herbal medicine toki-shakuyakusan for mild cognitive impairment: SPECT study. Psychiatry Clin Neurosci, 61: 447-448.

[13] Matsuoka T, Narumoto J, Shibata K, Okamura A, Taniguchi S, Kitabayashi Y, et al. (2012). Effect of toki-shakuyaku-san on regional cerebral blood flow in patients with mild cognitive impairment and Alzheimer’s disease. Evid Based Complement Alternat Med, 2012:245091.

[14] Fu X, Wang Q, Wang Z, Kuang H, Jiang P. Danggui-Shaoyao-San: New Hope for Alzheimer’s Disease.

Aging Dis. 2015 Dec 20;7(4):502-13. doi: 10.14336/AD.2015.1220. eCollection 2016 Aug. Review.

PMID: 27493835.

[15] Yang WJ, Li DP, Li JK, Li MH, Chen YL, Zhang PZ. Synergistic antioxidant activities of eight traditional Chinese herb pairs. Biol Pharm Bull. 2009 Jun;32(6):1021-6. PMID: 19483308.



The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient’s own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

Thanks and graduate for reading this blog if you would like to discuss your individual needs, please feel free to email or 02 8213 2888. 

Sydney Acupuncture & Sydney Chinese Herbal Medicine

Six Stages to effective Hamstring Rehabilitation

6 Stages to Effective Hamstring Rehabilitation

hamstring 1

Rian Kenny Chiro, wanted to present his thoughts at a more in depth look at one of the more common presentations at the clinic, Hamstring Strains!

From a slight strain or a ‘twinge’ to a more serious grade ‘tear’ it is unfortunately an injury that often reoccurs especially if a thorough rehabilitation program is not completed.


A systematic review performed in the UK and published in the 2009 Strength and Conditioning Journal 31(1) concluded; there are 6 key steps or stages that need to be addressed in order to properly rehabilitate and reduce the chance of reoccurrence.

hamstring 3

1. Initial Treatment

The general RICER protocol should be followed during the first 48 hours of any acute soft tissue injury. Rest, Ice, Compression, Elevation and Referral (To a qualified professional)

2. Restoring Range of Motion

A stretching protocol involving a minimum of 4 stretching session each day using a combination of 3-4 stretches held for 30-45 seconds each. It was suggested that the early increase in range of motion is essential in reducing scar tissue formation.

3. Initial Strengthening

Along with stage 2, Resistance training (very light to no resistance) is introduced incorporating use of available range of motion. Exercises such as Deadlifts, Romanian deadlifts and light leg curls will target the hamstring group.

4. Slow Eccentric Strengthening

Eccentric movement is defined as a muscle lengthening under a load, for example during a squat going from a standing position to squat position is eccentrically utilising muscles and from squat to stand is a concentric action. It has been shown that eccentric action is essential for muscular hypertrophy (cell size) and hyperplasia (cell number). So this stage requires introduction of slow lowering exercises such as Deadlifts, Nordic Hamstring Lowers, back extensions and lunges, with most focus on the lengthening or eccentric phase of the exercises.

5. High Speed Eccentric

As above but introducing more plyometric (jumping) based exercises and sports specific drills at greater speeds, for example; split jumps, depth jumps from a bench and other bounding drills.

6. Sports Specific

The last phase of a full rehabilitation program involves taking the athlete from straight line activities to dynamic change of direction tasks with different surfaces and body positions e.g. single leg bounding, acceleration drills, zig-zag running and hopping activities.

It is essential each phase is carefully monitored to avoid aggravation of the condition. If you have been struggling with a hamstring injury and finding it a frustrating recovery come and have a chat with one of the team..hamstring 2

Book with Rian Here






The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient’s own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

Thanks and graduate for reading this blog if you would like to discuss your individual needs, please feel free to email or 02 8213 2888. 


Kids and Acupuncture Techniques

Kids and acupuncture


By Audrey Cortez 

A question we are asked often in clinic is, “Can acupuncture help children for their ailments/conditions?” and the answer is a resounding “Yes!”. The question most ask is  “do you use needles on children?” and the answer is in short is “Yes” and “no”; let us explain first with a little bit of history and techniques used today.


In China and Japan, paediatric medicine historically not as well respected as it is today, due to a multiple of reasons such as: high mortality rate or children were seen as a ‘burden’. During Japan’s Edo period attitudes to paediatric medicine began to change when diseases such as small pox, measles and parasitic conditions became prevalent. In this era the Shonishin technique was born. It was here acupuncturists (especially blind acupuncturists) were not able to needle under law consequently, these acupuncturists developed the “Shonishin” technique which is using specific tools which are non-invasive and results are quite effective (Wernike 2014). In China at the same time, paediatric medicine was more focused on herbal medicine utilising popular formulas and modifying them to fit the child’s needs.

Selection of Shoni Shin tools for pediatric acupuncture

What is Shonishin?

The word Shonishin can be broken into two parts: ‘shoni’ meaning ‘child’ and ‘shin’ meaning ‘needle or needling’. The Shonishin technique is a non-invasive which is pain free and relatively easy to perform for the practitioner. It involves using a simple tool which looks like a nail, and its used to stroke gently on the patient’s skin. The technique itself is like a massage which children are more welcoming than being needled or taking herbal medicine, which sometimes may not be a pleasant experience for both parent/carer and child. One advantage of performing Shonishin techniques is it can be used a whole extensive range of ailments and it be done on from as young as 6 weeks old to adults. Another advantage is the technique is relatively quick to do which is great as children are quick to respond to treatment.


What other techniques used?

Other techniques used for paediatric acupuncture are massage such as Shiatzu or Tui Na and using Low Level Laser Therapy (LLLT)  devises. These techniques are once again non-invasive which is great while treating because they do not cause pain to the child and can be combined with herbal medicine.


Can you needle young patients?

Macro detail of a pine brush Japanese Shonishin acupuncture tool being used on young boy’s leg

This is an interesting question to answer. In short, yes you can needle children if they feel confident in the knowledge the needles are there to help them then there is no reason for them not to start early. Children are very open to needles and if explained properly. Of course, for those who are scared of needle, they can always opt for the non-invasive techniques if they choose to change their minds at the last minute.

In the next newletter we will be discussing what common conditions paediatric acupuncture can treat and what research supports this.

Here at the Sydney Acupuncture Clinic we offer non-invasive paediatric acupuncture treatments with both the Shonishin technique and laser acupuncture.


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The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient’s own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

Thanks and graduate for reading this blog if you would like to discuss your individual needs, please feel free to email or 02 8213 2888. 

Water in Traditional Chinese Medicine

waterWater in Traditional Chinese Medicine

What is the one ingredient that is found in absolutely every part of traditional Chinese herbal medicine? It’s water, of course. Water is essential to life, but the ancient understanding of water can inform our own lives.

Water as an “Element”

Water is one of the five “elements” in Traditional Chinese Medici ne, along with wood, fire, earth, and metal. Water is the winter element that feeds the new growth, the “wood,” of spring. Not surprisingly, it is associated with the kidneys.

However, the “kidney’ in Traditional Chinese Medicine is not just a physical organ. It is a set of energies that become emotions that in turn become physical objects, all associated with human reproduction and development. The kidneys are the governing organ of the sex organs. Their energies create vaginal fluids and semen, as well as, of course, urine. But they are also the governing organ of “development,” including bones and hair, and the govern the body’s ability to make and detect sound.

Surely this quaint ancient theory does not have any bearing on the modern understanding of health, does it? We invite you to judge for yourself.

The Surprising Importance of Hydration from Head to Toe

Keeping adequately hydrated by drinking enough water with electrolytes is essential to life, but it is also essential to some unexpected aspects of healthy living. Here are just a few reasons we need water in ways that are predicted by Traditional Chinese Medicine.

  • The hair on your head and the skin on your scalp are regenerated by stem cells. Some of these stem cells differentiate into melanocytes, the cells that make the natural color in your hair. Some of these cells differentiate into hair follicles, which generate the hair itself. The two groups of stem cells communicate by hormones and chemical messengers that they send through the tiny capillaries and intercellular fluid in the scalp. If the color-making cells can’t communicate to the hair-making cells, guess what happens? Gray hair. Regular hydration is important to maintain your natural hair colour.[1]
  • The voice In older adults, in particular, tends to shimmer and jitter when the body is dehydrated. Dehydrated people cannot hold a sound so that it blends into other syllables. Their voices have a reduced resonance and a higher frequency (but not in a good way). Drinking water helps to restore the voice. Steam inhalation is useful, too. Voice problems may be prevented by using a nebulizer that provides pure water in tiny droplets.[2]
  • The human body ordinarily keeps almost all of its calcium in the bones and just a tiny amount of calcium in the bloodstream to power muscles and nerves. Dehydration can be a cause of hypercalcemia, too much calcium in the bloodstream.[3]
  • In Traditional Chinese Medicine, the “kidney” (which is a concept more than a physical organ) also governs the knees. You won’t find dehydration listed as a trigger for attacks of knee arthritis (or gout in the ankles and toes), but that is the experience of many people who have to manage these diseases.[4]

How Much Water Is Enough?

Some health-minded people are so intent on staying hydrated that they walk around making sloshing sounds. The best amount of water isn’t more, more, more.  Healthy hydration keeps water consumption in balance with the amount of water that the body uses, no more and no less.

Infants and disabled people are especially susceptible to dehydration because they can’t get their own fluids to drink. Older children are especially susceptible to dehydration because their bodies keep less water in the interstitial fluid around their tissues. The most common precipitating event that leads to death from dehydration is diarrhea. If you get diarrhea, keep hydrated!

It takes as little as 1.2 liters (5 cups) of water a day to keep hydrated. Drinking 3 or more liters of water a day is actually associated with poorer health outcomes, not better.[5] (If you happen to live in the Australian Outback or some other desert, of course, you may actually need more water—but you probably won’t have a longer lifespan as a result of drinking it).

The key is what else is in the water. Water that contains just a little sodium, the ion found in table salt, can keep your body hydrated up to twice as long as water that does not.[6] Almost any natural beverage contains at least a little sodium, even orange juice, whole (full-fat) milk, and tea.  Caffeinated and carbonated beverages are not dehydrating.[7] Tea, in particular, including tea with milk, does not dehydrate.[8]

Hydration Isn’t All About What You Drink

Traditional Chinese Medicine tells us that mastering the “water” element, however, is not just about drinking water and other beverages. The kidney is a yin vessel that stores a property called jing, or essence. This is the set of instructions that the body follows to make its densest structures, such as bone.

The “energy kidney” also consolidates the mysterious energy called chi that governs over our lives from birth to death. It is specifically related to our ability to pro-create, physical growth through childhood, and transition in to old age. Someone with a compromised water element will not have the vitality and endurance necessary throughout our lives to endure, especially during stressful times of change.

You can’t tackle life’s challenges if you aren’t physically hydrated. But you become “spiritually hydrated” by conquering fear, anxiety, and specific phobias. When we master the fluid challenges of our daily lives, we overcome fear. And when we overcome fear, we master the energies of water, unleashing vital energy to make us healthier from head to toe.

Drinking water, tea, and other healthy beverages won’t automatically result in mastery of the watery aspects of human vitality. A great deal of healthy hydration really stems from emotional health, not just diet. But getting at least those 5 cups, 1.2 liters, of water every day is a healthy start to hydration. If you drink water, you have some of the physical sustenance you need to master your life energies. And if you master your life energies, you will keep your water intake and use in healthy balance.


[1] Hsu YC, Li L, Fuchs E. Emerging interactions between skin stem cells and their niches. Nat Med. 2014 Aug;20(8):847-56. doi: 10.1038/nm.3643. Review. PMID: 25100530.

[2] Alves M, Krüger E, Pillay B, van Lierde K, van der Linde J. The Effect of Hydration on Voice Quality in Adults: A Systematic Review.J Voice. 2017 Nov 6. pii: S0892-1997(17)30389-2. doi: 10.1016/j.jvoice.2017.10.001. [Epub ahead of print] Review. PMID: 29122414.

[3] Fernandes LG, Ferreira NR, Cardiga R, Póvoa P. Severe hypercalcaemia and colon ischaemia: dehydration as an unusual cause? BMJ Case Rep. 2015 Mar 25;2015. pii: bcr2014208809. doi: 10.1136/bcr-2014-208809.

PMID: 25809432.

[4] Abhishek A, Valdes AM, Jenkins W, Zhang W, Doherty M. Triggers of acute attacks of gout, does age of gout onset matter? A primary care based cross-sectional study. PLoS One. 2017 Oct 12;12(10):e0186096. doi: 10.1371/journal.pone.0186096. eCollection 2017. PMID: 29023487.

[5] Kant AK, Graubard BI. A prospective study of water intake and subsequent risk of all-cause mortality in a national cohort.Am J Clin Nutr. 2017 Jan;105(1):212-220. doi: 10.3945/ajcn.116.143826. Epub 2016 Nov 30.

PMID: 27903521.

[6] Sims ST, van Vliet L, Cotter JD, Rehrer NJ. Sodium loading aids fluid balance and reduces physiological strain of trained men exercising in the heat. Med Sci Sports Exerc 2007;39:123–30.

[7] Grandjean AC, Reimers KJ, Bannick KE, Haven MC. The effect of caffeinated, non-caffeinated, caloric and non-caloric beverages on hydration. J Am Coll Nutr. 2000 Oct;19(5):591-600. PMID: 11022872.

[8] Ruxton CH, Hart VA. Black tea is not significantly different from water in the maintenance of normal hydration in human subjects: results from a randomised controlled trial.Br J Nutr. 2011 Aug;106(4):588-95. doi: 10.1017/S0007114511000456. Epub 2011 Mar 30. PMID: 21450118.



Water fall


The information and reference materials contained here are intended solely for the general information of the reader. It is not to be used for treatment purposes, but rather for discussion with the patient’s own physician. The information presented here is not intended to diagnose health problems or to take the place of professional medical care.

Thanks and graduate for reading this blog if you would like to discuss your individual needs, please feel free to email or 02 8213 2888. 

Rodd Sanchez Sydney acupuncture and Chinese medicine