Why do you restrict new patients to referrals only, Doc?

Recently, I've gotten asked this question by some very nice folks whom I wish I had the time, energy, & bandwidth to help out. If I had the means to help everyone and still honor my obligations, I'd be all over it, but reality is otherwise. And as I've said on Facebook a number of times, if I did actually have the time, energy, & resources to help a huge population in a more hands-on fashion, it'd be our veterans FIRST. [Are you listening, Veterans Administration?]

Here's the short version of why I continue to restrict my practice to accepting new patients by referral only.

1) My rates are far from cheap & my time has never been more limited with increasing demand (in spite of increasing my fees).

2) My patients & clients are some REALLY cool people, and they go out of their way to protect me from anyone who will be a pain in the ass. 

3) My patients & clients are people I'm emotionally invested in. If they're not feeling better, meeting their goals, and oftentimes surpassing them, I feel like I've let them down. I need to know that the people I get invested in are worth that kind of energy.

Take it or leave it, but if you're too focused on quantities, you'll never comprehend what's possible with quality.

The Lower Back & the Glutes - Robbing Peter to pay Paul

The lower back is one of the most common sites of pain in the human body. As our rapidly modernizing and industrializing society shifts our daily lives towards chairs and fixated on staring at a stationary screen instead of scanning the horizon and moving through a variety of different positions athletically throughout the day, our bodies are developing problems and pains that we don't need to suffer.... especially in the lower back.

I'm not trying to say that lower back injuries don't happen. Disc bulges, disc herniations, vertebral fractures, and all sorts of other nasty things can and do happen to the human spine. But oftentimes, the lower back is a victim of a lazy neighbor - the glutes.

Through hours & hours of sitting over years & years, the glutes are placed in a stretched position and worked negligibly, leading to the atrophy that's known as "skinny jeans syndrome". [One of my patients with more "colorful" language referred to it as overdosing on "Noassital"pills.... and yes, it took me a while to figure that one out.]

When your glutes aren't working properly, your lower back is forced to pick up the slack to provide you with relatively upright posture. So the poor, overworked lower back starts to scream for relief because it's been doing a job that the glutes were supposed to be doing all along. While it might feel like the best thing to do would be to stretch out the lower back and massage it, that might just prolong the situation where the lower back is robbed of efficiency and rest because it's been paying for the inactive glute.

So if your glutes aren't as muscular as you'd like and you're suffering from lower back discomfort, one of the approaches to remedy that might be with glute activation exercises. The one I demonstrate in the video below here with the high-yield tactile cue can help your nervous system get into the habit of activating those muscles better when you lock out the apex of your deadlift, your squat, or your lunges.


In fact, for some of my patients who've been suffering from chronic lower back pain for years and who find themselves holding a seated position for hours at a time due to the nature of their work, usually on long-haul drives or longer flights, this seemingly simple exercise gets many of them walking upright with erect posture and without lower back pain & stiffness if performed right when standing up to disembark.

Give this Hard Style Lock breakdown a try and see if it makes a difference in your lower back!

Meeting a Giant: Marcin Gortat of the Washington Wizards

I've had the privilege of working with a number of professional athletes. This gentleman is a rarity. His outspoken appreciation & off-the-court acts of class are truly something else.

http://www.csnwashington.com/basketball-washington-wizards/talk/la-doctor-fixed-marcin-gortats-back-pain

Coffee, Caffeine, Healthy Diets, & Quality Control

After hearing both sides of the debate on caffeine, looking into the health effects of different qualities of coffee, and having this unfortunate quality of needing to verify things in a firsthand manner, I blocked out some time to get an education this morning from a very patient barista at Intelligentsia on coffee beans, their harvesting practices, brewing, caffeine, and bean quality.

I had a single cup of the barista's personal favorite there as what he said was a single origin, "clean" coffee and consumed no other supplements or stimulants today.

Suffice it to say that my experience has been that coffee, like  everything else, can't be thought of with the "It's all the same" mindset. That single cup has kept me going all day without lagging once, without feeling like I'm running on toxins or fumes, and without making me bloated, jittery, or any other negative feeling.

I spent $15 for a 12oz bag of these beans to see for myself if the effects are consistent.... Now, for a similar price, I could have gotten double that amount of instant coffee & wouldn't have had to buy a coffee bean grinder, filters, etc., and wouldn't have to spend the time doing anything other than dumping hot water into instant coffee powder.

Those of you who know me or who've gotten to know me a little better through FB know that I'm about as pressed for time as it gets. I'm also not at the stage in my professional life yet where I'm the Asian-American Bill Gates & throwing cash around like a rockstar at a strip club.

So why did I spend all that time outside of the clinic & money on something so seemingly unrelated to my orthopedics & rehab specialty? Because one of the things I get asked about VERY frequently is whether or not coffee is bad for you if you're trying to keep a healthy diet.

Without spending a lot of time researching the question, I had to answer honestly by saying, "I don't know, but I have my suspicions." I won't answer a question on any issue that I haven't had time to gather firsthand experience on. Now that I've put some time into looking into this question with more depth, I have to answer the question with my usual phrase "Context is king."

Bad coffee is bad for you. The cheap stuff that's readily available as instant coffee is made from the lowest quality beans, many of which are infected with molds that are full of some sinister stuff. I started drinking coffee in high school when I was staying up for all-nighters to get done AP classwork. That stuff has some nasty side effects, such as gas, bloating, fatigue, anxiety, etc., etc., etc... Good coffee is different.

The coffees that are single origin, that are made from beans that are organically grown and mold-free, and that are minimally processed are VERY different animals from their more ubiquitous cousins. I've heard this without variation from the experienced coffee drinkers that I've spoken/corresponded with, and today's experience bears is certainly in line with that. While it's easy to be dismissive & treat coffee with the same sort of carelessness that we treat so many other facets of our lives, we reap in terms of our health what we sow in terms of our diets... or just like with medical care or training, you get what you pay for!

Quality Control & Patient Referrals

It's been a while since I've updated this site, but for the past 5 years, I've never been busier... as many of you know.

With the onslaught of projects, teaching requests, consulting jobs, and other commitments (such as family), I've gotten to the point where I never imagined I'd be.... too busy to take on all comers.

In order for me to maintain some semblance of quality service to my existing patients, I've recently instituted new policies limiting new patients to only those who come with referrals from existing patients, as well as having raised my prices.

So that I can keep the kind of focused, devoted, and emotionally invested energy in the care of my patients, these steps have been quite necessary. To offset my severe lack of availability, I will eventually start offering workshops to clinicians teaching them my preferred methods of diagnosis & care.

Thank you for your understanding, for your support, and most of all, for your devotion.

Best always,

Mark Cheng, L.Ac., Ph.D., Sr RKC, FMS faculty

Are your feet hurting? It could be Plantar Fasciitis

Plantar fasciitis is quickly becoming a more common condition, as we spend more time seated, wearing "heel lifted" shoes, and using irregular exercise patterns. Here's a short vid clip I did with Beachbody to explain the rough idea behind what might be feeding your foot pain & give you an idea of how to intervene with it!

Running into a dead-end with pain?

All too often, patients (and their doctors) get lulled into a vicious cycle of pain & treatment without end.

It's a common problem that plays out like this:

- Patient hurts.
- Patient goes to see doctor.
- Doctor prescribes treatment. Treatment works temporarily, often with side effects.
- Patient hurts again.
- Patient goes back to see doctor.
- Doctor repeats treatment again... and again.... and again.... and again.

Now while that sounds like it might be a great business plan for the doctor, it's a losing proposition for both the patient and for the advancement of medicine.

Doing the same thing over & over yet expecting a different outcome is the definition of either insanity or abject denial. I've heard of it happening plenty of times with the patient even going to see different surgeons, different specialists, and even practitioners of different modalities and still receiving outcomes that are anything but effective.

This isn't a slam at those doctors, but rather it's a call to start opening our eyes and our minds - both as patients and as physicians. We need to look outside the "usual suspects" when it comes to treating pain, especially chronic pain, but we also need to use a scientific method that is reproducible and logical.

This is our mandate as medical professionals. Let's make sure that we hold ourselves accountable to that and continue to strive to give our patients the BEST care possible, even if it means that we ourselves have to get outside of our comfort zones to learn new treatment methods!