Who Is the Untreatable Patient?


There is an unfortunate yet pervasive trend among some patients, and even practitioners, to speak of “fixing their problem,” versus “having themselves healed.”  At first glance it doesn't seem to be that important of a distinction; “fix” is more objective sounding, while “heal” is a bit more abstract, or mystic in contemporary jargon.  One term typically applies to the recourse taken on a refrigerator or defunct transmission, the other to a human being.  This semantic difference is, in almost all cases, an often innocent and benign mistake spoken out of desperation, convenience, or simply uncertainty.  On rare occasion, however, it can be a more noxious indicator of a pernicious and highly difficult condition to treat… the case of “the patient that doesn’t want to help himself.”

In classical Chinese Medicine, physicians were esteemed not only by the potency of their medicines or the success of their treatments but by their ability to determine which patients were decidedly untreatable.  One such legendary doctor, named Bian Que, lived almost 2,000 years ago and has been long revered for his ability to cure many difficult illnesses, and bring many hopeless cases back from the brink of death.  


However, Dr. Que is also uniquely remembered for a case that he would not attempt to cure.  His patient at the time was an arrogant, and robust king.  The affluent man led an indulgent, selfish lifestyle, but also harbored a “hidden” illness that only the doctor could see.  The king, reveling in his apparent good health and fortune, scoffed at Dr. Que and disregarded all opportunities to change his ways and undergo relatively simple treatment interventions.  Finally, and all at once, the king became gravely and irreversibly ill.  It was then, at this “untreatable” state, and in fear of the king’s delirious wrath, that Bian Que fled the royal palace and ran safely off into the woods.

Although many practitioners today would love to “run off into the woods” at the first sign of a troublesome patient, professional protocol and local State Law prevent such an amusing convenience.  However, this true story does illustrate the importance of the patient’s “active” and working participation in the process of becoming better, that is… being healed.

Personally, I have learned through clinic experience that there is always hope in healing even the most difficult and “untreatable” conditions if the patient is of a positive and encouraged attitude.  Likewise, how impossible it is to work with the opposite type of person, who condemns himself, or herself, at the onset of treatment, preferring instead unnecessary surgical approaches or other “passive” panaceas.  Perhaps the inanimate, more lifeless term “fix” is here more appropriately resigned.  


In contrast to our modern medical machine, the ancient system of patient and healer was without solicitation, salesmanship, or commercial bargaining on behalf of the doctor.  These ancestral patients would “actively” seek out help for themselves by traveling far off the beaten path, and overcoming much hardship, to find and commit to a distinguished healer.  Therefore, it is just as important for us today that we approach our own health and wellness with the same dedication and enthusiasm as those that have come before us.

So take charge of your body, reach out in the form of hope for active “healing,” surmount impossible obstacles and grasp upward with the desire to help yourself.


What Is the Definition of Beauty?

Caesar Cantone, PT, LAc


As a professional in the realm of analyzing body shapes and physiology, I fall into the habit of deconstructing what is attractive to me.  Who is handsome?  What qualifies as pretty… anatomically?  Sometimes I think about what it is about someone that I actually like to see.  “I like the way your foot springs off the ground when you’re happy.  I like the way you hold your head to the side when you’re excited, the way you bounce your hair when you walk with me.”  

Is it  possible to quantify attractiveness, to define a standard of what constitutes objective, “physical,” beauty?  This type of physique could be attractive to me, that type may not be.  I may like a person that is tall with short-brown hair and widely set cheekbones, because she reminds me of my grandmother.  And for you, perhaps, the exact opposite may be true for the very same familial reasons.  If the awesome perplexity of defining beauty wasn’t short of being a miraculous phenomenon, then it would certainly default into the realm of confusion.

Putting Freudian idiosyncrasies aside, it is typically said that we as a human race are generally attracted to that which is unique among a species, and not that which is repetitive or common.  “Opposites attract” … so it is said.  And there are a multitude of other ponderous quotations on beauty that are peppered from the modern age to antiquity.  Think for a second, and more than a few will immediately come to mind.  “Beauty is only skin deep,” “Beauty is in the eye of the beholder,” even “Beauty and the Beast,” and my personal favorite by Fyodor Dostoyevsky, “Beauty will save the world!”  I can assure you that this existential giant of Russian literature was not commenting on the vanity of Italian stilettos or “poke-you-in-the-eyebrow” mascara.


I had a patient once, a professional female dancer, who defined for me at least five distinct, physical and aesthetic benefits that come from wearing shoes with very high heels.  The first, most obvious, was improvement in height.  The second was shrinking of the appearance of the size of the foot, making it look petite.  The third was smoothing the contour of the leg at the sharp angle of the heel.  The fourth was pointing of the toes to strengthen up the arch.  The fifth was amplifying the tone of the muscles in the backside, and also the buttocks and the calves.  Actually there were at least three more legitimate reasons how these artificial “hooves” served to replicate the walking grace of a horse-- but I won’t beleaguer you further on society’s penchant for animals and fashion.      

But it is true, there are dull peacocks and brown robins and then there are brightly colored ones.  That’s just the way the juxtaposition of life works and the expression of genetic code.  Believe it or not, there’s even a “golden rule” of aesthetic balance found within the sterile vault of Mathematics; it is called the Fibonacci Code.  Interesting to note, by which, based upon the sarcophagus of Cleopatra’s face, she was apparently considered “perfect.”  If you are bored, look up The Marquardt Mask.  It is fascinating… but is it beautiful?


Sociologists have attempted to distill the myriad of definitions on physical attractiveness down to a rudimentary four: symmetry, harmony, clarity, and homogamy.  If you need to pull out a dictionary to understand the last term, you are not alone.  It basically means we are attracted to qualities that remind us of ourselves, and therefore essentially goes against everything I have just previously established about “opposites being able to attract.”  Confusion, as I mentioned from the beginning, was a disclaimer about beauty that will unfortunately hold true.  

There is symmetry in snowflakes and microscopic grains of salt, but ideals of beauty are not so simple in people.  What about pretty or handsome viewed through the “eyes” of those who have not been clouded by unrealistic opinions or societal trends toward perfection?  Is it even possible to see physical attractiveness transcended, unadulterated by the subconscious bowels of an opinionated, fully developed adult mind?  In essence, “what makes a baby smile?”

I remember reading a scientific study, for whatever that’s worth quoting at this point, that nonetheless determined one’s physical attractiveness can be improved by at least 50% when somebody genuinely effectuates a smile.  Science and “effectuating” are just overly complicated ways of stating the obvious… smiling makes us happy.  And people ultimately are “attracted” to other people who make them feel good about themselves, who make them smile.  The complication here lies only within the elegance of its simplicity.


Isn’t it tragically too easy to fixate within ourselves, to amplify our imperfections in our minds and then infect them into our behavior like the common cold.  Everyone knows it can be a sad, tragic, and lonely world, so don’t deprive people of the joy of feeling more attractive about themselves when they are around you.  They are not looking at the flaws you consume daily in the mirror, they’re experiencing all of “you” at once… the holistic picture.  

Does anyone really fixate on the “prettiness” of the dancer, instead of the way he or she moves within the dance.  The face here is concerned with the power of emotion, not with symmetry of the hair line or smooth angle of the jaw.  In fact, I would say an almost mesmerizing, or hypnotic effect, is produced by the way we move and behave that transcends our imperfect appearance— a “symmetry” that harmonizes the body with the soul.  

So stand up straight and engage the world, walk the way you’d want to dance, and above all inspire others with your beautiful smile.


Examples of Breath Training Exercises

By Caesar Cantone, PT, LAc




The principles of breathwork, or guided breathing, can be applied to any exercise or activity by consciously controlling the flow of air entering and exiting the body.  In addition to the transformative effects that breath control can impart upon any specific training routine, it can also be taught as an isolated exercise with both meditative and restorative benefits.  

I have outlined three specific types of breathing exercises, which I’ve learned and practiced over the past 10 years through my experience in the Russian Martial Arts.  The physical mechanics of these exercises can appear quite simple, but the mental and emotional depth found within them can be as sophisticated as the participant permits.  Remember, breathing is natural and fluid, and even when controlled it should not seem forced or irregular.  

If you seem to lose your focus within the exercise and your breath becomes unnatural, you should stop immediately.  Take a deep breath in through your nose and blow out quickly through pursed lips.  Restore yourself, as often as required, and then continue as you feel able.

Ex. #1 - WAVE BREATHING - Stress Reduction


1 - Lie in a relaxed, supported position, preferably on the ground, and close your eyes

2 - Breathe IN gently through your nose, and out through your mouth (equal volumes)

3 - Gently contract the muscles of your feet with no more than 50% tension as you inhale, guiding the air into the lower body and relaxing everything else above the ankles

4 - Slowly relax the muscles of your feet as breathe OUT, returning your body to its baseline state

5 - On the next inhale, contract your feet again and then bring your breath and muscle contractions higher up the body to the knees, still making sure not to tense even 1% above these areas (especially in the face)

6 - Exhale and release the knees, and then follow with relaxing the feet completely

7 - You can sequentially move the breath up and down the body, as if you were lying on the beach and the tide was rising and receding beneath you

8 - Bring the breath flow and muscle contractions to a level no higher than your neck, always making sure to keep your face soft, pleasant-looking, and free from anxiety or tension

This is a fantastic exercise to be done at night after a long, stressful day of work or training.  The key to your success with this lies in your ability to “specifically” isolate just the areas you are targeting with your breath, and completely relaxing everything else.  There is a serene, almost meditative quality to this exercise that makes it appropriate for any person and condition.


Ex. #2 - STRETCHING YOUR BREATH - Walking Endurance


1 - Walk, strut, or stroll at a comfortable and even pace (eg. around the park)

2 - Breathe IN over 2 steps (ie. halfway at each step), then

3 - Breathe OUT over the next 2 steps (ie. 4 steps equals one breath cycle)

4 - When you are ready, progress your breath in over 3 steps (ie. one-third at each step), “stretching” it across a full, and even inhalation

5 - Breathe out over the next 3 steps (ie. 6 steps equals one breath cycle

6 - Eventually progress your inhale/exhale repetitions in a sequential manner to a target number that feels challenging, but not distressing

7 - When finished, restore yourself with deep, pursed breathing until you feel relaxed

This is a very challenging variation of breath training, because the purpose of the exercise is to gradually bring yourself to a self-imposed limit, which is inherently uncomfortable.  The key to reaping benefit with this method of training is by making sure the volume of air breathed in and out is at even, smooth increments.  The movement of air flow is not staccato, or step-like as if on a graph, but fluid, and sinusoidal.  Do not make yourself distressed or panicked!  The goal is to improve your lung capacity and regulate your sympathetic nervous system.  Always restore yourself with recovery breathing until you feel relaxed and able to breathe in a normal manner again.  You should feel tired, but also refreshed, and not exhausted.

Following an type of rigorous activity, your breathing may be rapid, and seem difficult to control.  Use the next exercise to help yourself recover more calmly and efficiently.


Ex. #3 - PYRAMID BREATHING - Recovery


1 - Stretch your breath IN over a count of 2 seconds (ascending the pyramid)

2 - Stretch your breath OUT over a count of 2 seconds (descending the pyramid)

3 - Don’t breathe for a count of 2 seconds (base of the pyramid)

4 - Progress the count to 3 seconds as you see fit, until you feel restored

It is important to note that the concept of the “breath hold” is anathematized in Western Medicine, primarily because of potentially dangerous blood pressure fluctuations when practiced improperly.   There are Eastern disciplines that can take breath holding to extremes, such that they only be undertaken with careful guidance and medical supervision.  The restorative exercise of pyramidal breathing is not a “breath hold” exercise, and should by no means create tension, anxiety, or any blood pressure consequence.  If, however, you have any personal concerns because of your medical history, you should definitely discuss them with your doctor first.

Much of what has been outlined here is by no means my singular invention, or the copyright of one particular person or school of thought.  Rather it is a small, generalized, yet helpful introduction to the seemingly infinite world of breathing exercises found spotted across ancient cultures from around the globe.  If you would like a further exploration of breathwork, you can investigate the Indian discipline of yoga, the Chinese tai chi, and the Russian martial art of systema.  An excellent book titled, LET EVERY BREATH, by Vladimir Vasiliev, has been the foundation for my introduction to breath training, and may prove a good place for you to start too!


Backpacks & Back Pain

By Sara Mikulsky


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The fall season is here and that means the kids are heading back to school.  That also means it’s time to hit the store for new school supplies and backpacks!  To help prevent your child from experiencing back pain from his or her backpack, follow these simple steps (video below)


Purchase a backpack that fits your child

A backpack should fit in the space between the cervical (neck) and lumbar (lower back) spine.  Essentially, this is where the thoracic spine and ribcage are located.  The shoulder straps should be wide or narrow enough to fit in the middle of the shoulder (not on the tip).  Additionally, the backpack should be adjustable to allow your child to grow




Don't load a backpack with more than 10% of body weight

A backpack should never be filled with weight greater than 10 % of your child’s weight.  For example, if your child weighs 70 pounds, the backpack should not be heavier than 7 pounds!  Many times, kids can over fill backpacks with books, binders, and other school supplies.  Make sure the essentials are in the backpack, as to prevent back pain or poor posture routines.


Educate your child on how to wear a backpack properly

The backpack should sit just above the hips and buttock area and snug against the middle back.  Show your child how the backpack should sit, and teach them how to adjust the straps.  Some backpacks also have a waist strap.  This strap is designed to fit snuggly over the hips and NOT the waist.  This strap is meant to help decrease loads on the lumbar spine.  


Encourage good posture all the time!

If you notice your child is walking with bad posture or carrying too much, remind them not to!  Reinforcing good posture habits is the first step to preventing lower back pain.  If your child does start to report pain in his or her back, contact a physical therapist to assess your child.   They can help determine if further tests or healthcare professionals should be involved.  Often times, fixing posture and strengthening muscles is the key to reducing your child’s back pain.  


Can Breath Training Improve Your Health?

By Caesar Cantone, PT, LAc

There is an old Chinese adage that proclaims, “Where there is movement, there is life!”  But for most of the average American population, this invocation to move functions as more of a tease than it does an incentive.  Many office professions have tethered their employees to the confines of a narrow cubicle, while other more physically laborious occupations push their employees to a level of movement and activity that is bound by complete exhaustion.  Both of these extremes are injurious, both are marked by significant levels of stress, and both can truly benefit from the one constant, and omnipresent “exercise” of breath training.

As the conscious ambassador between the higher and lower levels of the nervous system, breathing, itself, is the quintessential exercise to remove stress, reduce pain, and restore health and healing.  If there is life in movement, then there is illness and ultimately death in stagnation.  Therefore, the extent and severity of all injury, be it from either external or internal sources, is dependent upon the mind’s ability to hold and retain tension, or “lack of movement,” within the confines of the physical body.  More specifically, this sequence of “tension-retention” is called pain.  Even more specifically, it is called “pain that you care about.”

Considering the gamut of life roles we participate in throughout our daily routine, how do we move without tension?  Or, for those of the more sedentary obligation, how do we move… without moving?

Obviously, the answer is in the way we breathe.  If there is no breath (aka internal movement), there is no animation to the body-- no life!  This is not just obvious, this is instinct.  So therefore, as you breathe guide your breath throughout your body.  Pay special attention to the areas where stress most readily harbors, where injury retains your pain.  Don’t confine the flow of “air” to the anatomical boundaries of the throat, chest and lungs, but instead breathe through these regions and restore them.  Whether your personal bias is to label the intangible movement here as air, energy, Qi, psycho-somatic awareness, or just plain “imagination,” your body will still reap the benefits of this transformative work with or without the appropriate choice of vocabulary word.

The physical mechanics of breathing with exercise should actually resemble the pendular sway of a clock or the ebb and flow of the tide, where there is perfectly uniform movement in both directions.  The inhale and the exhale should be of equal volumes of air, with only the tiniest of pauses during the transition state from one cycle to the next.  It is especially important not to get fixated on the idea of a “perfect” breathing pattern while exercising, since most functional activities will never mirror the ideal training circumstances of your gym or home living room.  Instead, breathe continuously and learn to manipulate the flow and speed of your breath to create strength or softness as you see fit.

I can tell you from personal experience, the most important consideration when beginning to undertake any breath-work routine is not to obsess over it.  Breath training at its most fundamental level is meant to be restorative and rejuvenating.  It is important to relax and be natural and fluid, leading the air in through your nose and out through your mouth.  If it looks like you’re trying to “do something” then you are doing something wrong, that is, with too much effort.  Many times a quick, full inhale followed by a hard, pursed exhale is enough to “reset the system” before beginning breath-work again.

The first, and ultimately only one, real, true rule about breathing is to NOT STOP breathing.  By adhering to the multiplicity of variations within this broad directive and the few aforementioned caveats, you will find a colorful way to reinvent your exercise program and invigorate your work life.


(Part 3 - Breathing Exercises - Next Month)

Is There a Right Way to Breathe?

Almost nothing is ever counseled on the subject of breathing at either the beginning or advanced levels of training.  Occasionally one will receive the obligatory disclaimer, “Exhale while lifting,” or “Don’t hold your breath!”  Most clients typically show an understandable level of annoyance when instructed to “breathe,” with objections invariably following.  “If I wasn’t breathing I’d be dead,” they’d say, or, “My body knows how to breathe. I’ve been doing it since I was born.” Of course, the body itself knows how to breathe, when it’s left purely to its own devices; it’s the mind that always gets in the way!

How Does Your Posture Affect Your Mood?

How Does Your Posture Affect Your Mood?

In Chinese philosophy there is a principle of balance and mutual transformation, called Yin and Yang. It is very common, and most have heard of it, and all of Oriental Medicine believes one hundred percent, completely in it. This elegantly simplistic ideology states that cause and effect are self-perpetuating, and even reversible. That is, given enough time, an action or ‘effect’ can actually begin to mimic, and in some cases even ‘create,’ the type of environment most suited to fostering its own, natural development. In simple English, “Fake it till you make it,” seems to actually work!