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A New Ailment: 'Sushi Elbow'?

A New Ailment: 'Sushi Elbow'?

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One Washington, D.C. sushi chef says that years of sushi-making have taken its toll

Wikimedia Commons/ Japan Sushi


After more than 20 years of preparing sushi at Washington, D.C. restaurants Kaz Sushi Bistro and Oh Fish!, chef Kaz Okochi has come down with an interesting ailment, according to The Washington Post: Sushi Elbow.

Or, more accurately, tendinitis brought on by the movement of the elbow needed to mold the sushi rice into that perfectly rectangular shape.

At first, Okochi thought that the pain was caused by playing squash, but it continued to worsen even after he stopped.

A cortisone treatment didn’t help, and now the chef is planning to have surgery on his elbow sometime soon, and it could take six months to fully recover.

While Sushi Elbow isn’t a commonly reported ailment, it definitely appears to be a phenomenon. A 1989 article, also from The Washington Post, profiled chef Kojiro Inoue, who claimed that making upward of 1,000 sushi rolls per day caused him to develop the ailment "Just like Tennis Elbow," he claimed), that required him to wear a cast for a year.

Looks like the dangers of sushi-making extend beyond sharp knives.

Review: A Sushi Spot, Ajihei in Princeton, Diversifies Its Menu

In the days before “Iron Chef,” there was “Ajihei the Cook,” a 1970s Japanese comic about a young chef who faced battles of the knife and the noodle in his quest to become the best.

Ajihei, a Japanese restaurant set below street level in Princeton, is hardly a cartoonish operation. After the beloved, 16-year-old establishment was renovated, in 2014, Koji Kitamura updated his menu, which was known for its clean, simple presentations of sashimi and sushi, to focus more on his cooked dishes, like teriyaki, tonkatsu, and various donburi. The biggest change, however, was the addition of ramen.

A case of what might be called sushi elbow forced Mr. Kitamura to find ways to diversify to continue serving customers — up to 150 a day — at his one-chef, 24-seat operation. Now, on trips to the Bronx to buy fresh fish at Hunts Point, he sticks to the basics: tuna, salmon, yellowtail, fluke, scallop and eel. But there’s a new item on his shopping list: Soup bones.

Pork neck and femur bones enrich his 15-hour tonkatsu ramen broth. Shio, shoyu, and miso ramen are based on a clear, or “chintan,” broth, made with a combination of chicken, pork and fish. If you want more than two slices of utterly tender chashu pork in your soup, order extra, and throw in a soft-boiled egg. If I were a teenage boy, I would order the tan tan men, with ground pork instead of sliced it’s the sloppy Joe of ramen.

Don’t shy away from broth labeled not clear, or “paitan” — milky and opaque, it is still bracing even on a summer’s day. Ajihei’s tonkatsu ramen stood out, piquant with slivers of pickled red ginger, a treasure hunt for small, springy kikurage, or wood-ear, mushrooms. The straight, slender white noodles were a touch slipperier than the crimped ones in the sweeter, thicker miso ramen.

Mr. Kitamura intends to start making his own noodles in the coming year, part of a plan to open a second, similar restaurant, with a partner, in Bushwick, Brooklyn.

Ajihei has its fan base, especially among those who share Mr. Kitamura’s appreciation of midcentury jazz and are willing to dine in close quarters in a party of four or less. Some relished the rules on the old menu: No hard liquor. No birthday cake. The admonition is gone if not forgotten, but Ajihei remains a good place to stay cool and focus on your bowl or plate.

The 2014 renovation created more bar seating and less space for conversation. The standard fish-on-ice case was also removed, so that patrons can slurp their noodles side by side, in rhythm if not in haste, and catch only a glimpse of the sensei’s baseball cap behind the counter.

There is plenty left to please this Old Schooler, including more than respectable sashimi platters. However, one evening in May, apparently irate over finding that sushi was no longer front and center on the menu, one couple managed to order nothing but 20 pieces of orange salmon sushi. At a nearby table, the shoyu ramen steamed and glinted with scallion and flecks of oil, and a bowl of chirashi sushi displayed the contrasts of uni and cucumber, tamago omelet and shrimp, and tuna and shiso leaf on a bed of sweet and tart sushi rice.

It is so rare to get real shiso leaves instead of plastic representations that one might come here for this alone. A special request might get you an umeshiso roll, with pickled plum.

If you feel like playing it safe, order the Japanese curry, a plate of warm brown sauce and rice, or the vegetable croquettes, basically crisped patties of mashed potato and a few peas. Salads and appetizers are hardly a presence on the newer menu, but are still available upon request. The one I would not miss is hiyayakko, a simple dish of cold silken tofu under grated fresh ginger, scallions, and bonito flakes.

Ajihei is particularly satisfying as a spot for lunch, when the more experienced servers are at work. The pace is brisk and the menu offers the Business Lunch, a bento meal that changes daily it’s a good deal at $15, and a chance to role play if you are not really very businesslike. You can choose between a yellowtail (or salmon or eel, whatever fish Mr. Kitamura has extra of) roll and a California roll — though why would you opt for a California roll? — and you will get whichever is the day’s cooked dish, like crisp fried pork tonkatsu with its sweet-sour sauce, fried chicken karaage and fish or chicken teriyaki, plus a basic lettuce salad in miso dressing and a bowl of miso soup.

Ajihei has made the shift from mostly raw to the raw-and-the-cooked, and such a bento is a modest piece of genius, one that combines a bit of cool, cleansing raw fish and wasabi with comforting fried meat and rice, organized into lacquered rectangles, in a manner our midday brains might well envy.

Folded Sushi Wraps

Folded sushi wraps are a delicious low-carb alternative to tortilla wraps, and best of all, they're super simple to put together.

You can use any ingredients you desire for each section of nori sheet, including sushi rice, lettuce, tuna, etc. But keep in mind that piping hot or wet ingredients will cause the seaweed to quickly wrinkle up, so it's best to allow hot ingredients like freshly cooked rice to cool before using, and to avoid wet ingredients like hummus unless you layer wet ingredients between non-wet ingredients like folded egg.


Lightly sauteed organic egg
Avocado slices
Cucumber slices
Bell pepper slices
Roasted seaweed sheets (nori)
Sea salt

1. Place nori sheet on a clean flat work surface. Use scissors to make just one cut halfway up the middle of the sheet to about the center point of the sheet - this will allow you to fold the sheet one quarter at a time in a clockwise direction to "wrap" your ingredients.

2. Place one of your four ingredients in each quarter section of the sheet.

3. Fold the bottom left quarter up to lie on top of the top left quarter. Continue by folding the stacked layers over the top right quarter. Finish wrapping by folding stacked layers over the remaining bottom right quarter.

4. Enjoy your wrap as is, or feel free to wrap it with parchment paper or even saran wrap, which will allow you to neatly cut the wrap into two halves for tidier eating.

For more photos of the process of making sushi wraps, you can swipe left on the following post at our Instagram page:

Please Rate This

Wow - this looks great

Thank you for this recipe Dr. Kim. I can't wait to try it it looks so yummy!

Thank you!

I always learn something from your postings. Thank you! :D I wonder if brown rice can be used?

You can

If you like brown rice you can. I like brown rice, but I think white is better for sushi, though. I can't testify to it's rollability but I've seen it. Have to say it's always better with fish. I can't say I'm a fan of carrots in sushi but they add color to kimpira (burdock) here is a recipe I found:


question can these be made using soy paper and if so, where do I purchase it?

Thanks Ben for your beautiful

Thanks Ben for your beautiful lesson. I love your site! As a nutritionist in Australia I can see that what is needed more than ever is good food education! What a great way to teach in our busy world! I too am a great fan of Weston A Price, as I know you are. I am a bit of a foodie nut, make my own sour dough breads, keifer, cheeses etc and will try one day to do a pictorial for education purposes. You have inspired me!
Keep up the good work.

Nori maki

As asian groceries are much more common than Korean ones and the Korean terms are never seen in the asian stores, readers should know the more common Japanese terms, such as nori maki (laver roll), daikon (Asian radish), takuan (pickled asian radish. named after the zen master reputed to have invented it). When you order sushi at your local sushi shop, you will not be getting the recipe above. the rice will have only rice vinegar, sugar and salt added. Ben says to add sesame oil, but it looks like he is adding toasted sesame oil, a quite different item. I use the traditional Japanese recipe with unrefined rice vinegar (never distilled), subbing honey for the sugar, and an unrefined salt. And for those aware of the inadvisability of using refined carbs, know that pressure cooked short grain brown rice works fine for me. I sometimes put pickled ginger (look for undyed), umeboshi (salt plum), or any colorful vegetable like string beans inside my maki. I prefer to steam my julienned carrots, buy the nori raw (black) and fresh toast it myself until it is bright green. This can be done in an oven, over a gas burner or even over an electric burner. And last, but not least, don't forget the frosting on this cake: wasabi! This sinus-clearing condiment can be found in pure, undyed powder form (avoid the many adulterated imitations. just add water.

How to make sushi

Thanks for the detailed steps especially the pictures on how to make sushi. My 9 yo son has been bugging me to make sushi for the longest time (he loves sushi), but I have not tried to do so because of the many, many ingredients that I would have to buy to get started. After reading your post today, it has given me "courage" to get started, especially now that I know I don't really need all the typical sushi ingredients on hand before making sushi !


I agree with nadaman that short grain brown rice (genmai)can/should be used for increased nutrition. I much prefer the Korean method of using toasted sesame oil with the rice and no sugar and intend to try it. I love the idea of leaving it in a roll to eat away from home. I also agree that wasabi is imperative. I was recently introduced to a Japanese/organic market (in Windsor) where I purchased wasabi powder that includes spirolina to add the green colour. Isn't that clever!


Great selection of ingredients! I love all of them.
Cucumbers and carrots are so yesterday.

Delicious sushi rolls!

Thank you Dr. Kim for this amazing recipe, it's delicious and healthy too! The pictures are great, they make my mouth water!:-)Please tell your mom THANK YOU!! she is awesome. You are the best!

My sushi picture

Thank you Dr Kim for yet another great suggestion of how to make sushi. I'd love to add here with my sushi, made last week with salmon and mayonaise and rice that was seasoned with vinegar and sugar (I know, sugar is not healthy at all, but the combination gave a great taste:

Wishing you all the best in your further work :)!

Sushi making 101

I can attest to using brown rice for "regular" sushi making, but no doubt, the white rice for the "inverted" roll (rice on the outside) seems so much more workable.

Also, nobody including Dr. Ben has mentioned what side up should the nori be positioned on the mat. I generally have the shiny side (yes, there is a shiny side) lying down and the dull side looking up.

Shushi rice mixed with cauliflower rice

We mix cauliflower rice to reduce the carb content and add some salt and toasted sesame seeds to the rice mixture. It is so yummy and healthy even my child loves it and takes as a packed lunch to school.

Maki Sushi Rolls!

Hi Dr. Kim! and All!
These are GREAT! I haven't tried to make this in 20 years, but your article got me going again.
Pure Amateurs here!
Some dear friends came over a couple of weeks ago with the SAME idea and brought all the fixings, and what a pleasure it was to make and eat them together. This is a social food. And Pure Joy.

I made the maki/sushi rolls again tonight, this time alone, though for my husband, and this time trying different tactics:

-I steamed the carrots and soaked them in cold water
(I was worried I didn't have enough time to saute the carrots as you suggest. Next time)

-I made a Sushi Rice sauce combo of:
1/3 c. Rice Wine Vinegar
2 T raw sugar
2 tsp salt

As per my friends recently successful tasting recipe. QUESTION, is the Sesame Oil just as tasty and healthier?
Also I read that Mirin might be good, but I'm not sure how to use it. It sits in our fridge so sad and lonely.
Will try Sesame Oil NEXT.
Hoping someone chimes in on Mirin uses.

Guilt Admission: I was feeling so low down that I actually bought and included Imitation Crab--I know I know! Badness.
But it had the salt and whatever that made the rolls comforting tonight. My husband liked them as well.
I LOVE raw fish, I'm just afraid to risk that in Tucson, Arizona right now. Any advice on how to choose a really safe place for raw sushi? Sashimi, Nigiri?

Our fillings tonight were English Cucumber, slightly steamed carrot sticks, avocado slices, and imitation crab. My rolls turned out kind of big, perhaps I used too much rice?

Appreciate ANY advice from you all!

Softening the carrots was so much better than raw carrots! Any suggestions welcome.
Thanks for kicking my dinners into gear and reminding me of the incredible joy that comes from making these, and actually interacting with our food.

The body actually cares about fresh food and preparation--sigh, I had forgotten that.
What is particularly joyful about this dish is that it's so much happiness when prepared with friends or family. It's a very interactive joy space for food.

Elbow Ailment May Keep Morton Out of Action Against the Redskins

PLEASANTVILLE, N.Y., Nov. 9—The metropolitan area quarterback who needed hospitalization was, it turns out, not Joe Namath, but Craig Morton.

Namath, even though he did not have to enter Lenox Hill Hospital today for an arthroscopy on his swollen right knee, will probably not be able to play for the Jets next Sunday against the Tampa Bay Buccaneers. Steve Joachim will back up Richard Todd at Shea Stadium.

Morton, whose right elbow filled with fluid and puffed up last Sunday night after the Giants lost to the Cowboys in Dallas, was listed as “questionable” for next Sunday's game against the Washington Redskins and all those Giants Stadium fans who have been chanting, “We want Snead,” this season may get a chance to see 37‐year‐old Norm Snead, Meanwhile, the Giants are looking around for a backup quarterback in case Morton can't play Sunday, and the signing of one is expected to be announced tomorrow.

The Jets doctors originally planned for Namath to undergo extensive hospital tests today, but after further examination they decided the quarterback's problem was just an irritation of an old injury and prescribed heat pads, rest and medication.

Morton's injury caught the Giants, including Morton, by surprise. The quarterback was examined in the trainer's room after the game in Dallas for knee and rib bruises. At the time, the abra sion on his right elbow, which Morton suffered in the final minute of the first half while completing a 17‐yard pass to Ray Rhodes, seemed no more important than any of the multiple sore spots suffered every game by football players.

It didn't seem bad enough to interrupt dinner with friends in Dallas after the game, but after dessert Morton's elbow was paining him. One of his friends, a doctor, examined the elbow in the men's room of the restaurant and, after seeing the swelling, called one of the Cowboys’ team physicians, Dr. James Pat Evans, who arranged for Morton to be examined at a hospital.

Coach John McVay reported the injury was probably some burst blood vessels and about 45 c.c.'s of fluid were removed from Morton's elbow in the Dallas hospital. “I don't know what 45 c.c.'s is,” said McVay (i.e. It's a little more than a shot glass). “If he had equated it to a can of beer, I would have understood.”

McVay said he didn't know if the elbow would be drained again this week, but there was a “50‐50” chance Morton could play against the Redskins, who have beaten the Giants 11 straight times, including a 19‐17 lastminute decision in the opener this season that started the Giants on the way to their ninegame losing streak.

Bill Arnsparger, who was dismissed as head coach after the seventh game, benched Morton three weeks ago and Snead quarterbacked the team in a 24‐7 loss against the Minnesota Vikings. That was the last time the Giants scored a touchdown.

Snead is ready and willing to take over again, “encouraged” by the way the offensive line has improved in two weeks under McVay. “What we did in that first quarter, I've never seen done to a Dallas football team,” said the 16‐year National Football League veteran.

McVay thought so much of the Giants’ first quarter performance at Dallas—running 28 plays to the Cowboys’ 3 and gaining 114 yards to the Cowboys’ 8 while taking a 3‐0 lead—that he put a copy of the playby‐play on the lockerroom bulletin board. “I ought to have that framed,” the coach said.

Sneed, who has been on losing teams before, said he thought the Giants’ spirit was remarkable. “I think this club is unique,” he said, “not very good, but unique.”

Thiesmann Stays as Starter

Other Giants listed as questionable were Torn Mullen (sprained ankle), Doug Kotar (thigh contusion), Bill Ellenbogen (sprained ankle) and Karl Chandler (back spasms). . . . The only serious Redskin injury was Dennis Johnson's sprained knee. . . . George Allen, who has beaten the Giants 14 times without a loss (including three times when he was coaching the Los Angeles Rams), said Joe Thiesmann would continue to start at quarterback ahead of Billy Kilmer. Thiesmann completed 20 of 32 passes for 302 yards and three touchdowns last Sunday as the Redskins beat the San Francisco 49ers, 24‐21, to keep their playoff hopes alive.

Snead, asked if he was excited about the possibility of starting against one of his former teams, replied: “If I got excited about playing everybody Iɽ been with, Iɽ be fired up every week.”

The Jets hope Bob Martin, the rookie linebacker who was leading the team with tackles, would be sufficiently recovered from his hip injury to play Sunday.

Hart Resigns Football Post

NORMAL, Ill., Nov. 9 (AP) — Gerry Hart resigned today as head football coach at Illinois State University, effective at the conclusion of his contract, Aug. 15, 1977.


What it looks like: hair loss

The cause: "Hair loss can be due to a number of different factors, including genetics, medications, inflammation, hormonal abnormalities and hair fragility," says Dr. Ko. Regardless of the cause, it is super distressing. If you notice hair breaking/shedding or bald spots on your scalp, it is important to get evaluated by a health care provider immediately. They almost certainly will run blood work to evaluate for anemia, vitamin deficiency, thyroid abnormalities, irregular hormone levels and autoimmune markers.

If blood tests check out, other sources of stress such as the death of a loved one, major weight loss, surgery, a car accident or major infection and illness can cause a massive shedding months after the incident &mdash a condition called telogen effluvium. For instance, a survey conducted by Survivor Corps found that nearly 68% of 1,700 COVID-19 survivors that were interviewed reported experiencing hair loss in the wake of their coronavirus infection. "Actress Alyssa Milano even recently took to Twitter to describe her experienced with COVID-19-related hair loss," notes Dr. Lenzy. Age can also play a role: As estrogen levels decrease between childbearing age and menopause, so often does our hair. Years of bleaching, dyeing, straightening, perming and rocking tight, slicked-back hairstyles can also catch up to us. The issue of hair loss is obviously complex and takes proper medical attention to figure out.

The treatment: Your doctor is going to want a thorough physical done so that any medical problems that are detected can be treated. Underlying scalp conditions such as seborrheic dermatitis or psoriasis should be addressed. In the case of hormonal thinning, there are treatments such as Rogaine, a solution that thickens existing hair, and spironolactone, a pill that helps block hormones called androgens.

Eating a well-balanced diet filled with vitamins such as B12 and folate are also useful when experiencing hair health woes. On top of that, taking a break from over-processing your hair and rocking more natural styles is definitely encouraged. "Platelet-rich plasma (PRP) is an effective option for androgenetic alopecia (also called male and female pattern hair loss) and the residual thinning after telogen effluvium," says Dr. Lenzy. "During PRP, a patient's blood is drawn and the plasma, which is rich in various growth factors effective for stimulating hair regrowth, is isolated and injected or applied to the scalp with microneedling." In extreme cases, hair transplant is an effective option.

Here are 5 Simple Options to use ACV as a Natural Remedy:

1. ACV Morning Iced Tonic

Combine 1-2 teaspoons of apple cider vinegar in 1 cup of water. Add ice for a chilled option (particularly refreshing right after you workout or wake up in the morning), or drink at room temperature.

2. Natural ACV Tea

Add 1-2 tablespoons of apple cider vinegar to warm water and lemon to drink as a natural tea. Add a green tea bag for even more healing effects.

3. ACV Spiked Smoothie or Simple Salad Dressing

Add apple cider vinegar to a fruit-based smoothie to add a tangy, zesty twist or use apple cider vinegar as a natural salad dressing.

4. ACV Simple Shot

Take it plain in the morning as a shot!

5. ACV Healthy, Cleansing Super Shot

Make a cleansing shot with water, the juice from one lemon, cayenne pepper, and a touch of stevia to add sweetness. (Cayenne and lemon are both naturally anti-inflammatory and cleansing too.)

5 Ingredients You’ll Need:

  1. Macaroni – You can use other short pasta, or even spaghetti noodles (we call it Spaghetti Salad (スパゲッティーサラダ)).
  2. Cucumber – Use Japanese or Persian cucumber. If you’re going to use English cucumber, slice in half lengthwise and remove the watery seeds with a spoon. I don’t recommend American cucumber for this recipe as the skin is thick.
  3. Onion –I recommend using it for the texture and zing.
  4. Ham –You can substitute it with shredded cooked chicken, canned tuna, imitation crab, or sweet corn.
  5. Boiled Egg – Add richness, creaminess, and savoriness.

It’s a simple layering, but that’s what makes a difference! You’ll yield a much tastier and superior salad. Rich and creamy, yet refreshing. Sweet yet tangy. All at the same time! It’s so good that you’ll want to come back for more.

The Japanese Macaroni Salad isn’t what it is without Japanese mayo. Period. However, if you can’t get it, I’ve included a quick recipe to convert American mayo to Japanese mayo. It’s not exactly the same, but only if you absolutely can’t get it. You’ll also find my homemade Japanese mayonnaise in the recipe.

Mizkan Natural Rice Vinegar in this recipe. Crafted with real organic ingredients, the rice vinegar has a mild tang, refreshing aroma, and brings out the flavor beautifully.

You’ll find that I solely use Mizkan Natural Rice Vinegar in all my Japanese cooking. You can use it to toss, stir-fry, marinate, dress and dip all kinds of Japanese-inspired dishes. The brand has been around in Japan for over 200 years and is known for using the finest ingredients and brewing according to traditional practices. If you wish to create authentic Japanese recipes at home, I always recommend using Mizkan.

With this rice vinegar in your pantry, you’ll be able to cook up many delicious Japanese dishes at home with confidence and ease!

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Eating dishes at restaurants or preparing them at camp gives the party certain stat boosts.

LVL 10: Item drop rate +100%.

Drop rate increase does not affect enemies that drop nothing

LVL 2: HP Recovery Rate +50%

LVL 3: HP Recovery Rate +75%

LVL 4: HP Recovery Rate +100%

LVL 5: HP Recovery Rate +125%

LVL 6: HP Recovery Rate +150%

LVL 8: HP Recovery Rate +200%

Allies: Technique Leveling Rate +100% and always land critical hits for Techniques

Watch the video: 9 Riddles Only People with High IQ Can Solve (June 2022).


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