Sometimes called “meditation in motion” due to its gentle movements, tai chi is growing in popularity. In fact, the last national survey that asked about alternative health practices showed that nearly 2.5 million Americans have practiced tai chi. You may have seen a small group performing it in a park, or you’ve likely seen ads for classes in your community. This article explains why tai chi for arthritis is often encouraged for people who suffer from the disease and related conditions — it also suggests how you can best locate a class appropriate for you.
What is tai chi?
Tai chi, or tai chi chuan, is a system of postures and movements performed in a slow manner, with each posture flowing into the next, without a pause. The moves are coordinated with deep breathing, requiring a level of concentration that helps people be “in the moment.” People of all ages who practice tai chi report a feeling of relaxation and calm.
The history of tai chi is complex, with many stories and myths surrounding its past. Though probably fictional, the most popular tai chi origin story attributes the creation of tai chi to a Taoist monk named Zhang Sanfeng. Legend has it that Zhang Sanfeng came upon a fight between a bird and a snake and studied their movements closely. Inspired by what he saw, Zhang Sanfeng sought a martial art that used softness and internal power to overcome force. Since then, many styles and variations of tai chi have been developed.
Reasons to consider tai chi
Consumer Reports has called tai chi the “ultimate low-impact exercise” that can be done by anyone who can walk. One study showed it was equivalent to brisk walking in its effects on heart rate, blood pressure, and stress hormones. Those are pretty good stats for what is usually a slow-moving exercise!
Dr. Robert Whipple, a physical therapist in New York who has researched tai chi and balance, believes tai chi is a good exercise choice because it keeps a person stable: It uses a widened stance to maximize a person’s standing base, and it keeps the head and torso as vertical as possible. There is minimal leaning in tai chi, with many instructors telling students to hold their heads as if suspended from above.
An NIH-sponsored review of numerous studies involving tai chi in people with arthritis concluded that tai chi can be safely recommended to people with osteoarthritis, rheumatoid arthritis, and fibromyalgia. The published review also said that tai chi may reduce pain and improve physical and psychological health and well-being. Individual studies involving people with osteoarthritis and rheumatoid arthritis have shown that tai chi can strengthen muscles; increase knee endurance and bone mineral density; reduce the risk of falling; and improve cardiovascular function through lowered blood pressure, heart rate, and stress. Studies in fibromyalgia show improvements in quality of life, sleeping, and symptom management.
Of course, although tai chi is considered safe for almost anyone, it’s best to talk to your doctor before starting a new exercise program to get suggestions for your particular symptoms.
Tai chi styles
Today you can learn many different styles of tai chi in community centers, health clubs, senior centers, and YMCA/YWCAs. Many tai chi styles emphasize its health effects, although some stress competition or self-defense and may involve strikes or kicks. For example, the Chen style has a martial arts focus and includes fast punches, jumps, and kicks. It’s considered the least suited for people with arthritis. On the other side of the spectrum is the Sun style, which uses smaller movements and stances that are held for shorter times. The Wu, Wu (Hao), and Yang are other popular styles, with a variety of versions.
One of the best options for learning tai chi is to use a style that was designed specifically for people with arthritis. Through the Arthritis Foundation, Australian family physician Paul Lam developed a gentler form of the Sun style, which he now teaches throughout the world. After developing arthritis as a teenager in China, Lam found tai chi strengthened his muscles and improved his cardiovascular fitness. Lam also believes that tai chi increases his qi (internal energy, usually pronounced chi), according to traditional Chinese beliefs.
Lam prefers the Sun style because its stances involve less knee bending and less chance for injury. For his version, Tai Chi for Arthritis, Lam worked with rheumatologists, physical therapists, and tai chi experts to remove higher-risk movements. His version also uses forward and backward movements, which he says offers mobility that provides people with arthritis more flexibility and improved muscle strength.
The Arthritis Foundation sponsors more than 450 Tai Chi for Arthritis classes throughout the United States, with many new ones added each year. To see if there is one near you, call your local Arthritis Foundation office, or go online to find classes in your area. Just click Tai Chi under the heading Community Programs for Better Living at www.arthritis.org to go to the Tai Chi page and see how you can get involved. If you want to contact your local office but don’t know how, you can call the national Arthritis Foundation office at (800) 283-7800.
Marty Kidder is a Tai Chi for Arthritis instructor and has certified hundreds of instructors in addition to teaching classes in Canton, Connecticut. He also loves to share his story.
Kidder was told at age 35 that he needed knee replacements but that it would be best to try to postpone the surgery until he was 55, or even 60 if possible. At age 52 he started participating in Dr. Lam’s Tai Chi for Arthritis program. His usual knee pain went away, and he decreased his pain medication. When he retired from the Navy three years later, a physical exam showed he no longer needed knee replacements. He wasn’t surprised.
Kidder explained that Tai Chi for Arthritis instructors teach participants to be mindful of their knee and toe alignment so the stress on their knees is minimal. For example, people with arthritis should move or pivot their feet only after the weight is off them, which is emphasized in Tai Chi for Arthritis to protect the knees. Kidder also said many students new to tai chi tend to move too far forward when shifting their weight. The stances in Tai Chi for Arthritis, however, are designed to make this less likely.
Another feature of Dr. Lam’s arthritis program is that it has been well studied. A recent study involved 354 people with many different forms of arthritis. Half were enrolled in an eight-week Tai Chi for Arthritis program, while the other half didn’t begin tai chi classes until the study had ended. Individuals who did tai chi during the study showed moderate improvements in pain, fatigue, and stiffness. Their reach or balance improved, and so did their sense of well-being.
Finding a class
If you don’t have a Tai Chi for Arthritis class near you, or if you would prefer to join another class in your community, other styles can be used effectively too. Lam encourages people to look for an instructor who is familiar with working with people with arthritis and older people, and who can modify the movements. He recommends classes that have more emphasis on health than martial arts.
“I suggest that potential students go to a class and observe it and talk to students who are similar in age and condition to find out if the class is suitable,” he said. (See My Experience with Tai Chi.)
Learning or practicing tai chi through videos is another option, and luckily there are many tai chi videos available, including one of Dr. Lam’s Tai Chi for Arthritis.
Tips for getting the most out of tai chi
In addition to observing a class before taking it, Dr. Lam has some other suggestions for people with arthritis who are interested in learning tai chi:
- Take time to adjust to the rhythm and feel of tai chi. “Most people are not used to being slow and gentle, so it may take a few months to get used to the rhythm and feel. Please be patient; you will gain health benefits and enjoyment after a few months once you get used to the movements,” said Dr. Lam.
- Recognize that the slow movements may have other advantages. In addition to slowness reducing the likelihood of injury, Lam says that moving slowly is beneficial for mind—body integration as well as in strengthening your muscles. “We also believe that moving in curves and circles is more useful than a straight line,” he said.
- Establish a routine to continue tai chi long term. Like all exercises, it’s most beneficial to practice tai chi consistently. Doing tai chi in the same place and at the same time helps develop a routine. Daily practice, even for brief periods, is very beneficial. This may include group classes and individual time.
- Consider using tai chi in stressful situations. It may seem strange, but once they memorize the movements, many people reap benefits from practicing the movements in their minds when facing a challenge or feeling anxious.
For more information
A short video introducing Tai Chi for Arthritis — including the first movement — can be viewed online. Go to www.taichiforarthritis.com and click on Instructional DVDs under Resources. Click on Tai Chi for Arthritis and scroll down to see a 10-minute clip with Paul Lam.