Saturday, May 28, 2011

Benefits of the Tai Chi for Arthritis (TCA) Program

This week, there are two studies I would like to review that used Dr. Paul Lam's Tai Chi for Arthritis (TCA). Dr. Lam developed his TCA program in the 1990s and it is now being taught all over the world.

First Study
The first study was the largest fall prevention study in the world. It involved 702 people from Australia, with a minimum age of 60 and an average of 69. The majority of the participants were taught TCA. Baseline tests were made and results were measured after a 16-week class that met once a week. Additional results were measured after 24 weeks.

RESULTS: Falls were less frequent in the tai chi group than in the control group. The hazard ratio of time to first fall was 0.67 (P=0.02) after 24 weeks. There were statistically significant differences in changes in balance favoring the tai chi group on five of six balance tests.

CONCLUSION: Participation in once per week tai chi classes for 16 weeks can prevent falls in relatively healthy community-dwelling older people.

For those that want to read the original, see A Randomized, Controlled Trial of tai chi for the Prevention of Falls: The Central Sydney tai chi Trial, Journal of American Geriatric Society: 55.1185-1191, August 2007. The abstract is available free.

Second Study
The second study was from Korea. This study looked at the effect of Tai Chi for Arthritis (TCA) on arthritis pain. Baseline tests were made and results were measured after 12 weeks.

RESULTS: The tai chi group had 35% less pain, 29% less stiffness, 29% more ability to perform daily tasks (like climbing stairs), as well as improved balance and abdominal muscle strength.

CONCLUSION: Older women with osteoarthritis were able to safely perform the base level of TCA and this was effective in improve their symptoms of arthritis, balance, and physical functioning.

For those that want to read the original, see Effects of tai chi exercise on pain, balance, muscle strength, and physical functioning in older women with osteoarthritis: A randomized clinical trial, J Rheumatol September 2003 30(9):2039-2044. The abstract is available free.

© 2011 Eric Borreson

Saturday, May 21, 2011

Integrating Mind and Body with Tai Chi

Mind-body integration means to be aware of your movements, thoughts, feelings, and behaviors. In order to develop a mind-body connection, we need to learn how to continuously adjust our movements, posture, breathing, thoughts, and emotions. Tai chi is the perfect vehicle to do this. Tai chi helps develop clarity of mind, awareness of body and qi, and strength of spirit.

A basic principle of tai chi is that the yi (mind) directs the qi (internal energy) and the qi drives the jing (internal power.) This makes it sound like yi, qi, and jing are separable and can be developed independently. However, in practice they are inseparable.

It takes a lot of practice to develop your internal power. You need to rewire your nervous system so that your mind can properly understand your body. With extensive practice, you can begin to understand the connection between yi, qi, and jing. There is a saying, "The first 10,000 times don’t count", referring to the amount of practice needed to understand tai chi. It doesn't really take that long to make progress, but growth continues to happen with more practice.

The tai chi classics often make statements that mind is more important than the body. I don’t think that this means to separate mind and body. It means that mind directs the body. Mind and body are inseparable but they must be properly integrated. There are three steps, or parts, of the process of integrating mind and body. They are not independent of each other. The three steps are 1) clarity of mind, 2) awareness of body and qi, and 3) strengthening your spirit (unconscious mind).

1. Clarity of Mind
Clarity of mind comes from focusing your mind on your tai chi form. Be aware of each of the movements. Know where your muscles and joints are moving. Be aware of the intention. The mind must be engaged in every part of every movement. There are three parts to developing clarity of mind.

Clarity Part 1 - Jing - Mental Quietness. Quiet your monkey mind.
Mental quietness happens as you breathe deeply and rhythmically during performance of the forms. During the close part of a form, you exhale and sink your qi, which also helps to calm your mind. It also can help to develop jing if you imagine that you are practicing in a peaceful, tranquil place.

Clarity Part 2 - Song - Relax and Loosen. Loosen your muscles and joints.
Song does not mean to allow your body to go limp. It means to get rid of any unnecessary tension in your body. Your qi flows freely when your body is loosened and stretched out. Imagine your qi sinking to your dan tian. Thinking of your dan tian helps you focus and pay attention to your body.

Clarity Part 3 - Mental Focus. Focus your mind on one thing at a time.
Mental focus is the ability to concentrate on one thing and ignore the monkey mind that constantly distracts us. The three parts to developing focus are to focus on your body, the martial meaning of each form, and your internal emotional balance.

First, focus on your body. Be aware of what is happening and where your Qi is moving. Try to get to know a little bit about the acupuncture meridians because that’s where your qi moves. Focus on your muscles and joints. The shorter forms develop our understanding of the movements and develop our understanding of qi. The longer forms develop our focus by requiring us to concentrate for several minutes at a time in order to do the form correctly. The longer concentration develops our ability to use and move our qi.

Second, focus on the martial meaning of each form. It is important to understand the open and close of each form. Know how and where power is developed and delivered. This helps you to understand the correct posture and movement. Then your mind can direct your body into the right movements. Focus on the movements and their intention.

Third, focus on cultivating your internal emotional balance. This gives you a controlled and relaxed personality to match the controlled, slow, and relaxed tai chi form.

2. Awareness of Body and QiTai chi is a martial art. You need to concentrate to develop clarity of mind, but you also need to be aware of what is happening around you. Closing your eyes during the form helps build awareness of your body, but it doesn’t help you become aware of the environment around you. Once again, there are three parts to this.

Awareness Part 1 - Develop the correct posture and tempo.Without practice and feedback, our mind may not know exactly what the body is doing. For example, you may think that you are keeping an upright body during your forms, but you may actually be bending forward a little bit. You need feedback during your training so that you can develop this integration. Use another person, a video camera, or a mirror to test your posture.

Awareness Part 2 - Learn how to direct your force.Even the simplest forms have several (many) parts to learn and master. It is a big oversimplification, but we can say that the six things to focus on at this point are 1) what your are feet doing, 2) what your hands are doing, 3) what your waist (body) is doing, 4) what your eyes are doing, 5) opening, and 6) closing.

Awareness Part 3 - Focus on moving your qi.When you are practicing tai chi, move slowly and continuously and use intent to move beyond the physical part of the form. This helps to develop a strong mind-body connection. Qi gets stronger as it continues to flow, just like the force of water gets stronger as it flows downhill. If you stop moving during the forms, your qi also stops moving.

3. Strengthening Your Spirit (Unconscious Mind)The word "spirit" needs a little explanation. It has nothing to do with the Christian idea of the Holy Spirit. It is attitude, in the sense of "Being in high spirits." Spirit is mostly controlled by your unconscious mind. You can be aware of your spirit and make temporary changes, but long-term change requires long-term practice. Tai chi can be a path to control your unconscious mind.

Spirit Part 1 - Use guided imagery.A key component of managing your spirit is using guided imagery. The imagery may have a short-term goal, such as mastering a difficult part of a form or keeping upright during a form, or it may have a long-term goal, such as improving your control of your speed during the entire set.

The classics of tai chi clearly recognized the use of imagery. Many of the names of the individual forms reflect this idea. Tai chi sets have descriptive names like "playing the lute" and "white crane spreads its wings" that bring the images to mind.

Mental imagery works on the unconscious mind and can be effective in ways that standard practice alone cannot be. It can help guide you to a higher level of tai chi. As a suggestion, set aside 5 or 10 minutes every day for mental imagery before practicing your forms. Use this time to work on your goal. Visualize that you do your forms perfectly. Imagine the smallest details. Your unconscious mind doesn’t know the difference between visualization and actual movement. The visualization influences your following practice.

Spirit Part 2 - Get your flow going.Flow is the feeling you get when you get lost in the moment. This is when you don’t even notice anything going on around you. This is sometimes called being in the zone. People perform their best at everything and have the most enjoyment when they are "in the flow." When someone is in flow, their emotions become energized and aligned with the task at hand. Agitation and anxiety prevent you from getting in the flow.

There are three main factors that improve your flow. First, have a clear short-term goal for each practice. Second, it is important to receive immediate and relevant feedback. Third, match your goals to your skills. You want an achievable challenge.

When you are beginning to learn taiji, your goal may be to remember how to remember the movement. Your feedback comes from knowing that you completed the movement correctly. For a more advanced movement, your goal may be to focus on the substantial and insubstantial weight shifts during the form. In this case, your feedback, comes from you knowing that you completed the form or set and were aware of your weight at all times. In both cases, you are selecting an appropriate goal for your skill level.

Spirit Part 3 - Practice, practice, practice.It is not possible to learn all of these things at once. During your daily practice, pick one thing to work on for that day. Work on that topic for several days or weeks and then move on to something new. Eventually, come back to the fhttp://www.blogger.com/img/blank.gifirst topic and work on that one again. You can continue to learn something new about yourself as you continue to work.

Note: I use the term "tai chi" even though the correct Pinyin translation is "taiji." It has become part of the English language as tai chi, so that is what I use.

This was originally published in the April issue of Yang-Sheng, www.yang-sheng.com.

© 2011 Eric Borreson

Saturday, May 14, 2011

Tai Chi Warmup Exercises

It is important to warm up your body before beginning exercise of any kind. These tai chi warm-ups also have an added component of opening up your joints and strengthening the flow of qi. Work within your comfort zone for all these exercises. If you have any problems with balance at any time, feel free to use a chair back or wall for support. If there is any unusual pain, stop immediately and consult a medical professional.

These exercises are from Dr. Paul Lam’s Tai Chi for Health. I have completely rewritten his descriptions and added quite a bit more information to explain how you can use the exercises to help your tai chi. As far as I have been able to learn, this is the only detailed write-up of these exercises available on the internet. I strongly recommend that you view Dr. Lam's Tai Chi for Arthritis videos for more information.

Beginning
The exercises start by working with your hands. Walk in a small circle, opening and closing your hands, and smile. This gets the blood flowing and your energy moving. Smiling promotes good energy and good feelings.

In Depth: Keep your body upright and avoid tensing up. Visualize that your spine is a string and you are gently pulling the string from both ends to stretch your torso. The top of the string is at the Bai Hui point at the crown of your. The bottom of the string is at the Hui Yin point at the center of your perineum. Breathe slowly and be aware of transferring your weight, gently touch down your heel, and slowly shift your weight. Work within your comfort zone. If possible, practice dan tien breathing while walking.

Main Exercises
There are two exercises each for six main body parts. There are two exercises each for the neck, shoulders, spine, hips, knees, and ankles. Do three repetitions of each exercise before beginning your tai chi forms.

Move into wu ji and keep your body upright during these exercises. Allow your body and mind to relax. Let your shoulders drop and loosen the neck and shoulder muscles where you build up tension during the day. Work with your knees slightly bent at all times.

Neck
1 - Head Down.
Start with your chin down toward your chest. Inhale and slowly raise your hands in front of you with your palms down. As your hands move, follow the movement with your chin. When your hands reach shoulder height, you should be facing straight ahead. Turn your hands so that your palms are toward your face. Bring in your hands toward your chin and move your chin backward, as if your hands were pushing it back, keeping your head upright. This straightens your spine. Exhale, turn your hands so the palms are forward, and push your palms forward and then down. Allow your chin to follow the hand movements by extending your head forward and bending it down.

In Depth: Keep your elbows slightly below your shoulders and gently push your shoulders out. This loosens (song) your shoulders and improves your flow of qi. With practice, you should eventually be able to feel the qi in your hands. During the entire exercise, imagine that you are moving against gentle resistance to develop your inner force. In addition, focus on your qi and allow it to sink to your dan tien. This allows you to generate force in opposite directions to loosen your joints.

2 - Side to Side. Raise one hand to shoulder height in front of your shoulder with your palm facing in. Move your hand out in an arc to the side. Keep your hips still and turn at the waist. Follow the movement by turning your head. Return to center and switch hands. Repeat to the other side.

In Depth: Stretch your shoulders outward and maintain a small space in your armpit to open up the shoulder joint. Keep your elbow below your hand and shoulder and imagine stretching your hand out and up to stretch the arm tendons. Optionally, add some spiral force and rotate your dan tien to the side. Be sure to turn your head to get that neck stretch.

Shoulders
1 - Shoulder Roll.
Roll your shoulders forward three times. Then do it again by rolling them backward three times.

In Depth: Stretch your shoulders outward and maintain a small space in your armpit to open up the joint to promote the flow of qi.

2 - Hands Up and Around. Inhale and bring your hands around from the sides toward your body in a big circle, bending your knees slightly and gathering qi as you move. Exhale and press your hands down in front of you.

In Depth: Imagine gathering qi into your hands from the universe around you. Reach out to expand all the joints in your arms as your move. As you exhale, sink your qi to your dan tien.

Spine
1 - Stretch up & Down.
Slightly tuck in your chin to straighten your upper spine. Hold your hands in front of you with one hand about chest height and palm down and the other at your lower abdomen with the palm up, as if holding a ball. (Alternatively, hold your hands at the same level with fingertips pointing toward each other.) Separate your hands and inhale, moving one hand palm up over your head and one palm down at your hip. This is a gentle stretch with your elbows bent. Repeat to the other side.

In Depth: As you inhale, visualize that your spine is a string and you are gently pulling the string from both ends to stretch your spine. Feel your qi flowing up your spine to the top of your head. Pause briefly without moving and feel your spine stretching and the space between the vertebrae opening up. Imagine yourself growing taller. As you exhale, bring your hands back to the center and visualize that your qi is flowing down the front of your body.

2 - Side to Side. Hold your hands in front of you, right palm down and left palm up, as if holding a ball. Rotate at the waist in the direction of the top hand. When you reach your limit, reverse your hands and rotate in the other direction. Try to separate the movement of your hips and your waist and keep your hips still. There is no need to turn more than about 45° each way.

In Depth: Use your waist to lead the movement as you turn. Your hands follow your waist. Exhale and sink your qi to your dan tien.

Hips (It's OK to hang on to something for balance as you build leg strength)
1 - Forward & Back.
Shift your weight to your right leg and bend your knees slightly. Lift your left leg and extend it toward the front, touching your heel down. Keep most of your weight on your right foot. At the same time, push your hands back from your sides toward the back. Lift your left leg, bring it back to where you started, and extend it behind you, touching down on the ball of the foot. At the same time, raise your hands in front to about shoulder height. Repeat for a total of three stretches. Repeat on the other side. For best balance, keep your feet apart so you are not “walking a tightrope”.

In Depth: Maintain an upright posture to keep your qi flowing properly. Make sure your movements are slow and continuous. Stretch your hip joint from within by keeping your crotch in an arch.

2 - Side Stretch. Shift your weight to your right leg and bend your knees slightly. Extend your left leg out to the left and gently touch down. Raise your hands with the palms facing to the right, right hand above the left. Press your hands to the right as if against a wall on your right side. Repeat the exercise to the left side.

In Depth: Visualize that your hip and knee joints are stretching and opening. Imagine that your arms and legs are being stretched in opposite directions from your center. This improves your balance and improves your flow of qi.

Knees
1 - Step & Punch Forward.
Make your hands into loose fists and place them at your waist. Shift your weight to your right leg and bend your knees slightly. Slowly lift your left foot slightly, place it forward, touch down on your heel, and touch the rest of your foot down. At the same time, shift your weight forward and slowly punch forward with your right fist while exhaling. Keep your back heel flat on the floor so you don’t become overbalanced. Keep your feet apart so you are not “walking a tightrope”. Shift your weight back, pick up your left foot, bring it back, and touch down where you started. At the same time, bring your fist back to your waist while inhaling. Repeat to the other side.

In Depth: Focus on slowly, gradually transferring your weight. Your internal force (intention) is delivered from the back foot, through the waist, and then the spine, shoulder, arm, and fist. Your punching fist is yang and your other fist is yin. Focus on both to maintain your yin/yang balance. Rotate your hips toward the front as you step and punch. Be aware of the kuas opening and closing to store and deliver power.

2 - Kick & Punch Forward. Make your hands into loose fists and place them at your waist. Shift your weight to your right leg and bend your knees slightly. Slowly lift your left leg, raising it until your thigh is horizontal. Slowly kick out with your left foot. At the same time, slowly punch forward with your right fist while exhaling. Bring your foot back in and touch down where you started. At the same time, bring your fist back while inhaling. Repeat to the other side.

In Depth: Focus on your posture and stay upright. Be sure to avoid hunching over. Slowly punch against a gentle force to develop your internal force. This exercise helps you focus your mind on delivering energy and at the same time it builds leg strength and balance. Additionally, as you step with your left, slightly rotate your waist and hips to the right. This helps you align your femur with your knee so that your weight is more directly over your knee. As you shift your weight forward, rotate your waist and hips back to the center. As you step with your right, slightly rotate your waist and hips to the left. This minimizes strain on your knees.

Ankles
1 - Heel & Toe.
Shift your weight to your right leg and bend your knees slightly. Extend your left foot and touch down on your heel. Lift your foot slightly and touch down on the ball of your foot. Alternate for a total of three touches on heel and on toe. Repeat on the other side.

In Depth: Focus on slowly, gradually transferring your weight. Be aware of your weight being placed evenly on your foot. Be aware of sinking your qi. Make the ankle movements very slow and concentrate on opening the joint.

2 - Side to Side. Shift your weight to your right leg and bend your knees slightly. Extend your left foot and touch down on the outside of your foot. Lift your foot slightly and touch down on the inside of your foot. Alternate for a total of three touches on outside and on inside. Repeat on the other side.

In Depth: Focus on slowly, gradually transferring your weight. Be aware of your weight being placed evenly on your foot. Make the ankle movements very slow and concentrate on opening the joint.

Cooldown ExercisesThese are exercises to be done after completing your forms practice. They help you learn to relax your body after exercise.

1 - Gently Punching Thigh. Make a light fist and gently punch your thigh. Repeat with the other hand on the other leg. If you can, raise your leg so that your thigh is horizontal as you punch.

In Depth: Your legs get a good workout practicing tai chi. A gentle punch relaxes your thigh muscles and gets rid of any residual tension caused by the exercise. This helps with qi flow.

2 - Tense and Relax. From wu ji, make a fist, inhale, and rise up to your full height. If your balance is good, rise up on your toes. Relax and repeat.

In Depth: This exercise relaxes your entire body. The tension causes by making a fist and rising up is released when you relax. This helps make you aware of any residual tension anywhere in your body.

3 - Gathering Qi. This is the same as the shoulder exercise Hands Up and Around. Inhale and bring your hands around from the sides toward your body in a big circle, bending your knees slightly and gathering qi as you move. Exhale and press your hands down in front of you.

In Depth: Imagine gathering qi into your hands from the universe around you. Expand all the joints in your arms as your move. As you exhale, direct your qi to your dan tien.

© 2011 Eric Borreson

Sunday, May 8, 2011

Should you celebrate when your enemy dies?

There was a lot of news earlier this week when it was announced that Osama bin Laden had been killed in Pakistan. The saturation news coverage was almost constant for a couple of days.

We had a long discussion about it during our dharma class this week. We were all upset with the images we saw on TV of people celebrating in the streets in New York and Washington. There is no doubt that bin Laden was going to continue killing people. He was like a rabid animal that presented a clear danger and he had to be stopped. His killing should give people a sense of relief. It should not be cause for celebration.

One person in our group made a comment about bin Laden being such a madman that he had to die. I strongly disagree with that characterization. He was not mad in the sense of being insane. He was a very intelligent and capable man. However, his values were so different from ours that people didn't understand him and called him mad.

Don't get me wrong. I am not condoning anything bin Laden did. I am simply saying that we should not celebrate when a man dies. If we do celebrate, how are we better that the people that celebrated in the streets after the attacks of 9/11? Do you remember seeing that on TV? How did that make you feel?

Someone else made a comment about how she wished that we could prevent people from going so wrong. Unfortunately, we don't live in a world of wishes and make-believe. We live in the world as it truly exists now. Nicole commented that it seems that the military operation that killed bin Laden did the most good with the least harm.

That's a meaningful thought. Osama bin Laden was alive on April 30 and was plotting attacks against the West. What is the best thing that can be done with the least harm under those circumstances? In this case, they went in and killed him. They treated his body with respect and buried him at sea. He was buried with respect to Muslim tradition. His body was placed somewhere where it could not become part of a shrine.

In fact, the Dalai Lama himself suggested that the killing was appropriate. He said, "Forgiveness doesn't mean forget what happened. ... If something is serious and it is necessary to take counter-measures, you have to take counter-measures."

We all feel somewhat helpless when the world events overwhelm us. It's hard to imagine how we can have any way to make things better. Steve suggested that we think of this as our opportunity to plant seeds. We need to think of ways that we can influence one person, one situation, one life. The ripples spread out from that. Here is a seed. Please, think before you act.

For the Christians among my readers,
Proverbs 24:17-20 (New American Standard Bible)
17 Do not rejoice when your enemy falls,
And do not let your heart be glad when he stumbles;
18 Or the LORD will see it and be displeased,
And turn His anger away from him.
19 Do not fret because of evildoers
Or be envious of the wicked;
20 For there will be no future for the evil man;
The lamp of the wicked will be put out.

For the Jews among my readers,
After the Children of Israel passed through the Red Sea and the waters closed in on Pharaoh's armies, the angels began to sing the Song of the Sea to praise God. God rebuked the angels, saying "My creatures are drowning in the sea and you are singing praise?" (Megillah 10b and Sanhedrin 39b.)

For those who have no religious leanings,
We failed to stop the attacks of 9/11. We failed to stop the attacks of 3/11 on the Spanish trains. We failed to stop the attacks of 7/7 on the London subway. We failed to stop the terrorist attacks on the US embassies in Africa. There are still active, capable members of al Qeada that are making plans to attack us. And you want to celebrate? You want to inflame moderate Muslims around the world? Stop and think. Don't do it.

© 2011 Eric Borreson

Sunday, May 1, 2011

Perseverance in Tai Chi

The term yi li is sometimes used when describing the requirements of tai chi practice. Yi Li can be translated as perseverance, constancy of purpose, or determination. It implies steady, unceasing effort, patience, and a long-term point of view. The word heng is also sometimes used. Heng implies a sense of permanence.

Perseverance is an important element of learning tai chi. When you start learning tai chi, you will probably find it slow and even awkward. This is because tai chi is very different from most western exercise and sports. Tai chi puts emphasis on soft flowing movement while delivering powerful internal energy. That is why we move slowly. In nature, slow and fast and soft and hard complement each other. The slow, yet controlled, movement of tai chi provides a complement to the stressful fast pace of today’s life.

Tai chi can appear easy but it really does take time to get used to. You should practice regularly. Making the time and effort to practice regularly tests your character and develops strength of mind. This is closely related to the ideas of morality expressed in martial arts training. Morality of the mind includes will, endurance, perseverance, patience, and courage. Persevere and soon you get used to the rhythm and feel of tai chi. Begin to enjoy the wonderful feeling of well-being and serenity from within.

In traditional Chinese thinking, we have 2 minds. The emotional mind (xin), also called the monkey mind, is the part of the mind that jumps around from one idea to another and lacks focus. The wisdom mind (yi), also called the horse mind, is the calming, strong, and stable part of the mind. Without training, xin dominates yi. When someone fails at something that requires long-term effort, it is usually because the emotional mind has overcome the wisdom mind.

With training and practice, the yi can learn to control the xin. This means that you have to fine-tune your wisdom mind in order to control your emotions and become calmer and more focused. Different meditation styles use different methods to train your mind.

This article is primarily about learning tai chi. However, the lessons apply to all aspects of life. According to a translation of the I Ching, “Perseverance demonstrates how, faced with the complexity of things, one yet does not give way to cynicism.” Sometimes we hit rough patches in life and become distracted from practice. However, achievement comes from steady effort at improving. Improvement comes from perseverance and continued practice. Success comes to those who endure and have faith in themselves because of their long hard work.

© 2011 Eric Borreson