Tai chi is a centuries-old practice rooted in meditation, traditional Chinese medicine, and martial arts. It is the more widely recognized, and more active aspect of the ancient Chinese tradition of Qigong (Chi Kung) done throughout history to enhance health and harmony. Using movement, posture, breath and awareness these practices serve to integrate mind, body and spirit. Tai chi and Qigong are characterized by graceful, repetitive movement and stillness to align, balance, and strengthen the body as a whole. Clinical trials show that regular practice can help maintain wellness in healthy individuals and improve quality of life for people managing chronic health conditions. These time-tested practices are renowned for cultivating vitality and resilience, both physically and mentally.
Ted Sohier and Gurney Bolster, Tai Chi for Health Pittsburgh, © 2015
Stress is a constant companion these days. Modern life is full of hassles, deadlines, frustrations, and demands. Moments of stress, indeed, are neither unusual nor particularly harmful. In fact, in small doses, it can help you perform under pressure, and allow you to do your best. The human body and mind are equipped to respond appropriately to instances in which we feel upset or threatened. Adrenaline flows, the heart speeds up, muscles tense, and concentration is sharpened. This is the result of the stress response.
“These systems are beautifully adapted to helping us respond to unexpected emergencies. They are elegant systems that are there for a reason. But, being stressed all the time can also be damaging,” says J. David Cresswell, Ph.D., a Carnegie Mellon University psychology professor.
Dr. Sidney Cohen, director of CMU’s Laboratory for the Study of Stress, Immunity and Disease, says, “Under stress, people cope by smoking, drinking more, not sleeping as well, and eating a poor diet.” And, he says, while these poor practices are related to greater health risks, they don’t account for why stressed people get sick.
Acute stress narrows blood vessels and increases blood pressure. It sends more cholesterol into the bloodstream and makes blood platelets clump together, setting us up for a possible heart attack. Chronic stress worsens autoimmune disorders such as asthma, multiple sclerosis, and irritable bowel disease; wounds take longer to heal, and physical pain is more severe. There is evidence that chronic stress can hasten memory loss, prompt weight gain, and even increase one’s risk of cancer.
Long-term stress may result from a variety of causes – being in a bad relationship; caring for a loved one with physical, mental or emotional problems; coping with financial strain. This kind of stress can make us more susceptible to infectious diseases, such as colds and flu.
So, while the human system is well-equipped to deal with moments of stress, recurrent or constant stress can be a real health threat. Given the prevalence of stress in our modern lives, and our need to maintain our health and well-being, many ask what we can do to protect ourselves.
The staff of the Mayo Clinic writes, “If you’re looking for a way to reduce stress, consider tai chi. Originally developed for self-defense, tai chi has evolved into a graceful form of exercise that’s now used for stress reduction and a variety of other health conditions. Often described as meditation in motion, tai chi promotes serenity through gentle, flowing movements.”
According to Jane Brody in The New York Times, “There is no question that tai chi can reduce stress.” If nothing else, she says, “this kind of relaxing activity can lower blood pressure and heart rate, improve cardiovascular fitness, and enhance mood. For example, a review in 2008 found that tai chi lowered blood pressure in 22 of 26 published studies.”
The Mayo Clinic says that, when learned correctly and performed regularly, tai chi can decrease stress and anxiety, and increase energy and stamina. It goes on to say that “some evidence indicates that tai chi also may help enhance quality of sleep, enhance the immune system, lower cholesterol levels and blood pressure, (and) improve symptoms of congestive heart failure.”
The Clinic recommends that, “…although you can rent or buy videos and books about tai chi, consider seeking guidance from a qualified tai chi instructor to gain the full benefits and learn proper techniques.”
“Life Under Pressure,” by Kelly Casey; Pittsburgh Quarterly, Winter 2014
“A Downside to Tai Chi? None That I See,” by Jane E. Brody; The New York Times, 9/27/10
“Tai chi: a gentle way to fight stress,” by the Mayo Clinic Staff; mayoclinic.org January 2015
Gurney Bolster, Tai Chi for Health Pittsburgh, © 2016
Tai chi is a centuries old exercise known to integrate body, mind and spirit. Though many forms of exercise are mechanical in their execution, tai chi is grounded in the realm of awareness: moving from the inside out. Described as a “moving meditation,” its natural images and flowing rhythms have inspired millions of people to enjoy this movement practice to promote health and well-being.
Tai chi teaches you to move slowly and gracefully: to listen to your body, relax and replenish your energy. You learn to breathe more easily. This can help reduce tension, thus improving concentration, memory and sleep. When recovering physically and emotionally from cancer and its treatments this gentle practice can enhance your quality of life. Tai chi is a pro-active way of engaging your natural powers of healing, finding inner strength and peace of mind.
One of the leading investigators of meditative movement is Karen Mustian, Ph.D., an exercise physiologist and Associate Professor at the University of Rochester Medical Center, Department of Surgery, Cancer Control. In 2006 she shared her study of breast cancer patients who had participated in a three-month program of tai chi after completing chemotherapy and radiation treatments. They showed a steady improvement in energy levels, mood, self-esteem and quality of life. Being active in the tai chi program provided participants with psychosocial support and helped give them a sense of control over their lives.
Tai chi is an excellent weight-bearing exercise. In 2010, Dr. Mustian and her colleagues reported that tai chi significantly reduced bone loss in breast cancer survivors, a problem for many patients who have received treatments that exact a toll on the bones. She also reported that tai chi seems to improve strength, flexibility, and heart and lung function in women with metastatic breast cancer.
Julie Everett, a physical therapist and certified lymphedema specialist at John Hopkins, recommends tai chi for breast cancer patients because the gentle movement will start to stretch and strengthen the patient’s arms, targeting the areas that were affected through the treatment. While anecdotal evidence suggests that tai chi may reduce the side effects of upper limb lymphedema and poor circulation, more clinical research is needed.
Recent studies have indicated that tai chi enhances the immune system and relieves pain, anxiety and stress in cancer patients and survivors. Lorenzo Cohen, Ph.D., is a professor in the departments of Behavioral Science and General Oncology and director of the Integrative Medicine Program at MD Anderson Cancer Center at the University of Texas. He says he often recommends tai chi to patients because of its overall health benefits.
“In terms of the evidence that’s out there and the scientific literature, practices such as tai chi have been found to help improve patients’ quality of life,” Dr. Cohen says. “There are some studies showing that these types of mind-body practices can also have an impact on physiological functioning, improving aspects of immune function and decreasing stress hormones.”
High levels of stress hormones can contribute to the mental cloudiness, a common side effect of chemotherapy, which interferes with the ability to think clearly, remember details, and pay attention. Stephanie Reid-Arndt, Ph.D., of the University of Missouri recommends tai chi as an effective way of coping with stress to help lessen memory problems and enhance emotional well-being. According to Dr. Keith Block, medical director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois, mindfulness-based practices can contribute to reducing pain, decreasing side effects from chemotherapy, and increasing responsiveness to treatment.
Effects of Qigong Exercise on Upper Limb Lymphedema and Blood Flow in Survivors of Breast Cancer: a pilot study. (2014). Integrative Cancer Therapies. Fong SS, et al., Institute of Human Performance, University of Hong Kong.
Stress, Coping and Cognitive Deficits in Women After Surgery for Breast Cancer. (2012). Journal for Clinical Psychology in Medical Settings. Reid-Arndt, S.
Tai Chi: Healing From the Inside Out, (2010). Lana Maciel, Staff Writer, MD Anderson Cancer Center, University of Texas.
Tai Chi and Qigong Can Bolster Cancer Survivorship, Dr. Keith Block, medical director of the Block Center for Integrative Cancer Treatment in Evanston, Illinois, and author of Life Over Cancer: The Block Center Program for Integrative Cancer Treatment, (2009).
A Pilot Study to Assess the Influence of Tai Chi Chuan on Functional Capacity Among Breast Cancer Survivors. (2006). Supportive Oncology 4(3):139-145.
Gurney Bolster, Tai Chi for Health Pittsburgh, © 2015
In a report published in the spring of 2014, the Centers for Disease Control stated that more than one in three older adults fall each year. Treatment of injuries due to falls is the most expensive health cost. A 2015 publication of the Harvard Medical School HEALTHbeat reported that more than 90% of all hip fractures are caused by falls. As we get older, falls can have greater consequences, with four out of five deaths due to falls occurring in people over 65. The simple fear of falling often causes people to curtail the very activities that strengthen the muscles and reflexes essential for good balance.
Although the burden of falls among older adults is well documented, research suggests that falls and fall injuries are also common among middle-aged adults. Chronic illness and medications can impair vision and balance. We sit too much and move too little. Sometimes we just do dumb things, not paying attention or trying to do too much, too fast.
Given the serious medical and emotional toll associated with falling it is obvious that prevention is key. At a certain age balance can’t be taken for granted, and we must work to maintain it. Balance is both physical and mental so it is important to involve the mind as well as the general fitness components of strength, endurance and flexibility. A sharp mind helps us to think — and stay — on our feet.
“We need careful planning of our movements, decision making, reaction time, and attention,” says Brad Manor, PhD, an instructor in medicine at Harvard Medical School and director of the Mobility and Falls Program at the Harvard-affiliated Hebrew SeniorLife in Boston. “Staying mentally active is very important to avoiding falls.”
We depend on several body systems to keep us upright. The inner ear, which senses head motions, is important for equilibrium. The body’s somatosensory system relays the feeling of the ground beneath your feet. Vision plays an essential and obvious role. Then something called proprioception (sensors in our muscles, tendons and ligaments) lets the brain know where our body parts are in space. Our brain takes in all this sensory information, plans out movement, and carries it out. “Balance is a complex system,” Manor says. “Especially as we get older, cognition becomes a big part of it.”
Manor and his fellow researchers are conducting studies to evaluate the balance benefits of tai chi, a form of exercise that involves moving gently through a series of poses. Tai chi improves balance because it works with both the mind and body. The CDC recognizes tai chi to be an effective fall prevention intervention because it improves neuromuscular function, which encompasses balance, agility, and coordination. In 2013 the CDC recommended Dr. Paul Lam’s Tai Chi for Arthritis program as an exercise form to prevent falls among older adults. The endorsement is a reflection of evidence-based research supporting the program as well as the training materials, video resources and standardized instructor certifications of the Tai Chi for Health Institute.
Dr. Paul Lam, founder and director of the Tai Chi for Health Institute, explains that tai chi works to prevent falls because “it is a gentle controlled exercise which involves the entire body, and strengthens the muscles, especially those connected with balance. It strengthens the deep stabilizer muscles, which support the spine and the back.” Further, Dr. Lam explains that the slow, smoothe movements of tai chi serve to calm the mind, increase body awareness and stabilize blood pressure. It also helps to build confidence which has been shown to decrease the likelihood of falling.
“Falls and Fall Injuries Among Adults with Arthritis – United States, 2012;” CDC, 5/2/14
“Good balance requires mental and physical fitness”, Harvard Medical School, HEALTHbeat, April 2015
“Tai Chi for Fall Prevention;” Dr. Paul Lam, Dr. Pamela Kircher, and Maureen Miller, Tai Chi for Health Institute© 2013
Gurney Bolster, Tai Chi for Health Pittsburgh, © 2016
People with chronic pain sometimes find it difficult to exercise, thus missing out on the health benefits of physical activity. Maintaining mobility is an essential component of a person’s physical and emotional well-being and independence. Tai chi, a gentle exercise that originated in China, might be a viable option to help manage pain. Developed centuries ago as a martial art for self-defense, it has evolved into a mind-body practice to promote health and vitality. It is often described as “meditation in motion,” and according to a 2009 Harvard Health Publications article, “might well be called medication in motion.”
Tai chi is characterized by slow, flowing movements, and concentrated mental focus. Physically, the work of balance, agility and coordination is complemented by the mindful emphasis on relaxation, breathing and body awareness, thus addressing the person as a whole. Many of the fundamental principles and patterns of movement are readily transferable to every day activities, contributing to a feeling of ease and self- confidence outside of class. Tai chi does not require any equipment. It can be done sitting or standing, inside or outside, alone or in a group, and at any time of day. In that way it is an easily accessible resource for self care. When taught by experienced teachers, it can be readily modified to suit any fitness level.
People who are dealing with chronic pain know that medication is not the only answer, so alternative “lifestyle” remedies are often recommended. Regular practice of low-impact exercise, such as tai chi, is an essential part of treatment. A study published in Arthritis Research & Therapy found that tai chi significantly reduced pain in patients with fibromyalgia and osteoarthritis. It was found to improve sleep and reduce fatigue and anxiety, while enhancing overall physical function and wellbeing.
In 2010, the New England Journal of Medicine reported a clinical trial done at Harvard, involving 66 people with fibromyalgia who were randomized into two groups: one group took tai chi classes twice a week, the other group attended wellness education and stretching sessions twice a week. After 12 weeks, those in the tai chi group reported less pain, fewer depression symptoms, and better sleep than the control group. Participants in the tai chi group were encouraged to practice outside of class and hence the improvements were maintained well beyond the completion of the study. No tai chi-related adverse effects were reported and some of the subjects were able to cut back on their use of medications compared to the control group.
While it may not be for everyone, Harvard’s Dr. Wang said 50% to 60% of the patients were “really engaged,” and after about eight weeks began to feel better. Improvement was gradual but steady. Patients who benefited from tai chi asked the researchers to continue the program when the 24-week study ended.
“Tai chi may be an ideal exercise option for patients with fibromyalgia. It seems to be safe and effective,” says Dr. Gloria Yeh, an assistant professor at Harvard Medical School. “If you are a patient suffering with fibromyalgia without much relief from conventional options — or are looking for more you can do for yourself — there is no reason not to give tai chi a try.”
In 2015 the British Journal of Sports Medicine reported an analysis of 24 studies, involving 1,594 adults (most in their 60s and 70s) with chronic illnesses, such as osteoarthritis and COPD, which showed that the people who practiced tai chi showed improvement on physical performance tests, including muscle strength, when compared with those who did another type of exercise program, or those waiting to begin the tai chi program. After 12 weeks of tai chi, two or three times per week, the people who had osteoarthritis had less pain and stiffness. Those suffering from COPD reported improved breathing. All found that their tai chi experience improved their quality of life.
Other studies have shown that tai chi can enhance quality of life for people living with rheumatoid arthritis, chronic back pain, and autoimmune diseases, reducing feelings of disability and depression, and building self-confidence. Also significant was the strong adherence to the tai chi programs, indicative of the enjoyment and safety of tai chi. Researchers reported that the participants in the tai chi classes tended to bond with one another which also contributed to the positive effects. These many factors all suggest that tai chi is a beneficial and sustainable life-style practice.
The Health Benefits of Tai Chi, Harvard Health Publications, 2009
A randomized trial of tai chi for fibromyalgia. Wang C, Schmid CH, Rones R, Kalish R, Yinh J, Goldenberg DL, Lee Y, McAlindon T. New England Journal of Medicine. 2010 Aug 19;363(8):743-54
Tai Chi: Best fibromyalgia treatment? Daniel DeNoon, WebMD Health News, 2010.
Wayne, Peter and Fuerst, Mark. The Harvard Medical School Guide to Tai Chi: 12 weeks to a healthy body, strong heart and sharp mind. Boston, Shambala. 2013.
Tai chi, a Chinese gentle movement exercise, may ease chronic disease.
British Journal of Sports Medicine, online, September 17, 2015.
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