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How Can Tai Chi Help People With OA Knee Pain

21st March 2019

There is proof that the martial art tai chi can help with the symptoms and pain of knee osteoarthritis (OA). We look at the evidence below and explain how tai chi can improve the condition.

What is osteoarthritis?

Osteoarthritis, sometimes called ‘wear and tear arthritis’, is a degenerative condition of the joints causing pain, stiffness and inflammation. It occurs when cartilage that normally protects the joints degrades over time, ultimately causing joint damage. Osteoarthritis occurs mostly in women and older people.

The importance of exercise

Exercise is vital for good health and it is particularly important for those with osteoarthritis. However, joint stiffness and pain often deter people with OA from exercising. But in the event of a lack of activity, muscles weaken and joints get stiffer, leading to further stiffness and pain. So essentially arthritis gets worse without exercise.

Exercise has many benefits. It keeps muscles, joints and bones in good shape, thereby improving muscular strength and flexibility. And it leads to better circulation of body fluids and blood through your tendons, muscles and joints, which aids the healing process. If you have OA, you want to look for a gentle form of exercise which spares your joints, such as tai chi.

What is tai chi?

Tai chi consists of gentle, flowing movements which promote balance, strength, mobility and inner harmony. It has a meditation component which sharpens the mind-body connection and it can improve mental clarity and wellbeing. Tai chi also incorporates visualisation and deep breathing techniques. It avoids putting pressure on painful joints including the knee.

Tai chi can be practised indoors or outdoors, alone or in unison with classmates. No special equipment is necessary - just comfortable clothing. Exercising together in a group means that participants often gain social support and make friends. This can help prevent stress and ease the problems of pain and chronic illness.

The functional movements in a tai chi class gently increase flexibility. For example, one sequence involves shifting weight between your feet while raising the arms slowly.

You can start tai chi at any age and you will soon see a progression. As you reach higher levels, you will become stronger and more serene. If you have osteoarthritis you should seek medical advice before starting any new form of exercise and ensure that you find an experienced instructor.

Origins of tai chi

Tai chi began in ancient China at least 800 years ago as a martial art. Although some types of tai chi still use weapons, most people know the form of tai chi performed in parks all over the world, where people who are often elderly perform graceful movements and postures in unison.

Types of tai chi

Many different forms of tai chi exist; the most common are Wu and Yang which use slow and gentle flowing postures and movements that are carried out without stopping, often with a balance on one leg. The movements of the Sun style follow qigong principles.

The qigong element

Tai chi incorporates the principles of qigong, an ancient concept that promotes wellbeing and health. Qigong cultivates qi or chi - the energy that permeates our universe and flows through all living beings - by utilising breathing, movement and meditation. ‘Gong’ means ‘exercise needing practice to be skilled’.

When qi flows potently through the body, it encourages healing and brings vitality. The slow and gentle movements of tai chi open up the energy channels, keeping them supple and strong. Chinese medicine proposes that arthritis is due to a sluggish flow of qi and for hundreds of years, Chinese doctors have recommended tai chi to arthritis sufferers.

Studies into tai chi

Studies have found that tai chi can provide pain relief, reduce stress and improve balance.

A study by researchers at Tufts Medical Center in Boston, published in Annals of Internal Medicine in 2016, found that tai chi can reduce the physical impairment and pain of those who have severe knee osteoarthritis. Tai chi was found to aid the symptoms of osteoarthritis to the same extent as normal physical therapy and it occasionally surpassed the effects of physical therapy.

Study author Dr Chenchen Wang, director of the Center for Complementary and Integrative Medicine at Tufts Medical Center, selected 204 people with knee OA who had pain and stiffness with X-ray alterations in the knee, dividing them into two groups. One group performed Yang-style tai chi twice a week for 12 weeks (including a warm-up, meditation, breathing techniques and relaxation). The other group had tailored physical therapy for six weeks followed by six weeks of exercises in the home.

The participants in both groups were aged 60 on average and had all experienced OA pain for approximately eight years. The groups were compared at 12 weeks and at 52 weeks. Both groups took less pain relief than before, had less stiffness and pain and found improved function, but the benefits were greatest in the tai chi group. This group found that their mood and wellbeing were elevated too.

In 2010 a study in the Journal of Alternative and Complementary Medicine reported on women with OA who practised Sun-style tai chi using qigong breathing techniques for six months. The study revealed improved bone density, greater strength of the knee extensors (the muscles that make your legs straight), and a lessening of participants’ fear of falling when compared against an educational self-help programme. Studies have also noted the benefits of short- and long-term tai chi on fall prevention and balance control.

The benefits of tai chi for OA

If you have OA, tai chi is an excellent exercise regime. It improves muscle coordination and strength, which leads to more stable joints. In addition, the controlled breathing and mind-body focus promote mental calm, which can mitigate arthritis pain.

Better flexibility

Tai chi helps people to stretch more, improving their flexibility. Increased flexibility lessens stiffness and keeps joints mobile, as well as minimising pain.

Better muscle strength

Strong muscles help protect and maintain stable joints, lessening the risk of injury and reducing pain. Greater muscular strength through practising tai chi supports you to be more active, improving body fluid and blood circulation.

The power of the mind

Being positive mentally helps healing and the power of mind over matter is evidenced in many studies and anecdotally. Tai chi integrates the body and mind; your head will be clear while you focus on bodily movements. Relaxation and a mood boost are the results of this concentration.

As a powerful mind-body practice, tai chi inspires students to be mindful of its intrinsic energy, leading to greater self-control and feelings of empowerment. Staying relaxed and positive improves the way we experience pain and you should find your OA knee hurts less after tai chi sessions.

Improved fitness

Good cardiorespiratory fitness will make the lungs and heart stronger and increase stamina. Improved circulation of fluid, oxygen and blood will reach arthritic tissues and joints, promoting healing.

Fall prevention

If you have osteoarthritis, pain and weakened muscles can make it difficult for you to balance. Tai chi will help to improve your poise and prevent falls.

If you want to try tai chi, find an instructor with at least five years’ experience who understands and can work with your osteoarthritis.

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