Tai Chi and Knee Pain

-->

In previous posts I’ve mentioned that over the past few years it’s become increasingly common for Tai Chi practice to be recommended as a form of physical therapy for patients suffering from an assortment of ailments. However, as with any form of exercise, Tai Chi practice can cause more harm than good if done improperly.

The American Academy of Orthopedics Surgeons has previously indicated that knee injuries constitute the largest category of injury in the US. In their book, Save Your Knees, Fox and McGuire estimate that 1 in every 4 Americans have suffered knee pain or injuries. Tai Chi’s slow measured movements and focus on relaxation would therefore seem to be the ideal cure for this rampant condition. That's why it's such a surprise then to find that there are claims and reports of a prevalence of knee injuries among American Tai Chi practitioners.

Most people who claim that there is such a rampant occurrence of knee injuries among Tai Chi practitioners cite Dr. Jay Dunbar’s 1991 doctoral thesis, wherein 60% of the 216 Tai Chi teachers surveyed stated that they, and/or their students, suffered from knee injuries. To date I have not found any other study to corroborate these claims, nor have I personally observed any such prevalence of knee injuries among experienced practitioners. However I have observed several Tai Chi demonstrations wherein students bend and move their legs in ways that are, without a doubt, causing them to strain their knees. In The Complete Book of Tai Chi Chuan, Wong Kiew Kit states his belief that this is a phenomenon unique to American practitioners, and one likely due to improper form and faulty teaching; I believe that he is correct.

Among my students many arrive to their first class complaining of different health problems, and yes knee pain is fairly common among them. However, after training for a few months these health issues generally fade away or drastically improve. One issue that has popped up occasionally is unexpected joint pain or soreness among students who’ve been practicing for a few years. They complain that their joints sometimes feel sore after pushing hands or forms practice. This is an immediate red flag; these are people who’ve over come joint injuries that plagued them for year thanks to their diligent Tai Chi practice. Suddenly feeling sore after class means something is very wrong.

I always remind these students that one of the most important parts of correct Tai Chi practice is listening, specifically to their own bodies. Any sudden joint pain or soreness is their body letting them know that they are doing something wrong. If they don’t listen and insist on trying to push past the pain they will only injure themselves, possibly permanently. So I have them run through their practice until they can pinpoint what movements or posture are causing them pain. I have them freeze in the position where is hurts and then take a look at themselves. Where does it hurt? What is supporting, or being supported by the body part in pain? They very quickly realize that the pain and soreness are being caused by either improper body alignment or excessive muscular strain. Once they correct this the pain suddenly disappears. In other words if they relax, listen and fix their practice the pain suddenly goes away; trying to push through the pain was only making things worse and going completely against the core principles of Tai Chi.

The most common problem I’ve seen is that students try to shift their weight while 1-straining their muscles to hold a low stance and 2- shearing their knees because their legs aren’t properly aligned. To address this:

1-Always remember the Tai Chi principle, “use 4 ounces to overcome 1 thousand pounds”. Simply put, if your body is relaxed and properly aligned you will never need to strain your muscles to generate or redirect great force. However this requires the practitioner to maintain muscular relaxation and mindfulness when they face heavy pressure. It’s hard to condition the mind to adopt this as a response to external pressure, so most students fall back into the habit of trying to use brute strength and hurt themselves in the process. Always remember: Song (Relax), when you face pressure relax your body and focus on maintaining proper body alignment. Any external pressure will slide right off you that way.

2- Speaking of proper body alignment, remember to rotate and shift your weigh with your hips. Make sure your knees are always aligned with your feet. Never let your knees bend past your toes, and preferably keep your knees bent directly above your metatarsals (the center of your foot). When shifting your weight rotate from the hip, never from your ankles or knees. (For a more in depth discussion refer to my post on the Six Harmonies principle).

These two reminders alone solve about 90% of my student’s complaints. It would also fix most of the problems I’ve seen with the demonstrations I previously mentioned. This all leads me to conclude that Wong Kiew Kit is correct in his assessment that too many students are failing to apply proper Tai Chi principles and their teachers are failing to correct them, either because they don’t know any better or because they are inattentive of their students. Either way as a student and a person always remember to be mindful of, and listen to, your body; ultimately it’s your responsibility and you are the one that will pay the penalty for any wrong moves you make. Relax and listen to what your body is trying to tell you, that is always your best guideline.

“Secrets” in the Martial Arts

                I occasionally get asked about “secret” techniques or applications. While there are historical records of secret techniques or applications in history they are not unbeatable. An example of an old secret technique is il passato sotto, a dodge and low counter thrust on-the-pass (with a forward-outward step), which many Italian Renaissance fencing instructors often taught to wealthy students at great cost as a secret technique.

Historically there has been a long running tradition of visualizing martial artists as possessing supernatural levels of skill and power in the popular imagination. There have been multiple reasons for this phenomenon throughout time.  Often martial artists have sought to reinforce this stereotype themselves for that simplest and most primal of reasons; intimidation. Tacticians have always made a point of emphasizing that if your opponent is afraid of you at least half your battle has already been won. The key to successfully implementing such a boast is the same as for any other bluff; that the opponent can’t know what you’re hiding.

There is no such thing as a perfect technique or an unbeatable attack. We live in a world that imposes many physical laws on our movements and these affect our techniques whether or not we like it. As a result any and every attack or technique has a weakness or vulnerability that can be exploited. However it’s much more difficult to recognize and exploit those weaknesses if we don’t know what attack is coming our way or if it’s very different from what we have previously encountered. If we’re already scared of an unknown technique our minds slow down and it becomes nearly impossible to overcome an unknown “ultimate” or “secret” technique. Countless fighters have exploited this very phenomenon to great effect. So the word has spread, over time, of lethal and unstoppable “secret” techniques and as so often happens, memories become gossip and gossip become legends.

Sadly this has lead many adept martial arts students to wrongly believe that such a thing as an “unbeatable secret technique” exists. This is not true of course, there are countless powerful techniques which are difficult to counter, especially if they are not known to the opponent, but they all have some weakness. Continuing with the example of the passato sotto mentioned earlier fencing historians all agree that as the technique became more widely known it stopped being a secret (obviously) and counter movements began to appear.

On the other hand, many young students have, in their ignorance, bought into the legends. This can lead to two different problems; they either underestimate themselves because they feel that they have not received any “secret” technique and are therefore less able than those who claim to have learned such techniques, or they actually believe that they have learned some unbeatable technique from their teachers (sadly there are many unscrupulous “teachers” out there) and now think that they are invincible. Both are very wrong and can be very dangerous mindsets for the student to have on the day that he/she needs to apply them in real self defense.

The fact is that the only “secrets” some teachers do hide is attention to detail. The student is taught a form and that’s it; no explanations about the correct posture, body alignment, weight distribution, breathing, timing, applications, focus, intention, vulnerabilities, possible combinations  with other movements, possible counters, etc. This usually happens because the teacher has either lost conscious awareness of these minute details after years of personal practice, or simply is unfamiliar with them himself (in the case of the latter this lack of mindfulness in movement is visible to an experienced fighter; as with any expert athlete when they execute their technique it should look flawless and effortless).

Another possibility is that the teacher would choose to hide this knowledge from all but a few students. This was a popular practice in the age before firearms, when knowledge of martial techniques could mean the difference between life and death by giving the practitioner the power to hurt or kill opponents. Some teachers felt a moral obligation to hide some or all of the applications from those they did not deem of high moral fiber. Others chose to hide the details behind the movements for personal benefit; after all if no one else knew their techniques they could hardly defend against them. However the value of martial arts purely as a form of self defense has decreased as firearms have become preferred tool of defense. Therefore moral and self defense issues have ceased to be a reason to hide the details behind techniques.

Therefore know that the so called secret techniques or secret applications to known techniques are merely a matter of learning proper body mechanics through diligent and mindful solo practice and employing them in partnered practice to identify what techniques and applications work, and when and how best to employ them. The only real secret is finding a qualified teacher who can help you learn the techniques and all the little details within them then practice until it flows naturally and smoothly. That’s what kung fu is, high skill acquired by diligent practice. That is all the “secret” really is.

The Benefits of Tai Chi Chuan

I was recently asked to give a presentation on some of the benefits of practicing Tai Chi Chuan so I’m posting a condensed version of that speech. I hope this will give potential students the extra kick they need to finally get up off their butts and start practicing.

          Some of you may have heard about Tai Chi from a friend or a doctor who recommended it for it’s health benefits. Others may have noticed signs for classes at a local gym or seen a group practicing in a nearby park. Maybe you saw Tai Chi being practiced in a martial arts film. This probably led you to ask: “What is Tai Chi? What good can it do me? Is it hard to practice?”

            The usual explanation is that Tai Chi is an ancient Chinese martial art, which uses slow graceful movements to relax the body and tone the muscles while focusing the mind and boosting the spirit. This probably led you to a simple reaction: “What the hell does any of that mean?” Not only did you not get any of your questions answered but now you’re seriously confused. This is where most people say: “screw it!” and forget about the whole thing. I’d like to address some of these questions so you can decide for yourselves whether or not Tai Chi is right for you.

            Tai Chi Chuan is a martial art based on several Taoist principles; which, again, sounds very foreign but let’s take a look at what it means. Taoism is one of the oldest philosophical belief systems in China (and the world). Basically it’s a philosophy that values personal freedom, simple joys, and living a life in harmony with nature. Nothing particularly complicated about that. Taoists believe that the world exists as a manifestation of opposing and complementary forces known as Yin and Yang. The state of harmonious and balanced exchange between these two forces is known as Tai Chi. Tai Chi Chuan (or Taiji Quan) is a martial art based on following this principle of balanced, complementary forces. One way of seeing this in action is during practice when you’ll notice that as we perform Tai Chi Chuan one limb will straighten and the muscles stretch while the opposite limb will bend and the muscles will relax; opposite and complementary.

            This leads me to the second question: what are the benefits of Tai Chi Chuan practice? The benefits are seemingly endless. Traditional Chinese medicine practitioners have been recommending Tai Chi Chuan practice for centuries to cure an endless assortment of ailments. Over the past few decades Western medicine has begun to experiment with Tai Chi Chuan practice and been amazed with just how successfully it works as a complementary treatment for an ever-growing list of conditions and diseases[1].

            At a very simple level Tai Chi Chuan is wonderful in that it uses slow focused movements emphasizing balance, posture, coordination, and slow steady breathing. It gently stretches and relaxes the muscles, which helps to reduce stress while strengthening the muscles and joints (which help knee and back injuries). It’s slow movements offers a low impact form of exercise while offering an excellent cardio workout. The deep, gentle breathing helps maximize blood oxygenation and the release of endorphins, all of which help to improve circulation, digestion, and blood pressure.

Practice also helps to improve posture, balance, and coordination while exercising the body and mind. Its gentle, elegant movements look graceful (generally described as poetry in motion) and grant a sense of calm relaxation, while generating a quiet sensation of power that can be readily seen in action when applied to self-defense.

            Lastly Tai Chi Chuan is being used as a component in treating a myriad assortment of diseases and condition such as: hypertension, diabetes, rheumatism, asthma, arthritis, Alzheimers’s, gastritis, Parkinson’s, insomnia, migraines, depression, assorted heart conditions, etc. Science is still actively researching new and unexpected benefits of Tai Chi Chuan. In summation, I can’t think of anyone who would not benefit from Tai Chi Chuan practice.

            In regards to the final question: no, Tai Chi Chuan is not hard to practice. You don’t need special clothes or expensive equipment. You don’t need any special courts or areas; you can practice anytime, anywhere. Practice can be adapted to varying levels of difficulty so that beginners and advanced students can all practice together by using different variations of the same techniques to suit their level of skill. Most often Tai Chi Chuan will be practiced in parks, at the beach or some other place where students can enjoy a natural view to help them relax and focus on their practice, but many practice in their living rooms before starting out their day. It’s truly a wonderful practice that can help any one, whether you only practice for fifteen minutes in the mornings or a few hours by the sunset. There really is no excuse to keep you from reaping the benefits of Tai Chi Chuan practice, so give it a try.

---

[1] Complementary means just that, complementary. I’m not espousing Tai Chi Chuan as a magic potion that will cure all your troubles. The medical community is using it as a powerful component of treatment, not as an entire form of treatment in and of itself.

Stances

Training stances is usually considered a boring practice, and most teachers no longer emphasize it as was traditionally done. Why? Because for a beginner it IS boring! No one can argue that stances are a fun practice for beginners. However I'd like to remind students of the Chinese maxim “Chi Ku” which translates as "Eat Bitter” or "Eating Bitterness". It is a Chinese phrase for enduring hardship to achieve the sweetness of power and/or success. We can't learn to read and write without first learning letters. They are the basic building blocks of written language. Letters let us build words, with words we make sentences, next come paragraphs and then pages of full of text; but without learning letters any attempt to learn to write will be amateurish and flawed (at best). The same applies to martial efforts. That said, it is imperative that students start by practicing breathing, posture and balance. Over millennia Chinese martial arts have found that the most effective exercise for a beginner to train all of these is by doing stance practice, first static then dynamic. Therefore the most fundamental part of my own teachings is stance practice.

I like to begin with Zhan Zhuang or “Standing Post” meditation described in an earlier post. This is about as basic as you can get in Tai Chi Chuan practice. The posture is basically a relaxed or at ease position which is universal to every normal human being on the planet. You stand with feet about shoulder width apart and try to relax; the only minor difference between this and the way every one on the planet regularly stands still is that the arms are kept in front of the body. Honestly it's simplicity itself and sounds like the most idiot-proof thing on the planet for anyone who's ever used an average human body to exist, but ask anyone who's ever done the practice and they'll tell you otherwise. Whenever you begin to train any traditional martial art of any sort the first thing you'll usually hear from senior students are all the horror stories about all the grueling, torturous exercises that are involved. For my Tai Chi Chuan students the first horror stories start from day one with this stance. Though as I and their seniors will gladly tell them there is a justification and a method for this practice; their efforts in the beginning will bear fruits later in their practice, the first of which is learning how to relax.

For many reasons learning to relax, especially when under pressure, is about the most difficult thing to learn for people any and every person who's ever been in a tense situation. Every professional fighter, as well as military and police personal the planet over will attest to this. The conundrum however is that the more relaxed we are in a tense situation the more easily we can act and overcome the threats and challenges before us. To solve this problem training has been created to accustom individuals to stressful situations. Over time the student is trained within ever more difficult and stressful scenarios so that they slowly learn to asses the danger without becoming tense themselves. We train to learn to be the calm eye in even the most terrible storm. Otherwise we tense up, slow down and get taken out.

Standing Post Meditation is the first “baby step” I employ with my students on the long road of exercises designed to accustom them to stop being tense. Essentially you learn how to get relaxed and stay relaxed in while the most comfortable posture possible. Once this first and most basic posture has become a comfortable practice for the student staying relaxed while holding other, more difficult, postures is trained. Which postures are trained will vary depending on the school and the style, but many are standard within the Chinese Martial arts as well as other styles across the globe. As the student begins to master how to correctly hold the postures comfortably the next step is dynamic movement. The students can now learn how to make the transitions from posture to posture quickly and effectively while staying relaxed and balanced. Only after all of this has been trained will students learn the basic forms so that they learn how to coordinate the upper and lower extremities (aka the six harmonies) in movement. This is another huge milestone and the precursor to learning techniques and applications.

I must remind the reader however that posture training is a vital and necessary first step in effective Tai Chi Chuan training; it's what allows the student to learn how to properly apply the techniques. Much like building any structure if you want it to stay up you need a firm base, doubly so if the structure has to sustain vibrations and/or movement. If you've ever tried to apply any technique without proper form all you're doing is opening yourself up to your opponent's counters. Any technique fails without proper form, merely becoming a detriment to the student's safety by leaving them open and distracting them from the actions of their opponent. Therefore I must emphasize the virtue of this most fundamental and basic of all trainings, after all any baby who tries to run before he/she can walk, or worse, stand is doomed to fall and cry; don't be that baby.

-Jon

Here are some links that may be helpful:
How to: Tai Chi Chuan stance training
Gilman Studio On-Line Lessons
In addition take a look at this book:
Tai Chi Chuan 24 & 48 Postures by Master Liang, Shou-Yu and Wu, Wen-Ching. In addition to explaining how to perform both forms it gives detailed instructions on all the poses along with step-by-step pictures. Definetely a good buy.

Recently I received an e-mail from someone who was going to be moving to our area and was interested in learning Tai Chi. She'd found me online and wanted to know where she should go. Since she was a little vague I replied asking for information. As I began to write back I realized that there was quite a few things we both needed her to answer in order to be able to further her instruction in the art. I came up with a questionaire that I believe will be of great aid to any student, particularly at the outset of their search for instruction since it forces them to evaluate what their goals are and how they plan to achieve them. To that end I'm reproducing a more general version of this questionaire so prospective students have a better idea of how to proceed in their search for instruction.

------------------------------------------------
1-Training Duration- Like any art it's an endless process. There's no end so if you truly want to practice understand that you are incorporating something into your life. Practicing any art, martial or otherwise is (to varying degrees) a change in lifestyle. That being said:
How long do you plan to train? Are you looking to train for more or less than one hour per session? How many sessions per week? (Bear in mind that some instructors, myself included, are more demanding).

2-Training Content- Are you looking for a refresher course on something your already know? Are you looking for an introduction into Tai Chi? Are you looking to learn something specific, like a seminar on training some particular weapon or form?

3-Goals- What do you want to achieve MOST through your practice (although a good instructor trains all of the following everyone has some prefference or area of focus): physical fitness, relaxation (mind or body), self-defense, spiritual growth?

4-Cost- The way things are right now this is usually one the biggest factors for most people so it's vital that you know ahead of time how much you're going to be spending. Cost of instruction will vary, but there's 2 major factors: 1-who's the instructor, 2-what circumstances will you be learning under? The first usually boils down to fame; a more famouse instructor has greater demand and charges more (although as with all things fame is not always an indicator of quality). The second is a matter of group vs private instruction. Private classes are great, the instructor is there just for you and he can help you work on all the things you personally need. However this also raises the cost significantly. Commercial instructors depend on this income and they need to earn certain amounts in certain hours. This is the benefit of group instruction, since the cost is split between students the price you pay is a fraction of the total cost. However the downside is that the hands-on time you get with the instructor is also divided up.

Now lets talk numbers, prices can vary anywhere from 10 dollars per hour of instruction upwards to several thousand dollars. This varies a lot depending on the factors I detailed above. Keep in mind that this is merely a starting point, as always I encourage students to question what they learn; google some local schools, shop around and compare prices.
Most private lessons will circulate from $30-100 per hour. Group classes will vary greatly. This depends on the level of instruction and the formality. Larger, more laid back groups who practice in local parks tend to be cheaper (no overhead for the instructor means he/she can charge less) and will generaly be anywhere from $10-35 per session (some also give longer or shoter sessions, which affects the price).
As always there's some people who teach for free. I'm not going to lie and say that every one who does is unskilled because that is simply untrue. There are many who just love the art so much that they choose to teach freely (the way some lawyers work pro-bono), but as always the quality of the instructor varies greatly so be careful of trying to save money only to end up wasting time. Don't expect an amazing master to show up and train you for free. The fact is the best instructors spend most of their time practicing the art, which means they have to make a living off their skills to survive. Also, instructors that teach for free can afford to be more demanding of their students, as well as discriminating in who they choose to train since they don't depend on them for their livelihood. This means they can be more selective, and only take students recommended by other instructors or friends and family members.
In all honesty you usually get what you pay for, so be cautious and frugal, but not cheap.

5-Personal Experience- Do you have any previous training? With whom and for how long? Do you practice any particular style or forms (ie Yang, Chen)? Do you practice any weapons?

6-Learning Preference- Do you preffer a more hands-on, critical/focused approach (with the intructor constantly pointing out areas to improve on) or do you prefer a more hands-off approach (learning more by observation with minimal pointers from the instructor so you can learn to fix things yourself, over time and at your own pace)?
------------------------------------------------

After answering these questions you should be able to narrow your search quite a bit, as well as have some good questions to ask potential instructors so you can find the one that's right for you. Good luck!

-Jon