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I recently spent a morning at the Congress of Rheumatology at the London Excel Centre. I was invited to talk at the congress alongside two illustrious Phd's Till Uhlig PHd and  Karin Niedermann PHd, who were reporting on the evidence supporting the view that Tai Chi is good for Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia.

Session Title: Joint Workshop: Is Tai Chi good for me?
Date/Time: Saturday 28.05.2011 08:45-10:15
Room: Room S25
Chair 1, Niedermann Karin
Chair 2, Kent Alison
Lecture 1, 20 min: Uhlig Till: When should we advise people to do Tai Chi?
Lecture 2, 20 min: Niedermann Karin: What is the evidence for Tai Chi for people with rheumatic diseases?
Lecture 3, 30 min: Chappell Chris: How I experience and perform Tai Chi

I was very pleases to have the opportunity to present Tai Chi Chuan alongside distinguished Representatives of the health community who are doing research into natural forms of intervention for the treatment of Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia.. I was surprised at the limited scope of the scientific studies and equally surprised at the small size of the audience.

For my part I could offer observations based on my personal experience gained from the 27 plus years of Tai Chi Practice and professional teaching.( Teaching which involves helping people who have exhausted conventional means of treatment) I discussed the some specific case histories pertaining to my own clients suffering with chronic conditions. My recommendation was, that although Tai Chi can be adapted to groups of people with Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia, it must be understood that severe cases more often need one to one attention. It is not a problem if people only receive verbal instruction in class, but the efficacy of the Tai Chi session will be very slow and highly variable due to the quality of information, teacher ability, duration of study, etc.

For example I gave a 10 minute practical session to the attendees of the talk, which was, frankly, cosmetic and of no practical value. ( There is no way that anyone can get a feel for Tai Chi as theraeutic tool from an adhoc few minutes, specially when taken in the context of the thrust of the conference, the treatment of Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia.  I would need at least a few hours to lay down some sound experiential ( get everyone to feel ) bio mechanical principles and to elicit some structural guidelines, followed by some simple experiential, hands on transmission.  

There were a few misconceptions arising from the scientific studies, the science for ( or against ) the referral of Tai Chi to patients. As always in scientific matters results varied and so that one conclusion drawn was that Tai Chi made no difference to pain in fibromyalgia but was ok for increasing range of motion in Osteo Arthritis and Rheumatoid Arthritis. So let me try here to reframe what Tai Chi is not. Tai Chi Chuan ( or a first class Qi Gong ) is not a tablet, it does not suppress symptoms or block the natural immune response and therefore it initially and periodically can illicit what is called a healing crisis. These events will effect the results when questioning study groups.  This is a natural process of change and can be uncomfortable, but the pain will clear with proper guidance. In is incredibly important that the scientific studies that Tai Chi is not viewed as some magical gesture, or pill equivalent, but rather a process of change, a letting go. 

"Tai Chi is not a tablet or a magic gesture"

Anyone teaching Tai Chi for Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia must be:

a) experienced with basic structural anatomy and how to transmit the information within the context of teaching Tai Chi Chuan.

b) be aware that there is not a one shoe fits all practice of Tai Chi Chuan for chronic conditions and be capable of modifying the tai chi form and know how to read the patients body structure.

c) be able to modify movements that stabilize group learning which are inclusive of the lowest common denominator of the presenting group.

c) results will be greater when a control group works with a high level teacher rather than people who have only learned from a teacher who learned to teach on a weekend of Tai Chi Chuan teacher training. ( that is physiotherapists attending a weekend CPD ( I am strictly against the teaching of Tai Chi Chuan by people who do not have a personal practice and gain certification to teach others after one weekend training). My reasoning for this is that low level skill will disseminate low level practice and in the long term undermine the real potential benefits of Tai Chi Practice and in worse case scenario someone may give inappropriate guidance. Would you have your car fixed by an od job man who  took a weekend course of basic car mechanics!

d) the studies done on Tai Chi in control groups were of a low duration 6 or 12 weeks. This is not long enough

e) Three elements are necessary for the correct teaching of Tai Chi Chuan for Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia., they are Mindfuulness-Correct Nutritional Support-Intelligent functional movement.

f) any approach to treating Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia. must be multi-dimensional and address degeneration due to lifestyle and nutrition as well as locomotion.

g) Studies to discover the effectiveness of Tai Chi must be of a longer and more consistent duration. Self practice must be encouraged and the teaching of integrated learning that relates to the everyday use of the body must be addressed. ( sitting, standing, walking, etc )

f) people who have any chronic condition like Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia , need to explore experientially what increases their pain compared to pain that arises from the body opening up and releasing.

g) know what is an exercise induced healing crisis and be able to help someone through this.

It was very interesting to be at a conference that in he main is sponsored by the drug industry which is primarily involved in the suppression of symptoms and not in finding the cause of Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia. The development of a self healing strategy for the public is a faint and distant voice compared to the multi-billion Euro pharmaceutical juggernaut. This is a strange idea to me, however the inclusion of Tai Chi must be seen in a positive light. During my years of teaching I have witnessed people become pain free and capable of self healing from arthritic conditions. People have achieved this using Qi Gong and Tai Chi methodologies. I have also managed the healing crisis that inevitably arise when dealing in particular with chronic cases, so for me it is a no brainer that good quality Tai Chi is a wonderful intervention in the treatment of Osteo-Arthritis, Rheumatoid Arthritis and Fibromyalgia

I salute the brave PHd's who are making strides against the rising tide of drug therapy.

keep moving Crc copyright June 2011