Food & Fitness After 50: Tai Chi for Your Knees

Last year I interviewed Chris Cinnamon, owner and head instructor of Chicago Tai Chi™ and an American College of Sports Medicine (ACSM) certified exercise physiologist about the benefits of Tai Chi for older adults.  In the post, Chris answered your questions about Tai Chi for overall health, and we explored his path from Navy flyer to lawyer to Tai Chi expert and healthy aging advocate. To read the post, click here.

Tai Chi book coverToday I want to talk about his new book, Tai Chi for Knee Health, available at Amazon as a softback or E-book by clicking here.

The book is a comprehensive, step-by-step guide to performing this low impact exercise for preventing knee problems, treating knee issues, or recovering after a knee injury or surgery. Since knee osteoarthritis affects about 14 million adults it is likely that you, a family member, or friend have some issues with knee pain. Let’s start with a few observations about the book and then ask the author to elaborate.

The book is divided into 4 parts and 18 chapters, loaded with illustrations to make the content relatable.

The first part is devoted to getting to know your knees and establishing the reasons why Tai Chi is beneficial for knee health. This part is replete with illustrations of the knee and the many structures that support your knee…. bones, ligaments, tendons, cartilage, muscles, and the inner working of the knee itself. I’m sure you’ve all heard of people (or perhaps yourself) who have meniscus tears or ACL repairs. Chris’s clear explanations and accompanying illustrations will help you understand what these structures are, where they are located, and the functions they serve.

The second part focuses on the first three movements of the seven movement Tai Chi for Knee Health exercise system. The basic elements of the movements are discussed, and each step is illustrated, along with practice exercises to make sure you are doing the exercises in a manner that promotes knee health.

Part three presents the next two movements, reinforcing and building upon the lessons in Parts one and two. Part four guides you through the final two movements, then a complete set of movements 1 through 7.

Each chapter ends with a bulleted list of the content wrap up; I found it helpful to read this first and then read the chapter and ending with a review of the wrap up. (I like the bottom-line up-front approach to learning!)

The book includes links to online practice videos where Chris leads you through the exercises, providing helpful cues.  In addition, the book provides a wealth of references for further reading.

What I like most about the book is that is great for beginners, but also a useful tool for seasoned pros to take their practice to the next level.

Question: Can you explain your 3 objectives for writing this book?

I wrote the book for 3 main reasons:

  1. To help more people discover how Tai Chi-based exercises, when properly taught and practiced, can restore knee health, and improve, even eliminate, knee pain.
  2. To guide readers through a gentle exercise program, anchored in solid science, that gives people an alternative, or compliment, to more invasive, and risky, interventions for knee osteoarthritis and other conditions.
  3. To provide a clear, practical, no nonsense guide for knee pain sufferers so they can accomplish the 3 main objectives of the Tai Chi for Knee Health System because until now, these skills have rarely been taught in the west. The skills are to:
    • develop the sensitivity to feel inside your knees
    • develop the skill to precisely align your knees during dynamic movement, so you stop hurting them
    • learn to move in ways that stimulate physiological mechanisms that can restore knee health.

Question: You make a pretty bold claim that Tai Chi can eliminate knee pain. How do you support this claim?

I appreciate your question. That may seem like a bold claim, but when you dig into the science, it’s entirely supportable.

Let me start with my own experience. In my late 40s, after a lifetime of high impact athletics, multiple knee injuries, and surgery, I endured chronic knee pain. It hurt to climb or descend stairs. It hurt to kneel. It hurt to sit at a desk. I took lots of ibuprofen and worried about my ability to stay active.

Then I received a diagnosis of osteoarthritis (OA) in both knees. Knee OA is typically degenerative, meaning it keeps getting worse. I didn’t like that. About that time, I discovered Tai Chi. I was soon hooked by its graceful, powerful, yet low-impact movements. Soon my knees began to feel better. As I continued to practice Tai Chi, my knees continued to improve. Today, my knees are virtually pain-free. And as the Head Instructor of the leading Tai Chi school in Chicago, I lead an active life.

I’ve guided hundreds of students and clients through my Tai Chi for Knee Health system. They learn the material, practice it, and consistently report a reduction in knee pain. All that is anecdotal, I recognize. But there is solid science to back it up.

Multiple research studies have tested Tai Chi as an intervention for knee OA. All of the studies show significant improvements in pain. Most of the studies show significant improvements in function. All without drugs or surgery. In short, Tai Chi for Knee Health works. (Note, there is a comprehensive list of references in the book.)

Question: How long and how many times a week should Tai Chi be practiced for knee health?

I recommend people practice my Tai Chi for Knee Health exercises 15 – 20 minutes per day for 4-6 days per week. A small investment of time for a big payoff in healthier knees and a more active life.

With one important qualification, however. If that amount of exercise causes discomfort, then the person needs to back off and do a lower volume and duration of exercise. Say 3 days per week for 10 minutes per day. Then gradually build from there.

As I explain in the book, you can’t reduce knee pain by moving in a way that hurts your knees. Especially when dealing with knee OA.

Question: You talk about the 70% rule…please explain that because everyone thinks you must give 100% to anything to make it successful.

The 70% Rule holds that we perform no movement or practice greater than 70% of our maximum.

For people like me, raised in a “No Pain, No Gain” society, that may initially seem bizarre.

But when it comes to healing your knees, the 70% Rule makes total sense. By moving within your 70% range, you reduce tension, allowing chronically tense tissue to relax. Relaxation of tissue improves circulation of fluids, which promotes healing. So, when healing is the goal, the 70% rules applies.

In the same vein, by moving within your 70% range (or less depending on your circumstances), you avoid a range of motion that irritates arthritic tissue and triggers pain. Viewed in this way, the 70% Rule helps you avoid hurting your knees while the gentle movements of Tai Chi for Knee Health promote healing.

Question: If you could explain the book in a tweet of 240 characters, what would you say?

My book Tai Chi for Knee Health will guide you, step-by-step, through a low-impact Tai Chi-based exercise system that will:

  • Transform your knee health
  • Eliminate pain
  • Get you moving again

Beyond the limit of 240 characters, The Tai Chi for Knee Health System provides an ideal exercise program for adults experiencing chronic knee pain from knee osteoarthritis, tendonitis, bursitis, patellofemoral syndrome, and other causes. It can be incorporated into prehab and rehab for knee surgery and knee replacement.

The Tai Chi for Knee Health System combines time-tested Tai Chi principles with cutting edge scientific research to deliver a step-by-step program that anyone can do. Richly illustrated, with access to online videos, Tai Chi for Knee Health delivers an ideal resource to help you take charge of your knee health, eliminate pain, and enjoy moving again.

Question: Would you like to add anything else?

I developed the Tai Chi for Knee Health System to help millions of knee pain sufferers experience the transformation I and hundreds of my students have experienced—from chronic knee pain to virtually pain free knees.

The response to the book has been outstanding. Readers across the US and 8 other countries are enjoying the program, checking in with questions, and reporting their progress.

There are lots of sore knees out there. Tai Chi for Knee Health can help many of them.

Chris Rosenbloom is a registered dietitian nutritionist and a nutrition professor emerita at Georgia State University in Atlanta. Along with Dr. Bob Murray, she is the author of Food & Fitness After 50.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

Food & Fitness After 50: Owning a Dog Might be Good for Your Fitness

Thanks to Dr. Bob Murray for writing this post. As a dog-lover and dog-owner (well, I think Samson and Buddy own me!) I can related to the benefits of having a dog. Even when I don’t feel like walking, those pleading doggie eyes get me every time!

woman-walking-dogThat sure is a wishy-washy title.  Why not something more definitive such as “Owning a Dog Makes You More Fit”?  After all, most dog owners can vouch for the increase in their daily physical activity just to care for their pet, including regular walks around the neighborhood.  About half of U.S. households own at least one dog and some studies do suggest that dog owners walk more than non-dog owners and are much more likely to meet the current physical activity recommendations (150 minutes of physical activity each week).  I use the word “suggest” because it is not yet fully clear if dog owners walk more just because they already lead more active lifestyles or if the dog owners studied overestimated the amount of time they actually spend walking their pets.  On a more positive note, other studies report that dog owners are less sedentary because they do move more and sit less during the day.

a-person-walking-a-dogIn theory, dog ownership might help reduce the epidemic of sedentary behavior that increases the risk of all sorts of diseases such as heart diseases, stroke, obesity, and diabetes.  It is clear that increased daily physical activity combats all those nasty outcomes, yet most adult Americans do not come close to getting the recommended amount of physical activity (150 minutes each week).

isolated jack russell terrier holding leather leach over white backgroundWe often think of physical activity as something to be scheduled into our days rather than as the total of all the movement we’re able to accomplish during a day.  It’s actually the sum of that movement—day after day—that provides lifelong benefits to health and well-being.  For example, if a person goes to a one-hour daily exercise class, works up a sweat, but is then sedentary the remaining 23 hours, the benefits of that hour of exercise are greatly diminished.  In contrast, there are great benefits for those who are active all day long in one way or another, be it housework, gardening, walking, labor, and so on.  Add to that list taking care of pets, especially dogs.

Motivating people to swap a sedentary lifestyle for an active lifestyle is no easy task.  It’s relatively simple for us to change our habits in the short-term (e.g., joining a gym), but sustained long-term behavior change (e.g., going to the gym regularly) is much more difficult for most people.  And that’s where dog ownership comes in.

You may or may not be surprised to learn that some scientists have put a lot of thought into what motivates us to exercise.  Here’s one recent scientific explanation: “… the multi-action control (M-PAC) framework is a [physical activity] PA-specific model that recognizes reflective processes (e.g., perceived capability) as antecedents of PA intention formation, regulatory processes as key to the translation of intention to behavior (also known as action control), and reflexive processes (e.g., habit) as potential hallmarks of PA maintenance.” (Click here to see the study cited.)

Responsible dog owners recognize their pet’s need for physical activity and that involves daily walks, among other dog-related activities (feeding, petting, grooming, etc.)  Good dog parents develop sustainable, repeatable daily physical activity habits that can last for many years, motivated by the love they feel for their pet and their desire to provide the best care possible to ensure their dog has a long healthspan.

funny-5-miles-dog-walkingOwning a dog is obviously not a sure solution for reducing sedentary time and increasing physical activity time, but being a responsible dog owner does mean that you’ll be taking more walks (and bending over more often) than you did before you owned a dog.  And if those activities add to your daily activity total, you’ll be better off both physically and emotionally.

If your spouse or partner is reluctant to take on the responsibilities of a pet parent, perhaps a convincing argument might be “But honey, owning a puppy will help us both live longer, happier lives and there’s nothing I’d like more than to spend more time with you.”

For more tips on moving well as we age, check out Food & Fitness After 50, available at Amazon and other book sellers.

Copyright © 2019 [Christine Rosenbloom]. All Rights Reserved.

 

 

Food & Fitness After 50: The Strong Live Long

This post was written by Dr. Bob Murray, co-author of Food & Fitness After 50.

Maintaining muscle strength is a critical factor in ensuring a long healthspan—being as healthy as possible for as long as possible—and in ensuring that we can do so independently.  Fending for oneself is an important psychological component of successful aging.  That’s not to say that we don’t all need to be looked after periodically throughout our lives—illness, injuries, and surgeries being obvious examples of when it is both nice and often essential to temporarily relinquish our independence and allow others to care for us.  But to be dependent on others to help us accomplish the daily demands of living—opening jars, carrying groceries, rising from a chair, climbing stairs—is a scenario most people would like to avoid.

1253414  Muscle weakness with age is often, but not always, accompanied by sarcopenia—a severe loss of muscle mass and muscle function—often referred to in older adults as frailty.  The perils of sarcopenia are not surprising: higher risk of falls, faster functional decline, more bone fractures of all types, greater chance of hospitalization, longer hospital stays, and higher death rate.  It is estimated that about one-quarter to one-third of those over age 70 are sarcopenic and it is likely that even more are dynapenic—muscular weakness with or without sarcopenia.

We will all gradually lose muscle mass and strength as we age, but we can control the rate at which we lose it.  In simple terms, inactivity and a poor diet accelerate the aging of muscle while regular exercise and a good diet remain the best ways to keep our muscles young.  To that end, any kind of physical activity is better than no physical activity, but the best results come from a combination of aerobic exercise and strength training.  The current recommendations are to engage in at least 150 minutes of aerobic activity (walking, biking, swimming, etc.) each week, along with two sessions of strength-training exercise.

Regular physical activity preserves strength and function by stimulating not only the muscles involved in exercise, but also the nerves responsible for muscle contractions.  In addition, active muscles release compounds called myokines that travel in the bloodstream and positively affect cells throughout the body.  Also, fit muscle cells recover more quickly from injury and surgery, additional benefits to staying active.

Bob2   Added good news is that we do not have to devote hours each week to strength training.  Preserving and even increasing muscle strength can be accomplished with short bouts of exercises that are continued to fatigue.  For example, doing a combination of push-ups, tricep extensions with weights, and chair dips will quickly exhaust the shoulder, chest, and arm muscles involved in elbow extension, adding strength and protecting muscle mass.  Doing similar combinations of movements with other muscle groups will reap the same results.  As with all exercise, the best results come from getting our muscles out of their comfort zone on a regular basis.

When it comes to diet, studies show that older adults who increase their daily protein intake can better support improvements in strength and muscle mass.  The simplest way to accomplish increased protein intake is to consume more protein at breakfast, the meal that often has the least amount of protein.  Consuming 30 to 40 grams of protein at each meal will give most of us the recommended amount of protein. (For ideas on how to eat about 30 grams of protein per meal, check this out.)

Use it or lose it is the operative explanation for age-related changes in muscle strength and mass, as well as for most every other body function that we’d like to preserve as we grow older.  For older adults just getting started with strength exercises, the U.S. National Institute on Aging has examples of activities that can easily be accomplished at home (click here for a link to strength exercises.) YMCAs, fitness centers, and various internet sites (click here for one internet site with many at-home workout videos.)

Chapter 6 of Food & Fitness After 50 is devoted to gaining and maintaining muscle and strength, and chapter 2 has all sorts of tips for how to eat for optimal aging.  Aging is inevitable, but we can exercise control over the rate at which we age.  We just have to do it.

 

Food & Fitness After 50: Sam’s Story: Here’s to a Long Healthspan

Sam bike ridingThis post was written by Dr. Bob Murray, co-author of Food & Fitness After 50.

When he was 61, Sam’s right leg collapsed as he was getting out of bed, the result of a long-ago knee injury from playing lacrosse, damage (torn meniscus cartilage) that happened two months before he graduated from West Point in 1971.  His compromised joint is now supported by a knee brace that allows Sam to be physically active.  Sam wrestled and played golf and baseball in high school and remained physically active during his college years at West Point.  Meals at the Academy were high in calories and consumed quickly, laying the foundation for rapid weight gain after college when Sam’s career as an aerospace engineer entailed much more sedentary time, lots of travel and restaurant meals, and a frequently disrupted routine for exercise and eating.  His love of sweets hasn’t helped matters; Sam says he has Bob bike 1been at least 10 to 20 pounds overweight for most of his adult life.

Sam’s story is typical of so many older adults whose busy family and professional lives—along with injuries or health setbacks of one sort or another—made it difficult to maintain a healthy balance of food and fitness.  Such is modern life.  Now retired and in his late 60s, Sam now has the opportunity to find the right balance.  “I want to be consistent with my calorie intake each day,” Sam said, “I want to eat a healthy breakfast, reduce eating out, drink more water, and lose fat weight.  These are important goals for me because I want to live longer than age 87 that my annuity says is my life expectancy.”

Bicycling is Sam’s primary form of exercise and he also stays active doing yard work and repairs on rental properties.  He credits his wife Elizabeth for being a great role model who cooks healthy meals, joins him on bike rides, and watches her calorie intake.  High blood pressure runs in Sam’s family but he has been able to keep his BP well within the normal range by biking more often, eating healthier, and staying well hydrated.  Sam has found that increasing his daily water intake has helped curb his appetite and keep him energized, especially important in the warm weather he experiences living in San Antonio.

Sam understands what he has to do to achieve his goals and is committed to staying the course.  That commitment does not mean that he has to follow a stringent diet or exercise to exhaustion every day.  Living a long healthspan—a term that reflects the importance of being as healthy as possible for as long as possible—includes enjoying what life has to offer … in moderation, of course.  According to much scientific research, Sam is on the right track.  For example, scientists from Harvard University recently estimated that a low-risk lifestyle (never smoking, a healthy weight, regular physical activity, a healthy diet, and moderate alcohol consumption) could considerably prolong life expectancy (longer than 10 years) compared with individuals who followed none of the low-risk lifestyle factors.

Sam’s main advice to others who want to strike a better balance between food and fitness is twofold: 1) count calories—Sam uses a phone app called FatSecret to help keep him from overdoing it, and 2) read Food & Fitness After 50 because Sam considers the book to be a great guide for pointing out errors and helping motivate him to achieve his goals.

(We appreciate Sam’s unsolicited compliments and are happy to hear that he found our book helpful.)