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: Answering Your Questions

Slide openingI enjoyed talking to an engaged and inquisitive audience of about 100 older adults in Asheville, North Carolina on my favorite topic, Food & Fitness After 50. There were so many good questions that Dr. Bob and I will answer a few of them in this post. For some of the questions, we will refer you to some older posts that covered the topic in greater depth.

Question: What is the best oil to use…I am confused about so many choices?

The cooking oil aisle has become as crowded as the yogurt dairy case! With so many choices, brands, and health claims it is a challenge to sort it all out. In my opinion (based the nutritional properties of the oils) and the oils I use in my kitchen I recommend extra virgin olive oil for sautéing, salad dressings, and drizzling over roasted veggies and pasta. I like some flavored olive oils, too, like lemon, Tuscan herb, and garlic. For everyday cooking, I use a neutral-tasting canola oil. Both have a high percentage of monounsaturated fats with low levels of saturated fats. I also use peanut oil for stir-frying because it has a high smoke point, meaning that it can be heated to a high temperature without setting off the smoke detector. In addition, I use a dash of sesame oil at the end of stir-frying to give the meal a distinct flavor. The other factor in recommending these oils is economic. They are affordable compared to some of the new kids on the shelf.

Here’s a chart of the various oils; choose the oils with the yellow and blue bars and limit the ones with red bars.

oil-comparison-chart

Question: What is the difference between extra virgin olive oil (EVOO) and light extra virgin olive oil?

Light extra virgin olive oil is more refined than regular EVOO, making it lighter in color, giving it a neutral taste and a higher smoke point. It is not lighter in calories or fat.

Question: Is vitamin K good for bone health and what foods is it found in?

The fat-soluble vitamin K works as a co-factor for making proteins important in blood clotting and bone metabolism. Deficiency of vitamin K is rare in the U.S. and it is unclear if supplementation will reduce the risk of osteoporosis, but this is a robust area of research, so stay tuned for more information as it becomes available. For now, your best bet is to eat plenty of leafy green veggies, one of the richest food sources of vitamin K. Collard and turnip greens, spinach, kale, and broccoli are all excellent sources. Also, canola and soybean oils contribute to our vitamin K status. You will probably find vitamin K in your multi-vitamin supplement as well as some calcium supplements touting bone health.

Contrary to popular belief, people on warfarin (Coumadin®) don’t need to eliminate vitamin K, but they do need to maintain a consistent intake of the vitamin so as not to interfere with the drug’s action. For more information of vitamin K, check out this fact sheet from the Office of Dietary Supplements.

Question: Is Tai Chi helpful for arthritis?

older-adults-tai-chi-outside-e1505160556655I asked Tai Chi expert, Chris Cinnamon, founder of Tai Chi Chicago, and he gives Tai Chi an enthusiastic “yes” as a good exercise for those with arthritis. A recent review of research on the health benefits of Tai Chi reveals that the strongest evidence is for reducing fall risk and reducing pain from knee osteoarthritis. To learn more about the benefits of Tai Chi check out this interview with Chris from our blog.

Question: I love to swim and is swimming the only exercise I need, or do I also need to some strength training?

Swimming is a fantastic whole-body exercise that can help build and maintain muscle strength, improve stamina, and spark weight loss.  As with all types of exercise, we get out of it what we put into it.  In other words, we can’t expect great benefits if we constantly swim at a casual pace.  We need to push ourselves in the water so that our lungs and our muscles are frequently taken out of their comfort zones.  Isolating the legs with kicking exercises and doing the same with the arms by using a pull buoy can add variety and challenge to your swimming.  Out of the water, if you can make time for additional exercise—even if that’s only an extra 5 minutes a day—then briskly walking stairs or jogging or weight lifting or calisthenics are good ways to place stress and strain on your bones to help keep them strong, something that swimming does not do.

Question: Can you recommend specific exercises for fall prevention?

Falls can have devastating health consequences, especially in older adults.  We are all going to fall from time to time, so our goal should be to minimize the number of times we fall, along with the damage that occur when we do fall.  Improving our balance is just one aspect of fall prevention because on those occasions when we find ourselves off balance, we need the leg and core strength, along with quick reactions, to prevent ourselves from toppling over. Happily, there is good scientific evidence—coupled with common sense—to indicate that staying fit through a variety of different activities is a great way to reduce the risk of falling. Balance exercises such as standing on one leg for at least 20 seconds can help improve balance, but that shouldn’t be surprising.  More useful are exercises that require stepping over obstacles to mimic walking through a crowded attic or tiptoeing through a garden.  Exercises that increase leg and core strength are helpful, as are activities that improve agility—our ability to change directions quickly and accurately.  Dancing of all sorts, tennis, team sports, pickle ball, and handball all fit that bill.

Question: Can I get enough quality protein on a plant-based diet?

Absolutely. According to the Plant-Powered Dietitian, Sharon Palmer. “There are many examples of high-quality plant protein foods—similar to the quality of animal protein. The star plant protein is soy—it is similar in quality to animal protein. In addition, pulses (beans, peas, and lentils) are high in quality, too. The important point is that if someone consumes a balanced plant-based diet, with adequate sources of a variety of plants—pulses, soy foods, whole grains, vegetables, nuts, seeds—they can get the all of the amino acids needed by the body from those foods. It’s not necessary to “combine” or “complement” proteins at each meal. However, it is important to make sure you are selecting a variety of protein-rich foods at each meal to ensure adequate protein intake. One note: vegans may need slightly more protein daily to accommodate for digestibility—the high fiber nature of many plant foods means that the proteins are not quite as digestible. So, it’s a good idea to get servings of protein-rich foods at each meal and snack. And don’t forego soy needlessly—this is a really important plant protein source for vegans.”

For more on plant proteins, here is an interview with Sharon and be sure to check out her website for terrific tips, recipes, and lots of other great stuff.

Question: Can you recommend some online sites or videos for exercises designed for older adults?

There are plenty of websites and YouTube videos that focus on exercises for older adults.  Here are four examples:

1) National Institute on Aging has educational materials and videos targeted at getting older adults more active through basic exercises that can be done at home.

2) Fitness Blender offers a wide variety of at-home workouts of varying durations and difficulty.

3) For those interested in yoga, Yoga with Adriene is a good place to start.

4) For older adults who desire challenging strength training, along with an understanding of the science behind it, take a look at videos from Athlean-X.

All of these resources provide great ways to get started with new activities, all of which can be modified to suit individual needs and interests.

To learn more about foods and physical activity for those in the 50s, 60s, 70s, and beyond, check out, Food & Fitness After 50 , available at Amazon (both as a soft-back or an E-book) or other booksellers.

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

Food & Fitness After 50: The Benefits of Tai Chi

My friend Bonne asked about the health benefits of Tai Chi for older adults, so I was thrilled to meet Chris Cinnamon, owner and head instructor of Chicago Tai Chi.™ I met Chris, an American College of Sports Medicine (ACSM) certified exercise physiologist, at the ACSM Health & Fitness Summit and we struck up a conversation about Tai Chi. I knew I had met the perfect person to help me understand and explain the benefits of this ancient martial art to my Food and Fitness After 50 friends.

From Navy Flier to Lawyer to Tai Chi Practitioner

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Chris practicing Tai Chi in Utah

Chris, age 59, is also an example of someone who eats well, moves well, and practices what it takes to be well, but his journey was a winding road that led him to his current path. After college, Chris joined the Navy where he flew carrier-based fighter jets. After his stint in the military he attended the University of Michigan Law School and had a successful law practice for over 20 years. As managing partner of a busy firm, it dawned on him that the “intensity and volume of work endemic to the law profession was shortening my life,” said Chris. That examination of his life while in his mid-40s made him map out a new plan. Athletic and a competitive martial artist, he discovered Tai Chi as “softer martial art.” So, he began training with a high-level Tai Chi Master. After the first week he knew that this was the right direction for his life.

As he transitioned out of law and into his new life, he decided to go back to school to get a graduate degree in exercise physiology to better understand the science behind movement and exercise. It was also a way to bridge the difference between Western and Eastern perspectives in promoting health and wellness.

Chicago Tai Chi

Founding Chicago Tai Chi was certainly “an unconventional step for a lawyer but it felt deeply right for me,” says Chris. He started his school as an experiment with just a few classes but in 8 years has grown it into the leading Tai Chi school in Chicago. “I teach 12 to 14 classes a week, see private clients for individual sessions, lead workshops, and manage a growing business. It’s hard work at times, but very meaningful and exciting.” With a total of three instructors, they have over 150 students attending classes, online trainings, and workshops.

Understanding Tai Chi

Tai chiWhen asked to explain Tai Chi to the uninitiated, Chris puts it this way. “I describe Tai Chi as a sophisticated exercise system.  Tai Chi originated as a martial art in China over 600 years ago. Introduced in the U.S. about 60 years ago, Tai Chi is mainly performed today as a health practice. It is a low impact, yet powerful whole-body exercise.” The benefits are many, “Tai Chi works the muscles, all connective tissues including fascia, the joints, the spine, and the nervous system.” Chris describes how, unlike many forms of exercise, Tai Chi works the entire body, even internal organs. “By performing smooth, fluid Tai Chi movements in increasingly connected ways, you work more than just muscles and the cardiovascular system, you intentionally work internal organs, like the kidney, liver, spleen, and digestive tract with gentle compressing and releasing motions. This promotes circulation of fluids, motility of tissue, and healthy functioning of organs. Healthy organs support healthy aging.”

When I asked Chris the difference between yoga and Tai Chi he described “yoga is a practice that assumes positions and holds them to stretch muscles and other tissues. Tai Chi is almost the opposite, you relax to stretch. The more you release tension, the more the tissues relax and elongate.”

“I have had extensive training in Tai Chi, Qigong, Meditation and related practices, some of which may seem esoteric.  My background helps me explain the health benefits of Tai Chi from a Western exercise science perspective. My clients and students find that really helpful,” says Chris.

The Health Benefits of Tai Chi

benefits-of-tai-chi-exercisesA recent review of research of the health benefits of Tai Chi reveals that the strongest evidence is for reducing fall risk and reducing pain from knee osteoarthritis. Evidence is also growing, but not conclusive for enhancing cognitive function, as well as many other health conditions.

Reducing fall risk is a critical for an aging population. A recent report in JAMA (Journal of the American Medical Association) cites falls as “major epidemic” for older Americans. One in three persons over the age of 65 falls every year and falls can be life threatening. Broken hips, knees or ankles can mark the start of downward cycle of hospitalization, loss of independence, and lasting effects on both physical and mental health.

Several studies have shown that practicing tai chi helps reduce fall risk. Chris describes Tai Chi as a great exercise to combat all the things that contribute to falling. “Tai Chi can make you more stable and secure in your gait by strengthening leg muscles, which in turn makes you more confident in your abilities to move through space. I’ve seen clients get stronger after about 6 to 8 weeks of Tai Chi practice.”

Tai Chi is also a great exercise for those with knee osteoarthritis. Many people with knee pain stop exercising and Tai Chi can be great way for someone who has been sedentary, deconditioned, or overweight to begin exercising. “Tai Chi works the weight bearing joints and the gentle movement can help alleviate pain,” reports Chris.

From personal observation based on his 8 years of watching clients transform, Chris says “the emphasis on relaxing in Tai Chi has mental and emotional benefits. It calms the mind and helps people learn to cope with stress. My students and clients frequently report being less upset and reactive to stressful situations.”

Chris also shared a story of a long-time student who was practicing Tai Chi at home. Her husband observed her and remarked how graceful she looked. The woman was thrilled, no one had ever called her graceful before. That didn’t surprise Chris, “the neurological connections made in practicing Tai Chi lead to fluid, graceful movement.”

Getting started

older-adults-tai-chi-outside-e1505160556655I asked Chris how someone could get started in Tai Chi and what to look for in an instructor or class. “I suggest monitoring a class to learn about the instructor and students. Ask the instructor about his or her training and experience. And, the bottom line of any class, it should be convenient and enjoyable.” Chris offers a series of online courses and that is a good place to start if Tai Chi instruction is not available where you live. (Click here to learn more about the online courses.)

Advice for aging well

We closed our conversation by reviewing the three pieces of advice that Chris gives for optimal aging.

#1. Move more. “The research is overwhelming that activity reduces the risk of chronic disease. It doesn’t matter what you do, just move and get strong.”

#2. Pursue a practice that calms emotions and settles the mind. “High stress adversely affects health, and exercises like Tai Chi that emphasize relaxing and calming the mind can help with the mental side of life.”

#3. Eat well. “Get the advice of a qualified nutritionist.” Or in other words, don’t fall for the fads or diet du jour and learn to eat healthfully and with enjoyment.

I encourage you to visit Chicago Tai Chi™ website and follow Chris’ blog at this link.

For more information on eating well, moving well, and being well, check out Food & Fitness After 50.

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