According to the 2008 study by the CDC and the University of Carolina, the risk of having symptomatic knee osteoarthritis is nearly 45%. Dr. Robert H. Shmerling, Faculty Editor of Harvard Health Publishing, states more than 700,000 knee replacements are performed annually in the United States. According to Dr. Shmerling, if the usual treatments of weight loss, exercise, pain relievers, anti-inflammatories and physical therapy worked well, there would be fewer knee replacements.
And yes, studies have found that Tai Chi can help ease osteoarthritis knee pain.
In 2009, Tufts Medical Center, Boston, researchers led by Dr. Chenchen Wang, studied 40 individuals with symptomatic tibiofemoral osteoarthritis. Chosen randomly, one group performed 12 weeks of Tai Chi twice a week, while the control group received the same amount of wellness education and stretching. The Tai Chi group scored higher on pain relief, physical function, quality of life and decreased depression. The researchers repeated the study at 24 and 48 weeks and concluded that Tai Chi reduces pain and improves physical function, self-efficacy, depression and quality of life for individuals with knee osteoarthritis.
In 2016, Boston researchers conducted a 12-week study comparing physical therapy with Tai Chi in 204 adults with painful knee arthritis Chosen randomly, both groups had significant improvement in pain, which lasted a full year. However, the Tai Chi group did better on decreased depression and improved quality of life. The researchers also compared Tai Chi instructors to determine if there was a difference in their personalities, charisma, experience and none was found. Of course, we know that Tai Chi has many more benefits than just pain relief.
The knee is a weight transferring joint, not a weight bearing joint. Body weight should only pass through the back of the knees, as there is no support in the front of the knee, only a “floating kneecap.” To bend the knees, bend at the hips (or Kua), like sitting back on a stool. Focus your attention on the back of the knee, moving gravity down through the center of the hip into the center of the back of the knee. Then into the foot. Then the ground. In other words, let the weight travel straight down the leg(s).
Knees should never bend inward, bow outward or go too far forward. You should be able to see your toes over you knee. Never rotate the knees, as they don’t handle wrenching or twisting well. There is little to no reason to bend knees deeply when practicing Tai Chi. You will still derive the same benefits with a slight knee bend, and without the risk.
And always remember, if you experience a sharp or deep pain: STOP.
In a previous blog, we discussed Tai Chi walking or stepping. The way you walk affects the knees. Be sure you are stable before taking that first step, maintain good posture, and be mindful of what you are doing. You may want to go back and re-read the Tai Chi Walking blog.
If you have had a knee replacement, you still need to find an exercise that provides range of motion, flexibility and muscle strength to improve, not only your quality of life, but the longevity of your new knee. Tai Chi is gentle on your knees and can provide all that, in addition to helping with weight loss and gait retraining. Tai Chi also improves your sense of your body’s position and movement (known as proprioception) more than swimming, running, and, of course, being sedentary.
Many students do Tai Chi well into their 90s because it is very low impact and provides many health benefits. Always check with your physician before starting a Tai Chi exercise program, and make sure your Tai Chi instructor is certified and knows how to teach correctly. He or she should understand how the body works. When done incorrectly, even Tai Chi can hurt more than help your natural or replacement knee. And if you have any questions or experience pain during or after class, talk to your instructor.
Your knees are depending on you!