BMJ: Britain Medical Journal Publication & Time Article Featuring Ramel Rones!

Welcome back mind-body students!

I am proud and humbled to share with you another publication of my research & collaboration with Tufts Medical Center in the world-renowned BMJ: British Medical Journal! The study/research, published just a couple weeks ago, March 21 - 2018, is called "Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial."

Thank you to Dr. Chenchen Wang and the entire research team at Tufts Medical Center!

You can read up on the BMJ study at the link above, or check out the following articles and videos as well:

• The New Time article/video (March 22 – 2018)! Why Tai Chi Works So Well for Pain Relief.
• Amy Price Testimonial in the BMJ Opinion, (March 21 – 2018): The unintended consequences of tai chi for fibromyalgia.
• Dr. Chenchen Wang article in the BMJ Opinion: Chenchen Wang: Time to rethink exercise for fibromyalgia care. (March 21 – 2018)

As some of you may know, I have been involved in research over the last 15 years with Tufts Medical Center. We studied/researched autoimmune diseases such as rheumatoid arthritis and chronic pain conditions such as osteoarthritis of the knee, and fibromyalgia/chronic pain.

If you want to learn more about those conditions and the work me and my team did (as well as watch the video Tufts communication did), check out my last blog, or read up at the links below:

• What is rheumatoid arthritis?
• What is osteoarthritis of the knee?
• What is fibromyalgia?

As I mentioned in my last blog, 15 years ago when I first met with my PI (principle investigator) Dr. Chenchen Wang at Tufts medical center, I was challenged with designing a mind-body Tai Chi intervention for all three of the conditions above. Not all at once, of course! But over those years I would develop an intervention for each one separately.

I was also given the task, in the first six years, for the R21grant, to teach and implement the Tai Chi or mind-body intervention that I designed for each one of the three conditions.

Using my knowledge and understanding of Tai Chi, Chi Kung, and Yoga (and what I have learned from years of experience working with individuals with the three conditions) I created a simple mind-body/Tai Chi intervention. It included gentle modified stretching, modified strengthening exercises, a strong emphasis on deep breathing in different postures, and a focus on engaging in different forms of meditation and visualizations with some Tai Chi movements from the Yang style Tai Chi.

You can see all of these components in my books and DVDS, such as Sunrise Tai Chi, Sunset Tai Chi, and Tai Chi Energy Patterns. 

For the rheumatoid arthritis, the mind-body intervention was 70% deep breathing and meditation, and 30% stretching and some strengthening elements. You can read the article/publication about the rheumatoid arthritis study/research in the Oxford Academic Rheumatology 5 -2005; with the title: “Effect of Tai Chi in adults with rheumatoid arthritis.”

For our study of osteoarthritis of the knee, the Tai Chi intervention was 70% physical: lots of flexibility and strengthening exercise. The other 30% was mental: deep breathing, meditation, visualizations, and evoking the spirit. You can read the osteoarthritis study/research publication in the NCBI November - 2009 with the title: “Tai Chi is Effective in Treating Knee Osteoarthritis: A Randomized Controlled Trial.”

The Fibromyalgia study, like the one for rheumatoid arthritis, used a Tai Chi intervention that was more mental (~60%) such as deep breathing, visualizations, and evoking the spirit. The physical elements made up about 40% of the intervention. Read the fibromyalgia study in the New England Journal of Medicine, August 19 – 2010 with the title: “A Randomized Trial of Tai Chi for Fibromyalgia.”

Of course, as all the groups advanced, across all the conditions being studied, even the physical exercises became more and more internal -- integrating the physical movements and exercises with deep breathing, engaging in meditation and Tai Chi typical visualizations, and eventually evoking the spirit.

Many times I would start the students on a chair for certain exercises, and over time and practice most students were able to move out of the chair into standing positions.

In both the osteoarthritis and fibromyalgia studies, I witnessed tremendous positive changes on both the physical and mental levels. In the study on rheumatoid arthritis, which is an autoimmune disease and therefore a much harder challenge, the differences, from before and after, were not as notable. It is also possible that pursuing notable changes for only the time allotted to us by one R21 grant was not enough; maybe more time and a longer period of research are needed to show differences from before and after, especially with the side effects and symptoms of this difficult condition.

After doing the 5 years of R21 research (which are smaller studies/research that involved only 60 patients) and producing good enough results, Dr. Chenchen Wang was able to get more grant funding from the NIH to do larger-scale research which is referred to as an R01 grant. 

Using the R01 grant, we dealt with hundreds of patients verses just 60. That created a greater challenge. But with an outstanding PI (principle investigator) Dr. Chenchen Wang, and a great, smart, experienced, and knowledgeable research team of individuals, we were able to make it the research a success. Thank you again to each member of the research team!

In order to eliminate my personality element for the R01, the larger studies, we brought two other Tai Chi instructors in to teach in addition to myself. We also divided the participants into groups of roughly ten students. The groups were divided between the three Tai Chi instructors for teaching. This way we took out the factor of my “great personality” which, theoretically, could have a strong effect on the outcome.

This whole 15 years of research with Tufts and a few years of research with Dana-Farber was, for me, an unbelievable learning process and also a wonderful and humbling experience.

We compared the Tai Chi intervention to the regular care which is and was physiotherapy interventions, with hundreds of patients over a period of 5 years. Patients were randomly placed either in the Tai Chi groups or into the physiotherapy group. We also followed up with the participants one year after the studies, because we wanted to see and learn as well as collect data to how is there health a year after the research? Are they still practicing? 

Once the different researches were finished and many of the participants did not have the option to keep practicing my teaching/intervention at the research, some of the students followed me to other classes that I teach around the Boston area, and some became my private students! You can hear some of their testimonies in this video.

Over time teaching and implementing my mind body/Tai Chi intervention, the scientific community found that it produced great enough results to publish in some prestigious medical journals. 

If you are interested, take the time tp read through the different publications and articles. Learn, enjoy, and grow.

Thank you Ramel Rones (Rami).

As always, Happy stretching, deep breathing, empty your mind, strengthen your energetic system, and evoke your spirit!

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If you are interested, in privates lessons, for improving quality of life or investing in prevention. If you are suffering from years of chronic pain which western system could not help you without pain killers; email me at rami@ramelrones.com.

If you are going through cancer treatment or its side effects and you are interested in complementing the treatments and the side effects with a mind body intervention, please email me at rami@ramelrones.com and we can talk and, if possible, I will design a tailored mind-body intervention specifically for you.

 If you want to hear what that is like, you can hear about it from my student Larry Lucchino in is testimonial about my mind body intervention: testimonial from former President  & CEO of the Boston Red Sox, and current owner of the Pawtucket Red Sox, Larry Lucchino.

Thank you, Ramel Rones (Rami)

A Look into My Work on Integrative Therapies at Tufts Medical Center

Tufts media covering the research that Ramel Rones has been collaborating on with Tufts Medical Center for the last 15 years.

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Hi mind-body students! This week, we have a special edition blog for you. You may have already seen that the Tufts Medical Center media team is covering the integrative therapies research that I have been collaborating with the center on for the last 15 years. Today I wanted to give my readers a look into the all the work that we have been doing.

Over these 15 years, me and my colleagues at the medical center engaged in many research topics including Rheumatoid Arthritis (an autoimmune condition) osteoarthritis of the knee, and Fibromyalgia (chronic pain).

• What is Rheumatoid Arthritis: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024678/     

• What is Osteoarthritis of the knee: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766936/    

• What is Fibromyalgia: https://www.niams.nih.gov/health-topics/fibromyalgia 

I was first challenged to design and then asked to teach and implement the Tai Chi intervention for each one of the conditions above. Over time, with hard work, and thanks to Dr. Chenchen Wang our center was able to get R-21 grant money and R-01 grant money from the NIH, allowing us to do much larger research. Between the smaller studies which took 3 years and the large ones that took another 6 years, I worked with hundreds of individuals who were diagnosed with any of these conditions. The tremendous changes that I witnessed over the years, from before and after the studies, were amazing. Regaining physical independence, reducing chronic pain, getting off pain medication, and the change in mood and quality of life are what led to our studies gaining notoriety.

In both the smaller and the larger studies that we conducted at Tufts, the participants who used my Tai Chi intervention showed excellent results, and our evidence appeared in several of the top medical journals and publications in the world, including:

• NEJM publication about Fibromyalgia/chronic pain:   http://www.nejm.org/doi/full/10.1056/NEJMoa0912611                     

• NCBI publication about Osteoarthritis of the knee:     https://www.ncbi.nlm.nih.gov/pubmed/27183035 

Happy stretching, deep breathing, empty your mind, strengthen your energetic system, and evoke your spirit!

Freeing the Skeleton with the Body Markers: Complete Series

Happy Holidays mind-body students! This will be the final blog of 2017 (can you believe it?) and then we will take our winter break until late January. I hope everyone has learned a lot and benefited from all the content on the blog this year. We always do our best to pick exercises and blog topics that are as relevant as possible to the needs my students have.

Also, a big 'thank you' to all of our new blog readers! December saw a big increase in new subscribers, so I'd like to welcome all our new mind-body students!

This week, we are completing and compiling the blog series on Freeing the Skeleton with the Body Markers. To refresh everyone's memory, here is the introduction I wrote to the first installment of this series:

“The 12 Body Markers are a system that I have used for years to help teach my students both online and in my classes. They are designed to measure a person’s range of motion through all of their joints, using a scale of 1 (least flexible) to 10 (most flexible). In western health an wellness traditions, everyone seems to be able to measure strength, but very few people have a good grasp of flexibility. Even professional athletes often don’t know what the proper range of motion for each of their joints are. Many people are even unsure about what their personal level of flexibility is: usually under or over estimating it until they test it out.

To help address these issues, my wife (Ilana Rosenberg) and I are putting a book together that will feature an extensive guide to the 12 Body Markers to help everyone from average Joe to professional athletes avoid injury, recover from injury more effectively, and recuperate from training faster.

We’ve covered some of these Body Markers in the past on varies blog posts and our mini Office Exercise series. For this blog series, we will be focusing on the 9 Body Markers that measure a person’s flexibility, starting this week from the ground and moving up!”

— Rami's Blog, November 10th, 2017

From there, we covered the 9 Body Markers, moving from the ground up. First we did stationary stretches, and then we did moving exercises. Today, we will do a quick review of all of these steps, so you can easily move from one to the next.

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Freeing the Skeleton with the Body Markers: Complete Series

Part 1: Starting from the Ground

We began the first week's post with an ankle stretch. This is a key stretch for improving your walking posture, your balance, and your ability to recover from foot pain. If you don't have the special foot rollers that I do, you can simply use the first step at the bottom of a set of stairs to do the stretch.

We moved on to the quad stretches, either the heron or the "seiza" sitting position. This stretch can release a lot of tension you might not know you have, especially those of us who stand all day for our job.

Lastly, we covered the hamstring stretches. Hamstrings are notoriously the tightest muscle in the modern body, not least of all because we spend much of our day sitting, and very few people do forward folds as much as they should. But not to worry! Now is your chance to start! Loosen up the soft tissue in your hamstrings!

Part 2: Abdomen and Back

In week two we were moving on up to the body with more stationary stretches for the abdomen and back. We did the groin stretch, both using a chair and using a machine. This stretch is key for athletes and "weekend warriors" to avoid injury during their athletic activities. How many times do you sports fans hear about a professional athlete being benched due to a groin injury? They are not fun to have, and they can take a while to heal because the area is where a lot of soft tissue and bone structure connect. Don't hurt your groin, do this stretch!

Next was freeing the hips with the classic hip extension posture against the wall, or free-standing if you want to work on your balance at the same time. Remember: your skeleton is designed for your knees to get right up beneath your collar bone in this position. If you can't get your leg that far up, you have soft tissue tension that needs to be worked on!

To close out week two, I showed you guys the chair twist (which you can easily do in the office), and the "five musketeers" for releasing the stress in your lower back. As the weather gets colder and more snow begins to fall (for my New England readers), keeping your lower back free and healthy is even more important. One wrong move with the snow shovel when your back is tight and you could be in bed for the next three days. Nobody wants that, so be sure to pay attention to your lower back and work toward that 10/10 flexibility.

Part 3: Arms and Shoulder Girdle

In week three, we reached the top of our body with static stretches, starting with the shoulders. The shoulders are a very complex joint, able to move in a huge number of different directions. To free all the tension that occurs because of that complexity, i showed you a set of four stretching postures, using a belt or rope if necessary, to release shoulder stress from every direction.

Next was a new technique I call "Three Postures for the Neck" that helps target one of the most tight areas in the upper body: the neck. With so many people looking down and computers and phones all day, it's no wonder our neck gets tight. Tight necks leads to headaches, walking issues, bad sleep, and a million other potential problems. Definitely do not forget to stretch the neck.

Finally, we did an oldy but a goody: the wrist stretch using the wall. This helps relieve tension in the firearms and hands, and is particularly good for relieving carpal tunnel symptoms, or avoiding them completely.

Part 4: Back to the Ground, in Motion

In week four, we returned to the lower body to learn several moving techniques that can be even better than static stretches at relieving certain tension. First up was leg rotations, which focuses on the knee and ankle joints. Use a chair for this exercise if there is any worry of losing your balance.

Then, we did another new exercise I call "kick backs" which help to release tension in the quads. First we start with small kick backs, bringing the heel up about halfway, and eventually we move on to kicking all the way back and touching the heel to the butt.

Lastly, we did a very advanced movement called the "windmill" to release hamstring stress. This one is not for the feint of heart! If you are not up to the task, don't worry! In the next installment, we showed a movement that can accomplish the same thing with much less effort.

Part 5: Moving the Core

We kicked this week of movements off with a new technique called "Swinging Leg." The side-to-side variation helps you get the best groin stretch, but the forward and backward technique can also release tension in the hamstrings (particularly the forward part of the swing). Don't forget to use a stick or wall to stabilize yourself while doing this. Being stable actually helps you get a better stretch while doing this movement.

Next was a fan-favorite: the Tai Chi Walk! This is a great whole-body movement, and even works the core and the back. But for our purposes in this series, the goal is to gently move the hips to release that soft tissue in the hips. Notice how you do a modified hip extension stretch at the top of every step!

To finish up week five, we did the Tai Chi move "grind." Grind looks like an arm movement, but experienced Tai Chi students will tell you it is all in the core, particularly the lower back. Make sure your belly button moves from side to side while you do the motion. If the naval stays in the same spot the whole time, you are doing an arm movement, not a back movement!

Part 6: Moving the Upper Body

Finally, we completed the series in week six with three upper body movements. We targeted the shoulders first, with my new "Swinging Arms" exercise, which you can do sitting or standing.

Then we moved our head like a pigeon does to gently massage the neck. Throw in some deep breathing here and relax the face too! A tight neck and face feed off of each other. If you can relax both at the same time, you will get the best results.

And to end our exercise routine, we revisited the "40% effort movements" I created for people suffering with arthritis in the arms and hands. These motions are a great way to release all kinds of tension in the elbows, forearms, hands, and even fingers.

And that is it! Talk about freeing the skeleton! I don't think there is a single bone we didn't touch by the end of our techniques.

It's been another great year, and I hope you all keep an eye out for the first blog post of 2018 next month. I'm excited to see what mind-body adventures the new year will bring!

Happy stretching, deep breathing, empty your mind, strengthen your energetic system, and evoke your spirit!

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Still searching for a last minute gift for a friend or family member? Do they like exercise, meditation, health and wellness, or stress reduction? My online courses over at Udemy offer all of those things and more, and they are currently on sale! It is the perfect time to pick one up. Remember, setting up a Udemy account is totally free, so anyone can do it.

Is the person you are shopping for more old school? No problem. I have books and DVDs available on Amazon and YMAA. Some of these are also on sale, so hurry and pick them up before you miss out on the savings!

Happy Holidays!

New Study on Tai Chi and Osteoarthritis of the Knee

Knee osteoarthritis is a painful, chronic disability. Currently, there are very few effective methods for treating the symptoms, and virtually no remedies available for treating the root causes of the condition or improving longterm pain levels and knee function. Previous studies that I have helped develop, and other studies from around the world, suggest that Tai Chi could be an effective way of improving the lives and reducing the symptoms of knee osteoarthritis patients.

Until recently, no trials have directly compared Tai Chi to other therapies for knee osteoarthritis. But, I am excited to announce that I helped develop a study that does exactly that, and it was published in the Annals of Internal Medicine Journal!

The study, titled Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial, examines the effectiveness of Tai Chi versus standard physical therapy as a treatment for knee osteoarthritis in a 52 week, single-blind, randomized trial.

To read the scientific abstract in full, click here.

204 participants (who averaged 60 years old) took part in the study. 70% were women and 30% were men, and all of them suffered from osteoarthritis of the knee. Each participant was put into one of two groups: one group did Tai Chi regularly for the duration of the study, and the other group did physical therapy.

At the end of the trial, both groups showed significant improvement in their symptoms. That’s good news, because it means that both Tai Chi and physical therapy work! However, the participants that did Tai Chi also reported a significant decrease in their feelings of depression, and felt that the physical part of their quality of life had improved dramatically.

Overall, this study did not prove that Tai Chi is better for your knee osteoarthritis than regular physical therapy, but it does provide evidence for the body AND mind benefits of a Tai Chi practice.

After all, why just have less pain when you can also feel happier and have a higher quality of life with the same amount of effort?

Again, if you would like to read the full study abstract, you can find it here.

I also want to give a big thank you (and congratulations) to all of my co-authors who worked hard to make this study happen. One more important study bringing the mind-body world and the world of science together.

Happy Stretching!

Integrative Pain Management, Part 1: The Problem of Pain

Chronic pain is a common symptom of countless conditions and injuries. Whether it's from fibromyalgia, knee osteoarthritis, cancer, or any other ailment, chronic pain can take you from 60 to 0 in no time flat. When doctors can't treat the underlying causes of chronic pain, "Take two aspirin and call me in the morning" just doesn't cut it.

Over the years, numerous solutions to the problem of chronic pain have developed, such as surgery, Cortisone shots, and Physiotherapy, to name a few. Each of these strategies has their ups and downs with regards to cost, invasiveness, permanence, chance of success, and so on. Many people find that one or more of these treatments is the solution they were looking for. Others, however, try all of them without any luck.

A recent development in the world of pain treatment is the widespread use of prescription painkillers, opioids in particular, which are a type of drug that works on the nervous system directly to inhibit pain. Common prescription opioids for pain relief include oxycodone, hydrocodone, codeine, morphine, and fentanyl, an accidental overdose of which is believed to have caused the death of the late great musical artist Prince. 

The consequences of prescribing addictive substances to patients, even in highly controlled dosages, are only coming to light now. The numbers, however, are already staggering. In 2012, 259 million opioid prescriptions were written in the US, which is enough to give one bottle of pills to every adult in America. In 2014, nearly 2 million Americans were addicted to prescription pain killers, and in the same year, almost 19,000 Americans died from overdosing on them. The rate of such deaths has quadrupled since 1999. (For these stats and more, check out the ASAM's opioid addiction report, as well as the CDC's section on opioid overdose.)

And perhaps the worst part of this national situation is that these people still have chronic pain. The painkillers only work for as long as they are taken, and eventually the body will develop a tolerance for the medications that will make them less effective. The solution that I and many others have collaborated on is Integrative Pain Management. This mind-body approach not only avoids the dangers of prescription medication or surgery, but also seeks to incorporate the entire being (body, breath, mind, energy, and spirit) into the healing process, and fix the underlying causes of the chronic pain so that, through practice and discipline, it can be cured and not just numbed.

Over the next several weeks I will be posting integrative pain management content selected from my chapter in the book Integrative Pain Management: Massage, Movement, and Mindfulness Based Approaches. Share the blogs with your friends, post them on Facebook, and retweet me on Twitter so that we can get this pain-fighting knowledge to the people who need it.

Happy Stretching!

Na - Sensitivity Training - Listening with the Skin

When doing Na, or sensitivity training, you want to go slow and try not to compete but to be a good partner. Close your eyes and learn to sense with the skin on your hands. Go slow and start with one hand at a time and over time move to two hands simultaneously. Once you are comfortable with the physical movements then try visualizing your lower energy center while practicing Na. After that, work on the visualization of the 4 gates breathing while practicing Na; you can start with two gates, the upper ones, and over time add the lower ones as well. When you advance even further, you can do Na training on two wooden blocks (still visualizing the lower energy center, of course!).