Rami's Blog

Like the Yin-Yang, Eastern Martial Arts and Western medicine are two halves of a whole. My mission is to preserve the ancient mind-body tools and pass them on to you.

 

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 2: Mind and Body

This is a continuation of my Integrative Pain Management series, based on content selected from my chapter of the book Integrative Pain Management: Massage, Movement, and Mindfulness Based Approaches. 

See also: Part 1.

For in-depth routines to deal with upper back pain, lower back pain, and other conditions, check out my video courses on Udemy!

Pain is not just a physical sensation, it is also a psychological phenomenon. This is particularly true of chronic pain, which can go on long after a physical injury has healed. The interplay between mind and body when it comes to pain is extremely complex, but there is one thing about it that is dead simple: the power of the mind cannot be ignored.

An amazing example of this power is a condition called Phantom Limb Pain. This effect can occur when an injured or paralyzed limb is amputated, but the amputee continues to experience pain as though the limb were still there. Obviously, when a limb is amputated, the nerves that were responsible for sensing pain in that limb are also gone. However, the brain has 'learned' over months or years of real pain, that the limb, even after it is gone, is in pain. it isn't until the unconscious mind can 'unlearn' that the limb is in pain, and instead learn that the limb is gone, that the chronic pain will go away.

This technique of experiencing the pain and then learning to release it via the mind is one of the main reasons that integrated strategies for managing pain have so much potential. Mind-body techniques like Tai Chi target pain in both the body and the mind. A dedicated mind-body pain management routine can simultaneously reduce pain caused by the tissues, as well as pain caused by a learned psychological pattern, or other mental obstacle.

Next week, we'll discuss how Eastern philosophies reconcile the split between mind and body into the flow of energy, or qi, in the body, and how that relates to our experience of pain.

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!

Surgery, Exercise, and Understanding Your Body's Limits

One of the most difficult aspects of maintaining a healthy lifestyle is adapting your exercise, diet, and activities to your body's changing capabilities. There are countless reasons why our body may not work the same as it used to. Injury, surgery, having children, and even the natural aging process can change our body's ability to function. It could even be something as simple as not getting a chance to exercise for a while.

In my experience, if I don't do arm exercises for a couple weeks, I have to ease back into a routine to avoid straining myself too much and risking injury. When I am in good practice, I can do two sets of 30 wall push-ups (elbows in then elbows out). But if I even go two weeks without upper body exercise, I need to start back at 15 repetitions on each set, rather than the full 30.

And what if you have just had surgery? Many exercises on the blog are related to recovering from or preparing for surgery. I always show you how to do the exercise with no resistance, because adding resistance when you are weak after surgery is dangerous. You have to accept your new level of ability, and slowly work your way back up to your previous capability. Even if you are not strong enough to completely lift your arms, or if you have very low range of motion after an operation, do not feel ashamed and do not push yourself to get better too fast. The wise thing to do is to be confident that you will get better with time, and stick to your new routine very closely.

Recently, I had a blog reader ask me how they should do the breast cancer exercises when they aren't planning on having surgery. Should they do them the same? Differently? Should they bother to do them at all?

My answer was, of course they should do them! These exercises are not just for surgery, but for getting oxygen and healing energy to the site of the cancer. The difference is, what is your 80% level when you have not had surgery? 80% effort after surgery might mean just stretching your chest a tiny bit while lying in bed. If you aren't having surgery, but are going through chemo, 80% effort may be doing a few chest exercises for 10 minutes while sitting in a chair. If you are completed treatment and are feeling healthy, 80% effort could be chest and arm motions with some 5lb weights in your hands, while standing up.

It's all about recognizing what your ability is at this stage of your life, and doing the right amount of exercise to maximize healing and minimize your chance of further injury or illness.

Happy Stretching!