Question: I have pain in both knees due to osteoarthritis. It’s not too bad, but I want to avoid surgery in the future. What are your thoughts about tai chi?
Answer by Howard LeWine, MD
Osteoarthritis develops when cartilage — the tissue that covers bones and acts as a cushion — deteriorates over time, eventually leading to joint damage. For the early stages of this condition, tai chi may very well decrease your pain and might help prevent the condition from getting worse.
Tai chi is a low-impact, slow-motion exercise you do without pausing through a series of movements. As you move, you breathe deeply and naturally, focusing your attention — as in some kinds of meditation — on your bodily sensations. Tai chi differs from other types of exercise in several respects. The movements are usually circular and never forced, the muscles are relaxed rather than tensed, the joints are not fully extended or bent, and connective tissues are not stretched.
A study published in Arthritis & Rheumatism found that participants with knee osteoarthritis who practiced tai chi twice a week had less pain and better physical function compared with study participants enrolled in a wellness education and stretching program. The tai chi class lasted 12 weeks, but the improvements were sustained a year later. These participants also reported less depression and greater well-being.
Among other things, tai chi provides benefit by improving muscle strength and coordination, which leads to better joint stability. In addition, the mind-body aspects and breath control promote mental calmness, which may help to break the cycle of arthritis pain.
Taking a class may be the best way to learn tai chi. Watching a teacher in action, getting feedback, and experiencing the camaraderie of a group are all pluses. Most teachers will let you observe the class first to see if you feel comfortable with the approach and atmosphere. Instruction can be individualized. Ask about classes at your local Y, senior center or community education center.
If you’d rather learn at home, you can view videos geared to your interests and fitness needs. There are some excellent books, but it can be difficult to appreciate the flow of movements from still photos or illustrations.
Most beginning programs and tai chi interventions tested in medical research last at least 12 weeks, with instruction once or twice a week and practice at home. By the end of that time, you should know whether you enjoy it, and you may already notice positive physical and psychological changes.