Newsletter #69 - May 2007

In this issue:

-- From me to you, by Dr Lam
-- Summary of tai chi for people with osteoarthritis study, by Libby Spiers
-- Some comments about the results of the ‘Tai Chi for People with Osteoarthritis’ study, from Sue Fry
-- A toast to tai chi and all those involved in the research program, from Joan Peters
-- Me and my heart, by Norman Precious
-- Blending the ancient and modern, East and West, by Hazel Thompson and Rob Condliffe
-- What I’ve learned from participating in a Tai Chi for Diabetes research study, by Cheryl Lee Player
-- Mindfulness: Extending tai chi benefit outside the box, an address, by Rani Hughes
-- ‘Don’t panic: help is here’, an article reprinted from Your Health magazine
-- Positive humor for better health, by Dr Bob McBrien

Click on the titleabove to read the articles, this link to read all previous newsletters and here to subscribe.

Hello Everyone,

The mid-year workshops in the USA are fast approaching and I am looking forward to working with many of you there. Please note that the Tai Chi for Osteoporosis instructors’ training workshop in Terre Haute is now fully booked, but the one week workshop still has a few space left. If you want to come, please enrol soon.

‘Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes’ is a study published in the April 2007 issue of the Arthritis Care and Research Journal by Dr M Fransen, L Nairn, J Winstanley, Professor J Edmonds and myself. It is the biggest study done of tai chi and arthritis. It has shown both the Tai Chi for Arthritis program and hydrotherapy are effective for people with arthritis. Libby Spiers, physiotherapist and warm water exercise coordinator at Arthritis Victoria, has written a summary of the study for this newsletter.

If anyone is interested in learning the Tai Chi for Arthritis program or learning how to teach it, please contact your local arthritis foundation, or see How to learn tai chi on my website.

In this newsletter:

• Libby Spiers gives us a summary of the study ‘Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or tai chi classes’.
• Sue Fry, who used to work for Arthritis New Zealand, has some interesting comments to make about the results of the study.
• Joan Peters, one of the instructors of the study, in an email to Dr Lam, applauds both tai chi and all those involved in the research program.
• My friend Norman Precious from the UK is an amazing man. Norm is a dedicated tai chi practitioner and teacher and he is also one of the Senior Trainers of the Tai Chi for Health programs. He was surprised, therefore, to find that he had a problem with his heart. In this newsletter he describes what happened to him and how tai chi has helped him to meet his health challenges. Good on you, Norm!
• Hazel and Rob have written to tell us about the tai chi classes they are now running so successfully at St Luke’s Anglican Church, a beautiful old building with a wonderful peaceful atmosphere right in the middle of Christchurch, New Zealand’s busy town centre.
• Cheryl was involved recently in another study of my Tai Chi for Diabetes program and she gave a talk, reprinted here, about what she has learned from it at the January tai chi workshop in Sydney.
• We also have a copy of a talk given by Rani at the same workshop, about mindfulness – how we can nurture our inner self apart from practising tai chi on a regular basis.
• ‘Don’t panic: help is here’ is an article reprinted from Your Health magazine about panic disorder, which can be a terrifying condition. Effective treatment is available and the first step is to see your doctor for a check-up to rule out any underlying physical cause.
• Finally, Dr Bob gives us another dose of positive humor for better health.

This month's special offer
In May, when you buy the DVDs of Tai Chi for Arthritis Part I and Tai Chi for Arthritis Part II, you’ll get a copy of the Tai Chi for Arthritis handbook, worth US$9.95 (AU$12.95) free of charge.

Tai Chi for Arthritis is a simple, safe and effective program designed for people with arthritis and is supported by many arthritis foundations worldwide. Proven to be effective by medical studies, this program has helped many thousands of people improve their condition and quality of life. The DVDs are available in English, Chinese, French, Spanish, German and Italian. The Tai Chi for Arthritis Handbook is designed to assist you with your practice and provides a summary of all movements with photographs and instructions.

For more information about these products and to order your copies, go to the online shop. Please quote SP0507 in the comments section to get your free handbook.

Product review of the month
Congratulations to ‘smittyah’, of NYC, for winning a tai chi music CD for this review of the Tai Chi for Back Pain DVD.

‘I've been a back pain suffer on and off for many years. In December 2006 the pain worsened, and I had a severe case of sciatica. The pinching has subsided somewhat, but it's still there. Went for PT, but pinching is still there.

I went to my local library to see what they had on back pain. Lo and behold I found Tai Chi for Back Pain on DVD. Tried it out yesterday and today. Wow!! Can't believe how this has eased the pinching down my leg. Slow smooth movements, redirecting my mind from my pain. I finally found something that works for me. I'm so happy right now because I feel there's hope for me yet. Dr Lam is a genius. To be able to reach out beyond the call of your daily work to help others who are in pain, makes you special in my book. Thank you.’

Thanks smittyah for your review. We would like to send you a tai chi music CD for being our winner. Please email us at service@taichiproductions.com and give us your postal address.

Enter your review of any of my products in the Forum and you will have a chance to win a tai chi music CD too.

Upcoming workshopsby Dr Lam

May 17-18, Bradenton, FL, USA
Explore the Depth of Tai Chi for Arthritis

May 19-20, Bradenton, FL, USA
Tai Chi 4 Kidz Instructor's Training Workshop

June 4-9, Terre Haute, Indiana, USA
One Week Tai Chi Workshop

July 21–22, Stanmore, Sydney, Australia
-- Tai Chi for Diabetes Instructor's Training
-- Tai Chi for Arthritis Instructor's Training
-- Tai Chi for Arthritis Update & Part II Workshop
-- Tai Chi for Diabetes Update and Enhancement Workshop

August 18–19, Stanmore, Sydney, Australia
Therapeutic Tai Chi for Physical Physiotherapists and Occupational Therapy Professionals

Find out about other Tai Chi for Health workshops conducted around the world by me or my master trainers on the workshop calendar page on the website.

Yours in tai chi,

Paul Lam, MD

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Summary of the study ‘Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes’, by Libby Spiers

Libby Spiers is a physiotherapist and warm water exercise coordinator at Arthritis Victoria.

A recent study published in Arthritis and Rheumatism found that both hydrotherapy and Tai chi for Arthritis classes can provide large and sustained improvements in physical function for older, sedentary people with chronic osteoarthritis (OA) of the knee or hip.

The researchers carried out a randomised controlled trial among 152 older people with chronic OA of the hip or knee. Participants attended either Tai Chi for Arthritis classes or hydrotherapy twice per week for 12 weeks. At 12 weeks, compared with controls, the exercise group participants demonstrated significant improvements for pain and physical function scores. These improvements were maintained at 24 weeks.

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Fransen M, Nairn L, Winstanley J, Lam P,  Edmonds J : Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or Tai chi classes Arthritis & Rheumatism (Arthritis Care & Research) April 2007, 57:3 pp 407-414.

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Some comments about the results of the study of the effects of hydrotherapy and Tai Chi for Arthritis in the management of arthritis, from Sue Fry

Dear Paul

Congratulations on the successful Sydney study in which both hydrotherapy and Tai Chi for Arthritis (TCA) were shown to be effective in the management of arthritis.

However, I found the result showing a higher attendance for hydrotherapy was an interesting and surprising anomaly. During five years as an Arthritis Educator in Wellington, New Zealand, I found that TCA consistently achieved higher attendance rates; both actual numbers and frequency of attendance. Accessibility to a low cost, effective, easy-to-follow and enjoyable program resulted in consistent high attendance rates for TCA.

Perhaps the most significant factor restricting participation in hydrotherapy programs in Wellington (and elsewhere) is the serious shortage of pools. Hydrotherapy pools are expensive to maintain; indeed, many facing closure. Referrals are often limited to people requiring acute rehabilitation – frequently in-patients.

Other hydrotherapy limitations can include minor infections, skin lesions or simply a fear of water. Cost may prove prohibitive. Even transport to a central hospital venue may be restrictive. Frequently limited to weekly attendance, hydrotherapy can only be practiced in a pool. TCA, on the other hand, can be delivered at readily accessible local venues. No special equipment or clothing is required. TCA can be practiced life-long; anywhere, anytime; facilitated by inexpensive back-up aids (eg. handbook, CD, DVD). TCA holds the attention because the intention is to ‘remember’ the Form, providing mental stimulation. Valuable social support is created as participants encourage each other, in and out of class. Additionally, substantial research shows that tai chi practice is effective in reducing falls.

The dwindling number of hydrotherapy pools, combined with the user-friendly, beneficial aspects of TCA, saw a rapid increase in TCA participation, in the Wellington area at least. Therefore, I was surprised by the study’s ‘attendance’ findings. Nevertheless, the study clearly shows that both hydrotherapy and Tai Chi for Arthritis are beneficial in managing arthritis, allowing little doubt that both modalities should be readily available. However, given the comparative low cost effectiveness of TCA, clearly it must be considered seriously by anyone managing an arthritis condition.

Sue Fry

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A toast to tai chi and all those involved in the research program, from Joan Peters

Dear Paul,

Thank you for the email newsletter. I have read it with great interest and must say how pleased I was to see the results that tai chi can bring – can I say its a winner, if I may use the term.

We, that is all who participated in the teaching of this research program, could clearly see within weeks how beneficial this exercise was to those who suffered the debilitating pain of arthritis in their knees and hips.

How many times, laughter would fill the room. They would make comments like, I will never be able to do a certain part of the exercise, but after reassurance from the instructors, they would always come and say to us how happy they were that now they could do things that they have not been able to do for years. For myself, the satisfaction I felt inside to see the quality of life return to them was just a wonderful feeling.

I am also pleased to see that, after completion of the study, some have continued on with their tai chi classes in various areas.

I give a toast to tai chi and to all who participated with the program.

Cheers,
Joan

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Me and my heart, by Norman Precious

I was asked, did tai chi help me recover from my heart operation? My story starts in March 2006, when for three months I had been plagued with a sore throat and a throaty cough. In itself, this did not seem strange to me, as for years I had suffered with sinus problems.

So off I went to see my doctor in the hope he would give me some antibiotics. He gave me a thorough examination and told me I had a heart problem, which he explained was a fault with my mitral valve, which meant the one-way valve in my heart was not working properly and it was allowing the blood to spurt back into my lungs. This was a big shock to me as I think I am a pretty fit person, even more so after taking up tai chi a number of years ago.

Anyway, I was sent for some intensive tests involving cameras and scans, which all confirmed the valve was faulty. This was over the period March to September 2006.

On 18 September 2006 I met the surgeon, who explained that I could wait until I had symptoms ( ie, shortage of breath, heart pains etc) before I had the operation, the problem being that if I left it too late, my lungs might have deteriorated and my heart might have over worked itself, because of the fault in the valve.

I decided to go ahead with the operation (this was a big decision as we are talking major heart surgery). The surgeon then said he was going to try and repair the valve but if he could not, did I want a biological valve, made out of animal material, which might need changing after 10 years and would mean major surgery again, or did I want a mechanical one that should out last me, but with the downside being I would be on Warfarin for the rest of my life. He joked and said I had to decide now, as he could not wake me in the middle of the operation and ask which one I wanted.

So now it was just a matter of waiting for a date for the operation – or so I thought. I went into hospital more than once, only to be sent home. Finally, after 8 cancellations I had my operation on 14 February 2007 (Valentines Day ).They could not repair my valve so I have a new metal one (complete with serial number).

Wednesday 14 February I had the operation and spent the night in intensive care. 11am Thursday morning I was moved out to high dependency ward and on Friday moved back to the main ward. They were going to send me home on the following Tuesday, but because I was on Warfarin they had to stabilise my blood. On Monday 19 March I was discharged and back driving again.

Three weeks after the operation I was picked up and sat and watched my tai chi class; four weeks after the operation I was taking class again. So yes, I do believe that tai chi and qigong did help me before and after my operation. It’s not so much the outside that we can see as the inside that we can’t see that we need to look after more.

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Blending the ancient and modern, East and West, by Hazel Thompson and Rob Condliffe

Right in the middle of Christchurch’s busy town centre stands St Luke’s Anglican Church, a beautiful old building with a wonderful peaceful atmosphere. St Luke’s is designated a ‘quiet’ church, or sanctuary, and many office workers slip inside at lunchtime for a few minutes’ quiet reflection away from the noise of the city.

St Luke’s Community Trust provides many activities for their parishioners, and recently decided to trial tai chi lessons. Because of initial concerns that an exercise class might disrupt the restful environment, the group was limited to 12 students, for a six week course.

Last year Dr Lam visited Christchurch, and gave a free talk to the public on the benefits of tai chi. So much interest was stimulated by this event that we local teachers find ourselves besieged with pupils, and finding time for new classes is a challenge. Rob Condliffe and I took alternate lessons for the first six weeks, and the course proved extremely successful.

The Vicar, Father David Moore, was very enthusiastic, and even volunteered to take class photos for us. We have been asked to provide tai chi on a permanent basis, with the possibility of providing a second lunch-time class, open to office workers and passers by.

Our outdoor classes have attracted quite a lot of attention, but we are impressed with the way the peaceful church setting creates a peaceful backdrop, despite the heavy traffic – truly a blend of ancient and modern, East and West.

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What I’ve learned from participating in a Tai Chi for Diabetes research study, by Cheryl Lee Player

My name is Cheryl Lee Player and I teach tai chi in Newcastle and Lake Macquarie, NSW, Australia. I have spent a lifetime, in the performing and visual arts and use many of these skills in my tai chi teaching.

I share Paul Lam’s passion for promoting tai chi for health, and the opportunity to work with him and his colleagues on a research study was very exciting.

In June last year, a randomised group of participants with diabetes arrived to particpate in a research study and learn the ‘Tai Chi for Diabetes’ form. They were required to attend two one hour classes a week for three months, then one class for a week for three months; six months in total.

The participants had little body awareness, were unfit, unwell, unsteady on their feet and sceptical. All of these people had restricted movement and various health issues and I heard regularly ‘It’s wrong – I can’t do it’.
My reply to this is: ‘If it can be wrong – it can be right’. It’s a yin-yang journey. We are all on the same mountain, the only difference is that while you may be looking at flowers, I might be looking at ferns.

I say to my students that my tai chi classes are like a painting, and the people are the colours. When a drop of water is touched by a paintbrush, the colour swirls in all directions, twisting and turning, like tai chi, until finally, the droplet becomes the colour.

It was a challenge from the start and, like an artist, I began with an empty canvas. Or in tai chi terms, an uncarved block.

When the classes started , the colours were, uncertainty, disbelief, pain, caution and hope. Working as a team, we gently coaxed the colours into shapes, beginning to recognise the form in our work. As we became more confident, we began to move the colours, each brush stroke blending with another, leaving no edges.

There was now purpose in our strokes and we began to relax and enjoy the adventure. We were then able to work boldly with stronger colours, feeling our confidence grow as the picture began to reveal itself.

Then, months later, we shared the joy of our masterpiece. There were tears of frustration and smiles of delight as we worked together to help our bodies become stronger and healthier, while the spiralling tai chi colour wove us together.

If you have bad balance it robs your confidence; if you are unwell it is difficult to move, let alone exercise. If a friend shares your journey, it is made easier. Be a friend!

One of the participants was named Neville. He had been married for 46 years with a loving wife and two daughters. This was the first time he had ever done anything for himself. He is busy looking after many others, and one of his daughters has Downs Syndrome and the other is schizophrenic.

Neville was being interviewed by Paul, telling him how tai chi had improved his balance and flexibility, how he now had less fluid build-up in his knees and generally felt his quality of life had improved greatly.

Paul was pleased and said ‘You must be very pleased; did you expect all these improvements?’ Neville’s reply was ‘No, but I hoped it would inprove my sex life.’

What I have learned
I have learned that we need to look beyond the obvious. We need to recognise that there is a way to teach everyone and it is our job to find the way.

Everyone has individual needs and they know better than we what their body is capable of. We must be able to adjust to their requirements, as there is more than one way to teach and to learn a movement.

A small achievement to some, is mammoth to others.

Most importantly, learn to listen. Not just with our eyes, but our whole being. Become sensitive to students needs. Encourage and support every step they take and love them as individuals.

How it can help our other students
If we apply this knowledge to our other students, their growth in tai chi is well rounded; the experience is more fulfilling, and the journey more enjoyable, because we as teachers are more aware. We are listening with our hearts and minds open.

Conclusion
Despite all their problems, during six months of classes, no one dropped out of this group. They became a tai chi family and a masterpiece. Most want to attend tai chi classes, and all intend to practise at home.

For myself, it has been an emotional, loving, rewarding, and extremely successful experience and a great privelige to share their journey. These people were inspiring as both students and teachers.

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Mindfulness: Extending tai chi benefit outside the box, an address, by Rani Hughes

Rani is an accredited occupational therapist, meditation consultant and master trainer in Dr. Lam’s Tai Chi for Health programs

When I was invited to speak today, I started to reflect on the theme of this tai chi workshop ‘Nurturing the inner self’. What does this mean? How can we nurture our inner self besides practising tai chi on a regular basis?

Mindfulness, or the moment-to-moment awareness of what is happening as it is happening, came into my mind. When we focus our full attention on what is occurring in the present moment, we notice how most of our lives dwell in memories of the past or plans for the future. We see how rarely we are connected to the present moment.

For example, as you sit hear listening to this talk, you may be thinking about how you were too busy to eat breakfast this morning, or perhaps you are wondering what you may learn in your tai chi class at the conclusion of this talk. Either way, your mind is stuck in the past or concerned with the future, it is not truly connected to this very moment.

Why is it important to live mindfully in the present moment? When we consider the past, there may be tasks that we have not completed yet, or words/actions that we have done but don’t feel very happy about. When we think about the future, we may have many chores/ tasks that we need to do. Either way, our thoughts of the past or future may create stress or anxiety for us.

However, when we are fully absorbed in what we are doing right here, right now, there is little stress. For example, think about a time that you were completely absorbed in what you were doing. Perhaps you were walking your dog in the park, talking with a friend or doing some gardening. When you reflect on this time no doubt your experience was one of great joy, peace and ease. 

So often we live on ‘autopilot’ in our life. To illustrate this, consider how you washed yourself in the shower this morning. Did you hold the soap in the same hand as you did yesterday morning? Do you use the same hand to hold the soap every morning? Did you wash your body in the same pattern this morning as yesterday morning, or the day before yesterday? Often when our mind is on autopilot in the shower, we are already imagining our first meeting for the day, solving some problem of the day. Our mind is working overtime projecting what may or may not unfold. No wonder we get so tired each day!

Let us start to create small changes in our life that will allow us to live more mindfully, live with more joy, peace and ease. Tomorrow morning while you are showering, hold the soap in your other hand; start to wash yourself in a different pattern. Pay attention to what happens when you no longer shower on ‘autopilot’: instead, shower with mindfulness. In the shower you will no longer worry about what problems the day may or may not bring to you, showering will become a peaceful activity, as you are connected to what you are doing while you are doing it. The shower will become a haven from stress.

Practising tai chi offers us another opportunity to break from our habitual thought patterns and live more fully in the moment. As you practise your tai chi sequence, focus on the movement that you are currently doing, not the last movement that you have completed, nor the next movement that you will do. Initially, as we learn a new tai chi sequence, it may be difficult to achieve this connection with the present moment, as we tend to focus on what movement comes next. Overtime, as we become more proficient with the sequence of movements, it will become easier to place our full awareness on our current movement. The classics say that knowing one tai chi form is enough to fuel a lifetime of tai chi practice, as it is contained within the layers of the tai chi movements, where we deepen our understanding of our tai chi practice. Mindfulness will help us to peel back these layers.

If we can remove ‘autopilot’ patterns from other daily activities such as eating break-fast, driving our car, working, buying groceries, putting our tai chi shoes on and collecting our mail, then we have more and more moments in life that that are filled with joy and great ease. As these positive moments grow in number, moments that are filled with stress and dis-ease subsequently diminish. Slowing down and developing mindfulness through everyday activities enables us to enjoy each moment more – is life but a combination of these individual moments?

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‘Don’t panic: help is here’, an article reprinted from Your Health magazine

Panic disorder is a terrifying condition. Sufferers have sudden and repeated episodes of intense fear and anxiety (panic attacks) for no apparent reason.Attacks are accompanied by physical symptoms such as a pounding heart, sweating, weakness, chest pain, hot flushes, shortness of breath and dizziness.

Although the attacks are simply due to anxiety, people having panic attacks believe they are about to lose control, have a heart attack, die or go crazy. Many develop intense anxiety between attacks, worrying when and where the next one will occur.

Panic disorder typically begins between the ages of 20 and 40 years. The condition is often inherited and is more common in people who are already anxious.

Effective treatment is available
Firstly, see your doctor for a check-up to rule out any underlying physical cause. Many people find relaxation strategies, regular exercise and avoiding caffeine helpful. Slow breathing techniques or breathing into a paper bag can ease the symptoms.

1. Two effective treatments are available and work best when used together:
   Cognitive Behaviour Therapy (CBT) is a type of counselling which helps you identify and challenge the anxious and unrealistic thoughts you have when you panic. CBT helps you understand that your symptoms are not harmful and teaches you to overcome your fear of panicking in certain situations.
2. A number of antidepressants are commonly used to relieve the symptoms of panic disorder, even in people who do not have depression. These medications are effective and generally well tolerated but can cause side effects. They are not addictive.

Ask your doctor for help. For more information, visit www.crufad.com or www.mentalhealth.com.

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Positive humor for better health, by Dr Bob McBrien

Neuroscientists may have grown tired of studying the brains of depressed and anxious persons. Lucky for us, some have scanned happier brains and are able to tell us about the biology of humor and laughter. We learn that when we are listening to a funny story, watching a comedian on the TV or responding to a joke our brain is multi-tasking.

This complex activity requires the teamwork of three brain areas.  Firstly the cognitive area helps us get the punch line. Remember it is the surprise in the story that tickles us.  Secondly a movement-controlling zone helps move the muscles of the face to smile and laugh. Finally an emotional area of our brain helps generate happy feelings.  When we have good feelings we are counter balancing our stressful feelings that our hurried, hassled and harried lifestyle produces.

One way to test your brain’s humor/laughter system is the comic device called the 'one-liner'. The following bumper stickers may bring a chuckle. If you have a favorite bumper sticker one-liner let us know.

Plan to be spontaneous tomorrow
I used to have a handle on life, but it broke
Help wanted - fortune teller: you know where to apply
The one who laughs last thinks slowest
I feel like I'm diagonally parked in a parallel universe
I used to be indecisive; now I'm not sure
The only cure for insomnia is to get more sleep
Help stamp out and eradicate superfluous redundancy
COLE'S LAW: Thinly sliced cabbage
A day without sunshine is, like, night

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END OF NEWSLETTER
Warning: Dr. Lam does not necessarily endorse the opinion of other authors. Before practicing any program featured in this newsletter, please check with your physician or therapist. The authors and anyone involved in the production of this newsletter will not be held responsible in any way whatsoever for any injury which may arise as a result of following the instructions given in this newsletter.

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