The Harvard Medical School Guide to Tai Chi by Peter Wayne. PhD, a review and commentary

January 2014
BY VICTOR S. SIERPINA, MD, ABFP, ABIHM, Distinguished Teaching Professor, Family and Integrative Medicine, UTMB Health

I want to share with readers a great new resource on the health benefits of Tai Chi. It is a very well done book by a Harvard assistant professor who also is an acupuncturist and long-time Tai Chi practitioner. Dr. Wayne and I met a number of years ago and he was kind enough to gift me with his recent book, The Harvard Medical School Guide to Tai Chi: 12 weeks to a Healthy Body, Strong Heart, and Sharp Mind (Shambhala Press, 2013). This was fortuitous as I am working on a book chapter on Tai Chi and Osteoarthritis for a new book in the Weil Integrative Medicine Library on Integrative Medicine for Pain.

If you are not familiar with it, Tai Chi is a slow-moving, meditative movement and martial art. Tai Chi as translated from the Chinese means “the grand ultimate fist” and is both and ancient art and science of health, mind, body, spirit. Historically derived from practices in the Shao-Lin temple in China as an exercise done by the monks as a form of meditative exercise and fitness program, it also helped them to protect the peasants from surrounding warlords.

The practice involves gentle activity, deep breathing, and a focus on the principles of Taoist philosophy. These include yielding, oneness, connection, balance, awareness, and energy flow. Tai chi is an easy and accessible exercise for both young and old. Parks in Asian cities are often a great spectacle of groups of seniors moving gracefully together like a harmonically flight of birds or school of fish as they use this low impact, aerobic, flexibility and agility building exercise to sustain and grow their health and well-being. The classic writings about Tai Chi state that all its movements are rooted and started in the feet, directed by the waist, and administered by the hands. Energy flows like an electric field from ground to hands.

I first came across Tai Chi in 1983 at the Steven’s Point Annual Wellness Conference where I learned eight basic forms at a class called Spiritual Disciplines of Well-Being. I liked how it made me feel, how it improved symptoms of a torn knee ligament, and how it calmed and centered me. After a few months of self-directed home practice, I found Master Waysun Liao teaching at a Tai Chi studio a couple miles from my home in the Chicago suburbs. I studied under him for 7 years and, as they say, the rest is history. Tai Chi has become a core part of my overall daily fitness and wellness program. While studying Tai Chi, my Tai Chi master taught me many life lessons, in addition to the practice of the Tai Chi forms. These were amazingly broadly based including philosophical and practical advice about health, business, and relationships. The teachings of Lao Tsu and the yin and yang of Taoist thought were central aspects to the practice of Tai Chi.

From these conversations with Master Waysun Liao, I developed an interest in the study of acupuncture, which is based on improving the flow of energy, or “chi”, that Tai Chi is based upon. He encouraged me to study acupuncture two or three years into my training when I could start to actually feel the flow of chi in my own practice and in my body. While “chi” has never been dissected or noted on any medical diagnostic or physiological instrument, it is a subtle energy that underlies the effects of both Tai Chi and acupuncture.

Though Tai Chi was not originated for treating any specific health condition, Tai Chi has a rather long list of healthrelated benefits. These include improving balance and reducing falls in the elderly, improving motor control in Parkinson’s disease, increasing bone density, improving outcomes for those with heart disease and COPD, preserving cognition, improving sleep, reducing stress, anxiety, and depression symptoms.

Related to pain management, Tai Chi offers a natural option for movement, strength and balance training, flexibility, and aerobic fitness. Studies have shown Tai Chi is useful in the treatment of connective tissue and musculoskeletal health conditions such as back pain, osteoarthritis, rheumatoid arthritis, and fibromyalgia. Tai Chi is highly cost effective, as it requires no equipment and minimal space.

For many years, I have recommended certain Tai Chi motions and forms to help patient rehabilitate from a wide variety of musculoskeletal and neurological conditions. For example, a person with rotator cuff problems and arthritis of the shoulder will benefit from some simple shoulder rolls used in tai chi warm ups as well as more advanced movements such as Slanting Flying, Shooting Star Palm, and Upward Downward which require stretching, reaching, and circular or lateral motions that are both relaxing and challenging. They encourage motion and graduated improvement of range of motion. A person with knee osteoarthritis will utilize Arrow and Bow, Brush Knee and Twist, Snake Creeps Downward, Ride the Tiger, Arrow and Bow with Twist, and other forms to mobilize not only the knee joint but the muscles and connective tissue around it in a gentle, systematic way. Such movements improve synovial fluid flow, reduce inflammatory cytokines, and keep supporting structures of the knee supple and strong. So after years of prescribing Tai Chi for patients, I was pleased to note that Tai Chi programs are recommended for nonpharmacological management of knee OA by the American College of Rheumatology 2012 guidelines and recommendations statement.

Not to be ignored are the effects of Tai Chi on pain reduction through the central nervous system via the link between stress and neuroendoimmune function in rheumatic disease, particularly in the inflammatory phase of these conditions. The Harvard Medical School Guide to Tai Chi is an easy, credible read. It is well referenced and illustrated. Part One covers Tai Chi and Its Essential Elements, reviewing the historical context of Tai Chi, the “active ingredients” of Tai Chi, and outlines a simplified program based on basic principles. Part Two, Proof of Promise: Tai Chi through the Lens of Modern Science provides well evidenced, extensively referenced chapters on the application of Tai Chi for balance, bone health, pain management, heart health, improving breathing, cognition, sleep and overall psychological well-being. Believe me when I say if Tai Chi were a pill, it would be a best seller. Part Three is fun and interesting as it is Integrating Tai Chi into Everyday Life. Included here is two person Ti Chi, applying Tai Chi to cross train for sports such as tennis, golf, and others, using Tai Chi on the job, to enhance your creativity, and Tai Chi for lifelong learning.

If you have ever been interested in Tai Chi but never knew where to start, get a copy of this excellent textbook. It can guide you to improved health, fitness, balance, and awareness. You can also learn Tai Chi from videos, from classes, or from individual instruction. Such personalized instruction is important, though Dr. Wayne offers a well-illustrated Tai Chi program that you can learn from this book and then followup if you wish with more intense training.

Dr. Wayne’s book may do the same as that long ago demonstration of Tai Chi at a conference did for me. I predict it will inspire you on the road to better balance, flexibility, and a peaceful mind. Importantly, it will provide another integrative approach to offer your patients for a broad variety of health concerns.