St. Louis T'ai Chi Ch'uan

1/14/07

A response by Dr. David Walls-Kaufman to the article: Knee problems and the t'ai chi player, by Betsy Foster MPH (2006), published in T'ai Chi Magazine, August, 44-46. This response is reproduced with the permission of Dr. David Walls-Kaufman. It was published in the December, 2006 issue of T'ai Chi Magazine. Another response by Dr. Tom Krapu can be found at:

http://www.krapu4.com/taichi/foster.htm:

To: T'ai Chi Magazine

Your volume 30. No. 4 article on knee problems caused by Cheng Man-ch'ing t'ai chi was brought to my attention by students and I was asked to respond.

To say that Prof. Cheng's t'ai chi has "passed on a knee disaster" is wrong-headed in the extreme. The author is not an expert in sports injuries and has reasoned poorly and given very bad advice.

A person must be "whole" in order to practice t'ai chi without certain consequences. If a person does Professor's form with a broken foot and it hurts, it's not Professor's fault. Make yourself whole and then practice. True, tai chi can help make a person whole better than most anything, but there are always limitations of matter to be considered.

Further, Ms. Foster bases her criticism on a myth about knee function and pain. The myth has been debunked, yet she gives it new life, so that it can go on frustrating and debilitating more people.

Ms. Foster also advises to cut corners on the form for prevention. This could be harmful advice both for tai chi and for the management of most pain problems.

The myth: Knee (patellar) pain is caused by muscle strength imbalance creating an abnormal knee glide so that the knee cap bumps the bone. This logic is antiquated. First, the body compensates for any such problem by recruiting adjoining muscles. Adjoining muscles are worked progressively more by the "offending" muscle pulling harder. Harmony is maintained.

Besides, if the outer thigh muscles pull harder, they pull the knee cap outward. Yet 9 out of 10 knee (non-cruciate) pain sufferers show worse pain on palpation on the inside margin of the knee, away from the mythical "bumping" knee cap.
Better research on knee pain has found problems arise from any combination of the following four reasons: 1) rolling of the foot inward (pronation) buckling the knee joint inward, 2) low back irritation of nerve structures that feed leg tissues and joints (amplifying any pain signals from knee structures and deranging micro-movement), 3) overweight, 4) generalized inflammation of the body highlighting areas where buckling happens.
None of these factors is Cheng Man-ch'ing's fault. The student is not whole.

1) Explore orthotic supports and foot arch exercises that will roll your foot outward (tip your foot out until your Achilles tendon drops straight at the floor, i.e. perpendicular). This restores the knee joint to level; otherwise, the inward buckle chronically grinds, tears and inflames.

2) If the curvature of the lower spine departs from normal, then nerve roots are pulled, carrying tissue breakdown signals and pain amplification signals to the legs. Only a chiropractor can address this problem.

3) Lose weight. Even 10 extra pounds exponentially raises wear on joints, especially buckled ones.

4) Generalized body inflammation in America today is more the rule than the exception, due to our diet. A recent overview of the literature on Omega 3 fatty acids and their powerful anti-inflammatory properties, and their diminished presence in our diet, gave over 300 references. These articles advise using pharmaceutical grade fish oil (pollutant free) with its co-factors. I would add to this Glutathione and NAC (N-Acetyl-Cysteine), your body's two most powerful detoxifiers, as well as anti-oxidants, a good multi-vitamin, and the avoidance of glutamate and aspartame (a nerve-toxic flavor enhancer and an artificial sweetener, respectively). These two assailants crop up consistently in joint maladies.

If these measures fail to solve your knee pain, then find a chiropractor to double check your procedures.

Inward knee buckling with all of the weight upon it is a definite problem, and that's why Cheng never taught Yang form that way.

Lastly, Foster's cutting out "difficult" parts of the form advice is bad. It stems from the old "if it hurts, don't do it," recommendation. This strategy never once stopped a progressive disease. Fascia and ligament progressively creep short and they will paint you into a range of motion corner, unless you work to hold the ground, or win it back. Even for the most crippled, the better strategy is to treat the causes outlined above and challenge yourself within tolerance to win back territory you've lost.

Each degree you regain raises quality of life and prolongs life. Regional pain syndromes (in the low back) are now known to kill off up to 15% of brain cells in six months (Journal of Neuroscience, 2004) and increase the likelihood of cancer death by an average of 55% (British Med Journal, May, 2004.)And pain meds don't appear to stem the tide and are the number one cause of kidney failure and liver cancer.

Cheng Man-ch'ing was a top notch doctor. He knew what he was doing. Trends in biomedical research suggest his form may be the most perfect exercise on the planet. This is a form criticism from a t'ai chi beginner armed with solid misinformation on sports injuries.

David Walls-Kaufman, D.C. is a senior student of Ben Lo with 23 years t'ai chi experience. He is a Doctor of Chiropractic with 26 years of clinical experience and the sports doctor for numerous elite cycling athletes, power lifters and Olympic rowers. He is also a chiropractic researcher currently working on publication of several studies and has certification in Human Health Outcomes Research from NIH.