Yoga and Tai Chi for better quality of life

Tai chi, yoga, regular physical exercise, prudent eating are not rocket science. They are readily accessible tools and methods that we can choose from or combine, and make best use of for our own good

First of all I must clarify that I do not myself practise either tai chi or that form of yoga which is popular throughout the world, that is the asanas or postures. The latter has gained more traction after the International Yoga Day was officially declared by the United Nations in 2015, sponsored by the then new Prime Minister of India Shri Narendra Modi – but it must be pointed out that even before that millions of people around the world were already practising yoga.

The question may therefore be asked why I am ‘preaching’ what I do not practise! And justifiably so, hence the reason for this preamble to put things in perspective. It’s very simple really: as a medical doctor but also as an orthopaedic surgeon having to treat conditions relating to what is known as the musculoskeletal system of the body (that is, its bones, muscles, nerves, tendons and ligaments), I am naturally interested not only in treating disease but also in preventing it and in the promotion of good health. For this purpose there are many tools and techniques, all of which I must be sufficiently knowledgeable about so as to be able to advise not only my patients but also to share with people at large so that they can also benefit.

“Tai chi is described as a gentle form of exercise that can help maintain strength, flexibility, and balance, and is based on two concepts: Qi — an energy force thought to flow through the body: tai chi is said to unblock and encourage the proper flow of qi; and Yin and Yang — opposing elements thought to make up the universe that need to be kept in harmony. Tai chi is said to promote this balance, and is often described as ‘meditation in motion,’ to which the experts – being health professionals — have added their own touch, saying it might well be called ‘medication in motion’…”

This is the spirit in which this article is therefore offered, so that people can make an informed choice for the sake of their own health and well-being. As far as I am concerned, I have chosen the pranayam and meditation aspects of yoga after initial guidance, and for the physical aspect for many years I have taken to regular exercise, which is essentially walking and that, touch wood, has kept me going well enough so far, without any major ailment to complain of. So it’s a choice that one must make on an individual basis, depending on many factors, amongst which medical advice is one. Further, both literature and instructors for yoga and tai chi are now much more available than they were decades ago when I began my medical career, when the options were thus limited, and simple walking especially with like-minded friends was a very accessible and practical option.

I was already familiar with yoga but not tai chi. My interest in the latter is directly related to a common problem in the elderly that orthopaedic surgeons deal with daily: fracture of the hip, specifically what is known as fracture of the ‘neck of the femur’. Practically all cases need surgery, which is of course costly. So costly in fact that in the US it is estimated to run into billions of dollars every year, and there is every reason to look for ways to reduce that economic burden. Besides, that fracture, even if operated, still carries a high degree of mortality and morbidity. The latter refers to the disability that results and that entails further costs in terms of caring for those affected, as they become dependent on others to a lesser or greater degree for the rest of their lives.

It so happened that a few years ago I came across an article describing a study that had been carried out by a team from Harvard, and which showed that there was a reduced incidence of falls due to loss of balance amongst the elderly who were put on a tai chi programme. It is usually such simple falls that cause a hip fracture. The reasoning was therefore straightforward: if one could reduce falls – to boot by a simple, low-cost measure – that would lead to a reduction of the incidence of hip fractures, and as a result diminish the overall burden especially the economic one, since healthcare as a percentage of GDP is the highest of the world in the US, and increasing. The approximate financial impact was estimated, and found to be significant.

Whether or not as a consequence of this and subsequent other studies tai chi has been instutionalised in the US as official health policy I am not in a position to say, but certainly more people are practising it, and not only in the US but across the world.

So what is tai chi and what are its benefits, according to these expert studies?

It is described as a gentle form of exercise that can help maintain strength, flexibility, and balance, and is based on two concepts: Qi — an energy force thought to flow through the body: tai chi is said to unblock and encourage the proper flow of qi; and Yin and Yang — opposing elements thought to make up the universe that need to be kept in harmony. Tai chi is said to promote this balance, and is often described as ‘meditation in motion,’ to which the experts – being health professionals — have added their own touch, saying it might well be called ‘medication in motion’. And they add that there is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.

They go on to say that in this low-impact, slow-motion exercise, ‘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’. Further, ‘tai chi can be easily adapted for anyone, from the most fit to people confined to wheelchairs or recovering from surgery’. Of course, it is advised, especially for those of a certain age, to check with their doctor before they start on a tai chi programme.

Much the same general reasoning applies to yoga as well, although the types of practices are different. Much more is known about yoga generally, and many rigorous and scientifically validated studies have established its benefits in a number of medical conditions ranging from backache and osteoarthritis to chronic diseases such as asthma, hypertension, diabetes, depression and symptoms associated with cancer after chemotherapy. In some cancer centers yoga now forms part of the management programme, which is referred to as ‘integrative medicine’.

This year, on the occasion of International Yoga Day, Indian Prime Minister Narendra Modi will lead with a public programme in Dehra Dun, a beautiful hill station in North India, and about 60,000 participants are expected to join in.

In the US week-long celebrations have begun, and a report in India media noted that ‘addressing the gathering, Congresswoman Carolyn Maloney, the Chief Guest for the event, said yoga is a “unique way” to approach an individual’s health and well-being. A yoga practitioner herself, Ms Maloney said she considers the ancient practice one of the best ways to exercise and relax at the same time’.

She added: ‘Practising yoga has been shown to decrease stress, fatigue, and alleviate chronic pains, as well as improving physical fitness. I know first-hand the benefits of practising yoga. It is an essential part of my life, I practise it as often as I can, and it helps me to find balance and peace’.

With our growing burden of non-communicable diseases here, caused by our unhealthy lifestyle, is it too much to ask that we start taking responsibility for our own health, a sine qua non for a better quality of life? Tai chi, yoga, regular physical exercise, prudent eating are not rocket science. On the contrary they are readily accessible tools and methods that we can choose from or combine, and make best use of for our own good – but also for the country, for if more of our people were to adopt these sound practices they would be fitter, less prone to diseases and thus reduce the burden on our services, and prevent too steep a rise in health expenditure.

Best is to start early in life, so as to prepare for a life of well-being. Will we?

* Published in print edition on 22 June 2018