Pain

Pain is your body’s alarm system. If you touch a hot stove or step on a tack, the pain you experience lets you know that something is wrong and you need to remove yourself from the situation due to the potential for harm or damage to your body. In a healthy, normal nervous system, the pain subsides shortly afterwards. However, sometimes the alarm remains on even after the threat has been removed. The sensitivity of the alarm system may also be decreased where activities and movements that used to be carried out with no pain or discomfort are now painful, in the absence of actual physical damage or injury.

Pain can originate from any situation, injury being the major cause. The pain perception in every individual is complex and is controlled by a number of variables. Recently, the concept of pain has evolved from one-dimensional to a multi-dimensional entity involving sensory, cognitive, motivational, and affective qualities. Pain is always subjective and every individual’s experience is very different. The amount of pain experienced is not related to the amount of tissue damage present (or not present). Pain can be acute, such as a cut on a finger, or it can be a component of chronic conditions such as arthritis, diabetes, cancer, multiple sclerosis, fibromyalgia, shingles, stroke, AIDS, and many other inflammatory conditions.

No matter where you feel pain in your body, it must be processed by your central nervous system- your brain and spinal cord. When you touch that hot stove or step on that tack, sensors in your hands or feet send messages about the sensation for your spinal cord and brain to process. If your brain or spinal cord determine it to be a threat, you will likely remove yourself from the situation.

The intensity of your pain is largely influenced by your mood and other psychological factors. Your brain and entire nervous system are influenced by your thoughts, your feelings, your beliefs, your memory, your experiences, and your environment.

This does not mean that pain is “all in your head.” It is a very real experience. This means that for every single person, pain is not just physical- it is psychological as well. Pain acts as a stressor on your nervous system and your mind. It causes changes in your respiratory and heart rates, increases muscle tension, constricts blood vessels, and can cause anxiety, over-focus on pain, and feelings of helplessness. Focusing on physical aspects and components of pain is only part of the solution. Other emotional, psychological, and environmental factors may also need to be addressed to help alleviate pain.

Types of Pain

There are several different types of pan, depending on the source of information. The most common types are nociceptive, neuropathic, and radicular. Each of these may be acute or chronic in nature. Neuropathic pain is pain caused by damage to nerves. It is typically described as shooting, stabbing, burning, or pins and needles. Common examples include carpal tunnel syndrome and peripheral neuropathy as seen in people with diabetes. Less common examples are Complex Regional Pain Syndrome (CRPS) and phantom limb pain after an amputation. Neuropathic pain is usually chronic but may be constant or intermittent.

PSYCHOGENIC??

Acute pain is the most common. It may last from several minutes to several weeks. If you stub your toe, the pain may last several minutes. If you sprain your wrist or ankle, the pain may last several days to several weeks. In most cases, the pain resolves with or without treatment. Acute pain may eventually evolve into chronic pain if the injury does not heal properly or if other factors are present.

Chronic pain is pain that lasts more than several weeks. It may be constant or come and go, like headaches. Chronic pain may be caused by conditions such as arthritis, fibromyalgia, migraines, etc. Chronic pain may also occur in absence of any physical injury. This will be discussed in a later section.

Qigong/Tai Chi and Pain

The practice of Qigong and Tai Chi have been shown to help those affected by pain and chronic pain syndromes. There are several mechanisms that may help to explain why.

The slow, gentle movements accompanied by the diaphragmatic breathing and mental focus avoid setting off the so-called pain “alarm.” This increases parasympathetic nervous system activity, and decreases activity of the sympathetic nervous system. The result is relaxed blood vessels and muscles, and decreased heart rate, breathing rate, and blood pressure. Exercise also releases neurotransmitters, or hormones into the blood, such as dopamine, serotonin, noradrenaline, acetylcholine, GABA, and endorphins. These are called the “feel good” hormones because they cause a feeling of contentment and well-being. Diaphragmatic breathing has also been shown to stimulate anti-inflammatory and enhanced immune system function in the body.

[Source: Rhoads CJ. Mechanism of Pain Relief through Tai Chi and Qigong. J Pain Relief, 2013: 2:115.]

TO WHOM IT MAY CONCERN

he director of the George Washington University College of Medicine argues that the brain of an elderly person is much more plastic than is commonly believed. At this age, the interaction of the right and left hemispheres of the brain becomes harmonious, which expands our creative possibilities. That is why among people over 60 you can find many personalities who have just started their creative activities.

Of course, the brain is no longer as fast as it was in youth. However, it wins in flexibility. That is why, with age, we are more likely to make the right decisions and are less exposed to negative emotions. The peak of human intellectual activity occurs at about 70 years old, when the brain begins to work at full strength.

Over time, the amount of myelin in the brain increases, a substance that facilitates the rapid passage of signals between neurons. Due to this, intellectual abilities are increased by 300% compared to the average.              

And the peak of active production of this substance falls on 60-80 years of age. Also interesting is the fact that after 60 years, a person can use 2 hemispheres at the same time. This allows you to solve much more complex problems.

Professor Monchi Uri from the University of Montreal believes that the brain of an elderly person chooses the least energy-intensive path, cutting unnecessary and leaving only the right options for solving the problem. A study was conducted in which different age groups took part. Young people were confused a lot when passing the tests, while those over 60 made the right decisions.

Now let's look at the features of the brain at the age of 60-80. They are really rosy.

FEATURES OF THE BRAIN OF AN ELDERLY PERSON.

1. The neurons of the brain do not die off, as everyone around them says. Connections between them simply disappear if a person does not engage in mental work.

2. Absent-mindedness and forgetfulness appear due to an overabundance of information. Therefore, you do not need to focus your whole life on unnecessary trifles.

3. Beginning at the age of 60, a person, when making decisions, uses not one hemisphere at the same time, like young people, but both.

4. Conclusion: if a person leads a healthy lifestyle, moves, has a feasible physical activity and has full mental activity, intellectual abilities DO NOT decrease with age, but only GROW, reaching a peak by the age of 80-90 years.

So don't be afraid of old age. Strive to develop intellectually. Learn new crafts, make music, learn to play musical instruments, paint pictures! Dance! Take an interest in life, meet and communicate with friends, make plans for the future, travel as best you can. Don't forget to go to shops, cafes, concerts. Do not lock yourself alone - it is destructive for any person. Live with the thought: all the good things are still ahead of me!

👀 Information!

A large study in the United States found that:

▪The most productive age of a person is from 60 to 70 years.

▪ The 2nd most productive human stage is the age from 70 to 80 years old;

▪ 3rd most productive stage - 50 and 60 years old.

▪ Before that, the person has not yet reached his peak.

▪The average age of the Nobel Prize laureates is 62;

▪The average age of the presidents of the 100 largest companies in the world is 63 years;

▪The average age of pastors in the 100 largest churches in the United States is 71;

▪The average age of dads is 76 years.

▪ This confirms that a person's best and most productive years are between 60 and 80 years of age.

▪This study was published by a team of doctors and psychologists in the NEW ENGLAND JOURNAL OF MEDICINE.

▪They found that at 60 you reach the peak of your emotional and mental potential, and this continues until you are 80.

▪ Therefore, if you are 60, 70 or 80 years old, you are at the best level of your life.

* SOURCE: New England Journal of Medicine *.

Pass on this information to your family and friends aged 60, 70 and 80 so that they will be proud of their age.

Qigong and Sports

When most people think of or decide to start practicing qigong or tai chi, it is usually for the tremendous health benefits they bring, whether it is for symptom management for a chronic condition, balance improvement and fall prevention, mental and emotional health, etc.

Have you ever thought about what qigong or tai chi may do for your golf game? Tennis? Running?

Qigong and tai chi are full body workouts, including physical, mental, emotional, and spiritual health. Most western style workouts may involve one or 2 of these aspects together, but usually not all. In regard to physical workouts, most western based workouts typically focus on 1 muscle, joint, or linear movement at a time. However, most functional activities including sports rely on the simultaneous and coordinated effort of multiple muscles and joints in a variety of planes at any one given time. In tennis, your body may be heading in one direction while you are attempting to hit the ball in another; at the top of the golf swing, your hips may be moving in one direction while your shoulders and upper body are still moving in another.

During the practice of qigong and tai chi, many of these same movement patterns are performed repetitively in a slow, safe, and controlled fashion, giving your body and brain time to hard-wire them. What then happens is that rather than your body tensing up when you are required to perform these movements, your body is already familiar with them, resulting in more flexible, freer, controlled motions. These repetitions over time also strengthen your nervous system and muscles, resulting in increased strength as well. Overall, this leads to improved performance and a reduced risk of injuries.

If you golf like I do, then you know there can also be a mental/stressful side to the game that is sometimes more impactful than the physical side. Time and time again, qigong and tai chi have been shown to improve stress, anxiety, and mental focus and concentration in not only people with clinical conditions, but those without them as well. These improvements can carry over into every aspect of your life, including sports or recreational activities.

Whether you are practicing qigong or tai chi for health related reasons, think of other areas in your life where they may be helping? Maybe it is golf, tennis, or running. Maybe gardening or other activities. Chances are, an activity you enjoy doing and have done for quite a long time has already experienced benefits from your practice of qigong or tai chi.

We would love to hear from you. What are some activities you feel have improved from your practice of qigong or tai chi?

Parkinson’s Disease

Parkinson’s Disease  by Dr. Joe Baumgarden DPT

Parkinson's disease is a disorder of the brain and nervous system that leads to difficulty with walking, balance, and coordination. Parkinson's symptoms usually begin gradually and get worse over time. There is currently no known cure, but there are ways to manage symptoms and slow progression of the disease. Common signs and symptoms of Parkinson’s disease include slow and rigid movements, uncontrolled tremors (typically in the fingers and hands), diminished facial expressions, and possibly soft or slurred speech.

Medications used to manage symptoms of Parkinson’s disease are typically the first line of defense. Initially, they can provide significant improvements in symptoms. However, the effectiveness and consistency of the medications typically decrease over time, leaving results very unpredictable.

Exercise is also very effective in helping to manage symptoms of Parkinson’s and resultant limitations. Exercises designed to help improve strength, flexibility, balance, and coordination are very beneficial. Fortunately, qigong and tai chi have proven to be effective in not only these areas, but other areas as well!

Qigong and tai chi have been shown to be effective for many of the motor symptoms and concerns associated with Parkinson's disease. The exercises are slow and gentle, and may also be practiced in sitting if needed due to decreased standing tolerance or balance. As tolerance and balance improve, people often move to standing and holding onto a chair or counter for support and eventually may be able to progress to no support at all.

A systematic review and meta-analysis of 15 studies found that the practice of qigong and tai chi are associated with significant improvement on most motor outcomes (speech, hand movements, posture, gait quality, tremors, coordination), balance, Timed-Up-and-Go and 6-Minute Walk Test (walking safety and efficiency), fall prevention, as well as depression and quality of life1.

Another study examined the effects of qigong on gait performance, functional mobility and sleep quality in older adults with mild to moderate Parkinson’s. One hundred people participated in the study and were randomized into 2 groups. The group performing qigong demonstrated significant improvements in sleep quality and disturbed sleep. The qigong group also demonstrated improvements in balance and walking safety and efficiency as well as increased gait speed when compared to the control group2.

Digestive Health by Dr. Joe Baumgarden DPT

Digestive Health  by Dr. Joe Baumgarden DPT

Digestive health is very important for overall health and well-being. We all know how gastrointestinal issues can make you feel, whether it is a short term stomach bug or even chronic conditions. Your body gets depleted of essential nutrients, leaving you with no energy, and you may have persistent discomfort or pain. For people with long-term conditions, this has a significant impact on quality of life. Fortunately, qigong and tai chi can help in a number of ways!

Diaphragmatic breathing plays several roles in aiding digestive health. First, it has a natural anti-inflammatory effect by stimulating the vagus nerve, which in turn triggers an anti-inflammatory cascade of events in your body. Many digestive disorders have a significant inflammatory component to them, such as Crohn’s disease, ulcerative colitis, and others. By reducing inflammation, people are able to help control their symptoms.

Another way diaphragmatic breathing helps is through the mechanical action of breathing itself. The diaphragm is a dome shaped muscle which peaks just underneath your lungs. As you inhale, the diaphragm flattens out, which gently compresses your abdominal cavity and internal organs. This up and down action gently massages your insides, helping to stimulate your organs and ensure proper circulation of blood, nutrients, and waste products.

One of the most important ways that diaphragmatic breathing aids in digestive health is through its effects on the sympathetic and parasympathetic nervous systems. When your body is in a state of stress, blood and oxygen are shifted away from your digestive organs to your limbs in preparation for “fight or flight.” When you are under a state of chronic stress, this is happening constantly, meaning your digestive organs are not getting the blood, oxygen, and nutrients they need to heal. When we practice diaphragmatic breathing, our bodies shift to a parasympathetic state, or “rest and digest,” allowing healing and recovery to take place.

In addition to the movement of the diaphragm, the actual movements of the qigong and tai chi forms also aid in providing gentle massage and stimulation to your organs. For example, in movement #11 of the 24-Posture Qigong Form (Pushing the Stone Tablet) your trunk and shoulders rotate while your hips remain stationary. This has an effect of gently “ringing out” your internal organs as if you were ringing out a wet towel.

Last, but certainly not least, qigong and tai chi have been shown to dramatically increase activity of the immune system of the body. Diseases such as celiac disease, Crohn’s disease, and lupus are auto-immune diseases which attack the gastrointestinal system of the body. Anecdotally, people who practice qigong and tai chi have reported significant improvements in symptoms and quality of life while at the same time reducing medications and other forms of medical treatment for these conditions, with the guidance of their medical practitioners.

A Goal without a Plan of Action is an Illusion.

Qigong and Modern Medicine

There is universal agreement among practitioners of Modern Medicine that regular exercise is beneficial for maintaining and restoring health. A tenet common to both Integrative Medicine and Traditional Chinese Medicine is that while an injury or chronic disorder may be identified as a local pathology, it is the whole-body including emotion that participates in healing and management. For centuries, Qigong exercise has been prescribed within traditional Chinese medical practice. 

In recent decades, its popularity as part of healthful living has spread to proponents of Integrative Western Medicine. Therefore, it was not so surprising that, authors of an article published in the Harvard Women’s Health Newsletter, May 2009, coined the apropos phase that tai chi (qigong) was Medication in Motion. The only surprise was why did it take so long for Western medical practitioners to come to this epiphany? But then again, maybe not so surprising, as modern medicine evolves from fact validated in scientific research rather than theoretical, empirical or intuitive belief. As such, modern medical practitioners are just beginning to understand what the Chinese have accepted for millennia: regular practice of qigong is a true path to health, healing and longevity. It is accessible to everyone: safe, effective, easy to learn, adaptable to level of activity tolerance, and needs no special equipment or expense. 

Over the past 20 years, scientific research studies investigating beneficial effects, physiologic pathways and actions of qigong practice have grown exponentially. While additional research is still needed to validate theoretical claims and exploratory research, and to understand mechanisms of action, there is sufficient evidence to substantiate validity. Clinical studies have found evidence of improved balance and fall prevention, cardiovascular function, motor control, postural correction, improved bone density, pain management, immune response, stress reduction, quality of sleep, sense of well-being, quality of life, and mediation of inflammatory response. This wide array of potential health benefit is explained in theory by an analysis of mode of qigong exercise such analysis reveals the multi-dimensional components of qigong exercise including mind/body, relaxation, focus, autonomic response, weight-bearing, and stretching, as well as aerobic, strengthening, proprioceptive, balance, and neuromuscular training. This multiplicity of action suggests a very broad base of therapeutic application. Further research is providing some insight into mechanism of restorative and healing action. In a year –long randomized clinical trial, Dr. Shinn-Zong Lin from the China Medical University of Taiwan reported evidence of increased t-cell production in healthy young adults practicing tai chi (Qigong exercise). This finding is notable because t-cell production is related to restorative (healing) and anti-aging processes. Two clinical trials, one from Sidney Australia and the other from UCLA, both studying clinical populations with cancer and both reported in 2014, found evidence of mediation of inflammation attributed to tai chi (qigong) practice. Results of these latter studies have implication because inflammation is known to be a precursor to many disorders including, cancer, cancer recurrence, heart disease, arthritis and autoimmune disorders. 

So given the current state of evidence, the relevant question emerges: Just how much evidence will it take to convince us that a daily investment of time performing qigong exercise should be an essential part of our healthy lifestyle? Answer: Maybe just one time – doing the 24 Posture Qigong Routine. 

Professor Emeritus Dr. Penelope J Klein, EeD, PT © 2015. 

Eastern versus Western Exercise

Sifu George and Dr. Joe Baumgarden, DPT 

Anytime you are able to exercise and move the body, you will benefit. Circulation improves, mindset improves, your muscles get stronger, and a list of other positive changes occur as well. 

However, Eastern and Western cultures view exercise differently. Much like that of their philosophical differences, Eastern exercises such as qigong or tai chi are holistic, meaning they involve every aspect of our being whereas Western style exercises are more reductionist, meaning they tend to focus on one thing or one part at a time. You need to do exercises for each individual muscle group, cardiovascular exercises, flexibility exercises, etc. 

Both styles of exercise are good for you. They both have different philosophies and ways to improve your health. It is ultimately up to you to decide which one is right for you. 

When you practice qigong or tai chi, from a physical viewpoint, your entire body is involved. Movements involve your upper body and lower body simultaneously in many cases. In this way, your body is balanced. An important aspect of this whole-body training is the effect it has on your fascia, which is tissue that is involved in every internal structure of your body from the top of your head to the tips of your toes, including your organs. It aids in structure, movement, circulation, and a host of other functions. Anything that impacts fascia in one part of your body ultimately impacts it everywhere. By practicing qigong and tai chi, your fascia is gently stimulated and stretched throughout your body, improving its pliability and keeping it healthy. This will not give you the defined physique as strength training would, but you will be balanced overall. From a cardiovascular exercise viewpoint, it may not seem like much but studies have shown that practicing qigong or tai chi can help improve blood pressure, heart rate, cholesterol levels, and many other heart health variables. These practices use slightly more energy than brisk walking and nearly as much as riding a bicycle at a comfortable speed. 

Western exercise on the other hand is much different. There are a number of different exercise programs and methods available, each with a different focus. One may choose to focus exclusively on a certain type of exercise such as strength training, flexibility training, cardiovascular exercises, or they may perform a number of combinations of the three. There are also many programs which commercialize the various types of exercise available. When doing strength training, you typically focus on one part of the body or muscle group at a time, such as bicep curls or bench press (which involves a few muscle groups). In some cases, this can lead to an imbalance and an over development of some muscle groups and if neglected, atrophy of those areas. If lack of balanced exercise continues, this may lead to pain, degenerative changes, and increased stiffness in the body. 

Another major difference is breathing. Eastern exercise emphasizes focusing on the breath. Slow, deep, diaphragmatic breathing can lead to a number of health benefits due to its effect on the parasympathetic nervous system. Breath training is not really emphasized in Western 

exercise. When it is, the pace and timing of breathing, or when to exhale during a movement and when to inhale- not necessarily whether it is slow, deep, diaphragmatic breathing or not- is usually the focus. During or after Western types of exercise, you may see people become very short of breath because they hold their breath or do not breathe properly. People even pass out from heavy exertion and not breathing properly. However, with proper training, people can increase their cardiovascular health, endurance, and stamina so they may participate in very intense activities such as marathons, various sports, or other desired events. 

One of the tendencies of Western exercise is to also favor aesthetics, or someone's physical appearance. Bodybuilders and fitness enthusiasts perform certain exercises to help transform their body into what they desire. The result may be enormous, well-defined muscles, a very slim physique, or anything in between. 

Qigong for the Prevention, Treatment, and Rehabilitation of COVID-19 Infection in Older Adults

The outbreak of coronavirus disease 2019 (COVID-19), that was first reported by local health facilities in Wuhan, China, in December 2019, has rapidly spread throughout the world. Older people and patients with existing medical conditions are prone to have severe complications associated with Covid-19 infection. 1

Clinical practitioners and researchers are working to find effective treatments for COVID-19, and complementary and alternative medicine may be a feasible and valuable option. In China, Traditional Chinese medicine (TCM) and Qigong have played important roles in the battle aga#inst this disease. The Chinese herbs Qingfei Paidu decoction have been recommended by the National Health Commission of China as a treatment for COVID-19 infected patients with mild to moderate symptoms.2# For COVID-19 infected patients with severe respiratory symptoms, the herbs were used in combination with Western medicine. In the Wuhan Fangcang Hospitals, field hospitals for the isolation of mild cases instead of home quarantine, patients practiced Ba Duan Jin Qigong under the guidance of TCM doctors for treatment and exercise.3 This review discusses the application of Qigong in older people for the prevention, treatment, and rehabilitation of respiratory infectious diseases, including COVID-19.

Go to:

Methods

Studies for inclusion were identified by querying Pubmed, the China national knowledge infrastructure, the China Science and Technology Journal Database, and Wanfang data. The main mechanisms for the occurrence and development of COVID-19 are immunosuppression and cytokine storm.4 COVID-19 patients with severe symptoms may develop respiratory impairment and need rehabilitation, including respiratory muscle training, whole-body movement and psychological rehabilitation.5 We searched in the above databases using terms to address the potential mechanism of Qigong in the prevention, treatment and rehabilitation of COVID-19, including “immune function”, “inflammation”, “cytokine”, “respiratory muscle”, “stress”, “mood” and “emotion”, combined with terms which address different types of Qigong: “Qigong”, “Qi Gong”, “Tai-Chi”, “Tai Chi”, “Taichi”, “Taiji”, “Yi Jin Jing”, “Yijinjing”, “Wu Qin Xi”, “Wuqinxi”, “Liu Zi Jue”, “Liuzijue”, “Ba Duan Jin”, “Baduanjin”, as well as “abdominal breathing” and “abdominal respiration”. Given that clinical studies on the intervention of Qigong for COVID-19 are limited, we used the terms “respiratory infection” and “respiratory rehabilitation”, combined with terms mentioned above to search for clinical evidence about the application of Qigong in the treatment and rehabilitation of respiratory infection. The abstract and the full text of each article were reviewed and included if it identified as clinical research or as a clinical systematic review published in English or Chinese.

Understanding Qi and Qigong

"Qigong" is composed of two Chinese characters “Qi” and “Gong”. "Qi" refers to the energy that motivates human life activities, and "Gong" refers to the regulation of Qi through practice.

The concept of Qi in TCM is very broad, and it is involved in nearly all physiological and pathological processes.6 According to its different functions, Qi can be divided into different types, for example defensive Wei Qi, and the organ Qi that regulates the function of each organ. The channels through which Qi moves in the body are called meridians, which are distributed on the surface of the limbs and trunk and extend to the inside organs.

Qigong is a mind-body training skill that can regulate body, breath and mind under the guidance of theory of TCM to guide Qi operation in the meridian, to regulate physical function, and to prevent and treat diseases.7 Qigong regulates the body through an adjustment of body movement and posture. Qigong's body regulation is aimed at relaxation, so the movements are typically gentle and smooth. Regulation of breath involves changes in respiratory movement, rhythm, and pattern. Breath in Qigong needs to be slow, long, and deep. Sometimes changes in breath pattern are also required, such as abdominal breathing, and breathing with phonation, both of which are typical patterns of Qigong respiration. Abdominal breathing refers to a breathing pattern with obvious abdomen movement, and breathing with phonation is a combination of breath and the production of speech sounds. Regulation of mind includes focusing attention and visualization. Most operations of mind regulation are similar to meditation, therefore Qigong is also considered a meditative movement.8

Qigong originated in the primeval time of China as a means of self-care. According to the first historical record in China “Shang Shu”, 4000 years ago, ancient Chinese people found that stretching and dancing could release pain. This is the rudiment of Qigong. Almost all religions and philosophical schools, such as Taoism, Buddhism, Traditional Chinese medicine, and martial arts, have elements of Qigong practice methods, with different appellations. In the 1950s, experts and scholars reached a consensus and coined this methodology "Qigong", and the first Qigong institute was established in China in 1954.

Many studies on Qigong have been carried out through modern research methods, including the observation of physiological and psychological changes during or after Qigong practice, along with clinical trials of treating various diseases with Qigong. Qigong is particularly appropriate for older people due to its gentle and smooth movements, and there are wide applications of Qigong in geriatric medicine,9 including in the treatment of musculoskeletal disorders, pain relief, and muscle strengthening. As a mind-body skill, Qigong has been found to impact internal and psychosomatic diseases, such as asthma, hypertension, peptic ulcers and diabetes. Qigong is also used as a meditative movement for treating geriatric mental conditions including mood disorders and cognitive impairment.10 , 11

Classification of Qigong

According to different operations, Qigong techniques can be divided into two groups: dynamic or active Qigong, and passive or meditative Qigong. Dynamic Qigong refers to those techniques that primarily focus on body movements and involve more movements of the whole body or limbs. Tai-chi, Yi Jin Jing (Muscle Change Classic), Wu Qin Xi (Five-animal Exercise), Liu Zi Jue (Six-Healing Sounds), and Ba Duan Jin (The Eight Brocades) are examples of dynamic Qigong that have gained worldwide popularity. Contrastingly, passive Qigong techniques have almost no body movement, but require maintaining a certain posture and carrying out exercises mainly involving the breath and mind.

Dynamic Qigong is more successful than passive Qigong with regards to physical regulation, therefore it can be more effective in treating musculoskeletal and psychosomatic disease. Practitioners who have difficulty focusing their attention can concentrate on movements and actions in dynamic Qigong, which is an easier skill to master. Passive Qigong pays more attention to mind regulation. Attention training is an important and common technique of mind regulation that asks practitioners to focus attention on an object or on the present, which is similar to mindfulness meditation. According to theory of TCM, through extensive practice of focusing attention, practitioners can enter a state of tranquility. Passive Qigong has few requirements for physical strength, as it can be practiced in any posture without movement. In addition, for those with impaired body movement ability, passive Qigong is a better choice than dynamic Qigong. A study on mindfulness, conducted by Lacaille et al.,12 indicated that prolonged mindfulness practice was associated with an increase in mindful responding, which was in turn associated with increased positive affect and with less perceived stress and negative affect. Thus, those who engage in extensive practice of passive Qigong may be likely to experience better psychological outcomes.

How Qigong Can Treat Respiratory Infective Disease Utilizing TCM Theories

Respiratory infectious diseases belong to the category of external pathogens diseases in TCM. Its pathogenesis is that external pathogens invade the human body and produce tension in the balance between “good and evil”. The “evil” refers to exogenous pathogens, which can be considered similar to the pathogen of infection. “Good” refers to the defensive function of the human body. When exogenous pathogens invade the human body, defensive Wei Qi fights against them. It can be considered that Wei Qi represents immune function from the perspective of modern medicine. The relationship between Wei Qi and exogenous pathogens determines whether the disease will develop and the prognosis of the disease. If Wei Qi is strong enough to defend against the exogenous pathogen, the disease would not occur, or would be easier to heal, and the prognosis would be good.

Because of a decline in organ function and an increase in chronic medical conditions, older people are considered to be in a state of weakness or insufficient energy, conceptualized as Qi and blood deficiency in TCM. Wei Qi is thought of as being scarce in the elderly. Therefore, according to theories of TCM, when encountering infectious diseases such as COVID-19, the elderly are more likely to be affected, and infections are more likely develop into severe diseases with poor prognoses. Given that Qigong regulates the function of Qi in the human body, in which Wei Qi is included, it may prevent respiratory infection or promote recovery from respiratory infection in the elderly.

Potential Mechanisms of Qigong in Respiratory Infectious Diseases

Outbreaks and illness are a source of stress, and stress reactions or emotional problems can occur in hospital inpatients, people in isolation, and those in the general population. Benson et al.13 observed physiological changes during meditation, and found that meditation can counteract stress response. Benson coined the physiological change elicited by meditation a “relaxation response”. As a meditative movement, Qigong has been studied as a tool for stress management. Ryu et al.14 observed changes in stress hormones during Qigong practice, and found that beta-endorphins increased in the middle of training while levels of adreno-cortico-tropic-hormone declined mid and post-practice suggesting decreased stress levels. It has been suggested that Qigong regulates emotion through enhancing nonreactivity to aversive thoughts and impulses by focusing attention, regulating the hypothalamus-pituitary-adrenal axis reactivity and the balance of the autonomic nervous system, and through changing the function of the brain, limbic system, and expression of genes linked to inflammatory responses and stress-related pathways.15 In a meta-analysis on treating chronic obstructive pulmonary disease (COPD) with Qigong, Wu et al.16 reported that Qigong alleviated depression and anxiety among patients with COPD. Meanwhile, during the Severe Acute Respiratory Syndrome outbreak, practicing Qigong was found to strengthen individuals’ sense of control, and taking part in a practicing group improved their senses of social support.17 , 18

Qigong can enhance physical strength through the training of specific muscle groups. Liu et al.19 found through measuring grip strength, jumping height, and toe contact test in older people that Qigong can increase muscle strength. With regards to respiratory muscles, studies in stroke patients found that the myoelectricity and activity of the diaphragm increased after a 3-month abdominal respiration training when compared with thoracic breathing.20 In COPD patients, Wu et al.21 observed improvement of respiratory muscle strength after 3-month Liu Zi Jue practice.

Qigong can reduce both inflammatory factors and inflammatory response. Irwin et al.22 examined the cytokines in older adults who had participated in a 6-month Tai-Chi program, and found reductions in levels of IL-6 in subjects in the intervention group who previously showed high levels of this inflammatory marker. In another study, Irwin et al.23 found that in older adults with insomnia, Tai-Chi reduced proinflammatory gene expression and marginally reduced C-reactive protein by the end of the 4-month practice, and reduced monocyte production of proinflammatory cytokines at the end of the program and at the follow-up after 7 and 16 months, when compared to the control group. Additionally, a 12-week program of Tai-Chi has been found to increase levels of the anti-inflammatory cytokine IL-10 in middle-aged adults.24 Chen et al.25 found that in COPD patients, 60-day Liu Zi Jue practice lowered the level of IL-4,IL-13 and IL-17, and increased the level of IL-10 when compared to a regular treatment control group.

Qigong's enhancement of immune function has manifested in both non-specific immune response and specific immune response. Regarding non-specific immune response, Qigong can increase the amount or activity of immune cells in the body. Yeh et al.24 found that in middle-aged healthy people, after a 12-week program of Tai-Chi practice, there was a significant increase in the ratio of T helper to suppressor cells(CD4/CD8), CD4CD25 regulatory T cells, and the production of the regulatory T cell mediators transforming growth factor β. Qiu et al.26 studied a sample of elderly people using Ba Duan Jin and found CD4, CD4/CD8 and NK cell percentage increased after a 24-week program when compared to a control group who received health education without exercise. Yu et al.27 observed the effect of Wu Qin Xi on NK-cell activity in elderly adults tested by lactate dehydrogenase release assay, and found that the activities of NK cells increased after practicing for half a year when compared with a blank control group. Study results indicated that Wu Qin Xi is a moderate intensity exercise for older people. According to Nieman,28 moderate exercise can lower the risk of respiratory tract infection, and heavy exercise can increase the risk of infection.

The effect of Qigong on specific immune response can be observed in the increase of immune cells and immunoglobulin. Chiang et al.29 selected 20 sedentary males as subjects, and found that Tai-Chi increased the number of circulating myeloid dendritic cells when compared with a blank control group, but that plasmacytoid dendritic cells remained the same in both groups. The degree of growth in myeloid dendritic cell significantly increased with the years of practice. Vera et al.30 examined the acute effect of Qigong on adults who participated in a 1-month-Taoist Qigong program. The researchers took blood samples the day before the experiment commenced and 1 hour after the last session of the training program ended, and found higher values in the number and the percentage of B lymphocytes, as compared with a control group that did not engage in the practice. Niu31 investigated the effect of Tai-Chi on middle-aged participants and observed that blood IgA, IgG and IgM levels increased significantly in the Tai-Chi exercise group with increasing exercise time.

The promotion of Qigong in the specific immune response has also been reflected in the level of antibodies after vaccination. In Irwin's study,32 participants took part in Tai-Chi or health education for 25 weeks, and after 16 weeks of intervention, subjects were vaccinated with Varivax. They found the Tai-Chi group showed higher levels of cell-mediated immunity to VZV than the health education group. In Yang's study33, older adults practiced Tai-Chi and Qigong for 5 months and then received the influenza vaccine during the first week of the intervention. Improvement of the magnitude and duration of the antibody response to influenza vaccine were observed when compared to the control group.

Clinical Evidence on Qigong in Respiratory Infectious Diseases

Some studies have demonstrated the effectiveness of Qigong in preventing respiratory infectious diseases. Hu et al.34 selected elderly men as experimental subjects and randomly divided participants into either a Qigong intervention group or a control group who performed jogging. Compared with the control group, the experimental group experienced significantly fewer respiratory tract infections after Qigong exercise for two years, and the difference between the two groups increased with exercise time. Wright et al.35 found that in swimmers who practiced Qigong at least once per week, cold and flu symptoms showed a significant non-linear association with frequency of Qigong practice, with a strong, inverse relationship between practice frequency and symptom scores.

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  Use of Qigong in Treating Respiratory Infectious Diseases

There are few studies on the intervention of Qigong in the acute phase of respiratory infection, but according to limited research results Qigong can be found to shorten the course of infection. In Ties’ study,36 90 female healthy students were separated into three groups; a control group, a three times a week movement group, and a five times a week movement group, after a six-month Tai-Chi training. In the two Tai-Chi groups, the levels of IgA and IgG became higher, as compared with the control group. There was no difference in the frequency of respiratory tract infection in the three groups, however the duration of each onset became shorter in the Tai-Chi group.

Severe respiratory infections can cause reduced respiratory function and require rehabilitation. Although research on the application of Qigong in the rehabilitation of respiratory infections is limited, researchers have shown that Qigong can promote the rehabilitation of other respiratory diseases which cause impaired respiratory function. Tong's meta-analysis37 on 10 studies examined 993 participants who were in the stable stage of COPD infection. Results indicated that Qigong can improve lung function in COPD patients, including forced expiratory volume in 1s (FEV1), forced vital capacity rate of 1s (FEV1/FVC), and forced expiratory volume in 1s/predicted (FEV1/pre). Additionally, results showed that it can improve exercise capacity, Functional Task Evaluation, COPD Assessment Test for exercise, and increase the score of Short Form-36 Health Quality Survey, which indicates improvement in quality of life. The researchers analyzed the function of Ba Duan Jin, Yi Jin Jing and Liu Zi Jue respectively, and found the first two resulted in significant improvement, and that Liu Zi Jue did not have significant effect. However, other studies have shown Liu Zi Jue to be effective in the rehabilitation of COPD patients. A study by Li et al.38 indicated that COPD patients’ lung function (FEV1/pred, FEV1/FVC) improved significantly with Liu Zi Jue practice, as did the 6-minute walking test, 30-second sit-to-stand test, and St George's Respiratory Questionnaire score. Chen39 observed that in chronic bronchitis patients who practiced Ba Duan Jin, hospital stays decreased, and lung function (FEV1/FVC) and arterial blood gas analysis (PaO2, PaCO2) improved when compared with the control group who received regular treatment.

How to Learn and Practice Qigong

Some simple Qigong can be learned independently through watching Qigong videos. Before learning Qigong, consulting with doctors is necessary for safety reasons. Learners can begin with physical movements of the forms. After practitioners acquire the sequences of both isometric and isotonic segmental movements in upper and lower extremities, they can try to combine breathing techniques and focus their attention on movement, breath and Qi.

Tips for Practice

Practice environment: Qigong can be practiced both indoors and outdoors, though indoor practice is more appropriate during an epidemic of infectious disease. The practice environment should be clean and quiet for breathing exercises and concentration. Practice space needs to be chosen according to the type of Qigong being practiced. For patients with fall risks, an instructor who is experienced in working with elderly people may be necessary.

Practice time: Qigong practicing needs to be persistent. Fixed time can help in forming a habit. Being either too hungry or too full is not suitable for practice.

Intensity: Attention needs to be paid to personal condition at each practice, on which intensity should depend. As mentioned above, moderate exercise is the best option for respiratory infection patients. However, what can be considered moderate exercise differs between individuals, thus the increase in heart rate can be a indicator of intensity. Increasing heart rate by 60%-80% is recommended.

Recommending Forms of Qigong

Considering the physiological characteristics of the elderly, the pathological features of respiratory diseases, and the psychosocial factors in the face of the COVID-19 epidemic, we recommend Ba Duan Jin, Liu Zi Jue, and abdominal breathing. According to the research results mentioned above, these three kinds of Qigong are often used in the prevention and treatment of respiratory infections, for the movement is smooth with low intensity, and easy to learn. In addition, the range of these three Qigong movements is small, and the space requirements are not significant. Thus, they are suitable for home practice during the current epidemic.

Abdominal breathing can be found in a variety of mind-body exercises, including yoga, meditation, and Qigong. The technique is very straight forward: consciously move your stomach when inhaling, tightening your stomach muscles, and let them fall inward as you exhale, while focusing attention on breathing. Do not hold your breath.

Abdominal breathing can enhance respiratory function, and create a relaxation response. Abdominal breathing has been found to stimulate the vagus nerve,40 which can regulate breathing and help with relaxation. Focusing attention on breath is one of the simplest ways to achieve emotional regulation and to decrease anxiety-related dysfunctional thoughts about the pandemic. Abdominal breathing requires the least amount of exercise of the three Qigong exercises recommended, and can be practiced standing, sitting, or lying on the back so that it can meet the needs of practitioners with poor physical conditions or more serious illness. Since abdominal breathing can be practiced anytime, anywhere, and in most physical conditions, it is a highly recommended method for coping with COVID-19 related stress.

Ba Duan Jin exercise consists of eight separate, delicate, and smooth exercise movements, to achieve self-psychosomatic regulation and enhance function. Since Ba Duan Jin exercises emphasize body and Qi, slow body movements along with musculoskeletal stretching should be combined with physical relaxation, deep breathing, and mental concentration41. Movements of the whole body can enhance physical well-being. According to TCM theory, stretching the upper limbs, where the lung meridians are, can facilitate Qi moving in the respiratory organs and thereby promote recovery from respiratory symptoms. Deep, rhythmic breathing along with slow bodily movements accompanied by mental focusing frequently leads to a state of meditation, which can produce a relaxation response and stress reduction. We recommend using Ba Duan Jin for the prevention of COVID-19 and treatment of respiratory symptoms if infected, as well as for the management of stress derived from the pandemic.

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  Liu Zi Jue

Liu Zi Jue combines abdominal breathing and pursed lip breathing with uttering six different sounds, along with corresponding mild-body movements and a calm state of mind. This exercise is easy to learn and can be performed in any position including standing (preferred), sitting, or lying down, since the exercise mainly involves mild upper-body movements.42

The type of respiratory pattern of pursed lip breathing performed by expiration to produce six different sounds (xu, he, hu, si, chui, and xi) is similar to the pursed-lips breathing in rehabilitation training for COPD patients43. It can modify rapid shallow breathing patterns and retard the expiratory flow rate. Additionally, the different sounds can produce vibrations with different frequencies, which is commonly used in neurorehabilitation44 and tension relaxation45. Research indicates that Liu Zi Jue might help tissue and organs in respiratory recovery through these vibrations. Liu Zi Jue is a good choice for people seeking to recuperate from respiratory dysfunction and sequela of COVID-19 infection.

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Conclusions

The available biological and psychological evidence suggest Qigong may be potentially useful for the prevention, treatment, and rehabilitation of respiratory infections, including COVID-19. The elderly, in particular, could benefit from Qigong during the ongoing pandemic, for it is easy to practice. Future studies are needed to confirm the effectiveness of Qigong in this context and to provide more evidence on this topic.

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Author contributions

Albert Yeung, MD, ScD: Design of the work; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Fan Feng, MD, PhD: Literature searching; Preparation of the manuscript

Sylvie Tuchman, BA: Preparation of the manuscript

John W. Denninger, MD, PhD: Preparation of the manuscript

Gregory L. Fricchione, MD: Preparation of the manuscript

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DISCLOSURE

Declaration of Interest: Dr. Denninger reports non-financial support from Basis/Intel, grants from Onyx/Amgen. His declared interests are not related to the submitted work. The other authors report no conflicts with any product mentioned or concept discussed in this article. The authors alone are responsible for the content and writing of this article.

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Footnotes

Acknowledgments: No funding sources were used in preparation of this review.

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Emotions

 Prolonged negative emotions may lead to a host of problems for people, including phobias and anxiety disorders, depression, and a number of stress-related physical disorders [Fredrickson]. 

Depression has been shown to be an independent risk factor for falls [Stalenhoef]. It is associated with a characteristic pattern of cognitive deficits, affecting mainly attention, executive function, and processing speed. In older adults, walking becomes more of a cognitive task and less automatic. They need to allocate greater attention to walking to compensate for changes in their sensory and motor function. When walking with distractions, depressive symptoms and deficits in executive function are associated with increased unsteadiness [Hausdorff 2008]. People with depression have also been shown to demonstrate an altered gait pattern characterized by reduced walking speeds, vertical head movements, and arm swinging, shorter stride length, longer standing phase, and increased gait variability [Michalak; Hausdorff 2004]. These gait features have been shown to be linked to an increase risk of falling [Hausdorff 2001; Maki]. People with increased sadness and depression also display larger lateral swaying movements of the upper body and a more slumped posture, which may displace the center of gravity and make someone more prone to balance problems and falls. 

Fear and anxiety have also been linked to an increase risk for falls [Lavedán; Hallford]. A healthy fear of falling may make someone more cautious and aware of their environment and surroundings. Most studies report a prevalence of a fear of falling at 25-50% in community-dwelling seniors. However, approximately half of those who are fearful develop an unreasonable or extreme fear of falling and will begin to withdraw or avoid activities such as socialization, hobbies or recreational activities, or leaving their home altogether [Murphy]. An unreasonable fear of falling is also a risk factor for future falls [Lavedán]. Older adults who are fearful of falling also walk with abnormal characteristics, which may in fact increase their risk for falling [Menz]. They tend to walk more slowly, take shorter strides, have a wider base, and have a longer double limb support time and increased variation in their gait [Chamberlin]. Many often walk with slumped posture and their head looking down, which may displace their center of gravity and also limit their ability to observe potential obstacles in their environment. When attempting to make postural corrections for balance, they often make disproportionate adjustments and display increased stiffness [Delbaere; Nagai]. Similar gait characteristics have been observed in those with increased anxiety [Pluess; Richards]. It has been shown that older adults may have an increased risk for a fall with a serious injury, including hip fractures, for up to one hour after a perceived stressful event (anger, worry, sadness, anxiety, fear) [Stalenhoef]. 

The practices of tai chi and qigong have been shown to have positive effects on emotional well-being in both young and old adults [Zhang]. It has been suggested that these practices reduce negative emotions by enhancing attentional control, improving emotion regulation and altering self-awareness during the meditative movements [Tang]. Tai chi and qigong have been shown to induce physical changes and enhanced functional connectivity in various regions of the brain among practitioners [Wei; Tao]. These physical changes and improved connections have coincided with improvements in mood or emotional states. 

Meditation which is an integral part of tai chi and qigong has been reported to improve symptoms of depression and anxiety through the modulation of functional connectivity between the dorsal anterior cingulate cortex and insular cortex [Yang]. The medial prefrontal cortex has been linked to increasing our attention to positive, pleasant emotions and suppressing negative emotions such as sadness or depression [Critchley]. Along with the anterior cingulate cortex, the medial prefrontal cortex is also involved in emotional processing, namely in fear and anxiety. They both also work together to process fear memory and emotional conflict [Etkin]. Additionally, connections between the medial prefrontal cortex and bilateral hippocampus have been shown to be increased in tai chi practitioners [Tao]. As stated earlier, the medial prefrontal cortex is involved in the regulation of memory, while hippocampus is involved in regulation of both memory and emotion. This enhanced connection may improve emotional processing by linking up the current emotion with previous events [Yu]. 

The thalamus, ventral hippocampus, and right inferior segment of the circular sulcus of insula were shown to have larger gray matter volume in those who practiced tai chi compared to those who did not. This increase in size also correlated to significant improvements in emotional processing and stability, and these areas have also been linked to modulating anxiety. [Liu; Wei]. Another part of the brain, the amygdala, has also demonstrated changes in structure and connectivity after meditation practices. The amygdala has a crucial role in regulating stress and associated responses. Under stressful conditions, the amygdala has demonstrated increased functional activity with various regions of the brain [Hölzel]. However, after mindful meditation, research has shown that not only does the volume of the amygdala decrease, but the activity of the amygdala decreases as well, which has correlated to decreased reports of stress and anxiety in individuals [Taren]. 

Studies of tai chi practitioners also reveal increased gray matter density in the right insula compared to that of members of a control group. The insula is believed to be responsible for integrating internal and external information and for forming a global perception of how the self feels, or interoception [Craig]. It is also believed to generate emotionally relevant contexts, such as emotional pain, happiness and sadness [Critchley]. Many psychological disorders such as depression and anxiety involve problems with the perception of the body and the emotions produced by various interoceptive signals [Paulus]. These problems may be related to structural 

declines/atrophy in the insula [Soriano-Mas]. The resultant increase in gray matter of the insula in tai chi practitioners may also help to explain the alleviation of symptoms, and experience of peacefulness and relaxation during tai chi practice [Wei]. 

Overall, the improvements in gray matter density and improved functional connections among these regions of the brain may help explain the improvement in emotions and mood related symptoms among tai chi and qigong practitioners, thus decreasing significant risk factors for falls in the elderly. 

Qigong and Modern Medicine

 There is universal agreement among practitioners of Modern Medicine that regular exercise is beneficial for maintaining and restoring health. A tenet common to both Integrative Medicine and Traditional Chinese Medicine is that while an injury or chronic disorder may be identified as a local pathology, it is the whole-body including emotion that participates in healing and management. For centuries, Qigong exercise has been prescribed within traditional Chinese medical practice. 

In recent decades, its popularity as part of healthful living has spread to proponents of Integrative Western Medicine. Therefore, it was not so surprising that, authors of an article published in the Harvard Women’s Health Newsletter, May 2009, coined the apropos phase that tai chi (qigong) was Medication in Motion. The only surprise was why did it take so long for Western medical practitioners to come to this epiphany? But then again, maybe not so surprising, as modern medicine evolves from fact validated in scientific research rather than theoretical, empirical or intuitive belief. As such, modern medical practitioners are just beginning to understand what the Chinese have accepted for millennia: regular practice of qigong is a true path to health, healing and longevity. It is accessible to everyone: safe, effective, easy to learn, adaptable to level of activity tolerance, and needs no special equipment or expense. 

Over the past 20 years, scientific research studies investigating beneficial effects, physiologic pathways and actions of qigong practice have grown exponentially. While additional research is still needed to validate theoretical claims and exploratory research, and to understand mechanisms of action, there is sufficient evidence to substantiate validity. Clinical studies have found evidence of improved balance and fall prevention, cardiovascular function, motor control, postural correction, improved bone density, pain management, immune response, stress reduction, quality of sleep, sense of well-being, quality of life, and mediation of inflammatory response. This wide array of potential health benefit is explained in theory by an analysis of mode of qigong exercise such analysis reveals the multi-dimensional components of qigong exercise including mind/body, relaxation, focus, autonomic response, weight-bearing, and stretching, as well as aerobic, strengthening, proprioceptive, balance, and neuromuscular training. This multiplicity of action suggests a very broad base of therapeutic application. Further research is providing some insight into mechanism of restorative and healing action. In a year –long randomized clinical trial, Dr. Shinn-Zong Lin from the China Medical University of Taiwan reported evidence of increased t-cell production in healthy young adults practicing tai chi (Qigong exercise). This finding is notable because t-cell production is related to restorative (healing) and anti-aging processes. Two clinical trials, one from Sidney Australia and the other from UCLA, both studying clinical populations with cancer and both reported in 2014, found evidence of mediation of inflammation attributed to tai chi (qigong) practice. Results of these latter studies have implication because inflammation is known to be a precursor to many disorders including, cancer, cancer recurrence, heart disease, arthritis and autoimmune disorders. 

So given the current state of evidence, the relevant question emerges: Just how much evidence will it take to convince us that a daily investment of time performing qigong exercise should be an essential part of our healthy lifestyle? Answer: Maybe just one time – doing the 24 Posture Qigong Routine. 

Professor Emeritus Dr. Penelope J Klein, EeD, PT © 2015. 

Bone Washing

“Bone Washing” has been around for thousands of years. The ancient Chinese people believed it would remove the body of waste and toxins, and help stimulate the flow of qi and blood throughout the body.

Modern science has proven this to be true, and has shown additional benefits as well. Studies have shown that depending on the area you are tapping, you are helping to facilitate lymphatic drainage and circulation of important nutrients throughout the body. Dr. Roger Callahan performed a study on war veterans in 2013 and found that these techniques were very effective in treating pain, anxiety, and other symptoms associated with PTSD. As a massage technique, it is effective at relieving any stress or muscle tension built up in the body. The vibration from the tapping also stimulates acupressure points in the body, so it may be used on selected points to obtain desired benefits.

Bone washing is simple, easy and only takes a few minutes a day but the benefits are significant. You simply tap gently feeling a vibration in the area you are tapping. Start with the arms, progress to the hips then both sides of the lumbar vertebrae not on it. Move down to the thigh and calf muscles. Tap a half dozen times on each area. This also helps produce healthy red and white blood cells.

Chronic Pain

Pain is a very individualized experience. You can not see it. You can not objectively measure it. But it is very real. Two people may have a similar condition- one of them may be able to manage with minimal to no pain medication and the other may require significantly higher and/or stronger doses. Why? What makes them different?

There is much more to understand about pain than what is able to be written in these few simple paragraphs. There have been volumes of books and extensive research performed and we still do not know all of the answers. However, there have been some significant advances in the past few years. In an effort to help clinicians and researchers better understand and treat pain, attempts have been made to classify pain and results thus far have been promising. Depending on the source, there are several major classifications of pain. However, these classifications may not be completely independent of each other and may overlap. The following list is also not all inclusive. It includes pain classifications that are more likely to be chronic in nature.

The first classification is central sensitization. In this instance, the body’s nervous system is over excited and the person may experience significant pain, even after their injury or condition is healed. The person’s sensitivity threshold for pain may also be lowered, so that they may experience pain with much less of a causative factor. Something like a sheet touching their foot or even a small, insignificant bump into something may send their reports of pain sky-rocketing. It is like the fire department being called to put out a single match. There are several conditions which have been linked to an increased incidence of central sensitivity. They include depression, fear-avoidance, anxiety, poor sleep, and other stressors. These conditions often over-excite the nervous system, which is believed to be how they are linked.

Inflammatory pain is just as it sounds- pain from an acute or chronic inflammatory condition, an infection, or an auto-immune response. This could be something like an acute sprain or strain of your ankle that turns red and starts to swell or an insect bite. Under these conditions, an inflammatory response turns on to help pain and other signs/symptoms resolve within a few days, possibly with or without additional treatment. However, some conditions may be more long lasting. In some of these conditions, the inflammatory response may fail to “turn off.” In this case, the body’s defense systems may start to attack its own healthy tissues, mistaking them for being damaged. Common examples are rheumatoid arthritis, lupus, celiac disease, diabetes type I, and Multiple Sclerosis. As with central sensitization, increased activity of the nervous system (sympathetic nervous system) may contribute to increased symptoms. Two of the most common ways to manage inflammatory pain are managing your stress and gentle exercise. Qigong anyone?

The affective pain classification pertains to conditions where a person’s emotional status may influence their reports of pain or discomfort. Common examples of people in this type of classification often report increased symptoms when at a job they do not like, when in a toxic relationship, or when in some other stressful situation. These may include severe headaches, low back pain, upper neck, shoulder, and back pain and tension, etc. Once they are removed from the stressful environment, their symptoms may drastically decrease or even cease, until they return to their stressor. Oftentimes, journaling about their experience may help to identify stressors and help to alleviate symptoms. As with central sensitivity, depression, fear- avoidance, anxiety, poor sleep, and other stressors may exacerbate this condition.

Motor autonomic pain may be one of the least understood classifications of pain. Conditions which fall into this category include Complex Regional Pain Syndrome (CRPS) and Phantom Pain or Phantom Sensations, which may typically be experienced by a person with an amputation. In this situation, a person may experience a wide variety of symptoms including pain, hypersensitivity, spasm, vascular changes, and skin changes. The cause of CRPS is not completely understood. Some people develop this condition after sustaining a fairly benign sprain/strain where most others do not. In some instances, the condition may inexplicably spread to the opposite limb. In patients with Phantom Pain or Phantom Sensations, they report pain or other symptoms such as itching in a body part that has been amputated. For example, someone may have their right leg amputated below their knee but still report pain or itching in their toes or ankle. Much of the research into this classification of pain pertains to how the brain perceives the affected area. There are certain areas of your brain responsible for sensation and motor responses of each body part. It is believed that these areas become disrupted and somehow no longer recognize the affected area of your body. Through gradual retraining which involves distinguishing the right and left sides of your body, your brain is “reprogrammed” to recognize the body part, and symptoms may improve. Qigong may help to alleviate symptoms and “retrain your brain” because many of the movements are performed on both sides of the body. In addition, you often cross the imaginary midline of your body, bringing one hand or leg to the opposite side. This has been shown to increase blood flow in the brain and strengthen neural connections. All of this is combined with diaphragmatic breathing which tones down the sympathetic nervous system and increases activity in the parasympathetic nervous system, which is required for health and healing.

The last classification to be discussed is neurogenic pain. This is pain caused by dysfunction of a nerve. Common examples include neuropathy such as that experienced by people with diabetes or as a side effect of chemo or radiation treatments, nerve entrapments such as carpal tunnel syndrome, or nerve compression from a herniated disc. In the case of nerve compression, treatment is aimed at relieving the source of the pressure and restoring normal, pain-free motion. For neuropathy caused by diabetes or as a side effect of treatment, symptoms are typically treated by medications and balance and proprioception exercises, as these conditions often target the feet and legs more than the arms and hands. Qigong has been shown to be very powerful at improving neuropathic pain, and also improving balance, proprioception, and sensation.

Not all reports or experiences of pain are equal. As such, each experience should be treated accordingly. Fortunately, the practice of qigong has helped many people not only manage their conditions, but in many cases, completely eliminate their symptoms.

Digestive Health by Dr. Joe Baumgarden DPT

Digestive health is very important for overall health and well-being. We all know how

gastrointestinal issues can make you feel, whether it is a short term stomach bug or even

chronic conditions. Your body gets depleted of essential nutrients, leaving you with no energy,

and you may have persistent discomfort or pain. For people with long-term conditions, this has a

significant impact on quality of life. Fortunately, qigong and tai chi can help in a number of ways!

Diaphragmatic breathing plays several roles in aiding digestive health. First, it has a natural

anti-inflammatory effect by stimulating the vagus nerve, which in turn triggers an

anti-inflammatory cascade of events in your body. Many digestive disorders have a significant

inflammatory component to them, such as Crohn’s disease, ulcerative colitis, and others. By

reducing inflammation, people are able to help control their symptoms.

Another way diaphragmatic breathing helps is through the mechanical action of breathing itself.

The diaphragm is a dome shaped muscle which peaks just underneath your lungs. As you

inhale, the diaphragm flattens out, which gently compresses your abdominal cavity and internal

organs. This up and down action gently massages your insides, helping to stimulate your

organs and ensure proper circulation of blood, nutrients, and waste products.

In addition to the movement of the diaphragm, the actual movements of the qigong and tai chi

forms also aid in providing gentle massage and stimulation to your organs. For example, in

movement #11 of the 24-Posture Qigong Form (Pushing the Stone Tablet) your trunk and

shoulders rotate while your hips remain stationary. This has an effect of gently “ringing out” your

internal organs as if you were ringing out a wet towel.

Last, but certainly not least, qigong and tai chi have been shown to dramatically increase activity

of the immune system of the body. Diseases such as celiac disease, Crohn’s disease, and

lupus are auto-immune diseases which attack the gastrointestinal system of the body.

Anecdotally, people who practice qigong and tai chi have reported significant improvements in

symptoms and quality of life while at the same time reducing medications and other forms of

medical treatment for these conditions, with the guidance of their medical practitioners.

Cardiovascular Health by Dr, Joe Baumgarden DPT

Some people may not believe that Qigong or Tai Chi are good for your heart. They feel you are moving too slow to get enough of a workout. In all reality, Qigong and Tai Chi are supported by the American Heart Association and the Canadian Heart and Stroke Foundation as safe and effective exercises for preventing heart disease and also as part of a cardiac rehabilitation program.

● Qigong/Tai Chi have been measured at a 4.1 MET, more than walking 3.4 mph or 5.5 km/hr (3.6 MET’s); just over riding a bike for 10 mph or 16 km/hr (leisurely pace)

● They are both slow, gentle exercises and easier on the joints compared to traditional aerobic activities;

● They involve the entire body, unlike riding a bike or treadmill- promotes whole body flexibility and circulation

● Move in all directions instead of straight planes

● Include stress,anxiety, and depression reduction; improves mood

● Improves breathing efficiency so your heart does not have to work as hard

● Includes social support and motivation- others may share similar experiences

● Studies also show that Qigong /Tai Chi are equivalent to Phase II cardiac Rehab Programs; these programs help you transition from hospital to home after things like a heart attack, open heart surgery, heart transplant or congestive heart failure

Copyright 2020

Stress and Anxiety by Dr. Joe Baumgarden DPT and Sifu George Picard

Did you ever feel overwhelmed, or get so worked up about something that you could not think straight? The first thing someone tells you to do is take a deep breath. It turns out they are right. The problem is, most of us are breathing wrong, or not as efficiently as we should be. Now you may wonder, “how can I breathe wrong? I don’t even have to think about it.” It is something that we all take for granted. We do it 12-20 times a minute, and over 20,000 times a day. When we are babies, we all breathe using our diaphragm. This is known as abdominal breathing or belly breathing. The diaphragm is a large dome shaped muscle that lies at the lower end of our ribs and separates our lungs and heart from the rest of our internal organs. As we breathe in, our diaphragm contracts and pulls down, acting like a vacuum and decreasing pressure in the chest. This allows our lungs to inflate most efficiently, allowing for important exchange of oxygen and nutrients and removal of waste products. As we get older, we begin to breathe much shallower. We tend to use muscles in our neck, between our ribs, and our chest. This can lead to neck and shoulder pain as well as intense headaches from over active muscles. In addition, your lungs never get a chance to fully inflate or deflate. This causes your body to retain more waste products and does not allow for circulation of oxygen and important nutrients. Long term shallow breathing can decrease how well your body fights disease and infection, puts more work on your heart, and makes any respiratory conditions much worse and harder to fight. A frequently overlooked benefit of abdominal breathing is that the up and down plunger like action of the diaphragm when it contracts helps to massage and stimulate our digestive organs helping to stimulate the system and promote optimal function Diaphragmatic breathing activates your parasympathetic nervous system, or “rest and growth”. This allows your body to slow down and heal. Breathing in this manner also can lower blood pressure, reduce heart rate, relax muscles, decrease stress, and increase energy levels. Deep breathing is the easiest and best way to change your body from acidic to alkaline by adding more oxygen and removing more C02. Conversely, chest breathing, or shallow breathing activates the sympathetic nervous system, or the “fight or flight” response. This is your body’s stress response. It raises your blood pressure and heart rate, increases muscle tension and respiration rate, increases stress, and decreases energy and mental clarity. Great news! You do not need any special equipment or training to learn how to breathe correctly. Sit up straight in a chair and put your hands on your belly. As you breathe deeply through your nose, feel your belly push your hands out. As you exhale, your belly shrinks and your hands return to the starting position. With practice, this pattern will become automatic and you will be able to do this all day, everyday with no conscious effort. Afterall, if you breathe over 20,000 times a day, why not do it correctly and take advantage of all of the benefits?

Copyright 2020

How Much Research Is Needed? by Sifu George Picard

Embedded in this website is research published by the Village research team. In addition, many years teaching Qigong and Taiji verifies the healing benefits. Of course, my preferred Qigong practice is the 24 Posture Therapeutic Qigong for good reason. More on this later. There has been well over a thousand research studies on many health issues. They include cancer, arthritis, Parkinson's, fibromyalgia, Anxiety, depression, PTSD, learning disabilities, diabetes and many other miladies that plague the population. most studies are positive. The point is, how much information is needed before the health system integrates these practices as part of the healing process for the patient? It would appear obvious that that the medical system can not heal you. That is the job of the body. However the system is necessary to support the bodies ability to heal.

Now, this is where Qigong comes in, just the BASIC benefits of Qigong, reduces inflammation, reduces stress and boosts the immune response All three are necessary for the body to heal, however, the additional benefits go far beyond these and are a perfect holistic healing system.

My next blog will explain how the 24 posture Qigong impacts the physiology of the body and increases the natural healing processes. Until then, be well! 

A Little Bit About Myself by Sifu George Picard

I have been teaching Taiji, Qigong and Karate for 25 years starting in Toronto. I opened my studio in 1999, St. Catharines Ontario. From here on in I’ll focus on Taiji and Qigong. I had been teaching both for some time and I thought I was all that and a bag of chips. Then I went to a Taiji Fan workshop with Grand Master Helen Wu in 2002. That was the changing point in my life. I was so impressed with Sifu Helen I asked if she would take me as a private student and she agreed. After four years of weekly trips to Toronto I received my 4th generation diploma presented to me by Grand Master Helen Wu and her mother and father, Grand Masters Wang Ju-Rong and Dr. Wu Cheng De.

Sifu taught me 4 Fan forms, Sun, Chen and Yang Taiji forms but to me the greatest gift was the 20 posture therapeutic Qigong for health healing and longevity. This system was developed by her Grandfather Wang Zi-Ping and her Father in the 1950’s and published in pamphlet format. It was published as a system to “treat disease and prolong life.”  Sifu Helen added Four additional postures to make this 24 Posture Therapeutic Qigong for Health (prevention), Healing and longevity (the ability to participate in life until the end).

As I started teaching this system in my classes, students started telling me stories about their health that caught my attention “I’m off all my puffers” (asthma) “no more back pain” and so on. I was teaching Taiji at a cancer care support centre and added this Qigong. The student’s experiences were exceptional. Now we have personal stories of healing covering a large range of health issues. This story I just heard today. A 94 year old student who has had cancer twice started Qigong 9 years ago. No signs of cancer, her bones are growing (minimal but are growing according to bone density tests). 2 days ago she was taking the bus home from shopping “alone” (longevity). The bus stopped and she fell, cut her head which required stitches. Now remember she is 94, she went to the hospital and the doctors wanted a list of medications she must be taking. They could not believe she was not on any medications. (Exception was a thyroid medication due to removal from cancer.) She got the stitches and went home. She does this Qigong routine every day. I here amazing stories like this every day from students and certified Instructors across Canada and the United States.

So my search for why has been continuous. In this search I have developed a medical board and a research team from students who have experienced the benefits. Look for our research in this section. My belief is we can help anyone.

Next blog I will explain how this system works from a western medical model.

Until then, Blessings to all.