In addition to lowering blood pressure, this gentle form of exercise can help maintain strength, balance, flexibility and mental health and is an ideal activity for all ages!
This research was brought to my attention by my friend and mentor from Dalton, Peter Frieder, Chairman,Gentex Corporation and current Board Chair at WVIA. Peter is celebrating his birthday today with a number of years that clearly does not represent his physiological age, in great part due to his dedication to health and wellness. Happy Birthday and thank you!
According to a new study by the China Academy of Chinese Medical Sciences (CACMS), the ancient martial art practice of Tai Chi is effective in lowering blood pressure as much, if not more, than traditional aerobic exercise. For those with prehypertension or hypertension and are unable to tolerate the repetitive and prolonged weight bearing stresses of running, walking or cycling, these results have tremendous implications. The slow, gentle and controlled movements and positions of Tai Chi coupled with controlled breathing and meditation may be a valuable alternative, especially for those with aging muscles and joints. Improved strength, flexibility balance, posture and mental health are additional bonuses.
Tai Chi is multifaceted in that it combines martial arts, slow gentle and controlled movements, sustained postures, a focused and meditative mind, and controlled breathing. It is considered by many to be “meditation or medication in motion.”
Tai Chi involves slow-motion movements transitioning with control from one position to another. The positions have historically been named for the actions of animals, for example:
Deep and purposeful breathing, mental focus, body awareness and meditation are integral components of the exercise. The beauty of Tai Chi is not only in the physical form, but also in its safety for all levels of fitness. It is helpful for individuals from high level athletes to those with physical disabilities. The movements are natural and gentle without forcing the muscles and joints to extreme or uncomfortable positions. It is often used as an adjunct therapy in the wellness as well as rehabilitation of a variety of athletic (ACL surgery, joint replacements) and neurological conditions (Parkinson’s, MS, head trauma), to name a few. Based on the aforementioned Chinese study, Tia Chi can be applied as a technique to control or lower blood pressure, especially for those who cannot utilize traditional aerobic exercise.
Tai Chi has been found to offer many physical and mental benefits. Some of these include:
Muscle Strength – upper and lower body, trunk and core strength
Flexibility – participants report improved range of motion and flexibility of the spine and extremities
Balance and Proprioception – some studies report a reduction of falls due to a variety of sustained positionsand improved awareness of one’s body in space
Aerobic Conditioning - recent studies have found that participants have lower heart rate and blood pressure
Mental Health – through improved balance, strength, and flexibility, studies show participants have gained confidence and control as well as lower blood pressure and stress reduction.
All Tai Chi classes begin with four basic principles: warm-up, instruction, practice and breathing.
Warm-up- gentle easy motions to warm-up and loosen the joints and muscles to prevent injury.
Tai Chi Forms – “Short Forms” are beginner movements which are gentle, slow, and short in duration while “Long Forms” are more advanced.
Breath Work – gentle breathing combined with movement to relax the mind and focus energy
Don’t be intimidated by the language or history – Yang, Wu, Cheng are only brands of movements with a history of martial arts but this in no way impacts participation.
Get medical clearance – check with your physician to see if Tai Chi is safe for you. Some orthopedic or vestibular problems might require special attention.
Observe or take a beginner class – often available at local fitness clubs or senior centers. Research options in your area and find a friend to join you. Consider an introductory instructional video to get a feel for Tai Chi. (See local Tia Chi classes below)
Meet with an instructor – if it makes you more comfortable, make time to talk to an instructor before enrolling in a class.
Dress for success – wear loose-fitting clothes that allow for range of motion and comfortable shoes for balance and support.
Track your progress – use an app or keep a journal of your progress. Heart rate, blood pressure and endurance (the time you can hold a pose or tolerate a class) are easy to monitor.
Model: Lily Smith, University of Scranton Physical Therapy Student and PT aide at Mackarey Physical Therapy.
Sources: HarvardHealthPublishing; New Atlas; China Academy of Chinese Medical Sciences (CACMS); National Institutes of Health
Local Tai Chi Classes: Steamtown Yoga, Scranton, PA; Mission Yoga, Scranton, PA;Dragon’s Heart Tai Chi & Kung Fu, Clarks Summit, PA; Rothrocks Kung Fu & Tai Chi, Duryea, PA
For more information: HarvardHealth; www.taichihealth.com; www.treeoflifetaichi.com
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
During a recent “lunch-and-learn” meeting at our office, several younger staff members were discussing the use of supplements to compliment their fitness routines. One such staff member, Lily Smith, a physical therapy student aid at our clinic from the University of Scranton, is also a serious weight training and fitness enthusiast and shared her experience with creatine supplements with the hope of educating others, especially those preparing to “get fit” in 2024!
A National Health Interview survey found the creatine use among adolescents and young adults to be 34%. It is also very popular in the military with 27% average usage. While athletes and exercise enthusiasts use protein shakes and creatine supplements with hopes to improve size, strength and performance, it appears that most users do not have a full understanding of the risks and benefits. In view of this, today address the use of creatine in strength training and make recommendations based on the literature.
As long as I can remember, young athletes would take or do anything that they believed would improve their speed, strength, agility and athletic edge in order to succeed in sports. Running with weights wrapped around the ankles, drinking raw eggs and whole milk, and consuming copious amounts of beef, pork, and chicken were not unusual. Today, it may not be much different. However, the products do not come from our kitchen cabinet and tremendous misinformation is associated with it. Creatine is one example that was purported to enhance performance as early as the 1970’s but only gained popularity in the 1990’s. 40% of all college athletes and 50% of professional athletes admit to using creatine at some point, despite a lack of scientific evidence to support its effectiveness or safety.
This supplement is a natural substance that turns into creatine phosphate in the body. Creatine phosphate helps produce adenosine triphosphate (ATP), which provides energy for muscles to contract. While the body produces some creatine, it can also be found in foods rich in protein such as meat and fish. Manufacturers claim that creatine use will improve strength, increase lean muscle mass and aide in the recovery from exercise induced fatigue.
While creatine is popular among young people due in part to its availability, very little research has been done in people under 18 years of age. Even in the few studies conducted on adults, the results regarding efficacy are mixed. Some studies show that creatine may improve strength performance due to the recovery cycle of ATP. In theory, the use of creatine is purported to allow one to recover more quickly from exercise. For example, shortly after lifting heavy weights to failure, a quick recovery might allow the weight lifter to lift an additional set of repetitions to increase the duration of intensive training. Therefore, based on this theory, one must work out to complete failure during training to benefit from creatine. However, it is important to remember, there is no evidence that this purported benefit is realized in performance improvement in weight training or endurance sports.
Furthermore, no studies support the notion that it improves performance in endurance sports. Also, research does show that not all users are affected by creatine the same way. Most users fail to find any benefit at all. More concerning to this author is the fact that there are no guidelines for safety or disclosure of side-effects from long term use. Make no mistake, based on the research and current wisdom, CREATINE IS AN UNPROVEN TREATMENT SUPPLEMENT!
If one decides that creatine is a product they would like to use, despite the lack of evidence for its effectiveness, there are recommendations that one should follow for proper use. But there is no consistently established dose. Some studies have found 25 grams daily for 14 days as a “kickstart” dose or “loading” phase followed by 4-5 grams (or 0.1 g/kg of bodyweight) daily for 18 months with few side effects such as: muscle cramps, dehydration, upset stomach, water retention/bloating with weight gain. It is important to remember when establishing a dosage that many weight training supplements already contain creatine and in high doses excess creatine is excreted by the kidneys. It is also recommended that creatine users “wean off” the product when they decide to discontinue use.
Remember, an average adult in the United States receives 1 to 2 grams of creatine each day from a normal, well-balanced diet. Creatine is naturally found in meat, poultry and fish and theoretically, one could increase their creatine intake through dietary changes. Some manufacturers recommend 10 to 30 grams per day with a maintenance dose of 2 to 5 grams per day for athletic performance. Creatine is available in many forms; tablets, capsules and powder. It should be kept in a cool, dry place out of direct sunlight.
Creatine use is not recommended if you are pregnant, breast feeding, have kidney disease or bipolar disorder. There are many reported side effects associated with creatine use such as; water retention, nausea, diarrhea, cramping, muscle pain and high blood pressure. It is recommended that users consume large quantities of water when taking creatine to prevent dehydration. It may be very dangerous to use creatine when dehydration or weight loss is associated with an activity such as wrestling or summer sessions during football.
Furthermore, some studies show that large amounts of carbohydrates may increase the effects of creatine and caffeine may decrease the effects. Users are warned that using creatine with stimulants such as caffeine and guarana (a Brazilian plant extract similar to caffeine found in energy drinks) can lead to serious cardiac problems. The effects of creatine supplements on the many organ systems of the body are unknown. High doses may cause kidney damage. Although no cases have been reported in the literature, it is not known how it may interact with other supplements, over-the-counter medications and prescription drugs.
In conclusion, despite the lack of scientific evidence that creatine is more effective than proper nutrition and effective weight training, it remains a popular, easily available supplement purported to improve strength, endurance and performance in athletes. While relatively safe if taken as directed, it is always wise to consult your physician, especially if you have a history or risk of kidney problems. And, by the way, Lily did not feel that creatine supplements made any significant difference, positively or negatively. She no longer uses it due to the expense, inconvenience and lack of scientific evidence to support its efficacy.
Sources: University of New England; Medicine & Science in Sports & Exercise; NIH and Lily Smith, PT student, University of Scranton, Student PT aide, Mackarey Physicla Therapy
.Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
