Yi Quan and Focused Muscular Tension Exercises for Prevention and Rehabilitation

Before going into the main topic, I want to explicitly state that Yi Quan is a Martial Art and thus has combative aspects. Because of its historical ties to meditative and health traditions, it is also a very valuable art for the preservation of health. Just because the health and therapeutic aspect are emphasized in this article, does not mean that the combative side should be excluded or looked down upon.

One of my main interests is the application of alternative body/movement practices in a therapeutic and preventive context. ´Alternative` does not refer to non-scientific or esoteric concepts (such as Qi, prana or chakras)  rather to body/movement practices that have a different paradigm or mind-set than mainstream practices and are therefore less researched by the scientific community – so exact knowledge on the effects are scarce. What we can do is use the already available knowledge of exercise/health and sport science and apply it to the movement art in question and see how it can be used to enhance one’s health.

One can find a lot of anecdotal evidence for the efficacy of Internal Martial Arts such as Yi Quan for improving one´s health. There are even a few studies how for example Tai Ji Quan can reduce the risk for falls among the elderly (Gallant, Tartaglia, Hardman, & Burke, 2017; Zhao, Chung, & Tong, 2017) or how Tai JI Quan reduces depression (Yeung et al., 2017) and so on. To me, these studies are useful but they are not researching what I am really interested in. Here Tai Ji Quan is mere a form of a Choreography with specific characteristics (i.e. a choreography with shifting the weight from one leg to the other with a few specific coordinative challenges, like moving the hands in a specific manner). What I find particularly interesting in Yi Quan is not the Choreography of the movements, but the approach and method to learn, feel and analyse the movement.  Its use of awareness to understand the structure of body and how force is applied through it. First, when we talk about how Yi Quan can improve one´s health, it must be explained what “health” is. There are different concepts of what constitutes ´health`. I will not go into too much detail on the theoretical concepts, as I think it is enough to know, that in this article I am referring specifically to a functional and pain free muscoskeletal system.

In terms of elements that influence the health of our muscoskeletal system negatively, we can discern two different types: acute-traumatic injuries and chronic disorders. Acute-traumatic injuries such as broken bones, muscle tears, torn ligaments and so on are caused by playing sports, external influence (i.e. violence, accidents), improper footwear (“twisting one’s ankle”) and so on. The causes of chronic disorders are long immobilisation, muscular dysbalance, obesity and genetic dispositions.

Although it has been demonstrated that training can have an influence on the prevention of sport injuries (for example coordination training “feedforward strategy” [for example (Besier, Lloyd, Cochrane, & Ackland, 2001; Cerulli, Benoit, Caraffa, & Ponteggia, 2001)], eccentric strength training for tendons (Vogt & Hoppeler, 2014)), there are circumstances that cannot be controlled (road accidents, natural disasters etc.).  Because of the high focus on structural aspects of the body, the approach of Yi Quan could be really valuable tool for a future segment of physical therapy for the post-operative treatment of acute-traumatic injuries and in the prevention and improvement of chronic muscosekeletal disorders.

In terms of prevention, through the correct application of Yi Quan principles arthrosis of the joints could be minimized as the correct axial position of the joints are (re)-learned – namely, because one of the causes of arthrosis are misalignments that cause over a period of time damages to the cartilage and bone structure. Pain that is specifically caused by muscles working too much (i.e. tensed muscles) and others working to little could also be treated with Yi Quan as one training principle is the correct interplay of tension and relaxation. The action of muscles that are not needed in a particular movement should be minimized and the muscles that are underused should be incorporated in the kinetic chain. For example, one cause of idiopathic lower back pain is that certain stabilizing core muscles are not firing correctly and other muscular structures are compensating. One could utilize Yi Quan training in the same manner as Motor Control exercises. (Saragiotto et al., 2016)

The effects of focused muscular tension exercises are the almost the same as normal strength training exercises albeit with its own advantages and disadvantages. Almost everybody (except someone with extreme paralysis or brain damage) no matter the current level of fitness can use this form of training to strengthen the muscles. There is little to no loading on the joints, no special equipment is needed, and it can be done (in theory) wherever you are.

In terms of rehabilitation, the relearning of correct axial positing applies as well. In addition after an operation longer immobilization phases occur and as a consequence the affected structure has worse innervation and less strength. Thus the Yi Quan technique of using visualization paired with small movement could be used to improve the recruitment. Once this has been brought up to a satisfactory level, the strengthening of the surrounding muscles can begin. Here the value of the focused muscular tension exercises show.  These exercises use no or very little additional load, thus not much stress is put on the injured structure. In fact, it is common to use isometric exercises in rehab. In the beginning it is important to provide carefully the correct amount of resistance. First use isometric tension and then carefully increase the range of motion until pain free movement is possible on the whole range of motion. So the course of action would be to learn to recruit the correct muscles. If the desired effect has been achieved specified strength training with focused muscular tension exercises could be applied to further strengthen the surrounding muscles of the injured area.

In further articles I will try to pick some typical injuries and try to apply the outlined approach on these injuries. Although I have a background in exercise science, it should be stated that I am not a licensed physiotherapist. Therefore my approach should not be thought of as a substitute for PT, but mere a complement to conventional rehabilitation or PT.

Sources:

Besier, T. F., Lloyd, D. G., Cochrane, J. L., & Ackland, T. R. (2001). External loading of the knee joint during running and cutting maneuvers. Medicine and Science in Sports and Exercise, 33(7), 1168–1175.

Cerulli, G., Benoit, D. L., Caraffa, A., & Ponteggia, F. (2001). Proprioceptive Training and Prevention of Anterior Cruciate Ligament Injuries in Soccer. Journal of Orthopaedic & Sports Physical Therapy, 31(11), 655–660. https://doi.org/10.2519/jospt.2001.31.11.655

Gallant, M. P., Tartaglia, M., Hardman, S., & Burke, K. (2017). Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 733464817703004. https://doi.org/10.1177/0733464817703004

Saragiotto, B. T., Maher, C. G., Yamato, T. P., Costa, L. O. P., Menezes Costa, L. C., Ostelo, R. W. J. G., & Macedo, L. G. (2016). Motor control exercise for chronic non-specific low-back pain. The Cochrane Database of Systematic Reviews, (1), CD012004. https://doi.org/10.1002/14651858.CD012004

Vogt, M., & Hoppeler, H. H. (2014). Eccentric exercise: mechanisms and effects when used as training regime or training adjunct. Journal of Applied Physiology (Bethesda, Md.: 1985), 116(11), 1446–1454. https://doi.org/10.1152/japplphysiol.00146.2013

Yeung, A. S., Feng, R., Kim, D. J. H., Wayne, P. M., Yeh, G. Y., Baer, L., … Fava, M. (2017). A Pilot, Randomized Controlled Study of Tai Chi With Passive and Active Controls in the Treatment of Depressed Chinese Americans. The Journal of Clinical Psychiatry, 78(5), e522–e528. https://doi.org/10.4088/JCP.16m10772

Zhao, Y., Chung, P.-K., & Tong, T. K. (2017). Effectiveness of a balance-focused exercise program for enhancing functional fitness of older adults at risk of falling: A randomised controlled trial. Geriatric Nursing (New York, N.Y.). https://doi.org/10.1016/j.gerinurse.2017.02.011

 

 

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