Tai Chi Exercises for Rheumatoid Arthritis

How This Gentle Workout Can Improve Rheumatoid Arthritis Symptoms

By Lori Newman, Lifescript Staff Writer

Published February 12, 2013
Reviewed by Edward C. Geehr, M.D., Lifescript Chief Medical Officer

If you have rheumatoid arthritis symptoms, tai chi exercises are a great way to stay physically active while improving mobility and balance. Find out why tai chi is so beneficial and try movements specially selected for people with RA...

During a flare-up of rheumatoid arthritis symptoms , pain and fatigue make exercise the last thing you want to do.

But one workout – a traditional Chinese practice called tai chi – is gentle enough to do even with aching, swollen joints, says Daniel Arkfeld, M.D., associate professor of clinical medicine and director of rheumatology education at the University of Southern California in Los Angeles.

Tai chi is a safe way to stretch and strengthen muscles and de-stress your mind, Dr. Arkfeld says. And the slow, gentle movements are so easy on the body that most rheumatoid arthritis patients can practice them, he notes.

“Patients are able to participate even with advanced cases of the disease,” he says.

Rheumatoid arthritis patients who did tai chi exercises for at least eight to 10 weeks felt significant improvement in their range of motion, especially in the hips, knees and ankle joints, according to a 2010 research analysis by the Cochrane Database of Systemic Reviews, a nonprofit British scientific organization. They also had a 35% lower risk of falls than those who didn’t do the exercises.

Tai chi also improved mood and reduced depression, the studies found.

Based on a centuries-old martial art, tai chi exercises require no special equipment and very little space.

They were traditionally meant to strengthen chi – a sort of life force or energy flow that can be blocked in particular areas of the body, leading to health problems, says Weimo Zhu, Ph.D., a professor of kinesiology and community health at the University of Illinois at Urbana-Champaign and co-author of Tai Chi Illustrated (Human Kinetics, written with tai chi master Pixiang Qiu).

“According to Chinese medicine, rheumatoid arthritis is caused by aging, weak chi in the kidney and liver meridians, [along with] decreased immune functions,” he explains. “To promote chi flow in these meridians, tai chi movement involving all parts of the body is recommended.”

Ready to give tai chi a try? First, get your doctor’s approval before beginning this or any other exercise program.

That’s because you need to be careful not to injure yourself by moving joints too far – especially if they’re fused together – and your physician can determine if you may be at risk, Dr. Arkfeld says.

Since tai chi movements are almost dance-like and involve many steps, they can be complex to perform. That’s why it helps to find a class or instructor to teach you how to do each form correctly. To find a class, contact your local recreation department or the website of the American Tai Chi and Qigong Association, which has a database of teachers.

To get a taste of the flowing movements of tai chi, try these exercises, reprinted with permission from Tai Chi Illustrated. The poses in each set, called “forms,” should flow easily into one another.

Tai chi exercises #1: “Vega Working at Shuttles”

This form is based on shuttles, weavers’ tools that are passed back and forth by the hands. The movements are similar to someone weaving with two shuttles, moving the arms gently and constantly in a circle from left to right and then right to left.

Tips: To perform Vega Working at Shuttles correctly, coordinate hand and leg movements with shifting your body weight, but don’t shift your weight until you feel balanced. You’ll also maintain better balance by keeping some distance between the legs.

Step 1. For the starting position, stand naturally with your legs shoulder-width apart and feet parallel to each other. Keep your upper body , head and neck upright and straight

Hold your chin slightly down and relax your face with a slight smile. Hang your arms down along your sides with your hands resting naturally beside your thighs. Keep your body weight equally distributed onto both legs. Clear your mind and keep a peaceful mental state throughout the whole form.

Tips: Keep your head straight and chin low. Keep shoulders relaxed.

Step 2. Raise your arms slowly in front of your body until they’re level with your shoulders; your arms will be parallel to each other, shoulder-width apart, palms facing down (see image at left).

Tips: Breathe in while your arms move up. Keep your head held high, facing forward, and chin held slightly down. Do not bend your wrists.

Step 3. To shuttle left, gradually shift the body weight to your right leg, ending with your left toes touching the ground. Move your left hand down toward the front of your right side and turn your left palm up while you move your right arm slightly up to shoulder level. End the movement when you appear to be holding a large ball in front of your right side (see image below).

Tips: Control your balance by moving weight onto your right leg slowly. Move your left hand down along an arc and turn your left palm slowly upward while your hand is moving down.

Step 4a. To shuttle forward, move your left leg one step straight forward, with the heel touching the ground first and keeping most of your body weight on your right leg. Move your left hand upward and right hand forward with palms facing out (see image to the right), and start to shift your body weight onto your left leg, gradually ending with your entire left foot firmly on the ground.

Tips: Simultaneously move your left hand up and right hand down slightly and out. Touch your left heel to the ground first with body weight still on the right leg.

Step 4b. Meanwhile, keep moving your left hand up and right hand forward (see image to the left). Finish shifting your body weight onto your left leg, ending in what’s called a left bow stance [because your front leg is bent like a bow and your rear leg is stretched like a bowstring].

Tips: Coordinate weight shifting with moving your left hand up and pushing your right hand forward simultaneously.

Step 4c. Your hands and the leg in bow stance should point in the same direction, with your left hand just above your left temple, palm turned up, and your right hand pushed forward in front of the midline of your body. Keep looking forward to maintain your stability and balance, and make sure both heels are on parallel lines about a foot apart (see image to the right).

Tips: Your right elbow should be slightly bent. Do not bend your left knee so much that it goes past the left toes.

Step 5a. To transition from left to right, shift your body weight gradually back onto your right leg, raise your left toes with your left heel remaining on the ground, swivel your left foot to the right about 90 degrees, and slowly return your left toes to the ground. Meanwhile, move your left hand to the right with palm facing the ground while your right hand moves down with palm facing up (see image to right).

Tips: Move your right hand down along a curve.

Step 5b. End the transition by moving all your body weight onto your left leg and raising your right heel so that only the right toes are on the ground. You should look like you’re holding a ball in front of your left side (see image to left).

Tips: Shift your body weight back completely onto your left leg. Slightly bend your left knee.

Step 6a. To shuttle right, move your right leg one step straight forward with your heel touching the ground first, keeping most of your body weight on your left leg (see image to right).

Tips: Eyes follow the movement of the left hand. Coordinate weight shifting with moving your right hand up and pushing your left hand forward simultaneously.

Step 6b. Move your right hand upward and left hand forward, palm facing out; and start to shift your body weight onto your right leg, gradually ending with your entire right foot firmly on the ground. Meanwhile, keep moving your right hand up and left hand forward.

Finish shifting your body weight onto your right leg, ending in a right bow stance (your hands and the leg in bow stance should point in the same direction), with your right hand just above your right temple, palm turned up and left hand pushed forward in front of the midline of your body (see image at above right).

Keep looking forward to maintain your stability and balance, and make sure both heels are on parallel lines about a foot apart.

Tips: Your left elbow should be slightly bent. Do not bend your right knee so much that it is over your right toes.

Step 7. Repeat steps 3 through 6 several times. Once you’re ready to finish the movement, continue to step 8.

Step 8. To close the form, turn your body toward the front and shift your weight equally onto both legs. Move your arms up and out to shoulder level, with your palms facing down and parallel to the ground (see image to right). Bring both arms down alongside your body and straighten your knees as you lower your arms so you’re back in the starting position.

Tai chi exercises #2: “Cloud Hands”

During this form, your arms rotate in front of your body, looking like clouds floating by. Your hands move along two circles, with your right hand moving clockwise and your left hand moving counterclockwise.

Tip: Use your lumbar spine (low back) as the axis of your movement (so your hand movement follows your waist movement), and shift your weight according to the position of your hands. Keep your hands within a medium distance from the body so they can comfortably move along clockwise and counterclockwise circles.

Step 1. For the starting position, stand naturally with your legs shoulder-width apart and your feet parallel to each other. Keep your upper body, head and neck upright and straight. Hold your chin slightly down and relax your face with a slight smile. Hang your arms down along your sides with your hands resting naturally beside your thighs . Keep your body weight equally distributed between both legs (see image at top right). Clear your mind and keep a peaceful mental state throughout the whole form.

Tips: Keep your head straight and chin low.

Step 2. Raise your arms slowly in front of your body until they’re level with your shoulders. Arms will be parallel to each other, shoulder-width apart, and palms will be facing down (see image to left).

Tips: Breathe in while your arms move up. Keep your head held high, facing forward, and chin held slightly down.

Step 3a. To shift weight to the right leg, turn your body slightly to the left, moving your right hand up and then down from right to left and then up along a clockwise circle (see image at right). With your palm facing you, follow your right hand with your eyes.

Step 3b. Move your right hand in a clockwise circle. Shift your body weight onto your right leg in time with your right hand movement (see image at right).

Step 3c. Move your left hand down along a counterclockwise circle and follow the movement of your right hand in sequence (see image at left).

Tips: Move your right hand up as you shift body weight onto your right leg. Turn your upper body toward the right side at the same time.

Step 4a. To shift your weight to the left leg, keep moving your right hand down along its clockwise circle, and start to move your left hand up along a counterclockwise circle. Slightly raise your left foot (see image at right).

Step 4b. Slide your left foot out a half step to the left side (see image at left). Keep moving your left hand up along the circle and start to move your body weight onto your left leg.

Step 4c. With the right palm facing inward, follow your left hand with your eyes (see image at right). Shift your body weight completely onto your left leg as your left hand moves up. Turn your upper body to the left, and move your right hand down along a clockwise circle, ready to move up for the next circle.

Step 5. Repeat steps 3 and 4 several times. Once you’re ready to finish the movement, continue to step 6.

Step 6. To close the form, shift your body weight back onto both legs equally. Move your arms up and out to shoulder level with palms facing down and parallel to the ground (see image above). Bring both arms down alongside your body and straighten your knees so that you’re back in the starting position (see image at right).

To learn more about rheumatoid arthritis symptoms and treatments, visit Lifescript’s Rheumatoid Arthritis Health Center. And for more on the benefits of tai chi exercises, read Tai Chi 101.

How Much Do You Know About the Types of Arthritis?

About 46 million American adults – nearly one in five – suffer from some type of arthritis. It’s estimated that number will rise to 67 million by 2030. Do you or someone close to you have arthritis? Take this quiz to see how much you know about this disease.

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