it's been a vwhle

our yard in full summer

tai chi with tongue

A wonderfully instructive posting by Peter.

Hi Joel,

Here is some more good chi right back at you!

As you may already know, the body-mind is filled with maps of many varieties...foot reflexology and the homonculus (the map of the body in the brain) to name a few. Yet unknown to but a few is the map of the body in the mouth.

Appreciate the intersecting histories and energy systems shared by yoga, qi gong and tai chi (ie. the chakra-nadi/meridian systems)- then give the chi and prana palpable anatomies to call home, via western allopathic medicine.

To begin with there are distinct types of energy (earth, water, fire, air, ether, spirit, light plus wood and metal that can be associated with the 7 chakras/energy centers: starting at the base of the spine and opening out to the top of the head, operating much like a valve or sphincter which can be formed by opening and closing the hand.

In fact a series of hand positions or mudras follow this analogy quite well which in turn 1. activate nerve centers that coincide with the chakras 2. stimulate breathing at specific levels of the body 3. initiate and support controlled movement, however slight or pronounced at those same levels.


This is where the qi based energy systems fit in nicely to promote the circulation of energy through the body mind to balance harmoniously with nature, Heaven and Earth.

Interestingly, the part of the body that is simultaneously out of conscious control AND potentially the most controllable access to nerve function, hard and soft tissue facilitation, breathing, blood flow and joy is (did you already guess?) . . . THE TONGUE!


And with that in mind, get ready to be able to access your body fully and deeply via the map in the mouth where the tongue tip contact positions are with respect to the numbered chakras from base of spine (#1 on up), sound & corresponding anatomical location in CAPS:

1. On the gum ridge behind the lower teeth
BASE OF SPINE-toes/foot/ankle/knee/pelvis,
sex organs and elimination organs
AH as in "shah"
2. Retroflexed back touching the soft palate
LOWER tan tien intestines,bladder, kidneys
AW as in awful
3. Up onto the middle of the roof of the mouth
MID TAN TIEN solar plexus, liver, stomach
adrenals and spleen/pancreas.
AY as in aim
4. On the gum ridge behind the upper teeth
HEART, lungs - accessible with all hand
mudras (referred to below)
OH as in OM
5. Mid mouth not touching anything (nta)
THROAT, thyroid/parathyroids, neck, upper
back, base of skull/reticular formation
OO as in broom
6. Back of mouth, nta
MIDBRAIN, pituitary, occipitals & frontals
IH as in bin
7. Tongue pulled further back, nta
CROWN, corpus collosum
EEE as in seem

Now this system can be navigated by the use of modified tongue shapes and the kind of hand shapes or mudras mentioned earlier, giving access to anywhere in the body/mind. Since they defy verbal description, I can share them with you by other means later.

While assuming a particular "posture" or combination of tongue position, breathing level, sound etc. you can become aware of
how you feel in general (ie. temp, mood), what parts are tight or relaxed, the kind of inner sounds, music, visual imagery, or tai chi memories are invoked.

Try to focus on and perpetuate the ones you prefer or are more comfortable with. Then practice re-experiencing them by simply repeating the tongue position alone.

Meditation on a Wheelchair

The wheelchair as a transport vehicle, old-fashioned, clumsy, sometimes modified by athletes for sport and sportsmen for hunting, but intentionally or unintentionally  waving a disability flag.

Instead, the chair is an integral part of my therapy: an enabler for standing, aerobic exercise, and independent living.

Profitably, industry products are rip-off priced and indifferently engineered for active users, marketed for frailty not independence.

Routines easier.
Motivation slips.
I'm slacking.

Life friends travel to Taos
just-in-case.

Paraplegic problem solving.
First snow.
Healings.

My story's written.
I can't read.

Enjoying photography's mystery.
Frame a world.

when my plumbing works
everything's possible.

24-hour cathing nightmare concluded!
Urologist flummoxed!

Gracious thanks from past
heart-felt uplifting.

optimism pessimism

standing walking
PT-Sue optimistic
more technology.

incurable
urinary tract infection
slowly dying?

optimism pessimism
dualing isms
foolish mind.

EFT

Body point tapping therapy.
Simple.
WORKS!

Refocusing therapies.
Hypnosos:microvements.
Core strengthening.

East over Wet.
Rooting chi.
Shodo.

Less leg micromovements,
More tongue-flapping.

8 months therapy.
Fatigue.
Motivational slippage.

Yearning to walk.
Mellow between crises.

Baca Park one-lap
Sunny, Linda, Bodhi.

Paraplegic Firsts

Gerbil uncaged.
Cafe and park.
Wheeling.

Evening comfort
in my leather recliner.

Handicap van scheduling
Convoluted
Error prone.

Work our routines.
Eases paraplegic frustrations.

Screaming legs.
"Somebody tell a joke."

Weary.
Always adjusting, adapting, wondering.

Basic ParaMS
Permission to leave, SIR!

Handicap-Van driver
Penitente and mensch.
Taos.

Micrometer.
Voluntary movements.
Believe as if....

Nothing works.

They say "multiple morbidities.
Nothing works.

Nothing works.
I don't work.
Fuck!

Nothing works.
Urge to work smarter.

Bucking knee.
15 second rides.

Scoped.
Clean.
20 french cath.
Re-plumbed.

Gin rummy.
Sleeping dogs.
Quiet weekend

Big rattler
No moles this year.

Revulsion
seeing my legs
self-pity's ugly.

Linda's pharmacology
saving my ass
everyday.

Continuing cath malfunctions
disposable caths suck!

"with all deliberate speed"
that's me

Anyone who wants yogurt
bark now!

by Linda, on our lab's insatiable appetite. Her wit makes her a 6 word natural and funny to boot.

6 word fun
everything goes away.

Pain-free 28 years
Now #3-#8
sweetbitter

referencing chronic pain

Bodhi streaks
Chihuahuas yapping
Trots back

Bodhi our gentle, mellow labrador retriever, shows a playful side.

Our tall grasses
Landscaping with wind

autobiography

Aimed low
Paraplegic
New woo*
Dawning

*MJ's worddplay on New You

Teaching tai chi to MS clients

Hi Joel,

I am a clinical social worker who works with individuals with MS. I have been practicing Yang style short-form Tai Chi and mindfulness meditation for many years and recently saw your blog about your practice of Tai Chi. I would love to teach my clients Tai Chi for all the reasons you mentioned. Do you have any suggestions in terms of teaching Tai Chi to clients with special needs? I would greatly appreciate your input. Are there any books you might suggest?

I look forward to hearing from you.

Jeanne B., MSSW, LCSW

============ ============
Hi Jeanne

Wish you the best as you share your tai chi with MS clients.

I have found the challenge to be adapting tai chi to the individual needs of he student. Everyone comes with something different in terms of mind and body. Over the past two years I guided an 80 year old man who is blind to the point where he is able to do the 108 move long form. Of course, he was highly motivated and of generous spirit.

Being adaptive has meant communicating the underlying mind/body element in any particular movement regardless of range of motion or balance limitations.

The blog is my reflections on the effort at making tai chi work for me.

One can gather bits and pieces to experiment with from various books but in the end it is the particular form of tai chi that you practice that will guide your teaching. The form is your template; your teaching the adaptation of the template to people with individual and special needs.

Happy Thanksgiving -- there is much for which we are grateful.

sending you good chi,

Joel

Returning

It’s been a long while since I’ve had anything that I wanted to say about either MS or tai chi. I‘m now able to resume a daily practice that I feel good about since I am standing after 108 moves.

We lost our beloved pup/therapy dog/mobility assistance dog of 18 months to osteosarcoma. MS made an extra effort at contributing fatigue, hip pains, loss of sensation in the torso, and new challenges standing upright.

October the winds changed: an extraordinary stayover at Best Friends Animal Sanctuary in Kanab, Utah, adopted a gentle Lab mix who we renamed Bodhi, bought a wedding dress for my youngest daughter, celebrated the many new friends from Taos, the magic of living with Linda, and the beauty of the almost 200 ornamental grasses we planted last year.

Tai chi remains an anchor in the storm of MS. At times it seems a matter of faith.

Jeep near the end


adoption day

Bodhi at home

Withdrawals from savings

This summer I've run into one of those bad patches with MS amplifying other pains. Consequently I've been unable to do any kind of tai chi practice even a sitting set. This counts as the most physically frustrating time in very long time.

So I am making withdrawals from savings, from the years of tai chi practice. The withdrawals are mental and aimed at keeping myself centered with good bounceback. I am grateful that my practice has created a savings account to draw upon during difficult times.

Looking forward to resuming a physical practice .

Mindful awkwardness

Even the most ordinary movements such as getting up from a chair are no longer automatic and effortless. My awareness lags behind the reality of the continuing loss of automaticity. Deliberate movement, an imposed mindfulness, occupies more of my mental activity. No movement can be taken for granted. Deliberateness is a zen booster in the full sense of loss and gain packed together-- loss of automaticity in movement and gain in mindful awkwardness and effort. Part of the hard work of integrating good chi and MS progression.

Bounceback

With our puppy in training as a service dog, we became aware of the importance of "bounceback" when he confronts new, startling, or fearful situations. Happily, Jeep shows remarkable bounceback.

It got me thinking about bounceback. Enlightened individuals, zen masters, may not have been perfect individuals but I see them as having remarkable bounceback, an ability to refocus their awareness in the moment. Perhaps, that is what we strive for in living with MS, bouncing back from whatever the disease presents in our life. Instead of setback, we can choose bounceback.

PS Jeep makes us laugh everyday and at 1.5 years he is doing therapy work at the nursing home and in training as a mobility assistance dog for yours truly.

Three faces of Jeep:

The Way We Age (link)

A must read for everyone especially MSers. I've often thought that MS effects resembled accelerated aging. Getting older and staying independent as long as possible is something most of us want.

Towards letting go of multiple sclerosis

Stephen's recent comment on my blog entry "MS at 65" makes me think of the Zen image of "letting go" shown in photos of Linda being a hand model. Grasping is a state of mind, a way in which I think and feel about things, relationships, memories, whatever. When I begin to feel bad, be it anger, frustration, fear, or anxiety, it is a signal that I am grasping. If I become calm, I permit myself to discover what it is that I am grasping so tightly -- be it a self-image, a childhood trauma, a fear of being confined to a bed and a wheelchair, a belief about what our politics should be, an expectation about a child's future, a treasured piece of stuff.....

Placing whatever it is that triggers my anxiety, anger, or suffering in the the open palm of my hand, is the beginning of my letting go. Like peeling an onion, letting go reveals successive deeper layers of grasping. Each peeling brings a breath of fresh air, possiblities. Can I make this practice an integral part of daily life? hmmmm....

Mutiple Sclerosis at 65

Now I'm on the other side of 65, that cultural age convention that triggers thoughts about being old and dying. For the past two years I’ve written about my experiences with tai chi and multiple sclerosis, trying to better understand the path I am on.

So what is it like at 65 with secondary progressive, aging, and the challenges of maintaining a tai chi practice that is physicial, mental, emotional, and spiritual. Paradoxically, I am feeling more whole than I remember inspite of my mobility and balance continuing to decline.

I am grateful for every day that that I can walk on my own and every day that I can practice tai chi from standing positions.

Looking back through the postings, so much is about retaining mobility. At this moment, I know that grasping, hanging on to my mind’s reality of movement, is a self-imposed mental constuct that generates anxiety and fear. Being liberated from “the importance that I’ve attached to being able to move independently” may enable me to do more of what I am capable of doing.

I often confused “letting go” with “giving up.” Now I see and feel that letting go opens up other ways of being in the world.

Time for a reassessment

As I near 65 with 25 years of multiple sclerosis and 14 years of tai chi, what are my reasons for sticking with tai chi ?

1 Practicing tai chi changed my relationship with my body from one of periodic hostility and frustration to one of communication. I listen to my body and converse through tai chi. It’s a gift to be free of so much anger and to have an ongoing positive relationship with my body for the first time in my life.

2 Tai chi enables me to experiment with my body to see what works best as the disease progresses. Consequently, my relationship to MS becomes proactive in mind, body, and spirit.

3 Tai chi informs my Zen and Taoist disposition. It is all part of piece.

4 Tai chi leads to incremental improvements regardless of the activities of my MS. I can’t overstate the significance. The disease is one of debilitation and loss. Being able to see improvements in mind and body enables me to see myself as healthy (with limitations) but not sick!

5 Tai chi cured my back problems of 30 years of suffering. I promised myself at the time (1993) that I would continue to practice for the rest of my life to be free of back pain.

6 Tai chi provides an avenue for me to do volunteer work/teaching in the community with people who have special needs for which I am grateful. My willingness to share tai chi seems to be enough to offset the lassitude generated by MS.

Tai continues to be a gift that keeps on giving. For that, I am deeply grateful to my teachers and the tradition.

Gravity can be my friend

Multiple sclerosis makes me gravity aware whether I am upright, moving, sitting, or lying down. This past year I fell four times, only once with anything broken.

I find that tai chi points to ways of putting gravity to work for me. I explore gravity in tai chi movements. Most of these movements use the quadriceps to support my pelvic girdle while sinking from in the inside out. For those of us gravity-challenged, YouTube clips of gravity based movements would be very helpful.

Tight hamstrings

If you think your hamstrings are tight at 35, wait until you are 65 accompanied by MS. I've been working with the tightest hamstrings my physical therapists remember seeing, and they've tried everything, and I've attempted what they recommended. Not much to show for all the effort.

One of my therapists thought that the extremely tight hamstrings were keeping me upright given a center of gravity that was so far forward for all of my life. Makes sense that as my center shifts posterior the hamstrings can relax and let the new alignment keep me upright.

The only movement that enables me to feel some lengthening involves the tai chi creep low like snake although it is more creep high like tree snake. My hamstrings won't lengthen until hips open enough to enable my center gravity to drop from the tailbone. It's a beginning. Hamstrings may lengthen as part of a developmental progression. I feel that the tight hamstrings are holding me back but it may be other changes must come first.

My reiki

I've been practicing reiki for 8 years. I use reiki to fall asleep, speed healing, relax, and share healing energy with others. If I had young children, I would have them reiki attuned by three.

Reiki also seems to work at a subtler and deeper level. I only suspect that reiki may have been in play when I look back at positive changes in my life which seem to come out of nowhere. It remains a mystery of how it works and what it does. For that reason, I've tried to relate reiki to specifics in my life.

Placing my hands over heart brings sleep with minutes if not seconds, healing broken ribs -- the usual two weeks of pain medication was cut to 3 days, speeding up recovery from a hernia operation -- pain-free after three days and able to return to normal activity, eliminating spasms by placing my hands over affected area, calming myself when agitated, and working with others who request healing energy.

MS and pain

Fortunately, my MS does not often manifest itself in any kind of pain. Perhaps it is my tai chi and reiki practice but one never knows with a disease which has its own ecology.

Whenever, I do experience pain, whatever its source, I turn to reiki. I am surprised that so few MS bloggers write about reiki. Yet reiki attunement is readily available, even free online. One doesn't have to believe for it to work. Just do it frequently and see if it works. I apologize for proselytizing.

MS extraordinary

It's been almost a year blogging MStaichi, and one of the pleasant surprises is contact with extraordinary individuals for whom creativity becomes a major part of how they manage their diseases. I'm very grateful to have this window to see the world through their eyes, ears, and words. Many thanks to

Charles

Stephen

Jaime

mdmhvonpa

Fran

2007 begins on good footings

We're in good patch. Tai chi is the old friend who is always there with a comforting familiarity. MS is the difficult relative you can't be rid of who insists on telling you what you don't want to hear.

Linda and I quietly celebrated our 21st wedding anniversary today on a beautiful wintry day, several inches of fresh snow, Jeep romping about, cedar burning in the kiva fireplace, and some friends dropping by for a visit.

We're both doing well in body and spirit. We came through the holidays losing weight on a vegetarian diet with Linda preparing exceptionally tasty recipes.

Jeep won our hearts in his first year of puppylife. He turns one year old tomorrow weighing in at over 80 lbs. A joy to be around, he accompanies me to some of my tai chi classes and does his rounds of therapy dog schmoozing with the old souls.



Tomorrow I restart a tai chi class with some of my regular students. I'm still able to ambulate without aids at the speed of an old tortoise .

Just bend your knees

I’ve been thinking about this entry for some time. I begin with one of the standard tai chi instructions to beginners—“bend your knees.”

After 13 years of tai chi, I cannot say that I fully know what this instruction entails. There are different ways to move, all of which result in knees being bent.

Presently, I practice bending my knees by opening my hips, checking to feel some weight in my heels, allowing my center of gravity to drop, waiting for the heads of my femurs to move in the direction of the floor, lengthening whatever muscles, ligaments, and tendons resist the downward motion.

As my practice progresses, I look for the knees to bend by flexing like a hinge, shins vertical, with a subtle upward tugging of the knee caps, and absence of feeling that the ligaments and tendons of the knee are supporting my weight. Any twinge means stop and try an adjustment.

It seems to me, that tai chi progresses from gross to subtle movements. Slowing movements increases awareness of the sequence of micro-movements necessary to move with the least effort, most strength, and greatest balance.

So I catch myself when I ask a student to just bend your knees or just fill-in the blank. The clarity of movement, which may come easily to the athlete, the dancer, or the person who moves with fluid grace, does not come easily to me and is only complicated by MS and aging.

With MS, I look for new ways to move as old ways are taken from me. I look to my years of instruction, books, the internet,for hints as to what I can try. I have not as yet found the book or person who can speak his language of micro-movements in a way that I translate into my practice.

Putting the hammer down

Taoist tai chi speaks of taking the empty step and "putting the hammer down." A metaphor? Often the metaphors take on a physical or energetic reality as one's tai chi develops. As my posture recalibrates, the heel strike is felt in the femur, the hip joint, and the movement of the pelvis. The movement of the pelvis is transferred down to the foot, in a hammer-like way so that the foot can strike with a loud slap. My less challenged right side makes a more pronounced slap than my left.

Stand/sit

My instructors' spoke of stand/sit as a simultaneous not a sequential movement. Sounds contradictory. At the time, I figured my tai chi was no where near far enough to get it. Recently I've experienced the internal sensation of dropping simultaneously with the lengthening of the spine so that I feel as if I am standing taller. Perhaps, it is another opening to be explored.

"Openings" in tai chi are like doors into an unfamiliar house. I know it is something new, but cannot know what I will find. It is a beginning with possibilities. Wish I had more energy to pursue more of the possibilities.

Rocking boat within

From time to time I try to find analogies, such as walking on a water bed, to better understand what I am feeling with MS. The latest analogy--walking on a boat moving with wave action except that the rocking motion is in my body. Doing tai chi with a rocking boat is the challenge. I think it means strengthening core and groin muscles to increase steadiness.

Another irony

Over 13 years I learned and practiced a number of forms: 108 move taoist tai chi, lok hup ba faa, tai chi sword, tai chi saber, and a chair set. Now I find myself doing fewer forms and focusing on elementary and remedial movements. I am in special ed-kindergarten. That is where my tai chi must be if I am to make progress in dealing with MS.

Drag free walking

Today, for the first time in years, I experienced drag free walking. Took Jeep, the 9 month 80 pound puppy, for a what I thought was going to be a short training walk. Instead, I found myself walking-walking without the usual drag and shuffle. I think the rebalancing and shifting of my pelvis has gone far enough to enable me to lift my foot effortlessly. After about an hour, the muscles around the pelvic girdle became tired. Nevertheless, the old man and his remedial tai chi are tracking. This could be really BIG.

Reinventing oneself

With MS, one changes -- you are reinvented in body, mind and spirit. Whether the disease reinvents a passive me or I reinvent myself, that is my choice. The fact that I will be 65 next year does not give me an exemption.

Having spent my adult years in education predisposes me to look for teachers -- in person, in books, in experience, in my tai chi training. Looking for teachers when I need to work on myself. A friend of mine likes to say -- "Personal growth is great except when you're doing it."

Biological reprogramming

Still able to "walk" without a stick. Slowly working myself back into tai chi routines. Climbing out of the hole. Seeing the light again.

I've always been fascinated with the biomechanics of tai chi. Perhaps, too much so since I know so little about the subject. Regardless, I persist because it seems to me that adapting to MS means changing one's biomechanics to reprogram how one moves. And tai chi is nothing if not a biological reprogramming.

The biology of change is very slow, especially at 64. Impatience never helps. It is as if each incremental change in mechanics, balance, posture, movement requires the death of old cells and their replacement by new cells with the new programming.

Walking without a stick

There are many who write well about MS and many more qualified to write about tai chi. I blog to better understand how MS and tai chi intersect in my life. After the roughest summer to date, my emotional and physical balance has been severely challenged. There was not much to write about until now.

I've used my tai chi exercises to continue the multi-year project of reshifting my weight and posture so that more of my weight pivots from the heels. I hesitated to report until I was more sure but I am now walking without the use of a walking stick. I don't have the pelvic strength to walk distances--it is my pelvic girdle that is doing the work of walking--but I am mobile and excited by the possibility of regaining some of my lost mobility.

Tai chi as ballast

Thank you to all who were concerned about the dry spell in the blog. Your kind thoughts were warmly welcomed.

Still in the middle of very difficult patch, a cluster of changes, none of which are pleasant think about. Most of it is probably MS related but one can rarely be certain.

However, out of the dark gray, there is a flicker. Tai chi unpracticed seems to operate on is own momenum rooted in my years of daily practice. Internal chi-type changes are continuing to occur -- micro but noticeable. I'm hesitant to draw any conclusions.

A couple examples. Some days my internal energy, not to be confused with the energy we expend in ordinary life activities, is so strong as to be discomforting. The movements around the spine continue to progress with only a few minutes a day of fundamental tai chi movements.

MS puts enormous strain on the closest loved ones. Anything I can do--medical, behavior change, attitude adjustment--is worth doing. A centering exists even in the fog of MS--years of tai chi practice are my ballast.

Still Processing

My hard fall at the end of May triggered a number of things which made for a difficult month. I’m still processing.

The broken foot may be the least significant as it is healing quickly and free of pain. The hip, which I though may have been fractured, was only bruised along with my feet. And the MS progression seems to have quickened making getting up, standing, and walking difficult and tiring. I am being reaquainted with some neurologically-induced muscle pain.

It has been the longest suspension of my tai chi practice in almost 10 years. I do some movements and two sessions at the nursing home but miss the centering and steadiness which daily practice brings. The will is there but the body is recalcitrant.

I found myself wondering what the new normal is going to be only to realize that I am creating expectations rather than taking each moment for what it is. Ultimately, all I have is each moment – why squander it on an expectation that is only guaranteed to add a layer of suffering if the expectation is not met or exceeded.

There is much to healing that remains hidden and mysterious.

Cramping My Style

Unable to do much tai chi or reconditioning with a fractured metatarsal. Grateful that we have reiki to speed the healing. Linda has been giving me spot reiki several times a day. I used intensive self-reiki to speed healing when I broke my ribs and had hernia operations. In those instances, I was pain-free in 48 hours and resumed ordinary activity.

I can't help but believe that reiki is a valuable adjunct to anyone with MS. Unlike tai chi which requires a sustained practice, reiki and self-reiki are immediately accessible.

The MS Fall

Yin and yang, balance and falling, all part of a piece.

Falling presents its own peculiar challenge. With my MS, I am a aware of most changes in situations which present balance problems and I compensate. All of my falls come in situations with which I am familiar, doing things I have done hundreds, if not thousands of times--like getting up from our dining table.

Getting up from the table, the side of my foot caught the grout line in the tile --hardly an obstacle-- but enough to have me fall-like-tree onto the tile floor. I injured my foot and have been nursing it for a week.

It is especially difficult to be mindful of ordinary movements that are part of familiar ways of daily living. However, it is in the ordinary that risk proves greatest. Nothing is too ordinary to be taken for granted. Mindfulness is living the micro-moment. I admire the zen monk.

I miss my tai chi practice. Substituting an abbreviated reiki practice.

The Unexpected

Just as I was mentally approaching the next phase of disability, the unexpected occurred. The night before I was dragging both feet and having more balance problems. This morning something had shifted bio-mechanically so that I am now able, be it slowly and deliberately, to lift each foot while walking. With it, balance has improved.

Apparently, the recent physical therapy on the hip flexors, and practicing tai chi practice focusing on hip flexion, has paid off.

Once again I was letting expectation creep in -- hoping that tai chi would help stave off increasing disability. As disability progressed, I began to feel bad.

How many times must I learn – practice tai chi without expectation. Practice without hope and without despair but practice.

Inertia

One of the consequences of the progress of my MS, is pushing against inertia. Each and every ordinary movement requires effort to overcome the feeling of "just sit/lie where you are." Here is where the thousands of practices of tai chi kick in. I just do it.

Discovery

Each year I grieve the loss of some increment of functionality. The disease is. Fortunately, there are work-arounds -- hiring others, relying on loved ones, reorganizing how one does things.

At the same time, my tai chi practice leads to discovery and growth. Changes register internally -- most likely they are unnoticed by others. However, each change in mind-body awareness brings with it an illumination -- a 25 watt bulb. The mystery of our bodily experiences becomes richer. Most recently, small changes in activating the hip flexors has had a rippling effect on my practice. Something new is being revealed.

Will you still need Will you still feed When I'm 64....

Celebrated my 64 with dear friends from Albuquerque, new friends in Taos, and a doggie playdate for Jeep and his buddies. There is nothing like puppy energy for good laughs and making one move. MS lethargy places a distant second when it comes to avoiding a puppy-inspired disaster. I think I've been moving or lurching more in the past two weeks than the past two years.

Adding a puppy to the MS-Tai Chi mix

Jeep, an 8 week old puppy mix, has been added to our household. He was the largest pup by a third in a litter sired by a 65 lb.poodle. The dam, a Golden Retriever, weighs in at 85 lbs. He will have a job -- balance assistance and therapy work.

Strength and Reconditioning

I've added a strength and reconditioning program working with a Rx for physical therapy. Three times a week, a physical therapist works with me on various machines and exercises tailored to my needs. It is like having a personal trainer who has specialized in rehab.

For example, he noticed that I have greater balance when I drop into my hips and bend my knee. So he is having me work on exercises strenthening my balance when my knee is only slightly flexed.

Lumbar Spine Movement

Openings are small but very welcome. I am now initiating distinct movement in the lumbar spine during the tai chi drop. The particular feeling of opening in that part of my body is novel. Each opening seeds promise and hope.

An Rx Interlude

Like many, my experience with MS drug therapies doesn't provide reliable information. At best, there are clues.

Since Fall 2005, my rate of MS progression has increased. In April 2005, after consultation with my neurologist, I came off Copaxone since it did not seem to be slowing progress of the disease. We decided to try Rebif. The Rebif reaction made my MS worse as well as made me sick. It seemed like I would have the flu for an indeterminate time. I stopped taking the Rebif.

During the summer, the MS was stable and perhaps improved. However, the last four months have become increasingly difficult: legs more jelly-like, a sudden loss of postural balance and marionette-like folding to the floor (once early in January 2006), and over the past few days, my right leg feeling painfully strange and cold.

My walking is severely compromised. On a recent trip to Denver, I used a wheelchair to get around Denver Botanical Garden and Denver Public Library. For walking I use a hiking pole wherever I go.

I do tai chi daily without much difficulty although it requires special mindfulness. I continue teaching tai chi several times a week to people in special needs situations.

Comparing rates of progression, it is clear to me that my MS has progressed faster this past 10 months off medication than over the previous year on Copaxone. The cataplectic-like event, the painfully cold right leg, increasing heaviness of my legs and loss of surface sensation, and the jelly-like legs strongly suggest some change in regimen.

After a recent consultation with my neurologist, I learned that there was reason to believe that Copaxone may also repair nerve damage (www.newswise.com/articles/view/516122/?sc=rsmn) . So, we agreed that I restart Copaxone.

An unfinished thought

A degenerative disease acutely brings personal strengths and weaknesses to the foreground. Multiple sclerosis insistently challenges me to look at myself and my circumstances and find something to build upon. I admire that part of myself. But it is only half of the ongoing story. The disease also underlines weaknesses, denials, escapisms, self-absorption.

Strong and fragile, fragile and strong, in every step and mis-step. Unsettling.

Re-reading what I have written, it seems as if the concept of my self that I have guarded so closely is slowly being eroded. Perhaps it is a good thing to remove the buffering self, but I don’t feel warm and fuzzy.

A Remarkably Good Chi Day

This morning I had my regular Friday class with two extraordinary people: Rod who is blind and in his late 70's and Jean who who is in her mid-70's and teaches Feldenkreis. Both have completed the the 108 move set and are now refining the form. I came away from our hour filled with good chi and blessed with full partners in tai chi.

This afternoon I did a tai chi segment in a training workshop for activity directors in New Mexico nursing homes and assisted living facilities. The 20 participants were introduced to adaptive tai chi kung. I partnered with a friend Barb, who teaches chi kung. The participants completed the 108 move tai chi chair set and were accompanied by two of the Taos Living Center residents with whom I have a special connection: Emma 94 and David 55 who has MS. Both demonstrated their tai chi. Truly remarkable.

A very good chi day.

Cataplexy: sudden loss of postural muscle tone

I ended 2005 with a cataplexy-like event. The drama unfolded while I was discussing my candidacy for town council with Taos County Clerk Elaine Montano, filing papers in hand. With the sudden loss of postural muscle tone (most often associated with narcolepsy), I folded like a marionette. No warning. Only shocked looks. No harm other than my brief candidacy which also folded. At this stage of my MS, adding the stress of political life borders on insanity.

MS surprises remind me how much we all live on the edge. Cataplexy unmasked yet another level of denials and rationalizations. A Buddhist might think of it as an awakening.

Linda thought that my tai chi may have prevented any injury as I folded neatly to the ground.

First thing the next day, I did my tai chi practice and was reassured.

Inside Out

Strange – more and more of my movement is inside out.

As my multiple sclerosis transformation progresses, I have less surface feeling on my body. The other day I noticed the complete absence of feeling on the top of my foot when directing a hair dryer two inches from my foot. I also have less external muscular control of my legs.

As my tai chi transformation progresses, I have more awareness and control of deeper muscles, an internal world of movement. I am able to contract/relax, to some degree, those internal muscles (sinking of the torso, turning of the spine, dropping the scapulae, medial rotation of the hip joint....) to assist in what passes for walking. It seems that the internal movements are directing and amplifying what remains of external muscular movement. For example, sinking my shoulders and torso sinking enables me to lift a reluctant leg and propel my foot forward or backward.

Tai chi or Karate?

Miss Chris asks whether tai chi involved enough physical exertion compared with hard core karate.

At the level of breaking a sweat, no. There is a period in the practice -- for me, it lasted two years-- when doing a set would result in a heavy sweat. Had to wear sweat bands on my head and wrists. However, that passes.

Tai chi practice works at other levels -- biomechanical, energetic, meditative. When I do aerobic I use a rowing machine -- no balance issues, core strengthing, rhythmic.

Tai chi and ms fit very well. I have no pain and spasticity is so low as to be unremarkable. I do TC anywhere (and have) -- Plaza San Marco, a small kitchen. Any time. Any clothes. Standing or sitting.

Whatever you decide, having a practice is essential. TC, yoga, karate, journal writing....whatever. Without a practice, there is no anchor in the MS storm.

How to practice tai chi

For most of my life I equated practice with repetition. I never learned the richer meaning of practice as refinement and cultivation. My challenge is 'how to practice' as much as 'how to do tai chi.' The question I ask myself is how to make each practice a step in my development—a step which offsets the progress of MS.

In my first four years of doing tai chi, I practiced with a group. Practice was directed by the instructor. We worked on what the instructor thought important for the group. The group energy sustained my practice. Without the society, my tai chi would have faltered.

As I came to understand practice as a form of training, individual practice became more important and its own reward. I regularly attended workshops and intensives for four years, learned additional forms, always looking for individual correction from advanced instructors.

Then I moved to Taos and my group practice ended. For the last six years my practice, exclusive of my teaching, has been individual. I attended several workshops, read extensively about tai chi, and began experimenting with different techniques.

Now my practice focuses on one or perhaps two aspects of the form. Sometimes the tai chi movement itself suggests what needs to be done and sometimes I bring the idea and intention to the practice. I both need and enjoy the practice. I also feel there is something missing.

I often think that I should find a tai chi master willing to make the corrections and give guidance. And just as often, I think it is up to me to find the next step, to make the next adaptation, to explore the next possibility.

My answers to the question – how to practice tai chi –are provisional and as much mental as physical. Perhaps that is the nature of practice—to always be provisional.

Tai chi athleticism

How can someone who is debilitated, with difficulty walking and maintaining balance, write about tai chi athleticism? Ridciulous! Delusional! Perhaps.

The challenge and grace of MS/Tai Chi is the ordinary/extraordinary way in which incremental MS deficits initiate tai chi adjustments. The adjustments make tai chi more athletic in the sense of greater awareness and control of my body. Today's practice was graced by a degree of control over my scapula and back muscles -- coordinating the drop in the lower abdomen (dantien) with the drop in the scapula resulting a greater degree of stability especially in one-legged movements. I measure my improvements in small degrees within my MS delimited range of motion.

I suspect athletes naturally have the basic awareness and accompanying muscular control -- enough so that it can be developed to a greater degree. Having MS and doing tai chi does not make me an an athlete but does put me on the athlete's path, a novel experience punctuated with serendipity as well moments that disturb the Wa.

Sisyphus

It has been many months, and feelings of flatness and frustration. The insidious progressive nature of MS demands continual readjustment.

I remember riding subways as a boy and playing a little game of standing without holding on to any supports. The unpredictable nature of sideway jolts as the train sped through tunnels required awareness and nimble balance adjustments. To master standing without support was a mini right of passage.

Here I am at 63, having to re-learn balance everytime I move, only this time there is no mastery. It is more like Sisyphus pushing his rock up the mountain, watching it roll down, and once again pushing it up the mountain.

But 63 brings some understanding, and I am grateful, even if weary, of the awareness of each moment, of not taking the ordinary for granted. And that awareness, cultivated by my daily tai chi practice—is a blessing in itself.

Undoing the strait jacket

In recent practices, I've become aware of the front of my torso participating in the drop. It feels like the strait jacket of tight muscles and joints in my torso is becoming pliable. A welcome sense of movement. It also seems to be making my drop more centered around my spine as wells as strengthening muscles in my core.

Physical Re-education

Trying to understand the most recent changes. The pathology of multiple sclerosis guides my physical education. As the central nervous system falters, I lose feeling in my legs and in my torso to a lesser degree. As my legs flop, there is strain and pain. My tai chi instructs me to strengthen my core, especially the muscles around the spine, the groin, and the adductors to compensate.

The physical reeducation progresses but does not keep up with the MS progression. My tai chi is playing tortoise to the MS hare. Waiting for the hare to be distracted. The biomechanics of human movement is fascinating. Keep Moving is my mantra.

Rehab

I train with tai chi to rehab poor posture and body mechanics that were habituated before MS, and amplified by MS and natural aging. I am changing but it is slooooow, incremental and long term. Reinventing my body becomes more and more important as I use tai chi to guide new adjustments to my progressing MS.

As I continually readjust the way I walk, even slight changes in body mechanics and posture enable the tai chi movements to translate into movement with less effort. The Three Nail training continues and has become one of my walking cues, assisting my elephant-heavy left leg, and reducing the tendency to foot drag.

The Geometry of Intention

I've wrestled with "intention" since beginning tai chi 13 years ago. First I denied its importance. Then I confused "will" with intention. For a long while, I substituted "awareness."

I find it helpful now to think of intention, or at least an aspect of intention, in terms of geometry -- distinct geometric shapes, such as holding (and compressing the ball of chi). The tai chi form is geometry set to motion. Moving through the set, I allow the geometry of the movement to guide me. The clearer the geometry, the clearer my intention.

Three Nails

My MS has severely reduced both feeling and control in my legs. However, my tai chi training has increased my feeling, control, and strength in my feet and my pelvis. In between my feet and my pelvis, occupied by my legs, is a "no man's land." The problem is how to move and control my legs as command and control by the central nervous system diminishes.

This week I've begun focusing my training on William Chen's Mechanics of Three Nails.

The three nails refers to three points on the medial or inner portion of the sole. In only a few days, the connection between pelvis and foot has markedly improved and with it balance and strength when standing on one leg. My base is becoming more solid and I am able to initiate turning of the spine from the 3 nails. I feel this practice is coming at a much needed time.

A third leg?

I've been focusing my practice on standing up using my spine as if it were a third leg. Keeping the pelvis level, anchored by tai chi foot placement and the femur of the bent leg, and making sure my torso does not move forward or back, the spine lengthens and with it the sensation of standing up. For this to happen, I must give it extra time. Linda remarked about my doing extra slow sets. From slow to really slow.

As the spine lengthens, it stretches my rib cage, the sternum rises, and the bent leg is pulled up, leaving me standing. With a standing/balance deficit from a progressive disease, this internal standing practice has become more and more important. Bit by bit, my body is being reconformed by my tai chi training.

Tai chi and MS: Hertz and Avis

In the few months since posting any reflections, my MS reached a new low and my tai chi a new high. MS continues to be my Hertz -–“we’re #1” and tai chi my Avis -–“we try harder.”

The Hertz-Avis rivalry reminds me to cultivate “beginner’s mind” and stay open to the reality that some things get worse and some things getter better at the same time. Of course, it goes against linear and either/or thinking. We go from young to old—the direction doesn’t change except in instances where we see unusual youthfulness in the old. But being young at heart does not reverse the biological linearity of getting old.

In my tai chi, the linearity of progressive disease is joined by an increased strengthening of bodymind—incremental changes that are as real as my MS. Gettingbetter/GettingWorse is so zen and like zen, must be relearned and practiced regularly, especially when Hertz is in the driver's seat. The lesson is in my tai chi -- standup/sitdown (more accurately, drop internally/lengthen the spine so that your head rises). What appears to be a contradiction -- how can you stand and sit at the same time, turns out to a different mode of movement, a different mode of being where polarity is transformed in a union of yin/yang.

Yesterday's legs

The past month has been one of those times that MS is in the driver's seat. I am grieving the loss of yesterday's legs. Today's legs are slower and tire quickly.

I am settling into my new Rebif regimen with the usual flu-like symptoms being controlled by ibuprofen. Too soon to tell if Rebif is making an impact.

My tai chi hangs in there. Here again, even with fewer daily practices, positive body changes continue to occur. The sacroiliac episode of last month had a beneficial effect in furthering my efforts to rebalance posture. More of my weight and balance is shifting posterior in the pelvis giving me greater support when I am on one leg.

Tai chi to break the final spasms

My week-long episode of sacroiliac joint inflamation ended when I went through a day of doing danyus and hamstring stretches. The steroids gave enough relief that I was able to use a tai chi exercise to break the remaining spasms. The tai chi complemented the steroids and pain killers.

A stealth disease

Multiple sclerosis is an insidious disease punctuated with a number of traps. Loss of sensation affects my judgment. I think I am working within my limits but I am relying upon neuromuscular misinformation and incomplete feedback. I find out only after I have done too much.

Following what has been my late night training regime aimed at greater opening of the back of the pelvis with tai chi exercises and time on the WaterRower, I awoke the following day with pain that hunched me over. Began ibuprofen, shallow danyus , and reiki but recovery was slow. After several days, I felt well enough to hoe some weeds and I felt no pain while hoeing. Bad judgment! Within 12 hours, I knew that I had aggravated something. The pain worsened. By Memorial Day, after some spousal urging, I asked for medical help from a physician friend. I began heavy duty Methylprednisone and Percocet for a strained sacroiliac joint that triggered localized sciatica pain. I am on the road to recovery.

Is this latest episode a setback or painful readjustment? Based on previous experiences, the pains associated with intense tai chi training have been followed by developmental gains. I don’t subscribe to “no pain, no gain” but my training exercises have a focus and intensity. The MS may be masking the early warning pain signals. Subsequently, when I think I am doing 80%, I may be fooling myself. My bodymind listening skills are not as yet finely tuned enough to pick out subtle precursor signals that I am nearing the edge.

Blogging effects

In this first three months of blogging on tai chi and multiple sclerosis, I notice a subtle shift in how I think. I am more attentive to my practice, listening more carefully to what my bodymind tells me. Consequently, when I listen I am less performance driven. I practice, listen and later on reflect and blog.

The more carefully I listen the more I realize how performance expectations create a mental fog. I have difficulty listening if I am focused on performance.

However, I haven’t been able to give up all performance goals. Perhaps, that will be the next letting go. There are only small steps towards a meditative practice.

How much tai chi practice?

I know it takes a lot of practice to become adept at tai chi. Just how much I was unable to gauge until I read about the research conducted by K. Anders Ericsson, a psychologist who has studied expert performance. One of the outstanding differences between elite performers-- international violinists, chess grand masters, professional ice-skaters, mathematicians, athletes—is the cumulative amount of deliberate practice they’ve had.

For example, the critical difference between expert musicians differing in the level of attained solo performance concerned the amounts of time they had spent in solitary practice during their music development, which totaled around 10,000 hours by age 20 for the best experts, around 5,000 hours for the least accomplished expert musicians and only 2,000 hours for serious amateur pianists. More generally, the accumulated amount of deliberate practice is closely related to the attained level of performance of many types of experts, such as musicians (Ericsson et al., 1993; Sloboda, et al., 1996), chessplayers (Charness, Krampe & Mayr, 1996) and athletes (Starkes et al., 1996).
quote from K. Anders Ericsson

Practice hours accumulate slowly. The numbers are daunting. Practicing one hour a day for 360 days a year, it takes 2.7 years to accumulate 1000 hours and 13.5 years to reach 5000 hours.

I’ve been practicing tai chi for 12 years but the willingness to engage in sustained training did not take root until the 5th year. Without making any correlation with level of skill, and if I figure generously, I've clocked 3- 4000 hours of deliberate practice and that includes group practices and classes. Under ordinary circumstances, the practice hours feel about right for a serious life commitment that began in my fifties.

Although my willingness to practice remains high, MS throws a couple of curves. Balance and fatigue issues affect the way I think about the amount of time devoted to practice. Do I try to override the MS fatigue? How far do I push myself? Testing my limits produces anxiety over the consequences of overdoing. At the same time, MS is always available to fall back upon and rationalize doing less than I am able. When is doing less laziness and when is it coping with MS?

So like so much of life, I hear the friendly prod--"you're doing too much" "you need to be doing something aerobic" "what about upper body strength?" -- and I recalibrate the balance with an evershifting reference point.

Beyond optimism and pessimism

Like others with a chronic illness, I wrestle with my attitude. Although I am generally an optimistic person, I do not find a perpetual attitude of positive feeling to be a comfort in dealing with MS. Neither does the dark solace of pessimism offer much.

My reality and its accompanying emotions are most at home when I step beyond the expectations of being either optimistic or pessimistic. Carrying around any expectations, whether they be positive (a cure in the near future, a future of independent living ) or negative (there is no cure for MS, I will end up in a wheelchair), creates a burden that invites disappointment and emotional pain. If I am optimistic, I set myself up for a letdown. If I am pessimistic, I close myself off to positive happenings. Those sticky expectations, I didn't see them in the shadows.

Obviously, MS, like tai chi, is living and only done in the present moment—which may be happy or sad. And immediately thereafter another moment follows with its inherent unpredictability that lies beyond the half-hidden expectations that I have created. So, when I sm fortunate enough to recognize the expectation, I remind myself-- "let it go."

MS Fatigue and Tai Chi Practice

Like so many of my fellow-travellers, I am always looking for ways to get around the neurologically-induced fatigue. Early morning tai chi practice remains best. I am tired, almost groggy, in the early evening hours and sometimes feel too tired to sleep without first taking a nap. Suprisingly, I’ve found a second wind between 11PM and 1AM. So, I do tai chi exercises and rowing during the wee hours. What ever works!

MS may have introduced me to a pre-industrial pattern of segmented sleep that may have psychic rewards lost by continuous sleep.

See The cultural biology of sleep - Medical Anthropology
Townsend Letter for Doctors and Patients, July, 2002 by Tim Batchelder

Segmented Sleep
In Western society we embrace an ideal of the 8 hour night of continuous sleep. However, cross-cultural studies show that evolutionarily, a very different sleeping pattern is the norm. Worthman notes that in contrast to current sleep recommendations people in pre-industrial societies do not keep a regular bed-time. They slip in and out of sleep all night but spend much more time sleeping (more than 10 hours a night typically) since they go to bed when it is dark. People in pre-industrial societies complain of getting too much sleep, not too little. In general, sleep is considered risky since it exposes a person to ghosts, evil spirits and witchcraft, and the sleeper's spirit may wander off too far and fail to return. In addition, in pre-industrial cultures sleep is seen as an important source of visions and altered consciousness in contrast to the view in Western societies where sleep is considered "downtime." Sleep deprivation is used ritualistically for visions and initiations. In ceremonies somnolent or ne ar sleep states are maintained to increase spiritual visions. All night dance fests and feasts are conducted about once a month.

Studies of Western Europeans by historian Roger Ekirch of Virginia Polytechnic Institute and State University in Blacksburg show that "segmented sleep" was a common practice of rural and urban people 200-500 years ago. Each evening, exhausted from a day of physical labor, people first sank into a "first sleep," which lasted for several hours then shortly after midnight, awoke and spent 1 or 2 hours in a "watching period." A "second," or "morning," sleep followed. The watching period featured prayer, conversations with a bedfellow, sex, contemplation of dreams or the day's events, or wandering of the mind in a semiconscious state that was prized at the time.

According to Thomas Wehr of the National Institute of Mental Health, when deprived of artificial light people and other animals sleep in two periods separated by an hour or two of quiet rest and reflection. Many mammals sleep in two major bouts during the night or day. In pre-industrial people this regular awakening out of REM sleep allows them to reflect on and remember their dreams in a semiconscious state, which is not available to modern people. This pattern of awakening at night over evolution suggests that people who suffer from this tendency are not really insomniacs.

Kitchen sink is my friend

Before bed I visit the kitchen sink. Holding on to the sink, I align myself, open the hip joints, and then, super-slowly, do various tai chi movements using gravity to lower myself. With multiple sclerosis, I am always looking for ways to substitute gravity for effort. The kitchen sink is an indispensable prop that assists in opening up the pelvis, moving the sacrum, strengthening my core and legs, and stretching groin muscles. I often spend 20-45 minutes in this practice.

Rogue tai chi

I am not trying to develop a rogue-style of tai chi but that may be happening.

When I first learned the basics of tai chi, I was told that health benefits would accrue by practicing the form as well as I was able. After several years of study, that understanding was expanded by training in what is now being called adaptive tai chi -- tai chi modified for special needs, such as MS. I've witnessed how the tension between "just do tai chi" and "adaptive tai chi" erupts into personal and organizational conflict over how tai chi should be taught.

At this point, a few years years later, my understanding has shifted once again. "Just do tai chi" and "adaptive tai chi" address classes of individuals, not the individual. Multiple sclerois is a highly individual disease and each individual brings a bodymind shaped by genetics and experience. Each of us requires individualized remedial work to correct specific problems. The remedial work is person-specific.

Tai chi practice, done mindfully, generates specific knowledge about the way my bodymind functions. I feel this knowledge as much as I understand it. This Joel-specific knowledge informs my daily practice, guiding the focus of each session.

However, my own understanding is limited and I need the guidance of more advanced practitioners attuned to my specific needs. Until I find those teachers, I rely upon my understanding of tai chi principles and their applications.

An internal movie

A dark morning, my legs/balance not working well. I question myself. I feel the need to try tai chi to see what is going on. Has the baseline shifted?

Tai chi practice is liking watching an internal movie of what I feel as I do the set. Sub-titles call attention to specifics: be aware of giving enough time for right hip to open (fraction of a second more), pay attention to drop being centered, shift hands a bit higher to feel more movement in the thoracic spine.

Tai chi movements send mental signals. It is the reverse of sending a mental instructions to my body. These bodymind signals are not planned or willed; they appear spontaneously in the practice. Joel-specific knowledge emerges from this internal feedback.

I complete the set. The darkness has lifted. I am left with a sense that I am still moving along the path.

Heart Practice

Early in my training I heard a story about Master Moy Lin-shin. One of his more advanced students asked what was keeping him from making more progress. Master Moy’s correction was for him to stop doing tai chi altogether, give up his job, and work in the kitchen of the Society’s retreat as a volunteer for a year. The student was asked to do a “heart practice.”

My first reaction was “exploitation.” How was volunteering as a chef going to help accelerate tai chi development? Years later, the wisdom of the correction began to sink in. Without a heart practice, a practice of compassionate giving, tai chi progresses only so far. Jef Morris, one of my dear friends and master trainer, would always say -- "Give it away." Good chi is cultivated in the giving.

Offering tai chi to the old souls at the nursing home, special education kids, and people with disabilities is as much a part of my tai chi as my own personal practice. It must also be learned and cultivated. It took me awhile to key into Linda's observation that the practice was not teaching a class but a more a ministry. Now I would be at a loss without my new friends and my tai chi development would be stunted.

Connective Tissue

In the past couple of years, I've experienced ways in which connective tissue affects remedial and developmental aspects of tai chi. There are times when I feel like parts of me are bound in spandex that has lost most of its give. The fabric of connective tissue, a network of connecting cables under tension, molded over a lifetime, is crucial in holding the body erect. To remain upright and ambulatory with multiple sclerosis, I must continue to improve my biomechanics and with it changes in the shape of the connective tissue that sheaths my torso under my skin. Remolding feels like tugs on the warp and woof of the living fabric.


several quotes on connective tissue and posture:

In addition to supporting individual cells, tissues, and other organs, this connective organ serves an over-all structural purpose as well--it is woven with the bones to create the movable frame which supports our posture and from which everything else is suspended....When all the bands and cords are properly adjusted, and the hydrostatic pressure is strong and balanced, this tensional force alone goes a long way towards keeping us erect, and can give that wonderfully light "skyhooked" sensation, as though our frames were suspended from the tops of our heads--as, to a degree, they literally are.
from Deane Juhan, Job's Body: A Handbook for Bodywork


Poor posture is not a result of bad habits or laziness. Postural problems are caused by tension in the muscles and microfibers in the connective tissue create local areas of tightness, which distort our posture.
http://www.somaxsports.com/posture.htm

Fascia molds itself over time according to how the body is used....The moldability of fascia is the reason that ergonomics is so important.... If a person habitually sits in a slouched posture, then over time the fascia in their body will mold itself to that posture. Fascia in the chest will pull the ribcage down, fascia in the neck will pull the head and neck forward, the slouched position of the upper torso will change how the arm bones fit in the shoulder joints and the fascia in the shoulder area will change as a result. All of these posture-related tissue changes will be felt by the body as a source of strain.
http://www.selfcare4rsi.com/fascia.html

Still puzzling

One of the stark differences between the Taoist form that I practice and other forms of tai chi chuan concerns up and down movements. I learned that down/up, sit/stand were essential to lengthening the spine and achieving the health benefits of tai chi. Every other form I am familiar with insists on the opposite: not letting the body rise, staying level.

I’ve played with it both ways. I know I am missing something. But what?

A recurring paradox

Hit one of those difficult patches with multiple sclerosis where I've been losing more feeling in my legs. I trudge. This time the changes coincided with my annual neurological exam. The medical option is pharmeceutical roulette. In this instance, switching from Copaxone to Rebif.

There is always emotional fallout for myself and Linda in terms of increased anxiety and depression. I am tempted to call everything that I am doing into question. But, my daily tai chi practice and teaching continue. I add a rowing exercise. After a couple of weeks, some tai chi sense begins to sink in and the familiar paradox reemerges. The disease unrelentingly takes away but at the same time tai chi practice refines my bodymind awareness. I am experiencing greater awareness and control of my heel-spine connection, and my groin muscles have become engaged in securing a lower center of gravity with a "new" resource for balanced turning.

MS works in one direction; tai chi in another: the paradox of dis-ease/greater-ease at the same time.

Or has the Zen Monk masquerading as MS presented the paradox as a koan to his numbed-skull novice? Will I carry the paradox like a heavy stone in my mind or take in the traces of the seasons?

Center of gravity alignments with tai chi

I am training to increase stability by lowering my center of gravity. The matter has some urgency since my disabilities associated with multiple sclerosis put me at level 6.0 on the Kurtzke Expanded Disability Status Scale . EDSS steps 5.0 to 9.5 are defined by the impairment to ambulation.

As the muscles and ligaments of the pelvis open over months and years, millimeter by millimeter, my long femurs (about 20”), seat themselves further back in the pelvis. The femurs, connected to the knee joint, move like levers, supporting the posterior of the pelvis and moving my center of gravity further back (posterior). I see why athletes have well-developed butts.

As the pelvis opens and the hip joints rotate, the triangular geometry of the tai chi stance, one foot at 45 degrees and the other foot either forward or back, permits the inner organs to sink between the legs. This creates an increasingly stable platform. Of course, the sinking is experienced internally and may be visible perhaps only to the highly trained observer.

The stable platform and low center of gravity also develops by degree. Each side of the body is different. On my left side, the hip joint turns smoothly, the sinking and platform-effect more pronounced, but the left leg is less responsive neurologically. Consequently, I find it more challenging to balance on my left leg+coccyx combination. The right side is less open, the femur doesn’t seat as far back, the sinking does not feel as stable, but the right leg responds more to neuro-muscular command-control so that I am better able to stand on one leg+coccyx and do kicks and leg separations.

My training premise is that the more I sink, the more stable I will be when turning either right or left, since my body will be relying less upon the compromised neurology of my legs, and more upon the sacrum/coccyx for rotation and support.

Relentless it is--Yoda

There are times, like now, when secondary progressive MS seems Sisyphean. I push/pull my MS rock up the mountain, only to watch it roll back. I begin again but the rock does not go up the mountain as far before it rolls back.

Unlike Sisyphus, I have choice. I can settle into an easy chair with my self-pity. I rebel against the easy chair. I return to the push/pull of tai chi merging myself and my rock. And in those moments, my efforts of bodymind, my MS, and me are one: sad, even happy, and determined.

Managing Multiple Sclerosis by Teaching Tai Chi

I cannot imagine managing my multiple sclerosis apart from teaching tai chi. I teach for many reasons: the rewards of teaching, the sharing of a gift, cultivating my practice, being engaged in my community, meeting wonderful and often inspiring people, satisfying my teaching bone, making new friends.

But there is an MS side to why I teach. MS takes away. Letting go of what I used to do is forced upon me. It is something I must accept, graciously or not. Teaching reverses the psychology. I am choosing to give rather than being forced to accept. Disease or not, I am in charge.

MS fosters its own brand of fear and anxiety. For me, it’s a fear of losing my place in this world. Teaching tai chi enables me to find my place in a way that is not defined by multiple sclerosis.

Stabilizing My Gait: Brush Knee with Twist Step

As multiple sclerosis reduces feeling and control over my legs, I am aware of additional deficiencies in alignment and gait.

I’ve been to a Health Recovery Instructor Workshop where the physician-instructor demonstrated the Brush Knee With Twist Step form with individuals afflicted with severe rheumatoid arthritis as well as other conditions that affected gait and balance, such as flat feet. The form challenges the mind and body and provides the needed template for making corrections.

Presently, I am practicing the tai chi twist step to activate the adductors of the inner thigh to stabilize my foot when shifting balance from one leg to another. Feedback comes from the arch and the big toe. The movement counters any tendency to over-shift weight to the outside of the foot. Since my central nervous system command and control over legs is compromised, any over-shift can easily destabilize my balance. The normal hardwired balance compensations are not available.

Injury and the interruption of my tai chi practice

If an injury halts my tai chi practice, I lose my daily sense of grounding. During these moments, thoughts about my multiple sclerosis gain the upper hand. It is likely that I have become too attached to the specifics of my tai chi practice and experience the break in routine as loss.

As the acute phase of injury passes, I find myself experimenting with my practice, reconfiguring the form so that it connects me without inflicting pain. These times are among the most trying and I am thankful for the chair set version of tai chi.

The chair form of tai chi has its own subtleties. I practice it regularly with the old souls at the Taos Living Center, our community nursing home.

A thoughtful comment from a professor of exercise physiology

A much appreciated comment on injury, tai chi, and MS from a friend who is a professor of exercise physiology.

"I read through March 14th and will continue reading. I was particularly impressed with your insight into the pathomechanics of the injuries. While I did not understand some of the forms you referred to I could visualize movements contributing to the injuries and the adaptations you made.

While I attempted to visualize the movements, I realized that had I been watching you perform the movements I would not have a sensitive enough of an eye to detect the subtle, inappropriate movements contributing to the injury. I wonder if any clinician (therapist, personal trainer, or tai chi master) would have detected the errors. After the injury occurred, it would have been easier to go back and visually analyze the movement and say yes at this point there was a lack of synchronization and as a result undue stress may have been placed on the ligaments or the tendons. Then again, some biomechanical errors are so subtle that detection requires motion analysis using high tech equipment and computerized interpretation.

So to answer your question of whether I know a personal trainer who specializes in working with individuals who have MS my answer is no. Your entries, however, have made me realize that working with individuals that have MS requires going beyond a simple understanding of biomechanics. Adjusting for the muscular imbalances created by tai chi are even more problematic. What would make sense is designing a program using reciprocal movements or stimulating the anatagonists with electrical stimulation. (Don't ask me how) Perhaps another alternative is to use the vibratory platforms. (Some research is being conducted with the use of this modality with individuals who have incomplete spinal cord injuries.

As usual, you have left me with many more questions than I have answers for. The one thing that I can say with certainty however is that while reading your entries I wanted to rise from my chair and experience tai chi.

As promised, I will continue reading and learning from your entries.
Your friend
Rich

Injury: A Neglected Subject in My Tai Chi Training

Injury is part of living and common in any form of training. Tai chi and multiple sclerosis give it a different twist.

Almost everything I’ve learned about injury associated with tai chi is firsthand. The subject was barely touched upon by my instructors and is not written about in the tai chi books that I’ve read and scanned.

In managing multiple sclerosis with tai chi, I have personal experience with four types of minor injuries. I am not medically qualified in any way. I relate only my experiences with injury and those changes I have made to minimize recurrence.

Of course, when I attribute an injury to tai chi I am acknowledging that my tai chi movement was not being done correctly. And when I attribute an injury to MS, I am saying that I have not adequately learned how to cope with an aspect my MS.

1- Injury caused by my tai chi practice

The Knees. In my first few years of tai chi practice, I often found myself wearing an ace bandage over one or the other of my knees. It was not uncommon to find four five people out 20 in my class wearing an ace bandage on the knee. Knee injuries are common with tai chi and I’ve met a number of people who quit because of knee problems.

My instructors cautioned us about the knees but I did not receive or understand any correction that made a difference. I finally figured out what worked for me and have used that understanding in my teaching.

Most tai chi instruction begins with some thing like “bend your knees slightly.” Unless you really know what you are doing with your body, this instruction puts one on the path of knee problems by shifting weight into the knees. Alternatively, if the hip joints open first, the knees flex like a hinge, there is no extension and consequently no injury or pain. The biomechanics are straightforward. The depth of a squat hinges on the degree of openness in the hips. Consequently, I have no knee problems and if I get a twinge in one of my knees, I know immediately what I’ve done wrong and how to correct my movement.

Shoulders. I should have known better. I was demonstrating a foundation movement to a friend of mine. 24 hours later I found myself checking into the Emergency Room at 3 AM with acute pain in my right shoulder. A cortisone shot fortunately did the trick. I had over-rotated my shoulder when demonstating. I know what I did incorrectly. I had lost focus and was not rotating from the elbow. Rotating the arm by turning the elbow reduces the torque in the shoulder. Teaching can be hazardous if I am not in the moment.

2- injury sustained as a consequence of not adequately adjusting to my MS

MS reintroduced me to the hazards of tripping and falling. It seems like I fall a couple of times a year. I can stumble over a flat piece of paper. Not knowing where my foot is in space, or dragging my foot, are things to be aware of all of the time. All of the time is the catch.

Yet I have never come close to falling when I practice tai chi. To the extent I incorporate tai chi, both movement and attitude, in my walking, I minimize the instances where I fall. However, this crossover effect is difficult in social situations because it makes my walking even slower. If I don’t override the social expectation which I have internalized, I increase my chances of stumbling.

One of my MS students delighted herself when she discovered how to semi-automatically recapture her balance by assuming a tai chi posture.

3- Injury in which MS and tai chi both play a role
There is a gray area in which MS limitations and tai chi make me susceptible to injury. Recently, I have been working hard on further opening my hips. Ligaments may have been stretched. Consequently, when I shoveled snow, I caused an injury in the vicinity of muscles on the side of the hip. I think the remedy involves strengthening the abductor muscle grouping.


4- Ordinary injury
If the injury involves a joint, after applying ice, I do reiki. When the acute pain phase is gone, I look for specific tai chi forms to rehabilitate the joint. I slow down and soften my practice as much as I can. I try to call up a tai chi attitude and gratitude for having the form to assist me. Even when I am only partially successful, I feel calmer and more centered.

Shoulder pain attributable to adhesive capsulitis is fairly common in middle age. My left shoulder brought me to physical therapy for 6 weeks and much pain from Rita PT. The PT was successful. When I began having similar symptoms in my right shoulder, I was fortunate to have a tai chi lesson which showed me how to raise my arm. Within days of making the change in my practice, the shoulder pains disappeared. Range of motion in both shoulders was further increased with a year of body work.

Love in my corner

When I write about managing multiple sclerosis with tai chi there is an unspoken truth. Management of a chronic illness is rarely done alone. For me, it is Linda, my life partner who is always in my corner. She unobtrusively makes sure that I have the time and space for my practice.

I’ve been to MS support group sessions where a common complaint was that the partner did not understand the limitations of MS and was hostile to any proactive mode of management. Any practice, whether meditation, yoga, or tai chi, is challenging enough without having to live with negative chi from a partner.

A tai chi success over multiple sclerosis

I am always looking to validate the direct benefits of tai chi for managing MS. This week marks one of those successes.

Five years ago, when my neurologist tuning fork-tested for feeling in my ankles, nada. I have learned to feel my heels and my ankles even though the tuning fork test shows no feeling!

I am now practicing shifting my weight from my heel, through the ankle, forward to the Bubbling Spring, and to the big toe, and then reversing the sequence. Perhaps these shifts are ordinary for the normal foot, but they are novel for mine. Weight shifting occurs with the foot flat. I am at the beginning of the learning curve so it takes 2-3 seconds for a full cycle. Shifting weight through the foot gives me an improved sense of balance and stability.

Psychologically, I can’t underestimate the positive effects. This weight shifting tells me that managing MS can be more than adapting. I can be getting better even as the disease gradually progresses.

The Tai Chi and Multiple Sclerosis Partnership

Tai chi and MS are well-mated. Both modalities slow movement. The slow pace of tai chi gives my MS body the neuro-muscular time to make mini-balance and strength adjustments. With secondary progressive multiple sclerosis, I experience gradual decline and changes that are barely noticeable from day to day. In response, I make daily small-scale adaptations as a matter of course. Tai chi forms enable me to structure many of those adjustments by providing what is now a familiar template for movement.

Feelings of connection with tai chi

Paradoxically, while multiple sclerosis diminishes feeling in my legs, tai chi engenders wonderful feelings of connectedness. Movement feels like gentle internal ripplings connecting different parts of my body and making it all one. I think of it as finding "the real me" in the tai chi movements.

Wondrous since I had never experienced feelings of connection. I just moved. Although there are many reasons for sticking with tai chi, the real hook, that which makes tai chi mine, are these feelings of hydraulic connection in my daily practice. A day without tai chi and I don't feel myself.

Sweaty Chi

Tai chi is punctuated with surprises. In my second year, I found myself sweating profusely. I had to wear a headband and wristbands to our group practices. I’ve spoken with others who also had the tai chi sweats for over a year. Not much was made of it at the time. The sweating has never returned. Fortunately, my multiple sclerosis was in a prolonged remission.

The challenge of bringing a tai chi attitude to each practice

Tai chi is a “soft” form, embodying effortlessness, water flowing over rocks. Raised in our culture of “no pain, no gain” and giving “110% effort”, turning down the intensity my practice is not so easy. It is as if the urge to push oneself is hardwired. And then there is the lingering sense of urgency contributed by my MS partner. So, I gave myself an 80% rule. Each practice done with the clear intention to stay well within my capabilities, affirms “less is more.” But the mindless urge to do more is always there.

But it’s more complicated. There are exceptions to “less is more.” Part of my practice is remedial geared to opening my body to tai chi: adapted exercises for getting specific joints to turn easily, lengthening and strengthening particular muscles, and working on alignment. Remediation demands extra effort but it is not tai chi. Another exception occurs during tai chi practice. If I am unable to move fluidly into the next movement effort gets me through.

Multiple sclerosis and a tai chi walk

I’ve committed myself to re-engineering a way of walking. For six years, my walking has become more labored. Numerous adjustments have been tried based on various corrections and suggestions. As with so much of life and the uncertainties of MS, I cannot answer whether the glass is half-full or half-empty, whether the changes have kept me mobile or whether the natural history of MS is taking its course. The only response I accept is zen; the glass is neither half-full or nor half-empty; it is half-a-glass of water. I'm working on filling up the glass.


Now I see a way to improved walking—not as I once did, but a walk which is rooted and centered, albeit slow. The different way of walking is evolving out of my tai chi practice; the mechanics of the gait are coming into focus, fuzzy as it is. I re-engineer segments as I practice with my left side requiring greater remedial effort. Tai chi, as best as I can understand, provides the template. Instead of pushing off from the back foot I am pulling forward from behind the forward knee, with thrust coming from the tailbone moving under my center. My intention is directed to the internal drop as a trigger which itself is prompted by a heel strike. At this stage, I am getting a taste for what may be possible. I’m in it for the long haul, literally trying to stay one step ahead.

He got the action
he got the motion
Yeah, the boy can play
Dedication Devotion
Turning all the night time
into the day
--"The Walk of Life"--Dire Straits

Adapative Tai Chi for Multiple Sclerosis

Multiple sclerosis and senioritis draw me to the health recovery aspects of tai chi. I’ve had training as a tai chi instructor for health recovery and offer tai chi to a variety of people with special needs. There is a growing movement in Adaptive Tai Chi: TC for MS, TC for Arthritis, TC for Diabetes; TC for Back Pain, TC for the Blind…. The adaptations are not necessarily Tai Chi Lite; instead, the bio-mechanical adjustments often involve breaking down movements into components and further breaking down each component into increasingly more elementary moves until the challenged student is able to perform the movement. However, I find with myself and with teaching others, that adaptive tai chi also incorporates an aspect of one-size-fits-all. Yet, not all MSers have the same difficulties and each has his or her own strengths.

I am working with a husband and wife, both of whom have MS. His MS affects vision and balance in a minor way. He has been athletic all of his life. She is not exercise-oriented, has balance difficulties and loss of feeling in her legs, but her joints turn extremely well. The adaptations for each are very different. In some areas, pelvic alignment for example, she is far more open and her alignment is very good. Development is paced to the strengthening of her legs. In teaching Brush Knee with a Twist Step, we are experimenting with a series of toe props to enable her to control her balance. His development is paced to opening of the pelvis; he already has leg strength. He muscles through movements, something we all know a lot about, so more attention is focused on using the toe prop to soften his drop.

My current thinking on adaptive tai chi is moving in the direction of a Personal Trainer for Tai Chi. For my own development, I need someone who can adapt my tai chi, making corrections that I can build upon at my current level of disability. The emphasis would be on individualizing the training. I think I might benefit most from either an advanced tai chi master or a tai chi personal trainer skilled in adapting movements to me. Although, I have always learned something important from generalized instruction, I believe a variation of the 80-20 rule applies to those with chronic conditions such as MS: 80% individualized instruction and 20% generalized or group instruction.

Tai Chi Legs and Multiple Sclerosis

One of the paradoxes of tai chi has been the strengthening of my legs. Three years ago, my quadriceps were tested at a pre-season ski clinic and they were strong enough to qualify as ski instructor material. Subsequently, my legs have become stronger. All the while, MS continues to limit neurological control over my legs making them feel heavy and challenging my balance.

My Posture, Multiple Sclerosis, and Tai Chi

Throughout my life I’ve had posture corrections. I guess I never really knew how to make postural changes so my carriage pretty much remained the same – poor but serviceable. I can now look back and recognize hips unevenly balanced, weight carried forward, lower back stiff as a board, no lumbar curve, chronic back problems, no spinal flexibility, no flexing of hip joint, chin jutting forward, shuffling gait with legs thrown forward. It was distinctive and very much part of how I presented myself.

MS informed by tai chi, makes improved posture crucial. The old habits of personal carriage amplify the new hazards resulting from MS: foot dragging, uncertainties regarding balance, uncertainty of where my feet are in space, heavy and often wobbly legs. If I was to use tai chi to offset deficits arising from MS, my posture had to change.

Postural change demands more understanding than I have. I know enough to use the tai chi form and what knowledge I do have of biomechanics to guide my experiments.

I use gravity danyus to reposition my femur so that it can lever the back of the pelvis. I practice toryus with the internal drop initiating the weight shift into the forward leg so as to make the IT band more pliable. I align myself so as to stretch the connective tissue on the front of my torso much as you would stretch a large piece of fabric. I often pause mid-movement to allow a gravity-assist. I am especially conscious of not letting my torso lean forward when I stand or move.

I use the tai chi form to integrate and consolidate the changes as they occur. The rate of progress appears to be controlled by the biology of tissue regeneration and the clarity of intention. In other words, change is gradual and not an extreme makeover.

Wind and Balance: Multiple Sclerosis and Tai Chi

My MS-impacted central nervous system reacts to wind greater than 20 mph by making subtle but noticeable shifts in my equilibrium as if it thought the force was enough to destabilize my balance. These minor adjustments create a perception of instability. This is all happening reflexively and resists conscious control. I know in my mind that the wind will not blow me over but my CNS is giving me signals otherwise. Obviously, this is not a comforting situation.

Short of coming in out of the wind, I practice tai chi. In particular, moves that can be strung together in a line such as, brush knees, parting wild horse’s mane or repulse monkey.

I focus my awareness on the internal drop, the lowering of my center of gravity and alignments that intensify sticky feet. The practice reduces the wind-induced anxiety by providing my CNS with a different set of signals, all of which indicate greater stability and balance.