Q: Shouldn’t I be doing some shoulder strengthening exercises along with the Tai Chi?
This question comes from Katharine, a current client diagnosed with scapular dyskinesis and correlative myofascial pain. Very often both clients and professionals can have a knee-jerk and myopic reaction to dealing with muscular imbalances by focusing solely on improving strength, without fully considering how the imbalances developed and why they persist. I, of course, am speaking from experience and proudly claim membership in both groups. In most cases, unraveling the entire pattern of dysfunction is necessary for long term and sustainable improvement; however, the body’s tendency towards complex compensations can make the process somewhat challenging.
Katharine had already begun the acute phase of the RQTC for Neck & Shoulder Dysfunction program where we focus on both agonist inhibition and specific muscle recruitment in simple, pain-free movements. Many traditional rehabilitative strengthening programs stall here, in that they continue to work on specific muscle isolation while adding increasing amounts of resistance. Undoubtedly this approach improves isolated muscle strength, however, it doesn’t necessarily translate to agonist/antagonist coordination and functional abilities. Studies indicate that functional based strengthening programs may result in longer term strength gains than traditional, muscle specific exercise programs*.
In the Rehabilitative Qigong & Tai Chi paradigm isolated muscle re-education and motor recruitment are important early steps to restoring optimal function. Advancing to the subacute and chronic phases of the Neck & Shoulder program bring enhanced focus on both integrating foundational agonist/antagonist relationships and progressing muscle resistance in functional patterns. I was happy to see that a recent MEDBRIDGE article** focused on treating scapular dyskinesis with evidence based muscle strengthening and included isolated movement patterns that are incorporated throughout all phases of the RQTC Neck & Shoulder program.
In traditional Tai Chi practice there is a saying that, “Qi follows Yi”; essentially meaning that energy follows intention. Qigong and Tai Chi practices are rich with imagery and in the case of Tai Chi focused on martial applications. Surprisingly, when students struggling with learning a new Tai Chi movement are shown the martial application they more quickly synthesize and accurately perform the gesture. Just as with sports like golf and baseball where simply intending to hit the ball in a certain direction directs accurate muscle recruitment, visualizing the purpose and execution of a Tai Chi movement tends to engender more efficient agonist/antagonist patterns. Recounting an earlier mention of the body’s tendency to create complex compensatory patterns, we often attempt to correct these patterns through piecemeal recruitment of specific muscles with little change in the over all dysfunctional pattern. Rehabilitative Qigong & Tai Chi gives us the opportunity to release the linear, rational mind, build on foundation strength, and visualize/intend gestures that result in more efficient, integrated patterns of movement.
Do you have a question for your IRQTC community? Share it with everyone and together we can visualize a whole new world of rehabilitative care.
* Stutz-Doyle, Christine M., “The Effects of Traditional Strengthening Exercises Versus Functional Task Training on Pain, Strength, and Functional Mobility in the 45-65 Year Old Adult with Knee Osteoarthritis” (2011). Seton Hall University Dissertations and Theses (ETDs). Paper 98.