Bikram Yoga

Also known as Hot Yoga it is practiced in a room heated to 40 °C (104 °F) with a humidity of 40%. It is a form of hatha yoga named after its founder Bikram Choudhury and is delivered via a franchise, Bikram Incorporated, based in Los Angeles and also founded Choudhury. It is a “one size fits all” set of 26 postures.

www.bikramyoga.com

Classification: Active

Bilates

This combines Pilates with ballet based exercise. It is in general more active/aggressive than pure Pilates.

Classification: Active

Body Balance

Relatively new this blends a series of simple yoga moves with elements of Tai Chi and Pilates and is performed to an inspiring soundtrack. Breathing is controlled throughout all the exercises. It attempts to strengthen the entire body and produce a feeling calm. It is offered in gyms by fitness instructors.

Classification: Active

CHEK Therapy

Paul Chek describes himself as working in the fields of “corrective and high-performance exercise kinesiology”. Kinesiology is the study of body movement. He set up the “CHEK” Institute in California; referring not to his name, (really!), but to “Corrective Holistic Exercise Kinesiology”. He recommends “treating the body as a whole system and finding the root cause of a problem” by addressing six areas: -

• Thoughts – suggesting that “the biology of your body is linked to your mind – healthy thinking produces a healthy body.”
• Movement – expressing the belief that “movement is life and life is movement - exercise pumps your organs, removes waste, improves metabolism, and cultivates energy.”
• Nutrition – he promotes organic foods “eaten according to your Primal Pattern Diet Type” suggesting this will “fuel your body for success”
• Breathing – by optimising breathing he attempts to maximize “the most important nutrient – oxygen” suggesting this “removes waste, and energizes your body”. (Now, whilst we have avowedly avoided recommending any particular therapies here we can clearly and unreservedly endorse this element of Chek’s thinking; life without oxygen is miserable, short and often quite desperate. If you want to get the most out of life you must remember to breath, all day actually.)
• Hydration – on the basis of the old adage that “the solution for pollution is dilution” – they suggest “water is an essential cleaning agent for the body”. Drink water.
• Sleep – believing “we get stronger when we rest” they promote 8 hours of sleep each night as being essential for rest & repair.

This is a whole way of life and is not for the faint hearted.

www.chekinstitute.com

Classification:Passive; Active; Prevention/ergonomic

Chiropractic/chiropractor

Invented by Daniel David Palmer a charismatic healer from Iowa USA in 1895 the initial theory was that all kinds of illness could be relieved by spinal manipulation; like its older rival osteopathy, also invented by an engaging American from the mid-West. Palmer’s first patient, Harvey Lillard, had apparently gone deaf when “something popped in his spine” and a few days after some spinal adjustments his hearing returned. Initially surrounded by theories that today sound laughable it is now one of the largest alternative medicine professions. Chiropractics are skilled in musculoskeletal diagnosis and deliver a range of therapies aimed at relieving symptoms and aiding in healing and prevention. Their work very much focuses on spinal disorders. Extensively practiced around the world many chiropractors work in elite sports whilst others are integrated into GP services. In Denmark they study during their first years with standard medical students. Like with all the professions there are good and bad ones but most now address the three pillars of spinal care. chiropractic students in the UK study for four to five years to gain their Integrated Masters in Chiropractic (MChiro) degree. In the United Kingdom, chiropractors are Statutorily Regulated by the General Chiropractic Council (GCC)

www.gcc-uk.org

Classification: Passive; Active; Prevention/ergonomic

Cognitive Behavioural Therapy

A form of psychotherapy, or “talking therapy” it was originally designed to treat depression, but is now used for a many other mental disorders and chronic pain changing unhelpful thinking and behaviour. It focuses on specific problems and assists in developing specific strategies to help address them. This is different from psychoanalysis where therapists look for the unconscious meaning behind the behaviour and then diagnose the patient.

It is used in the treatment of mood, anxiety, personality, eating, addiction, dependence, tic, and psychotic disorders as well as a multitude of chronic pain states including low back and neck pain, fibromyalgia, arthritis, regional pain syndromes in addition to a variety of other chronic conditions such as tinnitus (a constant ringing in the ears) and chronic fatigue syndrome. It attempts to challenge "errors in thinking such as overgeneralizing, magnifying negatives, minimizing positives and catastrophizing with more realistic and effective thoughts, thus decreasing emotional distress and self-defeating behaviour.” In chronic pain the technique is used to help individuals diminish the impact of their condition – the condition remains but its effect on well-being is diminished.

CBT uses a number of different methods: exposure therapy, stress inoculation training, cognitive processing therapy, cognitive therapy, relaxation training, dialectical behaviour therapy, and acceptance and commitment therapy.

A typical programme would consist of face-to-face sessions between patient and therapist, made up of 6-18 sessions of around an hour each with a gap of a 1–3 weeks between sessions. However, this varies. It may be delivered via a live remote computer interface, (CCBT), there are standalone computer based programmes, (some now utilising artificial intelligence), it may be delivered in book format or group sessions and it can be combined with other cognitive therapies such as Mindfulness.

In February 2006 NICE recommended that CCBT be made on the NHS and here is what they say of it: it is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems …… CBT cannot remove your problems, but it can help you deal with them…..it is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle…...CBT aims to help you crack this cycle by breaking down overwhelming problems into smaller parts”

ww.nhs.co.uk

The British Association for Behavioural & Cognitive Psychotherapies (BABCP) keeps a register of all accredited therapists in the UK 

www.cbtregisteruk.com/Default.aspx

The British Psychological Society (BPS) likewise has a directory of chartered psychologists but only some will specialise in CBT.

www.bps.org.uk/bpslegacy/dcp

For a good review of its use in chronic pain:

www.apa.org

Classification: Active; Prevention/ergonomic

Complimentary and Alternative Medicine

This term refers to all of the physical therapies and treatments excluding physiotherapy, podiatry/chiropody and all types of therapy excluding Western/modern medicine.

In 2015 the Australian Government's Department of Health published a review of alternative therapies. Whilst those practicing many of the therapies it covers may criticise the report for looking at them through the wrong lens, a Western objective “evidence based” lens, it is a good read.

Regulation and standards are an issue in this field as it is in many. The European Federation for Complimentary and Alternative Medicine EFCAM is instead mainly concerned with “equality of access for citizens to CAM across Europe, and, to gain the right of all appropriately trained providers of CAM to practice”.

However, in the U.K. the Complementary and Natural Healthcare Council (CNHC), a regulator for complementary therapists was set up with government support to protect the public by providing voluntary register of complementary therapists. CNHC's register has been approved as an Accredited Register by theProfessional Standards Authority for Health and Social Care for: Alexander Technique, Acupuncture, Aromatherapy, Bowen Therapy, Craniosacral Therapy, Healing, Hypnotherapy, Massage Therapy, Naturopathy, Nutritional Therapy, Reflexology, Reiki, Shiatsu, Sports Therapy, Yoga Therapy.

www.cnhcregister.org.uk/newsearch/

www.efcam.eu

www.cnhc.org.uk

Classification: Active; Prevention/ergonomic

Core muscle exercises

The “core” relates to the muscles of the abdominal wall, pelvis, lower back and diaphragm: transversus abdominis, internal and external obliques, quadratus lumborum , errector spinae, multifidus and the diaphragm muscles. The action of these muscles contracting together upon the incompressible contents of the body, your giblets, supports and protects the spine. The core is thought of as the body’s centre of gravity and as essential for stable safe movement. However, many studies have questioned if core stability training has any more benefits than general, non-specific exercise and even walking. Some studies have failed to demonstrate preventative benefits against injuries or to improve performance in sport. Most believe that it is important to keep the spine in a neutral position and to increase intra-abdominal pressure before doing movements that might risk the spine. This is often now referred to as “lumbar motor control”. Training methods for developing and maintaining core stability include Pilates, Swiss ball stability work and yoga.

Classification: Active

Hydrotherapy

This involves doing physiotherapy in water, usually a specifically designed very warm small pool, with a physiotherapist trained in the technique. It is very useful for patients who are “non-weight bearing” after orthopaedic injury or surgery. In the context of spinal conditions it is used by patients whose spine is too painful or stiff for them to be able to exercise or stretch on land. It is used at the beginning of a treatment plan that will move out on to land based physiotherapy as a condition improves.

www.arthritisresearchuk.org/arthritis-information/therapies/hydrotherapy.aspx

Classification: Active

Mackenzie Exercises

The McKenzie Method is a method of care developed by the New Zealand physical therapist, Robin McKenzie, (1931 to 2013) who gained an OBE for his work. He developed the method in the late 1950s and called it Mechanical Diagnosis and Therapy, MDT. It is a system applicable not only to the spine but also conditions affecting the limbs. The system categorises patients' complaints not on an anatomical basis but by the clinical presentation of patients. Its other characteristic is its reliance on self-treatment minimising the passive manual therapy. McKenzie training teaches that passive procedures should only to be used if an individual’s “self-treatment” program is not fully effective. By self-treatment he referred to active, exercise based treatment i.e., two pillars with the second one being the most important. He argued that self-treatment is the best way to achieve a lasting improvement of back pain and neck pain. Launching his programmes in the 1980’s he was very much part of the movement towards exercise. When one views this in comparison with the history of Yoga and Ti Chi it is perhaps not so much a case of West meets East as West catches up!

At its heart is a philosophy of active patient involvement and education. There are four key steps: assessment, classification, treatment and prevention.

Assessment: the clinician listens to the symptoms and examines the patient by asking them to repeatedly make certain movements and sustain specific postures. This information is used to categorise the problem.

Classification: each condition is categorised into one of four syndromes. The first three are mechanical with the forth, “Other Subgroup” including serious pathologies, non-mechanical causes, true chronic pain.

Treatment: this consists of specific exercises and advice regarding postures to adopt and postures to temporarily avoid. The therapist may need to add hands-on techniques until the patient can self-manage. The aim is to use the least number of sessions. The underlying strength is that a treatment performed five or six times a day by the patient on their own is that much more likely to be effective in a shorter period than treatment administered by a therapist once or twice per week. The patient has to be actively involved. In the event of recurrence most patients can successfully then treat themselves.

Prevention: according to the McKenzie website this is actually just more treatment; “problems are more likely to be prevented through self-maintenance than by passive care.” This does not really address the third pillar of what it is an individual or activity is doing to create symptoms and how this can be prevented.

In 1982 McKenzie established the McKenzie Institute to carry out further research and training and there are now 28 branches Worldwide. He also invented the McKenzie Lumbar Roll and McKenzie Neck Roll to help patients prevent a recurrence of pain.

www.mckenzieinstitute.org

Classification: Passive; Active

Mindfullness

An English word for the Buddist term “sati” it is a form of meditation that promotes a sense of well-being and the perception at least of good health. Popularised by Jon Kabat-Zinn it is used therapeutically to alleviate a variety of mental and physical conditions: depression, stress, anxiety and drug addiction. In addition it is used by many to enhance mental and physical performance and has gained worldwide popularity as a method of controlling emotions and reducing avoidance behaviour. It is used by many in high powered, high performance and demanding occupations.

Practiced sitting upright with eyes closed and cross-legged on a cushion or chair, breathing is the initial focus of thought. Starting with short 10 minute sessions a day these are gradually increased as it becomes easier to keep the attention focused on breathing. Eventually awareness of breathing is extended to thoughts, feelings and actions. It is not surprising that scientists have shown alterations in brain function with this meditation.

A two-component model has been proposed: first, by focusing attention on immediate experience awareness of that experience is enhanced; second the adoption of curiosity, openness, and acceptance of one’s emotions reduces their control over you.

The aim is to avoid trying to produce a particular mental state such as relaxation but instead simply to notice states as they arises in the “stream of consciousness”.

In Buddhism Sati is one of the seven factors of enlightenment. Right mindfulness is the seventh element of the noble eightfold path. An antidote to delusion it is considered as a 'power'.

In 1979, Jon Kabat-Zinn founded the Mindfulness-Based Stress Reduction (MBSR) program at the University of Massachusetts to treat the chronically ill. In mindfulness-based cognitive therapy (MBCT) it is combined with traditional cognitive behavioral therapy (CBT).

In the business world interest in Mindfulness arose from the need to succeed. Books abound: Awake at Work (Carroll, 2004) and Resonant Leadership: Renewing Yourself and Connecting with Others Through Mindfulness, Hope, and Compassion; The Mindful Leader (Carroll, 2007) Leading companies provide training programmes: Procter & Gamble, Monsanto and Unilever. Top executives recommend it include the chairman of the Ford Motor Company, Bill Ford, Jr., and CEO at the Monsanto Corporation, Robert Shapiro.

Other uses have seen: Harvard University held a workshop on "Mindfulness in the Law & Alternative Dispute Resolution”; it being taught in prisons to reduce violence and improve self-esteem. Even the British Parliament organised a mindfulness-session for its members in 2014, led by Ruby Wax!!!

Of Mindfulness the NHS says it “can help us enjoy life more and understand ourselves better ….. mindfulness means knowing directly what is going on inside and outside ourselves, moment by moment …… an important part of mindfulness is reconnecting with our bodies and the sensations they experience ….. waking up to the sights, sounds, smells and tastes of the present moment ….. the feel of a banister as we walk upstairs….. another important part of mindfulness is an awareness of our thoughts and feelings as they happen moment to moment……becoming more aware of the present moment can help us enjoy the world around us more and understand ourselves better…… most of us have issues that we find hard to let go and mindfulness can help us deal with them more productively”.

By way of explanation the NHS quotes Professor John Williams of Oxford: "It might be useful to remember that mindfulness isn't about making these thoughts go away, but rather about seeing them as mental events. Imagine standing at a bus station and seeing 'thought buses' coming and going without having to get on them and be taken away. This can be very hard at first, but with gentle persistence it is possible.

Mindfulness is recommended by the National Institute for Health and Care Excellence (NICE) as a way to prevent depression. Chronic pain is a potent source of depression and low mood is often reported by those enduring lasting episodes of either chronic low back pain or neck pain. A large US study showed Mindfulness was effective in relieving chronic low back pain, equally as effective as cognitive behavioural therapy.

Div table grids are great to layout website sections on the page!

www.bemindful.co.uk/

www.nhs.uk/conditions/stress-anxiety-depression/pages/mindfulness.aspx

www.nhs.uk/news/2016/03March/Pages/Mindfulness-may-be-effective-for-treating-low-back-pain.aspx

The Mental Health Foundation has an online mindfulness course at:

www.bemindfulonline.com/

They also have a teacher locator on:

www.bemindful.co.uk/learn-mindfulness/

Classification: Active; Prevention

Neural Glides

This is a physiotherapy technique whereby nerves that may have become tethered, perhaps by disc herniations, narrowing of the nerve canals, under muscles/tendons or by scars formed after surgery, are stretched across or through the obstruction. It forms part of the rehabilitation phase of your treatment.

Classification: Passive; Active

Occupational Health/Therapist

At its core occupational therapy concerns the occupations of people and their effect on health. Occupations vary so much that OTs work with a wide range of techniques. Indeed their work is not confined to the employed. They will work with whatever “occupies” people: they help people of all ages, abilities, disabilities and with all manner of illnesses and conditions including a substantial amount of back pain and neck pain patients. They cover activities ranging from computing to the activities of daily living: dressing, cooking, and eating.

Physical exercises may be used to improve strength and coordination and mental exercises to improve visual acuity, short term memory, decision making and problem solving. They may use other techniques cognitive behavioural therapy.

Classically they have two roles: work with spinal cord injury and stroke patients on adaptive equipment, including wheelchairs, orthotics, and aids for eating and dressing, they may even design and make special equipment for home or at work; in the work place they will perform work station assessments to prevent problems arising and with individuals whose abilities are either temporarily or permanently impaired.

They will often work within a multidisciplinary team with chronic back pain patients on “self-management strategies” the return to work. They may work in a clinic, the community as part of GP services, the workplace, school or nursing home

In the UK delivery is fragmented and varies depending on the setting and condition. Many employers have OTs. If you are ill then for short-term conditions, such as after an operation, OT is provided by the NHS via the hospital or GP. However, for long-term conditions, such as a permanent physical disability, occupational therapy has to come via a local council. Chronic back pain will probably fall into this latter category as would permanent weakness/paralysis. It is also available privately.

The professional body for OTs in the UK is the British Association of Occupational Therapy which includes the College of Occupational Therapists. Only healthcare professionals registered with the Health and Care Professions Council are allowed to use the title "occupational therapist".

Where to get OT/ergonomic equipment for spines:

www.spinegroup.co.uk/

Patient information leaflet on OT:

www.cot.co.uk/leaflets/leaflets

Information link about OT:

www.nhs.uk/Conditions/occupational-therapy/Pages/techniques-and-equipment.aspx

Health and Care Professions Council on:

www.hpc-uk.org/

Check the registration of your OT:

www.hcpc-uk.org/check/

Information on how to access NHS/Council OT:

www.nhs.uk/Conditions/social-care-and-support-guide/Pages/what-is-social-care.aspx

OT Bodies:

www.cot.co.uk/

www.cohpa.co.uk/

www.som.org.uk/

Physiotherapists specialising in OT:

www.acpohe.org.uk/

Classification: Active Prevention/ergonomic

Osteopathy, Osteopath

This is a type of alternative medicine that emphasizes the physical manipulation of the body's muscle tissue and bones. There is "good" evidence for osteopathy as a treatment for low back pain and "limited evidence” for other conditions. The term osteopathy was coined in 1874 by the physician and surgeon Andrew Taylor Still in Kansas, USA at the time of the American Civil War. It has a long history in the UK; the first school was established in 1917 and it was accorded formal recognition by Parliament in 1993 by the Osteopaths Act. Regulated by the General Osteopathic Council an osteopath must hold a recognized qualification and there are currently more than five thousand osteopaths registered in the UK. Just as in any speciality there are good and bad ones. For a good outcome any specialist needs to address all three pillars of spinal care. (In the USA there is a potential confusion as they have to be differentiated from osteopathic medicine which refers to a medical doctor specialising in orthopaedic/bone medicine cf the USA use of the term physical therapist for physiotherapist.)

www.osteopathy.org

www.bso.ac.uk

Classification:Passive; Active; Prevention/ergonomic

Physical Therapist

In the UK and most of the World this is a collective term for physiotherapists, osteopaths, chiropractors, McTimoney Chiropractors, Cranio-sacral therapists etc. In the USA it is the name given to physiotherapists and has to be distinguished from consultant doctors specialising in “Physical Medicine” a field others term musculoskeletal medicine.

These physical therapists, (physiotherapists, osteopaths and chiropractors), can be differentiated from medics as instead of using medicines they utilise some physical manipulation of the patient to effect relief. Just as medicine has developed over the years so too have these specialties. It matters less which is seen than that the overall treatment plan addresses all three pillars of spinal care.

Classification:Passive; Active; Prevention/ergonomic

Physiotherapy

The most established and common of the physical therapies this aims to make people better by improving their mobility, strength and function. They may work independently or in conjunction with medics. It goes back a long way. Physicians like Hippocrates and later Galen are believed to have been the first practitioners of physical therapy, advocating massage, manual therapy and techniques like hydrotherapy as long ago as 460 BC. However, physiotherapy as a profession dates back to Per Henrik Ling who founded the Royal Central Institute of Gymnastics (RCIG) in 1813. Sweden was the first country to give official registration to physiotherapists and in 1894 four nurses in the UK formed the Chartered Society of Physiotherapy, still their regulatory body, a full 20 years ahead of the USA.

A physiotherapist, like an osteopath or chiropractor, will take a history, examine the patient, reach a diagnosis, develop a care plan including information/education, symptom relief, rehabilitation and prevention.

The aim is to restore movement and function when someone is affected by injury, illness or disability through movement and exercise, manual therapy, education and advice. They work with all ages and will specialise in one of many fields. Spinal physiotherapists will overwhelmingly restrict their activities to that field though spinal disorders make up such a large percentage of musculoskeletal medicine that all will have significant experience of it.

This is what the CSP says of themselves – “Physiotherapy is a science-based profession and takes a ‘whole person’ approach to health and wellbeing, which includes the patient’s general lifestyle. At the core is the patient’s involvement in their own care, through education, awareness, empowerment and participation in their treatment.”

Some of the main approaches used by physiotherapists include:- education and advice, movement, tailored exercise and physical activity advice, manual therapy – where they use their hands to help relieve pain and stiffness

www.csp.org.uk

Classification: Passive; Active; Prevention/ergonomic

Pilates

A physical fitness system developed Joseph Pilates in the mid1900’s and now practiced worldwide. Pilates called his method "Contrology" emphasising the need for precision and control. He developed his system of exercises believing that mental and physical health were interrelated. The concept of "corrective exercise" and "medical gymnastics" was very much alive in the early 20th Century.

Along with many Germans he was interned in Britain during World War I on the Isle of Man where taught his fellow internees exercises and began developing a variety of equipment from the bunk beds. The most popular apparatus today is the Reformer though there is now a full complement of equipment:- Cadillac, Wunda Chair, High "Electric" Chair, Spine Corrector, Ladder Barrel and Pedi-Pole. There is range of difficulty from beginner to advanced and the intensity can be increased over time as the body conditions and adapts to the exercise.

The six "principles of Pilates" are: concentration, control, centre, flow, precision, and breathing. "The Pilates Method teaches you to be in control of your body and not be at its mercy." The “centre” refers to the abdominal muscles and those of the lower and upper back, hips, buttocks, and inner thighs. Known as the "powerhouse" all movement in Pilates begin there and flow outward to the limbs. The aim is for an elegant economy of movement that with precision flows out from a strong core. Pilates saw considerable value in increasing the intake of oxygen which he saw as cleansing and pointed out that forced exhalation is the key to full inhalation, obviously. “Squeeze out the lungs as you would wring a wet towel dry.” In order to keep the lower abdominals close to the spine the breathing is directed deep into the back and sides of the rib cage. When exhaling the deep abdominal and pelvic floor muscles are fully engaged. Breathing has to be coordinated with movement; breathing instructions are given with every exercise.

Though recent reviews have seen little evidence it promotes health, (2015 Australian Government's Department of Health review of alternative therapies), it is now widely practiced and for the treatment of lower back pain, there is evidence that Pilates may provide greater benefits than other types of exercise. Certainly there is strong evidence that exercise helps back pain. Clearly acute and extreme back pain prevents exercise. However, chronic low back pain is less common in those that exercise and core muscle weakness is a feature of those with chronic low back pain and those who have repeated acute episodes of low back pain – so called “acute relapsing low back pain” where sufferers get bad episodes lasting days or months, usually brought on by trivial triggers such a bending over or getting out of a car, and which are interspersed by long periods of little or no pain during which they can do strong exercise without a problem. In addition sufferers get relief from the exercise element of any rehabilitation programme. The key publication in this regard was in 1987 when Professor Claus Manniche of Denmark published his results of an active exercise programme in back pain patients in the leading medical journal The Lancet. When compared to the then standard recommendation of rest the exercise group completely outstripped those prescribed rest. It was a revolutionary idea which received much initial criticism – back pain was attributed to “wear and tear” and so logically rest would promote healing and exercise would only generate further damage. Manniche had proved the reverse was true and as acceptance of this truth grew the world and his wife took up exercise witnessing a global explosion of Pilates and all manner of other exercise methods. It was Manniche’s group that 25 years later discovered an association between certain forms of chronic low back pain and bacterial colonisation of discs so adventing antibiotic therapy.

Pilates is unregulated though the Pilates Method Alliance provides an international organization to connect teachers, studios, and facilities, promote quality training and so the legacy of Pilates and his exercise method.

Web content composed with the free online HTML editor. Please purchase a membership to remove promotional messages like this.

www.pilatesmethodalliance.org

www.pilates.co.uk

Classification: Active Prevention/ergonomic

Tai Chi

In Mandarin tàijí 太極 is an abbreviation of tàijí quán 太極拳 and means "Supreme Ultimate Boxing". Originally a Chinese martial art it is mainly practiced now not for self-defense but as a health tool.

It has its origins in Taoist and Confucian Chinese philosophy, where it represents the fusion of yin and yang into a single “ultimate”, represented by the taijitu symbol . However, when it became a distinct entity is variously attributed to the 12th or 17th century with the name first recorded only in the 18th.

There are five elements: taolu - hand and weapon routines; neigong - breathing, movement and awareness exercises; qigong – meditation; tuishou - response drills; sanshou -self defence techniques. Typically a solitary exercise of slow, peaceful movements some styles have a faster pace and others partner exercises or martial arts forms.

In China, tai chi is categorized as a Wudang or "internal art" as distinct from the Shaolin a "hard/external" or combative martial art. Its widespread promotion for health arose only in the early 20th century and it then developed a worldwide following. Whilst many martial arts require a uniform in general, tai chi teachers simply advocate loose, comfortable clothing and flat shoes. This makes them hard to spot.

The movements use of leverage through the joints, coordination and relaxation as opposed to the muscular tension of other exercise and thereby remains suitable for the frail and elderly –visit any Chinese square or park and you will see groups of the elderly in slow swing.

Originally there were five major styles named after the Chinese families who developed them (Chen, Yang, Wu Hao, Wu Ch’uan-yu and Sun) with Yang being the most popular though now there are many new and hybrid offshoots such as the Zhaobao and Fu styles. The differences lie in their tempo and size of movement.

Accurate, repeated movement over the centre of gravity either empty handed or with a weapon, often a wooden sword, is said help posture, circulation and flexibility. Breathing exercises are coordinated with these physical movements, c.f., Pilates

From the mid-nineties it became as common as Yoga and even more associated with health benefits. The NHS site claims that “studies have shown that tai chi can help people aged 65 and over to reduce stress, improve balance and general mobility, and increase muscle strength in the legs”, that “Some research suggests that tai chi can reduce the risk of falls among older adults who are at increased risk” and that “there is some evidence that tai chi can improve mobility in the ankle, hip and knee in people with rheumatoid arthritis (RH). However, it is still not known if tai chi can reduce pain in people with RH” but in regard osteoporosis “there is currently no convincing evidence that tai chi can prevent or treat the condition.” In a remarkable omission it makes no comment in regard back pain, a condition way more common than any of the above, though it does comment that as a “low-impact exercise …….it won’t put much pressure on your bones and joints” but “you may need to take certain precautions if you’re pregnant, have a hernia, back pain or severe osteoporosis..”

In regards this advice it is important to remember that in chronic back pain or chronic neck pain any exercise is better than none. People who exercise have less back pain and for the majority, not all but the majority, people with back pain get better with exercise. If a system works for you, if it motivates you to exercise and is accessible and providing it doesn’t make the pain worse it is probably doing you good.

The Tai Chi Union for Great Britain (TCUGB) was founded in 1991 with the aim of promoting the art.

Web content composed with the free online wysiwyg HTML editor. Please subscribe for a membership to remove promotional messages from the edited documents.

www.taichiunion.com

www.nhs.uk/Livewell/fitness/Pages/taichi.aspx

Classification: Active

Yoga

Yoga is a physical, mental, and spiritual discipline developed in India perhaps in the Northeast Indian, pre-Vedic, Indus Valley Civilization of 3300–1900 BC. History here is hampered by our failure to unravel their particular hieroglyphical language so all their writings are as yet inaccessible to us – a massive and ancient civilisation that we cannot hear. Concentration and bodily postures described in the Vedas period 1700 – 500 BC lead to an identifiable movement probably in around the sixth and fifth centuries BC.

The term yoga could have derived from one of two roots in 6th century Sanskrit, yujir to “yoke” or yuj samādhau to concentrate. It has since been linked with many other meanings: to listen, add, join, unite, attach, harness, use, employment, application, performance, exertion, liberation, endeavour, zeal, diligence, connection, contact, union, method, application, addition, performance. Hatha yoga texts emerged around the 11th century.

With deep roots in the religions of Buddhism and Hinduism, yoga gained prominence in the West in the 20th century taking off in the 1980s. Now, apart from the spiritual goals, the physical postures of yoga are used to alleviate health problems, reduce stress, improve flexibility, often a problem in spinal problems, and by others simply as an exercise program.

There are a variety of schools and practices with perhaps the most well-known types including Hatha yoga and Rāja yoga. Bikram is a recent addition. They reflect the history of its evolution.

When Alexander the Great reached India in the 4th century BC his comrade, Onesicritus, described yogis practicing "different postures – standing or sitting or lying naked – and motionless". The Middle Ages saw the development of Hatha yoga with the earliest references being in Buddhist works dating from the eighth century. Compared to the seated meditation posture of Raja yoga it utilises 'postures' and is the style that many people associate with yoga today. Yoga came to the attention of an educated western public in the mid-19th century along with the Hindu teacher, Swami Vivekananda, touring Europe and the USA in the 1890s. By the early 20th century the West equated "yoga" with Hatha yoga and its asanas or “postures” seeing it primarily as a form of exercise. The 1980’s saw the second "yoga boom" when Dean Ornish connected it to health presenting it as a purely physical system of exercise unconnected to any religious denomination.

Its growth has continued; in the USA the number practicing yoga increased from 4 million in 2001 to 20 million in 2011. The 21 June 2015 saw the first international day of Yoga was when around 35,000 people, including Indian Prime Minister Narendra Modi, performed 21 Yoga postures for 35 minutes at Rajpath in New Delhi and the day was observed by millions across the world.

Barack Obama recently commented "Yoga has become a universal language of spiritual exercise in the United States, crossing many lines of religion and cultures”. (According to Foyle’s Philavery to obamulate is an obscure word meaning “to wander aimlessly”. How has that not come out?) The American College of Sports Medicine supports its integration into health exercise regimens and in chronic low back pain, a UK study found yoga 30% more beneficial than “usual care” with an American study showing a drop of 80% in the use of pain medication. A small number suffer physical injuries analogous to sports injuries so some caution and common sense is required e.g., headstands are not sensible if you have neck pain.

www.nhs.uk/Livewell/fitness/Pages/yoga.aspx

Classification: Active