Tai Chi Journal

My Aching Back

I've run into a snag in my Tai Chi practice. My lower back keeps coming up stiff and sore if I practice two days in a row.

I also have stiffness/soreness in my knees, particularly the right one. And in the shoulders — again, particularly the right. I have a pre-existing injury to that shoulder muscle or its tendons, several years old. So I'm not surprised it's barking at me. And my knees have long been achy-breaky. The back problem, however, comes as something of a surprise.

It is possible I injured a muscle, tendon, or ligament down there in the lower back (in the lumbar region, I think) when I was practicing Tai Chi walking two or three weeks ago. I felt a noticeable stab of pain and had to stop. Though the soreness goes away after a day of rest, that area has continued to act up the day after I do my exercises. If I do two days in a row of exercising, as I did yesterday and the day before, then during the remainder of the second day and on the following day (i.e., today) I'm real sore.

One worrying factor is that some years ago an orthopedist looking at my back x-ray said I had a possibly congenital malformation somewhere down there (I forget exactly where) in the lower spine. I don't know if that has anything to do with this.

Nor do I know whether this recurring soreness could be a sign of a disc problem. I doubt it at this point, but who knows?

I will rest today and then see. Possibly I'll avoid Tai Chi for another day or more after that — which I am extremely loath to do. I've already missed two classes in a row due to flu and snow, and tomorrow evening I'd like to be there. But if I have a minor injury that will go away only with more than just a single day off, I'd better heed it. And if I have a more serious problem, I'd better heed that, too. Curses!


Update #1: I went to this webpage to learn more about lumbar or lower-back strains and sprains, since I imagine I have one of those.

Apparently the difference between a sprain and a strain is that a sprain affects ligaments (they get torn from their attachments). Ligaments are pieces of tough tissue connecting two or more bones. In this case, we are talking about the ligaments that connect the five lumbar vertebrae together.

A strain affects muscle (the fibers are abnormally stretched or torn). The muscles that may be involved are the paraspinal muscles, which are large and support the spinal column and the weight of the upper body.

The distinction between a sprain and a strain is a technical one, since both are treated the same way and offer a similar prognosis.

As for tendons, the things which attach muscles to bones, they apparently aren't involved in this kind of problem.

The most common symptoms of a lumbar strain or sprain are (says the article):

• Pain around the low back and upper buttocks
• Low back muscle spasm
• Pain associated with activities, and generally relieved with rest

I've got the first and third, but no spasms.

The article says that these sprains/strains "often force patients to remain in bed for a day or two, and can cause intermittent symptoms for weeks." Fortunately, "over 90% of patients are completely recovered from an episode of lumbar muscle strain or sprain within one month."

The first step in treating the condition is rest for up to 48 hours to quell the tissue inflammation. (I think the original injury in my case was weeks ago, but that I have continued to aggravate it in doing my Tai Chi exercises.)

Next, anti-inflammatory medications can help (as can muscle relaxers where appropriate). Non-Steroidal Anti-Inflammatory Medications (NSAIDs) include the COX-2 inhibitors which have recently been called into doubt for heart-related side effects.

Then come physical therapy/exercises. (Of course, it was exercises that brought this on.)

Without some simple exercises [the article says], the low back muscles can become "deconditioned," or weak. When the low back muscles are deconditioned, it is very difficult to fully recover from low back injuries.

The article links to a Low Back Exercise Program here.

So it sounds as if I may have to do some non-Tai Chi exercises in order to condition my back so I can do my Tai Chi exercises! Life is nothing if not complex!


Update #2: Last night after I wrote the update above, it crystallized in my mind that possibly most of my stiffness/soreness — lower back, knees — stem from an improper approach to Tai Chi Walking.

Tai Chi Walking is an exercise in which you walk forward, putting no weight on the forward foot until just the right moment. You keep your weight on one foot and extend the other foot forward. You touch that foot's heel to the ground without transfering any weight to it. Then and only then do you shift weight forward onto the front foot, gradually and smoothly. You bring the back foot up into the air, next. Now you are poised over what had been your front foot, with all your weight on it. The erstwhile back foot now becomes the next foot to go forward, and the process is repeated.

Sounds easy, but it's not. Takes balance, excellent muscle tone and control, proprioception, pre-visualization of each move — things which we normally don't put at a premium.

One trick is supposedly to keep the knees somewhat bent. That avoids bobbing up and down with each pace.

In fact, a bent- or soft-knees approach is fundamental to all of Tai Chi as I'm learning it (with the exception of certain fundamental exercises I'm doing, from the Step-by-Step Tai Chi book, which need straight legs). The various Wu Chi or Standing Meditation postures all emphasize bent knees and a tucked-in pelvis.

Well, I had been practicing Tai Chi Walking without giving much thought to my basic posture. I was trying to keep my knees bent, but I wasn't tucking in my pelvis.

So last night I did some Tai Chi Walking in front of a full-length mirror for the first time — and what I saw astounded me. What I was doing didn't bear much resemblance to what I thought I was doing ... or to the Tai Chi Walking demonstrated by Brad, my instructor.

Oh, I was managing to do what I outlined above, in terms of my feet and footsteps. But I was not doing it in a smooth, free-and-easy fashion. I was swaying my hips from side to side, not moving calmly forward in a straight-torso fashion. I was managing to keep my knees just-barely-softened only some of the time; they would at times straighten out and at other times get too bent. And, most importantly, I did not maintain the forward pelvis tuck of Wu Chi.

Instead, I was arching my pelvis back in the other direction, which allowed me to support my upper body while my lower body was doing the wrong thing!

That meant there was a lot of strain on the paraspinal muscles and lumbar ligaments, all in the name of compensating for poor lower-body form.

I decided to try standing in approved Wu Chi posture and then lifting one foot and putting it forward to initiate the Tai Chi Walk. As I continued the Walk, I would consciously (using the mirror) maintain my upper body posture with the necessary tuck, and I would keep the same amount of relaxed-knee lower-body posture as well.

That made the whole affair smoother, easier, more relaxed, and with noticeably less strain felt at lower back and knees. I progressed forward toward the mirror just as I imagined I ought, with no hip sway or other unnecessary busyness.

When I go to class tonight — I'm still sore, so I won't stay for the whole thing — I'll ask Brad about this. But my current thinking is that it was incorrect Tai Chi Walking that brought on my aches and pains.

posted by eric @ 9:07 AM