Qigong: An Essential Solo Health Practice for Everyone

By Dr. Paul Williams, PT, DPT

​Now that we have been quarantined and social distancing for some time, most of you have already been seeking solo practices to supplement your aikido training. In most styles of aikido, solo training is not common. Even for those that practice weapons like aiki-ken and aiki-jo, there’s not much of anything beyond suburi and weapons kata practice. I’d like to proselytize a solo practice that I believe has been instrumental in my recovery from chronic low back pain and has greatly improved my aikido.
 
Last year, I wrote an article about my lower back pain and how changing my posture affected my aikido practice. However, as rehabilitation research has shown, the pure biomechanical approach has failed to improve the lives of patients with chronic low back pain. (1) Reason being, one cannot separate the mind from the body. Therefore, I’d like for the reader to consider this article as an addendum to my previous work.  Since writing it, I have deepened my qigong and tai chi practice to the point I feel comfortable expressing my personal experiences and results of this practice by providing a physical therapist’s spin on the subject. First, I’d like to give you a little background into my process.
 
My first job after graduating physical therapy school was at a neurological rehabilitation facility. At the time, we called it a catastrophic inpatient rehabilitation center. This was due to the fact that our patients were victims of horrible accidents that either resulted in traumatic brain injury and/or spinal cord injury. It was incredibly challenging. As a new graduate, I was expected not only to be the lead physical therapist but also to develop a physical therapy program for these patients. In the two years that I worked there I learned just as much as I did in school.
 
One such learning experience taught me a valuable lesson of the mind-body connection. I had a patient that sustained a right sided brain injury. It was so severe that they suffered from left sided neglect. This is a common condition which occurs either after a stroke or brain injury to the right side of the brain. The patient not only had a hard time seeing the left visual field but also had a difficult time recognizing and identifying the left half of their body. This is due to the fact that the right side of the brain is mostly responsible for spatial awareness.
 
My team would co-treat with this patient daily. We’d be looking into a mirror with the patient providing tactile and verbal cues. We would instruct, “This is your left arm. This is your left leg” in order for this patient to recognize the left half of their body. We did this in hope of eliciting neuroplastic changes in the brain creating new neural pathways that allow the patient to recognize the left side of their body.

This is an extreme example of how our minds can disassociate from our bodies with changes to the brain. According to research by Lorimer Mosely, less drastic cortical changes can occur in those that have chronic lower back pain (CLBP). (2) In a study, he had several students divided into two groups. The first group had a history of CLBP and the control group didn’t. Both groups were asked to draw an outline of their lower torso as they sensed it. No touching or thinking what it might look like but to actually feel it. Surprisingly, the control group had no problem at all drawing a detailed outline of their lower back. The CLBP group not only had difficulty, but all in the group stated they could not even feel it.

This research was further confirmation that cortical changes occur in the brain of CLBP patients similarly to those with phantom limb pain. This change causes a disrupted body image and reduced proprioceptive acuity of the affected body part. Due to the principles of neuroplasticity it is possible to retrain the brain’s representation of the distorted body image in order to reduce CLBP as it has shown to be done with phantom limb pain. (3) All one needs is a practice that can help reintegrate one’s body image back to its normal functioning state.
 
With phantom limb pain there is a biofeedback modality that I’ve used successfully in my practice. It’s called mirror therapy and was created by neuroscientist and all around cool guy V.S. Ramachandran. This method would have patients look at the reflection of the intact limb and perform therapeutic exercises. One simply uses the reflection to trick with the brain that the missing limb is still there. Most patients state they actually feel as though the missing limb is the one performing the exercise.
 
I believe the technique of dissolving your energy gates found in the book, Opening the Energy Gates of Your Body by Bruce Frantzis, provides a crucial practice that can be used similarly to mirror therapy. (4) To summarize, this is a standing practice that uses consciousness to sense the landmarks of the body from head to toe. Once these landmarks are felt then one can learn to release any tension thus dissolving any blockage at the “energy gates”. Instead of using a mirror, in a quiet stance you are using your mind to scan up and down the body feeling the outside and inside of your joints and other landmarks. As explained by eastern medicine, this modality uses conscious awareness to address chi instability and inject life to an area that was once blocked or neglected.

Qigong is often mistaken for only being a standing meditation but there is a specific process in connecting the mind to every aspect of your body. This is a very different intention compared to mindfulness meditation where if a sensation or thought arises you notice it and let it pass. When you dissolve an energy gate you are actively putting your awareness into your body and relaxing it thus initiating a natural biofeedback.
 
When I first started this practice, I could feel my arms and legs with little problem. However, I could not feel my lower back for at least a year just like the subjects above with CLBP. That was a big shock to me! I had practiced aikido and yoga since I was a teenager. At the time, I believed myself to be very connected to my body. So, to realize that I couldn’t really feel my lower back felt defeating. But I kept working at it diligently and after a year I was not only able to feel my lower back but for the first time I can deeply relax it on cue as well.
 
This was a significant breakthrough for me. I was constantly walking around with tension in my lower back and not even realizing it. My lower back was always sore after aikido practice even at the best of times when my pain was minimal. In aikido, it is crucial that one can generate energy from the ground up to perform a technique and conversely absorb energy via ukemi from the upper body down through the feet. Having a relaxed lower back has helped link the kinetic chain between the two halves of my body.
 
Unfortunately, there are no studies to corroborate my personal findings in this specific style of qigong. However, there are studies that may shed light on why this method works. One study demonstrated that people with lower back pain have altered muscle activation patterns of trunk muscles leading to stiffening and poor postural control. This study demonstrated that improved postural awareness was associated with decreased pain intensity. (5)
 
A systematic review and meta-analysis looked at the efficacy of graded motor imagery (GMI) on chronic pain and found moderate effect. (6) There are three levels of graded motor imagery. The first is being shown an image of a limb. This activates the premotor cortex. The second method is imagined movement of that area. These imagined movements activate the motor cortical areas of the brain similarly to actually performing that movement. Lastly, the GMI practice uses mirror therapy which provides a convincing input to the motor cortex telling us that these movements are occurring without pain or difficulty for that affected limb. This then catalyzes brand new neural pathways and connections in the brain. 

​I believe that these studies illustrate why the dissolving energy gates qigong practice could be a valuable tool in one’s training toolbox. In my practice and personal rehabilitation, I’ve learned that becoming cognitively aware of the parts of one’s body that have been neglected, ignored, and avoided is absolutely and objectively important. One must bring his or her consciousness into their body in order to heal and recover from chronic pain.
 
I would love for this qigong method to be as vigorously studied as other classical therapeutic arts like yoga and tai chi. There are well over 500 studies on tai chi and countless studies on yoga. Not much is known about this practice and good studies on qigong in general are few and far between.
 
One of the reasons I wanted to share my personal story is to show how evidence based physical therapy and qigong could complement each other. In fact, I would make the case that the field of physical therapy needs to look seriously into this modality. If anything, my experience in neuro rehab has taught me that principles like biofeedback come in many forms: to name a few there’s electrical stimulation, electromyography, thermal, reflection of a mirror, and now virtual reality. I believe that dissolving the energy gates of your body qigong has a lot of potential to be added to this growing list of essential therapeutic practices.
 
If you want to learn more and start your own qigong practice, then I highly recommend studying this video by Hoa Newens Sensei. He expertly and clearly explains how to get started in this incredible solo practice. I hope this helps you in your daily journey during this challenging time.
 
 
Works Cited

1. Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain. Peter B. O'Sullivan, J.P. Caneiro, Mary O'Keeffe, Anne Smith, Wim Dankaerts, Kjartan Fersum, Kieran O'Sullivan. s.l. : Oxford University Press, 2018.
2. I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain. . Moseley, G. Lorimer. s.l. : Elsevier B.V., 2008.
3. Mirror therapy for the alleviation of phantom limb pain following amputation: A literature review. Jason Timms, Catherine Carus. s.l. : International Journal of Therapy and Rehabilitation, 2015.
4. Opening the Energy Gates of Your Body . Frantzis, Bruce. Fairfax : Energy Arts, 2006.
5. Postural awareness and its relation to pain: validation of an innovative instrument measuring awareness of body posture in patients with chronic pain . Holger Cramer, Wolf E. Mehling, Felix J. Saha, Gustav Dobos, Romy Lauche. s.l. : BioMed Central, 2018.
6. The effects of graded motor imagery and its components on chronic pain: A systematic review and meta-analysis. K. Jane Bowering, Neil E. O'Connell, Abbey Tabor, Mark J. Catley, Haley B. Leake, G. Lorimer Moseley, and Tasha R. Stanton. s.l. : American Pain Society, 2013.