Teaching Students With Hip Or Knee Replacements

I recently received an email from a new teacher who is working with seniors, some of whom have had knee and hip replacements. Her class was about to start Carry the Ball To The Side and she wanted my ideas about how best to approach this new move with them. This article is excerpted from the dialogue that followed over the next few hours.

T’ai Chi Chih has been a very good thing in my life and I find that my understanding and appreciation of it changes and grows every time I stand with a group of students and we learn what TCC has to teach us that day. I have been doing this for years and have not yet felt the need to move on to something else because I still want to know more from TCC. It is very satisfying and has helped me cope with so many of the challenges life presents.

One of my dear friends, Jan Block, taught in Kansas City right through her 80’s until cancer took her last year. She had had two hip replacements and one knee replacement before she even started the practice. I’m 70, and teach ongoing classes for all ages at a health club in San Luis Obispo, California, and have taught at several physical therapy clinics. Many of my students are what the exercise industry refers to as “de-conditioned,” which means that they have health problems or just aren’t used to using their bodies in good ways. Several have been weakened after multiple rounds of chemotherapy. Often they have balance problems caused by weak legs, so we sometimes talk individually about how they can strengthen the muscles that support their hips and knees.

With students unaccustomed to body image I sometimes use a “rain stick” to teach the concept of the weight shift. Yin and Yang equates to one side giving (or relinquishing) as the other receives (as opposed to takes). I tip the stick slightly to one side and ask them to envision the movement of each of those little seeds in the stick rolling and sliding downhill as energy moving from one side to the other. This seems to help people understand that any energy applied to the emptying side is counter-productive, just like pushing with the back leg is counter-productive. After all, a leg cannot become yin if it is still working, so no effort will be expended by either side trying to get rid of anything. Giving the weight away is like rolling down a hill.

Starting Carry the Ball to the Side

I have finally come to completely accept that in TCC it is more important to make a full weight shift than to make a large weight shift, and so, people with disabilities can experience a powerful flow of energy with little mobility. Smaller steps, fully committed to, will move much more energy than big steps that are still depending on leg we are moving away from.

Since Carry the Ball to the Side is the first sideways movement, I have new students just rest their elbows at their waists with bent arms and their hands in a relaxed position. I want them to concentrate on settling all of their weight onto one (even slightly) bent leg before setting the other “empty” leg slightly to the side – heel touching down and going only as far as is comfortable for them and without reaching or leaning.

Then I ask them to slowly bend the “empty” leg (the one without weight on it) beginning to gently settle onto it by relaxing the top of the muscle at the inside of their thigh (adductor), which begins movement through the hips. As they move, I suggest that they imagine the energy building in the new leg (like the little seeds running downhill in the rain stick).

Through the weight shifts, I cue them to allow the starting leg to relax more and more as the weight is “given” to the softly bent “receiving” leg until it becomes “full.” Both legs remain soft throughout this transfer of energy, feet firmly planted. Little by little we let the arms kind of follow the move, elbow still resting at the waist, until everyone is making a full weight shift.

Finally we add the full circular hand pattern, hands always following the weight shift, not leading it. The hands are mentally linked to the tan t’ien as though by an invisible slack bungee cord. At the end of each shift, if everything is soft, the hips will automatically orient themselves in the direction of the weight-bearing foot and knee (just like in basketball), so this doesn’t have to be taught.

The reader may notice that I tend to approach the practice from the “body teaches mind” perspective. As I practice I enjoy the geometry of my body and how its design allows us to respond to gravity. I see gravity as the most accessible experience of energy available to us, so it is a door to the Chi, and physical grace is the ability let gravity move you, rather than fighting or opposing it. I enjoy feeling the ways in which TCC has changed how I walk and run, gaining energy from gravity, rather than using up energy in the process. (Don’t get me started on the neurochemistry of it all – that’s another article.) While this approach may seem analytical, for me it isn’t analysis but enlightenment: my body is being explained to me by this perfectly natural mind-body experience that is TCC.