It should not be forgotten that it is now proven that the breathing practised in Tai Chi Chuan enables greater pain control. Probably as a result of stimulation induced by abdominal breathing on inhibitory medullary cells or through the release of endorphins and enkephalins (analgesic substances), medullary G-cells are stimulated, which have the task of ‘closing the gate to the entry of pain into the body’.
Schematising and concentrating, for reasons of space, on just a few concepts, we can consider the favourable effect of diaphragmatic breathing to be twofold.
On the one hand, during inhalation, when the diaphragm moves downwards, the space available for more O2 in the lungs increases. More O2 in the lungs translates into more oxygenation of the tissues. The gentle and prolonged massage of the abdominal organs exerted by diaphragmatic pressure and decompression allows a greater blood supply, consequently a greater supply of O2 and supporting substances.
On the other hand, the massage exerted on the abdominal organs promotes an increase in what is called ‘venous return’ in physiology, i.e. it increases the amount of blood flowing from the abdominal organs into the vena cava and thus to the heart.
This dual effect translates into multiple preventive and therapeutic effects taken into account by medical science. Let us briefly, and only in passing, evaluate some of them.
Ischaemic heart disease The patient suffering from angina pectoris or who has recently suffered an infarct can combine anti-angina and anti-ischemic drug therapy with an appropriate habit of abdominal breathing in order to prevent painful symptoms and infarction. Abdominal breathing by allowing a greater width of the chest in the longitudinal direction and thus favouring greater distensibility of the lung leads to a greater ventilatory capacity.
Angina pain arises when there is a discrepancy between increased O2 demand and supply to the heart made difficult by coronary stenosis. The increased O2 supply to the tissues decreases its demand, the decrease in heart rate induced by the modulation of respiration and the decreased O2 demand by the tissues leads to a decreased utilisation of O2 by the cardiac muscle even in circumstances of increased demand such as in relative exertion.
In the case of stable exertional angina, the support of regular gentle medical exercise, such as Tai Chi Chuan, practised at a level below the angina threshold, has been proposed so that no pain appears during physical activity. Several studies have shown that practising Tai Chi one hour three times a week for a period of eight to twelve months results in a significant reduction in heart rate, respiratory rate, and blood pressure for submaximal levels of exertion in the groups of elderly heart patients who chose to participate in the studies. This reduces myocardial O2 consumption and raises the exertion threshold that the body can tolerate
Heart failure The patient suffering from heart failure can benefit greatly from the use of the simple method of abdominal, deep breathing, typical of Chinese medical gymnastics, Tai Chi Chuan in particular.
Tai Chi, as we have said, foresees the execution of wide respiratory acts, supported by the abdominal musculature, with the passage of time and with the exercise of a gradually smaller number (from 14 – 16 respiratory acts per minute many practitioners, in a year, a year and a half of practice, with a rhythm of an hour, an hour and a half of practice per week, manage spontaneously to reduce the frequency of breathing to five, six breaths per minute) and this leads, according to traditional Chinese medicine, to an increase in the oxygenation of tissues and organs, a reduction in the symptom dyspnoea, i.e. air hunger, shortness of breath, typical of the patient suffering from heart failure, a greater tolerance to fatigue and physical effort.
In Western scientific circles, it is argued that these considerations and the evidence of an improvement in the decompensated heart patient do not stand on concrete experimental grounds and therefore cannot be accepted.
Recently, however, ‘The Lancet’, one of the most prestigious medical journals ever, published (May ’98) research conducted by a Pavia-based group with rigorous scientificity and statistical method. In this study, a group of patients with heart failure were taught to progressively reduce their respiratory frequency from 15 breaths per minute (these patients, even though they breathed 15 times in a minute, presented air hunger and reduced oxygenation of the blood, precisely because the disease from which they suffer, heart failure, induces an impoverishment of pulmonary capacity) to 6 breaths and then to only three breaths per minute
The controlled modulation of respiratory activity for just one month led to an improvement in lung ventilation, a spontaneous decrease in respiratory rate even outside the study exercises, a significant increase in blood oxygenation, a greater tolerance of exercise, and therefore of fatigue, which for these patients we all know is a problem that affects their quality of life.
This type of study confirms what Chinese medicine claims about the therapeutic effects of Tai Chi Chuan breathing and serves as a starting point and analysis for other studies on other pathologies.
Arterial hypertension As has been known for some time, Tai Chi Chuan, as well as aerobic exercise, the breathing techniques practised in Chi Kung or the more familiar, to westerners, autogenic training, are able to favourably reduce systolic blood pressure, the so-called maximum arterial pressure. Some studies started in Great Britain in 1996 and still in progress, conducted on patients suffering from heart attacks, seem to show a statistically significant role of Tai Chi Chuan, associated with correct breathing control, compared with simple aerobic exercise (running, walking, cycling), in reducing minimum blood pressure (diastolic blood pressure), which is dangerous if it is high, because it is at the root of cardiovascular and cerebrovascular pathologies
Asthma One of the pathologies with the most unfavorable social impact in young people and for which it is known what are the current advances of drug therapy.
Studies are underway that are confirming what is asserted by traditional Chinese medicine regarding the therapeutic role of respiratory methods of medical gymnastics. Young subjects undergoing pharmacological treatment for asthma and undergoing Tai Chi Chuan exercises, with particular attention to breathing, have seen, in eight weeks of training for four days a week, the number of asthmatic attacks regress in a statistically significant way.
A possible explanation could lie in the influence exerted by diaphragmatic breathing on the tone of the orthosympathetic autonomic nervous system that prevails over the vagal parasympathetic autonomic system that exerts a bronchoconstrictor effect on the respiratory tract. Bronchodilator effect is instead exerted by the orthosympathetic.
The abdominal breathing typical of Tai Chi Chuan is particularly effective in gastro-intestinal pathologies, in controlling the symptoms of gastro-duodenal ulcer; A greater blood supply is promoted at the level of the spleen and liver, attenuating and delaying the symptoms of hepatitis. Studies are underway to evaluate possible correlations of Tai Chi Chuan practice with improved immune system function.
In China and currently in the United States and Europe, abdominal breathing training and special Chi Kung techniques are taught to patients who will undergo thoracic surgery and for whom there is a post-operative period characterized by limited respiratory chest excursions that could be harmful and painful.
Taken from the text of: Giuseppe Ghezzi, Dr. Andrea Baldi
