"Marciano's incredible power began in his feet as they pushed off the mat. The energy was fed by his thick muscular legs, the swivel of his hips, and the twist he'd put into his upper body as he snapped forward his arm and fist"------B. R. Bearden
"The intrinsic strength should be rooted in the feet, generated from the legs, controlled by the waist, and manifested through the fingers."----- Tai Chi Classics

I visit Milt once a week. He's on my agency's long term program. Chronically ill and depressed he spends most of his time in bed. During one visit Milt decided that he needed to let some fresh air into his apartment. Using his walker, he hobbled to the window and attempted to slide it open. It didn't budge. I placed a chair under the window and had Milt try again, this time seated. It wasn't easy, but he succeeded. The difference had nothing to do with his arms. The chair provided him with a reliable path to the ground. It was classical physics; action/reaction. When Milt stood and pushed up against the window, the force of friction between the window and its frame exerted a downward counter force that should have passed through his legs, and then, into the ground. A corresponding ground force would then be generated, traveling back through his legs, to his arms, and finally the window. Milt's atrophied legs broke the chain. Hours of lying in bed robbed him of strength, flexibility, balance, and body awareness.

I faced a similar situation a few years ago while attempting to scrape ice off my windshield. I thought I was standing on snow covered driveway pavement, not realising there was a thin sheet of ice under the snow. My arms were useless as I scraped upward because the slick ice broke my connection to the pavement.

Tai Chi deals with mastering this ground force. It's slow, graceful, circular movements have inspired many to view it as a "moving meditation", often used as a modality in stress reduction programs. Unfortunately, in the West, Tai Chi has been co-opted by the "New Age" movement. There is a mistaken impression that even superficial practice of this art will bestow abundant health and tranquility. Its true origin as a highly sophisticated martial art is often overlooked. Traditional training focused on developing a unique set of body mechanics that would enable a practitioner to generate enough power to seriously injure, or perhaps kill someone with their bare hands, if needed. Interestingly enough, Tai Chi's much touted health benefits can best be realized through understanding and practicing its martial aspects.

Contemporary training usually consists of learning a progressive set of movements, called a form. In my own instance it took six months to learn an entire "form" that takes ten minutes to complete. The class would practice a new movement sequence each week, linking it to previously learned parts of the form.

Traditional martial training, by contrast, was extremely arduous. Practitioners had to master the individual postures that formed the basis of the movements. These postures typically had to be held for at least 30 minutes at a time. Some required a 70/30 weight distribution, others 100/0 , done with varied degrees of bent knees The postures were held with different arm positions. The teacher would manually correct the student's posture in order to enhance the ground force path. Visualizations concerning direction of force accompanied by whole body micro movements supplemented static standing. An adept would spend months at a time practicing a single posture, before being deemed competent by the teacher to progress to the next posture. Eventually these postures would be linked together to form movements, and finally, the entire form. Obviously, these training methods would not be commercially viable in today's fast paced, quick result oriented culture.

The initial result of such training was improved leg strength. The goal however, was to lessen dependence on muscular strength. By refining balance, posture, and breathing, load bearing was gradually shifted to the skeleton and inert connective tissue. Excessive muscular tension impedes the ground force utilization. Martial demonstrations of seeming incredible power, (a small movement causing an opponent to become airborne) are not due to muscular strength or some mysterious energetic force, but rather, the result of superb timing, balance, and expert utilization of the ground force. The basis for these skills is forged through hours of standing practice.

Unfortunately, most rehabilitation practices ignore this vital ground force factor. Strength training appears to be the panacea for all ills. Patients are strapped into various state of the art devices, usually supine or seated. Isolated resistive exercises are performed that often have no functional carry over to the every day environment. Muscles do not work in isolation, and, much of the gravitational and ground forces that come into play during day to day activities are eliminated by this kind of positioning. Try this experiment. Try to lift your kitchen counter. With continued effort you will experience increased compressive force between the floor and your feet. That's the ground force that Milt could not take advantage of because of poor balance, flexibility, and strength. What appears to be diminished upper extremity strength while standing may actually be the result of poor utilization of the ground force vector. Lower extremity strength deficits may not be the primary reason for this. The ground force has to pass through the legs in order to be effective. Adequate balance is of the utmost importance. The effects of suboptimal balance are often overlooked. I've worked with individuals with significant balance deficits, who ambulate with walkers. When the walker support is removed, often their entire body will start to tremble. Because of poor balance large muscle groups reflexively come into play to maintain balance. The patient may mistake this for muscular weakness, yet the trembling abruptly ceases when they are allowed to gently grasp the walker and restore their equilibrium.

Would a traditional strengthening regimen have helped Milt move the window - I don't know. He would have certainly benefited by making a habit of spending more time out of bed on his feet, reacquainting himself with gravity and the ground force. I don't propose trashing state of the art strength building equipment, nor am I suggesting that our frail patients hold difficult martial postures for 30 minutes at a time. What I do believe is that with aging a progressive loss of body efficiency occurs that has little to do with strength loss. Tai Chi's traditional training methods are designed specifically to enable the body to act as an coordinated unified whole. With a little ingenuity these methods can be easily utilized in the clinical setting. Our reliance on, and infatuation with high tech exercise equipment is responsible for perhaps the most practical modality to be overlooked - the human body.