Our kidneys are quite precious organs in our body, yet are sometimes overlooked in terms of the vital role they play in our overall health. And because of their specific location within the body, our Tai Chi practice can have a direct influence on their ability to function in an optimal manner.
The kidneys are two bean-shaped, fist sized organs that rest behind the abdominal cavity, on either side of the spine (between the 12th thoracic and 3rd lumbar vertebrae), just below the rib cage (please see diagram). Of direct significance to our practice, they sit behind and above the psoas major and under the diaphragm at the 11th and 12th rib level. They are also wrapped in renal fascia, which blends with that of the diaphragm, psoas, as well as the thoracolumbar fascia. We must remember that fascia is found everywhere in our body and serves to connect and strengthen various organs, muscles and bones.
What is the role of the kidneys?
The kidneys have several major roles. The first is filtration. On a daily basis, their millions of tubules filter approximately 200 liters of fluid daily, removing metabolic waste, drugs, and toxins through our urine. They also work to adjust the fluid volumes and electrolytes (sodium, potassium, etc.) in our body, and these adjustments serve to manage our long-term blood pressure. Our kidneys also protect our bone health by stimulating the red blood cell production in our bone marrow.
In order to perform these major bodily functions, it is critical to appreciate that about 20% of our heart’s cardiac output is delivered directly to the kidneys daily for cleansing via their renal arteries. This filtered blood is then carried back to our heart via the renal veins in order to receive oxygen (via the lungs), after which it is distributed throughout our bodies for nourishment. Quite the sophisticated system!
How can Tai Chi affect the role of the kidneys?
As mentioned earlier, the anatomical location of the kidneys is key because they are “sandwiched” between the diaphragm above, the psoas below, and the abdominal muscle wall in front. This means that they can be easily influenced by movement, breathing, posture, and especially the position of the pelvis. Once again, it is the fascial web that connects these organs to their surrounding areas that comes into play. As a result of the overlapping fascia, any changes in our pelvic angles, for example, will create a secondary subtle shift in both the tension and position of the kidneys in space.
Let’s break this down a little.
1.
Intra-abdominal Pressure (IAP). Our IAP is normally low (4-7 mmHg). If it rises, the blood flow to the kidneys decreases and can even injure them.
In Tai Chi, we encourage smooth breathing with the diaphragm, never forced. It is additionally a good idea to allow our breath to expand softly to a full 360 degrees (front, sides and back) to keep the intra-abdominal pressure low. Further, we are often reminded to keep a “soft belly”. This may seem like a simple intention. It is, however, a significant one to keep in mind, as this is what keeps the IAP surrounding the kidneys low, allowing them to receive the important blood flow to carry out their various functions.
2.
Pelvis-Spine Alignment and the Psoas. Alignment is key in this area. Any excessive forward tilt of the pelvis or hyperextension of the low back will create tension of the psoas and alter the mechanical structure around the kidneys (via the renal fascia). In this scenario, intra-abdominal pressure will increase, resulting in compromised blood perfusion to the kidneys.
In Tai Chi, we aim to have a neutral pelvis and lengthened (somewhat flattened) lumbar spine by sitting into our inguinal crease (groin), especially in our dan-yus. This posture helps to maintain a balanced tension in this area, avoiding an increase of the IAP around the kidneys.
3.
Allow Core Support without Over Bracing. As we move in Tai Chi, we are naturally allowing our core structure to stabilize us as we move. If we overuse our abdominal and pelvic muscles, however, by excessive bracing, we limit the ease of fluid and blood flow to the kidneys. Our focus, instead, needs to be on our bony alignment and posture, which assist in maintaining a stable structure rather than overuse of our muscles. Remember the “soft belly” intention.
4.
Overall Posture. A few bodily postures have been shown to markedly reduce blood flow to both the heart and the kidneys. These include a backward head tilt as well as bent knees. This is true at any moment of our daily activities and is equally relevant to our Tai Chi practice.
A ‘chin tuck’ is easy to do and helps keep the spinal arteries of our neck open. Our knees, as well, are only flexed as we shift our weight from one position to another while performing our movements. ‘Relaxed knees’, rather than overly flexed or locked stances, are good postures to keep in mind. This is especially true in the standing Jongs.
5.
Trunk Postures. Torso rotations that engage the thoracic spine, such as in wave hands, assist with the opening the thoracolumbar fascia, which in turn enhances the elasticity of the renal fascia it is connected to. Rotational movements around the spine need to be slow and gentle for this to occur, a hallmark principle of Tai Chi.
Another reminder for us is to avoid excessive forward flexion of the trunk. Gentle, easy forward bends, as in the tor-yus, can widen the vena cava portal through the diaphragm, allowing for an increase in venous return from the kidneys to the heart. Any very deep forward flexion (collapsing down) will increase the intra-abdominal pressure and close off the circulation to the kidneys.
What do the studies say about Tai Chi and the kidneys?
To date, there are few studies available on the role of Tai Chi on specific kidney function. An earlier 2014 study included persons who had both cardiac and kidney disease. This interesting study demonstrated remarkable changes in systemic markers such as the eGFR filtration rates of the kidneys, total body cholesterol and blood pressure following a 12-week Tai Chi intervention (30 minutes, three to five times per week)1.
Functional independence and quality of life studies in persons with chronic kidney disease (and on hemodialysis) are more commonly found. In one study, the effect of a 12-week Tai Chi intervention (1 hour/week) revealed that several measures of physical functioning improved in the Tai Chi versus control group. Objective findings included sit to stand ability, 6-minute walk test (a measure of endurance) and gait speed (stability and balance). In addition, quality of life scores were markedly improved along five dimensions measured2.
It is wonderful to have received the gift of Tai Chi to help improve our precious health and quality of life. Thank you, Master Moy!
Translation by Jordi Awarita, Cathy Filion
- Effects of a 12-week program of Tai Chi exercise on the kidney disease quality of life and physical functioning of patients with end-stage renal disease on hemodialysis – PubMed ↩︎
- The effects of tai chi on the renal and cardiac functions of patients with chronic kidney and cardiovascular diseases – PubMed ↩︎