Exercise for seniors with knee or hip problems, once your doctor says yes

How to use the table above

The table is a list of rules, not a list of moves to try. Here we copied each row from the book, where it sits on the page of the move it belongs to. Each row is a caution printed in the book, next to the move it belongs to.

Read the first row first. Recent hip, knee or spine surgery, and joint replacement, are on the book's list of reasons to talk to your doctor before you start. That comes before any row below it.

The middle rows are for specific moves. The seated spine twist turns your chest while your hips and knees face front. After hip or back surgery, the book says to ask your doctor first. The one-leg standing move is in the optional standing part. With a hip replacement, you keep the knee lower than the hip and ask your surgeon first.

The last two rows apply every day. Move only about 70 percent as far as you could, a rule many tai chi teachers use, set out by the Tai Chi for Health Institute. And any fresh pain, swelling or pain that lasts into the next day means rest and a call to your doctor.

Why your feet can stay still

Here is a detail that helps a lot with sore knees and hips. In the chair moves, the legs do very little.

Standing tai chi steps and shifts weight. In the book's seated versions, a step becomes a small slide of the foot, and you can skip even that. The "Make it easier" line on Part the Wild Horse's Mane, for example, says to keep your feet still and turn only a little. The arm and waist parts work on their own.

Every move begins in the same seated position. Feet flat, hip-width apart. Knees above your ankles, bent at about a right angle. Sitting on the front half of the seat, back tall. That is a steady place for a knee to be.

Seated moves that ask little of your knees and hips

Once your doctor says yes, these moves from the book keep your feet flat and your knees and hips still. Your arms, shoulders or breath do the work. Show the list to your doctor or therapist and ask which ones suit you.

Ankle circles (W04) work the ankle, not the knee. If your leg feels heavy, the book says to keep your heel on the floor.

What about leg-strengthening moves?

Many seated routines you will find online add knee straightening, leg lifts or work with a resistance band. Some of these are used in rehab after a joint replacement.

The book does not teach them. It is a gentle tai chi practice, not a rehab program. If you want to build strength in the muscles around your knee or hip, ask your physical therapist or surgeon for moves made for your joint and your stage of healing.

The appointment where the doctor said "gentle"

Your operation went well. At the check-up, the doctor said you can start some gentle seated movement now. Then the visit ended.

At home, you looked at videos. Most of them stood up. The chair ones twisted and reached, and you did not know which moves "gentle" meant.

So you did nothing, to be safe. That is a sensible instinct. A better next step is to write your questions down and take them back. The book has a page at the back for this, with room for your questions and the answers.

The US National Center for Complementary and Integrative Health gives the same advice in its own words. Don't use tai chi to put off seeing a health care provider, and tell your providers about any practice like it.

Each caution printed next to its move

This is the problem Classic Chair Tai Chi for Seniors was written for. Nancy Whitaker's book is for people cleared for seated movement who want to know exactly what each move asks.

Safety First lists who should check with a doctor first, gives the questions to ask and the stop signs: pain, dizziness, chest pain, shortness of breath.

Six Warm-Ups includes the spine twist and ankle circles, each with its own caution and an easier version.

Four Standing Moves is optional and comes with the hip replacement note above. You can skip it and still use every other page.

Routines and a Six-Week Plan has a section for stiff or tired days: warm-ups only, smaller turns, half the repeats. The research on knee pain is in the book too, with the 2016 trial and its limits.