Martial arts Therapy refers to the usage of

martial arts Martial arts are codified systems and traditions of combat practiced for a number of reasons such as self-defense; military and law enforcement applications; combat sport, competition; physical, mental, and spiritual development; entertainment; a ...

as an alternative or complementary therapy for a

medical disorder A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that ar ...

. This can include disorders of the

body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anima ...

or of the

mind The mind is the set of faculties responsible for all mental phenomena. Often the term is also identified with the phenomena themselves. These faculties include thought, imagination, memory, will, and sensation. They are responsible for various m ...

. The therapy may involve applications such as promoting

kinaesthetic Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...

balance in the elderly or impaired, through

T'ai chi ch'uan Tai chi (), short for Tai chi ch'üan ( zh, s=太极拳, t=太極拳, first=t, p=Tàijíquán, labels=no), sometimes called "shadowboxing", is an neijia, internal Chinese martial art practiced for defense training, health benefits and medita ...

, or reducing

aggressiveness Aggression is overt or covert, often harmful, social interaction with the intention of inflicting damage or other harm upon another individual; although it can be channeled into creative and practical outlets for some. It may occur either reacti ...

in specific populations (Lamarre, 1999).

History

Comparison with other methods

While more conventional treatments such as

weight training Weight training is a common type of strength training for developing the strength, size of skeletal muscles and maintenance of strength.Keogh, Justin W, and Paul W Winwood. “Report for: The Epidemiology of Injuries Across the Weight-Traini ...

and

psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...

are also of significant benefit, martial arts therapy can embody unique traits that other therapies don’t incorporate into their practice. For example, in children with low

self-esteem Self-esteem is confidence in one's own worth or abilities. Self-esteem encompasses beliefs about oneself (for example, "I am loved", "I am worthy") as well as emotional states, such as triumph, despair, pride, and shame. Smith and Mackie (2007) d ...

, this therapy can simultaneously develop areas such as

self-defense Self-defense (self-defence primarily in Commonwealth English) is a countermeasure that involves defending the health and well-being of oneself from harm. The use of the right of self-defense as a legal justification for the use of force in ...

skills (to defend against physical bullying),

physical fitness Physical fitness is a state of health and well-being and, more specifically, the ability to perform aspects of Outline of sports, sports, occupations and daily activities. Physical fitness is generally achieved through proper nutrition, moderate ...

, instructions on how to handle stressful scenarios in a physical or mental context, and

self-confidence Confidence is a state of being clear-headed either that a hypothesis or prediction is correct or that a chosen course of action is the best or most effective. Confidence comes from a Latin word 'fidere' which means "to trust"; therefore, having ...

, through successful applications of martial technique, such as board-breaking or

kata ''Kata'' is a Japanese word ( 型 or 形) meaning "form". It refers to a detailed choreographed pattern of martial arts movements made to be practised alone. It can also be reviewed within groups and in unison when training. It is practised ...

. One of the crucial features of the therapy is the type of martial art, as well as the lesson plans of the instructor. For instance, a

boxing Boxing (also known as "Western boxing" or "pugilism") is a combat sport in which two people, usually wearing protective gloves and other protective equipment such as hand wraps and mouthguards, throw punches at each other for a predetermined ...

program with a competition-oriented instructor will not provide the same experience as a

t'ai chi Tai chi (), short for Tai chi ch'üan ( zh, s=太极拳, t=太極拳, first=t, p=Tàijíquán, labels=no), sometimes called " shadowboxing", is an internal Chinese martial art practiced for defense training, health benefits and meditation. ...

instructor who emphasizes mindfulness of one’s actions and thoughts. Although both boxing and t'ai chi can be defined as martial arts, their histories, emphasis and other features are drastically different. Looking specifically at

karate (; ; Okinawan language, Okinawan pronunciation: ) is a martial arts, martial art developed in the Ryukyu Kingdom. It developed from the Okinawan martial arts, indigenous Ryukyuan martial arts (called , "hand"; ''tii'' in Okinawan) under the ...

, a

kyokushin is a style of karate originating in Japan. It is a style of stand-up fighting and is rooted in a philosophy of self-improvement, discipline, and hard training. Kyokushin Kaikan is the martial arts organization founded in 1964 by Korean-Ja ...

karate class (which emphasizes full-contact sparring with bare knuckles) versus a

shotokan is a style of karate, developed from various martial arts by Gichin Funakoshi (1868–1957) and his son Gigo (Yoshitaka) Funakoshi (1906–1945). Gichin Funakoshi was born in Okinawa and is widely credited with popularizing "karate do" throu ...

karate class (which places more emphasis on personal discipline and control than fighting), research in this area has not yet determined which particular feature(s) of martial arts are of definite therapeutic value.

Psychosocial issues

An important issue with martial arts therapy in a psychological context is the distinction between a therapeutic approach and a martial approach to the lessons. With the evolution of martial arts into combat systems (

Krav Maga Krav Maga ( ; , ; ) is an Israeli martial art. Developed for the Israel Defense Forces (IDF), it is derived from a combination of techniques used in aikido, judo, karate, boxing, and wrestling. It is known for its focus on real-world situation ...

) and combat sports (

Kickboxing Kickboxing is a combat sports, combat sport focused on kicking and punch (strike), punching. The combat takes place in a boxing ring, normally with boxing gloves, mouthguards, shorts, and bare feet to favour the use of kicks. Kickboxing is pract ...

Submission Wrestling Submission wrestling, also known as Submission grappling, Submission fighting a form of competition and a general term for martial arts and combat sports that focus on clinch and ground fighting with the aim of obtaining a submission through the ...

Mixed martial arts Mixed martial arts (MMA), sometimes referred to as cage fighting, no holds barred (NHB), and ultimate fighting, and originally referred to as Vale Tudo is a full-contact combat sport based on striking, grappling and ground fighting, inc ...

), many instructors and organizations teach only martial/combative techniques with little (if any) attention to

philosophical Philosophy (from , ) is the systematized study of general and fundamental questions, such as those about existence, reason, knowledge, values, mind, and language. Such questions are often posed as problems to be studied or resolved. Some ...

, spiritual or

societal A society is a group of individuals involved in persistent social interaction, or a large social group sharing the same spatial or social territory, typically subject to the same political authority and dominant cultural expectations. Societ ...

issues. In other words, students may only be taught how to fight without lessons in the proper context for applying these techniques, something that is emphasized in more

traditional martial art There are many distinct styles and schools of martial arts. Sometimes, schools or styles are introduced by individual teachers or masters, or as a brand name by a specific gym. Martial arts can be grouped by type or focus, or alternatively by r ...

curricula. Hypothetically, if these philosophical/societal teachings were one of the specific therapeutic factors in martial arts study, studying an art without these teachings would be of little therapeutic benefit, and arguably detrimental to psychological health (Reynes, 2002). Additionally, if not properly informed, a patient undergoing martial arts therapy may erroneously believe they are acquiring martial proficiency when in fact, the curriculum they are learning is unsuitable for

competitive Competition is a rivalry where two or more parties strive for a common goal which cannot be shared: where one's gain is the other's loss (an example of which is a zero-sum game). Competition can arise between entities such as organisms, indivi ...

needs. Another contentious area is the topic of whether martial arts training promotes or inhibits pro-

social behaviour Social behavior is behavior among two or more organisms within the same species, and encompasses any behavior in which one member affects the other. This is due to an interaction among those members. Social behavior can be seen as similar to an ...

s, particularly among youths and adolescents. It has been only within the past 5 years (since 2006) that studies with high-quality methodologies have devoted themselves to this particular topic. Earlier studies had conclusions that suffered from issues such as: * A lack of follow-up following a study's end (which would help assess long-term efficacy of treatment) * Missing or mismatched comparison groups to evaluate treatment efficacy compared to control or even general fitness (i.e. martial arts therapy vs.

aerobics Aerobics is a form of physical exercise that combines rhythmic aerobic exercise with stretching and strength training routines with the goal of improving all elements of fitness (flexibility, muscular strength, and cardio-vascular fitness). It ...

vs. the

control Control may refer to: Basic meanings Economics and business * Control (management), an element of management * Control, an element of management accounting * Comptroller (or controller), a senior financial officer in an organization * Controllin ...

group) * Little attention to outcomes from the style or type of martial art (few style vs. style comparisons, modern styles vs. traditional, etc.) It is this last point that appears to be most pertinent to the question of promoting or inhibiting aggressiveness and delinquency among children. Some researchers point towards a

catharsis Catharsis (from Greek , , meaning "purification" or "cleansing" or "clarification") is the purification and purgation of emotions through dramatic art, or it may be any extreme emotional state that results in renewal and restoration. In its lite ...

model where practising a martial art enables a person to "burn off" emotional energy to revive themselves. Others claim that under

Albert Bandura Albert Bandura (; December 4, 1925 – July 26, 2021) was a Canadian-American psychologist who was the David Starr Jordan Professor in Psychology at Stanford University. Bandura was responsible for contributions to the field of education and to ...

social learning theory Social learning is a theory of learning process social behavior which proposes that new behaviors can be acquired by observing and imitating others. It states that learning is a cognitive process that takes place in a social context and can occur p ...

, receiving praise and benefit for practising violent activities (like some martial arts) reinforces violence in a person and conditions them to be more aggressive and hostile outside of their activity. Endresen & Olweus (2005) recently conducted a study that participating in power sports (which included kick-boxing, boxing, wrestling and weightlifting) "leads to an increase or enhancement of antisocial involvement in the form of elevated levels of violent as well as

non-violent Nonviolence is the personal practice of not causing harm to others under any condition. It may come from the belief that hurting people, animals and/or the environment is unnecessary to achieve an outcome and it may refer to a general philosoph ...

antisocial behaviour Antisocial behavior is a behavior that is defined as the violation of the rights of others by committing crime, such as stealing and physical attack in addition to other behaviors such as lying and manipulation. It is considered to be disrupti ...

outside sports." Given that these activities customarily contain few moral/philosophical teachings regarding conduct, this supports a tentative conclusion that traditional martial arts (which ''do'' typically offer moral/philosophical teachings) are superior to modern martial arts or combat sport training in reducing antisocial behaviour in children and adolescents.

Physical medicine issues

In a physical medicine context, the nature of an injury or disorder may disqualify some arts from usage, as their conventional curriculum/focus may be too rigorous. One wouldn’t expect a patient with joint issues to enroll in

Brazilian Jiu-Jitsu Brazilian jiu-jitsu (BJJ; pt, jiu-jitsu brasileiro ) is a self-defence martial art and combat sport based on grappling, ground fighting (ne-waza) and submission holds. BJJ focuses on the skill of taking an opponent to the ground, control ...

(which emphasizes techniques to hyper-extend joints to the point of pain submission) or elderly patients to enroll in

Muay Thai Muay Thai ( th, มวยไทย, , ), sometimes referred to as Thai boxing, is a combat sport that uses stand-up striking along with various clinching techniques. This discipline is known as the "art of eight limbs", as it is characterised ...

(which requires a high level of physical fitness and incorporates highly damaging techniques with the elbows, knees, legs, and fists). However, in some cases, curricula were modified so that within these disciplines, martial proficiency was de-emphasized in favor of physical betterment. In one notable study, an Israeli researcher (who was a former

Judo is an unarmed gendai budō, modern Japanese martial art, Olympic sport (since 1964), and the most prominent form of jacket wrestling competed internationally.『日本大百科全書』電子版【柔道】(CD-ROM version of Encyclopedia Nipponi ...

champion of

Israel Israel (; he, יִשְׂרָאֵל, ; ar, إِسْرَائِيل, ), officially the State of Israel ( he, מְדִינַת יִשְׂרָאֵל, label=none, translit=Medīnat Yīsrāʾēl; ), is a country in Western Asia. It is situated ...

) taught a modified form of judo to children that had significant visual and mental impairments (blindness, retardation), and in some cases, physical impairment (such as

cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sensa ...

). The resulting increase in physical and cognitive abilities of all the children was of greater quantity than other previous forms of physical exercise, in addition to being longer lasting (Gleser, 1992). In Kalarippayattu, Marmachikilsa (Marmam=Vital points) is another expertise achieved by masters who heal the Marma damages –impacts, internal injuries, dislocation, fracture, or paralysis type cases in fight or fall. Course of uzhichil or particular massage with special herbal oil, like ayurvedic model treatment is a routine affair for all Kalari trainees to enhance the flexibility of joints and toning of muscles. Chavitiuzhichil or foot massage is given at the stage of ankathari.

Areas for consideration

Current trends in research on martial arts' therapeutic benefit points towards generally positive outcomes, especially for physical benefits (one exception to this being possible sustained injuries from competitive applications). But for assessing psychosocial benefits, the evidence is more ambiguous. As with any psychological study, defining concepts such as "

happiness Happiness, in the context of Mental health, mental or emotional states, is positive or Pleasure, pleasant emotions ranging from contentment to intense joy. Other forms include life satisfaction, well-being, subjective well-being, flourishin ...

", "aggressive attitudes" and "

" can be a challenging task compared to defining physically related concepts such as "improved

cardiovascular The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...

health." A frequent measure used in martial arts research to determine therapeutic outcome is the Profile of Mood States (POMS), created by McNair, Lorr, and Droppleman (1971). This is a 65-item survey that measures 6 distinct mood areas, such as "tension-

anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...

" and "

anger Anger, also known as wrath or rage, is an intense emotional state involving a strong uncomfortable and non-cooperative response to a perceived provocation, hurt or threat. A person experiencing anger will often experience physical effects, su ...

-hostility." A commonly used methodology in martial arts studies that employed the POMS was to administer it before a set period of martial instruction and after that same period (ranging from a single lesson to several over days/weeks/months). A successful demonstration of therapeutic benefit would be if study participants showed positive, statistically significant changes in their scores from the first administration to the second. Beyond these issues of

construct validity Construct validity concerns how well a set of indicators represent or reflect a concept that is not directly measurable. ''Construct validation'' is the accumulation of evidence to support the interpretation of what a measure reflects.Polit DF Beck ...

, even if every study of therapeutic martial arts netted a positive outcome (which has not been the case), determining which facets of the instruction were responsible for the change would be vital for widespread application. Potential factors in martial arts could be: cultivating martial ability (being able to fight), philosophical/moral instruction, the proportion of "hard" and "soft" techniques, physical exertion, attainment of rank/status, successful application of techniques in the school, developed friendships with other classmates and any other number of factors. Additionally, the benefit may not be derived from any single factor, but through a unique combination of factors that only martial arts provides. At least one study has shown that compared to students in a sport-specific program, a general fitness program, and a

control group In the design of experiments, hypotheses are applied to experimental units in a treatment group. In comparative experiments, members of a control group receive a standard treatment, a placebo, or no treatment at all. There may be more than one tr ...

, students of a martial arts program derived superior improvement in POMS scores compared to the other three groups.

Perspectives

Martial arts therapy is a concept still in development. Researchers have yet to conclusively identify the specific features of martial arts that foster a physical or

psychosocial The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is ...

benefit. Some have theorized (see Israeli study cited above) that an important feature is the dyadic interplay between students in most arts; the cooperation and response to feedback in practicing techniques such as throws or strikes may have a carryover to cooperation in real-life settings. However, even if all features are conclusively discovered within a specific art or system, there remains the issue of to what extent the instructors within that art/system provide those features to their students.