What is Tai Chi

Tai Chi is also known as Tai Chi Chuan, is an ancient Chinese health‐promoting martial art form that has been recognized in China as an effective arthritis therapy for centuries. Tai Chi, a balance-based exercise, has been shown to improve strength, balance, and physical function and to prevent falls in older adults ¹. Tai Chi involves certain postures and gentle movements with mental focus, breathing, and relaxation. The movements can be adapted or practiced while walking, standing, or sitting. Tai Chi movements, if practiced quickly, can be a form of combat or self-defense. Tai Chi is a multi-component mind—body exercise that is growing in popularity, especially among older adults ². Tai Chi integrates moderate aerobic conditioning along with training in balance, flexibility, and neuromuscular coordination. At the same time, Tai Chi calls in to play multiple cognitive components including heightened body awareness, focused mental attention, and imagery. Together, these multi-modal training effects may result in a range of benefits to cognition, gait health, and postural control, beyond conventional uni-modal exercise ³. Tai Chi can improve balance and reduce fall risk in otherwise healthy and neurologically impaired older adults ⁴ and may impact multiple aspects of gait health ⁵.

In summary, practicing Tai Chi may help to improve balance and stability in older people and in those with Parkinson’s disease, reduce back pain and pain from knee osteoarthritis, and improve quality of life in people with heart disease, cancer, and other chronic illnesses. Tai Chi and qi gong may ease fibromyalgia pain and promote general quality of life. Qi gong may reduce chronic neck pain, but study results are mixed. Tai Chi also may improve reasoning ability in older people. Tai Chi and qi gong appear to be safe practices.

If you’re up for trying tai chi, look for a beginner’s class at a senior or community center, health club, or hospital. Many of the 58 academic health centers throughout the United States with integrative health programs offer tai chi classes.

Hour-long classes typically cost around $15, and some centers allow you to pay by the week, month, or several months. Wear loose, comfortable clothing, and supportive shoes like sneakers (or no shoes, if you prefer). During the class, the instructor will demonstrate graceful, slow arm and leg movements, often done with a slight bend in the knees. The sequence of poses can be done standing or while seated in a chair.

Some of the movements have evocative descriptions, such as “wave hands like clouds” or “white crane spreads its wings,” which encourage people to stay centered and focused, yet relaxed.

Are there different styles of tai chi?

Yes, such as yang, chen and wu. Some teachers often practise a combination of styles. The main differences between the different tai chi styles are in the speed of movement and the way the body holds the postures.

What’s the basic technique?

Tai chi is characterised by its slow, graceful, continuous movements that are gentle on the joints and muscles. Done correctly, you’ll find that the tai chi poses flow smoothly from one into another. Many movements are completed with bent knees in a squat-like position.

Can I injure myself doing tai chi?

Tai chi is essentially a gentle activity that is unlikely to cause injury if done correctly. The exercises involve lots of flowing, easy movements that don’t stress the joints or muscles.

Don’t I need to be fit to do tai chi?

No, tai chi is for everyone. It is ideal for inactive older people wanting to raise their activity levels gently and gradually. Also, many of the tai chi movements can be adapted to people with a disability, including wheelchair users.

Am I too old for tai chi?

No, tai chi is commonly performed as a low-impact exercise, which means it won’t put much pressure on your bones and joints. Most people should be able to do it.

Is tai chi good for treating osteoporosis?

Studies have looked into the potential benefits of tai chi for people with osteoporosis, but there is currently no convincing evidence that tai chi can prevent or treat the condition.

Tai Chi exercises

Tips for a better practice

One of the best ways to learn how to do Tai Chi is to observe it and follow along by watching Youtube videos below.

In addition, the tips below will help you to get more benefits out of your practice and reduce your risk of injury.

Enjoy it. Enjoy the movements and breathing. Don’t worry about whether you are doing everything right. Don’t think too much about doing it perfectly—just do. Enjoyment will deepen your practice and help your qi to flow more freely. Worrying or overthinking it disrupts the flow and pulls you out of the moment.

Get grounded. Feel the ground with your feet. Release your weight into the ground and maintain good body alignment to promote stability and balance.

Take it slow. Moving slowly gives you time to sense your body’s position, uncover hidden tensions, and make postural modifications so that different parts of your body move more harmoniously together.

Obey the 70% rule. A key principle of tai chi is moderation in effort, which may contribute to its low risk of injury. This principle is referred to as the 70% rule. Basically, it means to avoid extremes, in which injuries are more likely to occur. Instead, stay at about 70% of your effort, intensity, or range of motion. Never force a movement beyond about 70%. For example, keep a slight bend in your elbow when you extend your arm instead of fully extending it and locking your elbow. Similarly, when stretching your back, for example, stop well before you sense fear of straining muscles or causing a spasm. If you feel any pain or resistance to a move, back off from it.

Be mindful. As you move from side to side, do so in a mindful way. Can you feel the contact between your feet and the ground? Can you feel how your feet connect to the rest of your body? Can you feel your body slowly relaxing as you breathe? Can you do all that without clenching your neck and jaw? You may not be able to do any of the above well, but just being aware of these things is a critical first step. As soon as you start moving, the movement should serve as the “magnet” for your attention. Let it draw your awareness to the parts that are moving.

Move from your center. Imagine your head, torso, and pelvis as a single column aligned over your legs and feet. All upper and lower body movements are integrated with the movement of this “column,” which includes the body’s center of gravity. Do not twist the spine. The tai chi classics say that good movements begin beneath your feet, are steered by the waist, and applied through the arms.

Be aware of your “inner ocean.” Your body is roughly 60% liquid. With this in mind, think of moving an inner ocean when you perform tai chi, rather than changing the shape or position of a solid object. Keep the movements smooth and flowing, as if you were in a pool—the kind of movements that would create gentle waves instead of splashes.

Do some, not none. As with learning to play an instrument, the more time you put into tai chi, the more you’ll get out of it. Whether you have time for only a few 30-minute sessions a week, or 10 minutes a day, do it! You’ll still get benefits. But if you want to overcome a serious health problem or develop a deeper spiritual practice, a more rigorous regimen, such as longer 30- to 60-minute daily sessions, will help you to achieve those goals.

Pace yourself. Just like a young tree thrives when it receives intermittent rain instead of a single downpour, you’ll see more benefits by doing a little tai chi more frequently than doing a lot in isolated sessions that are few and far between. This is especially important when you are beginning a practice. Start with just 10 or 15 minutes and then gradually increase. Even five minutes most days of the week is better than doing nothing at all.

Be patient with your progress. No matter what type of exercise you do, even high-intensity workouts, it takes time to see changes. And with lower-intensity forms of exercise like tai chi, it may take even longer to see physical changes like increased strength or flexibility. The results are worth the wait. However, you need to be on the lookout for them. For example, you may be able to reach into overhead cabinets more easily or bend down to pick up something off the floor without needing to hold on to something. Look for improvements in everyday activities as a way to track
your progress. Celebrate these improvements.

Tai chi benefits

Research findings suggest that practicing Tai Chi may improve balance and stability in older people and those with Parkinson’s, reduce pain from knee osteoarthritis, help people cope with fibromyalgia and back pain, and promote quality of life and mood in people with heart failure and cancer.

Exercise programs, including Tai Chi, may reduce falling and the fear of falling in older people. Tai chi also may be more effective than other forms of exercise for improving balance and stability in people with Parkinson’s disease.

A 2014 review ⁶ determined that Tai Chi, as well as other group- and home-based activity programs (which often include balance and strength-training exercises) effectively reduced falling in older people, and Tai Chi significantly reduced the risk of falling. But the reviewers also found that tai chi was less effective in older people who were at higher risk of falling.

Tai Chi may also offer psychological benefits, such as reducing anxiety. However, differences in how the research on anxiety was conducted make it difficult to draw firm conclusions about this.

Chronic Pain

There is some evidence to suggest that practicing Tai Chi may help people manage chronic pain associated with knee osteoarthritis and fibromyalgia.

The evidence base on efficacy of Tai Chi for chronic pain associated with osteoarthritis consists of several small-to-moderately sized randomized trials included in systematic reviews and meta-analyses evaluating more broadly the effects of exercise on osteoarthritis symptoms.

Fibromyalgia

• Results from a small 2010 National Center for Complementary and Integrative Health-supported clinical trial ⁷ suggested that practicing Tai Chi was more effective than wellness education and stretching in helping people with fibromyalgia sleep better and cope with pain, fatigue, and depression. After 12 weeks, those who practiced tai chi also had better scores on a survey designed to measure a person’s ability to carry out certain daily activities such as walking, housecleaning, shopping, and preparing a meal. The benefits of tai chi also appeared to last longer.
• A small 2012 trial ⁸ suggested that combining tai chi movements with mindfulness allowed people with fibromyalgia to work through the discomfort they may feel during exercise, allowing them to take advantage of the benefits of physical activity.
• Results of a 2012 randomized clinical trial ⁹ with 100 participants suggested that practicing qi gong reduced pain and improved sleep, the ability to do daily activities, and mental function. The researchers also observed that most improvements were still apparent after 6 months.

Chronic Neck Pain

Research results on the effectiveness of qi gong for chronic neck pain are mixed, but the people who were studied and the way the studies were done were quite different.

• A 2009 clinical study ¹⁰ by German researchers showed no benefit of qi gong or exercise compared with no therapy in 117 elderly adults (mostly women) with, on average, a 20-year history of chronic neck pain. Study participants had 24 exercise or qi gong sessions over 3 months.
• In a 2011 study ¹¹, some of the same researchers observed that qi gong was just as effective as exercise therapy (and both were more effective than no therapy) in relieving neck pain in the 123 middle-aged adults (mostly women) who had chronic neck pain for an average of 3 years. Exercise therapy included throwing and catching a ball, rowing and climbing movements, arm swinging, and stretching, among other activities. People in the study had 18 exercise or qi gong sessions over 6 months.

Back Pain

In people who had low-back pain for at least 3 months, a program of tai chi exercises reduced their pain and improved their functioning.

Tai Chi for chronic obstructive pulmonary disease (COPD)

A 2016 Cochrane review ¹² found evidence of very low to moderate quality suggesting participants in the Tai Chi group walked farther, by 29.64 meters in six minutes, and had better pulmonary function, than those who received usual care. However, changes in quality of life were not apparent. When the effect of Tai Chi used in addition to another intervention (i.e. breathing exercise or exercise) was examined, the authros did not find that Tai Chi offered additional benefit in terms of shortness of breath or functional and psychosocial well‐being. Currently, only one study has investigated the beneficial effects of Tai Chi on muscle strength and balance; investigators provided insufficient information to allow comment on the data in this review. With the diverse style and number of forms being adopted in different studies, the most beneficial protocol of Tai Chi style and number of forms could not be commented upon. Hence, future studies are warranted to address these topics.

No adverse events were reported, implying that Tai Chi is safe to practise in people with COPD ¹².

Tai Chi for mental health and cognitive function

While a range of research has suggested that exercise helps reduce depression and anxiety, the role of Tai Chi for and qi gong for these and other mental health problems is less clear. However, there is evidence that tai chi may boost brain function and reasoning ability in older people.

• National Center for Complementary and Integrative Health-supported research suggested that practicing tai chi may help reduce stress, anxiety, and depression, and also improve mood and self-esteem. However, in their 2010 review ¹³, which included 40 studies with more than 3,800 participants, the researchers noted that they couldn’t develop firm conclusions because of differences in study designs.
• In a 2010 review ¹⁴, researchers found that the results from 29 studies with more than 2,500 participants didn’t offer clear evidence about the effectiveness of tai chi and qi gong on such psychological factors as anxiety, depression, stress, mood, and self-esteem. But the researchers noted that most of these studies weren’t looking primarily at psychological distress and didn’t intentionally recruit participants with mental health issues.
• Results from another review published in 2014 ¹⁵ suggested that practicing tai chi may enhance the ability to reason, plan, remember, and solve problems in older people without evidence of significant cognitive impairment. The data also indicated that tai chi boosted cognitive ability in people who showed signs of mild cognitive impairment to dementia, but to a lesser degree than in those with no signs of cognitive impairment.

Tai Chi for quality of life

Much research suggests that physical activity enhances quality of life. Health providers who treat people with cancer often recommend exercise to reduce illness-related fatigue and improve quality of life. Some studies also suggest that physical activity helps people with heart disease and other chronic illnesses.

Cancer

Research results ¹⁶ indicated that practicing qi gong may improve quality of life, mood, fatigue, and inflammation in adults with different types of cancer, compared with those receiving usual care. However, the researchers suggested that the attention received by the qi gong participants may have contributed to the positive study findings.

Heart Disease

• Regular practice of tai chi may improve quality of life and mood in people with chronic heart failure, according to a 2011 clinical trial ¹⁷.
• Results from a small study ¹⁸ suggested that practicing tai chi improved the ability to exercise and may be an option as cardiac rehabilitation for people who have had a heart attack.

Other

A 2010 research review ¹⁶ examined the effects of tai chi and qi gong on the quality of life of adults who were healthy, elderly, were breast cancer or stroke survivors, or had a chronic disease. The analysis suggested that practicing tai chi or qi gong may improve quality of life in healthy and chronically ill people.

Tai chi for seniors

Could Tai Chi help address some of the walking problems, including the risk of falling, that often plague older people? This preliminary clinical trial ¹⁹ adds to the growing evidence that the answer may be yes. The trial, funded by National Center for Complementary and Integrative Health and conducted by a team led by researchers at Harvard Medical School and Beth Israel Deaconess Medical Center, found that as little as 6 months of tai chi training might improve an important indicator of how well a person can walk: gait dynamics.

Declines in walking ability with age have been linked to a wide range of health issues as well as increased risks of falls and death from all causes. Gait, or the way in which one walks, has thus become a research target. Gait enlists many systems throughout the body and has them work together in complex ways. One aspect that has not been much studied is “long-range gait dynamics”—how much people’s gaits fluctuate and change over time when they walk.

This study compared gait speed and gait dynamics in 27 Tai Chi experts (with at least 5 years of tai chi experience) and 60 people of similar ages who had never practiced Tai Chi. These 60 people were then randomly assigned to two groups: one group received 6 months of Tai Chi training, while the other group (the control group) was placed on a waitlist. Gait was assessed at 0, 3, and 6 months. During gait testing, participants walked for 10 minutes at their preferred pace, and wireless switches on their heels and toes captured data on multiple aspects of gait. All 87 participants were very healthy adults aged 50 to 79.

The team found that the Tai Chi experts had gait dynamics indicative of better gait health. Six months of Tai Chi training led to a slight trend in the same direction, but it didn’t reach statistical significance. Tai Chi was not associated with gait speed. More Tai Chi class attendance and home practice appeared to be of some benefit (though this did not reach statistical significance). The authors noted that Tai Chi may exert its effects by maintaining or improving our flexibility to respond and adapt to unpredictable changes in terrain, stimuli, and stresses when you walk.

The authors cited a need for larger and longer randomized trials to more definitely ascertain whether Tai Chi can beneficially affect age-related gait dynamics, especially in people with impaired gait, e.g., from Parkinson’s disease. The study’s limitations included its small sample size and the possibility that factors other than tai chi training caused differences between the experts and the other participants.

Fall prevention in seniors

There is evidence that Tai Chi may reduce the risk of falling in older adults. There is also some evidence that Tai Chi may improve balance and stability with normal aging and in people with neuro-degenerative conditions, including mild-to-moderate Parkinson’s disease and stroke.

• A 2019 Cochrane review ²⁰ examined which fall prevention interventions, including Tai Chi, are effective for older people living in the community. The review included 159 randomized controlled trials of 79,193 participants. Reviewers found that Tai Chi significantly reduced risk of falling, but the researchers are uncertain of the effect of resistance exercise (without balance and functional exercises), dance, or walking on the rate of falls.
• Results of a 2015 systematic review and meta-analysis ²¹ of seven randomized controlled trials involving 1,088 older adults suggest that practicing Tai Chi is beneficial to improve the balance control ability and flexibility in this population.
• A 2014 Cochrane review ⁶ of 30 studies involving 2,878 older adults assessed the effects of exercise interventions, which included tai chi, for reducing fear of falling in community-dwelling older people. Reviewers concluded that exercise interventions had low quality evidence that they reduce the fear of falling immediately following the intervention and insufficient evidence to determine whether these interventions reduce fear of falling after the intervention has ended. The review also examined whether exercise interventions reduced the number of falls in participants as a secondary outcome, but was considered incomplete because only a portion of the studies in the analysis evaluated this outcome.
• Findings from a 2012 randomized controlled trial ²² of 195 patients with Parkinson’s disease demonstrated that tai chi improved balance impairments better than resistance training or stretching in patients with mild–to-moderate Parkinson’s disease. Additional benefits of improved functional capacity and reduced falls were also examined. A 2014 follow-up analysis showed that patient-reported outcomes from tai chi practice were associated with greater probability of continued exercise behavior than were either clinical outcomes or patient-reported outcomes from resistance training or stretching. Tai chi also improved patient-reported perceptions of health-related benefits.

Tai Chi for arthritis

Tai Chi for treating rheumatoid arthritis

A 2004 Cochcrane review ²³ found four trials with 206 participants, the results suggest Tai Chi does not exacerbate symptoms of rheumatoid arthritis. In addition, Tai Chi has statistically significant benefits on lower extremity range of motion, in particular ankle range of motion, for people with rheumatoid arthritis. The included studies did not assess the effects on patient‐reported pain. Tai Chi‐based exercise programs had no clinically important or statistically significant effect on most outcomes of disease activity, which included activities of daily living, tender and swollen joints and patient global overall rating. For range of motion, Tai Chi participants had statistically significant and clinically important improvements in ankle plantar flexion. No detrimental effects were found. One study found that compared to people who participated in traditional range of motion exercise/rest programs those in a Tai Chi dance program reported a significantly higher level of participation in and enjoyment of exercise both immediately and four months after completion of the Tai Chi program.

Tai Chi for treating knee osteoarthritis

• A 2013 meta-analysis ²⁴ of seven randomized controlled trials involving 348 participants assessed the effectiveness of tai chi for pain, stiffness, and physical function in people with osteoarthritis. The meta-analysis concluded that a 12-week tai chi training is beneficial for improving physical function and symptoms of osteoarthritis; however, the studies included in the analysis have methodological flaws and may be limited by potential biases.
• A 2015 Cochrane review ²⁵ of 54 studies involving 3,913 participants assessed the effects of non-aquatic exercise on osteoarthritis symptoms. Five of the studies examined the effects of tai chi on osteoarthritis, while the remaining studies evaluated exercise programs consisting of traditional muscle strengthening, functional training, and aerobic fitness. The reviewers concluded that high-quality evidence suggests exercise provides short-term benefit in terms of reduced knee pain that is sustained for at least 2 to 6 months after cessation of intervention. There was moderate-quality evidence for improvement in physical function among people with knee osteoarthritis. They further noted that the treatment effect would be moderate to small but comparable with estimates reported for NSAIDs.

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