Tai Chi Chuan: A Slow Dance For Health

Few low-velocity, low-impact exercise programs have high appeal for all ages and can be done almost anywhere. One that meets these specifications is tai chi chuan.

Pronounced "tie jee choo-on" and often simply called "tai chi," this traditional Chinese conditioning exercise combines deep breathing, relaxation and slow, gentle, structured movement. Tai chi offers health benefits that are particularly attractive to older adults, and classes have sprung up all over the United States in recent years.

Ancient Roots

Chinese martial artist Chang San Feng is credited with developing tai chi over 700 years ago as a method of self-defense for monks. Since then it has evolved into an art that exercises the body and mind.

Tai chi literally means "moving life force." Tai chi's choreographed movements, called forms, resemble a slow, graceful dance (figure 1). These forms were designed to mimic animal movements, such as those of the snake and the white crane. Because tai chi requires concentration, some people describe it as moving meditation.

Figure 1. The flowing movements of tai chi (called "forms") involve gradual shifting of weight from one foot to the other with smooth, coordinated body, arm and log movements. The 'brush the knee' form shown above involves slight flexing of the knees while weight is gradually shifted from one leg to the other and the feet are placed carefully. The left palm brushes the left knee as the person twists at the waist, which increases motion in the spine. Movements are smooth, with one position flowing into the next. Practicing tai chi forms like this may improve a person's balancing ability, flexibility and hand-eye coordination.

Tai chi is based on the Taoist belief that good health results from balanced chi or life force. An imbalance in or obstruction of the chi is said to result in health problems. According to this belief, chi can be made up of varying degrees of yin and yang, with yin representing qualities such as passivity, darkness, moisture and cold, and yang associated with such qualities as activity, light, dryness and heat. In accordance with this belief system, the forms are practiced in order to stimulate and balance the body's chi. This is done through proper breathing and by learning to keep the muscles active but relaxed, the mind alert but calm and body movements slow but well coordinated.

A Move Toward Health

A goal of health-oriented tai chi is enhancement of body awareness (proprioception) and overall well being. Numerous claims have been made about the healing benefits of tai chi, suggesting that it can boost the immune system, improve digestion, decrease depression and anxiety and promote relaxation. Some claims are substantiated; some are not. Recent research involving older adults has produced evidence that tai chi can help improve balance and lower blood pressure.

Balance: Tai chi can help improve motion by increasing flexibility and strengthening muscles used in posture and balance. This can lead to a significant reduction in falls (almost 50% in one study), which is thought to be due to improved proprioception and strength.

Blood pressure: Blood pressure reductions in older tai chi participants have been found to be only slightly less than those from a moderate-intensity aerobic exercise such as walking. (Aerobic exercise involves continuous, rhythmic use of large muscle groups like those in the legs for prolonged periods.)

Heart Health: Elderly people who practiced tai chi about I hour a day, 5 days per week for 1 year showed significant improvements in the function of their heart and blood vessels. Some tai chi participants have achieved health benefits in as little as one 1-hour session per week for 12 weeks.

Aerobic exercise is the best exercise for the heart. In some studies, tai chi has yielded aerobic benefits, but not to the same extent as standard aerobic activities like walking. Tai chi, therefore, should generally be practiced along with, rather than in place of, regular moderate aerobic exercise.

Safety: Tai chi is safe. Students are trained to be aware of their physical limitations as they practice the forms, which can involve standing on one leg or walking with a narrow stance. Students are taught to recognize and maintain stable footing until they develop a firm "root," or ability to balance.

The movements of tai chi are less jarring than those of a low-impact exercise class. In two studies involving rheumatoid arthritis patients, those who practiced tai chi for 10 weeks had no increase in joint symptoms in comparison with patients who were not involved in tai chi.

Fitting It In

A tai chi program can be done at various intensity levels and modified to fit into a busy lifestyle. It can be used to complement traditional programs such as walking, jogging, swimming and weight lifting.

Ideally, tai chi should be practiced for 20 to 30 minutes at least three times per week.  A person who is inactive could start with 5 minutes once a week, but the goal is to gradually build up to the above target recommendation or to a reasonable comfort level. The most important goal is daily involvement in physical activity.

To perform tai chi correctly, students should be supervised by an instructor trained to monitor their posture and movement. Once the forms are learned, they can be practiced alone or in a group.

Tai chi classes can be found at health clubs, hospitals, martial arts schools, and community centers. (Videos are available, but there is no substitute for hands-on instruction for feedback and for realizing the full potential of tai chi.) Classes taught in martial arts schools generally place the emphasis on improving health, but it's wise to ask, because some instruction is combat-oriented. Talking with tai chi students who have seen positive results from working with a qualified instructor can be invaluable in making the decision about where to learn the techniques.

Remember. This information is not intended as a substitute for medical treatment.  Before starting an exercise program, consult a physician.

John Cheng, MD
The Physician and Sports Medicine
Vo.l 27, No.6, June 1999