Tai chi (pronounced "tie chee") is a gentle exercise program that is a component of Traditional Chinese Medicine (TCM). Derived from the martial arts, tai chi is composed of a series of slow, deliberate movements, meditation, and deep breathing, which enhance physical health and emotional well-being (Castleman 1996).

Zhang Sanfeng, a martial artist who lived in China in the late 16th century, created the practice of tai chi (Novey 2000). According to legend, Sanfeng had a dream about a snake and a crane engaged in battle; their graceful movements inspired his non-combative style of martial arts (Rappaport 1997). This ancient form of movement has been practiced in China for centuries and is still a daily routine for tens of thousands of people there, especially the elderly. It was first introduced to the United States in the early 1970s and has since grown in popularity (Castleman 1996).

Metabolically, a tai chi workout raises heart rate and oxygen consumption into the aerobic range. It is similar to walking at a brisk pace and therefore has cardiovascular conditioning benefits comparable to any moderate exercise program. Tai chi also calms the "fight or flight" reactions of the sympathetic nervous system and activates the parasympathetic nervous system, making it analogous to other forms of mind-body therapy (Rappaport 1997).

Through the use of movement, meditation, and deep breathing, tai chi enhances health in many ways. The slow, gentle movements require the use of all of the major muscle groups and joints in the body. Through increased muscle and joint strength, Tai chi stimulates proprioceptive responses and trains neuromuscular reflex pathways, which improves balance, agility, flexibility, stamina, range of motion, and coordination (Lumsden et al. 1998). A safe, weight-bearing exercise, it is believed that tai chi strengthens bones and helps prevent bone loss by enhancing the supply of blood, oxygen, and nutrients to the bones and providing regular, low-impact stimulation (Beling 1999). In addition, tai chi requires constant shifts in balance from one leg to the other; this pattern of alternating muscle contraction and expansion in the legs improves venous return to the heart, which strengthens and tones the cardiovascular system (Null 1998). Studies have shown that tai chi reduces heart rate and blood pressure (Sifton 1999).

The deep breathing exercises required in tai chi increase lung capacity, strengthen the respiratory system, stretch the diaphragm and abdominal muscles, and activate the parasympathetic nervous system, which releases tension and anxiety. Through increased muscular activity of the diaphragm and enhanced blood circulation, tai chi delivers an internal massage to the stomach, liver, spleen, kidneys, and intestines, improving their function (Novey 2000).

The meditative aspect of tai chi soothes the mind, enhances concentration, and improves mental alertness (Sifton 1999). In addition, meditation and deep breathing have a beneficial effect on the body by activating the "relaxation response," a physiological reaction that engages the parasympathetic nervous system to repair and restore the body during times of rest (Murray and Pizzorno 1998).

According to Eastern philosophy, tai chi stimulates the flow of qi (pronounced "chee"), or life energy, which maintains physical, mental, and spiritual health. Tai chi also balances yin and yang, the opposite forces that exist in the universe, and helps make people more aware of the world around them.

Before beginning a tai chi program, patients should discuss their health needs with the tai chi instructor. Exercises can be modified depending on such factors as mobility, previous injuries, chronic pain, joint swelling, and medications that may affect balance. Patients usually learn tai chi in weekly group classes and may practice more if they wish. Ideally, practitioners recommend practicing for 15 to 20 minutes twice a day (Pelletier 2000), but any sustained, regular practice is acceptable for mastering tai chi and achieving long-term results.

Tai chi is both a preventive and a complementary therapy for a wide range of disorders. Since it enhances the function of the immune and central nervous systems, it is especially suitable for those coping with chronic illness, anxiety, depression, and stress-related conditions (Novey 2000; Castleman 1996).

Research shows that tai chi is particularly valuable for geriatric ailments. The elderly gain significant benefits in cardiorespiratory function, muscle strength, balance and flexibility (Beling 1999). One study indicates that practicing tai chi can reduce the risk of falls in the elderly by 47.5 percent (Wolf et al. 1996). In addition, tai chi holds great promise as a modality for people with osteoarthritis, since it decreases joint pain and swelling, and increases range of motion and hand-grip strength. Although weight-bearing exercise can further damage the joints in people with osteoarthritis, clinical trials show no increase in the rate of deterioration in the joints of those who practice tai chi (Lumsden et al. 1998). People with heart disease can gain lasting benefits as well. Clinical trials show that tai chi is successful at lowering heart patients' systolic blood pressure by an average of seven points (LoBuono and Pinkowish 1999).

One study shows that people with mild equilibrium disorders can significantly improve their balance and reduce dizziness by practicing tai chi (Hain 2000). Another study demonstrates that the focused attention required during tai chi can increase memory, concentration, and calculation skills in children (Novey 2000).

The deep breathing exercises characteristic of tai chi also regulate the respiratory system, thereby helping to treat asthma, chronic respiratory distress, anxiety, and shortness of breath. Since the practice also stimulates the abdominal region and improves intestinal function, tai chi enhances digestion and overall metabolism and may relieve constipation, gastritis, irritable bowel syndrome, and gastrointestinal disorders (Novey 2000).

Tai chi is safe for anyone, since it is practiced according to an individual's abilities. No adverse effects have been reported, though beginners may feel some aching and soreness at first. Specifically, lower back discomfort and a slight burning sensation in the knees are common; these disappear as people increase their muscle strength and learn correct body alignment. As with any exercise program, the safety of tai chi depends on the individual performing it and the degree to which he or she engages in proper stretching and warm-up exercises before practice. In addition, correct postural alignment is essential for preventing muscle strain and injury (Novey 2000).

There are no contraindications to the practice of tai chi, only to the way the movements are performed. For instance, a person with lower back problems should learn how to modify his or her movements in order to release the lower back muscles and prevent undue strain. Those recovering from an illness or who have balance disturbances should start slowly and may want to rest periodically and use a chair for support during certain movements (Novey 2000).

The focused concentration used during tai chi requires the cerebrum to be completely active, which enhances its regulating functions and increases the activity of the central nervous system (Novey 2000).

There is no national organization that licenses tai chi masters. However, numerous schools and organizations offer training and instructor certification. A master's training is constantly ongoing and progress is measured by the subjective observation of other masters.

Many local health clubs, YMCAs, senior centers, and continuing education organizations offer tai chi classes. For information on tai chi instruction, contact Patience Tai Chi Association in Brooklyn, NY at 718-332-3477. If you would like to receive T'ai Chi Magazine, write to them at P.O. Box 26156, Los Angeles, CA 90026. There are also many resources on the web; www.chebucto.ns.ca/Philosophy/Taichi/other has links to a wide variety of interesting sites and organizations. Wayfarer Publications (on the web at www.tai-chi.com or by phone at 800-888-9119) has information on books, videos, and other products.

Beling J. 12-month tai chi training in the elderly: its effect on health fitness. Physical Therapy. 1999;79(2):208.

Castleman M. Nature's Cures: from Acupuncture & Aromatherapy to Walking & Yoga, the Ultimate Guide to the Best Scientifically Proven, Drug-Free Healing Methods. Emmaus, Pa: Rodale Press, Inc; 1996:352-359.

Hain TC. Effects of tai chi on balance. JAMA. 2000;283(7):864.

LoBuono C, Pinkowish MD. Moderate exercise, tai chi improve BP in older adults. Patient Care. 1999;33(18):230.

Lumsden DB, Baccala A, Martire J. T'ai chi for osteoarthritis: an introduction for primary-care physicians. Geriatrics. 1998;53(2):84-87.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. Rev. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:175-187.

Novey DW, ed. Clinician's Complete Reference to Complementary/Alternative Medicine. St. Louis, Mo: Mosby; 2000:219-230.

Null G. The Complete Encyclopedia of Natural Healing. New York, NY: Kensington Books; 1998:553-554.

Pelletier KR. The Best Alternative Medicine: What Works? What Does Not? New York, NY: Simon & Schuster; 2000:78-79.

Rappaport J. Muscle and meditation: the ancient art of tai chi builds strength—and serenity—in a few minutes a day. Natural Health. 1997;27(2):104-110.

Sifton DW, ed. The PDR Family Guide to Natural Medicines and Healing Therapies. New York, NY: Three Rivers Press; 1999:151-153.

Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler CE, Xu T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc. 1996;44(5):489-497.