Tai Chi for Balance: Does It Really Prevent Falls?

Tai Chi can look too gentle to do much good. Slow movements, no sweat, nobody out of breath. But it is one of the few types of exercise with good evidence that it cuts falls in older people, and it suits many people who would never set foot in a gym.

What does the evidence say?

The biggest review of exercise to prevent falls, which pulled together more than a hundred trials, found that Tai Chi probably reduces the number of falls in older people living at home by around a fifth. Programmes that mix balance and strength work do at least as well, and often better.

So Tai Chi is not magic, but it is a real, tested option. That puts it ahead of many things older people are told to do, such as walking on its own, which is good for the heart but does little for balance.

Why it works

Look at what Tai Chi actually asks you to do:

• Shift your weight slowly from one leg to the other, which is exactly what you do every time you take a step
• Stand on one leg for a moment in almost every movement
• Turn the body and head while staying balanced, which is when many falls happen
• Bend the knees and hold positions, which quietly builds leg strength
• Pay attention to your feet and where your weight is, which sharpens the sense of balance

Done slowly, each of those is safer to practise than the fast version that happens when you trip. That is the point.

Who does it suit?

Tai Chi suits people who are steady enough to stand without holding on for short spells, and who want something gentle, sociable and not too tiring. Many people with arthritis find it comfortable because nothing is jarring.

It can be adapted. Many movements can be done holding the back of a chair, and some classes offer a seated version. A seated version is still good for posture and joint movement, but it does not train balance in the same way, so the aim should be to stand as soon as it is safe.

What it does not do on its own

Tai Chi builds some strength, but not a lot. People who are already quite weak — who need their arms to get out of a chair, for example — usually need proper strength work for the legs as well. The best results come from pairing the two: Tai Chi or balance work, plus a few simple strength exercises that get harder over time.

It also only works if you keep doing it. The trials that showed a benefit had people practising two or three times a week for months. A six-week taster is a good start, not a finish line.

How to start safely

• Talk to your GP first if you have had several falls, dizzy spells or blackouts, so the cause is checked
• Look for a class aimed at older adults or at falls, where the teacher expects people to need a chair nearby
• Wear flat, supportive shoes rather than slippers or socks
• Practise near something sturdy at home — the kitchen worktop is ideal
• Go at your own pace. Smaller, slower movements done well beat big ones done wobbly

Where a physiotherapist fits in

A physiotherapist can check your strength and balance first, so you know where you are starting from and whether Tai Chi on its own is enough. For some people it is. Others need a few weeks of strength and balance work at home before a class feels safe, and then the class keeps them going.

A physiotherapist can also teach a handful of simple Tai Chi-style movements you can do in your own kitchen, alongside the strength exercises, so you are not relying on getting to a class every week.

Home physiotherapy across Tyne and Wear

Home balance and falls prevention visits are available across North Shields, Tynemouth, Whitley Bay, Newcastle, Gateshead, South Shields, Sunderland and across Tyne and Wear.

About Steve McLaren

Steve McLaren is a chartered physiotherapist (MCSP, HCPC PH52681) providing home visit physiotherapy across North Shields, Tynemouth, Whitley Bay, Newcastle, Gateshead, South Shields, Sunderland and across Tyne and Wear. He qualified in 1997 and has spent more than 20 years in community rehabilitation, treating people in their own homes. He works in the NHS in Newcastle, in a rapid response team that treats frail older people at home and in the emergency department, and his particular interest is falls prevention. He lives in North Shields.

Read Steve's profile or call 07788 974385.

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