Tai Chi: History, What a Class Involves and What Research Shows

What tai chi is

Tai chi is a practice built from a series of slow, gentle movements and postures, a meditative state of mind and controlled breathing. [1] The movements are usually circular and never forced, and the muscles are relaxed rather than tensed. [2] The Chinese name, taijiquan, literally means "taiji boxing," a reminder of its martial roots. [3]

Origins and cultural context

Tai chi began as a martial art in China and has become more focused on health over the years. [1] Its origins are described as obscure, with older legends attached to it. The better-documented accounts point to the Chen family village in Wenxian County, Henan Province, and to Chen Wangting, though the sources read give his dates differently (16th century in one, the 1670s for his routines in another). [4][3] Yang Luchan trained in Chen Village and later taught in Beijing. The Wu (Hao), Wu and Sun styles also trace their lineage back to Chen Village through him. [3]

In 1956 the Chinese Sports Committee brought masters together to make a shortened 24-posture form for public health, developed from the Yang-style long form. [3] In 2020 tai chi was included in the UNESCO List of Intangible Cultural Heritage of Humanity after the Chinese government submitted it. [3] These details come from an encyclopedia summary and from a history written by a tai chi teacher whose organization runs tai chi programs, so treat dates as approximate. Styles are covered in Tai Chi Styles: Yang, Chen, Sun, Wu and Short Forms.

The traditional explanation

In the Chinese philosophy tai chi grew from, qi is an energy force thought to flow through the body, and tai chi is said to unblock it. Yin and yang are opposing elements thought to need balance. [2] These are traditional frameworks, not measured biological mechanisms, and the research below tests outcomes such as falls and pain, not qi. One encyclopedia summary states there is no scientific evidence for the existence of qi. [3] You do not need to subscribe to Chinese philosophy to enjoy tai chi's health benefits. [2] For the wider system, see what is traditional Chinese medicine.

What a class involves

A class often starts with a warm-up of easy motions such as shoulder circles, turning the head from side to side, or rocking back and forth. [2] Then comes practice of forms, which are sets of movements. Short forms may have a dozen or fewer movements and long forms hundreds, and a short form with smaller, slower movements is usually recommended at the start. [2] A class may also include a few minutes of gentle breathing, sometimes with movement, which is a qigong segment. [2]

Loose clothing that does not restrict movement is suggested, along with shoes that will not slip. [2] Most teachers let you watch a class first. [2] Programs tested in research usually last at least 12 weeks. [2] A fuller walk-through is in Tai Chi for Beginners: What a First Class Involves.

What research shows

Tai chi cannot be hidden from participants, so benefits in trials against usual care may partly reflect attention and expectation. Quality is also a concern. An overview of 210 systematic reviews rated the certainty of 114 effect estimates as high for 8, moderate for 43, low for 36 and very low for 27, mostly because of risk of bias. [5] It reported no evidence of disease prevention except for stroke, though it found clinically important benefits most consistently for Parkinson's disease, falls risk, knee osteoarthritis, low back pain and cardiovascular disease. [5] Another overview found 13 of 14 reviews on balance and falls were of critically low methodological quality. [6] The table below is NCCIH's summary of published reviews. Labels: established, promising but limited, mixed, insufficient evidence.

1. Fewer older adults falling

   established for fall risk, but not shown better than other balance exercise

   Against controls not thought to reduce falls, high-certainty evidence that tai chi may reduce the number of people who fall by 20% (8 studies, 2,677 people); low-certainty for the rate of falls. Other balance exercise also helped. [1]

2. Knee and hip osteoarthritis

   promising but limited (guideline-supported)

   A 2019 US guideline strongly recommends tai chi. [1] A 2021 review of 16 studies found low-to-moderate strength evidence of benefit. [1]

3. Low back pain

   promising but limited

   A review of 10 studies (959 people) cautiously concluded tai chi may decrease pain and improve function. [1]

4. Fibromyalgia

   promising but limited

   Reduced pain scores in a six-study review; larger, higher-quality studies are needed. [1]

5. Rheumatoid arthritis

   insufficient evidence

   Uncertainty whether it reduces pain or disease activity. [1]

6. COPD

   promising but limited

   May improve exercise capacity, lung function and quality of life. [1]

7. Type 2 diabetes

   mixed

   Better than no exercise for blood glucose measures but not better than other aerobic exercise. [1]

8. High blood pressure

   insufficient evidence

   A 28-study review reported benefits, but the studies were of poor quality. [1]

9. Mild cognitive impairment

   promising but limited

   A 2023 study of 318 older adults compared stretching, standard tai chi and cognitively enhanced tai chi. [1]

10. Cancer-related symptoms

    promising but limited

    Promising, but no definite conclusions can be made. [1]

In Parkinson's disease, tai chi may help improve balance and reduce falls, but the certainty was considered low. [1]

Teachers and training

In the United States tai chi instructors do not have to be licensed, and the practice is not regulated by the federal government or individual states. There is no national standard for certification, and various organizations offer training with differing criteria. [1] Harvard Health advises relying on recommendations and your own judgment, and looking for an experienced teacher who will accommodate individual health concerns. [2] Rules in other countries were not checked. Questions worth asking: where and how long the teacher trained, how long they have taught, and whether you can watch a class first.

See a clinician first when needed

Do not use tai chi to postpone seeing a health care provider about a medical problem. [1] Related pages: tai chi vs qigong, yoga vs tai chi, qigong, adapted yoga and movement and the overview Yoga & Movement.