Tai Chi for Prevention of Falls

Principle One – Relaxation

In any true Tai Chi you must always be relaxed. This brings many benefits but from a falls point of view it is particularly important. When you are mentally tense you hold tension in muscles and tissues. This tension (now known as postural hypertension) has a number of implications:

• First it causes changes in the body that raises the center of gravity. The

higher your center of gravity the more difficult it is to maintain balance. You do not have to believe me on this just stand on your toes with your hands over

your head and see how much harder it is too balance. Postural hypertension

creates a similar but not as extreme effect.

• Second, these muscular tensions act to reduce the ability of the muscles to

make the hundreds of small adjustments necessary to keep our body posture

balanced. To remain upright and walk the body must keep over 120 muscles

working in a balanced and co-ordinated form.

One of the most important techniques for achieving relaxation is the diaphragmatic breathing used in Tai Chi (this means use of the muscular sheet lying between the chest and abdominal cavities to initiate the breathing action). You should always check that your Tai Chi course includes instruction in this technique. Diaphragmatic breathing will also act to lower the center of gravity. The more you tend to use diaphragmatic breathing and stay relaxed the less likely you will be to fall.

Principle Two – Posture

The center of gravity needs to be maintained not only from a vertical but also a

horizontal viewpoint. That is from a horizontal viewpoint the further the center of gravity is from the center point between the feet the harder the muscles must work to maintain the balance. This is also easily demonstrated by keeping the body straight and leaning forward or backward. You will soon come to a position where you cannot maintain your balance.

You should look for a Tai Chi form that emphasizes the straight back with the head in the "riding the wind" position and the tailbone tucked under. The "riding the wind position" is often called "the suspended head top" and is where you feel as though the head is being lifted up through the crown of the head (Bai Huai point if you want to be technical).

 Principle Three – "Silk-like movement"

Tai Chi teaches a form of movement that avoids jerky, angular changes in direction and speed. This requires the avoidance of any situation in which the joint is "locked" or at full extension. This is important because such locking reduces the available ranges of movement reducing the opportunities for correcting balance. One is also taught not to come to a jerky stop at the end of an extension of leg or arm movement. Such jerky stops are situations where the momentum of a limb may act to throw the body off balance. In a sense what is being taught here is one aspect of kinesthetic awareness. That is the development of body awareness. Obviously when you are aware of how your body is moving and what its position in space is you are more likely to become aware of any loss of balance before it becomes extreme enough to be a threat.

One practical example of the importance of not having the limbs extended is in

walking. If you stand with the knees in the lock position and extend one foot you will find that it does not reach the ground in front. Only when you bend the supporting leg does the other leg reach the ground. So how do those people who habitually walk with their knees almost in the lock position walk? Basically they fall forward onto the front foot! Apart from damage to joints this is a very high fall risk maneuver. In Tai Chi you should be taught to "Walk like a cat" that is the foot comes forward first and the weight is only transferred when the foot is safely on the ground.

Principle Four – Unity of movement

The Tai Chi classics teach that all movement is rooted in the feet, powered by the legs, directed by the waist and expressed through the hands. As you learn this form of movement you learn techniques that avoid movements of the limbs that pull the torso of the body of balance. It is another aspect of kinesthetic awareness.

Principle Five – Base of Balance

Tai Chi teaches what is called the square stance and square stepping techniques. What this does is too teach movements that expand the base of balance that we use. If you place your feet side by side and wiggle your hips around you will find it much harder to keep your balance than if you stand with your feet shoulder distance apart. Similarly if you step with one foot directly in front of the other foot and wiggle your hips around you will find it much harder to balance than if you have your lead foot to forward but shoulder distance to the side. This may seem obvious but you would be surprised how many people habitually walk by placing their feet almost directly in front of the other thus exposing them to a high-risk fall posture.

Other aspects of Tai Chi training that may impact to reduce falls

While Tai Chi is often regarded as a gentle exercise, and should be pleasant and pain free to perform, the various bio-mechanical techniques that it uses does build muscular strength and physical stamina. These benefits are primarily due to the slowness of the movement and the fact that it is performed with bent knees (this increases the muscular and cardiovascular loading).

Tai Chi is a holistic exercise that works on more than bio-mechanics. Positive thinking is encouraged and developed. If you do not think that your state of mind has any influence on your propensity to fall consider walking across to planks. Both are 40 centimeters wide and 5 meters long. Both are completely rigid. The only difference is that one is lying on the floor and the other is connects to buildings 40 stories high. Which one do you think you are going to fall off? The one that you have the most negative thoughts about!

Tai Chi also works on balancing the Chi or vital energy of the body in Chinese terms the more unbalanced this energy the more likely you are to be unbalanced from a mental, emotional and physical viewpoint and the more likely you will be to have a "fall" in each of these areas.

Could other exercises achieve what Tai Chi does?

To date despite considerable efforts there is no scientific evidence that other

exercises can achieve the fall benefits that can be achieved by Tai Chi. Attempts are being made to show that sets of exercises in which individual exercises may work on such things as posture, muscular strength or relaxation can when added together achieve the same effect as Tai Chi but so far without success. I tend to suspect that it is the fact that so much is going on within each movement of Tai Chi that contributes to the development of fall prevention skills. Also, surely the point is that we have a scientifically proven way of reducing falls so why not use it? The case is strengthened when we realize that Tai Chi is not just exercise that prevents falls. It has also been shown to be beneficial to the immune system, arthritis, asthma, osteoporosis, stress management, cardiovascular development and so on. Tai Chi offers an exercise system that is fun that is well within the range of most of the population and that is relatively "risk free" to learn.