Diabetes Forecast

How Tai Chi Improves Balance and Flexibility

By Hallie Levine , ,

Caiaimage/Tom Merton/Getty Images

Safety Note: Check with your health care provider before starting or changing your exercise plan.

Maybe you’ve seen them: people in the park or a fitness class doing slow, deliberate moves in unison. And maybe you’ve wondered, “What the heck are they doing?”

They’re practicing tai chi (pronounced “tie chee”), an ancient form of exercise that combines low-impact, purposeful movements with deep breathing. “It’s been described as meditation in motion,” says Irina Todorov, MD, an integrative medicine specialist at the Cleveland Clinic. “Its repetitive movement, combined with deep breathing, appears to not only relax you but reduce inflammation in your body that can contribute to diseases such as prediabetes and type 2 diabetes.”

A review published in 2017 in the medical journal Frontiers in Immunology looked at practices such as tai chi and concluded that, when done on a regular basis, they appear to slow down the activity of genes associated with inflammation and repair some of the cellular damage caused by stress. But arguably the biggest benefit of tai chi is the way it helps improve flexibility and balance. That’s especially important for people with diabetes-related complications, such as nerve damage (neuropathy) and eye disease (retinopathy), who are more susceptible to falls.

The American Diabetes Association’s 2018 Standards of Medical Care in Diabetes recommends flexibility and balance training, such as tai chi, two to three times a week for older adults with diabetes.  

Ready to give it a try? Read on for the basics.

The Basics

Although tai chi is often mentioned in the same breath as yoga, the two are actually quite different. They both use meditation and deep breathing, but yoga involves holding specific poses, while tai chi entails moving from one posture to another so that your body is in constant motion. It has three main components:

  • Movement
    Tai chi movements are slow and mindful, gently stretching all of your joints and muscles in a single session. As you go from one movement to another, your body weight shifts from leg to leg. “These weight transfers improve balance and prevent falls,” says Paul Lam, MD, founder of the Tai Chi for Health Institute.

  • Meditation
    As you move, you focus your attention on certain bodily sensations, such as the feeling of the ground beneath your feet. This is meant to encourage mindfulness, which can increase feelings of well-being and also reduce stress.

  • Deep breathing
    As you go through the movements, you pay close attention to your breath, using your nose to inhale and your mouth to exhale. Focus on taking a long, continuous breath without pausing between your inhale and exhale. This helps your body take in more oxygen, which boosts energy. It also forces you to concentrate on your breath, which encourages mindfulness.

Here’s To Your Health

Tai chi doesn’t leave you breathless, so you may think you’re not getting much of a workout. Don’t be fooled. The benefits of tai chi include:

  • Better balance
    An analysis of 10 studies published in 2017 in the Journal of the American Geriatrics Society found that people over age 55 who took tai chi classes on a regular basis reduced their risk of falling by 43 percent compared with peers who did other forms of exercise. Tai chi also appears to improve sensation in the ankles and feet of older people with type 2 diabetes, according to a study at The University of Texas published in 2015 in the journal Evidence-Based Complementary and Alternative Medicine. This is important because people with diabetes are at an increased risk for nerve damage that can lead to numbness and loss of sensation in the lower legs and feet. That ups the risk of falls.

  • Lower stress
    A Tufts University review of 40 studies found that tai chi reduces stress, anxiety, and depression. It also boosts overall mood and self-esteem. “This is particularly important if you have either type 1 or type 2 diabetes, since stress can worsen blood glucose control,” says Todorov. People with diabetes are also more likely to experience depression; rates are up to three times higher in people with type 1 diabetes and twice as high in people with type 2 compared with the general population.

Getting Started

While you can do tai chi with a DVD or online video, it’s best to start with a group class taught by an experienced instructor. You could end up with mild aches and pains due to pulled muscles if you don’t position your body properly, says Todorov.

You can find tai chi classes at the gym, your local recreation or senior center, or at a YMCA. The American Tai Chi and Qigong Association has an online directory of instructors, searchable by city and state (check it out at americantaichi.net).

Some instructors encourage people to practice barefoot, but Lam advises against that for people with diabetes. If you have any loss of sensation in your feet, you may not notice a simple cut; left unchecked, it could result in a serious infection. Instead, opt for a lightweight shoe with a thin rubber sole. (You can buy tai chi shoes online, but they’re not essential.)

From there, it’s time to get moving. The moves below are a good place to start if you’re a beginner.

Try Tai Chi

These movements are from Tai Chi for Diabetes, a program developed by Paul Lam, MD, founder of the Tai Chi for Health Institute. They’re meant to flow from one to another. Once you’ve mastered them, you can find more moves on Lam’s YouTube channel.


Stand upright, looking straight ahead with your chin tucked slightly. Keep your hands at your sides and feet parallel, shoulder width apart. Run a mental check on your posture. It should be upright, but not tense.


Bring your hands up slowly with both palms facing each other until they’re in front of your chest. At the same time bend your knees slightly; be careful to stay within your comfort zone. Stay in this position for a few seconds.


Breathe in deeply as you slowly move your hands, palms still facing each other, until they are shoulder width apart. Imagine there is a gentle resistance against your movements. Then breathe out, pressing your hands together against an imaginary gentle resistance until both hands are nearly head width apart. Repeat six to nine times.



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