How Tai Chi Can Help Prevent Falls in Older Adults 

Building Strength in the Waist and Legs Is the Foundation of Health

As we age, most of us hope to stay mobile, flexible, and independent—without becoming a burden to others. However, the reality is that the risk of health issues increases with age, especially the risk of falls. Statistics show that roughly one-third of adults over the age of 65 experience a fall each year. Many of these incidents result in hip fractures, particularly in the femoral head. Due to age-related bone loss and weakened regenerative capacity, older adults often struggle to recover from such injuries, leading to prolonged immobility, dependence on diapers, and severely reduced quality of life. Sadly, some even pass away prematurely as a result.

In Japanese cities, it’s common to see signs outside medical facilities that read, “Classes to Prevent Falls in Older Adults.” These classes teach seniors specific exercises to strengthen their legs and improve flexibility, with the goal of preventing falls. Among all these exercises, Tai Chi is the most widely practiced. This trend is not limited to Japan—it’s also widespread in the United States, where Tai Chi is commonly recommended to improve balance and overall physical health in older adults. In fact, the ability to maintain balance is directly linked to lower-body strength, making it a key factor in preventing falls.

1. Preventing Falls Requires Three Types of Leg Strength

More than 70% of falls in older adults are caused by loss of balance, slippery surfaces, or tripping over small obstacles. As we age—especially after 65—our muscles, joints, and ligaments naturally weaken, particularly in the legs, making falls more likely. That’s why developing balance is essential, and good balance relies on three specific types of leg strength:

• The strength to support body weight

• The upward force generated by the legs and toes

• The ability to stabilize the body

Contrary to popular belief, seniors can and should engage in strength training, as long as exercises are chosen based on their individual condition. The key is to avoid high-impact or explosive movements, and instead focus on slow, gentle activities. Tai Chi is especially well-suited because it emphasizes slow, controlled movements. Its unique footwork—involving forward and backward stepping with a stable center of gravity—provides the perfect foundation for developing these three types of strength.

(1) Strength to Support Body Weight

Tai Chi is particularly effective at strengthening the muscles of the legs and feet. Supporting the body’s weight relies on muscles like the gluteus maximus, quadriceps, and calf muscles. Tai Chi’s slow, upright movements increase the workload on these muscle groups.

In Tai Chi, practitioners maintain an aligned posture (often described as “neutral waist”) and move slowly with knees slightly bent—this constant muscle engagement builds leg strength. Maintaining a standing posture and shifting weight gently from one leg to the other trains the quadriceps, which are key to knee stability and weight-bearing.

Falls often happen late at night or early in the morning when older adults rush to the bathroom with sleepy muscles and reduced coordination. Those who practice Tai Chi regularly tend to have stronger legs, better balance, and a calmer mindset, which reduces the risk of sudden falls.

(2) Upward Force from the Legs and Toes

When we stand or walk, the muscles of the feet and toes—especially the toes’ ability to press against the ground—play a vital role. Tai Chi helps enhance this “push-off” power. Beginners quickly notice improvements in their toes’ ability to grip the ground during movement.

In Tai Chi, footwork involves gently lifting one leg with the toes flexed upward, placing the heel down first, then rolling to the ball of the foot. Each step requires a careful shift of body weight and adjustment of the foot’s angle, which strengthens the toes and arches over time. This improves both balance and agility.

Regular Tai Chi practice slows muscle decline in the legs and maintains the height of toe lift while walking. Seniors who don’t exercise often lose this ability, and when their toe lift drops below 1.5 cm, they become more prone to tripping over small obstacles.

Tai Chi also strengthens muscles such as the tibialis anterior and flexor hallucis longus, as well as ligaments around the knee, hip, waist, and back—offering a well-rounded leg workout.

(3) Strength for Balance

● Enhancing Pelvic Stability with Tai Chi
Maintaining an upright posture requires coordination among multiple muscle groups, with the pelvis acting as a key stabilizer. The gluteus medius and tensor fasciae latae on both sides of the pelvis contract and adjust constantly to keep the body balanced over the legs.

When walking, one leg supports the body while the other moves forward. Successful walking requires enough strength in the supporting leg to stabilize the pelvis, or the other leg can’t lift properly. If the pelvic muscles weaken, seniors may struggle with walking and need canes to compensate for poor balance.

Tai Chi footwork includes long periods of single-leg support, which helps train the gluteus medius and surrounding muscles. Compared to regular walking, Tai Chi requires longer balance times on one leg, making it highly effective in building stability.

● Single-Leg Balance During Movement
Understanding the role of single-leg balance in walking is crucial. By practicing step-by-step balance during Tai Chi, seniors can intentionally strengthen this ability and significantly reduce their risk of falling.

Stable pelvic alignment depends on the strength and responsiveness of the gluteus medius and tensor fasciae latae. When these muscles are strong and well-coordinated, the whole body gains greater balance.

(4) How to Improve the Three Types of Strength

To prevent falls, seniors must develop:

• Weight-bearing strength

• Upward force from the toes

• Pelvic balance and stability

Tai Chi’s footwork directly targets all three. Among forward, backward, and lateral steps, backward stepping is the most effective for enhancing all three strengths due to the following reasons: 

First, backward steps involve longer periods of single-leg balance. This strengthens the quadriceps, tibialis anterior, and foot muscles, as well as the gluteus medius and other pelvic stabilizers.

Second, backward stepping is more mentally challenging, as it requires awareness of ground contact without visual confirmation. This stimulates the brain’s memory and balance centers, improving reflexive balance awareness over time.

Tai Chi backward steps should be practiced slowly and continuously, with no abrupt stops. Unlike other exercises, the number or length of steps is less important than maintaining smooth, connected movements with steady breath and stable posture. Setting aside time each day to practice backward steps in Tai Chi can produce noticeable improvements in health and fall prevention.