Tai Chi and Qigong for MS can offer a gentle way to work on movement, balance, coordination and body awareness. Many exercises can be adapted to individual abilities – for example, they can be practised standing, sitting or with support from a chair or walker.
My guest Mirko Lorenz is a movement educator, Tai Chi instructor and prevention trainer. His work focuses on movement disorders, and he trains people living with multiple sclerosis, Parkinson’s disease and dystonia, as well as people recovering from stroke.
We talk about the difference between Tai Chi and Qigong, why slow movements can still be physically demanding, and how training can be adapted when balance or mobility is impaired.
We also discuss proprioception, spasticity, concentration, fatigue and the importance of regular practice.
This is the English translation and adaptation of the original German interview. Some references to healthcare structures, courses and services in Germany have been supplemented with editor’s notes to make the information more useful for an international audience.
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Who is Mirko Lorenz?
Mirko, could you briefly introduce yourself and tell us what you do?
Mirko Lorenz:
My name is Mirko Lorenz and I have been living in Berlin for many years. I originally come from Saxony as well. My path took me through China, Bavaria and Lower Saxony before I eventually settled in Berlin.
For around 15 years, I have worked independently as a trainer, teacher and instructor for Tai Chi and Qigong.
My professional focus is now on movement disorders. I work with people living with Parkinson’s disease, MS and dystonia, as well as people recovering from stroke. I also continue to offer general Tai Chi and Qigong classes.
What motivated you to choose this profession?
Mirko Lorenz:
I actually trained as a chef. I lived in Switzerland for a long time and completed my culinary training there.
I still enjoy cooking very much, but even during my first years in the profession I realised that the stress and physical demands were too much for me in the long term. I wanted to find a profession I could practise for many years and genuinely enjoy – something that felt more like a calling.
I was already very interested in Asian martial arts at the time. That is why I went to China and tried to fulfil that dream while I was still young.
That is ultimately how I moved from cooking into Asian movement arts.
Tai Chi and Qigong for MS – Principles and Goals
What are the main goals when Tai Chi or Qigong are used by people with MS?
Mirko Lorenz:
I would start by looking at it a little more broadly. Tai Chi and Qigong can become a way of life. Tai Chi was originally a martial art and can also support personal development.
Today, for many people, the focus is no longer on fighting an external opponent but rather on maintaining and supporting their own health.
Important areas include balance, relaxation, concentration, motor skills and freedom of movement. Above all, it is about continuing to move in a gentle way.
If you engage with the practice more deeply, there can also be an aspect of personal development.
What is the difference between Tai Chi and Qigong?
Mirko Lorenz:
That is actually one of the most common questions I hear in my classes.
Qigong can be understood, in simple terms, as working with your own life energy. In traditional Chinese thought, “Qi” refers to life energy. Through regular practice, the idea is to strengthen it and support its free flow.
There are many different forms of Qigong. Some are very still and involve little movement, while others include stepping patterns.
Tai Chi has stronger roots in martial arts. There are also different styles of Tai Chi. I personally come from the Chen Tai Chi tradition.
One well-known origin story tells of a monk who observed a fight between a snake and a crane. The snake represented circular, evasive movement, while the crane represented more direct movement. The story reflects the idea of opposites and balance.
There are different historical explanations for the origins of Tai Chi. In my tradition, one story describes a retired general who combined his martial arts experience with health exercises, breathing and imagery.
That is why Qigong exercises are often included in regular Tai Chi training.
Tai Chi and Qigong for MS – Balance, Mobility and Body Awareness
How can Tai Chi and Qigong train coordination and balance?
Mirko Lorenz:
The answer is actually quite simple: by deliberately training those abilities.
One important Tai Chi principle is slow, conscious and controlled movement.
At the beginning, the aim is to get to know your own body better. Every small movement is first practised externally, and with more experience you begin to focus increasingly on the finer details.
Attention helps improve awareness of your own body.
This becomes particularly relevant when shifting your weight. If you practise weight transfer very slowly and precisely while paying attention to posture and your joints, you are training exactly the abilities needed for balance and coordination.
How can Tai Chi be adapted for reduced mobility or the use of walking aids?
Mirko Lorenz:
I do many exercises in a seated position with people who are not walking well at the moment.
I like working with separate groups – for example, seated groups and standing groups. That makes it easier to adapt the training to the abilities of the participants.
In a seated position, people can still perform the upper-body movements very well. Walking exercises are obviously not possible at that point, but you can build up gradually.
A walker or chair can also be incorporated into the training. During balance exercises, for example, I always keep a chair nearby, especially when someone knows that they are having a less stable day.
Safety always comes first.
What role does proprioception or deep body awareness play?
Mirko Lorenz:
In Tai Chi, we try to develop increasing access to our own body. That happens mainly through repetition.
The more often movements are performed consciously, the more differentiated your awareness of your own body can become.
Eventually, certain movements can also start to happen more automatically.
In martial arts, you might think of reflexes – a movement happens before you consciously think about it.
In everyday life, this might mean reacting more quickly when you are about to fall, or intuitively making a better compensatory movement.
These movement patterns do not develop after one or two practice sessions. They develop through repetition and regular training.
Proprioception describes the ability to sense the position and movement of your body or individual body parts without having to look at them.
Tai Chi and Qigong for MS – Relaxation, Spasticity and Concentration
How can the exercises be adapted when someone experiences muscle tightness or spasticity?
Mirko Lorenz:
When we begin Tai Chi, we first work with slow, relaxed, calm and flowing movements. The same applies to Qigong.
When I talk about relaxation, I do not simply mean lying on the sofa watching television.
It is more about using the body in a balanced way. We work with posture and body corrections, try to release unnecessary tension around the joints and bring conscious attention into the movement.
You almost have to become friends with your own body again. Even if a certain body area does not feel good, you try to reconnect with it and develop awareness.
I used to be a very tense person myself and regularly had problems with my lower back. I have experienced what gentle movement can do.
When people have spasticity, I explicitly encourage them to be very gentle and kind to their own body.
If a movement cannot be performed fully at that moment, you simply do a smaller part of it.
The goal is not to force your way through a limitation.
Can Tai Chi and Qigong also challenge concentration and cognitive abilities?
Mirko Lorenz:
Tai Chi can definitely be demanding.
There are many different movements. The stepping patterns may need to be combined with arm movements. Then there are the circular and flowing movements, which can feel unfamiliar at first.
That can be learned through gradual training.
Tai Chi is sometimes described as meditation in motion. You can take a simple movement and try to connect your full attention to it.
That actively involves the mind in the training.
In Qigong, imagery also plays an important role. When I consciously imagine a movement or process, the mind is involved as well.
For me, body and mind belong together. When both work well together, it is like a company in which everyone is pulling in the same direction.
What is important to avoid overloading people with MS?
Mirko Lorenz:
You have to meet people where they are.
If I were to take a traditional Tai Chi class exactly as it might be taught in China and bring it unchanged into a rehabilitation clinic, many participants could easily become overwhelmed.
So you need to build a bridge.
The basic principles should remain, but the level of difficulty can initially be reduced. Once something works, you can gradually build on it.
If someone enjoys Tai Chi or Qigong and practises regularly, their abilities can develop over time.
Tai Chi and Qigong for MS – Training and Individual Adaptations
How does Tai Chi or Qigong training usually begin?
Mirko Lorenz:
Traditionally, Tai Chi begins with learning how to stand correctly. After that come simple steps.
My training programme, Keep Moving, is based on a simplified system involving standing, walking and sitting.
If someone can stand, we first practise a stable stance. If someone trains while seated, we begin with an upright sitting position.
Then I guide participants forward step by step.
At first, these may be very simple Qigong exercises in a seated or standing position. We may focus on breathing and imagery, while the movement itself remains simple.
Later, simple stepping sequences can be added. I may leave the arms out initially so the participant can focus completely on standing, stepping and shifting weight.
The idea is to notice every step and every small part of the movement.
This works the legs and involves the hips and knees while also training balance.
If something works well at a very slow pace, it often becomes easier to perform at a more normal speed later.
Slow walking is therefore a training method. No one is expected to move through everyday life in slow motion.
How physically demanding are Tai Chi and Qigong?
Mirko Lorenz:
If you train Tai Chi intensively, you can definitely experience muscle soreness at the beginning.
Of course, the training needs to be adapted for people with more significant impairments.
Simply performing movements slowly while keeping the knees slightly bent already makes the thigh muscles work much harder.
Because the movements are controlled very slowly and precisely, muscle groups that are not normally used so consciously may also become more active.
More intensive Tai Chi can also involve very low stances, which can be physically demanding.
Another form of effort is concentration.
For many participants, it is genuinely challenging to perform a movement slowly and maintain their attention at the same time.
Everyday life is often fast. We rush from one place to another. Suddenly doing everything deliberately and slowly can therefore feel unfamiliar.
How quickly can someone start practising independently at home?
Mirko Lorenz:
That varies and depends on how intensively someone practises and whether they have previous experience.
After a course of around ten sessions, most people should normally be able to practise at least some things independently at home.
Simple step sequences or correct standing can be learned relatively quickly. More complex movements naturally take longer.
I also work with online tutorials and videos so participants can look movements up again later.
So it is usually possible to start practising something at home fairly quickly.
And of course, every teacher is pleased when a student comes back and says, “I practised at home.”
How important is a good Tai Chi or Qigong instructor?
Mirko Lorenz:
In Tai Chi, we work with very subtle body corrections.
At first, these are fairly obvious things: Is the stance roughly shoulder-width apart? Are the knees slightly bent? How are the knees aligned with the feet?
Later, the corrections become more detailed.
Perhaps the shoulder is no longer lifted, but it is still slightly rotated. Then you may look at the relationship between the shoulder and the hip, or whether the upper body is leaning too far forward or backward.
After that, you can look again at where unnecessary tension remains in the body.
A good teacher can observe from the outside and guide the student in the right direction.
Especially at the beginning, I consider that support very important.
Eventually, though, there also needs to be some independence. The student should increasingly be able to practise alone and assess their own body.
Many of my students tell me that at some point they start hearing my voice in their head. They may be standing in a supermarket queue or waiting for a bus and suddenly think: “Bend your knees slightly.”
That is when you know that certain principles have already become part of everyday life.
Tai Chi and Qigong for MS – Courses, Experience and Research
How can people take part in your classes?
Mirko Lorenz:
The easiest way is through my website or through Keep Moving.
I regularly offer online programmes and also work in different parts of Germany.
This includes workshops, patient events and training retreats, for example in monasteries.
In Berlin, there are also regular weekly classes led either by me or by trainers from my team.
So there are different ways to get to know Tai Chi and Qigong and try them out.
More information is available at:
Editor’s note for international readers: Mirko’s in-person programmes are based in Germany. If you live elsewhere, your national or local MS organisation may be able to recommend adapted Tai Chi or Qigong classes, physiotherapists or instructors experienced in working with people with MS. When choosing a class, ask whether exercises can be adapted for seated practice, walking aids, balance problems or fatigue.
What does research tell us about Tai Chi for MS?
Mirko Lorenz:
I looked at a small study conducted in Bayreuth.
It examined Tai Chi exercises in people with MS in relation to balance, coordination, fatigue and depression.
However, the study was small and included only 32 participants. As far as I remember, the Tai Chi group trained twice a week for 90 minutes over a period of around six months.
Compared with the control group, improvements were reported in areas including balance and coordination as well as depressive symptoms.
Life satisfaction also developed positively in the Tai Chi group, while fatigue worsened in the comparison group.
Of course, it would be interesting to know what happened after the study ended. Did the participants continue practising, or did they eventually return to their previous habits?
Especially in relation to fatigue, which is common in MS, I personally find the slow and gentle approach of Tai Chi and Qigong interesting.
For people who currently find movement difficult, even a simple seated movement may offer a lower threshold for getting started.
Participants in my classes sometimes tell me that certain movements were painful at first and became easier with regular, gentle practice.
One thing is important to me: you should not simply push through your limits. You can approach a limit carefully, but you should listen to your body.
Editor’s note: Mirko is describing the research available to him at the time of the original interview. The study he refers to included only 32 participants, so its findings should be interpreted cautiously. Tai Chi may be a useful complementary form of physical activity, but it is not a treatment for MS.
What positive changes have you observed in participants?
Mirko Lorenz:
Sometimes it begins with very simple things.
Even in an online class, for example, you can see participants smiling after 45 minutes. They have done something for themselves, completed the session and may feel better afterwards.
Of course, you cannot always clearly attribute that specifically to Tai Chi or Qigong. But the experience of actively doing something for yourself can already be very valuable.
With regular training, I also observe changes in walking and stepping. That is not limited to people with MS but also includes, for example, people with Parkinson’s disease.
During our multi-day retreats, people with different movement disorders train together.
After five days of intensive practice, I sometimes see noticeable differences in the way individual participants walk. In some cases, I record short videos before and after the retreat and compare a few metres of walking.
These are personal observations from my work, not scientific evidence. But for individual participants, visible changes like these can be very motivating.
How intensive are these training retreats?
Mirko Lorenz:
They can actually involve quite a lot of practice.
The day often begins before breakfast with around half an hour of Qigong. In the morning, there may be roughly two hours of training, followed by another two hours in the afternoon.
Sometimes we add another 20 minutes of very calm exercises in the evening, such as simple stepping work or quiet Tai Chi, to bring the day to a close.
Altogether, that can add up to four or five hours of movement a day.
The major difference compared with everyday life is that many daily demands disappear during a retreat.
At home, there is work, family, children and many other responsibilities. During a training retreat, much more of your energy can be directed toward the practice and toward yourself.
Final Thoughts and Key Takeaways
What developments in MS research and treatment would you like to see in the coming years?
Mirko Lorenz:
Of course, I hope we will continue to have good medications.
At the same time, I would like to see other factors investigated more closely – for example, movement, nutrition and their possible influence on living with the condition.
In the past, people with MS were sometimes even advised not to exercise. Today, we know how important it is to study these relationships more carefully.
I would like to see a more holistic perspective: What can different factors contribute in addition to medical treatment?
For me, that also includes the social environment.
I would like us to pay more attention to how important exchange and therapeutic support can be. People should have opportunities to talk about worries and fears and to receive professional support.
Many of these things already exist to some degree. I would like to see them studied more systematically and integrated more strongly into care.
What would you like people with MS to take away from this interview?
Mirko Lorenz:
From my own experience, I think it is enormously important to stay connected to yourself and listen to your own body.
Everyone should try to create an environment that strengthens both body and mind.
And I hope people have the courage to stay active and find methods that feel good and help them move forward.
That does not have to be Tai Chi. It could just as easily be yoga or something completely different.
What matters is sticking with it and, ideally, developing a routine that becomes part of everyday life.
For me, it is about living an active and self-determined life.
Consistency also builds confidence in yourself. You begin to notice small successes and realise: perhaps I can still influence something after all.
And those small successes can help rebuild trust in your own abilities.
Thank you, Mirko, for the conversation and for sharing so many insights into Tai Chi and Qigong.
One of the points I find especially important is that movement does not always have to be big, fast or particularly athletic. A stable stance, a conscious shift of weight or a movement performed while seated can be a meaningful starting point too.
Perhaps Tai Chi or Qigong could be a suitable way for you to stay active, become more aware of your body and train movement in a focused way.
And if not, there are many other forms of physical activity. What matters is finding something that suits you, your body and your everyday life.
See you soon and try to make the best out of your life,
Nele
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