Wednesday, July 29, 2015

What is tuina and how is it different from other massage forms?

As promised in my last blog, here is the next installment about Tuina. IN this blog I discuss the most important method of the Shanghai family school, guen-fa or rolling method. You can see the entire course (actually 3 courses) that I offer on tuina and how to combine it successfully with acumoxa therapy at Blue Poppy's website on the following page. 
http://www.bluepoppy.com/Tuina-Techniques-Protocols-for-Specific-Conditions/productinfo/DLTUINATEC/
There are also some videos of simple techniques at the Blue PoppyTV Youtube page.
https://www.youtube.com/watch?v=yqOsFKLkP8Y
This blog is excerpted from the handout notes for the entire series of classes on Tuina Basic Techniques and Specific Treatments for Specific Ailments.
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Thanks for reading my blog.

Tui simply means to push and na means to grasp, although there are a dozen different specific movements or techniques to most schools of tuina. Some of these have analogs in various Western massage forms, but the most important ones do not. Also, the basis for using tuina is pattern discrimination (bian zheng lun zhi) exactly the same as any other sort of therapy used in Chinese medicine.
  1. What does Tuina do physiologically? From the point of view of Chinese medical treatment principles, its main function is to move and rectify the qi and quicken the blood to resolve stasis. Some treatments state that they are supplementing or draining specific points and, by extension, specific viscera and bowels so that they will perform their jobs with more efficiency. One example of that might be to supplement the spleen so that it can transform and transport fluids more effectively. More of these discussions may come up as we go through this material.
  2. There are, historically, five schools of tuina therapy. The one that is most important in Shanghai is the Rolling School, which is the style of tuina in which I was trained. This style is flexible, includes many specific techniques, and has a broad range of application in terms of conditions and symptoms for which it is commonly applied.
  3. The six main techniques of this style and that I will cover and demonstrate in this video include: Rolling method, Kneading method, Pressing method, Grasping method, Twisting method, and Rub rolling method. There are a few other, less important techniques that we will cover more briefly as they are similar to massage therapy techniques in the West, while these main techniques have no Western massage analog.
  4. Many of these techniques may be accompanied by passive movements of the limbs or head. I will discuss what each of these techniques is indicated for as I demonstrate them.
  5. What are the essential requirements for effective tuina therapy? The Chinese list four main and one secondary characteristic of the form as general requirements for successful outcomes.
    1. The therapy must be gentle so that it does not damage the tissues  (GENTLE)
    2. The therapy must have enough qi power behind it to penetrate the tissue (POWERFUL)
    3. The movements must be even and smooth throughout contact with the patient (EVEN & SMOOTH)
    4. The therapy must last long enough to engender a change in the tissue (ENDURING)
    5. Finally, in some cases passive movements must be added where appropriate (PASSIVE MOVEMENTS)
    6. The correct movements of the therapist’s hand, wrist and body must be mastered. This is important to keep you from injuring your wrist, hand, elbow, or low back.
    7. In the case of injury management or specific musculoskeletal conditions and diseases, we may also apply liniments or herbal compresses of one type or another.
A word about your practice bag…
In Chinese medical school, tuina students begin their practice on a rice bag, although I suppose any grain would do the job. Instructions for making a rice bag are included with the notes, but basically it is a double layer of a soft fabric such as flannel or very smooth cotton for the sake of the skin over your knuckles, about 6 or 7 inches by 10-12 inches and very, very stuffed. If you don’t stuff it as full as absolutely possible, practice is frustrating as your movements work all the rice out of the way and you are down to the table almost instantly. The Tuina “lore” says that you should have worked your rice into flour before you are allowed to touch a patient. In this video, I will demonstrate each movement first on the rice bag and then on a human being. By the way, animals also love tuina!

With that introduction, let’s begin with the first and most important technique of the rolling school, which is Rolling method.

Rolling Method (Guen Fa)
This movement is the basis or foundation upon which most of this school is built. This movement is used for the neck, back, shoulder, and limbs, but not for the face or abdomen. It utilizes the strength of the entire core and upper body transferred through the shoulder, arm, wrist and hand. The important features start with the practitioner’s body position.

Body position
Again, this is important to master to keep you from injuring your own body, especially your forearm and wrist.
  1. knees slightly bent, core awake or engaged, shoulders and hips straight ahead of you
  2. body at a 45 degree angle to the treatment table
  3. relax shoulder down, keep elbow close to your body
  4. use the arm that is away from the table, not the one closest to the table
  5. Your wrist is relaxed, almost limp, never stiff
  6. The main contact with the patient is made with the triangle of the knuckles and the large end, or styloid process of the ulna
Then, using the distal end or styloid process of the radius to describe an arc, you move that part of your wrist back and forth in a wave like motion  away from and your body. Again, the carpal bones on the back of the hand, extending out to the knuckles, form a sort of triangle that is the surface actually making contact with the patient’s body, which, by the way, is usually clothed or covered with a cloth to protect their skin as well as their modesty.

This movement is extremely efficient. When done well it penetrates deeply without pain and should be maintained for 6-8-10 minutes as the first movement done on most body parts. It is often combined with passive movements and with liniments, which we will return to later on. All the other techniques are subordinant to this main technique.

When beginning your practice, start with little to no pressure in your hand and wrist and work up to stronger pressure as your hand and wrist strengthen. Keep practice sessions to 20-30 minutes maximum. Otherwise you can create tendonitis! I’m serious about this. Increase your pressure slowly over a period of days and weeks until you can feel the tissue moving pretty deeply underneath your hand and wrist….up to a few kilos of pressure per square centimeter.

Lots more in these notes...but cannot give it all away free. Thanks for reading. Check out the video link for a hot compress for pain recipe.

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