Definition of Tui Na

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Definition of Tuina

Tuina can be defined as the application of various specified manipulative techniques, using hands, limbs or other body parts; upon respective body surfaces by which varying magnitude of force is used.

Nomenclature of Tuina techniques

Due to the historical development of TCM Tuina it is quite confusing in terms of compromising upon the appropriate names given to specific techniques. Traditional ways of classifying Tuina techniques are multifarious:

• According to the movement appearance of the technique:-.e.g Pushing, Grasping, Squeezing, Nipping, Pinching, Tapping, Patting etc.

• According to the meaning of the word describing the techniques:‑ e.g. Mo Fa (to rub),

Tui Fa (to push) Yao Fa (to rotate) etc.

According to the apparatus used:‑ e.g. Bang Ji Fa (using branches collected from a mulberry tree to perform hitting movements)

• According to the movements performed by the therapist upon patients:‑ e.g. Flexion and Extension

• According to traditional custom:‑ e.g. One finger meditation.

However, most Tuina techniques can be understood according to their modes of dynamism.

1.   Force applied in a perpendicular fashion:‑ e.g. Pressing, One finger meditation and Trampling etc.

2.   Force applied in a horizontal fashion:‑ e.g. Rubbing, Scrubbing and Pushing etc. (Although downward force is still applied, the emphasis is on the horizontal surface.)

3.   3. Force applied in a symmetrical fashion:‑ e.g. Grasping, Pinching and Squeezing etc.

4.   Force applied in an antagonistic fashion:‑ Pulling, Oblique‑pulling and Counter­traction etc.

5.   5.    Joints manipulation:‑ e .g. Rotating, Traction and Back extension etc.

Functions of Tuina

 Tuina is to apply specific techniques upon selected body surface in order to improve or affect the physiological and pathological conditions of an individual. Tuina has the following basic functions:

• Improves meridian flow and dredges collaterals:-the manipulation techniques help to retain the balance of qi and blood caused by stagnant meridian qi.
• Promotes qi and blood circulation:-can be achieved by promoting the transportation and transformation function of the Spleen and Stomach; and enhancing the free flow of Liver qi.
• Regulates organs (Zang and Fu) function:-e.g. pressing B121 & 22 help release abdominal cramp; apply One finger meditation on Bl13 & Si 15 can ease off asthmatic attacks etc.
• Improves joints mobility:-by improving the qi and blood circulation of swollen areas; using specific techniques to loosen strained muscle or ligaments and; resetting dislocating joints and tendons.
• Invigorates body immune system:-this is the summation of all of the points mentioned above so that the general health state of a person can be constantly monitored by means of Tuina

one finger meditation technique

(I) One finger meditation technique.

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Description.- Hold one hand in a loose fist position, palm facing downward. Sway the thumb, using either the edge or belly, on specified body surfaces.

Rquirements. Shoulders and elbows should not be raised. The wrist of the performing hand should be slightly bent, not rigid. The wrist should be leading the thumb during swaying movement. Force applied downward through the thumb. Avoid jerky movements. The frequency of One finger meditation can range from 120 to 160 times per minute.

Dynamic functions: Dissipate blood stasis and dredge meridians, promote qi and blood circulation and, loosen muscles and tendons.

Clinical uniqueness: The contacting surface occupied by this technique is relatively small and focused, The pressure it exerts can be quite powerful and infiltrates into body tissues. Therefore it is more commonly used on meridians and acupuncture points

Clinical applications: Best treating headaches, constipation, aches and pain from joints and muscles.

Practice:

Facial area ; starts from Yintang towards Gv24; and from Yintang towards Taiyang.

Neck area ;apply on Gb20 & 21.

Back area ;along the Bladder meridian, apply on some of the points e.g. Bl11, 13, 15, 18-20,23.

Abdominal area apply separately on Cv4, 6, 10, 12, 13 & 17; St 25, Sp15.

Tui Na techniques

Swaying techniques

One finger swaying technique

rolling technique

kneading technique

Rubbing and scrubbing techniques

rubbing

scrubbing

pushing

Rub and Roll (foulage)

wiping

Squeezing and Pressing techniques

pressing technique

nipping technique

grasping technique

Tapping techniques

patting technique

hitting technique

pecking technique

Rolling technique, kneading technique

 Rolling technique.

Description: Use the edge of the palm on the Ulna side (the fifth metacarpal and the Hypothenar eminence) to roll against specified body surfaces. The rolling technique rely on a consecutive range of pronation and supination movements from the hand.

Requirements: Shoulders and wrists should be relaxed. Angle of the elbow of the performing hand should be flexed around 120 140°. Pronation and supination movements need to be continuous. Always keep in close contact with the body surface being treated, avoid jerky movements. Keep the movement frequency between 120 - 160 per minute.

Dvnamic functions: Promote qi & blood circulation and dredge the collaterals, dissipate

muscle soreness, relax muscles and tendons, enhance joints mobility.

Clinical uniqueness: The rolling technique has relatively larger contacting surface. It enables therapists to exert greater but gentle pressure. It is most suitable on large surface

areas e.g. the back ; or areas with thick muscle mass e.g. shoulders and thighs.

Clinical applications: Best treating muscle soreness and numbness, paralysis, joints

functional disability

Practice -

Neck & shoulders areas  around Trapezius, Deltoid. Back area  along Bladder meridian. Thigh areas  around Quadriceps and Hamstring.

(3) the Kneading technique.

Description: Apply either with the thenar eminence, belly of the thumb or, the root of the palm. Move in downward and circular motion lead by the relaxed wrist.

Requirements: When kneading always keep in close contact to the underlying muscle tissue. The circular motion is small. It is inappropriate to move as if a circle is being drawn. This circular motion should result in 'dragging ' the underlying muscle tissue.

Frequency required 120 160 per minute.

Dynamic functions - alleviate chest congestion regulate qi flow, tonify Spleen and Stomach, dissipate blood stagnation, dissolve swelling and alleviate pain.

Clinical uniqueness: The stimulation of Kneading technique is mild, gentle and relaxing. It is most suitable to both infants and persons with frail constitution. It is almost applicable to most body surface.

Clinical application: Best treating abdominal distension, chest and rib pain, constipation and diarrhoea, sprain and strain.

Practice -

Similar to the practices in One finger meditation technique.

Rubbing technique

Rub and Roll (foulage)

Pushing technique

Requirements:-Push in one forward direction only. The force applied is relatively greater than Scrubbing technique. The force should be steady and penetrative. Maintain frequency at approximately 50 per minute.
Dynamic functions:-Promote channels circulation and dredge collaterals; dissipate qi and blood stagnation; relax muscle tension and stiffness.
Clinical uniqueness:-Thumb pushing is more applicable on most body surface than the palm or elbow pushing. The palm pushing has a larger contacting surface therefore it is more suitable to be applied on chest, back and thigh areas. The stimulation of the tip of the elbow pushing is the strongest. It should be used with much discretion and caution. It should be applied on person with strong constitution and on areas with large and thick muscle groups.
Clinical applications:-Best treating numbness and pain due to wind and cold; muscle tension and stiffness esp. lower back problems.

scrubbing technique

Wiping technique

Requirements:-Either single or both thumbs can be used. When the thumb is attached on a specific site, the other four fingers provide a light support to the thumb. The direction of motion is unrestricted. Force applied should be steady and appropriate. The action of this technique needs to be moderate,not too slow or fast.

Dynamic functions:-Calming, tranquilizing and sedative.

Clinical uniqueness:-Wiping is also often used as a supplementary technique. With its tranquilizing effect it is commonly used around the head and facial areas.

Clinical applications:-Best treating frontal headache; neurasthenia and insomnia

Pressing technique

Requirements:-Press perpendicularly downwards. force apply gradually, from gentle to heavy. The pressing action needs to be steady and consecutive. When releasing pressure avoid sudden jerky movements. When using a finger, the thumb is more commonly used.

Dynamic functions:-Dissipate pain and wann the middle heater; release muscle tension and stiffness.

Clinical uniqueness:-

Finger pressing has better control over the stimulation applied on a specific site or point. It has better pain relieving effect. (It had been used in trials of anaesthetic operations in China.)
Palm pressing
larger contacting surface with milder stimulation. It is used more on the chest, abdominal and back areas.

Clinical applications:-Chest pain (angina pectoris); Stomach
abdominal pain; back pain; muscle tension and stiffness.

Practice:
Finger press: head and facial: Gv20, Taiyang;
neck and shoulders: Gb20 & Lu1 &2;
forearm: Col0, 11 , 4;
Palm press:upper and  lower back: along Bladder meridian, the scapulae;
abdominal: around umbilical and hypogastric regions.
eg: anterior and posterior of the thigh; and calf muscles.

grasping technique

(3) Grasping technique
Description:-Using the fingers of the hand to squeeze upon a specific region or muscle group.
Requirements:-Position the performing hand as if holding a glass. Relax the wrist of the performing hand. Force applied through the fingertips not the edge of the nails. Squeezing momentum needs to be consecutive and steady. Increase or decrease pressure gradually. Avoid sudden jerky movements.

Nipping technique

laceration. Must be accurate on the point chosen. Apply 4- 5 times will be sufficient. Once its purpose served, stop repeating. Not suitable for long and repeated applications.

Dynamic functions:-relief convulsion and open up the orifice from unconsciousness; stimulate nerve conduction.

Clinical uniqueness:-Nipping is a very strong technique. The stimulation is forceful and focused. More commonly used as a reviving technique.

Clinical applications:-Shock; syncope; unconsciousness.
Practice:-(unnecessary)

Patting technique

Hitting technique

Requirements:-Hold an empty fist and hit with the back of fist (the metacarpals).Wrist relaxed with fingers close in together. Hitting needs to be rhythmical. Force applied should be rapid and short. Adjust to the constitution of the patient.

Dynamic functions:-Activate blood circulation and dredge collaterals, relieve pain and dispel coldness.

Clinical uniqueness:-Hitting imparts greater force then patting. The action is rapid powerful. It is commonly used on shoulders, back, hips and areas with
thick muscle mass.

Clinical applications:-Arthritic pain, muscle numbness and soreness.
Practice
Shoulders: around the trapezius.
Back area: along Bladder meridian.

Pecking technique

Requirements:-Fingers close in together as if a hen pecking at a corn. Wrist relaxed. Pecking motion needs to be rhythmical, hasty and swift. Nails need to be clipped to avoid unnecessary laceration to the skin.

Dynamic functions:-Promote meridian ql and blood circulation, open orifice. Clinical uniqueness:-Pecking is commonly used for its sedative function.

Clinical applications:-Headaches, insomnia.

Practice:
Head and facial: Gv20, Taiyang;
Neck and shoulders: Gb20 & 21; Lu1 &2
Upper & lower back: along Bladder meridian, the scapulae;