Origin
Tui-Na (pronounced tway-na), and An Mo represent different aspects of Chinese massage, which like all forms of Chinese Medicine, trace its origins back to the Wei Ching – the Yellow Emperor’s Classic of Internal Medicine from 2300B.C.
Actually, the practice of Tui Na dates back to the Shang Dynasty of China, 1700 B.C. Oracle bones show that Tui Na massage was used to treat children’s diseases and digestive complaints in adults. As a therapy, it was especially popular in the Tang Dynasty (618-907 BC) and in the Ming Dynasty (1368 -1644 BC) and Qing Dynasty (1644 -1912 BC), many classics on Tui-Na were written. Five major styles of Tui-Na are currently differentiated in the lower Yangtze River valley. Of these, Guen Fa or Rolling Technique and Yi Zhir Chan Fa or Zen One-Finger method, are the two primary ones.
Tui Na flourished throughout China until the Qing Dynasty, where it was suppressed along with other Chinese cultural arts. Following the Communist revolution, Tui Na was restored along with other traditional medical arts and was included in the creation of the current system of Traditional Medicine Colleges. Currently, Tui Na is taught as a separate but equal field of study in the major traditional Chinese medical colleges. Tui Na doctors receive the same demanding training as acupuncturists and herbalists and enjoy the same level of professional respect.
What is Tui-Na?
Tui Na is a highly refined system of medical massage designed to treat specific pathologies. In all traditional Chinese Hospitals there are Tui Na wards, where doctors of medical massage treat patients for joint and muscle pathologies, insomnia, hypertension, headaches, toothaches, stomachaches, neuralgia’s, etc. At such hospitals, Tui Na is one of the most popular treatment modalities due to its effectiveness and comfort level.
Like most Chinese therapies, Tui Na is also based on the traditional Chinese medical theory of the flow of Qi through the meridians as its basic therapeutic orientation. Through the application of massage and manipulation techniques Tui Na seeks to establish a more harmonious flow of Qi through the system of channels and collaterals, allowing the body to heal itself naturally. Tui Na methods include the use of hand techniques to massage the soft tissue (muscles and tendons) of the body, acupressure techniques to directly affect the flow of Qi, and manipulation techniques to realign the musculoskeletal and ligamentous relationships (bone-setting).
Although, it is used to primarily relieve pain in the musculo-skeletal body, Tui Na can also ue used to treat common ailments.
The Methodology
Chinese massage techniques are simple and effective. Massage clears the meridians of blockages, stimulates circulation of blood and energy, loosens stiff joints and muscles, and raises vitality and resistance to disease.
It is most commonly used in cases of acute back strain, sprained joints, pulled muscles and tendons, rheumatism and arthritis, nerve paralysis, prolapse of internal organs, sciatica, and similar ailments. There are many massage techniques, but the most common and effective are focus on the nerve centres and meridians that run from the base of the neck down to the heels, especially along either side of the spinal column. The ball of the thumb is used to alternately push hard, then rub lightly along and around the site of massage. “*
This method simultaneously stimulates the internal organs connected to the meridians and nerves, while it tones up the muscles, tendons and ligaments through which the nerves and meridians run.
In a typical session, the client, wearing loose clothing and no shoes, lies on a table or floor mat. The practitioner examines the specific problems of the client and begins to apply a specific treatment protocol. The major focus of application is upon specific pain sites, acupressure points, energy meridians, and muscles and joints.
Advanced Tui Na practitioners may also use Chinese herbs to facilitate quicker healing. Sessions last from 30 minutes to 1 hour. Depending on the specific problems of the client, they may return for additional treatments. The client usually feels relaxed but energised by the treatment. Tui Na is now being popularised globally as a powerful therapeutic extension of traditional western massage methods.
Tui Na’s simplicity and focus on specific problems, rather than a more generalised treatment, make it both an excellent alternative and/or extension of the Swedish-style massage. By utilising treatments of shorter duration, it can be used in a variety of settings, including home, office, clinic or hospital. It is well suited for both the professional massage therapist and the active, health conscious individual.
Tui Na massage therapy is very effective way to remove muscular tension and spasm, in which it can not only relax the muscles but also get rid of the cause that leads to the muscular tension. The function and mechanism of Tui Na massage therapy consist of three parts:
• Firstly, it can locally promote blood circulation and raise body temperature.
• Secondly, it can increase the threshold value of pain of tissue with appropriate stimulation.
• Thirdly, it can extend the tense and spasmodic muscles so that the illness can be eliminated.
Tui-Na as a Tool of Chinese Medicine
The starting point is Tui Na (Tui = stroking, Na = lifting), or Chinese medical massage, which is learned by Chinese doctors as another tool to use alongside acupuncture and Chinese herbs. In essence, it’s simply a form of massage with a repertoire of different strokes, which are worked, on a clothed patient.
The basic techniques that form Tui Na include :
• Rou (circular kneading with palm or fingers),
• An (pressing), Muo (circular rubbing),
• Qian Yin (traction techniques) or
• Gong Fa (rolling technique), as well as others, and they are worked in combination, as appropriate.
In this therapy, the practitioner always works downwards, in contrast to Western massage, moving the Qi out to the extremities and clearing, nourishing and rebalancing the centre of the body.
The style focuses on deep pressure and movement along the Qi meridians and certain Qi points. Its invigorating and re-energising method releases blocked energy and restores a balanced flow throughout the body, promoting health and preventing disease.
Treatment is given through clothes as the technique does not use oils and can be given to the person, while seated or lying on a massage table. Various techniques such as squeezing, pulling, grabbing, kneading and stroking have been developed for certain conditions and all aim to relax the muscles, ease chronic pain and promote Qi flow.
These soft tissue massage techniques lead on to certain joint manipulations, which involve many types of arm and leg shakes, extensions and rotations that complement the overall treatment. Tui Na massage is often used in China to treat conditions that in the West would require an Osteopath, Chiropractor, Physiotherapist or Sports Therapist. Lower back pain is a common complaint, which many Western doctors will diagnose as sciatica, ‘wear and tear’, or a slipped disc.
Treatment is often combined with anti-inflammatory drugs and bed rest, with surgery as a final solution.
Tui Na represents another attractive treatment, whose vast appeal for such common and painful conditions is being reflected in increasing application and appreciation in the West.
How Does Chinese Massage Differ From Western Massage?
All kinds of massage are designed to promote circulation and release tension. The main emphasis is on the manipulation of the soft tissues. To that extent all forms of massage and massage-based therapies are identical but the difference lies in the techniques used for the physical manipulation of the tissue.
Chinese massage is not only concerned with the circulation of Qi energy. Imbalance and blockages in the flow of Qi are seen to be the root cause of all illness in the body. Chinese massage is therefore designed not only to relax the person and release muscular tension but also to treat illnesses. To do this, it combines a wide variety of massage techniques with acupressure as well as stretches and massage of the meridians. The practitioner first needs to diagnose, where the imbalances in the body lie. For example, which organs and meridians are affected and, in what way the forces of Yin and Yang are in excess or deficient.
A number of diagnostic techniques may be used, from questioning, looking, listening to observing the tongue, feeling the pulse, and so on. The massage can range from deep tissue massage to the lighter effects of dotting or nipping. Some of the strokes belong to Yang and have a forceful, purging effect; others belong to Yin and have tonifying, invigorating effects.
Understanding Tui Na Within the Framework of Chinese Medicine
Tui Na has to be understood within the framework of Chinese medicine with its emphasis on Yin and Yang and the Five Elements as well as the concept of meridians and acupressure points. Furthermore, it has to be used in conjunction with Chinese diagnostic techniques such as tongue observation and pulse-taking, which are designed to give a true, holistic impression of the patient’s condition at that particular moment.
In Chinese medicine there is no separation of the mind, the body or the emotions, you treat the whole person. This requires a high degree of knowledge and sensitivity. And when you use Tui Na, you have to be very focused, both on the physical and on the Qi levels. So, we’re not just talking about another massage technique, there is also the need to take on board a whole different philosophy of medicine.
This philosophy has evolved experientially over many hundreds of years as a result of thought, practice and clinical observation. It embraces the concept of the meridian system, invisible pathways that carry Qi throughout the body, and of acupuncture points along the meridians, the stimulation of which can affect the free flow of Qi moving along the pathways.
It also takes consideration of nature’s five main elements of earth, water, fire, metal and wood, as well as natural factors such as damp and wind, which are important in diagnosis. And, of course, there is Yin and Yang, which for good health requires balance and harmony. Whether you are using acupuncture, Chinese Herbs or Tui Na, all these factors need to be understood.
The Tui Na technique is only a tool. What is important to you as a practitioner is intention (Yi) and understanding. Through good diagnosis you have to decide, what it is you wish to change. This requires the sensing of Qi and Qi is the essence of Chinese thinking.
Benefits and Limitations
Tui Na is well suited for the treatment of specific musculo-skeletal disorders and chronic stress-related disorders of the digestive, respiratory and reproductive systems. Effective treatment protocols have been tested in a practical setting.
Tui Na is not especially useful for those seeking a mild, sedating and relaxing massage since it tends to be more task focused than other types of bodywork.
This therapy should not be used, when a person has problems like fractures, phlebitis, infectious conditions, open wounds, and lesions.
Tui Na in general has the following functions:
• It promotes structural and locomotive health by regulating the nervous system, so that the Qi flows through the body, properly. This will increase mobility, range of motion and decrease pain. It improves resistance to disease by boosting the defensive and immunolgical Qi of the body.
• It “flushes” metabolic waste out of the body. Rolling is used directly on sprains with bruising and swelling.
The Rolling Method, which is from Shanghai, treats locomotive and structural problems. Dr. Ting Ji-Feng, who was known as the Grandmaster of the Rolling method, advanced this method. Due to political repression he was forced to teach the techniques to his students, on the quiet. Later, this technique went on to become the most popular remedial massage in China.
The rolling method is best used for joint and soft tissue problems such as chronic joint pain, tenosynovitis, peripheral adhesions of the shoulder, contusions, sprains, strains, and impaired movement.
It is very effective in treating torticollis (wry neck), insomnia, migraine headache and high blood pressure.
The One-Finger Method concentrates on “one finger pushing” to push acupoints along energy channels. By concentrating, the practitioners exert force through the tip of the thumb or fingers. This technique is especially useful for treating internal, paediatric and gynaecological diseases. The One-Finger method was developed during the Sung Dynasty (960-1279BC) and most of the original movements are still in use, today.
Upper body tensions, which manifest as upper back, shoulder and neck tightness, can be cured very effectively by using the ‘Rolling Technique’. This loosens the muscles and opens the channels. The One Finger Method, when used in conjunction with the Rolling Technique, can give very good result.
For problems like ‘Tennis Elbow’, Tui Na is very effective. It can be performed with, either the patient seated or lying down. Treatment can be supplemented by external therapies such as herbal liniments, plasters or fomentation. In many patients, Tui Na methods achieve even better results than acupuncture.
Tui-Na can also be combined with other therapies, like moxabustion and acupressure, for greater benefit.
Aromatherapy and Chinese Massage
Aromatherapy can be used in conjunction with Chinese massage in that the essential oils can also be categorised according to the principles of Chinese medicine. A few examples of this are shown in the following table.
Essential oil – Energy – Main Element – Action
Bergamot – Cool and dry – Wood – Smoothes flow of Qi, harmonises the liver Qi.
Juniper – Hot and dry – Water and metal – Stimulates Yang energy (especially Kidney Yang).
Marjoram – Slightly warm and dry – Earth and fire – Moves Qi, calms the heart, tonifies Spleen Yang, clears dampness.
Palma Rosa – Cool and moist – Fire – Clears heat and Strengthens Yin.
Mind and body are inextricably linked hence, our emotional life can cause imbalances in the same way as our physical imbalances. For example, grief and sadness, which are associated with the Metal element, can result in weakened Lung Qi. This could lead to the person to experience recurring respiratory infections. They may feel withdrawn, cut off from others and have difficulty communicating.
In this case oils such as eucalyptus, cypress, frankincense, tea tree and clary sage will not only support the immune system, the ‘Defensive’ Qi, but also help the individual to let go of grief and be more communicative. Acupressure points such as Lung 7 and Lung 9 will support this process.
Someone who seriously overworks is likely to deplete Kidney Qi and Yin. As a result they may feel anxious, tired and depleted. In such cases Geranium oil could be used to support the Yin, along with the use of acupressure points such as Kidney 6 and Renal 4.
Meridian Massage and Passive Stretches
The meridians or lines of energy in the body, may also be massaged or stretched. Finger pressure along the meridian will release any blockages and stretching the appropriate part of the body will enhance the flow of Qi. For example, massaging and stretching the Lung meridian can improve breathing and stimulate the immune system.