THE TREATMENTS
Each treatment starts with a thorough soft tissue massage to prepare the tissues and joints, using steps from the relevant sections of the whole-body routine in chapter 5. Once your partner is warm and relaxed, start to work on the qi-points listed for the treatment, referring to the meridian illustrations and the captions that describe the positions of the points in chapter 3 Knead deeply on each of these qi-points for at least three minutes. For musculoskeletal points, the most effective local qi-points are shown in bold , while the distal points are used to enhance their effects. For internal conditions, points are divided into front and back qi-points. Finish by massaging along the meridians in that area. For maximum benefit, repeat the treatment daily, if possible, until symptoms subside.
Chronic and acute pain, including sports injuries
For the following, treat the recommended qi-points on the side of the body affected.
Neck and upper back pain
The trapezius and underlying muscles in the neck and shoulders easily become tense and knotted as a result of stress, causing a tight, heavy feeling and pain across the shoulders and neck affecting the gall bladder, bladder and small intestine meridians. With continued stress, muscles spasm, putting pressure on nerves, leading to headaches andpain in the arms and fingers. Chronic degenerative disease in the cervical spine, common in older people, also blocks qi and blood flow to cause pain.
Neck pain also results from trauma such as whiplash injuries from accidents or sport.
NECK PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part One, steps 1–7. You can also treat the neck in the supine position, as shown in Part Seven, steps 9–11.
• For general tension in the neck and across the top of the shoulders, with or without pain, sports injury or whiplash:
LOCAL GB 20, GB 12, BL 10, GB 21, SJ 15, SI 13,SI 14, SI 15, BL 11
DISTAL SJ 3, SI 3, nailing (see here , single thumb kneading) SJ 1, SI 1, GB 39, GB 34, BL 60
• For pain or numbness down one side of the neck and radiating down one arm to the fingers, add:
DISTAL SI 3, SJ 3, SJ 5, LU 7, LI 4, LI 11
CAUTION: don’t use LI 4 during pregnancy.
Lower back pain
Pain in the lumbar area is extremely debilitating. Acute lower back pain can be caused by muscle strain or nerve damage. As we age, arthritismay develop in the vertebrae and damage the intervertebral discs. This will reduce the mobility of the spine, which can result in severe, chronic pain. As tension develops, the muscles shorten and spasm. Resulting tension in the tissues puts pressure on the nerves, causing pain both locally and in the legs.
LOWER BACK PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Three, with emphasis on steps 2–8 and 12 (cupping); Part Four, steps 1–2 (buttocks) and 4–11 (back of leg); and Part Five, steps 3, 5, 6 and 11 (leg shake).
Manipulation of the lower back relieves pain from a rugby injury.
• For acute or chronic lumbar pain, with or without ‘slipped disc’:
LOCAL BL 22, BL 23, BL 24, BL 25, BL 26, BL 54
DISTAL BL 40, BL 60, BL 36, BL 37, BL 57
• For chronic lumbar pain due to weak kidney qi, choose from the above qi-points and focus on:
BL 23, K 3, K 13, R 4
• For chronic pain in the sacroiliac region:
LOCAL BL 23, BL 24, BL 25, BL 26, BL 27, BL 28,BL 32, BL 54
DISTAL BL 40, BL 60
Sciatica
Sciatica is chronic pain that radiates from the lower back/sacral region into the legs. It results from nerve damage, which can be triggered by a ‘slipped disc’, causing a nerve to be trapped. Nerves of the legs come from the spine. Damage to spinal nerves causes sciatica. It can be difficult to pinpoint the site of sciatic pain, which often seems to permeate the whole leg.
Sciatica has two components – inflammation of the spinal nerves and spasming leg muscles. Both of these cause pain. The first can be treated by massage on the lower back and the second by massage on the affected three leg yang meridians. It’s important to palpate the three leg yang meridians – bladder, gall bladder and stomach to identify which qi-points are painful.
SCIATICA TREATMENT
Apply Tui Na as described for the lower back and add side position and points shown above.
Your partner lies on their left side with a pillow supporting the head. The left leg is straight. Flex the right leg and draw it up in front so the thigh is almost at right angles to the body. Standing behind your partner and leaning over the right hip, elbow knead the buttock thoroughly. Focus on GB 30 for at least two minutes with small, circular movements. Elbow knead GB 29 and BL 54 in the same way. Then squeeze with the whole hand, and knead with the heel of the hand down the flexed leg. Press and knead GB 31 and GB 34 .
Deep kneading of GB 30 can be uncomfortable but relieves sciatica and hip pain. BL 54 reinforces the benefits of GB 30 .
MAIN QI-POINTS FOR LOWER BACK, HIP AND LEG MASSAGE
These are found on the gall bladder meridian (GB) and the bladder meridian (BL).
• For sciatica – lower back pain that radiates down one leg:
LOCAL BL 23, BL 24, BL 25, BL 26, GB 30, BL 54
DISTAL - GB meridian GB 31, GB 34, GB 39, GB 40
DISTAL - BL meridian BL 36, BL 37, BL 40, BL 57, BL 60
DISTAL - ST meridian ST 31, ST 34, ST 36
• For hip pain:
LOCAL GB 30, GB 29, BL 54
DISTAL GB 31, GB 34, GB 39, GB 40
Shoulder pain
There are a number of causes for shoulder pain, including all kinds of injury, inflammation and degeneration of tissues in the joint. Immobility often occurs when the condition becomes chronic. In extreme cases, this can turn into ‘frozen shoulder’, which is common in those over the age of fifty. In Chinese medicine, this is aggravated by exposure to wind, cold or dampness.
SHOULDER PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Two, steps 1–10 and 20; for top of shoulder, see Part One, steps 1–7.
• For pain in the deltoids and shoulder joint with or without immobility, due to acute soft tissue injury or joint degeneration:
LOCAL LI 15, jianqian, LI 14, SJ 14
DISTAL LI 11, LU 5, LI 4, SJ 5, GB 34
CAUTION: don’t use LI 4 during pregnancy.
• For pain in scapular area and/or the back of the upper arm:
LOCAL SJ 14, SJ 10, SI 9, SI 10, SI 11, SI 12,SI 13, SI 14
DISTAL GB 34, SI 3
• For pain on top of the shoulder:
LOCAL GB 21, SJ 15, SI 14
DISTAL SJ 5, SJ 3
Elbow pain
Repetitive strain injury of the elbow joint and surrounding tissues can result in conditions such as ‘tennis elbow’ and ‘golfer’s elbow’.
Wrists, in common with elbows, are subject to repetitive strain injuries and, in older people, arthritic conditions.
ELBOW PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Two, steps 11–14, followed by steps 9 and 10.
• For tennis elbow – pain in the outside of the elbow, often with extreme tenderness of the muscles overlying the upper third of the radius:
LOCAL LI 10, LI 11, LU 5 plus ashi points
DISTAL GB 34, SP 9, LI 4
• For golfer’s elbow – pain in the inside of the joint and tenderness in the muscles on the inside of the upper forearm:
LOCAL H 3, P 3, SI 8 plus ashi points
DISTAL GB 34, SP 9, SI 3
Wrist pain
Wrists, in common with elbows, are subject to repetitive strain injuries, inflammation of the tendon sheaths (tenosynovitis) and, in older people, arthritic conditions. Carpal tunnel syndrome is a common wrist problem, where a nerve is compressed as it passes through the wrist, causing numbness or tingling in the fingers.
WRIST PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Two, steps 12–13 and 17–19 to massage and manipulate the hand and wrist.
LOCAL P7, H 7, LU 9, LI 5 and ashi points
DISTAL LU 7
Knead deeply around the wrist to stimulate all the qi-points on it. If the fingers are numb due to carpal tunnel syndrome, give particular attention to P 7.
Thumb pain
Thumb pain can be due to injury or arthritis.
THUMB PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Two, steps 13, 18 and 19. Rotate the thumb vigorously, pull it several times and roll it for thirty seconds between your palms.
LOCAL LI 4, LU 10 and any ashi points
CAUTION: don’t use LI 4 during pregnancy.
Knee pain
Acute knee pain may be caused by a sprain or sports injury. Chronic pain can be due to sciatica, degeneration of the cartilage in the joint or inflamed ligaments.
If not caused by injury, most pain in the big toe, particularly in its basal joint, is probably the result of arthritis.
KNEE PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Five, steps 1, 2, 3, 7 and 8.
• For pain deep inside the knee joint caused by damaged cartilage or ligaments:
LOCAL ST 35 and xiyan Knead both points simultaneously and very deeply.
LOCAL ST 34, SP 10, ST 36, GB 34
• For pain caused by ligaments or tendons on the inner surface of the knee:
LOCAL SP 9, LV 8, SP 10, GB 34
• For pain caused by ligaments or tendons on the back of the knee:
LOCAL BL 40, K 10
DISTAL BL 37, BL 57
Ankle pain
‘Twisted’ ankles account for most ankle pain. In older people, weakness and chronic pain often results from arthritis.
ANKLE PAIN TREATMENT
Apply Tui Na as described in chapter 5, Part Five, step12. Give a full foot massage, emphasizing the ankle rotation and deep kneading across the tendons.
• For acute or chronic pain within the ankle joints and general ankle weakness:
LOCAL LIV 4, GB 40, BL 60, ST 41, K 3, K 6
DISTAL GB 34, GB 39, SP 6, K7, GB 44 – press five times with nail.
CAUTION: don’t use SP 6 during pregnancy.
• For sprain from ankle twisted outwards:
LOCAL GB 40, BL 60
DISTAL GB 34
• For sprain from ankle twisted inwards:
LOCAL K 3, K 6
DISTAL GB 34
• For inflammation of the Achilles tendon (squeeze and hack on the tendon):
LOCAL K 3, BL 60
DISTAL GB 34
Big toe pain
If not caused by injury, most pain in the big toe, particularly in its basal joint, is probably the result of arthritis.
BIG TOE PAIN TREATMENT
Apply Tui Na as described on page 121, steps 14 and 15, with several minutes of big toe rotations and pulls.
LOCAL LV 3, SP 4
DISTAL LI 4, LU 10
Common ailments
For the following, treat the recommended qi-points on both sides of the body.
Bronchial asthma
Asthma attacks are recurrent and can vary from mild to life-threatening. Attacks may be triggered by allergens such as pollen, dust, hair, feathers, smoke and even certain foods. Emotional stress often triggers asthma attack. To reduce the frequency of these attacks, massage qi-points to strengthen lung energies and calm the emotions.
BRONCHIAL ASTHMA TREATMENT
Apply Tui Na as described in chapter 5, Part One, steps 1, 3, 4 and 7; Part Six, steps 7 and 8; and Part Three, steps 1–8 (massage of the upper back).
• For the relief of symptoms:
FRONT POINTS R 17, LU 1, LU 2, LU 9, LU 7,LU 6, LU 5, P 6, P 8, LI 4, ST 40, ST 36
BACK POINTS BL 11, BL 12, BL 13, BL 23
CAUTION: don’t use LI 4 during pregnancy.
Constipation
Sluggish action of the colon often results from a diet low in fibre, too little aerobic exercise or qi deficiency in old age.
CONSTIPATION TREATMENT
Apply Tui Na as described in chapter 5, Part Six, steps 1–10, and abdominal massage with emphasis on deep kneading around the periphery of the abdomen.
CAUTION: women who are pregnant should not be massaged on the abdomen.
FRONT POINTS ST 25, SP 15, K 16, R 6, R 4,ST 36, LI 4, GB 34, LIV 3
BACK POINTS BL 25, BL 20, BL 21
CAUTION: don’t use LI 4 during pregnancy.
Diarrhoea
Acute diarrhoea resulting from contaminated food or water does not normally last for more than two or three days. If there is a sudden change of bowel habit to one of persistent diarrhoea, consult a doctor.
DIARRHOEA TREATMENT
Apply Tui Na as described in chapter 5, Part Six, steps 1–10 (abdominal massage).
FRONT POINTS ST 25, SP 15, R 12, SP 6, SP 9,ST 36, LI 11
BACK POINTS BL 25, BL 20, BL 21
• For vomiting accompanied by diarrhoea: P 6
Irritable bowel syndrome – IBS
This condition is frequently stress-related. Symptoms include abdominal pain and indigestion, with diarrhoea or constipation – or both.
IBS TREATMENT
Apply Tui Na as described in chapter 5, Part Six, steps 1–10.
FRONT POINTS ST 25, SP 15, R 12, R 10, R 6, R 4,ST 36, SP 6, LI 4, LI 10, LI 11, LIV 3
BACK POINTS BL 20, BL 21, BL 25
CAUTION: don’t use SP 6 or LI 4 during pregnancy.
Headaches and migraine
According to TCM, headaches and migraines are usually the result of disturbance to qi-flow in the yang meridians of the head – bladder, gall bladder and stomach. The most common headaches are tension headaches caused by emotions or excess alcohol. Migraines are severe, often accompanied by visual disturbances, nausea, vomiting and vertigo. If headaches are persistent and don’t respond to Tui Na, consult a doctor.
HEADACHE AND MIGRAINE TREATMENT
Apply Tui Na as described in chapter 5, Part One, steps 1–7, followed by Part Seven, steps 1–11 (massage of the face and scalp).
In TCM, headaches and migraines are usually the result of disturbance to qi-flow in the yang meridians of the head.
• For headache at the base of the skull (occipital):
LOCAL GB 20, BL10, GB 21
DISTAL LI 4, BL 60, LIV 3
CAUTION: don’t use LI 4 during pregnancy.
• For headache at the front of the head and/or ache around the eyes (frontal):
LOCAL GB 20, BL 2, GB 14, ST 8, yintang
DISTAL LI 4, GB 21, ST 41, ST 44
CAUTION: don’t use LI 4 during pregnancy.
• For headache at the side of the head (lateral) and/or on the temples (temporal):
LOCAL taiyang, GB 20, GB 21, GB 8
DISTAL LI 4, SJ 3, SJ 5
CAUTION: don’t use LI 4 during pregnancy.
• For headache at the top of the head (vertex):
LOCAL DU 20
DISTAL LIV 3, LI 4
• For migraine with nausea and vomiting:
LOCAL P 6, ST 36, LIV 3, GB 20
Use other points according to where the pain manifests, as above.
Other common conditions
Enlarged prostate gland
Difficulty in passing urine.
FRONT POINTS R 3, R 4, K 3, K 7, SP 6
BACK POINTS BL 23, BL 32
High blood pressure – hypertension
FRONT POINTS LIV 3, K 1, K 3, K 7, ST 36, P 6,LI 11, DU 20
BACK POINTS GB 20
Blood pressure tends to fall during Tui Na treatment, whether or not there is high blood pressure.
Heart problems
FRONT POINTS P 6, H 7
BACK POINTS BL 15, BL 14
Infertility
FRONT POINTS R 4, R 6, ST 25, ST 29, P 6,SP 6, K 3, K 1
BACK POINTS BL 23, BL 32
Premenstrual tension – PMT
FRONT POINTS R 6, R 4, SP 6, LIV 3, LI 4
BACK POINTS GB 20, GB 11
CAUTION: don’t use SP 6 or LI 4 during pregnancy.
Insomnia
According to TCM, insomnia is frequently a problem related to the substance shen (see page 16). It results in difficulty getting to sleep because of an active mind, shallow sleep disturbed by dreams, or waking in the night and being unable to get back to sleep. Tui Na for the neck, shoulder, back and face are particularly effective for insomnia treatment.
INSOMNIA TREATMENT
Apply Tui Na as described in chapter 5, Part Seven, steps 1–11.
FRONT POINTS H 7, P 6, P 7, P 8, yintang, K 1,R 4, SP 6, ST 36, LIV 3, DU 20
BACK POINTS BL 15, BL 14
CAUTION: don’t use SP 6 during pregnancy.
Emotional stress
Emotions such as anxiety, worry and frustration all cause stress. They can be treated by calming the shen (see page 16) and reducing stagnation in the liver and gall bladder meridians.
EMOTIONAL TREATMENT
This covers anxiety, worry, anger, frustration and sadness.
FRONT POINTS yintang, taiyang, DU 20, GB 13, P 6, P 7, P 8, H 7, LIV 3, SP 6, K3, K1
BACK POINTS GB 20, GB 21
CAUTION: don’t use SP 6 during pregnancy.
Runny or blocked nose, hay fever and sinusitis
Sinusitis is an inflammation of the facial sinuses, resulting in a blocked nose and pressure around the eyes. Hay fever symptoms include runny or blocked nose, sneezing and red, itchy eyes.
RUNNY OR BLOCKED NOSE, HAY FEVER AND SINUSITIS TREATMENT
Apply Tui Na as described in chapter 5, Part One, steps 5–6, and Part Seven, steps 1, 3, 4 and 5.
FRONT POINTS LI 20, yintang, BL 2, LI 4, LU 5,LU 7, LU 1, LU 2
BACK POINTS BL 11, BL 12, BL 13
CAUTION: don’t use LI 4 during pregnancy.
Eye problems
REFRESHING EYES AND IMPROVING VISION TREATMEN T
Eyesight depends on a good supply of qi. All the following local points boost eye health and can also improve some conditions such as twitching eyelids and sore, red or shadowy eyes.
FRONT POINTS BL 2, SJ 23, GB 1, ST 1, GB 14, taiyang, LIV 3, GB 43
BACK POINTS GB 20
Hearing problems
POOR HEARING, BLOCKED EARS, MILD TINNITUS TREATMENT
FRONT POINTS SJ 21, SI 19, GB 2, GB 8, ST 7
BACK POINTS GB 12
Tui Na massage for children under the age of six is widely practised in China.
Tui Na for infants
Paediatric Tui Na massage is a specialized branch of massage for children under the age of six and is widely practised in China. In young children the meridian system is delicate and still in the process of development. Paediatric Tui Na uses some extra points that are not used on adults, particularly on the hands, accessing the energies of the internal organs through the fingers. Each of the five fingers is linked with one of the yin organs. All the qi-points and soft tissue techniques in this book can be used safely on young children to enhance full physical and mental development and boost the immune system. Use light pressure at first, increasing it gradually as the child adapts.
Three effective techniques for common conditions are described here, one of which is a special hand technique for under-fives.
Rubbing the abdomen
Use the palm of the hand to rub clockwise at least fifty times around the abdomen.
BENEFITS
Excellent for restlessness. Strengthens the spleen and stomach and promotes healthy functioning of the digestive tract.
Stroking the eyebrows – meigong
Using your middle fingers, start at BL 2 and stroke outwards towards SJ 23 . Repeat fifty times.
BENEFITS
The technique – known as meigong – is powerfully calming, promotes healthy eyes and stimulates brain development. It also treats colds and coughs.
Rubbing around the neibagua
The neibagua is a circular area around qi-point P 8 . A good time to use this technique is just before bedtime. Using very small circular movements, knead P 8 at least fifty times. Now rub clockwise the area around P 8 – the neibagua – making between fifty and one hundred circles, and repeat on the other hand.
BENEFITS
Regulates the six yin and six yang organs and balances the qi energies between them to boost immunity and brain development. Soothes a baby who has colic.
Tui Na in adolescence
Adolescence is the period of physical, mental and emotional change and maturation that marksthe change from childhood to adulthood. Many adolescents are taking exams and having to make important career choices, which can cause anxiety, worry and frustration.
The typical physical problems of adolescence are usually due to hormonal imbalance and lifestyle.
Tui Na can help the body recover from living life in the fast lane, such as late nights, erratic and unhealthy meals and lack of sleep.
TREATMENT FOR ADOLESCENTS
Have fun trying out different Tui Na techniques and finding the qi-points. Kneading along the bladder meridian and massaging the neck and shoulders relieves tension. Use the shu points on the bladder meridian of the back (see here ) to strengthen the organs. See elsewhere in this chapter for treatments for insomnia, anxietyand other conditions.
Tui Na can help the body recover from living life in the fast lane, such as late nights, erratic and unhealthy meals and lack of sleep.
Squeezing the top of the shoulders improves qi and blood flow, removing any stagnation to create a feeling of well-being.
Tui Na in later years
According to Chinese theory, the problems associated with ageing are due to both qi and blood deficiency and stagnation as we grow older. The ageing process cannot be stopped, but with Tui Na you can feel good and reasonably pain free. People in their late eighties can enjoy Tui Na just as much as those in their thirties. When massaging an elderly person, bear in mind that joints become less mobile with age, and lying face down may be difficult, so you may have to give treatments in other positions. Be aware that the soft tissues are often tender and can bruise very easily, and that older people may have less body fat and less ‘padding’ on the bones. They may also have osteoporosis.
TREATMENT IN LATER YEARS
The neck, shoulders, arms and back should be massaged unless specifically contraindicated (see here ).
Squeezing the top of the shoulders improves qi and blood flow, removing any stagnation to create a feeling of well-being.
A gentle arm rotation loosens an arthritic shoulder joint, relieving pain and increasing flexibility.