Download - Anmo Tuina
Anmo Tuina- Chinese Massage
Tyler J. Rowe BTCM-Acu BTCM-Chm Dip-Tn CertIV-Fs Cert-CA Cert-ONM
按摩推拿
IntroductionChinese Massage• 按摩推拿 Ànmó Tuīná ‘Press rub Push grasp’
Eight Branches of Chinese Medicine• 针灸 Zhēnjiǔ - Acupuncture & Moxibustion• 草药 Cǎoyào - Herbal Medicine• 食疗 Shíliáo - Dietary Therapy• 推拿 Tuīná - Massage Therapy• 武术 Wǔshù - Martial Arts• 气功 Qìgōng - Meditation• 风水 Fēngshuǐ - Geomancy• 数术 Shùshù - Astrology
皇帝内经素问 Huángdì Nèijing Sùwèn ‘Yellow Emperor’s Internal Medicine Classic – Simple Questions’
• Chapter 1 – The Universal Truth
‘In the past, people practiced the Dao, the Way of Life. They understood the principle of balance, of yin and yang, as represented by the transformations of the energies of the universe. Thus, they formulated practices such as Daoyin, an exercise combining stretching massaging, and breathing to promote energy flow, and meditation to help maintain and harmonise themselves with the universe.’
• Chapter 24 – Channel Constituents and Acupuncture Techniques
People who are repeatedly startled or traumatised have an obstruction of qiand blood in the channels and collaterals. They can manifest numbness or paralysis of the extremities. One should use tuina, massage, and herb wine in these cases.
皇帝内经素问灵枢 Huángdì Nèijing Língshu ‘Yellow Emperor’s Internal Medicine Classic – Spiritual Pivot’
• …the conduct of the movement of qi, by massage, moxibustion, ironing out, needling, fire needling or drinking medicines. - Scroll 7 part 42. The Propagation of Disease
• The round needle has the shape of an egg. It is used for rubbing and massage, to divide and to separate so as not to injure the muscles and flesh. - Scroll 1 part 1. Of Nine
Needles and Twelve Source Points
• It is necessary to massage the channels first. - Scroll 1 part 4. Noxious Qi’s Disease
• It is necessary to first massage the locations for as long a time as there is a resonance in hand. - Scroll 8 part 52. Protective Qi
• When the channels are shallow, do not needle until the channel has been massagedso that the essence does not come out, then needle. - Scroll 2 part 7. On Governing the Needles
• To harmonize, press and massage that qi which is excessive in the channels. - Scroll 4
part 19. To Qi of the Four Seasons
• When the needling is finished, massage to finish the pain at this location.
• When the needling is finished, massage until it is established that the pain has stopped. - Scroll 5 part 26. Assorted Diseases
针灸甲乙经 Zhenjiu Jiayijing ‘The Systematic Classic of Acupuncture and Moxibustion’
• Throughout the course of their therapy [foot yangming channel sinew], massage should be applied. – Book Two verse 6. Channel Sinews
• To treat them [central region excess], cultivation of qi and massage are appropriate. – Book Six verse 2-3. Great Treatise on the Favourable & Unfavourable, Root & Branch of
Disease, Physiographic Characteristics, and Configurations & Orientations
• At this juncture [liver bi], massage and acupuncture are indicated… At this point [spleen wind]massage, medication, and ‘fire-branding’ are indicated… At this point [shan conglomeration], massage and medication are indicated. - Book Eight verse1-1. On the transmission of Disease Among the Five
Viscera Producing Cold & Heat
• In the case of tugging and tension [in the muscles], one must perform cultivation of qi and massage to promote circulation. – Book Ten verse 1-1. The
Contraction of Disease by Yin Causing Bi
Specialities
• 痹证学 Bìzhèngxué ‘Arthralgia Syndrome’
(Rheumatology)
• 外伤学 Wàishāngxué ‘External Injury’
(Traumatology)
• 正骨 Zhènggǔ ‘Bone Setting’
(Orthopaedics)
Characteristics
• Definition – the manual manipulation of points, muscles, bones and sinews with the hand, elbow or knee, for the purposes of alleviating injury and illness, maintaining health, and preventing disease, through stimulation or reduction of the channels and pathways.
• Requirements– Smoothness– Strength– Stability– Rhythm– Flexibility
Functions & Effects
Functions
• Promote circulation of qi and relieve stagnation
• Invigorate xue and dispel stasis
• Relax the sinews
Indications
• Soft tissue injury
• Chronic joint pain
• Muscular dysfunction & atrophy
• Paediatric Illness*
Contraindications
• Fracture & Dislocation
• Open wounds
• Deep Vein Thrombosis
• Spinal Manipulation*
Treatment prescription & sequence
i. Opening techniques – short duration, superficial, gentle methods
ii. Channel movements – long duration, moderate strength and depth
iii. Point manipulations – deep tissue, specific locations & mobilisations
Media & Tools
• Cloth – no oil needed, barrier, warmth
• Liniments, oils, ointments & plasters
• Appliances & devices
• Practice bag / rice bag
Structures
• 骨 gǔ bones
• 经 jīng channels
• 筋 jīn sinews
• 经筋 jīng jīn channel sinews(灵枢 Língshū ‘Spiritual Pivot’ Scroll 4 part 13)
Jingjin, David Legge (Sydney College Press 2010)
Jingjin, David Legge (Sydney College Press 2010)
Jingjin, David Legge (Sydney College Press 2010)
Jingjin, David Legge (Sydney College Press 2010)
Jingjin, David Legge (Sydney College Press 2010)
Jingjin, David Legge (Sydney College Press 2010)
Diagnosis气 Qì (Stagnation) 血 Xuè Blood (Stasis)
moving fixed
generalised localised
dull sharp
worse with emotional stress unaffected by emotions
虚 Xū Empty 实 Shí Full
chronic acute
aggravated by tiredness aggravated by stillness
alleviated by rest alleviated by movement
weakness & flaccidity stiffness & swelling
enjoys pressure tenderness
Assessment
a) Questioning – location, nature, duration, frequency, radiation, aggravating, relieving
b) Observing – alignment/posture, skin colour, vasculation, reproducing pain
c) Palpate – passive range of movement, resistance, 扪 mén ‘scan’ temperature, 循 xún‘go-along’ channels, 按 àn ‘press’ ashi-tender points, 拨 bō ‘pluck’ sinews
滚法 Gun fa –Rolling
• Frequency 120-180 b/p/m
• Intensity light to strong
• Penetration deep
• Location thick muscled areas, static or dynamic
• Action promote qi and invigorate xue
• Tools dorsal aspect of hand
• Method roll obliquely from the 5th knuckle towards the root of the thumb, fingers relaxed, hand open
一指禅推法 Yi ZhiChan Tui Fa- One Finger
Meditation
• Frequency 120-180 b/p/m
• Intensity light to strong
• Penetration deep
• Location points or channels, static or dynamic
• Action promote qi, invigorate xue and dispel stasis
• Tools radial aspect of thumb, thenar eminance
• Method flex and extend the thumb, taking care not to contact with the knuckles
摩法 Mo Fa –Rubbing
• Frequency 60-90 b/p/m
• Intensity light
• Penetration superficial
• Location systematic, dynamic
• Action opens channels
• Tools palmer aspect of hand
• Method circling clockwise or anti-clockwise, with a loose hand
擦法 Ca Fa –Scrubbing
• Frequency 180-240 b/p/m
• Intensity moderate
• Penetration superficial
• Location systematic, dynamic
• Action warm channels
• Tools palmer aspect of hand, blade of palm
• Method vigorously rub longitudinally or horizontally, with a firm hand
揉法 Rou Fa –Kneading
• Frequency 60-90 b/p/m
• Intensity light to strong
• Penetration deep
• Location ridges, dynamic or static
• Action promote qi and invigorate xue
• Tools palmer aspect of fingers
• Method pinch and squeeze with the finger and thumb pads, using a wide grip
拿法 Na Fa -Grasping
• Frequency 1-12 b/p/m
• Intensity strong
• Penetration deep
• Location ridges, static
• Action promote qi and invigorate xue
• Tools palmer aspect of hand and fingers
• Method clasp the finger pads toward the palm, lift using a narrow grip
按法 An Fa -Pressing
• Frequency 1-12 b/p/m
• Intensity strong
• Penetration deep
• Location points, static
• Action promote qi, invigorate xue and dispel stasis
• Tools tip of finger/thumb, root of palm, knuckle, fist, elbows, knees
• Method apply firm vertical pressure, optional circling
推法 Tui Fa –Pushing
• Frequency 4-12 b/p/m
• Intensity strong
• Penetration deep
• Location thick muscled areas, dynamic
• Action promote qi, invigorate xue and disperses stasis
• Tools thumb or finger pads, root of palm, elbow
• Method obliquely apply firm pressure then slide along the surface
击法 Ji Fa –Striking
• Frequency 240-360
• Intensity moderate
• Penetration deep
• Location thick muscled areas, dynamic or static
• Action promote qi and invigorate xue, relax sinews
• Tools blade of palm, fist, dorsum of hand, cupped hand, crane’s beak
• Method alternately strike in a drumming action with both hands
振法 Zhen Fa –Vibrating
• Frequency 240-480 b/p/m
• Intensity strong
• Penetration deep
• Location thick muscled areas, static
• Action invigorate xue and dispel stasis
• Tools finger tips, palmer surface of hand
• Method place finger tips/palm vertically over area, thumb pulled in, shake horizontally and longitudinally
搓法 Cuo Fa –Foulageing
• Frequency 120-240 b/p/m
• Intensity light
• Penetration superficial
• Location limbs, neck or costal region, dynamic or static
• Action promote qi and invigorate xue, relax sinews
• Tools palmer surface of hand
• Method with palms facing inward to the contact area create a rolling action by alternately moving the hands upward and downward
抖法 Dou Fa –Shaking
• Frequency 120-360 b/p/m
• Intensity light to moderate
• Penetration deep
• Location limbs, dynamic or
static
• Action relax sinews
• Tools hand
• Method firmly grasp the extremity with both or one hand (the other hand can support the joint), shake upward and downward
摇法 Yao Fa –Rotating
• Frequency 6-12 b/p/m
• Intensity moderate
• Penetration deep
• Location limbs and neck,
dynamic
• Action relax sinews
• Tools hands
• Method firmly grasp the extremity with both or one hand (the other hand can support the joint), progress the joint through the normal range of movement.
扳伸法 Ban Shen Fa –Stretching
• Frequency 1-2 b/p/m
• Intensity light to strong
• Penetration deep
• Location joints, static
• Action relax sinews
• Tools hands, elbows, knees
• Method various passive flexibility exercises depending upon joint
Head & Neck
• Common Ailments
headache, stiff neck, cervical osteoarthritis
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, tenderness, restricted range of movement, dizziness, light headedness, radiation to the upper limb, parasthesia, neuropathy, photosensitivity, nausea, nasal discharge or congestion, redness, oedema, heat
• Assessment
observation of symmetry, rotation, flexion, extension and side bending, palpation of Leg Taiyang Bladder, Leg Shaoyang Gallbladder, Arm Taiyang Small Intestine & Arm Yangming Large Intestine
Head & Neck• Main Treatment Sequence
Foulageing – neck Kneading & Grasping – neck, Gb20, 21, Bailao
One finger meditation - Anmain, Gb20, Bl10, Du16
Rolling – neck & nape Pressing – Anmain, Gb20, Bl10, 60, Du16, Si3,13
Scrubbing – Du14 Stretching & Rotating
• Modifications
Headache: Kneading – scalp Tapping – scalp
Pressing – Taiyang, Co4, Lv3, Bitong, Yintang
Stiff neck: Pressing - Gb39, Luozhen
Osteoarthritis: Pressing – Bl11 Pushing – Bailao, Bl11
• Rehabilitation
Sash rotation, flexion and side bending (passive and resited)
Thoracic Regoin
• Common Ailments
intercostal strain, muscular spasm, subluxation of vertebrae
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, tenderness, restricted range of movement, radiation to the head and neck or lumbar region, shortness of breath, redness, oedema, heat, dislocation of vertebrae
• Assessment
observation of symmetry during breathing, rotation, flexion, extension and side bending, palpation of Leg Taiyang Bladder, Leg ShaoyangGallbladder & Arm Yangming Large Intestine
Thoracic Regoin• Main Treatment Sequence
Rubbing – thoracic One finger meditation – Bl, Jiaji, Du
Rolling – Bl, Jiaji, Du Pressing – Si13, Bl, Jiaji, Du
Grasping – Bl, Du Pushing - Bl, Jiaji
Striking– Bl Scrubbing – Bl
Foulageing – Costal Stretching
• Modifications
Intercostal strain: Pressing – Lv13, Gb25, Sp21
Muscular spasm: Pressing – Bl17, 46
Subluxation of vertebrae : Pressing – Gb34, Si3, Sj5
• Rehabilitation
Sash cross on back
Lower Back
• Common Ailments
acute lumbar sprain, disc pathology, arthritis
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, tenderness, restricted range of movement, radiation to thoracic or pelvis and lower limb, parasthesia, neuropathy, weakness, tenderness, redness, oedema, heat or coldness, compensatory curvature deformities, narrowing of intervertebralspaces, vascular congestion, constipation
• Assessment
observation of symmetry, rotation, flexion, extension and side bending, palpation of Leg Taiyang Bladder & Leg Shaoyang Gallbladder
Lower Back• Main Treatment Sequence
Rubbing – lumbar One finger meditation – Bl, Jiaji, Du, Yaoyan
Rolling – Bl, Jiaji, Du Pressing – Bl, Jiaji, Du, Yaoyan
Grasping – Bl, Du Pushing - Bl, Jiaji
Striking– Bl Scrubbing – Bl, Jiaji, Du, Yaoyan
Stretching Rotating
• Modifications
Lumbar sprain: Pressing – Bl40, 60, Yaoytong
Disc injury: Pressing – Bl25, 31-33, 54, Si3 Scrubbing - Gao
Arthritis : Pressing – Du4, Bl23, 57 Pushing - Gao
• Rehabilitation
Sash assisted four-point core exercises, lumbar and hamstring stretches
Shoulder
• Common Ailments
tendonitis, a-c joint sprain, frozen shoulder
• Clinical Manifestations
dull ache or sharp pain, worse at night, rigidity, spasms, nodular masses, tenderness, restricted range of movement, radiation to thoracic, neck, upper limb, parasthesia, neuropathy, atrophy, weakness, joint luxation, swelling, tenderness, redness, oedema, heat or coldness
• Assessment
observation of symmetry, flexion, extension, internal and external rotation, adduction, abduction, scaption, palpation of Arm TaiyangSmall Intestine, Arm Yangming Large Intestine, Arm Shaoyang Sanjiao & Arm Jueyin Pericardium
Shoulder• Main Treatment Sequence
Rubbing – shoulder Kneading & Grasping – Co, Sj
One finger meditatn – Gb21, Co15, Sj14, Si9-13
Rolling – Co, Si, Sj Pressing – Gb21, Co15, Sj14, Si9-13
Pushing – Co, Sj Striking– Co, Si, Sj Scrubbing – Co, Si, SjFoulageing – Co Stretching Rotating Shaking
• Modifications
Tendonitis: Pressing – Co11, 16, Sj5, Gb34
A-C joint sprain: Pressing – Jianqian, Jianneiling
Frozen shoulder: Pressing – Co4, St38 Pushing - Bl41
• Rehabilitation
Health ball rotations on wall, Bamboo cane stretches
Upper Limb
• Common Ailments
tendonitis, carpel tunnel syndrome, rheumatoid arthritis
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, nodular masses, tenderness, restricted range of movement, radiation to shoulder, parasthesia, neuropathy, atrophy, weakness, joint deformity, swelling, tenderness, redness, oedema, heat or coldness
• Assessment
observation of symmetry, flexion, extension, rotation, adduction, abduction, palpation of Arm Taiyang Small Intestine, Arm YangmingLarge Intestine, Arm Shaoyang Sanjiao, Arm Taiyin Lung, Arm ShaoyinHeart, Arm Jueyin Pericardium
Upper Limb• Main Treatment Sequence
Rubbing – arm Kneading & Grasping – Lu, Sj, Co
One finger meditatn – Co10, 11, Lu3, 5, Pc3, 4, Sj5
Pressing – Co4, 5, 10, 11, Lu3, 5, 10, Pc3, 4, 6, 8, Sj2, 5, 10, Si3, 6, 8, Ht3, 8
Rolling - Lu, Sj, Co Pushing/Scrubbing - Lu, Sj, Co, Pc
Foulageing – Lu, Sj, Co Stretching Rotating Shaking
• Modifications
Tendonitis: Plucking - tendon Pressing – epichondyle points
Carpel tunnel: Pushing – Pc7, Sj4
Arthritis: Pinching – Shixuan Pressing – baxie, shangbaxe
• Rehabilitation
Health ball rotations, Bamboo cane stretches
Pelvis & Hip
• Common Ailments
sciatica/piriformis syndrome, arthritis, muscular strain
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, nodular masses, tenderness, restricted range of movement, radiation to lower back or lower limb, parasthesia, neuropathy, atrophy, altered gait, weakness, swelling, tenderness, redness, oedema, heat or coldness
• Assessment
observation of symmetry, flexion, extension, rotation, adduction, abduction, palpation of Leg Taiyang Bladder, Leg ShaoyangGallbladder, Leg Yangming Stomach, Leg Taiyin Spleen
Pelvis & Hip• Main Treatment Sequence
Rubbing – hip Kneading & Grasping – Gb, St
Rolling - Bl, Gb Pressing – Bl36, 54, Gb29, 30, 34
Pushing – Bl, Gb Striking– Bl, Gb Scrubbing – Bl, Gb
Foulageing – Hip Stretching Rotating Shaking
• Modifications
Sciatic/Piriformis: Pressing – Jiaji, Bl40, 57, 60, Gb41
Arthritis: Pushing/Scrubbing - Gao
Muscular strain: Pressing/Pushing – Bl37, Sp10, 11, St31, Lv8
• Rehabilitation
Sash assisted lumbar & hamstring stretch, plum blossom stake rolling
Lower Limb
• Common Ailments
tendonitis/ankle sprain, plantar faciitis, shin splints
• Clinical Manifestations
dull ache or sharp pain, rigidity, spasms, nodular masses, tenderness, restricted range of movement, radiation to lower back or limb, atrophy, parasthesia, neuropathy, altered gait, weakness, swelling, tenderness, redness, oedema, heat or coldness, crepitus, vascular congestion
• Assessment
observation of symmetry, flexion, extension, rotation, pronation, supination, palpation of Leg Taiyang Bladder, Leg ShaoyangGallbladder, Leg Yangming Stomach, Leg Taiyin Spleen, Leg ShaoyinKidney, Leg Jueyin Liver
Lower Limb• Main Treatment Sequence
Rubbing – leg Kneading & Grasping – Bl, Gb, St
One finger meditatn – Bl37, 40, 57, Sp6, 9, 10, Kd1
Pressing – Xiyan, St36, Sp6, 9, 10, Bl37, 40, 57, 60, Gb34, 41, Kd3
Rolling - Bl, Gb, St, Kd Pushing/Scrubbing – Bl, Gb, St, Kd
Foulageing – Lv, Gb Stretching Rotating Shaking
• Modifications
Tendonitis: Pressing – Gb40, St41, Lv4, Kd4 Plucking - tendon
Fasciitis: Pressing - Bl61, 62, St43, Sp3,4, 3, Kd2 Grasping
Shin splints: Pressing/Pushing – Lv5, Kd7 Striking – St, Lv/Kd
• Rehabilitation
Plum blossom stake stepping and rolling