Tuina, Massage and Shiatsu

In ancient China, medical therapy was often classified into "external" and "internal" treatments. Tuina was one of the external methods, especially suitable for use on the elderly population and on infants. Today it is subdivided into specialized treatment for "infants", "adults", "orthopedics", "traumatology", "cosmetology", "rehabilitation", "sports medicine", etc. Tuina has been used extensively in China for over 2,000 years.

Tuina has no side effects unlike many modern drug-based and chemical-based treatments. It has been used to treat or compliment the treatment of many conditions, especially specific musculo-skeletal disorders and chronic stress-related disorders of the digestive, respiratory, and reproductive systems.

History of Tuina

Tuina dates to the Shang Dynasty, around 1700 BC. Ancient inscriptions on oracle bones show that massage was used to treat infants and adult digestive conditions. In his book "Jin Dui Yao Lue", Zhang Zhongjing, a famous physician in the Han Dynasty (206 BC), wrote, "As soon as the heavy sensation of the limbs is felt, "Daoyin", "Tuina", "Zhenjiu" and "Gaomo", all of which are therapeutic methods, are carried out in order to prevent... the disease from gaining a start." Around 700 CE, Tuina had developed into a separate study in the Imperial Medical College.

The first reference to this type of external treatment was called "Anwu", then the more common name became "Anmo". It was then popularized and spread to many foreign countries such as Korea and Japan.

As the art of massage continued to develop and gain structure, it merged (around 1600 CE) with another technique called "Tuina", which was the specialty of bone-setting using deep manipulation. It was also around this time that infant "Tuina" became popular, with its own set of rules and methods.

Today, the term "Tuina" has replaced "Anmo" within China and in the West. The term "Anmo" is still used in some surrounding countries such as Japan.

It is not unusual to see practitioners working on street corners and parks in modern China. Tuina is an occupation that is particularly suitable to those with physical disabilities and in China, many blind persons receive training in the art of Tuina, where their heightened sense of touch is a great benefit.

Push and Grasp?

The term "Tuina" translates into "push-grasp" in Chinese. Physically, it is a series of pressing, tapping, and kneading that removes blockages along the meridians of the body and stimulates the flow of Qi and blood to promote healing, similar to principles of acupuncture, moxibustion, and acupressure. Tuina's massage-like techniques range from light stroking to deep-tissue work which would never to considered during a recreational or relaxing massage.

When Not to Use It

Tuina can be quite powerful and sometimes quite painful during the deep-tissue manipulations. Clinical practitioners often use herbal compresses and packs to aid in the healing process, which can cause allergic reactions on sensitive skin. Tuina is not used for conditions involving compound fractures, external wounds, open sores or lesions, phlebitis, or with infectious conditions such as hepatitis. Tuina should not be performed on the abdominal portion of a woman in menstrual or pregnant periods, and it is not used for treatment of malignant tumors or tuberculosis.

What to Expect?

When you go into a typical adult Tuina session, the patient wears loose clothing and lies on a massage table or floor pad. After answering some brief questions about the nature and location of the health problem as well as basic questions about general health, allergies and other existing conditions, the practitioner will concentrate on specific acupressure points, energy trigger points, muscles and joints surrounding the affected area. Never go for a treatment just after eating...wait at least an hour.

Don't expect a light, relaxing massage, this therapeutic method goes directly after the problems, sometimes requiring significant pressure. When excessive friction from rubbing or stroking is involved, the practitioner may choose to use talcum power, sesame oil, ointment of Chinese holly leaf, oil from HongHua, or a specialized massage emulsion or oil developed for Tuina.

Occasionally, clothing is removed or repositioned to expose a particular spot that requires direct skin contact. The patient should always be informed before this act, and no inappropriate or unexpected contact should ever be made in a professional session.

Treatment sessions last from 30 minutes to over an hour. Patients often return for additional treatments for chronic conditions. As with most "energy-based" treatments, the patient usually feels either relaxed and tired, or surprisingly energized by the treatment and release of pain.

Practitioners of Tuina

Tuina is a clinical practice based on the principles of Traditional Chinese Medicine (TCM). An expert physician of Tuina should be well versed in the knowledge of both Chinese and Western medicines, and has mastered the professional theories and skills needed for clinical diagnosis and treatment.

While performing Tuina, the physician concentrates his mind, regulates his breathing, and actuates the Qi and power of his entire body towards his hands. Even when exertion of strength is needed, the physician should never hold his breath or break his concentration.

Techniques of the Trade

Some of the techniques used in the art of Tuina include:

Tui: Pressing and dragging
Na: Grasping
An: Pressing
Mo: Palm rubbing
Rou: Kneading
Dian: Finger pressing
Ca: Rubbing
Gun: Rolling
Zhen: Vibrating
Cuo: Twist and rub
Mo: Wiping
ina: Lift and grasp
Anrou: Press and knead
Boyun: Forearm kneading
Ji: Beating or drumming
Pai: Patting
Dou: Shaking
Yao: Rotating
Ban: Pulling
Bashen: Extending

Self Massage

Here are several examples of self-Tuina, a very powerful technique for maintaining your own health. The techniques illustrated are used for for general well-being. Tuina also uses very specific techniques to help cure specific illnesses. We suggest a proper Oriental diagnosis from a Tuina practitioner or a doctor of Traditional Chinese Medicine before attempting to treat any specific condition.



Performing "Tui" (pressing and dragging) on both sides of the forehead

Bend the two index fingers and conduct Tui with the 2nd knuckles, from the midline of the forehead (acupoint Yintang EXHN3) to the midpoint of the anterior hairline (toward the left and right acupoint Sizhukong SJ23). Perform this 40 to 60 times or until discomfort is felt.

 Performing "Mo" (palm rubbing) on both temples

Put the surfaces of both thumbs tightly on the hairlines around the temples and slide them backwards forcefully, pressing with both palms and surfaces of the thumbs. Do this about 30 times or until a sensation of soreness and distension is felt.