ACUPRESSURE, STRETCHING AND BODY STRENGTHENING ANCIENT METHOD: THEORY AND CLINICAL APPLICATION

1. ACUPRESSURE, STRETCHING AND BODY STRENGTHENING ANCIENT METHOD: THEORY AND CLINICAL APPLICATION • The method – combination of three most effective clinical methods of natural body healing • Manual Therapy - acupressure and work on meridians • Manual Therapy – manipulation of hard and soft tissues, and internal organs. • Exercises

2. ACUPRESSURE • Acupressure as a VI part of manual therapy • Acupuncture and acupressure – what’s better? • Preparation of specialist in acupressure (physical and energetic components)

3. STRETCHING AND BODY TISSUE MANIPULATION • Advantage of the oriental methods over western methods of manual therapy. Attempts of western methods to catch up • Necessity of combination of both methods as a condition of the most effective approach • Method as a tool of self-development

4. TECHNIQUES AND ACUPOINTS: CLINICAL APPLICATION • Hand techniques and necessity of TCM theory application • Acupressure points – nature, proper location, significance and manipulation • Clinical application in various structural and functional disorders (8 diseases, combination of acupressure points, structural, visceral and craniosacral techniques)

5. SPECIFIC EXERCISES (INTEGREF) AS A MAIN TOOL IN LONG-TERM HEALTH • INTEGREF (3 levels) – theory and practice • Structural and physiological benefits of INTEGREF • Choosing exercises or group of exercises for specific disorders • Contraindication and avoiding of over-stretching oneself or the patient

6. ACTING PRINCIPLES OF CHINESE ACUPRESSURE • Balancing Yin and Yang • Regulating Zang and Fu organs • Dredging Meridians and Collaterals • Relaxing muscles and tendons • Activating meridians • Treatment and restoration of tissues and promoting their renovation

7. ACTING PRINCIPLES OF CHINESE ACUPRESSURE • Promoting blood circulation • Activating blood and Qi

8. MANIPULATION TECNIQUES (one finger)Yizhichan Tuifa • Pushing manipulation with one finger principles (the most basic technique) • Clench a hollow fist, upper limb muscles relaxed • Exert force naturally, avoiding violent pressure • Clinical application: • Could be used all over the body; • Usually applied to the head, face, chest, abdomen and limbs; • Has the effect of relaxing tendons, activating blood and meridians; • Removes blood stasis and food retention; • Used to treat headaches, stomach ache, abdominal pain, aching pain in the joints, tendons and bones. • Standing and sitting techniques

9. ROLLING MANIPULATION (Gunfa) • Using 2 to 4 metacarpophalangeal joints as an axis • Using ulnar dorsum side • Flexing the ulnar side of the wrist • The wrist and curled fingers • Clinical application: • Usually used at the areas of thick muscles (back, gluts, thigs, IT band, hamstrings, shoulders) • Used for aching pain, numbness and paralysis. • Activates blood, smoothing joints, relaxing tendons, relieves spasms of ligaments and muscles, removing fatigue (excellent against fatigue syndrome).

10. 3. KNEADING MANIPULATION (Roufa) • Palm kneading • Basic principles: fixing the T or PB on a certain part or point, relaxing the wrist, using the elbow as a pivot, moving slowly and softly. • Kneading with Thenar • Kneading with Palm Base • Clinical applications: • Suitable for points all over the body; • Provides mild stimulation • Used for epigastric pain, stuffiness in the chest, pain in the hypochondriac region, constipation, diarrhea and other GT diseases • Swelling and pain by the injury • Soothes the chest depression and regulates flow of Qi • Removes blood retention, promotes the BC, removes stasis

11. CIRCULAR RUBBING MANIPULATION(Mofa) • Palm rubbing • Finger rubbing • Clinical application • Light, mild and moderate stimulation • Used on the chest, abdomen, and hypochondriac regions • Used to treat epigastric pain and distension, dyspepsia, qi stagnation and internal injury of the chest and hypochondrium. • Regulates the stomach to smooth Qi, removes food retention to promote digestion and regulating peristalsis of the stomach and intestine.

12. Two-and-fro Rubbing Manipulations(Cafa) • Thenar is used on the shoulder, back, buttocks and lower limbs. • Thenar – used on chest, abdomen, buttocks and lower limbs. • Palm Base (in all three cases the frequency is about 100-120 times p/m), used on the chest, abdomen and hypochondriac regions. • Clinical application • Warming and activating of meridians • Promoting blood/Qi circulation • Stopping pain • Eliminating swelling • Strengthening spleen and stomach • Used to treat visceral asthenia impairment and syndromes caused by dysfunction of qi and blood • Activates blood and eliminates blood stasis • Some oil or ointment might be used

13. PUSHING MANIPULATION (Tuifa) - Palm pushing manipulation - Elbow pushing manipulation Clinical application: - Could be applied to all parts of the body; - Has an action of increasing muscular excitement, promoting BS, relaxing tendons and activating meridians.

14. PALM-TWISTING MANIPULATION (Cuofa) • Combination of two-way twisting and kneading movements • Clinical Application: • - Applicable to back, lumbus, hypochondrium, limbs; most commonly used on upper limbs • Used as an ending manipulation of tuina. • Coordinates Qi and Blood and relaxing tendons and dredging the meridians.

15. WIPING MANIPULATION (MAFA) • Attaching one or both thumbs close to the skin and doing up-and-down or left-and-right rubbing action. Force has to be rather light but not superficial, heavy enough but not stuck. • Clinical application: commonly applied to the head, face and nape, to relieve headache, stiffness and pain in the nape. Has an effect of tranquilization, inducing resuscitation and improving eye-sight.

16. SHAKING MANIPULATION (DOUFA) • Hold the distal end of the patient’s upper or lower limbs with both hands and make constant, up-and-down trembling movements in a small amplitude. The range of shaking movement should be small, but frequency considerable. • Clinical application: Used on limbs, especially on upper limbs. In clinic, it is often used in combination with palm-twisting manipulation (Cuofa), as a finishing manipulation. It has the same therapeutic effect as palm-twisting manipulation.

17. VIBRATING MANIPULATION (ZHENFA) This manipulation is divided into palm vibrating and finger vibrating manipulation. It is done by placing the finger or palm on the body surface, exerting force intensively and statically with the muscles of the forearm and hand to produce vibrating movements. Force should be concentrated on the fingertips or palm, frequency should be high and force exerted should be slightly heavy. Clinical application: this technique is usually operated with one hand, operation with both hands is also applicable. Its good for all parts and points of the body and has the effect of eliminating stasis to resolve swelling, regulating the stomach to smooth qi, promoting digestion to remove food retention and regulating the function of the intestine and stomach.

18. PRESSING MANIPULATION (ANFA) Same as previous, the Anfa is divided into finger and palm pressing manipulation. While pressing and manipulating, the part exerting force should closely attach to the body surface of the patient without moving. The force exerted should be steady and increase formlight to heavy, sudden violent force is prohibited. Clinical application: Is frequently combined with kneading m-n to form compound m-n. Fits to all points, palm pressing is used on back and abdomen. Relaxes muslces, removing obstacles, improving BS, relieve pain. Treats epigastric pain, headache, numbness and aching pain in the extremities.

19. SWEEPING MANIPULATION (SUOSANFA) Hold one side of the patient’s head with one hand, place the radius aspect of the other thumb above point Tayang (EX-HN 5) of the other side of his head. Bend slightly the other four fingers, separate them in a spread-fan shape and make them do act-movement rotationally with force driven by naturally swaying of the wrist joint. Action light and quick (nimble), natural and coherent. Clinical application: Mainly used on a head, has an effect of calming the liver to suppress hyperhepathic yang, dispelling wind and relieving pain, warming the meridian and dispelling pathogenic cold, tranquilization and inducing resuscitation. Headache, vertigo, hypertension, insomnia, poor memory and common cold are often treated with this technique.

20. PLUCKING MANIPULATION (TANBOFA) • PM is commonly performed by exerting force with the tip of the thumb and placing the other four fingers on the treated area. Or use the index and middle fingers to exert force and press their tips on the space between tendons or on the staring or ending point of a tendon. Pluck as if playing a string, first with light force, then heavy and at even frequency. • Clinical application: Applicable to all parts of the body and has an action of relaxing tendons and meridians, loosing spasm and adhesion and activating flow of blood and relieving pain. Adhesion around the shoulder joint, sciatica, Bi-syndrome, pain and discomfort in the hypochondrium due due to sprain or contusion, all kinds of pain, local spasm due to injury and adhesion are often treated with plucking manipulation.

21. GRIPPING MANIPULATION (ZHUAFA) • Attach fingers and the palm of one hand to the treated part with the five fingers slightly separating and extending naturally, squeeze and press from around to the center with force to hold the local skin and muscle in hand, an then loosen them gradually. Repeated action like that is called GM or Zhuafa. • Clinical application: the technique is commonly applied to the head, abdomen, back and other parts with thick muscles. It has the effect of dispelling wind and cold, dredging the meridians, inducing resuscitation and relieving pain. Headache, epigastric pain, aching pain and numbness of muscles are commonly treated with this manipulation.

22. DIGITAL-PRESSING MANIPULATION (DIANFA) • Bend the middle finger or both the index and middle fingers, exert force on the treated points with the tip of the proximal interphalangeal joint, increase force and press inward. Keep the action for a properly long period of time. • Clinical application: It is suitable for points all over the body. It is effective in dispelling wind and cold, descending adverse qi to stop vomiting, tranquilization and easing the mind and relieving pain. Headache, dizziness, insomnia, nausea, hiccup and vomiting are often treated with this manipulation.

23. CHOPPING MANIPULATION (PIFA) • Hold the wrist of the patient with one hand, ask him to separate the five fingers of the hand held and chop at the interdigital junctions one by one with the lateral side of the other palm. • Clinical application: the technique is applicable to I.J. and effective in inducing resuscitation, activating flow of blood and dredging the meridians. It is used in compatible treatment of numbness of the limbs, disharmony of qi and blood, palpitation, insomnia, depression and stuffiness in the chest and other miscellaneous diseases of internal and gynecological medicine.

24. SCRAPING MANIPULATION (GUAFA) • This refers to the m-n performed by dipping the radius side of the thumb or the pads of the index and middle fingers in water or other media, exerting force directly on certain parts or points of the body surface with them and making one-way rapid pushing movements. • Clinical application: Being a manipulation with moderate stimulation, scraping manipulation has the effect of activating flow of blood and dredging the meridians, dispelling wind and cold, diaphoresis and relieving superficies and eliminating pathogenic summer-dampness. Common cold, summer heat, vomiting and poor appetite can be treated with scraping manipulation.

25. GRASPING MANIPULATION (NAFA) • Use the thumb with the index and middle fingers or other four fingers to lift and pinch certain operated parts or points of the body rhythmically. In operating, exertion of force should be from light to heavy and sudden exertion should be avoided. Operation should be even, slow and coherent. • Clinical application: In clinic, the technique is often applied to the neck, nape, shoulders and limbs in combination with other manipulations. It has the effect of dispelling wind and cold, inducing resuscitation to stop pain, relaxing tendons and dredging the meridians.

26. FINGER TWISTING MANIPULATION (NIANFA) • Pinch a certain part of the patient and do twisting and kneading with the whorl surface of the thumb and index finger with opposite force. In operating, the manipulation should by nimble and swift, sluggish operation should be avoided. • Clinical application. • The manipulation is suitable for small joints of the limbs. It has the properties of relaxing tendons, dredging the meridians and lubricating joints, and is often combined with other manipulations to treat aching pain, swelling and stiffness of interphalangeal joints.

27. While performing the manipulation, close the fingers naturally, bend the joints of the finger and palm slightly and pat the affected area steadily and rhythmically. • Clinical application: • Patting manipulation is applicable to the shoulder, back, buttocks and lower limbs. Rheumatic aching pain, bradyesthesia in local areas and muscular spasm are treated with this manipulation in combination with others. The technique has the effect of relaxing tendons and dredging the meridians and promoting circulation of qi and blood. • PATTING MANIPULATION (PAIFA)

28. PERCUSSING MANIPULATION (JIFA) • Percussing manipulation refers to the manipulation performed by hitting or beating the body surface rhythmically with the back of the fist, the palmar base, the minor thenar of the ulnar palm and the fingertip driven by the wrist joint. • 1. First PM. Make a hollow fist, straighten the wrist and percuss the body surface with the palmar base. • 2. Palm PM. Loosen the fingers naturally, straighten the wrist and percuss the body surface with the palmar base. • 3. Lateral – palm PM. Stretch the fingers naturally, bend the wrist slightly backward and beat the body surface with the minor thenar of one palm or both. • 4. Fingertip PM. Beat the body surface with the fingertips ads if rain drops. • Clinical Application: Fist percussion is often used on the back, palm percussion on the vertex of the head, lumbus, buttocks and limbs; lateral – palm percussion on the lumbus, back and limbs; fingertip percussion on the head, face chest and abdomen; The manipulation has an action of relaxing tendons and dredging the meridians and regulating Qi and Blood. It is often used in compatible treatment of rheumatic arthralgia, bradyesthesia in local areas, muscular spasm or headache.

29. ROTATING MANIPULATION (YAOFA) • A manipulation to make a joint go passive, RM. • 1. Neck RM (general rotation and • 2. RM by supporting the elbow • 3. RM by holding the hand • 4. RM in a great amplitude. • 5. Hip Joint RM. • 6. Ankle Joint RM. • Clinical application: These techniques are applicable to the joints of the limbs, nape and lumbus, and is effective for stiffness and impairment of flexing and extending movements of joints. It has the action of lubricating joints and improving their function.

30. PULLING MANIPULATION (BANFA) • Pulling manipulation refers to a manipulation performed by pulling the body with force in one or opposite directions with both hands. • 1. Neck pulling manipulation • 2. PM of counter-reduced thoracic vertebrae • 3. PM of the expanded chest • 4. Obliquely PM of the lumbar region (regular and with foot stretch) • 5. Rotationally PM with the lumbus straight. • 7. PM of the retroflexed lumbus. • Clinical application: PM is often used in combination with other manipulations in clinic to gain a result of supplementing each other. It is commonly applied to the spinal column and joints of the limbs. Malposition and dysfunction of joints are often treated with this manipulation, for it has the function of relaxing tendons and dredging the meridians, lubricating joints, replacing and reducing displaced anatomic sites.

31. TRACTION MANIPULATION (BASHENFA) • Traction is pulling and extending. • 1. Traction of the head and neck (sitting and lying position). Towel traction. • 2. Traction of the elbow joint • 3. Traction of the shoulder joint • 4. Traction of the wrist joint. • 5. Traction of the interphalangeal joint.