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Tyler J Rowe 2011

Australian College of TCM & Qigong - Certificate of Advanced Qigong Studies Subject Outline Subject Presenter Duration Prerequisites Assessment Anmo Tuina Chinese Massage Tyler J. Rowe 21 hours (14 x 1.5hr lecture/practical) TCM theory, Acupuncture point location Practical exam 10 x Practical worksheets Practice rice bags Massage cloths Student notes Sun Chengnan (1990) Chinese Massage Therapy Shandong Science and Technology Press [reprinted as:- Sun Chengnan (2000) Chinese Bodywork A Complete Handbook of Chinese Therapeutic Massage Pacific View Press]

Materials Needed

Recommended Text

References Chase, Charles & Yang Shou-zhong (1995) The Systematic Classic of Acupuncture & Moxibustion by Huang-fu Mi a translation of the Jia Yi Jing Blue Poppy Press Deadman, Peter & Al-Khafaji, Mazin (1998) A Manual of Acupuncture Journal of Chinese Medicine Publications Legge, David (1997) Close to the Bone The Treatment of Musculo-skeletal Disorder with Acupuncture and other Traditional Chinese Medicine Sydney College Press Legge, David (2010) Jing Jin Acupuncture treatment of muscular system using the meridian sinews Sydney College Press Maoshing Ni (1995) The Yellow Emperors Classic of Medicine - A New Translation of the 'Neijing Suwen' with Commentary Shambhala Publications Pritchard, Sarah (1999) Chinese Massage Manual Piatkus Publishing: London Wang, Ju-Yi & Robertson, J. (2008) Applied Channel Theory in Chinese Medicine: Wang Ju Yis Lectures on Channel Therapeutics Eastland Press Wu Jing-Nuan (1993) Ling Shu or Spiritual Pivot University of Hawaii Press Zhang Enqin (1990) Chinese Massage Publishing House of Shanghai University of TCM Zhang Yisheng (2002) Tuinaology Peoples Medical Publishing House

Tyler J Rowe 2011 Timetable Week 1 Lecture Practical Introduction Demonstration An mo Tui na Character meaning Tuina treatment History & context in TCM References in classical texts Nijng Swn Lngsh Jiyjng Specialities B zhng xu Rheumatology Wi shng xu Traumatology Tuina Theory Exercises Characteristics of Tuina Standing postures Functions & effects of Tuina Sholn Nigng Internal Treatment prescription & sequence Cultivation Exercises Media cloth, herbal preparations Massage tools Tuina Physiology Technique Palpation Structures sinews, bones, channels Gun Fa Rolling Diagnosis palpation & assessment Techniques Revision of previous technique Yi Zhi Chan Tui Fa One Finger Meditation Mo Fa Rubbing Ca Fa Scrubbing Techniques Revision of previous techniques Rou Fa Kneading Na Fa Grasping An Fa Pressing Tui Fa Pushing Techniques Revision of previous techniques Ji Fa Tapping Zhen Fa Vibrating Cuo Fa Foulageing Dou Fa Shaking Yao Fa Rotating Ban Shen Fa Stretching Treatment of the Head & Neck Demonstration & practice Assessment palpation & movement Students to perform sequence in pairs Main treatment sequence with supervision followed by discussion Common ailments & variations Stiff neck Cervical Osteoarthritis Headache Rehabilitative exercises Treatment of the Thoracic Region Demonstration & practice Assessment palpation & movement Students to perform sequence in pairs Main treatment sequence with supervision followed by discussion Common ailments & variations Intercostal strain Muscular spasm Disc injury Rehabilitative exercises

Tyler J Rowe 2011 9 Treatment of the Lower Back Assessment palpation & movement Main treatment sequence Common ailments & variations Lumbar sprain Disc injury Arthritis Rehabilitative exercises Treatment of the Shoulder Assessment palpation & movement Main treatment sequence Common ailments & variations Sprain Tendonitis Frozen shoulder Rehabilitative exercises Treatment of the Upper Limb Assessment palpation & movement Main treatment sequence Common ailments & variations Tendonitis Carpel Tunnel Syndrome Rheumatoid Arthritis Rehabilitative exercises Treatment of the Pelvis & Hip Assessment palpation & movement Main treatment sequence Common ailments & variations Sciatica / Piriformis Syndrome Arthritis Hamstring / Groin Strain Rehabilitative exercises Treatment of the Lower Limb Assessment palpation & movement Main treatment sequence Common ailments & variations Tendonitis / Ankle Strain Plantar fasciitis Shin splints Rehabilitative exercises Practical Worksheets 10 Massages to be completed and reported on by this date. Questionnaire and self assessment to be filled on for marking. Demonstration & practice Students to perform sequence in pairs with supervision followed by discussion

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Demonstration & practice Students to perform sequence in pairs with supervision followed by discussion

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Demonstration & practice Students to perform sequence in pairs with supervision followed by discussion

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Demonstration & practice Students to perform sequence in pairs with supervision followed by discussion

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Demonstration & practice Students to perform sequence in pairs with supervision followed by discussion

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Practical Exam Demonstration & discussion of random main treatment sequence & variations

Tyler J Rowe 2011 1) Introduction

1.1 The meaning of Chinese Massage nm Tun - Press rub Push grasp

1.2 Eight Branches of Chinese Medicine Zhnji - Acupuncture & Moxibustion Coyo - Herbal Medicine Shlio - Dietary Therapy Tun - Massage Therapy Wsh - Martial Arts Qgng - Meditation Fngshu - Geomancy Shsh - Astrology 1.3 Historical references in the classics Nijng Swn 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 qi and 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. Lngsh 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 Qis 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 massaged so 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

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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 Zhnji Jiyjng 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 1.4 Specialities Bzhngxu Arthralgia Syndrome (Rheumatology) Wishngxu External Injury (Traumatology) Zhngg Bone Setting (Orthopaedics)

Tyler J Rowe 2011

2) Theory 2.1 Characteristics of Tuina 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. Of the many different techniques or manoeuvres in Tuina, they all retain certain characteristics which are essential to good practice. Requirements Smoothness Strength Stability Rhythm Flexibility 2.2 Functions & effects of Tuina 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* 2.3 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 2.4 Media cloth, herbal preparations Traditional media used in Tuina is a cloth. Usually cotton or other natural fibre, the cloth, measuring anywhere from 250mm to 2000mm square, serves three main purposes. Firstly it negates the need for oil. Most massage oils are inappropriate for use with Tuina techniques. They make the contact area slippery and difficult to handle or control. Skin on skin contact can lead to damage of the superficial skin layers, becomes uncomfortable, and in time sebaceous oil and sweat secretions render this 6

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media useless. Tuina techniques can be completed smoothly and most effectively with the cloth. Secondly, the cloth is a barrier of modesty. Much of the TCM we practice today was in ancient times practiced on the imperial family. Imperial physicians were the best of the best in TCM, their practices were more likely to be recorded, passed on and taught in the early medical schools. Though doctors had respect in the palace, it was unlikely they would have been allowed to directly touch the empress for instance. True, her pulse was usually taken through a piece of silk (with her hand passed through the doorway from another room) rather than risk this contact. The same extends to a degree into Chinese society, where they tend to be more conscious of exposing body parts than in the west. Thirdly in the north of China and the capital Beijing (where much of our TCM comes from they had more works of literature, the palace and a large population there) it can get particularly cold in winter (in excess of -10o) and its acts as somewhat of an insulator. Chinese Massage also utilises a number of herbal oils and liniments. These are prescribed and used according to functions and indications of the herbal ingredients. They are usually applied as an adjunct to the therapy (after the massage) rather than used as media. Most commonly used are herbal formulas to: invigorate xue and dispel stasis promote qi and disperse stagnation clear heat and reduce swelling disperse bruising and alleviate pain promote regeneration of tissue and mend bone relax sinews and strengthen joints alleviate bi syndromes (wind-cold-damp) release the exterior Most often in sesame oil, peanut oil, rice spirit, vinegar or water bases. Commonly used prepared products include Zheng Gu Shui, Hong Hua You, Die Da Jiu etc 2.5 Massage tools Massage clubs have been used over the years in some schools of Tuina. They can be useful for weaker practitioners, or when dealing with particularly strong clients. Generally they are used to intensify treatments. Traditionally made of horn, bamboo or mulberry (though now plastics and rubber are often substituted) the commonly used clubs include clubs shaped like digits, palms and elbows. Indeed virtually substituting any part of the arm or hand. Ball-like clubs (with a ball attached to a stick), chopping and patting clubs (shaped like a hand on a stick) and small rubber mallets can also be found in use. The rice bag is a traditional Tuina training device. It is considered the best way to practice before moving to a live patient. The heavy cotton or canvas bag, usually 200-300mm square, is filled with rice and sealed. A student can then perform many of the techniques, developing skill, strength and rhythm, with this device. Some traditional schools believed mastery of Tuina could only be gained once the students rolling had turned the rice within completely to power.

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2.6 Basic Training Exercises Physical training of the practitioner has long been a part of the study of Tuina. Many different sets of Qigong and Wushu exercises are used including famous sets such as the Ba Duan Jin - Eight Sections Brocade Exercises and the Yi Jin Jing - Sinew Transforming Exercises. All the systems use similar basic stances and hand patterns. Perhaps the most commonly used in training of Tuina are the Sholn Nigng Internal Cultivation Exercises. a) Stances Zhn b Upright stance M b Horse stance Gng b Bow stance b) Postures Shnb chngzhng Extend arms support palms Qintu bpm Push forward eight horses together Dol jituni Pull backward the tail of nine oxen Fnghung zhch Phoenix spreads its wings Bwng jdng Overlord holds up the cauldron Shnshu tuzhu Push the boat along the current Dnzhng ljnhun Pulling the golden ring with one hand Huizhng boyu Hold the moon in the centre of the chest Xinrn zhl Immortal points to the road Pngshu Tut Draw the pagoda in the hand Hid loyu Fish out the moon from the bottom of the sea Ynzhng hw Palm covering over the roof tile Fngbi hy Wind sways lotus leaves Lingshu tutin Two hands hold up heaven Dnfng choyng Single wind in the rising sun Dngtin bod Sustaining the heaven and holding the earth Lp hushn Strength to split magnificent mountain Snq snlu Three rising and three sinking Wlng zundng Dark dragon dives into the cave h psh 'Hungry tiger pouncing on its prey'

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3) Physiology 3.1 Structures g bones, jng channels, jn sinews The muscle channel of the Leg Tai Yang Bladder begins in the little toe of the foot, goes up to connect to the anklebone, then goes diagonally up to connect to the knee. A lower branch follows the lateral side of the foot to connect at the anklebone, then mounts and follows the heel to connect in the crease of the knee. A separate branch connects to the lateral part of the leg and ascends to the crease of the knee along the medial side, then goes from the centre of the crease of the knee to connect to the buttocks. It continues up along the pinch of the backbone on both sides to the neck. A branch separates and enters to connect with the root of the tongue. A straight branch connects the neck to the occipital bone to the top of the head, then travels down in the space between eyebrows and eyes to connect in the nose. Another branch goes along the upper net of the eye and eyelid, then descends to connect with the cheekbone. Another branch goes from behind the armpit on the lateral side to connect at Co15. Another branch enters the armpit, goes up to emerge at the supraclavicular fossa, then moves up to connect to the mastoid process. Another branch comes out at the supraclavicular fossa, and goes diagonally up into the cheekbones. The muscle channel of the Leg Shao Yang Gallbladder begins in the fourth toe, then travels up to the lateral anklebone and ascends along the lateral side of the leg to connect at the lateral side of the knee. A branch separates beginning on the lateral side of the thigh bone, then travels up through the thigh, where in the front it connects with St32 and in the back it connects with the buttocks. A straight branch ascends and rises to the depression under the bottom rib. It then travels up to the front side of the armpit, links with the region of the chest, and connects in the supraclavicular fossa. A straight branch goes up and comes out at the armpit, goes through the supraclavicular fossa to come out in front of the Leg Tai Yang Bladder, and then travels to behind the ear. It goes up to the corner of the forehead and makes a junction at the top of the head, descends and travels to the chin, and goes up to connect with the cheekbones. A branch connects in the lateral corner of the eye and is the lateral connective. The muscle channel of the Leg Yang Ming Stomach begins in the second toe and connects with the third toe, goes to the top of the foot, goes diagonally upward and laterally along the leg bone. It continues up to connect to the lateral side of the knee, and goes straight up to connect to the pivot of the thigh, ascends to follow the flanks, and is attached to the backbone. A straight branch goes up and follows the leg bone to connect with the knee. A branch connection goes along the leg bone and joins the Leg Shao Yang Gallbladder. Another straight branch goes up, follows St32, ascends and connects to the thigh, then assembles in the yin organs. Then it ascends and spreads in the abdomen to reach and connect to the supraclavicular fossa. It goes up the neck and the pinch of the mouth on both sides to meet in the cheekbones, descends to connect with the nose, then goes up to meet the Leg Tai Yang Bladder. The Leg Tai Yang Bladder is the upper eyelid. The Leg Yang Ming Stomach is the lower eyelid. Another branch goes from the cheek to connect with the front of the ear. 9

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The muscle channel of the Leg Tai Yin Spleen begins at the tip of the big toe on its medial side. Then it goes up to connect to the medial anklebone. A straight branch makes a path up along the leg bone to the medial side of the knee, ascends to the yin side of the thigh to connect with the upper thigh and assemble in the yin organs. It goes up the abdomen to connect in the navel, follows the base of the abdomen to connect with the flanks, then spreads in the middle of the breast. An internal branch is attached to the backbone. The muscle channel of the Leg Shao Yin Kidney begins in the bottom of the foot on a line with the little toe. Then it goes together with the muscle channel of the Leg Tai Yin Spleen and travels diagonally to below the medial anklebone to connect with the heel and join the muscle channel of the Leg Tai Yang Bladder. Then it goes up to connect with the medial side of the leg and goes together with the muscle channel of the Leg Tai Yin Spleen to ascend to the yin side of the thigh. It continues to the yin organs, then follows the backbone along the inner pinch of the spine along both sides until it reaches the back of the neck and connects to the occipital bone, and joins the muscle channel of the Leg Tai Yang Bladder. The muscle channel of the Leg Jue Yin Liver begins on the top of the big toe, then goes up to connect to the front of the medial anklebone, ascends and follows the leg bone. It continues up along the inside to connect below the tibia, then continues up along the yin side of the thigh to connect with the yin organs, where it connects with all of the muscle channels. The muscle channel of the Arm Tai Yang Small Intestine begins on the top of the little finger, connects with the wrist, follows the medial side of the arm to connect with the elbow behind the medial epicondyle, which, when snapped, has corresponding sensations on the top of the little finger. It continues by entering and connecting to the bottom of the armpit. A branch travels behind the armpit to ascend and to wind around the shoulder blade, then follows the neck to come out and travel to the front of the Leg Tai Yang Bladder, and connects behind the ear on the mastoid process. Another branch enters the middle of the ear. Another straight branch comes out above the ear, descends to connect to the chin and jaws, then goes up to subordinate the lateral corner of the eye. The muscle channel of the Arm Shao Yang Sanjiao begins on the tip of the ring finger on the side of the little finger and goes to connect at the wrist. It ascends along the middle of the arm and connects to the elbow, goes up around the lateral side of the upper arm, and ascends to the shoulder. It travels to the neck to join with the Arm Tai Yang Small Intestine. A branch from the point at the bend of the jaw enters to connect with the root of the tongue. Another branch goes up to the bend of the teeth and jaws, goes along in front of the ear, then subordinates the lateral angle of the eye. Then it ascends, mounting a line above the jaw to connect with the corner of the forehead.

jngjn channel sinews ( Lngsh Spiritual Pivot Scroll 4 part 13) 10

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The muscle channel of the Arm Yang Ming Large Intestine begins on the tip of the forefinger on the side next to the thumb. It connects with the wrist and moves up, follows the forearm, then goes up to connect with the outside of the elbow. It ascends the upper arm to connect with the shoulder. A branch winds around the shoulder bone to the pinch along both sides of the backbone. A straight branch goes along the shoulder bone and ascends the neck. Another branch goes up the cheek to connect the cheekbones. A straight branch ascends and comes out in front of the Arm Tai Yang Small Intestine, mounts to the left comer of the forehead, links with the channel of the head, and moves down to the right chin and jaws. The muscle channel of the Arm Tai Yin Lung begins on the top of the thumb, then travels along the thumb to connect to the rear of the thenar eminence, then moves to the lateral side of the radial pulse and ascends along the arm to connect to the center of the elbow. Then it mounts the medial surface of the upper arm to enter the bottom of the armpit, comes out in the supraclavicular fossa, and connects to the front of the shoulder joint. On top there is a connection in the supraclavicular fossa, below there is a connection in the base of the chest, where it spreads and goes through the cardiac orifice, assembles, then goes down to the lowest rib. The muscle channel of the Arm Jue Yin Pericardium begins in the middle finger, then travels together with the muscle channel of the Arm Tai Yin Lung to connect to the medial side of the elbow. It then ascends the yin side of the upper arm to connect with the bottom of the armpit, and spreads down both to the front and back by clasping the ribs. A branch enters the armpit and spreads to the centre of the chest to connect with the cardiac orifice. The muscle channel of the Arm Shao Yin Heart begins on the inner side of the little finger, then connects to the pisiform bone, the ulna, and goes up to connect to the medial side of the elbow. Then it goes up to enter the armpit, intersects with the Arm Tai Yin Lung, and clasps the base of the nipple to connect with the centre of the chest. Then it goes along the cardiac orifice and descends to connect with the navel. 3.2 Diagnosis Q (Stagnation) Moving Generalised Dull worse with emotional stress X Empty Chronic aggravated by tiredness alleviated by rest weakness & flaccidity enjoys pressure Xu Blood (Stasis) fixed localised sharp unaffected by emotions

Sh Full
acute aggravated by stillness alleviated by movement stiffness & swelling tenderness 11

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3.3 Assessment a) Questioning location, nature, duration, frequency, radiation, aggravating, relieving b) Observing alignment/posture, skin colour, vasculation, reproducing pain Palpate passive range of movement, resistance, mn scan temperature, xn go-along channels, n press ashi-tender points, b pluck sinews

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4-6) Techniques 1. Gn f 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

2. Y zh chn tu f - 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

3. M f 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

4. C f 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 13

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5. Ru f 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

6. N f - 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

7. n f - 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

8. Tu f 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

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9. J f 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, cranes beak Method alternately strike in a drumming action with both hands 10. Zhn f 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

11. Cu f 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 12. Du f 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 15

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13. Yo f 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.

14. Bn shn f 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

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7) Treatment of the 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 asymmetry, rotation, flexion, extension and side bending, palpation of Leg Taiyang Bladder, Leg Shaoyang Gallbladder, Arm Taiyang Small Intestine & Arm Yangming Large Intestine 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)

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8) Treatment of the Thoracic Region 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 Shaoyang Gallbladder & Arm Yangming Large Intestine 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

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9) Treatment of the 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 intervertebral spaces, vascular congestion, constipation Assessment observation of symmetry, rotation, flexion, extension and side bending, palpation of Leg Taiyang Bladder & Leg Shaoyang Gallbladder 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: Disc Injury: Arthritis : Pressing Bl40, 60, Yaoytong Pressing Bl25, 31-33, 54, Si3 Pressing Du4, Bl23, 57

Scrubbing - Gao Pushing - Gao

Rehabilitation Sash assisted four-point core exercises, lumbar and hamstring stretches

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10) Treatment of the Shoulder

Common Ailments supraspinatus tendonitis, acromio-clavicular 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, 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 Taiyang Small Intestine, Arm Yangming Large Intestine, Arm Shaoyang Sanjiao & Arm Jueyin Pericardium 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, Sj Foulageing Co Stretching Rotating Shaking Modifications Tendonitis: Pressing Co11, 16, Sj5, Gb34 AC joint sprain: Pressing Jianqian, Jianneiling Frozen shoulder: Pressing Co4, St38 Pushing - Bl41 Rehabilitation Health ball rotations on wall, Bamboo cane stretches

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11) Treatment of the 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 Yangming Large Intestine, Arm Shaoyang Sanjiao, Arm Taiyin Lung, Arm Shaoyin Heart & Arm Jueyin Pericardium 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

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Tyler J Rowe 2011

12) Treatment of the 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 Shaoyang Gallbladder, Leg Yangming Stomach, Leg Taiyin Spleen 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

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Tyler J Rowe 2011

13) Treatment of the 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 Shaoyang Gallbladder, Leg Yangming Stomach, Leg Taiyin Spleen, Leg Shaoyin Kidney, Leg Jueyin Liver 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 Fasciitis: Pressing - Bl61, 62, St43, Sp3,4, 3, Kd2 Shin splints: Pressing/Pushing Lv5, Kd7 Rehabilitation Plum blossom stake stepping and rolling Plucking - tendon Grasping Striking St, Lv/Kd

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Tyler J Rowe 2011

14) Practical Assessment Sheets Sample Student Name Date Client Name Date of Birth Gender Main Complaint Clinical Manifestation (signs & symptoms) your name of the massage the person massaged the clients the client Duration History Medications? Nature Location Intensity Frequency Duration Aggravated/Relieved Observation Palpation Testing Qi Stagnation/Xue Stasis Xu/Shi Heat/Cold Techniques Channels Points Duration client to provide this information client to provide this information client to provide this information client to provide this information client to provide this information client to provide this information client to provide this information client to provide this information client to provide this information

Assessment Diagnosis Prescription

Was the style of massage explained? How is it different? Was the massage appropriate for your needs? If no, why? Was the massage comfortable? Set up well? If not, why? Was the massage smooth and consistent? Or irregular/jumpy? Was the massage too heavy or too soft? Was the massage too fast or too slow? Could the massage have been improved in any way? Did the signs and symptoms reduce after the massage? Did you enjoy the massage? Client Signature

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Tyler J Rowe 2011

TUINA WORKSHEET #
Student Name Date Client Name Date of Birth Gender Main Complaint (dur, hist, med) Clinical Manifestations S&S (nat, loc, int, freq, dur, agg, rel) Assessment (obs, palp, test) Diagnosis (qi/xue, xu/shi, hot/cold) Treatment (tech, jl, pts, dur)

Was the style of massage explained? How is it different? Was the massage appropriate for your needs? If no, why? Was the massage comfortable? Set up well? If not, why? Was the massage smooth and consistent? Or irregular/jumpy? Was the massage too heavy or too soft? Was the massage too fast or too slow? Could the massage have been improved in any way? Did the signs and symptoms reduce after the massage? Did you enjoy the massage? Client Signature

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