Professional Documents
Culture Documents
Manipulations For Tuina
Manipulations For Tuina
Manipulations For Tuina
• Fingers
• Wrist
• Arms
-practitioners have to train their fingers, wrists and arms by means of push-up,
dumbbell and spring-grip dumb-bells.
Physical exercise (Qi-gong) for healthcare and training
太极拳(Tai Chi)
灵子术(Ling Zi Shu)
Swaying (摆动类)
Rubbing (摩擦类)
Vibrating (振动类)
Pressing (按压类)
Percussion (叩击类)
Joint movement(活动关节类)
• One-finger pushing “一指禅推法”
• Rolling “滚法”
(1)Swaying“摆动类”
• Kneading “揉法”
• Stroking “摩法”
• To-and-fro rubbing “擦法”
(2)Rubbing“摩擦类” • Pushing “推法”
• Wiping “抹法”
• Palm-twisting “搓法”
• Vibrating “振法”
(3)Vibrating“振动类”
• Shaking “抖法”
• Rotating
(6)Joint movement
“摇法”
“活动关节类” • Pulling-extending “拔伸法”
• Pulling “扳法”
Yi Zhi Chan Fa (One-finger pushing manipulation)
【Methods】
• Clench a hollow fist with suspended and flexed wrist and palm
• And stretch the thumb straight naturally to cover the fist hole
• Exert force on the body surface with the tip or the whorl surface of the
thumb
• Lower the shoulder, drop the elbow and suspend the wrist
• Sway the forearm initiatively to bring the wrist swing inward and
outward while flexing and extending the thumb joint to make the force
on the Acupoint heavy and light
• The frequency of 120-160 times per minute
【Essentials for performing
manipulations】
1. Lowering shoulders
2. Dropping elbow
3. Suspending wrist
1. The shoulders, elbow and wrist should be kept relaxed, but not lax.
• Flex the thumb with the force exerted from the radial
border or the back of the interphalangeal joint
• Known as 跪推法 (Gui Tui Fa)
【Methods】
2. The wrist joint extends and flexes about 120°;flexing the wrist joint
80°while swaying outward about 40°.
4. The frequency should be fixed. The speed should not be too quick.
-fix on the body surface with certain part of the finger and
palm and knead in circles to rotate slowly and softly the
subcutaneous tissues.
【Methods】
• Exert force with major thenar and flex the wrist joint slightly to 120°-
140°
• Use the elbow joint as a pivot and sway the forearm initiatively to knead
with major thenar and sway on the affected area
• The frequency is about 120-160 times per minute
2. Zhang Gen Rou Fa (Major thenar kneading manipulation)
2. The forearm sways in a small amplitude to rotate with force from the
wrist joint.
【Methods】
• Take the palm side of the index finger, middle finger, ring finger and the
little finger as the touching area with the fingers justaposed
• The palm straightened naturally and the wrist joint flexed slightly
• Use the elbow joint as a pivot
• Move the forearm initiatively to rub with the palm side of the fingers
circularly on the affected area
• It can be performed clockwise or anti-clockwise
• The frequency of 100-120 times per minute
【Essentials for performing
manipulations】
1. In performing stroking manipulation, the shoulders should be relaxed
and the forearm should sway initiatively to enable the relaxed wrist
joint to make circular movements.
3. The manipulation should be light but not superficial; heavy but not
stuck.
【Methods】
• Keep the palm close to the skin while straightening the wrist joint
• Take the shoulder joint as pivot, and move the upper arm initiatively
with the palm rubbing on the body surface to-and-fro along a straight
line
• The frequency is 100-120 times per minute
• Keep the major thenar close to the skin while straightening the wrist
joint
• Take the shoulder joint as pivot, and move the upper arm initiatively
with the major thenar rubbing on the body surface to-and-fro along a
straight line
• The frequency is 100-120 times per minute
3. The pressing force should be monitor not to make the skin folded. The frequency
should be kept even.
【Cautions】
2. Palm- mild warming effect; Major thenar- moderate warming effect; Minor
thenar- high heat effect.
3. Lubricants is often used to protect and lead the warmth deeply into the skin.
【Methods】
2. When performing spiral pushing manipulation, the joints of elbow and wrist
should be kept relaxed. The thumb moves in a circle within a small range.
3. When performing separate pushing manipulation, the force of the two hands
should be even. The movement should be mild and coordinate. Then pushing
can be in a straight line or in a curved line.
【Cautions】
2. The operating part should keep close to the body surface. The force
used should be steady, even and moderate.
-keep close to the skin with the whorl surface of the thumb
and push up and down or left to right or along a curved
path.
【Methods】
• Exert force on the body surface with one or two palms and
relax the wrist joint
• The forearm and upper arm exert force coordinately to
move the palm to and fro slowly unilaterally up and down
or left to right or a curved line
【Essentials for performing
manipulations】
1. When performing wiping manipulation, the whorl surface of the thumb or the
palm should be kept close to the body surface.
2. The force used in wiping manipulation should be even, while the movement should
be mild and slow. The operation route in the affected area should be longer
3. The manipulation should be light but not superficial, heavy but not stuck
【Cautions】
3. When finger wiping is applied to the head and face, the performing procedure is
fixed.
Cuo Fa (Palm-twisting manipulation)
【Methods】
3. The operation demands “rapid twisting and slow moving”. The twisting
movement should be swift while the up and down moving should be slow.
【Cautions】
【Methods】
• Drop the elbow and put the tip of the middle finger on the
affected area
• Straightening the finger and flex the elbow slightly with
forearm and hand
• And contract the muscles alternatively to direct the
vibration produced by arm to the body through the middle
finger
• The frequency of vibration is 300-400times per minute
2. Zhang Zhen Fa (Palm-vibrating manipulation)
2. Exerting force statically means to tighten the muscles of the hand and forearm.
3. The practitioner should highly concentrate his attention on the finger and palm.
【Cautions】
【Methods】
3. The amplitude of shaking should be small and the frequency should be rapid.
【Cautions】
1. When shaking the lower extremities, the amplitude of shaking can be wider
than upper extremities.
2. The frequency should be lower for the lower extremities which are heavier.
【Methods】
• Press the body surface with palm base, thenar or the whorl
palm
• If the force of one hand is not enough, both hands can be
overlapped to press
【Essentials for performing
manipulations】
1. The direction of pressing should be vertical.
2. The force use should be steady and continuous, and be increased steadily to
make the stimulation transmit sufficiently to the deep layer of the body tissues.
“light-heavy-light”
3. When performing pressing manipulation, the practitioner can incline his upper
part of the body slightly forwards to increase the stimulation with his own
gravity
【Cautions】
【Methods】
1. Ya Fa (Suppressing manipulation)
4. The force of pressing is light with small stimulation while the force of suppress
is strong with great stimulation
【Cautions】
2. Elbow suppressing is often applied to the muscles of waist and buttock for those
who are strong.
Nie Fa (Pinching manipulation)
【Methods】
• Clip the operated part with the thumb and the index finger,
middle finger or with the thumb and the other four fingers
• Extrude symmetrically and release immediately after that
• Repeat the manipulation mentioned above the move
gradually
【Essentials for performing
manipulations】
1. The force should be exerted with the thumb and the other fingers should be
symmetrical, even and soft.
【Cautions】
1. The force should be exerted with the palm, not the tip of the finger.
【Methods】
1. Na Fa (Grasping manipulation)
• Relax the wrist joint and clip the operated part tightly with
the thumb, index finger and middle finger or with the thumb
and the whorl surface of the other four fingers
• Lift the skin and repeat the performance of kneading and
pinching continuously and alternatively in a form of forceful
and gentle way
【Essentials for performing
manipulations】
1. Relax the wrist joint and straighten the fingers.
2. Clip the operated part with the fingers and exert force symmetrically to lift and
pinch the skin and the subcutaneous tissues.
3. Perform the manipulation slowly, softly and evenly, fluctuating from the light to
heavy, then heavy to light. (kneading and pinching together)
【Cautions】
1. When performing grasping manipulation, cautions should be taken not to clip the
epidermis to avoid flexion of interphalangeal joints.
2. Subcutaneous tissues should be pinched. The slippage of the fingers on the body
surface should be avoided.
3. Kneading and rubbing can be used after grasping to smooth Qi and blood
Nian Fa (Finger-twisting manipulation)
-hold the operated part with the thumb and the index
finger, and twist while kneading and pinching
symmetrically.
【Methods】
【Cautions】
-press the operated part deeply with the thumb, and pluck
back and forth. The direction of the movement should be
perpendicular to the direction of the tendon and muscle.
【Methods】
1. Bo Fa (Plucking manipulation)
• Extend the thumb, exert the force with the tip or the whorl
surface of the thumb, and support with the other four
fingers.
• Press deeply until the patient feels aching and distending
• Then pluck back and forth along the direction perpendicular
to the direction of the tendon and muscle
• If the strength of one thumb is not enough, two thumbs can
be overlapped
【Essentials for performing
manipulations】
1. When performing plucking manipulation, the thumb should
not rub and move on the body surface, but direct the
subcutaneous muscular fiber or tendon and ligament to pluck
together
【Cautions】
【Methods】
2. The patting should be springy and steady. Can be performed by one or two
hands.
3. The palm should bounce up right away after patting on the operated part. The
movement should be done in rhythm.
【Cautions】
1. The palm should pat on the body surface flatly. Any dragging and whipping
movement on the body surface should be avoided.
2. Patting should not go beyond the desirable state that the skin appears
reddish and congested.
【Methods】
• Hit the body surface with the palm base while stretching the
fingers naturally and stretching the wrist joint slightly
backward
2. Ce Ji Fa (Hitting manipulation with the
lateral side of palm)
2. When performing hitting with palm base, use the palm base as the force exerting
point and strike with the force from the forearm. With greater amplitude and 3-5
times.
3. Hitting with lateral side of palm can be performed with one hand or both hands
holding together. The minor thenar should be vertical with the direction of the
muscular fiber, and rapid with rhythm.
4. When performing fit hitting, the elbow joint is taken as the pivot. Make use of the
force from the flexion and stretch the elbow joint and forearm to strike.
5. When performing finger-tips hitting, relax the wrist joint and flex the elbow joint
in a small amplitude. Tap the body surface with the tip of the finger at a rapid
speed like rain drops.
【Cautions】
3. Fist hitting is applied to Dazhui (GV14) and the lumbar region; palm
hitting is applied to Baihui (GV20) and Huantiao (GB30); finger-tips hitting
is applied to the head;
Tan Fa (Flipping manipulation)
-press the back of the index tightly with the middle finger
and spring rapidly to flip a certain part or Acupoint.
【Methods】
• Flex the index finger and press the back of the index finger
tightly with whorl surface of the middle finger
• Then spring rapidly to hit the treated part
• The frequency is about 120-160 times per minute
【Essentials for performing
manipulations】
1. The manipulation should be performed evenly and continuously.
【Cautions】
【Methods】
【Cautions】
【Methods】
• The doctor holds the wrist of the affected finger with one
hand
• And fixes the affected finger between the flexed index and
middle fingers
• Then pulling and extending from opposite direction
• The patient takes a prone position with the knee of the affected side flexed for 90°
• The doctor stands by the affected side and presses the lower part of the backside
of the affected thigh with one knee
• Holds the ankle with both hands, then pulling and extending the knee joint up
around the longitudinal axis of the calf
2. When traction reaches a certain degree, it should be kept steady for a while
3. The angle of traction should be well adjusted and the pulling should be done
around the longitudinal axis of the extremity
【Cautions】
1. Violent force and action against the direction of the physiological activities
should be avoided
【Methods】
The doctor can feel a flick under his thumb even there is no
cracking sound
2. Xiong Zhui Ban Fa (Pulling manipulation of the thoracic
vertebrae)
• The patient takes a sitting position with his fingers crossed behind
the occiput
• The doctor stands behind the patient with one foot stepping on the
chair on which the patient sits,
• And put his knee against the patient’s spinal process of the thoracic
vertebrae
• Stretching both hands between the upper arm and the forearm from
the patient’s armpits
• Holding the lower part of the forearm, pressing the patient’s forearm
with both hands and raising his forearm to bend the patient’s neck
slightly
• At the same time, the doctor pulls the spine backward and upward
• Pausing for a while, the doctor’s both hands and arms exert force to
take a quick and controlled pulling action within a small amplitude,
then sustain his knee suddenly
• Cracking sound is often heard during such an action
2. Xiong Zhui Ban Fa (Pulling manipulation of the thoracic
vertebrae)
• The patients takes a lateral position with the healthy leg below
straightening naturally
• The affected leg flexes at the hip joint, its ankle is put on the
popliteal fossa of the healthy leg
• The doctor faces the patient, and puts both elbows on the patient’s
front part of the forearm and hip
• Then exerting opposite force slowly to pull the waist, and taking a
quick and controlled pulling action within a small amplitude
• Cracking sound is often heard during such manipulation
b) Yao Bu Hou Shen Ban Fa (Pulling manipulation of the waist)
• The doctor holds the lower end of the patient’s forearm to fix with one
hand
• And holds the patient’s palm to pull with the other hand
• Then flexing and stretching the wrist joint, followed by a controlled
flexing or stretched pulling action within a small amplitude
7. Di Qia Guan Jie Ban Fa (Pulling manipulation of sacro-iliac
articulation)
(Backward extending and pulling manipulation of sacro-iliac
articulation)
2. Turning the joint to the limited degree is a critical step for successful
performance of the manipulation
4. The patient should keep relaxed as much as possible. Manipulating with the
patient’s inhale and exhale exercise.
【Cautions】