CHAPTER 7 Area foundation routines

Area foundation routines have two important purposes. They provide you with a structure for learning to develop your Tui na skills and with a framework for creating Tui na treatments.

A structure for developing your Tui na skills

Practicing the area foundation routines will help you to develop your techniques and to learn how to adapt them to different parts of the body. They bring together a logical sequence of techniques that move through the adaptive, analgesic and dissipative stages of treatment.

I suggest that you learn them like a dance routine until one technique flows smoothly into the next and they feel like second nature. If you do, your confidence will grow and you will become fluid and coordinated in your application.

Once the sequences are second nature, you can concentrate on other aspects of your practice such as relaxation and softness, bringing Qi to your hands, developing sensitivity and directing your attention.

A framework for creating treatments

One of the most challenging aspects of Tui na is choosing what techniques to apply and where and how to apply them. The area foundation routines make this process more manageable by providing the foundations for creating and building up Tui na treatments. The routines provide a framework, which can be utilized and adapted. Techniques and points can be added or removed, and particular aspects of a routine can be focused on according to the requirements of treatment.

Note-taking is also made easier. Instead of writing down every single technique that you want to apply, which would be very time-consuming, you can refer to the area routines that you want to use and note what you focused on, added or removed. For example, you may say that you applied the chest routine, focusing on gentle Tui fa and Rou fa in the intercostal spaces.

Health maintenance treatments

You can provide excellent preventative and health maintenance Tui na treatments by linking the area foundation routines together and following the general principles of treatment on page 130.

There are several versions of area routines. This is because every experienced practitioner and teacher will have developed their own variations along with their style of practice.

In the rest of this chapter, I have provided foundation routines that will help you to develop a broad range of techniques and become familiar with working through the three stages of treatment. As you gain experience and develop your own style of practice, you can, if you wish, experiment with creating your own foundation routines. Just remember to follow the three stages of treatment.

The area foundation routines I describe are:

• The head and face

• The neck and nape

• The back

• The upper limb

• The lower limb

• The chest and hypochondrium

• The abdomen

Head and face

The head routine is applied with the patient seated.

The techniques applied to the head should be performed over a cotton Tui na cloth unless the patient has very short hair in which case you can apply them directly to the head.

1. Tui fa and Mo fa

Stand in front of your patient supporting the back of their head with one hand. Bring Qi to your other hand and apply Tui fa and then Mo fa from the anterior to the posterior hairline using your palm and fingers. Work the left side of the head first, then the right and finally the center. Start slowly and gradually increase your speed.

Alternate between these two techniques until the patient’s head feels hot.

2. Rou fa

Stand behind your patient, interlace your fingers and apply Rou fa to Fengchi GB20 using the minor thenar eminence of both hands.

3. Compound technique: grabbing–grasping

Grab and grasp the five channels of the head, from the anterior to the posterior hairline, about 10 times.

4. Ma fa

Apply Ma fa with your thumbs from the temporal hairline in front of your patient’s ears to the mastoid process. Work gradually backwards and forwards several times until the area feels hot.

5. Pai fa

Using a loose fist or the palm of your hand, apply Pai fa to Baihui Du20 10 times.

The face routine is applied with the patient lying supine.

1. Tui fa

Using the palms of your hands, apply Tui fa gently to stroke your patient’s forehead and temple area.

Using your thumbs alternately, push from Yintang to Shangxing Du23.

2. Ma fa

Wipe back and forth with your thumbs in horizontal lines from the eyebrows to the anterior hairline.

3. Compound technique: pinching–grasping

Pinch and grasp the eyebrows between your thumbs and index fingers from medial to lateral three times.

4. Yi zhi chan tui fa

Apply moving Yi zhi chan tui fa in a figure-of-eight around the eyes 6–10 times.

5. Rou fa

Knead Yintang and Tai Yang with your middle fingers.

6. An fa, Rou fa and the compound technique, kneading–pinching

Stimulate Zanzhu BL2, Benshen GB13, Yangbai GB14, Sibai ST2, Juliao ST3, Daying ST5, Touwei ST8, Yingxiang LI20, Renzhong Du26 and Chengjiang Ren24 using An fa and Rou fa or kneading–pinching, until the points are warm and slightly sore.

7. Ma fa

Using your index and middle fingers, wipe back and forth briskly from LI20 to BL2 until the area is very warm.

8. Compound technique: pinching–grasping

Pinch and grasp along the jaw line from Ren24 to Jiache ST6 using both hands, three times.

9. Rou fa

Knead underneath the jaw with your fingertips and knead the masseter muscle with your major thenar eminence at the same time. Apply to each side three times.

Apply light, brisk Rou fa with your thenar eminence to the jaw, cheeks, temples and forehead until warm.

10. Compound technique: kneading–pinching

Knead and pinch the ears, then lift and pull both ears three times.

11. Gua fa

Gently scratch the scalp with the tips of your fingers and/or nails along the anterior hairline from left to right and right to left three or four times.

To finish

Warming palm

Finally, rub your hands together until scorching hot, and then bring them over your patient’s eyes, ears or temples according to their presenting disharmony. (Refer to p. 135 using breath and visualization for more ideas.)

The foundation routine for the head and face has a soothing, relaxing effect, and in my experience, patients love it. It can be applied to calm the Shen, expel Wind, disperse obstructed Wei Qi, improve vision, clear the sinuses, alleviate pain, and facilitate and regulate the rising of clear Yang.

With the addition of appropriate distal work, work on the back, chest, abdomen, and so on, this routine provides a very useful basis for the treatment of problems such as:

• Headaches and migraine

• Insomnia

• Stress

• Anxiety/depression

• Ear, nose and throat (ENT) problems

• Common cold

• Sinusitis

• Allergic rhinitis

• Dizziness

• Facial paralysis

• Tinnitus

• Toothache

Neck and nape

The neck and nape routine is applied with the patient seated.

Adaptive level

1. Tui fa

Support your patient’s forehead with your non-dominant hand and apply Tui fa with your dominant hand using the tips of your index, middle and ring fingers. Work in lines from Fengfu Du16 to Dazhui Du14, Tianzhu BL10 to Dazhu BL11 and then using both hands from Fengchi GB20 to Jianjing GB21. Apply each about 5–10 times.

2. Rou fa

Apply Rou fa along the same lines as Tui fa above using your thenar muscle 3–5 times. Then using your thumb apply Rou fa between each of the cervical vertebrae, then just to one side of the vertebrae and then down the Bladder and Gallbladder channels of the neck.

Apply Rou fa with the heel of your palm all over the nape, top of the shoulders, scapula and the upper back until the muscles feel warm.

Analgesic level

3. Gun fa

Apply Gun fa all over the top of the shoulders, nape, the back and sides of the neck, incorporating some passive movements of the neck as you work. Apply for about 10 minutes.

4. Yi zhi chan tui fa, Ji fa, Zhen fa or An fa

Select a couple of local points to be stimulated, such as BL10, GB20, GB21, Jianzhongzhu SI15 and stimulate for 2–3 minutes using one or two of the above techniques.

5. Na fa

Knead and grasp the neck, from the occiput to the root of the nape several times. Pinch and grasp either side of the neck from BL10 to BL11 three times on each side. Knead and grasp gently along the sternocleidomastoid muscle three times on each side. Lift and grasp the top of both shoulders (GB21 area) briskly for about a minute.

6. Rou fa

Knead the patient’s throat gently with the pads of your thumb and fingers several times, working along the sternocleidomastoid, the Stomach and Large Intestine channels.

Passive movements

7. Ba shen fa

Apply Ba shen fa to the neck three times remembering to work with your patient’s breath. Apply kneading and grasping between each stretch.

8. Yao fa

Rotate the neck. Remember to start gently with small rotations and gradually increase the range of the movement. Do this in both directions.

Dissipative level

9. Pai fa, Ji dian fa and Ji fa

Apply loose fist Pai fa or five-finger Ji dian fa to the patient’s neck and nape and Ji fa to the nape and top of both shoulders.

10. Whisking–sweeping

Whisk and sweep the nape, shoulders and upper back.

To finish

Warming palm

Finally, rub your hands together until scorching hot, and then bring them to the top of your patient’s shoulders. (Refer to p. 135 using breath and visualization for more ideas.)

With the addition of appropriate distal and local points, this routine provides a useful basis for the treatment of problems such as:

• Restriction of neck movement, muscular tension, sprain, wry neck

• Cervical spondylosis

• Wind-Cold-Damp Bi syndrome

• Headache/migraine

• Insomnia

• Stress

• Anxiety/depression

• ENT problems

• Sore throat/hoarseness/vocal problems

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