CHAPTER 4 Compound techniques

The basic techniques are like an artist’s pallet of colors. Some lend themselves particularly well to blending. Compound techniques are essentially either two basic techniques blended together, such as Na fa grasping with Rou fa kneading to form kneading–grasping, or a basic technique blended with an action like holding or pinching, for example Na fa blended with pinching gives us pinching–grasping.

There are undoubtedly many possible ways to create compound techniques and I encourage you to explore the various possibilities in practice groups with fellow students and colleagues. However, there are 13 compound techniques that have developed over Tui na’s long history that are most commonly used and are especially useful in clinical practice. It is these that I will focus on in this chapter. Na fa and Rou fa, the most flexible basic techniques, are used in all but two of the 13 compound techniques.

As students of Tui na, learning and mastering these techniques will help you develop the sophistication and flow of your techniques and confidence and sensitivity in your hands. As Tui na practitioners, the compound techniques provide us with greater subtlety in our art and flexibility in practice.

In this chapter I will give a description of how to apply each technique, where it can be applied on the body, its therapeutic effects and indications for its use in treatment.

Compound techniques using Na fa

There are seven compound techniques that use Na fa as the root technique. They are:

1. Holding–grasping

2. Pinching–grasping

3. Grabbing–grasping

4. Nipping–grasping

5. Plucking–grasping

6. Lifting–grasping

7. Pulling–grasping

1. Holding–grasping

Holding–grasping makes use of the whole hand to hold, squeeze and grasp the muscles and channel sinews.

Attach the whole of your palm and fingers to the area to be worked on, hold and squeeze the underlying muscles and then add the grasp, which lifts the underlying tissues away from the bone. Hold and grasp the muscles firmly and suddenly, keeping the palm of your hand in full contact, and then release the muscles so that your hand is no longer touching. Do not be tempted to rush this technique; it needs to be applied at a steady pace allowing time to pause briefly in between.

Holding–grasping can be applied repeatedly in one particular area such as the deltoid muscle, or along the course of the channel’s sinews. You can use one or both hands depending on the area to be treated and the size of your patient. (Fig. 4.1)

Fig. 4.1 Holding–grasping on the backs of the legs.

Clinical application and therapeutic effects

Where to apply the technique on the body

Holding–grasping is most commonly applied to the muscles and channel sinews in the shoulders, arms, hips and legs. It can also be applied to the neck, back and around the waist.

Therapeutic effects

Holding–grasping is a comfortable technique to receive. I often use it at the end of the adaptive stage of treatment before applying some of the more intense and stimulating compound blends of Na fa.

Holding–grasping warms the channels and dredges the channels and collaterals. It can be used to release the Exterior, expel Wind and disperse Cold. It will relax the muscles, alleviate pain, invigorate Qi and Blood and eliminate stasis.

Common uses

Apply holding–grasping to the back of the neck to stimulate the Bladder and/or Gallbladder channels then apply several times along the course of the relevant channels in the arms and legs as part of treatment for common colds, flu, headaches and dizziness.

Use for muscular stiffness and spasm, Wind-Damp-Cold Bi syndrome, Wei syndrome and difficulty walking. Use for any disharmony caused by Cold, Qi stagnation and Blood stasis.

2. Pinching–grasping

Pinching–grasping is applied with the thumb on one side of a muscle or channel sinew and all four fingers on the other side. It can be applied using either one hand or both hands working side by side.

Pinch the muscle between the pads of your thumb and fingers, add the grasping to lift the muscles and then immediately let go, completely releasing the muscle, and then repeat. By adding pinching to grasping it produces quite intense stimulation.

This technique should feel deep and penetrating but not harsh; there must be softness within it. Keep a relaxed soft focus on what you are trying to achieve; keep your breath centered and even and use only the pads of your fingers, not the tips or nails.

Pinching–grasping can be applied with consistent repetition in one fixed place or along the course of a channel. It should be applied until the patient feels a sensation of soreness, numbness or distension. (Fig. 4.2)

Fig. 4.2 Pinching–grasping along the Lung channel in the forearm.

Clinical application and therapeutic effects

Where to apply the technique on the body

Pinching–grasping can be applied to most muscles and channel sinews. It is most commonly applied to both the Yin and Yang channels of the arms and legs.

Therapeutic effects

These are wide and varied as it depends on which channels are being stimulated.

• When applied to the Yin channels of the arms it will help to clear the Lungs, stop a cough, resolve Phlegm, aid respiration and calm the Shen.

• Applied to the Stomach, Spleen and Liver channels it can help to regulate and encourage digestion.

• When applied to the leg channels, it will move Qi and Blood in the abdomen.

• Generally, pinching–grasping will invigorate the flow of Qi and Blood, relax the muscles and open the channels.

Try moving from holding–grasping to pinching–grasping for stronger stimulation in the analgesic stage of treatment.

I find this a very flexible and effective compound technique, useful for a wide range of conditions. While working along a channel you can pause at important points relevant to the treatment along the way and focus the technique there for a minute or so before moving on.

Common uses

• Include pinching–grasping in your treatment of mental/emotional problems such as anxiety, depression, panic attacks and palpitations.

• You can use it for respiratory conditions such as asthma, acute and chronic cough and difficulty breathing due to retention of Phlegm.

• Use it for feelings of oppression in the chest and ribs from Phlegm or Qi stagnation.

• Apply to the leg channels for digestive problems such as hiccup, belching and flatulence, abdominal pain and distension caused by Shi conditions and for dysmenorrhea from Qi stagnation and Blood stasis.

3. Grabbing–grasping

Grabbing–grasping is applied with the tips of the fingers and thumb of one or both hands. The palm is empty, making no contact with the body.

Create an eagle’s claw posture with your hand. Bring your Qi to the tips of your fingers and thumb and grab the area to be worked on like an eagle grabbing its prey; add grasping by lifting the underlying muscles and then quickly release them. Repeat rhythmically in one place or along the course of the channels.

When applying to the head, have your patient seated and stand to one side. Support your patient’s forehead with your non-dominant hand. Apply grabbing–grasping with your dominant hand by spreading your clawed fingers so that the middle finger is in line with the Governing Vessel; your index and ring fingers are either side in line with the Bladder channel and your thumb and little finger with the Gallbladder channel. Grab and grasp from the anterior hairline working gradually backwards.

When applying to the abdomen, follow the patient’s breath, either by grabbing and grasping during the in breath and releasing with the out breath, or by applying several times during the out breath.

Grabbing–grasping is quite an intense technique: keep relaxed, brisk and rhythmic; use your Qi and do not let it become harsh. (Fig. 4.3)

Fig. 4.3 Grabbing–grasping on the shoulder.

Clinical application and therapeutic effects

Where to apply the technique on the body

Grabbing–grasping can be applied to the head, neck and nape, the back, abdomen, arms and legs.

Therapeutic effects

Grabbing–grasping is a dispersing technique. It has a powerful effect on Wei Qi and can be used to release the Exterior, expel Wind, disperse Cold and drain Damp. It warms the channels, relaxes muscles and channel sinews and invigorates and moves Qi and Blood. It can be used to promote urination and to stop pain.

Common uses

Grabbing–grasping can be used for any type of channel sinew problem, muscular stiffness, spasm or pain from backache to stiff neck. Specifically:

• It is definitely worth considering in cases where you have Wind obstructing the channels creating stiff contracted sinews in the arms and legs. For example, you may see extreme cases of this in cerebral palsy and multiple sclerosis (MS) when the legs or arms cannot be straightened.

• It can also be used as part of treatment for headaches and migraine, common cold and flu.

• It is a useful technique to apply to the belly for abdominal pain from stasis of Blood and retention of Cold or Cold and Damp.

• It can be used as part of treatment for diarrhea caused by Cold and Damp patterns with Weak Spleen.

• It can also help in cases where flow of urine is impeded or blocked by accumulations and stagnation.

4. Nipping–grasping

Using the tips of your fingers and thumb, nip a point or several points around a joint by pressing into it with your fingers and thumb, grasping and then releasing. Nip and grasp energetically and repetitively until the Qi is strongly stimulated and the patient feels a sore, numb, aching sensation.

Clinical application and therapeutic effects

Where to apply the technique on the body

Nipping–grasping is mainly applied to joints and points and any depressions and fossas. It is very useful for stimulating points at the occiput like Tianzhu BL10 and Fenchi GB20. I use it between vertebrae to stimulate the Governing Vessel.

It is commonly applied to the neck and nape, the shoulders, elbows, wrists, knees and ankles. (Fig. 4.4)

Fig. 4.4 Nipping–grasping Hegu LI4.

Therapeutic effects

Nipping–grasping is used to expel Wind, disperse Cold, move Blood and disperse Blood stasis; it dredges the channels of obstructing pathogens and stagnated Qi. It relieves pain, relaxes the channel sinews and opens and lubricates the joints by bringing Qi and Blood to them.

Common uses

Nipping and grasping is very useful in the treatment of arthritis, Bi syndrome from Wind-Damp-Cold, traumatic injuries and any restricted joint movement such as frozen shoulder. I have found it useful in the treatment of carpal tunnel syndrome and repetitive strain injury (RSI).

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