CHAPTER 5 Coordinated techniques

Coordinated techniques are essentially two different techniques, basic or compound, applied at the same time to stimulate two areas of the body simultaneously. Think of rubbing your tummy and patting your head. About 70% of the Tui na treatments I give involve coordinating two techniques in some way and I have several colleagues who do the same. It is a very effective and practical way of working.

Tui na can be time-consuming; techniques need to be applied for long enough to allow their particular vibratory frequencies to penetrate and their therapeutic qualities to emerge. Working with two techniques at the same time means that you can work locally and distally simultaneously, for example working on a local area such as the lower back with one hand and on a distal area such as a point on the Bladder channel in the calf with the other hand.

In a modern Western practice, if you are working on your own and your patient can only come say once a fortnight, working in this way means that you can cover more and maximize the use of the treatment time.

In theory, as long as you can perform the techniques fluently, you can coordinate any two techniques together: a basic technique with a compound technique, two basic techniques or two compound techniques. As you gain more confidence and experience of working with Tui na you will discover and develop your own particular favorite and effective combinations. When you feel confident and fluid with the basic and compound techniques, I would encourage you to explore and experiment with various combinations as they arise. There are many possibilities and variations.

In this chapter I will describe 11 coordinated techniques. I have included some classic combinations that are frequently employed in Tui na departments in China, some variations of these classics, and a few combinations that my colleagues and I use frequently and have found to be very useful in practice. These techniques are:

1. Gun fa and Rou fa

2. Gun fa and An fa or Ya fa

3. Gun fa and Pai fa

4. Gun fa and Yi zhi chan tui fa

5. Gun fa and Tui fa

6. Forearm Rou fa and pinching–grasping

7. Elbow Rou fa and Ji dian fa

8. Loose first Pai fa and pinching–grasping

9. An fa and Mo fa

10. Whisking–sweeping and Pai fa/Ji fa

11. Pai fa/Ji fa and Ji dian fa

1. Gun fa and Rou fa

Clinical application and therapeutic effects

Where to apply the combination on the body

This is a very flexible combination and can be applied to most areas of the body. It is commonly applied in the following ways:

1. Applying one technique to the lower back, sacrum and hips and the other down the back of the legs along the Bladder/Gallbladder channels.

2. Applying one technique on the abdomen and the other down the leg along the Stomach channel.

3. Applying one technique to the hip with one hand and the other technique to the shoulder with your other hand.

4. Applying Rou fa with one hand to a point with the thumb or middle finger and Gun fa with the other hand along a channel or section of a channel.

How to apply the combination

Below are examples of how to apply the first three of the above four methods of application. The fourth I think speaks for itself. Work with these methods until you feel comfortable applying Rou fa and Gun fa at the same time, then try experimenting and you will discover other ways. Keep the ones that work for you.

Applying to the lower back, sacrum and hips and down the back of the leg

Stand to one side of your patient and apply Rou fa to the lower back, sacrum and hips using either your forearm, palm, the heel of your palm, major or minor thenar eminence. Use whatever feels most comfortable. The forearm is very useful for working over large muscles such as the psoas and gluteus and for working over the Governing Vessel and Back Shu points.

Apply Gun fa with your other hand working gradually along the Bladder channel from the area of Chengfu BL36 down to Kunlun BL60 and then back up again. You can also apply the techniques the other way around, using Gun fa at the lower back, sacrum and hips and Rou fa down the legs. (Fig. 5.1)

Fig. 5.1 Gun fa and Rou fa applied to the lower back, sacrum and hips and down the back of the leg.

Applying to the abdomen and along the Stomach meridian in the leg

Adduct your patient’s leg slightly so that their toes are pointing inwards; this exposes the Stomach channel. One hand performs Rou fa on the abdomen, which can be applied in several different ways. You can use your palm or forearm over major abdominal points or you could use your thumb or middle finger to stimulate abdominal points.

While one hand applies Rou fa to the abdomen, the other applies Gun fa along the Stomach meridian working from Biguan ST31 to Jiexi ST41.

It is also possible to apply Gun fa to the abdomen along the Stomach channel, for instance, and to apply Rou fa to distal points in the leg. (Fig. 5.2)

Fig. 5.2 Gun fa and Rou fa applied on the abdomen and along the Stomach channel of the leg.

Applying to the hip and shoulder

Standing to one side of your patient who is lying prone, apply Rou fa with your palm, heel of your palm, forearm or elbow to the area of Tianzong SI11 and Gun fa to the area of Huantiao GB30. Then swap and apply the techniques the other way around.

Therapeutic effects

Gun fa and Rou fa can be used to expel Wind-Damp-Cold, strengthen the Stomach and Spleen, harmonize the Middle Jiao, warm and strengthen Kidney-Yang, eliminate Damp, promote urination and bowel movement, soften, release and nourish the channel sinews, move Blood and resolve stasis, warm and dredge the channels and alleviate pain.

Common uses

Bi syndrome, backache and aching muscles and joints, traumatic and sports injuries, Wei syndrome, weakness of the limbs, Kidney-Yang Xu, poor digestion, Liver–Spleen disharmony leading to irritable bowel syndrome (IBS), acute and chronic epigastric and abdominal pain, Spleen and Stomach Qi Deficiency and menstrual problems such as dysmenorrhea and irregular menstruation.

2. Gun fa and An fa or Ya fa

Clinical application and therapeutic effects

Where to apply the combination on the body

This combination is used to stimulate points using An fa with the thumb or Ya fa with the elbow and to work along a section of a channel using Gun fa with the other hand. Here are some common methods of application:

• Applying An fa with your thumb to a point on one side of the back while the other hand performs Gun fa on the opposite side

• Applying Ya fa with your elbow to points in the lower back, hips and thighs while the other hand applies Gun fa along a leg Yang channel (Fig. 5.3)

• Applying Gun fa to the back, hips and sacrum while the other hand stimulates distal points using An fa

• Applying An fa to points in the forearm while the other hand applies Gun fa to the shoulder

Fig. 5.3 Ya fa BL36 and Gun fa on the calf along the Bladder channel.

How to apply the combination

I will describe how to apply the first two methods. When you feel at ease with them, explore coordinating Gun fa and An fa or Ya fa in a variety of different ways. Be creative!

Applying An fa to a point on one side of the back while the other hand performs Gun fa on the opposite side

With your patient lying prone, stand at their head. Using the thumb of one hand, apply An fa to points at the top of the right shoulder and upper back; the Huatuojiaji and Back Shu points are a good place to start. Apply Gun fa with your other hand to the top of the left shoulder and the left side of the nape and upper back, stimulating the Tai Yang channel sinews. Repeat on the other side.

Applying Ya fa with your elbow to points in the lower back, hips and thighs while the other hand applies Gun fa along a leg Yang channel

Choose a Yang channel point to stimulate in the lower back, hip or upper thigh. Apply Ya fa to the point with your elbow and at the same time apply Gun fa back and forth along the related Yang leg channel.

Therapeutic effects

An fa and Ya fa stimulate the individual actions and spirits of the points so this combination has great versatility.

This combination is often used to: open the chest and aid respiration when applied to the upper back, nape and shoulders; to move and dissipate stagnation of Qi and Blood stasis; to soften, release and relax the tendons and muscles; to facilitate joints; to warm and dredge the channels.

Common uses

This combination can be used for: channel sinew problems such as muscular pain, stiffness, aching and weakness, restricted joint movement, Bi syndrome, Wei syndrome, traumatic injuries, menstrual problems and gynecological conditions caused by Qi and Blood stasis and Cold. It is also used for respiratory problems such as asthma and cough.

3. Gun fa and Pai fa

Clinical application and therapeutic effects

Where to apply the combination on the body

The most common methods of application are:

• Gun fa down one side of the Bladder channel of the back and Pai fa down the other side

• Pai fa over the lower back and hips and Gun fa along the course of the Bladder or Gallbladder channels of the legs; or the other way round

• Pai fa on the abdomen and Gun fa down the Stomach channel of the leg

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