推拿 - tuīná
What should I expect?
For an initial visit in the clinic, please budget up to two hours of time as paperwork will need to be filled out when you are accepted as a patient. Following appointments with the clinic will generally be around an hour. In an hour-long visit, you may anticipate our undivided attention. We will ask questions about your health and lifestyle, conduct an energetic physical exam, perform an assessment of imbalances, and propose a plan of action. Your office visit may include more than one approach of care (Chinese medicine, practiced in its true form is a multi-modality approach), such as: discussion with regards to lifestyle changes, some body work and/or acupuncture, and an herbal formula prescription.
In a typical tuina session, the patient remains clothed but should wear loose fitting clothing. The patient may sit in a chair, or perhaps sit/lie on a couch or table. Techniques utilized in a tuina session may include soft tissue massage, acupressure, and manipulation. We may sometimes use herbal compresses, liniments, ointments, and heat to enhance these techniques.
We focus on imbalances and do not simply treat the symptoms. Please keep in mind, most symptoms are products of disharmony/imbalance, and as your body-mind changes, re-balancing and approaching relief/healing, other ‘new’ symptoms may often manifest - some clearing on their own during the progressive stages of healing, and some needing to be addressed.
Although an initial treatment will likely create ‘relief’, opening energy flow, the energy flow may bring up new, unseen symptoms (and it also may not). Generally, patients are seen over a period of treatments and begin to feel immersed in a calm, more peaceful state of well-being. Chinese Medicine is a preventative approach to health care. If a body is listened to, and balance is maintained, wellness is known.
What conditions might be helped by tuina?
Tuina is best suited for rectifying chronic pain, musculoskeletal conditions, and stress-related disorders. It is well suited for neck pain, shoulder pain, back pain, sciatica, sports injuries, joint pains, et cetera. Because tuina can improve and restore the flow of qi, treatments will often impact the body as a whole. When the flow of energy in the body is opened up, the body will work to balance naturally. For example, a patient coming for tuina treatment may experience positive ‘side effects’ in other areas that were not the intention of the visit: headaches, constipation, premenstrual symptoms, even emotional problems may be effectively treated through tuina.
Tuina is generally more specific and intense than other bodywork forms and as such may not, necessarily, be used to sedate or relax a patient (though this can happen). The experience of tuina bodywork received from a trained practitioner can be vigorous; soreness may occur after a first session. Other common experiences of patients may include feelings of sleepiness or euphoria as energy spreads and soothes into areas of the body.
While we’re at it … what is tuina?
推拿 (tuī ná - too’way nah - push; grasp) is an ancient Chinese bodywork practice with roots dating back thousands of years. As a healing therapy it is often used in conjunction with acupuncture, moxibustion, and fire-cupping, using the traditional, foundation forming Chinese medical understanding of the flow of Qi through the meridians for its therapeutic orientation. Through the application of massage and manipulation techniques, tuina seeks to relieve discomfort by opening and establishing a more harmonious flow of Qi through the body’s system of channels, allowing the body to naturally heal and remain in health on its own.
Tuina is a central pillar to Chinese medicine. At ASAOM, we stand behind Chinese medicine as a complete approach to personal health when it has its triumvirate pillars (Tuina, Acupuncture, and Herbs) integrated into a unified approach. Each of the pillars of Chinese medicine should be considered in conjunction with one another, and not separately, as they were developed and continue to be expounded upon, as three modalities built to be enacted and achieve the single technique of healing, as one.
Second year student interns at ASAOM will perform skilled techniques and protocols under the supervision of licensed, trained practitioners with more than five years of personal development and study outside of their degree studies. In China, tuina is viewed with the same respect as any traditional medical therapy and is incorporated in the foundations for studying Chinese medicine.
What methods of re—balancing might be used in the clinic?
Tuina (Chinese Medical Massage) | Acupuncture | Electric Acupuncture | Auricular therapy | Moxibustion | Liniments | Guasha (scraping) | Cupping | Lifestyle assessment and counseling including foods/nutrition, movement/exercise, approaches to breathing, qi exercises, and thought structures | Herbal prescriptions or products from cough suppressant syrups to teas, ointments, pillules, medicinal ‘patches’ and so on.
How many visits will I need?
This depends on the duration, severity, and nature of your discomfort. If behaviors have become ensconced in a patients patterns, or injuries/dis—harmonies are severe/chronic, anywhere from five to fifteen visits may be needed. Some patients may require a direct follow up and continued maintenance. Many ailments have been developed over a patient’s lifetime. Holding this in mind, it is not difficult to imagine the healing process also requiring a respectful amount of time. Urgency is its own malady. The body, when returned to its proper state, resting in its natural strength, is an amazing healer. As you begin working with us it is important to allow for adequate time between appointments. Generally, care is best spaced two or three times a week to begin, and lengthened out over the progression of your healing state.
What is acupuncture?
Acupuncture is … the ubiquitous word surfacing when Chinese medicine emerges as a topic of conversation. What it is, or what is should be … is not alone. Acupuncture is not, and should not, as a practice, be considered a single modality. Chinese medicine has three core modalities: Tuina, Acupuncture, and Herbs. These modalities are best when they play off of one another. A patient’s best approach is to consider and be open to receiving these modalities together when addressing a health and wellness issue. We encourage this at ASAOM.
Acupuncture, as a proven, accepted healing technique, seeks to invite balance’s return to the body through the insertion of hair-thin needles into specific, documented, studied-for-thousands-of-years points on the body, clearing/opening the pathways within the body where energy (Qi) should be passing through meridians and channels as a continuous flow. Energy’s stagnation, or flow, will directly effect the state of the body, and the mind. The body and the mind are often considered as two incorporated pieces, acting upon a whole-form; the mind can build the body, and the mind can erode the body; body and mind, together, make up the physical form; they are viewed as one: body-mind; healing of body will impact mind; healing of mind will impact body. The need for acupuncture may arise from injury, harmful lifestyle habits, stress, discordant thoughts, environmental toxins, and environmental changes. The natural process of aging is a fine culprit for energy blockages and acupuncture’s necessity as it carries within it minutiae of change represented on many levels of human interaction and behavior over time: degrading joints, physical and mental stresses, emotional traumas, weakened organs, and so forth.
In the hands of a skilled practitioner, acupuncture will likely be utilized in conjunction with acupressure and/or bodywork techniques, and be accompanied by some form of herbal remedy to generate a tour de force of healing potential. Acupuncture invites the body’s energy back in. In essence, acupuncture will open the patient to heal themselves. You, the patient, are directly involved in the Chinese medicine process of healing.
Needles … what kind of needles? AKA: Does it hurt?
The needles used in the practice/art of acupuncture are hair-thin, stainless steel shafts. Their sensation is generally described as one of heaviness, or tingling, either around the needled zone or through the affected energy pathway/s. Acupuncture is often spoken of as relaxing, soothing, and ‘enhancing’ as a vibrant on-set experience of well being.
Though not as common, some patients do experience discomfort, generally referred to as a dull ache as stagnate/blocked energy releases. This sensation may radiate and follow the energy’s pathway/flow; it is most often fleeting, almost ethereal, and quick to pass.
What are you talking about?
At ASAOM we use Western terminology in communication with supervisors, interns, and patients, but Western vernacular means little in traditional Chinese diagnostic-speak. So you may hear, in referencing diabetes for example, an acupuncturist say ‘wasting thirst’ (of which there are three types, depending on which of the three burners has excess heat). Alternatively … Premenstrual Syndrome (PMS) is often an expression of constrained liver Qi. Bell’s Palsy is usually external wind/cold lodged in the meridians of the face. This could go on and on.
What types of ailments/issues can acupuncture address?
The list of health issues the World Health Organization now supports/endorses Traditional Chinese Medicine treatment for is growing, almost by the day. It is anticipated that most insurers will be supporting Acupuncture as a method of treatment by the year 2020.
A growing list of common ailments may be read up on in our How to Heal section.
As a quick reference, some common health issues addressed by acupuncture are:
Gastrointestinal disorders, such as food allergies, peptic ulcer, chronic diarrhea, gastrointestinal weakness, constipation, anorexia, and gastritis.
Urogenital disorders, including stress incontinence, urinary tract infections, and sexual dysfunction.
Gynecological disorders, such as irregular, heavy or painful menstruation, infertility in women and men, and premenstrual syndrome (PMS).
Respiratory disorders, such as emphysema, sinusitis, asthma, allergies, and bronchitis.
Disorders of the bones, muscles, joints and nervous system, such as arthritis, migraine headaches, neuralgia, insomnia, dizziness and low back, neck and shoulder pain.
Circulatory disorders, such as hypertension, angina pectoris, arteriosclerosis and anemia.
Emotional and psychological disorders, including depression and anxiety.
Addictions, such as alcohol, nicotine and drugs.
Eye, Ear, Nose and Throat Disorders.
Supportive therapy, for other chronic and painful debilitating disorders. *
*National Acupuncture and Oriental Medicine Alliance, “Introduction to Acupuncture,” Olalla, Washington, 1997.
What is herbology?
Hundreds of Chinese herbs are used in countless combinations to concoct medicinal formulas in TCM. Some herbs may be known to Western medicine and exist within the lexicon of Western herbology, but many are not native to the practice of herbs in the West. Many Chinese herbs and herbal concoctions are known by their Chinese names only … if you are around our clinic and practitioners, you may hear some strange things. To be honest, some of the references are not even Chinese (Mandarin or Cantonese) but exist as amalgamations of sound born from their adaptation into the West.
Chinese medicine has passed through a centuries-long filter: an erosion of signs, symptoms, formulas, and results to arrive at the highly refined and documented practice of Chinese herbology today. In ASAOM’s clinic, we stock hundreds of herbal varietals to completely customize a formula, and/or tailor classic formulas for individual needs, and we carry many traditional Chinese patent formulas in pill form. Our raw herbs find their way into teas, foods, poultices, salves, ointments … you name it.
Why are formulas often generated specifically to address individual needs? Aren’t there just common, set prescriptions for this? Isn’t it just more work for the clinic?
Well, a ‘common’ formula can address an imbalance, and many times restore health, but not always. ‘Common’, classic formulas were generated because many ailments are common-place. The cold for example, in the West, goes by the moniker ‘the common cold’ (it’s right there in the name). A common, everyone-address of a cold in Western medicine will often times look to alleviate symptoms for the duration of the cold, as the body deals with discomfort and rests. In Chinese medicine, the common address of the issue will do much the same, but will include herbs to buoy the body toward its balanced state - addressing areas that are commonly affected during the experience of the ‘common cold’ as illness.
The necessity for tailoring formulas unfolds when we take into account the innumerable variations people and their habits/life-situations illustrate. Following diets and life-styles, many imbalances (a cold) may have the same basic foundation where the imbalance was formed, but restoration must (often times) follow a path specific to a given person. Each person is a fingerprint; as we know, no fingerprint is the same. We may use custom formulas to harmonize and tonify a person’s constitution, strengthening the immune system, or we may expel excess fluids from upper respiratory issues, or we may help a patient to lose wait, deal with distention, and/or regulate the bowel. Formaulas may also be used in very complex ways, addressing a large issue in layers, each layer peeling off to reveal the next. As an example, in China, herbal formulas are commonly employed (and very successfully) to aid with conception. Herbs are whole, organic substances, forming complex, synergistic relations with one another, and within the body. Herbal formulas are composed from upwards of thirty different herbs, but the majority of formulas are built with around eight to twelve. As a difference in approach, again … where Western medicinal herbs (organic, not synthetic) are generally used to counteract a symptom … Chinese medicinal herbs may be utilized for the same purpose, but they will employed under a complex series of diagnoses to bring the system (the body) home to balance. It is interesting to note that in China herbs are also used, via encouraged integration, as complimentary additions to Western medical practices and treatment plans.
Chinese herbs seek the cause, the “root” as well as its symptoms, the “branches”. In Chinese medicine we want a treatment approach to address both issues (root and branch), predictably if possible. To treat both, a single formula will often not suffice. The patient might need to return for a second formula; other areas of a condition may also require time spent with acupuncture and/or tuina. And many times an issue will not present itself fully. Most discomforts are layered. Dis-ease is constructed in intricate patterns and layers before symptoms arrive on the surface (the body). To alleviate dis-ease, we need the same patience we used in layering dis-ease (realized or not, we do set our bodies and emotions into positions which incubate discomfort; accepting this fact is a large piece in the puzzle of recovering the power in our own personal health care) to bring it back to its foundation of health. The foundation, balance, is the solution to long-term health. This is the real gift of Chinese medicine. With a preventative mind set, we are always looking for the cause and … where the body was before the cause. Just clearing present symptoms is not enough. The cause must be dealt with or imbalance will wind its way back in one form or another.
What should you anticipate with a formula prescription?
It may not taste good. But that’s not guaranteed. And, it may be a first-layer formula. Meaning, it might strip away some surface issues and expose what lies beneath. What lies beneath may need to be addressed with a new formula, or by some other means. In China, you might anticipate after seeing the doctor that someone in a Chinese pharmacy would hand you a bag full of Chinese herbs and direct you to cook them down for several hours and separate them into various servings. Alternatively, the person behind the pharmacy counter might cook the herbs down for you. You would show up the next day or in a few hours to receive your formula/s skillfully cooked, separated, and prepared into the proper amount of servings denoted by their bundling into sealed plastic bags. You snip the bag, pour the contents into a little pot, heat, and consume (bag goes in the recycling). It’s a tidy endeavor. We have plans to offer this service soon … but right now we are saving on the work. Tea and powder formulas are pulled together in our herbal dispensary, daily, so that we have formulas on hand*. Alternatives to the formulas we build in-house are the patent classic formulas (pillules) provided by companies in the U.S. and China. You may be prescribed some of those. They’re popular, and for most constitutions they are effective.
Chinese herbs are taken in their full potency by imbibing a tea infusion, cooked from the raw herbs themselves. Potency is also dependent on how the herbs have been treated in storage and in preparation, and also how the tea is prepared (duration). Powdered forms of herbs (derived from single herbs) may be infused into a formula. Some powders also come in pre-mixed forms of TCM formulas known for their success in treating certain disorders. Pills are considered a weaker utilization of Chinese herbal medicine, but they are generally potent enough to address issues. Many pills are developed in the U.S. using exceedingly pure, controlled, and precise methods. Chinese herbal remedies in pill form have become ‘healthy’ (ah, the pun) competition for the other methods of herbal formula preparation; they’re convenient as well. Regardless of form, herbs serve as powerful tools in the hands of a TCM practitioner, boosting the effectiveness of treatments, often becoming the treatment alone.
*ASAOM’s student practitioners, toiling and building patient formulas in our herbal dispensary, passionate about they’re profession, healthcare, and about our patients, have intimately studied nearly 400 herbs, learning their general attributes as well as their interactions with other herbs.