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Tuina can sometimes cure even long-standing chronic pain in one session of treatment, Chinese therapists always assume a need for several treatments in quick succession. These all follow a similar pattern which can be summarised as follows:

1. Massage of soft tissues to make them receptive to qi flow

This involves the use of techniques which aid muscle fascia release and stimulate capillary blood flow and lymph drainage. Initially, those techniques that spread the force over a wide area are used. This reduces their penetrative pressure which, if excessive, could be extremely painful at this stage when muscles are still stiff or rigid. Palmar pressing and kneading are often used in this softening-up process together with gentle squeezing done with the whole hand. As the tissues respond, large scale pressing, kneading and squeezing give way to techniques that concentrate force onto smaller areas to increase the pressure exerted. The unique rolling method which uses the knuckles and dorsum of the hand like a rolling pin, is brought into action at this stage. The expert will already be thinking in terms of qi flow and the course of the meridians beneath his/her hand and rolling will be directed along the relevant ones.

2. Boosting qi flow in the meridians

Squeezing, kneading and rolling, is now applied with more vigour along the course of the meridians. Fingers and thumbs, the heels of the palms and even the forearms and elbows are now brought into action to give much deeper penetration. At all times pressure is accompanied by movement – a vast spectrum of it ranging from vibratory, rotational, rocking and percussive to large scale pushing and rubbing. Unlike the traditional Thai massage practitioner who uses a very steady, controlled and unhurried approach, his Tuina counterpart constantly changes the tempo. Some techniques, such as two hand chaffing, are done at lightning speed to generate maximum frictional warming; rolling can be effective at up to 140 rolls per minute and others are performed at very slow speed to facilitate more sustained pressure.

3. Stimulating the Qi-points

At this stage the tissues should be softer and more relaxed and thus able to accept deep penetration. Thumbs and elbows are most frequently used to focus pressure onto specific qi-points. Accuracy is very important here and pressure is once again delivered with movement – usually rocking or rotational. Qi-points that are painful when pressed can indicate some sort of qi blockage. For these, penetration must be progressive and during early treatments may never reach the ideal depth for complete release of qi blockage. It is very interesting, however, to see how quickly most people adapt to this very deep and vigorous type of therapy. Some even become addicted to it! The secret of success does not depend only on pressure but much more on the combination of points used in the therapy. Expert knowledge is required before the right choices can be made with certainty.

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