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These are only attempted when all the soft tissue work on the affected area has been completed. So important is the qi balancing process and the attainment of a good degree of muscle and connective tissue release that the first three stages of a treatment will require at least three quarters of the time allocated to it. Manipulations are really effective when all the soft tissue and qi-point work has been thorough. Some Tuina manipulations have a simplicity which belies their effectiveness. The extended arm shake and corresponding leg shake are good examples. In the case of the arm, the practitioner grasps the hand over its dorsum with thumbs just over the top of the wrist to give it mild support. Slight traction is applied and the shake is performed with rapid, small amplitude up and down movements. Apart from stimulating all six arm meridians, this generates a series of rapid, short duration pulls on the shoulder joint – wonderful as part of the treatment to restore mobility to a frozen shoulder.

The success of some manipulations e.g arm rotations, often depends on simultaneous pressing of the appropriate qi-points. The author, after having spent countless hours in TCM hospitals in China, is still amazed at the endless variety and subtle nuances of approach that characterise Tuina manipulations.

In China, even hospitals of Western medicine have departments of Tuina and acupuncture. The author strongly supports the view of that rapidly growing group of people who have experienced its benefits, that these should become available in hospitals in the West. Both Tuina and acupuncture gel into a system of therapy that has no equal.

There is no such thing as a full body Tuina massage in China. The Tuina doctor treats just the problem that the patient presents him with, very much like his Western counterpart does. The similarity goes even further. Just as drugs have side effects so does Tuina . . . . but here the similarity ends. Side effects resulting from the Chinese therapy are almost always good ones except some mild aching or soreness after receiving a first Tuina session. The reason for this is that successful balancing of qi in one area of the body results in improved qi status throughout.

Focusing as it does on specific meridians and acupoints, Tuina is able to treat all those conditions that in the West would be treated by osteopathy, chiropractic and physiotherapy plus a lot of others that would be treated with drug therapies. It excels in the treatment of chronic pain associated with the musculo-skeletal system such as neck and shoulder pain, fibrositis, lumbago, sciatica, muscle spasms, tennis and golfer's elbow, and frozen shoulder. As a means of treating sports injuries, it is unsurpassed. To this long list can be added chronic problems such as headaches, migraines, constipation, IBS, insomnia, tension and restless mind.

Brilliantly effective as it is, however, Tuina is not a miracle cure-all. It does not treat all migraines effectively. Some require a combination of acupuncture and Tuina. Knee problems are likewise less responsive to the hands on treatment than to acupuncture. In combination, acupuncture and Tuina can often seem to be a means of dispensing miracles! Both work in the same way to create qi balance and both achieve their effects holistically by treating the whole person to help the individual parts function more effectively. The lack of negative side effects or any kind of damaging impact on our seriously threatened environment, makes Tuina as relevant today as it ever has been during its very long history.
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