by Bill Helm
Tui na Chinese bodywork is usually thought of as treatment for musculoskeletal problems such as low back, neck, and shoulder pain. Its effectiveness for many internal disorders such as asthma, dysmennorhea, premenstrual syndrome, and diabetes is less commonly known.
Since tui na uses the same traditional Chinese medicinal (TCM) framework as acupuncture and herbal medicine, the symptom patterns can be addressed using tui na methods for activating the flow of qi and Blood through the Zang Fu, channels, and collaterals. Tui na is very helpful in treating asthma. Many of the distressing symptoms associated with asthma such as anxiety and muscle tension in the chest, back, and neck can be relieved with Tuina methods.
Asthma is a complicated disorder that is primarily associated with two major patterns: early onset and lifelong allergic hypersensitivity, and adult onset due to the effects of aging. Both conditions react to a variety of external and environmental pathogens such as cold air, dampness, dust mites, pet dander, pollen, smoke, and exhaust fumes. Regardless of the initiating factor, the result is the constriction of the airways and the discharge of mucous from the lining of the lungs, which produces great difficulty breathing. The person experiences shortness of breath, anxiety, an accelerated heart rate, and wheezing.
Western medicine utilizes preventative inhalers that reduce the sensitivity of the lungs to allergens, and medicines that reverse the bronchial constriction that characterizes an asthmatic attack. If the attack is severe, the person is taken to a hospital and given oxygen and corticosteroids to stop the progression of the attack. Failure to recognize the severity of an attack or to react quickly enough to an attack can be life threatening and result in death. Tui na treatments are used only for mild attacks and chronic conditions.
The TCM theory of the pathology of asthma identifies several patterns:
- Spleen Qi Deficiency with Dampness and Phlegm invading the lung, causing an obstruction with difficulty breathing.
- Kidney Qi Deficiency when the Kidney yang is too weak to draw/ grasp the lung qi downward for inspiration to occur.
- The Liver may also be causative by becoming stagnant and then attacking the Lung with Heat, causing the lung to be unable to descend the qi.
- Asthmatic attacks may be complicated or initiated by wind-cold or wind-heat.
- Asthmatic episodes may feature symptoms of either wind-heat, wind-cold, or asthma as the primary or secondary symptoms
Over the course of a chronic asthmatic condition, the accessory breathing muscles may overdevelop, and there exists a constant state of muscular contraction that eventually becomes a barrier to free breathing. The use of Tui na methods such as rolling, finger springing, press-rub, and pushing can relieve the contractions and descend the rebellious lung qi, opening up the airways and increasing the depth of respiration. This helps to relieve phlegm obstruction. The strategy in using tui na methods is to utilize oscillating techniques to activate the flow of qi, opening the channels and clearing the phlegm-obstruction. The gentle vibration of the kinesthetic wave pattern produced by the techniques penetrates through the surface of the chest and directly stimulates the underlying constricted bronchioles, facilitating an opening of the airways.
Directed pushing methods are used to move the qi in the proper direction through the lung channel. This relieves the obstruction due to stagnant qi. Percussion is used to facilitate the release of phlegm obstruction in the airways. This same type of method is used in Respiratory Therapy to help clear the bronchioles that are clogged by phlegm and mucous. Following the direct application of treatment to the lungs for the immediate effects of the asthma, spleen and kidney tonification methods are then used to increase the body's ability to transform fluids, prevent the formation of phlegm, and increase the depth and strength of respiration by facilitating the kidneys' ability to grasp the qi and draw it down.
The strategy in spleen and kidney tonification is to apply circular rubbing techniques to the abdomen and pressrub to acupoints for the spleen and kidney. Rolling method is used for the back shu points for the same purpose. Following is a tui na treatment for a mild to moderate acute attack of asthma. This treatment can be performed with the client supine or seated.
1. Pushing /thumb - R22 - R17 , down only, 2-3 minutes.
2. Finger springing - R22 - Lu1, R22-17, 2-3 minutes.
3. Divergent pushing - R22-Lu1, R17, 200-300 times.
4. Round-rubbing-R12, epigastric area, 3-5 min.
5. Round-rubbing- Clock/counterclock wise circles w/hypothenareminence following Large Intestine -5-10 min.
6. Press-Rub- Liv14, ahshi pts., ST36,
SP2, 3, 2-3 min.
7. Press-Rub-B20, 21, 2-3 min.
8. Press-Rub-B.23, DU4, K3,7, 2-3 Min.
9. Press-Rub-B13,17, LU9, K3,7 2-3 Min.
10. Chafe -sacrum, low back.
11. Grasping - GB21, 3-5 minutes.
12. Rolling-neck, shoulders, upper back, 3-5 minutes
13. Press/rub - B13, B17, upper spine, Du Channel, ahshi pts
14. Pushing palm - upper chest, back, arm, forearm, down only
15. Grasping - neck, shoulder, arms -L14