External therapies: Tui na

Two circles that are not the same

推拿 Tuī Ná

The difference between Rou Fa and Mo Fa is depth of action, and it is worth having crystal clear. In Rou Fa hand and skin move together over the deep tissue: there is no sliding between hand and skin, but displacement of the whole over the underlying planes. In Mo Fa the hand brushes the surface in circles without dragging the tissue.

Rou Fa

Hand and skin together over the deep plane

Mo Fa

Superficial circular brushing, no drag; sedating

Mo Fa on the abdomen

Its commonest use, precisely because it is superficial

The hand slides over the skin

Not bad Rou Fa: a different maneuver

Common mistake: Correcting Rou Fa by increasing pressure. If the hand slips, the problem is the grip, not the force.

The three rhythmic maneuvers

Why is the palm cupped in Pai Fa?

1. So it sounds louder and the patient feels the rhythm
2. Because the air cushion turns the blow into a wave that diffuses
3. To avoid tiring the wrist
4. Because it concentrates the impact on one point

Working area for the rhythmic maneuvers, or forbidden area?

• The spineCan be workedForbidden
• The bulk of the thigh muscleCan be workedForbidden
• The kidney areaCan be workedForbidden
• Upper back muscle, lateral to the spineCan be workedForbidden
• A bony prominenceCan be workedForbidden
• The gluteal massCan be workedForbidden

After three sessions in a row your thumbs hurt. What do you review first?

1. Duration: sessions should be shorter
2. Body mechanics: pressure comes from weight and trunk, not fingers
3. The table: it is probably too high
4. Frequency: you cannot chain three sessions

Put a tui na study session in order

1. Initial assessment and agreement on what will be done↑↓
2. Superficial maneuvers to prepare the tissue↑↓
3. Deep work on the relevant plane↑↓
4. Mobilizations within the available range↑↓
5. Gradual closure, lowering the intensity↑↓