acupressure; a science and an art

By Lori-Ellen Grant

When you press your thumb deeply into tissue, using acupressure, there is a sense of connecting, one person to another. With this link established, the Qi (pronounced “chi”) flows. Qi energizes, stimulates and transforms. When acupressure techniques are combined with knowledge of Chinese Medicine, the science and the art, it is possible to influence the entire body and its ability to heal.

What is Acupressure?

Acupressure is a form of physical manipulation that uses the fingers/thumbs to apply pressure to traditional acupuncture points. As well as being used within a massage session, you can teach clients to use it at home. It can correct internal organ malfunctioning, stimulate blood circulation and release muscle tension. It can also help to relieve acute pain, manage chronic conditions and is excellent for promoting and maintaining general health.

The Nei Jing (one of the earliest Traditional Chinese Medicine texts) states that 5,000 years ago, the Chinese discovered that pressing certain points on the body relieved localised pain as well as benefiting other more remote areas of the body.[1] Soldiers reported that, surprisingly, symptoms of disease were alleviated where stones and arrows had struck or pierced particular parts of the body. As a result, Chinese physicians learned to strike or pierce certain points on the body to alleviate specific illnesses.[2]

Acupressure may also have developed quite intuitively, through the treating of injuries incurred through labour. In the age of hunter gatherers, injuries such as fractures, contusions and strains were common. When these occurred, people would instinctively apply pressure to stop bleeding and rub afflicted areas to reduce swelling and alleviate pain. Gradually, as understanding of these techniques increased, people synthesised some primitive acupressure methods, which later helped to inform the acupressure techniques used today.[3]

How does Acupressure work?

The principle behind the use of Acupressure treatment is to increase the circulation and functioning of Qi[4] through the meridians that connect internal and external functions of the body. “Meridians/Channels are an invisible network linking vital substances to organs and carrying nourishment and strength. Meridians/Channels unify all parts of the body which is essential to remaining in a harmonious balance.”[5]

Once you have assessed which meridians are causing symptoms of pain or dis-ease, you can choose the most appropriate acupressure points. When an acupressure point is manipulated, it activates the associated channel / meridian, allowing qi to flow freely through it. This assists the muscles to relax, balances the meridian, and harmonises the internal organs. This process of nurturing and balancing links the inner and outer aspects of the body, supporting overall health and healing.


Massage styles and Acupressure

Acupressure relates to and can compliment several different styles of Massage. Chinese massage or Tuina (Chinese for “pushing and pulling”), which places emphasis on soft-tissue manipulation and structural realignment, also incorporates acupressure into techniques. Shiatsu, by contrast, is actually a Japanese form of acupressure. Its literal translation is finger (shi) pressure (atsu). Pressure is applied with hands, thumbs, fingers, elbows, knees and feet, depending on the style of Shiatsu practiced. It can consist of simple manipulations and pressure applied to acupuncture meridians and points.[6]

A common question is the relationship between acupressure points and trigger points; palpable nodules in taut bands of muscle fibres. Compression of a trigger point may elicit local tenderness, referred pain, or a local twitch response[7]. While acupressure points can, at times, correspond to trigger points, there is an important difference between the two. Manipulating a trigger point releases tension in the affected muscle and the structures directly surrounding it. In contrast, stimulating acupressure points means working with an awareness of the whole channel in the body, not just the portion of it where the symptom is localised. This means supporting and energising all of the channel’s functional connections, both inner and outer.

When can Acupressure be used?

There are two ways acupressure can be most useful for the massage therapist.  One is addressing common ailments seen in the clinic, such as tiredness, insomnia, sinus problems, headaches and stress related symptoms, to name just a few. When dealing with these, treatment may incorporate not only points related to meridian theory, but also specific locations around the body known as ‘empirical’ points. These are key acupressure points that are highly regarded for their functional effect on such ailments.

Another useful application of acupressure for massage therapists is to treat musculo-skeletal problems, with a focus on meridian theory. Where is the problem and which meridians traverse the affected area? Through stimulating points on the related channel, above and below the ailment and/or locally, a functional effect can occur. The stimulation of these points encourages qi flow in the meridian and assists in reducing pain by moving the qi through the affected area.

Clinical study confirms benefits of Acupressure

A recent study published in the British Medical Journal has shown that Acupressure is effective for treating back pain in terms of reducing disability and pain scores and increasing functional status. The study, which compared Acupressure and Physical Therapy[8], showed that overall Acupressure was more effective in these areas both immediately after the treatments and at the 6 month follow up. [9]

In my personal practice I have had some great successes using acupressure. In one case, a 40 year old female client presented with chronic headaches which she had been experiencing for 10 years.  During six massage sessions over a 4-5 month period, I incorporated acupressure into my treatments, using both meridian theory and empirical points with excellent functional effects. The client experienced a great reduction in her pain levels (from 9/10 to2/10), with the result that she needed less medication to treat her symptoms.  She also reported a marked increase in her ability to function effectively at work.

There is huge potential for the use of acupressure clinically with its clearly defined framework of Chinese Medicine and intuitive approach during palpation; the science and the art. These two are like night and day, one filled with reason, the other intuition. Together there is a whole approach, a balance, harmony and therefore, health.


References:

Chang, Dr Steven Thomas, ‘The Complete Book of Acupuncture’, Berkley Celestial Arts, 1976

Li, Bin, (Tuina Practitioner/Teacher), Chinese Tuina/Massage Notes, CCHH, 2005

Tukapua, Cameron, Form and Movement Notes, CCHH 2005

‘Huang-di Nei Jing Su-wen’(Inner Classic of the Yellow Emperor), Beijing, People’s Press, 1963

Shiatsu Therapy Association of British Columbia  -www.shiatsutherapy.ca

Travell, Janet; Simons, David; Simons, Lois (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual (2 vol. set, 2nd Ed.). USA: Lippincott Williams & Williams.

Tony Hsiu-His Chen Treatment of low back pain by acupressure and physical therapy; randomized controlled trial, February 17 2006, British Medical Journal 2006;332 (25 March), doi:10.1136/bmj.332.7543.0

Veith, Ilza (translation), “The Yellow Emperor Classic of Internal Medicine’, Berkley, University California Press, 1949

acupuncture & pregnancy

By Lori-Ellen Grant

As I write this, I have Maja (17 days old) sitting on my lap. Her mother had a homebirth in Wanaka and I had planned to be at the birth, yet Maja decided to arrive 2 weeks early…the beauty of letting life take its own course…

Acupuncture and Massage Therapy are great additions to a woman’s experience; from fertility, to pregnancy, the childbirth itself and then post-natal care. Chinese medicine has been well designed to create balance, physically, mentally and emotionally.

Relationships strengthen, bodies change shape, a deeper sense of home is created and careers make room during the transformational period surrounding childbirth. Embarking on this journey to nourish a child means that supporting oneself is well worth cultivating.

How does Acupuncture work?

Every phenomenon in the Universe is a manifestation of Qi originating from the Tao (Oneness). The character for Qi is ’cooking rice’. It can be as immaterial as vapour and as dense/material as rice. This is how Acupuncture, which influences the Qi, can treat simultaneously on a physical and mental/spiritual level.

Qi energizes, stimulates and transforms. The principle behind the use of Acupuncture is to increase the circulation and functioning of Qi through the meridians that connect the body both inside and out.

Meridians/Channels are an invisible network linking vital substances to organs and carrying nourishment and strength. Meridians/Channels unify all parts of the body which is essential to remaining in a harmonious balance.

Treatment
In your first Acupuncture treatment you will be asked about all aspects of your life, including your present and past well being, in order to develop a clear picture of your overall health. This assists with diagnosis and treatment and helps the practitioner to make appropriate lifestyle and dietary recommendations. Treatment may include acupuncture, moxibustion (herbal heat treatment), massage or tuning forks (sound healing).

It is important to note that while a woman is pregnant it is not necessary for needles to be inserted on the abdomen. Points away from the belly can be stimulated since the Qi moves through the meridians/channels to treat the local area.

How can Chinese Medicine help me conceive?

We can begin to look after ourselves before conception, to ensure the health of the baby. Acupuncture is useful to regulate and harmonise the menses which makes conception easier. The body can get into a clear rhythm ensuring the release of a healthy egg. Chinese medicine can support internal organ functions, stimulate blood circulation, release muscle tension and is excellent for promoting and maintaining general health.

How can Chinese Medicine help me during pregnancy?
Acupuncture offers women drug-free pain relief which can be a useful preventative treatment before medical intervention. It can assist with many discomforts that are often considered normal in pregnancy; morning sickness (nausea), urinary tract infections, fatigue, oedema, constipation, and musculoskeletal problems to name a few.

Due to the body changing shape, support for the tendons and ligaments can be particularly useful. Massage can help by stimulating blood circulation and relaxing the muscles and tendons, which assists the body to adjust to the physical changes of pregnancy. Back pain, hip pain, pubic symphysis discomfort can all be well supported with massage and acupuncture.

Pre-birth Acupuncture from week 37-39 is a safe and effective treatment to promote natural labour. It involves certain points that assist with dilating the cervix, relaxing the ligaments, and promote the descending of the head.

Also at this time, the practitioner can include points to treat other ailments. Research has demonstrated that the mean duration of labour in a group of women giving birth for the first time was reduced from 8 hours and 2 minutes to 6 hours and 36 minutes in the group of women that received pre-birth acupuncture. Midwives have reported a reduced rate of medical interventions with the use of pre-birth-acupuncture.

Using the heat treatment, moxabustion, is an effective way to change the position of the baby when there is a posterior or breech presentation. This can be self administered by the mother with guidance from their acupuncturist. An Italian study showed that 75.4% of babies in the moxabustion group turned compared to 47.7% in the control group.

How can Chinese medicine help me after birth?
Post-birth, women in China would traditionally stay home for a month. In our society this may be considered a long time, yet the less that is done actively at this time then more energy is able to go into restoring the body while caring for the newborn child. Rest is important.
Directly after birth the partner or a support person can massage down the mother’s chest to the abdomen, breathe in on the down stroke, remove the hand and breathe out. This helps to release any blood that may become stuck . Also, in the first week,

it can be helpful to gently massage the feet, every night before sleeping. This descends the Qi which can also help release any old blood in the uterus. On the 4-5th day after birth ‘mother warming’ can be used to tonify after birth. This is using moxabustion on the abdomen to energise and aid post-birth recovery. This can be guided by your acupuncturist and is best not to be used if the mother has a fever or has been feeling hot at night. It can be done in the comfort of the mother’s own home by her partner or support person.
Support for regaining strength, haemorrhoids, constipation, bleeding, abdominal pain, post-natal depression, and breast feeding is all available with Chinese medicine.

As women we are so beautiful, so resourceful and so full of creativity. I watch my friend with her first baby and hear her saying how amazed she is that her body knows what to do so naturally. Being here to cook for her, hold Maja so she can sleep, massage her neck and shoulders after breast feeding and treat her fever is a joy. A deeper sense of love and care emanates giving me the drive to share the knowledge of these tools with women in all stages of their journey.

Arohanui

References:

  • Tukapua, Cameron, Form and Movement Notes, CCHH 2005
  • ‘Huang-di Nei Jing Su-wen’(Inner Classic of the Yellow Emperor), Beijing, People’s Press, 1963
  • Kubista E, Kucera H (1974) Uber die Anwendung der Akupunktur zur Geburtsvorbereitung, Geburtshilfe Perinatol: 178, 224-9
  • Cardini et al (1998) Journal of the American Medical Association
  • McBride, Paddy, Gynaecology Notes CCHH Feb 2005
  • Betts, Debra, (2006) ‘The Essential Guide to Acupuncture in Pregnancy and Childbirth’ The Journal of Chinese Medicine