Asian bodywork therapy (ABT) is a term that describes different forms of bodywork based on concepts from traditional Chinese medicine (TCM). This article briefly explores tui na, shiatsu, and Thai massage to inspire further exploration by therapists early in their massage careers. It is important to point out that these systems are complex and require in-depth study and training for mastery. As you move from your massage classroom to working with clients, concepts and methods from ABT obtained through continuing education classes can expand your perspective on wellness and enhance your bodywork repertory.
Traditional Chinese Medicine Concepts
Yin and Yang
The ancient Chinese classified all phenomena as yin or yang based on observable properties related to fire and water. Yin is defined by the properties of water and any objects or phenomena that have characteristics similar to water (cold, dim, heavy, moist, or a tendency to sink). Yang is defined by the properties of fire and any objects or phenomena that have characteristics similar to fire (warmth, brightness, excitability, lightness, activity, or a tendency to rise). In a healthy body, yin and yang uphold and restrain each other to maintain a dynamic equilibrium, but if there is a predominance or deficiency of one aspect, this equilibrium is lost and disease or dysfunction can result.
Qi
Pronounced “chee,” qi is the energy that underlies everything in the universe, including the human body. If we view the body as an energetic system, as Eastern cultures do, it makes sense that outside forms of energy such as the changing of the seasons, the nutritional value of food, the quality of the air, pathogens, or environmental factors like cold and dampness could alter the flow of qi in and around the body, thereby influencing health and wellness. In ABT, the goal of treatment is to promote the harmonious flow of qi through and around the body.
The Five Elements
The five elements—wood, fire, earth, metal, and water—are believed to manifest as particular physical, mental, emotional, and spiritual characteristics in people. Understanding the five elements and their correspondences provides ABT practitioners clues that can influence treatment goals and techniques. For example, if the wood element is balanced, a person demonstrates benevolence, patience, and compassion. If the wood element is unbalanced, a person may be prone to anger, belligerence, or irritation. If one element exerts undue control over another, an imbalance results. Disease is the result of a destructive relationship between the five elements.
The Meridian System
This is an energy network composed of channels where qi flows to transmit energy to different areas of the body and to regulate the function of organs and body tissues. Qi flows through channels in a specific pattern and direction. Most often, channels run parallel to major blood vessels and nerves, allowing them to affect each other’s function. For example, if qi is blocked in an area, there is usually decreased circulation of blood in that region, which then affects local organs and tissue, including muscles.
Acupoints
Also known as qi xue (meaning “energy cavities”) in Chinese, qi points in tui na massage, or tsubo (meaning “body points”) in Japanese, these are places along channels where qi can be accessed and manipulated to improve qi flow. ABT therapists manipulate disordered qi at acupoints for a particular therapeutic effect, and to bring qi back into balance, promote the normal flow of qi, and to encourage general health and wellness. On average, there are approximately 150 points commonly used by acupuncturists.
Sample ABT Systems
Now that you have a brief overview of some essential ABT concepts, let’s explore some sample techniques from tui na, shiatsu, and Thai massage.
Tui Na
This is a bodywork form practiced as part of TCM for more than 4,000 years. Tui means “push” and na means “grasp” in Chinese, conveying the vigorous and firm quality of this massage system where squeezing, compression, kneading, and joint movements are used to positively manipulate qi. Tui na is applied with the client fully dressed and without the use of a massage lubricant. (See Sample Methods from Tui Na, page 101.)
Shiatsu
As a bodywork form composed of the Japanese words shi meaning “finger” and atsu meaning “pressure,” finger pressure is the primary technique used in shiatsu, but the palms, hands, elbows, knees, and even the feet might also be used to deliver pressure to body areas, and stretches are used to loosen joints. Shiatsu aims to promote the uninterrupted flow of qi through the channels, often called meridians, by manipulation of acupoints to improve health and wellness.
Shiatsu practitioners often refer to the term hara, which means abdominal region or belly. The practitioner’s hara is the source of his or her qi and brings strength and purpose to the session. All of the therapist’s movements and power originate from the hara and protect the therapist’s body from overexertion. Working from the hara is a concept unique to shiatsu and refers to the use of the practitioner’s own qi to stabilize the qi of the client. Hara also describes a person’s ability to achieve goals and actualize ideas. If someone works hard to accomplish a particular task, he or she is said to have good hara. People with good hara are not intimidated by setbacks and instead persist, even when circumstances are difficult. Aligning energy in the hara helps to harmonize the body, mind, emotions, and spirit of the practitioner so he or she can deliver the best possible treatment for the client. During a shiatsu session, the client reclines on a mat placed on the floor and the practitioner uses a kneeling or squatting stance to apply techniques. (See Sample Methods from Shiatsu, page 103.)
Thai Massage
Thai massage places an emphasis on the concept of vata, or wind, in the body and believes that when wind is out of balance, disease is likely to take root or develop from mild symptoms into a serious condition. Life force energy (Thai massage uses the term prana from ayurveda) travels on pathways called sen, which are closely related to the meridian system of Chinese medicine. There are 10 primary sen pathways that connect the abdominal region, where wind is held in the lower abdominal cavity, to the rest of the body. Thai massage is applied to a fully clothed client without massage lubricant. During the session, the client reclines on a mat while the practitioner applies techniques slowly with mindfulness. (See Sample Methods from Thai Massage, at left.)
There is much to learn about ABT and its complex systems, but this knowledge will eventually enhance your client sessions and ultimately put more tools in your massage and bodywork repertoire.
Anne Williams is the director of education for Associated Bodywork & Massage Professionals and author of Massage Mastery: from Student to Professional (Lippincott Williams & Wilkins, 2012) and Spa Bodywork: A Guide for Massage Therapists (Lippincott Williams & Wilkins, 2006). She can be reached at anne@abmp.com.
Sample Methods from Tui Na
Cuo Technique
The cuo technique, also referred to as foulage, is most often applied to the extremities or upper torso region. The practitioner’s hands are placed on either side of the area and rubbed back and forth rapidly so that the area twists with the movement. This technique is believed to regulate the flow of blood and qi, lubricate joints, and relax muscles.
Grasping Technique
Use one or two hands to slowly lift tissue in a particular region. Lift the tissue until all the slack in the tissue is removed. Continue to lift the tissue as you slowly and gently pull and twist it back and forth. Repeat this application to the same region until the tissue starts to soften. It is believed to improve consciousness, expel excess wind and cold, promote blood circulation, and relieve pain.
Bashen Technique
(Pull-Extend)
In this technique, the ends of a joint are pulled with even force in opposite directions at a slow pace and for a prolonged period. On the extremity, pull the arm out from the shoulder, then grasp the hand and pull on the hand while pushing the forearm back toward the elbow. Finally, pull each finger while holding directly above the wrist and pushing the tissue above the wrist toward the elbow.
Sample Methods from Shiatsu
Baby Walking
Position your body so you are kneeling next to the client and facing across the client’s back. Place your hands on the client’s back and allow your weight to drop through your palms. Now, move your hands over the client’s back as if you are a baby crawling on all fours. You can walk all over the back and posterior legs, but avoid placing direct downward pressure on areas of caution, like the popliteal fossa.
Retreating Cat
Position your body at the top of the mat by the client’s shoulder and facing toward the client’s feet. Glide your hands down either side of the client’s spine until your hands reach the client’s gluteal muscles. Press down on the gluteal muscles to stretch the back. Now “walk” backward with your hands from the client’s gluteal muscles to her shoulders. Repeat this process three or four times.
Heel Pulling
Position your body so you are standing at the end of the mat by the client’s feet. Lift the feet up to your waist by grasping the feet under the heels and lifting them slowly and steadily upward. Hold the feet in this position so that the client experiences a stretch in the low back.
Sample Methods from Thai Massage
Torso Lift
Position your body on one side of the client by her anterior superior iliac spine. Place your hands on both sides of the client just below her ribs and lift with both hands, bringing the client’s low back off the floor. Hold this position for a breath and repeat the lift two to three times.
Diagonal Back Stretch
Place one hand on the client’s scapula and the other on the posterior superior iliac spine on the opposite side of the back. Press down with both hands so the back is elongated. Repeat the stretch on the other side of the client.