CMTN211 Session 09 Yao Fa & Ba Shen Fa Chinese Medicine Department www.endeavour.edu.au
CMTN211: Session 9 o Rotating method (yao fa) o Pulling Stretching method (ba shen fa) Rationale Clinical usages Mechanics Cautions & contraindications Demonstration & supervised practice Endeavour College of Natural Health www.endeavour.edu.au 2
General tips and contraindications for passive movements First ask patient to move the joint as far as possible through its natural range of movement, telling you when they feel restriction or pain. Before applying passive movements, stimulate distal and local points and work with basic, other techniques on the channels sinews that relate to the affected joint first. Endeavour College of Natural Health www.endeavour.edu.au 3
General tips and contraindications for passive movement Yao fa (rotating) and ba shen fa (pulling stretching) are relatively simple and safe to perform; remember to mobilize slowly and smoothly, stopping if you feel any resistance to what should be a normal movement. If a patient is very elderly or frail and weak, only apply very gentle yao fa (rotating) or rocking movements to the joints but no other passive movement. Endeavour College of Natural Health www.endeavour.edu.au 4
What is a manipulation? A MANIPULATI ON is any movement that: Takes a joint BEYOND it s end range of movement (EROM) Involves elements of THRUST Involves elements of FORCE Involves elements of SPEED Endeavour College of Natural Health www.endeavour.edu.au 5
Manipulation Ban Fa NOT to be performed by Tui Na practitioners because: Against the law in Australia Breaches Tui Na Scope of Practice Deaths have occurred when attempting manipulations in Australia! Endeavour College of Natural Health www.endeavour.edu.au 6
What is a Mobilisation? A MOBILISATION is any movement that: Remains within any joint s normal range of movement/motion Does not involve elements of thrust Does not involve elements of force Does not involve elements of speed Mobilizations are generally safe for a trained Tui Na practitioners to perform Endeavour College of Natural Health www.endeavour.edu.au 7
Rotating Method (Yao Fa) Chengnan 2000 pp.69 Endeavour College of Natural Health www.endeavour.edu.au 8
Rotating (yao fa): rationale Passive circular movement of the joints through natural range of movement Designed to lubricate joints and relax surrounding tissue. Applied when channel sinews are warm. Patient needs to be relaxed and allow you to take the weight of their arm, leg or head. Endeavour College of Natural Health www.endeavour.edu.au 9
Rotating (yao fa): mechanics Yao fa for the head/neck: Support patient s head at occiput & forehead/chin. Use small, smooth circles to rotate the patient s head. Gradually increase the circle size. Repeat 10 times & rotate head the other way. (Imagine you are rolling a football in your palms) Endeavour College of Natural Health www.endeavour.edu.au 10
Rotating (yao fa): mechanics Apply this technique to these areas: Shoulder - Straightforward - Large amplitude - Flexed elbow -Patient prone Elbow Wrist Hip knee Ankle Endeavour College of Natural Health www.endeavour.edu.au 11
Rotating (yao fa): where to use? o Neck o Shoulders o Elbows o Wrists o Waist o Hips o knees o Ankles o Any joint in the body Endeavour College of Natural Health www.endeavour.edu.au 12
Rotating (yao fa): clinical usage Functions: Lubricate the joints Helping Qi & Blood to flow to joints Restoring joint s full range of movement Relaxes muscles, tendons & ligaments Breaks up adhesions Releases muscular spasm Endeavour College of Natural Health www.endeavour.edu.au 13
Rotating (yao fa): clinical usage Indications: Joint & channel sinew problems Stiffness, swelling & pain Restricted joint mobility Frozen shoulder Tennis & golfer s elbow Injuries Bi syndrome Wei syndrome Endeavour College of Natural Health www.endeavour.edu.au 14
Rotating (yao fa): cautions/contraindications Cautions: Contraindication: (Hongzhu, 2007, pp.284) Be aware of the normal joint movement. Fractured or dislocated joints If a joint is dysfunctional, adjust your technique. Myelopathy type Cervical spondylosis Take great care with the neck. Vertebral artery type of Cervical spondylosis For patients with excessive stiffness of cervical muscles, supine position is advisable Endeavour College of Natural Health www.endeavour.edu.au 15
Tips: Rotating (yao fa): demo & practice Start with small circles and get larger Work smoothly and don t rush Perform the technique on bilateral joints Hold they patient so they feel secure Be aware of restriction as you work Do not force a joint Endeavour College of Natural Health www.endeavour.edu.au 16
Pulling Stretching Method (Ba Shen Fa) Chengnan 2000 pp.67 & Jin Hongzhu 2007 pp76/284 Endeavour College of Natural Health www.endeavour.edu.au 17
Pulling Stretching (ba shen fa): rationale Stretching the channel sinews to create space for the joints. Used towards end of treatment. Endeavour College of Natural Health www.endeavour.edu.au 18
Pulling Stretching (ba shen fa): mechanics Hold either side of the joint Pull your hands in opposite directions. Hold 20-30 seconds In the case of the neck use patient s body weight Endeavour College of Natural Health www.endeavour.edu.au 19
Pulling Stretching (ba shen fa): mechanics Apply this technique to these areas: Neck - Seated version 1 - Seated version 2 - Lying supine Shoulder - Straightforward seated - Arm over your shoulder - Lying supine/prone Elbow, wrist & finger Lower back - Lying prone Ankle Endeavour College of Natural Health www.endeavour.edu.au 20
Pulling Stretching (ba shen fa): where to use? o Cervical vertebrae (neck) o Shoulders o Elbows o Wrists o Fingers o Lumbar vertebrae o Hips o Knees o Ankles o Toes Endeavour College of Natural Health www.endeavour.edu.au 21
Pulling Stretching (ba shen fa): Functions: clinical usage Creates space in joints Regulates Qi & Blood flow Relaxes muscles & tendons Frees obstruction from joints & channel sinews Releases adhesions Helps to realign joints Alleviates pain Endeavour College of Natural Health www.endeavour.edu.au 22
Pulling Stretching (ba shen fa): clinical usage Indications: Bi syndrome Wei syndrome Headaches & migraine (neck) Musculoskeletal disorders & injuries Frozen shoulder Tennis elbow Acute lumbar sprain RSI Carpal tunnel syndrome Trigger finger Endeavour College of Natural Health www.endeavour.edu.au 23
Pulling Stretching (ba shen fa): Cautions: cautions/contraindications Warming up first Do not force a joint outside of normal range of motion. Avoid violent force and action. Be careful with the neck. (Hongzhu, 2007, pp.286) Endeavour College of Natural Health www.endeavour.edu.au 24
Tips: Pulling Stretching (ba shen fa): demo & practice Use towards end of treatment Apply traction starting gently Apply traction smoothly and with great care Hold the stretch for 20-30 seconds Endeavour College of Natural Health www.endeavour.edu.au 25
References Chengnan, S 2000, Chinese bodywork: a complete manual of Chinese therapeutic massage, Pacific View Press, Berkeley, CA. Hongzhu, J 2007, Science of Tuina = Tui na xue, 2 nd ed., People s Medical Publishing House, Beijing Pritchard, S 2010, Tui na: a manual of Chinese massage therapy, Churchill Livingstone, Edinburgh. [Access ScienceDirect ebooks] Zhang, YS 2002, Tuinaology, People s Medical Publishing House, Beijing Endeavour College of Natural Health www.endeavour.edu.au 26