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Operation method of massage therapy
There are many kinds of massage techniques used in clinic, different schools and different movements. According to them, there are dozens, even hundreds, but only twenty or thirty kinds are commonly used. These technologies have certain rules in practical application. According to its stress direction, it can be divided into the following five types. (Plane Force Technology)

There are pushing method, kneading method, rubbing method, rubbing method and rubbing method.

1. Push: Push back and forth, up and down, left and right on a certain part or acupoint of the human body with fingers or palms. When pushing, the force should be from light to heavy, and the force should be determined according to different parts. When the force is high, the action reaches the muscles and internal organs; When the force is small, the effect reaches the subcutaneous tissue. The general frequency is 50- 150 times/minute, which starts slowly and speeds up gradually. Massage can be divided into thumb push, palm push, elbow tip push and fist push according to different parts and conditions.

The main functions of massage are relaxing muscles and tendons, promoting blood circulation, relieving spasm and pain, increasing skin strength, promoting muscle growth, eliminating fatigue and relaxing muscles.

2. Kneading method: Knead with fingers or palm surface in a certain part of the body.

Generally, the intensity of kneading is not great, only reaching the subcutaneous tissue, but it acts on the muscles when kneading again. The frequency is 50- 100 times/minute, generally from light to heavy and then to light. This kind of manipulation is mild, and it is mostly used in painful parts or after strong manual stimulation. It can also be used to relax muscles and relieve local spasms. When operating, the fingers and palms should be close to the skin and cannot move between them. At the same time, the subcutaneous tissue can be rubbed, and the scope can be gradually expanded. According to the different massage parts, it can be divided into thumb massage, sole massage, elbow massage, palm massage and so on.

The main function of kneading method is to relieve swelling and pain, promote blood circulation and remove blood stasis, eliminate food stagnation and regulate qi, and help digestion.

3. Moxibustion: Use fingers or palms to rotate clockwise and counterclockwise on the skin surface of a certain part of the body or acupoint. When operating, don't stick your fingers or palms to the skin, and do rotary friction on the surface of the skin, which is gentle and shallow and only reaches the skin and subcutaneous. Massage frequency depends on the condition, generally 30-60 times/minute, 100-200 times/minute. This method uses one-handed rubbing or two-handed rubbing. It is often used to relax muscles at the beginning of massage, or after severe pain and strong massage. The rotation direction of massage is generally clockwise, and there are three kinds of massage: finger rubbing, palm rubbing and palm root rubbing according to different parts.

The main functions of massage are promoting qi and blood circulation, relieving swelling and pain, resolving food stagnation, invigorating spleen and stomach, regulating viscera and enhancing skin elasticity.

4. Wipe method: After flattening the massage part with fingers or palms, rub it to one side with balanced pressure. Its strength can be shallow in the skin and deep in the muscle. Its strength is not big, and the effect is soft. Generally, it is operated by both hands at the same time, or by one hand. According to different parts, there are three methods: finger rubbing, palm rubbing and tendon management. Wipe method is different from push method, and its force is generally heavier than push method. Pushing is a one-way movement, and wiping can move back and forth at will according to different treatment positions. The frequency of wiping is also slower than pushing.

The main functions of wiping method are enlightening, calming, refreshing, dilating blood vessels and increasing skin elasticity.

5. Knead: It is a technique of rubbing back and forth on the skin with fingers or palms. Its force is very shallow, only acting on the skin and subcutaneous. Its frequency is high, reaching 100-200 times/minute. It causes great reaction to the skin, so it is often necessary to rub the skin until it is red, but don't scratch the skin. When operating, use medium lubrication to prevent skin damage. This method can be operated with one hand, and there are finger rubbing and palm rubbing according to different parts. Figure 2 1.

The main functions of rubbing method are invigorating qi and nourishing blood, promoting blood circulation and dredging collaterals, promoting blood circulation and relieving swelling and pain, expelling wind and removing dampness, and dispelling cold with dampness. There are pressing, pinching, dialing, vibrating, bouncing, beating, walking on stilts and rolling.

1. Pressing method: Use your fingers or palms to press down on a certain part of the body or acupoint. The strength of pressing can be as shallow as flesh and deep as bones, joints and some internal organs. When operating, the pressure should be light and heavy, so that the affected part has a certain sense of oppression, which lasts for a period of time, and then slowly relaxes. You can also press and relax rhythmically. This pressing method must pay attention to the strength and frequency of pressing, not too heavy or too urgent, but flexible. According to different parts, diseases and treatment purposes, the manipulations can be divided into thumb pressing, middle finger pressing, fist pressing, palm pressing and elbow pressing. Figure 23. In addition, there is also pressing with a massage tool.

The main functions of massage are dredging meridians, removing blood stasis and relieving pain, and correcting deformity.

2. Pinch method: It is to deeply and continuously pinch a certain part or acupoint of the body with the thumb, middle finger or forefinger. Figure 24. Pinch method has strong stimulation and is often used for acupoint stimulation massage. When operating, the force must be changed from small to large, so that its function can be changed from shallow to deep. When using the kneading method at acupoints, there may be a strong feeling of acid swelling, which is called "getting angry" reaction. Pinch method can also be called pointer method, which means pointer. Another fingercutting method, similar to the pinching method, is to gently and densely knead into rows with one hand or two thumbs, and push forward while pinching. This method is usually used to disperse the swelling by pushing forward when the tissue is swollen.

Pinch methods mainly include stimulating acupoints, dredging meridians, reducing swelling and removing blood stasis, calming the nerves and inducing resuscitation.

3. Dialing method: the fingertips are embedded in the soft tissue space, and then dialed sideways. The stimulation of the dialing method is very strong, and there may be a local acid swelling reaction. The intensity used should be more tolerable for patients. There is also a method called scraping, which is also a method of scraping with fingertips touching thick or indurated soft tissue. The direction of scraping can be determined according to the direction of the lesion.

The main function of scraping is to relieve muscle spasm, relieve tissue adhesion, relax tendons and activate joints, and relieve swelling and pain.

4. Vibration method: a technique of pressing a certain part or acupoint of the body with fingertips or palms to make it tremble continuously. When operating, it mainly relies on the muscles of the forearm and hands to constantly exert force, so that the force is concentrated on the fingertips or palms, forming an impact force and making the massage part tremble. The operation should be firm and fast, so as to have the feeling of deep penetration. Acupoint vibration in some parts is tired by hand vibration, so it can be treated with electric vibrator. But it is better to have an electric head and face massager. Usually, each acupoint can do about 1 minute. The vibration method can be operated with one hand or with two hands overlapping. According to the different treatment sites, it can be divided into three types: finger vibration, palm vibration and electric vibration.

The main therapeutic function of vibration therapy is to relax muscles, regulate nerves, relieve spasm and pain, and eliminate fatigue.

5. Bouncing method: the method of hitting a certain part of the body with the back of your finger. When playing, buckle your index finger with your thumb or middle finger, and then your index finger will slide down, so that the back of your index finger will play hard in your mind. The strength of playing the ball should be light and heavy, and the force should be elastic to avoid pain. This technique is mostly operated by one hand, which is suitable for joints and can be played around joints.

The main function of elastic method is to dredge joints, relax muscles, dispel wind and cold, and eliminate fatigue.

6. Paipai: The method of gently patting a certain part of the body with fingers or palms is called Paipai. Figure 28. The method of hitting a part of the body with a hollow fist or a fist side is the hitting method. The racket method is light, and it is mostly used in chest, back and superficial joints; The heavy impact force reaches muscles, joints and bones. The light and slow operation of the racket can stretch the bones and muscles; A quick blow can stimulate muscles. No matter whether you hit or not, you should use your wrist to exert your strength, from light to heavy, from slow to fast, or from fast to slow alternately. Actions should be coordinated and flexible, and efforts should be flexible. It can be operated with one hand or both hands. According to the different parts of the lesion, the treatment methods of beating and whipping were selected respectively. The racket method can be divided into finger racket, finger back racket and palm racket. The hitting methods can be divided into straight boxing, lying boxing and side boxing.

The main function of racket play is to promote qi and blood circulation, relax muscles and dispel cold, eliminate muscle fatigue and relieve local soreness.

7. Step method (also called foot step method): it is a method of stepping on a certain part of the human body with the sole of your foot and doing various actions. You can press your feet at the same time or alternately. When pedaling, focus on the treatment area with the front of the sole of your foot, loosen and pedal once at a time, and the intensity should be appropriate, and you must not use too much force. The frequency should be slow, the waist treatment should be coordinated with the patient's breathing, and it should not be sudden. In the process of treatment, if the patient is unwilling to cooperate or asks to stop treatment, he must not be forced. This method is mostly used in lumbosacral region and proximal limbs. It is often used to treat lumbar intervertebral disc lesions. Walking on stilts is a combination of pressing, pressing, kneading and pushing, and the massage intensity is relatively high. This method should be used with caution and is not suitable for the elderly, the infirm and children.

8. Rolling method: it is a method of rolling on the body with the back of your hand. During the operation, the metacarpophalangeal joint flexed slightly, the position near the little finger on the back of the palm clung to the treatment site, and the wrist kept swinging to coordinate forearm rotation and wrist flexion and extension. In order to concentrate the rolling force on your fingers, bend your wrist slightly before rolling, open your fingers slightly, and put the back of your hand flat on the massage part to help you exert your strength. However, (3) Massage Qihai, Shenque, Quchi, Neiguan, Shenmen, Hegu, Zusanli and Taichong for about half a minute.

2. The patient prone position

(l) deduction. The doctor puts his hands on both sides of the spine and rubs them repeatedly 5-7 times from the first thoracic vertebra to the lumbosacral region along the bladder meridian of the foot sun.

(2) Rolling method. The doctor put two palms and fingers alternately on both sides of the spine from top to bottom and rubbed them repeatedly for 5-7 times.

(3) Press Ganshu, Shenshu and Mingmen for about half a minute.

3, the patient sit down

(1) pinch method. The doctor holds one shoulder with one hand and the back neck symmetrically with his thumb, food, middle finger and ring finger with the other hand. Repeat the operation from top to bottom for 2 minutes.

(2) Click on Di Feng, Tang Yin, Sunshine and Ren Ying at each point for about half a minute.

(3) tapping method. The doctor taps the neck, shoulders and arms alternately with his hands and four fingers, and repeats the operation for 5-7 times. It is required to slap lightly and quickly.

Precautions:

Tell patients to live a regular life, don't be overworked, exercise properly, keep a happy mood, avoid mental stimulation, and eat less or no irritating food. Then restore your hand to its original half-clenched shape. Click rhythmically to scroll forward. The frequency is about 100 times/minute. When rolling, the force should be even, so that the rolling pressure of the back of the hand will continue to act on the massage part. Don't jump, bump or rub. The rolling method has a deep effect, reaching the degree of muscle layer. Its action surface is also large, and it is mostly used in areas with large soft tissue area and plump muscles. This method is generally operated by one hand and two hands alternately, or by both hands at the same time, or by means of instruments.

The main functions of rolling method are relaxing muscles and tendons, promoting blood circulation, relieving spasm and pain, strengthening muscles and bones, smoothing joints, relieving spasmodic fascia and relieving fatigue. There are kneading, grasping, rubbing and grasping methods.

1. Pinch method: lift the skin and act on the skin and subcutaneous tissue. There are two methods of kneading dough. One is to point your thumb at the middle finger of the food, lift the skin, and twist your hands alternately and push forward. The intensity of manipulation can be light or heavy. In light cases, the patient feels soft and stretched; In severe cases, the patient will feel pain. The frequency can be fast or slow, faster than 100 times/minute and slower than 30 ~ 60 times/minute. The other hand holds an empty fist, with the middle of the index finger facing the thumb, holding the skin, and pushing forward with both hands alternately twisting. The kneading method can be operated with one hand or both hands. Rubbing is often used to treat children's diseases, such as loss of appetite, indigestion, diarrhea, etc., and can also be used for adults to accept rubbing.

2. Grip method: Use your thumb to make corresponding pincer force on food, middle finger or other fingers, pinch a certain part or acupoint, and do a retracting or continuous kneading action. The grip method is different from the pinch method, and the force is concentrated on the fingertip, but on the fingertip and the whole palm surface of the finger. When holding, the wrist should be relaxed and flexible, from light to heavy, and then from heavy to light. At the same time, the method can be combined with the formula and used together. It is often used when lifting the muscle belly. When lifting the muscle belly, you should use force, and the force should be perpendicular to the muscle belly. That is, the longitudinal muscle belly is lifted horizontally and the transverse muscle belly is lifted vertically. The intensity of this manipulation is relatively strong, and the patients respond obviously. Generally speaking, the intensity of manipulation is to feel sore and slightly painful when lifting, and to feel stretched and light after relaxing. Usually, it is a fixed-point holding and lifting technique, and it can also be a mobile holding and pinching technique. According to different diseases and different parts, finger grip, four-finger grip, five-finger grip and shaking grip can be used. Speed can be fast or slow, rhythmic and continuous, neither fast nor slow nor sloppy.

The main function of manipulation is to relieve muscle spasm, regulate excited nerves, dredge collaterals and dispel cold, and eliminate fatigue.

3. Kneading method: It is a method of rubbing hands on limbs. Its acting force can reach muscles, tendons, fascia, bones, joint capsules, ligaments and so on. When the intensity is light, the muscles feel relaxed, and when the intensity is high, there is obvious pain. The frequency is generally about 30- 50 times/minute, and the kneading speed changes from slow to fast at the beginning and from fast to slow at the end. There are two kinds of rubbing methods: palm rubbing and side palm rubbing.

The main function of rubbing method is to disperse meridians, harmonize qi and blood, dredge joints, relax muscles and eliminate fatigue.

4. Formula: Formula refers to the method that the doctor lifts it up by pressing with both hands, or lifts it up (in the opposite direction) by pressing with both hands at the treatment site, or lifts it down by hand. Clinically, it can be divided into two types: pause method and end method.

(1) formula

The patient is sitting. The doctor stood in the patient's case and told the affected limb to raise its head and straighten it (hands inward). The doctor holds the index finger and thumb in his left hand and the ring finger, middle finger and little finger in his right hand. First slowly guide and relax the part, and then lift it hard for three times. Every time you lift 1 time, the joint can make a snapping sound of 1. But avoid using violence when operating.

(2) termination formulation

The patient is sitting. The doctor stood behind the patient, put his hands under the patient's ipsilateral earlobe, put his thumb on the high bone behind the ear, and put his index finger on the corner of the mandible. After aiming and insisting, his hand was forced to stand inward and lift up at the same time. However, when applying this method, it must be noted that the jaws of both hands must be aimed at the lower back side of the patient's ipsilateral earlobe, and both hands should be stuck on the patient's head. At the same time, the patient should be closely observed, and the common carotid artery should not be pressed to cause danger. There are shaking method, stretching method and so on.

1. Shake method: It is a method of shaking the body and also belongs to passive sports massage. When operating, hold the patient's distal end and shake it up and down or left and right while pulling. That is to say, like shaking a rope, the limbs are shaken with rigidity in the softness, so that the limbs fluctuate like waves with the shaking force. According to the different parts and diseases, the times of shaking are different. Shaking generally acts on the wrist, upper limbs, lower limbs and waist. Figure 38. The strength of this method acts on muscles, joints and ligaments, and it has the functions of stretching bones and muscles, smoothing joints, eliminating fatigue and restoring abnormal anatomical positions. For example, lumbar disc herniation is often treated with a shaker.

2. Extension method; It is a method of passively stretching joints when muscles relax. This method belongs to a special passive sports massage. The force of this method can temporarily make the joint beyond the normal range of physiological activities. This kind of operation skill is difficult, and it is necessary to follow the trend, so that the stretching action is powerful but not wild, and the range is large but not wild, just right, just right. Stretching methods can include upper limb stretching, lower limb stretching and waist stretching. Figure 40. The therapeutic effect of stretching method is to stretch joint contracture, correct joint dislocation and enhance limb mobility. There are flexion-extension method, shaking method, plate method and back method.

1. Flexion and extension method: it is a method to help joints with mobility disorders to stretch, flex and fluctuate. Flexion and extension method can also be called stretching method or stretching method, which belongs to passive sports massage. This method must be natural, not violent, stretching force should be applied to the soft tissue that causes joint contracture to overcome its pulling force, and the range of motion of the joint should be expanded by using reverse force. The movement direction should be in accordance with the normal movement direction and angle of each joint. When doing activities, we must gradually increase the possible range of flexion and extension with slow, balanced and sustained strength, and continue activities within this range, and gradually increase the angle of coextensive activities. After flexion and extension to the maximum angle, fix 1-2 minutes, and then slowly relax and recover. Repeat it several times. This method should pay attention to the patient's posture when operating, and should be placed in a position that can fully move the joints to be moved, so as to ensure that the massaged person will not be abnormal because of avoiding pain. Stretching is suitable for all joints of the human body.

The function of flexion and extension is to release adhesion, smooth joints and increase limb mobility.

2. Shake method: Take the joint as the axis and make a light and slow limb rotation. This method belongs to passive sports massage. When operating, the posture should be properly placed, the shaking action should be moderate and steady, the speed should be slow, and the range should be from small to large, depending on the condition. At the same time, we should also pay attention to the normal physiological range of sports joints. Shake is often used to prevent and treat various joint dysfunction. Both biaxial and polyaxial joints can be treated with circular motion, such as wrist jitter and so on.

The function of shaking method is to loosen adhesion, smooth joints and increase limb mobility. Restore one's strength, etc.

3. Pulling method (also called moving method): Pulling method can be applied to several parts of human body, such as shoulder, marrow, waist and neck. It means that one hand presses a certain part of the human body and the other hand pulls other parts. They all use equal and opposite external forces to rotate or extend joints. Figure 44. Pulling is also a passive exercise massage technique, which is often used to treat limb dysfunction and interlocking dislocation of spinal facet joints. Therefore, it can also be considered as a positive backbone method. Pulling is not a large-scale passive movement. During the operation, the joints to be pulled must be extremely stretched or rotated. On the basis of maintaining this position, slightly increase the operation. When pulling, you must make use of the situation to understand the normal range of joint activity and not exceed the physiological function. According to the direction of force and implementation methods, there are several kinds of side pull, back pull and diagonal pull.

The main function of pulling method is to release adhesion, help reset, scrape joints, relieve spasm, eliminate pain and stretch muscles and ligaments.

4. Back method: doctors and patients stand back to back. The doctor bends his elbow to hold the patient's elbow, then bends his knees, puts his hips against the patient's waist, and lifts the patient's back so that his feet are off the ground. Swing left and right, up and down, making the waist feel traction. Figure 45. Pay attention to the elbow hook not to slip off during the operation, and ask the patient not to stand. Back method is often used to treat acute abdominal sprain, lumbar disc disease, lumbar muscle strain and other diseases.