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Chinese Tuina

Course Title: Theories of Chinese Tuina Massage
Author: Antonio Carrico, LMT, MS., ND

Course Objectives

  • Learn the aspects of Tuina therapy
  • Understand the application of techniques during a Tuina session
  • Explore the history of Tuina
  • Compare Tuina with other bodywork treatments
  • Learn about types of health conditions that can benefit from treatments using Tuina
  • Learn the procedures involved in a Tuian session
  • Explore the indications and contraindication of Tuina massage

Passing Grade

Passing Grade will be based on 70% of correct answers and participants can retake the test as many times will be necessary in order to reach the appropriate passing grade.

How Should You Complete this Course

1. Read each course page and complete the exercise questions if applicable.

2. After you have finished reading the last course page , click on the link to take online test.

3. After receiving at least 70% passing score, allow us 48 hours to email you the certificate of completion.

Course Contents

This course begins with an overview on the basic principles of Chinese Tuina massage, focusing on the history and practice. After participants have been introduced to some of the basics of Tuina, they will begin their study by exploring the fundamentals of Tuina. Students explore about techniques, history, application, indications and contraindications of Tuina massage.

Part 1

Tui na or tuina pronounced (tōō·ē nä) or pinyin: tuī ná), is a form of Chinese manipulative therapy often used in conjunction with other forms of Chinese therapies. Tui na is a hands-on body treatment that uses Chinese Taoist and martial arts principles in an effort to bring the eight principles of Traditional Chinese Medicine (TCM) into balance. The practitioner may brush, knead, roll/press, and rub the areas between each of the joints, known as the eight gates, to attempt to open the body's defensive (wei) chi and get the energy moving in the meridians and the muscles. The practitioner can then use range of motion, traction, and massage, with the stimulation of acupressure points. These techniques are claimed to aid in the treatment of both acute and chronic musculoskeletal conditions, as well as many non-musculoskeletal conditions. Tui na is an integral part of TCM and is taught in TCM schools as part of formal training in Oriental Medicine. Many East Asian martial arts schools also teach Tui na to their advanced students for the treatment and management of injury and pain due to training. As with many other traditional Chinese medical practices, there are several different schools with greater or smaller differences in their approach to the discipline.

In ancient China, medical therapy was often classified as either "external" or "internal" treatment. Tui na was considered to be one of the external methods, thought to be especially suitable for use on the elderly population and on infants. Today, Tui na is subdivided into specialized treatment for infants, adults, orthopedics, traumatology, cosmetology, rehabilitation, sports medicine, etc

Part 2

Techniques Used in Tui Na

Tui Na uses rhythmic compression along energy channels of the body, as well as a variety of techniques that manipulate and lubricate the joints. Like acupressure, Tui Na directly affects the flow of energy by holding and pressing the body at acupressure points.

To a Westerner, Tui Na is the form of Asian bodywork most closely resembling conventional western massage. Many of the techniques are similar -- gliding (known as effleurage or Tui), kneading (petrissage or Nie), percussion (tapotement or Da), friction, pulling, rotation, rocking, vibration, and shaking. Despite the similarities, the intent of Tui Na is more specifically therapeutic than the simple relaxation of a Swedish-style massage.

One of Tui Na's advantages over simple massage is its ability to focus on specific problems, especially chronic pain associated with the muscles, joints, and skeletal system. It's especially effective for joint pain (such as arthritis), sciatica, muscle spasms, and pain in the back, neck, and shoulders. It also helps chronic conditions such as insomnia, constipation, headaches (including migraines), and the tension associated with stress.

Tui Na does not simply work on the muscles, bones, and joints. It works with the energy of the body at a deeper level. As the practitioner senses the client's body with her hands, she is able to assess the distribution of energy and affect its flow.

As with other styles of Asian bodywork, Tui Na is designed to prevent problems, not just correct them. By keeping the body's energy in balance, health is maintained. This is true not just for physical health, but for mental and emotional well-being as well.

Video Presentation 1

Part 3

History of Tui Na

Tui Na, which dates back to 1700 BC, is the parent of most modern Asian bodywork forms. Like all forms of Chinese Medicine, the practice of Tui Na in China suffered during the political and social upheavals of the 20th century. In 1929, the Chinese government instituted a policy eliminating the "old" medicine. In 1936, Chinese Medicine was denounced as having no scientific foundation and its practice was banned.

Tui Na survived as a popular form of healing among the general Chinese population, whereas Tui Na is a more specialized term indicating practices based on the theories of Chinese medicine.

After the Communist Revolution in 1949, the policy against traditional medicine changed, and the tradition of Chinese medicine was encouraged. There were further setbacks, however, during the Cultural Revolution of the 1960's and 70's.

The style of Tui Na practiced in China today is closer to the work of chiropractors, osteopaths, and physical therapists than to that of massage therapists. It's taught as a separate but equal field of study in schools of Traditional Chinese Medicine, requiring the same level of training as acupuncturists and herbalists.

As Tui Na has migrated to the West and become popular, the style of work has been modified. Most western trained Tui Na practitioners do not do "bone setting," as do their counterparts in China. Western style Tui Na can be thought of as a therapeutic extension of western massage, with an emphasis on restoring and balancing energy.

Part 4

Tui-Na vs. Other manual treatment methods

Tui-Na is also unlike either massage or chiropractic in technique and theory. On a theoretical level, Tui-Na uses traditional Chinese medical theory as a basis for treatment. Concepts of chi (ch’i, qi, or ki) energy, blood, yin & yang, and essence play pivotal roles. On a technical level, Tui-Na is far more broad and encompassing than either general massage or other bodywork therapies. General massage, by and large, does not treat diseases, but rather relaxes muscle tension and increases local circulation to relieve discomfort. However, most massage systems lack the kind of comprehensive scope that Tui-Na is known for. Most massages is also unable to effectively treat disturbances in bone alignment. Some manual therapies, on the other hand, while it may reliably reduce misalignments in bony structures, generally do not spend adequate time treating the muscles surrounding the bony structures before and after re-alignment. As a result, many patients of Western manual therapies complain of a rebound effect following treatments. Tui-Na, however, treats the muscular tension surrounding bony structures in such a way as to minimize the rebound effect immediately following treatments.

Part 5

Procedures Involved in a Tui Na Session

In a typical tuina session, the client remains clothed but wears loose clothing, and sits on a chair or couch. The practitioner will ask the patient a series of questions, and then begin treatment based on the answers to those questions.

Tuina practitioners may employ a variety of methods to achieve their goal. Commonly used techniques include soft tissue massage; acupressure and mobilization. Practitioners may sometimes use herbal compresses, liniments, ointments and heat to enhance these techniques.

Typical ailments that are successfully treated by Tui Na include:

  • Back pain
  • Neck pain
  • Hand / finger/ wrist problems (carpal tunnel)
  • Shoulder pain/ frozen shoulder
  • Migraines
  • Insomnia
  • Stress
  • Poor circulation
  • Digestive problems
  • Knee/ankle problems
  • Hip pain
  • Foot pain / plantar fasciitis
  • Sports injuries (tennis elbow, hamstring/ calf strains, Achilles tendinitis)
  • Pre/post event preparation (for triathlons, marathons, 10 & 5 km runs)
  • General tension
  • Relaxation

Video Presentation 2

Conditions and Contraindications

Tuina is best suited for rectifying chronic pain, musculoskeletal conditions and stress-related disorders that affect the digestive and/or respiratory systems. Among many ailments, Tuina works best for neck pain, shoulder pain, back pain, sciatica and tennis elbow. However, because tuina is designed to improve and restore the flow of qi, treatment often ends up causing improvements to the whole body, not just a specific area. There are circumstantial evidences that headaches, constipation, premenstrual symptoms and some emotional problems may also be effectively treated through tuina.

Because it tends to be more specific and intense than other types of bodywork, tuina may not necessarily be used to sedate or relax a patient. The type of massage delivered by a tuina practitioner can be quite vigorous; in fact, some people may feel sore after their first session. Some patients may also experience feelings of sleepiness or euphoria.

As with all forms of care, there are certain instances in which tuina should not be performed. Patients with osteoporosis or conditions involving fractures, for instance, should not receive tuina. Neither should patients with infectious diseases, skin problems or open wounds.


During a Tui Na session, the practitioner gathers information about the client's health issues through an interview and examination. Next, the practitioner applies a specific treatment protocol, using bodywork techniques to massage soft tissue and realign the musculoskeletal system along with acupressure techniques to improve energy flow.

Typical Tui Na sessions last from 30 to 60 minutes. Clients wear loose, comfortable clothing and usually lie on a padded table or floor mat. Depending on the client's condition, practitioners might recommend additional Tui Na massage sessions, herbal remedies to facilitate faster healing and at-home practices to help prevent health problems.

Massage-oriented professionals in general can anticipate a 19 percent increase in employment through 2018, according to the Bureau of Labor Statistics (BLS). The field continues to expand with the country's ongoing wellness boom and the public's increasing interest in massage and complementary therapies as a means to achieve health and wellness.

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