Viewing Chinese Manipulative Therapy in TCM

1. Promoting smooth circulation of vital energy to relax muscles and tendons， warming the channels and collaterals to dispel cold.

TCM holds that pains may be caused by cold, because physiological activities of the human body may be impaired by an invasion of exogenous pathogenic factors like cold, wind and dampness or eating cold food and having cold drinks, leading to an obstruction of channels and collaterals and a stagnation of vital energy, thus resulting in pain. So the heat-mud therapy can be used for treating arthritis, and hot bath for rheumatoid diseases. The CMT has its advantages over them. During treatment, several methods may be produced together. For instance, a pressing-kneading effect may rearrange bones and tendons and relax muscles, while thermal effect warms channels and collaterals to dispel cold and promote a circulation of vital energy.

2. Activating blood circulation to eliminate blood stasis and regulating qi to stop pain:

Wind, dampness and mental stress may cause a contraction of blood vessels and muscles. And trauma may lead to angiorrhexis, forming local hematoma and adhesion. Both of them can be regarded as a stagnation of qi and blood, also an obstruction of channels and collaterals. TCM believes that the stagnation or obstruction will certainly result in pain. Such a point of view is consistent with western medicine. For instance, inflammation due to local bleeding and hemotoma may lead to a compression and irritation of metabolites at the nerve endings, thus resulting in pain. Traditional Chinese medicine considers that recovery of a smooth circulation of energy and blood, an elimination of obstruction of channels and collaterals will certainly relieve pain, which corresponds to the term of western medicine, subsidence of inflammation.

3. Relieving spasm and relaxing muscles:

CMT can relieve spasms, improve nutrition, and enhance contractility and endurance of muscle. Clinically, spasms of muscles may cause severe or even unbearable pain. But CMT is an efficacious analgesic procedure for relieving it. For instance, gastrospasm can be improved by pressing Zusanli (ST36) He-Sea Point, Zhongwan (CV12) Front-Mu Point of the Stomach and Guanyuan (CV4) Front-Mu Point of the SmallIntestine, and systremma by pressing Chengshan (BL57). In some cases, only when the spasm is relieved in advance, the other kinds of maneuvers of CMT can be carried out. For example, spasms should be relieved before reduction of dislocation and fracture. So the maneuvers for relieving spasms or relaxing muscles and tendons are usually the first step of CMT.

4. Rearranging jin, setting bone and removing adhesion:

Jin in TCM corresponds to western medical terms of muscle, tendon, ligament, capsule, blood vessel and nerve, while bone mentioned in TCM means both bone and joint. People can not see with their naked eyes the real conditions of bones, muscles and tendons until the examination has been down like X-ray, CT Scan or MRI. In CMT, the therapist looks for information on the inside of body mainly by palpation basis on their rich clinical experience. The abnormalities of jin are usually categorized as deviation of jin, fragmentation of jin and version of jin. All of these can be labelled as "jin out of track”. CMT can be selected accordingly to make jin return to their original tracks. CMT is contraindicated for complete fragmentation of muscles, tendons, ligaments and nerves, because it should be treated by suture first. But for incomplete fragmentation, CMT can be used combined with external fixation.

5. Removing adhesion:

After trauma, bleeding and the pathological changes of organization, liquid exudation and proliferation of fibrous tissues often cause adhesion of muscles, tendons and nerves, leading to a limitation movement of those and resulting in pain. Passive movement and CMT can be used for separating adhesion and improving the movement. With an amelioration of local blood circulation and metabolism, the cicatricial tissues will be improved or recovered.

6. Exciting vital energy, regulating functions of zang-fu organs to balance yin and  yang:

When CMT is practiced on a superficial portion, the effect can spread to the entire body through meridians and collaterals. CMT will regulate qi and zang-fu organs and balance yin and yang through the body’s network. For instance, if CMT is carried out on abdomen and back of the patients, both hyper or hypoactivity of intestinal peristalsis can be improved. Also the activity of the stomach can be accelarated by kneading on Pishu (BL20) and Weishu (BL21) and ST36.

7. Rectifying derangement of the defensive and constructive energy:

Defensive and constructive energy play a very important role in protecting the human body from exogenous pathogenic factors. In case of derangement of the defensive and constructive energy, wind, cold and dampness may invade through the skin into the joints and internal orgains; bring about an obstruction of meridians and collaterals and cause pain and numbness. CMT with kneading, squeezing and patting can be performed on the superficial portion of the body for inducing mild perspiration to dispel exogenous wind, cold and dampness, thus relieving pain and numbness.

8. Reinforcing and reducing effects of CMT:

As same as Chinese herbs, the effects of CMT also can generally be classified into two categories, reinforcing and reducing. Reinforcing means adding nutrition or invigorating vital energy to enhance functional activities, while reducing means a dispelling of pathogenic factors or inhibiting of hyperactivities of the viscera. The effects vary depending on intensity, direction and frequency of the maneuvers and duration of each session of treatment, thus producing reinforcing or reducing effects. It has been proved by experiments that heavy and rapid manipulations may increase the excitation of nerves and muscles, while mild and slow ones inhibit their activities.

Key Words: CMT, Viewing