Tuina is a type of therapeutic bodywork developed in China almost 2,000 years ago, to work the energy channels of the body. Like acupuncture, the aim is to restore a balanced flow of Qi, or energy. Unlike acupuncture, no needles are used.
In Tuina, the practitioner uses their hands to massage soft tissue (muscles and ligaments) and to manipulate and realign the musculoskeletal and ligamentous relationships (bone-setting). This establishes a more harmonious flow of Qi, allowing the body to heal itself. In ancient China, Tuina was classified as an “external” treatment especially suitable for the elderly and infants. Today, Tuina treats chronic stress-related disorders of the gastro-intestinal, respiratory and reproductive systems and musculoskelatal disorders, like tennis elbow.
Lateral epicondylitis, or tennis elbow, is a common inflammatory injury involving the tendons attached to the lateral side of the elbow at the humeral epicondyle. Patients experience radiating pain, and sometimes weakness, from the elbow to the forearm and occasionally into the hand.
Achy discomfort accompanies activity and may be present when resting. Precipitating trauma may be either a violent injury or microtrauma due to repetitive motion or strain. The western treatment for tennis elbow is rest, anti-inflammatory medication and ice. Additional treatments include stretching and strengthening exercises alternating with immobility via straps or braces. Cortisone shots are also frequently part of the treatment protocol.
In Chinese Medicine, tennis elbow is known as zhou lao (elbow taxation), and involves shang jin (damaged sinews) and zhou tong (elbow pain). Taxation is viewed as overwork and injury to the sinews and vessels of the elbow, leading to blood deficiency and stagnation. Additionally, wind and cold factors may be contracted because of reduced Wei Qi strength. Treatment principles are: relax the constricted sinews; free the flow of Qi and Blood; regulate Qi in the channels and vessels. Warming the channel and expelling wind may also be in order.
Tuina treatment for tennis elbow involves:
Rolling technique from shoulder to elbow for 5-10 minutes.
Press and knead the elbow area while performing passive range of movement of the joint. Increase pressure on any ashi points, especially LI10 and LI11. Attempt to separate any fibrous tissues with the thumb.
Flex and extend the wrist joint while holding the elbow with the other hand.
Apply medicated liniment or ointment until the local area is warm and the patient has a feeling of heat.
Use the rearranging method on the fingers and rub, knead and shake the hand. 6) Rub/roll the whole arm from shoulder to hand.
Patient should keep the elbow immobile for at least 24 hours.
Repeat treatment daily until pain subsides (usually 3-6 treatments).
Ice is usually contraindicated in tennis elbow, as the contraction of wind and cold will be exacerbated with ice. Adjunctive measures include local moxibustion or warming with a TDP lamp, and herbal formulas that move Qi and Blood.
It is imperative that the patient refrain from activity that aggravates the condition, until the inflammation and pain resolve and tendons heal.