Application of Tui-Na In Veterinary Medicine for Holistic Healing of Dogs & Cats
Tui-na is an ancient Chinese form of medical massage that can have a profoundly healing effect on a range of conditions seen in veterinary practice, from osteoarthritis to respiratory symptoms.
Tui-na is one of the five arms of Traditional Chinese Medicine. The others include herbology, acupuncture, Qigong, and food therapy. Tui-Na is a safe and effective manual therapy, with no known side effects, used for disease treatment and prevention in people and pets. Although randomized placebo-controlled studies are limited, there is overwhelming evidence of historical use and appreciation for this specialized applied manual therapy.1 The active participation of the dog or cat owner is essential for optimum results. The use of Tui-na promotes open communication between the owner and the veterinarian, greatly facilitates the healing process, and honors the human-animal bond.
Often referred to as Chinese medical massage, Tui-na dates back to the Shang Dynasty, around 1700 BC. “Tui” means push and “Na” means pull or lift. It uses massage, acupressure, traction, and manipulation techniques for the prevention and treatment of disease
History of Tui-Na
Tui-na (推拿) is a traditional Chinese manual therapy, the term tui na (pronounced “twee naw“), which literally means “pinch and pull,” refers to a wide range of Traditional Chinese Medicine (TCM) therapeutic massage and bodywork. It has been used for over 3000 years since the 11th centuries BC and references to this treatment can be found in the Huang Di Nei Jing (黄帝内经)(Yellow Emperors Inner Classic, written in 475-221 BC).
Tui-na is not generally used for pleasure and relaxation, but rather as a treatment to address specific patterns of disharmony. As such, practitioners use it for many of the same reasons and according to the same principles as acupuncture. Like acupuncture, TCM uses tui na to harmonize yin and yang in the body by manipulating the Qi in the acupuncture channels.
The roots of Tui-Na (also spelled tuina) were developed long before acupuncture, using manual stimulation of affected areas to bring about pain relief. Primitive man instinctively knew that by rubbing painful areas on the body, the discomfort would be lessened. With the discovery and evolution of acupuncture meridian theory, Chinese massage therapy also evolved, first known as An Mo (pushing & kneading) in ancient times.
Currently, it’s still well used for human and pet over the world as an effective physical therapy.
THE MAIN FUNCTIONS
From a conventional medicine perspective, Tui-na can be thought of as corresponding to a combination of acupressure, conventional massage and chiropractic techniques. It can be used to regulate the Channels, soothe joints and sinews, promote circulation of Qi气and Blood, strengthen the immune system and promote normal function of the Zang-Fu organs (脏腑器官).
Tui-na is most commonly used to treat acute and chronic musculoskeletal conditions and is also useful as a preventative medicine therapy, because it promotes balance in the body. It can also be used in conjunction with and to enhance acupuncture and herbal treatments.
Jeffrey Feinman holds both molecular biology and veterinary degrees from the University of Pennsylvania. Dr. Jeff was the first dual degree recipient at Penn in the prestigious University Scholar program (which was designed to foster medical scientists).
TCM IN THE VETERINARIAN PRACTISE
In TCM theory, the lung dominates the Qi, skin, and hair, and regulates the water passages. Therapeutic manipulation (massage) of the body surface can improve the function of skin and body surface’s immune system function and therefore affect the Lung function, consequently improve the Qi movement. In TCM theory, the Spleen dominates the muscle and limbs and is the generator of Qi and Blood. Acupressure or Tui-na of the muscles can regulate the function of the Spleen and therefore influence the formation of Qi and Blood and strengthen the limbs.
RESTORATION THE BALANCE OF YIN AND YANG
According to TCM, any disease is caused by an imbalance of Yin and Yang. In order to restore the balance, the Tonifying method is used for Deficiency, and the Sedation method is used for Excess. Tonify is to increase organ, system or channel function or integrity in the case of hypofunction. Sedation refers to reducing the hyperactivity or hypersecretion in an organ or body system.
VETERINARY INDICATIONS OF TUI-NA
Musculoskeletal Conditions
Those conditions that are amenable to treatment with Tui-na include generalized muscle pain, thoracolumbar pain, fee pain, laminitis, osteoarthritis, cervical pain, lumbosacral pain, lumbar sprain/strain, tendonitis, and mild ligament injuries.
Internal Medicine Disorders
Internal medicine conditions that respond well to Tui-na treatment, include anorexia, non-infectious diarrhea, reduced gastrointestinal motility, dysuria, Bi syndromes, Wei syndromes, headaches, hemiplegia, peripheral facial paralysis, cough, asthma, acute and chronic bronchitis, disorders of pregnancy and parturition, cardiovascular disease, anxiety, sleep disorders, and generalized stress.
Various Geriatric Conditions
Geriatric conditions that may be gently treated with Tui-na with few deleterious side effects include general weakness, stiffness, osteoarthritis, Bi syndromes, Wei syndromes, sleeping disorders, and various neurovascular and neurodegenerative diseases.
Pediatric Diseases
Pediatric conditions that may be treated with good success include viral infections, cough, fever, diarrhea, infantile malnutrition, enuresis, torticollis, infantile paralysis, and tendon contracture.
Disease Prevention
Many Tui-na experts believe that disease prevention may be one important function of Tui-na manipulation based upon Patten Differentiation
Performance Enhancement
Performance enhancement has been demonstrated in human athletes treated with Tui-na and believed to be true in equine athletes as well.
Comparision Between Tui-Na and other TCVM Modalities
Tui-na is one of the five branches of TCM. The practice is under the guidance of TCM theories and principles, which include Zang-Fu, Five Element, four diagnostics methods, and Eight Principles. In general, TCVM can be divided into Li-Theory, Fa-Strategy, Fang-Method, and Yao-Protocol.
- Li-Theory means the physiology and pathology of TCM
- Fa-Strategy is the diagnostics of TCM and therapeutic strategies
- Fang-Method refers to the formulation of therapeutics
- Yao-Protocol includes herbs, needle, and manipulations
CONDITIONS BENEFITING FROM TUI-NA
- Neck / shoulder pain
- Back/ hip pain
- Shoulder joint pain
- Leg/ ankle pain
- Sciatica
- Muscle spasms
- Muscle, tendon, ligament and other skeletal conditions
- Aging issues such as arthritis, loss of vitality, weakness and joint stiffness
- Respiratory, cardiovascular, digestive and immune system disorders
It can also enhance mental focus, sensory acuity and help create a general sense of well-being.
NO KNOWN SIDE EFFECTS OF TUI-NA
Small animals, large animals, and exotic species all respond well to Tui-na, and it can be administered on animals that will not allow the insertion of acupuncture needles. It is safe and effective with no known side effects.
CONTRAINDICATIONS AND CAUTIONS OF TUI-NA
If the animal is frail – Very old and/or very weak animals may become depleted or weakened by therapeutic manipulation if too vigorous or prolonged duration.
Acute Fracture sites may be too painful for any form of manipulation in a conscious patient
During pregnancy : Pregnancy may be interrupted or prematurely terminated if abdominal acupuncture points are stimulated too vigorously
If the animal has an infectious disease : Infectious and epidemic diseases should be treated with consideration of both zoonotic and iatrogenic transmission potential.
Immediately after a large meal : Immediately after food intake, the bowel should be allowed to have blood shunted for digestion and absorption. It is best to wait at least 30 minutes after a meal before any form of Tui-na.
When undiagnosed masses are present : Masses of unknown origin should be investigated for infectious or neoplastic etiologies and avoided if either is determined
On or around skin eruptions or bleeding : Serious dermatitis or injured skin may be irritated by many Tui-na techniques.
WHY ADD TUI-NA TO YOUR PRACTICE?
Incorporating the art of Tui-na into your practice can benefit both your patients and clients, enhancing other treatments you already utilize. Tui-na can alleviate pain and stiffness and efficiently treat paralysis and hemiplegia. 4,5 It can improve respiratory symptoms such as nasal congestion and discharge, cough, and asthma, and can help treat vomiting, megaesophagus, and constipation. Tui-na can be incorporated into therapeutic plans for diabetic patients and those in renal failure. It can help with incontinence and prostate disorders, and help support animals with immunodeficiency. This is just a few applications for this ancient technique.
MO-FA (TOUCHING OF THE SKIN AND MUSCLE), PRONOUNCED “MOE-FA”
This technique stimulates the skin and underlying tissues in preparation for deeper work. Start at the top of the neck on one side and work caudally to the tail, going top to bottom,
from the dorsum to the feet. Be sure to do the legs and abdomen also.
This is a circular gliding movement with the palms and/ or fingers on the skin, going with the direction of the hair with both hands staying in contact. Practice by going firmer, lighter, faster, and slower. Every animal, on any given day, on any given part of the body, might prefer different depths of firmness or lightness and speed.
PAI-FA (PATTING), PRONOUNCED “PIE-FA”
This is a rapid patting motion using your palms and/or fingers, depending on the size of the animal. With smaller animals, you may want to use just one or two fingers. Your wrist must be loose and allowed to flex when doing Pai-fa. The palm should remain slightly concave.
Follow the same pattern as with Mo-fa, moving cranial to caudal and dorsal to ventral on both sides of the animal. Again, be sure to do the legs and abdomen. As you get
comfortable with this technique, begin to focus on the vibration going all the way through the body. As you do this you will find that your patting becomes softer, lighter and more effective as every cell in the body receives this healing vibration.
This is a good technique to practice on a family member or friend. Apply over the upper and mid back of the person until you get the vibration to be felt at the person’s solar plexus. You may find a desire to pat harder, but to be effective you in fact need to pat lighter with focused intent.
DOU-FA (SHAKING), PRONOUNCED “DOUGH-FA”
This shaking/vibrational movement is used on the legs. It is easiest if the animal will lie down on their side in a relaxed manner. Place your hands softly under the joints, supporting the stifle and hock in the rear, and the elbow and carpus in the front. You can also do this with the animal sitting or standing. Direct a light, rapid shake/vibration up the leg, into the shoulder, and into the spine.
NIE-FA (PINCHING), PRONOUNCED “KNEE-FA”
This technique is known for regulating the spine with no side effects. Using the thumb and fingers, softly pinch and lift the skin and underlying fascia. I use this technique up the dorsum from the base of the tail to the neck to release adhesions along the spine.
How it works
Through thousands of years of clinical observation, Chinese medicine practitioners determined that there are energetic pathways or channels called “meridians” that run through the body, nourishing and connecting the internal organs with the tissues and extremities. Nutrient-rich blood and chi need to pass freely and consistently through these meridians to support all the body’s systems and activities.
Whenever there is a blockage, stagnation or breakdown in the continuous flow of chi and blood, the body becomes imbalanced and can’t function properly. The longer the animal remains unbalanced, the more likely his health will become compromised. For example, what begins as a tight muscle, in which the flow of blood and chi is cut off through restriction, can lead to more pronounced lameness and potential immobility.
TCM is best used as a resource for preventing illness and injury by maintaining the energetic and nutrient supply to the entire body. If there’s an imbalance, dealing with it as soon as possible keeps it from going deeper into the body and creating ill health.
What Tui Na can and cannot do
Tui Na is a highly effective form of bodywork based on TCM. The hand techniques help promote the flow of chi and blood through the meridian system that feeds and energizes the animal’s body. Tui Na is known to address an extensive array of health issues, including:
- Muscle, tendon, ligament and other skeletal conditions
- Aging issues such as arthritis, loss of vitality, weakness and joint stiffness
- Respiratory, cardiovascular, digestive and immune system disorders
- It can also enhance mental focus, sensory acuity and help create a general sense of well-being.
Before you begin, note that there are some situations and conditions in which Tui Na is not recommended:
- If the animal is frail
- During pregnancy
- If the animal has an infectious disease
- Immediately after a large meal
- When undiagnosed masses are present
- On or around skin eruptions or bleeding
Try this technique
It can take years of practice to perfect Tui Na techniques, but everyone has to start somewhere. The technique commonly used in animal acupressure on specific “acupoints” (pools along a median where chi and blood can be influenced) is called Yi zhi chan tui fa or “one-finger meditation”. This technique stimulates the energetic action the particular acupoint is known to affect.
For example, by performing Yi zhi chan tui fa on the acupoint known as Stomach 36 (St36), the flow of chi and blood to the animal’s digestive tract will be enhanced. St 36 is also used to stimulate vitality and boost the immune system (see diagram on next page).
To perform Yi zhi chan tui fa, make a loose fist with your thumb extended down. Gently press with the soft, fleshy portion of the tip of your thumb on the acupoint you have selected from the chart (descriptions for each are on next page). Focus on the acupoint and its therapeutic value while relaxing your shoulder and elbow. Your other hand can rest comfortably on the animal to maintain connection.
Now, rhythmically oscillate your arm while your thumb remains focused on the acupoint. Make the movement as slow as needed to create an even oscillation; the intention is to create a vibratory frequency that can stimulate the energetic activity of the acupoint. Stay on the acupoint you have selected for approximately two to three minutes.
Practice your technique on a firm pillow or other forgiving surface before applying Yi zhi chan tui fa directly to your animal.
Acupoints for session
The acupoints presented in the chart have specific actions within the animal’s body. Each is known to affect the body in a particular way.
Stomach 36 (St 36) benefits the digestive tract, promotes vitality and enhances the immune system.
Bai Hui Point is a classic point known to encourage the flow of chi and blood to the hindquarters and back. It can help with lameness, hip joint issues and arthritis. The added benefit of the Bai Hui Point is that most animals love it!
Conception Vessel 17 (CV 17) benefits any respiratory disorder and can be effective for reducing anxiety. It is best to perform Yi zhi chan tui fa on CV 17 when the animal is lying down or on his back.
Spleen 6 (Sp 6) has influence over the urogenital system and rear portion of the abdomen. It is used for urinary tract infections, incontinence or retention of urine, regulating the estrus cycle and lower back pain.
Take time to practice the Yi zhi chan tui fa technique – the more proficient you are, the more effective your Tui Na acupressure session will be. The rhythmic vibration is essential to the stimulation of the acupoints.
Tui Na is a wonderful modality to share with your companion. It can help soothe aches and pains, calm his spirits, and enhance his wellness.
TUI-NA TECHNIQUES
Over the years, many different types of Tui-na techniques have been developed in China. Dr Han Ping, a professor of Tui-na/An-mo at Beijing University of Traditional Chinese Medicine, has compiled six systems of Tuina techniques (Table 1).3 These six Tui-na systems were developed for use in humans, but are easily adapted to animals and have similar applications in veterinary medicine. While performing any Tui-na technique, it is important that hand manipulation should be kept soft and fluid and appropriate evenness, duration and force of pressure be applied for optimal clinical results. Veterinary Tui-na practitioners are typically trained to perform all of Dr Han’s techniques (Table 1). However it is common to also teach caretakers to perform Tui-na techniques on their pets at home to help relieve pain and hasten recovery. Not all Tui-na techniques are appropriate for home treatment, but the nine techniques outlined below are simple, safe and effective and can easily be taught to clients for home treatments. • Mo-fa (touching skin and muscle): Mo-fa is performed by rubbing the skin in a spiral, rhythmic motion using the palms of the hands and fingers with light to moderate pressure. This technique is thought to use nervous system reflexes to exert an effect through the skin and superficial connective tissues to restore order to the circulation and may promote homeostatic reactions in internal organs. Mo-Fa is often used as a general introductory technique for Tui-na to acclimate animals for other techniques and is especially useful for weak and geriatric animals. It is used to regulate Qi, harmonize the Middle Burner (Zhong Jiao), drain Stagnation and remove accumulations and can be used to treat constipation, diarrhea and food retention. • Rou-fa (rotary kneading): Rou-Fa is performed with a gentle rotational motion using the ball of the fingers and the heel of the hand. This is one of the most common Tui-na methods and is used to regulate the actions of the other techniques. It functions to harmonize the Ying and Wei, resolve Qi and Blood Stagnation, relieve pain and eliminate food retention. Rou-Fa is especially good for Deficient animals and is often used as an introductory technique at various acupoints and Ah-shi points all over the body, before using techniques that work on deeper tissues. It is commonly combined with An-fa to produce a combination technique Rou-An-Fa • Ca-fa (rubbing): Ca-fa is performed by applying rapid, linear and moderately forceful movements of the palms, while firmly touching the skin. This technique produces softly warming stimulation to the skin and underlying tissues. It warms the Channels and Collaterals. It is very useful for Yang Deficient geriatric animals that feel cold to the touch and for Qi Stagnation and Cold Patterns with abdominal and lumbar pain. It is very useful to treat chronic renal failure with Yang Deficiency and in animals with poor peripheral circulation it can be combined with Cuo-fa discussed below. • Tui-fa (pushing): Tui-fa is performed in a forceful one-directional movement using the finger, thumb, palm or elbow that follow the lines of major muscles, tendons and ligaments. It can be performed using the index fingers and/or thumb bilaterally along the epaxial muscle groups of the spine from T10-L7 in a smooth gliding motion along these tissues especially useful in animals with intervertebral disk disease (IVDD). Initially very light pushing should be used with progressively deeper pressure as the tissues and the animal allow. Tui-fa can be alternated with An-fa described below. This technique is used to relax the tendons and invigorate Blood and Qi flow. It is one of the more common techniques to treat the vertebral column and limbs for Bi syndrome, IVDD and spondylosis and is one of the most important techniques to soften the connective tissues. It can also be used to dissipate nodules and masses. Tui-fa is similar to myofascial release techniques practiced in other conventional body-work techniques. • An-fa (pressing): An-fa is applying light pressure to an area using the thumb and or index finger with deeper pressure gradually applied. This technique is often performed with or following Rou-fa (discussed above). This single finger pressing technique is used to relieve Qi and Blood Stagnation and unblock obstruction. • Nie-fa (pinching): Nie-fa is performed by pinching and squeezing the skin and epaxial muscles of the vertebral column with the fingers. This technique is useful to invigorate the Blood and Qi and regulate the Spleen and Stomach and is especially important to help stimulate appetite. Nie-fa is commonly used to regulate the vertebral column. • Dou-fa (shaking): During Dou-fa each limb is continuously shaken or vibrated gently with an up-down motion using both hands, while fully supporting the limb. This technique is used to regulate the Qi and Blood and smooths the joints. • Ba-sheng-fa (stretching): The caretaker is asked to pull and apply gentle traction to the muscles and joints of the limbs. Traction on the tail can also be applied as part of this treatment for 10 repetitions each time. The owner should strive to perform this technique rhythmically for best results. Ba-Sheng-Fa is used to regulate the Channels, mobilize and restore the normal anatomic position of the joints, tendons and ligaments of the pelvic limbs • Cuo-fa (kneading): Cuo-fa is usually performed on each limb using rapid kneading movements with the palms of both hands, moving back and forth and up and down the limb. The force should be equal in both hands and kneading should be rapid, but the movement up and down the limb should be slow. This technique can also be used on the neck, chest, hypochondriac region, abdomen and waist. This technique regulates the Channels and moves Qi and Blood. Cuo-fa is typically used at the end of a Tui-na treatment.
TUI-NA TIPS
- Emphasize that all treatments are to begin softly and slowly. Too much force is to be avoided and treatments should be done with even pressure • Caution should be used in performing Tui-na on geriatric, weak and debilitated animals that could become further weakened by treatments that are too vigorous or lengthy in duration. Tui-na treatments can last 10 minutes to 1 hour • Don’t give owners too many techniques to do at one time; in the author’s experience; prescribing only 3-4 different Tui-na techniques (no more than 30-45 minutes) are met with the best compliance by the average caretaker • Give caretakers a Tui-na work sheet and write down all techniques to be performed and the duration of each; have the owner keep a log of treatments and review it during recheck examinations. • Demonstrate to caretakers each Tui-na technique to be done; then have them show you how they will do it at home. • It is recommended that treatment be performed every day to insure that treatments are done at least 3-5 times per week. Tui-na once daily is ideal • It is beneficial to have the caretaker return in 1 week and demonstrate to the veterinarian the assigned Tuina techniques on their pet • Tui-na treatments should be performed before acupuncture needles are placed; it is more effective to massage the area before and after acupuncture for best results • Tui-na techniques may also be supplemented with oral Chinese herbal medicine and herbal liniments, salves, sprays and patches as needed • It is best to wait 30 minutes following a meal before performing a Tui-na treatment to allow normal blood flow to the bowel for proper digestion. As Tui-na can promote balance in the body it can be useful to treat or prevent disease. Tui-na can be used to treat small and large animals as well as exotic species and is especially useful for the treatment of animals that will not allow acupuncture needles to be placed. Tui-na can be combined with acupuncture, Chinese herbal medicine, Food Therapy and exercise/lifestyle programs for an enhanced therapeutic effect and has been shown to be safe and effective with no known side effects. There is one national journal in China devoted to research on and the application of Tui-na. It is hoped that this valuable information will one day be translated into English for further application of Tui-na outside of China. One of the most valuable aspects of Tui-na is the active involvement and participation of the owner in a team effort with the veterinarian for the treatment of their pet. The use of Tui-na treatments by caretakers can help promote open communication with the veterinarian, facilitate and accelerate the healing process and deepen the human-animal bond.
Compiled & Shared by- Team, LITD (Livestock Institute of Training & Development)
Image-Courtesy-Google
Reference-On Request.
