Describe the development of massage practice/Acupressure

Author: Lori-Ellen Grant, 2008

Editor: David McQuillan

When you press your thumb deeply into tissue, using acupressure, there is a sense of connecting, one person to another. With this link established, the Qi (pronounced “chi”) flows. Qi energizes, stimulates and transforms. When acupressure techniques are combined with knowledge of Chinese Medicine, the science and the art, it is possible to influence the entire body and its ability to heal.

What is Acupressure?
Acupressure is a form of physical manipulation that uses the fingers/thumbs to apply pressure to traditional acupuncture points. As well as being used within a massage session, you can teach clients to use it at home. It can correct internal organ malfunctioning, stimulate blood circulation and release muscle tension. It can also help to relieve acute pain, manage chronic conditions and is excellent for promoting and maintaining general health.

The Nei Jing (one of the earliest Traditional Chinese Medicine texts) states that 5,000 years ago, the Chinese discovered that pressing certain points on the body relieved localised pain as well as benefiting other more remote areas of the body (Veith, 1949). Soldiers reported that, surprisingly, symptoms of disease were alleviated where stones and arrows had struck or pierced particular parts of the body. As a result, Chinese physicians learned to strike or pierce certain points on the body to alleviate specific illnesses (Chang, 1976).

Acupressure may also have developed quite intuitively, through the treating of injuries incurred through labour. In the age of hunter gatherers, injuries such as fractures, contusions and strains were common. When these occurred, people would instinctively apply pressure to stop bleeding and rub afflicted areas to reduce swelling and alleviate pain. Gradually, as understanding of these techniques increased, people synthesised some primitive acupressure methods, which later helped to inform the acupressure techniques used today (Li, 2005).

How does Acupressure work?
The principle behind the use of Acupressure treatment is to increase the circulation and functioning of Qi (Tukapua, 2005) through the meridians that connect internal and external functions of the body. "Meridians/Channels are an invisible network linking vital substances to organs and carrying nourishment and strength. Meridians/Channels unify all parts of the body which is essential to remaining in a harmonious balance." (Huang-di Nei Jing Su-wen, 1963)

Once you have assessed which meridians are causing symptoms of pain or dis-ease, you can choose the most appropriate acupressure points. When an acupressure point is manipulated, it activates the associated channel / meridian, allowing qi to flow freely through it. This assists the muscles to relax, balances the meridian, and harmonises the internal organs. This process of nurturing and balancing links the inner and outer aspects of the body, supporting overall health and healing.

Massage styles and Acupressure
Acupressure relates to and can compliment several different styles of Massage. Chinese massage or Tuina (Chinese for "pushing and pulling"), which places emphasis on soft-tissue manipulation and structural realignment, also incorporates acupressure into techniques. Shiatsu, by contrast, is actually a Japanese form of acupressure. Its literal translation is finger (shi) pressure (atsu). Pressure is applied with hands, thumbs, fingers, elbows, knees and feet, depending on the style of Shiatsu practiced. It can consist of simple manipulations and pressure applied to acupuncture meridians and points (Frequently asked questions, 2008).

A common question is the relationship between acupressure points and trigger points; palpable nodules in taut bands of muscle fibres. Compression of a trigger point may elicit local tenderness, referred pain, or a local twitch response (Travell, Simons & Simons, 1999). While acupressure points can, at times, correspond to trigger points, there is an important difference between the two. Manipulating a trigger point releases tension in the affected muscle and the structures directly surrounding it. In contrast, stimulating acupressure points means working with an awareness of the whole channel in the body, not just the portion of it where the symptom is localised. This means supporting and energising all of the channel’s functional connections, both inner and outer.

When can Acupressure be used?
There are two ways acupressure can be most useful for the massage therapist. One is addressing common ailments seen in the clinic, such as tiredness, insomnia, sinus problems, headaches and stress related symptoms, to name just a few. When dealing with these, treatment may incorporate not only points related to meridian theory, but also specific locations around the body known as ‘empirical’ points. These are key acupressure points that are highly regarded for their functional effect on such ailments.

Another useful application of acupressure for massage therapists is to treat musculo-skeletal problems, with a focus on meridian theory. Where is the problem and which meridians traverse the affected area? Through stimulating points on the related channel, above and below the ailment and/or locally, a functional effect can occur. The stimulation of these points encourages qi flow in the meridian and assists in reducing pain by moving the qi through the affected area.

Clinical study confirms benefits of Acupressure
A recent study published in the British Medical Journal has shown that Acupressure is effective for treating back pain in terms of reducing disability and pain scores and increasing functional status. The study, which compared Acupressure and Physical Therapy, showed that overall Acupressure was more effective in these areas both immediately after the treatments and at the 6 month follow up (Chen, 2006).

In my personal practice I have had some great successes using acupressure. In one case, a 40 year old female client presented with chronic headaches which she had been experiencing for 10 years. During six massage sessions over a 4-5 month period, I incorporated acupressure into my treatments, using both meridian theory and empirical points with excellent functional effects. The client experienced a great reduction in her pain levels (from 9/10 to2/10), with the result that she needed less medication to treat her symptoms. She also reported a marked increase in her ability to function effectively at work.

There is huge potential for the use of acupressure clinically with its clearly defined framework of Chinese Medicine and intuitive approach during palpation; the science and the art. These two are like night and day, one filled with reason, the other intuition. Together there is a whole approach, a balance, harmony and therefore, health.