Acupuncture, Acupressure, and Massage movements as rubbing, rolling, kneading, Invigoration of the skin

pressing, slapping, and tapping. Revitalizes and enhances blood circulation

Objectives: Used for therapeutic purposes such as: Treatment of various conditions
Arthritis and ulcers
After 4 hours of varied classroom Promotes the functioning of striated
activities, the level 2 Nursing students will i. Relaxation of the muscles muscles
be able to: Promotes the harmonious functioning of the
ii. nervous system
1) Define the following terms: Relief from pain Correction of the disorders of the skeletal
Acupressure system
Acupuncture iii. Regulation of the operation of the endocrine
Massage Restoration of metabolic balance gland
Acupuncture points Stimulates the normal function of the
Acupoint iv. internal organs
Yin Promoting circulation of the blood and Promotes homeostatic effects
Yang lymph
Shiatsu
Meridian
Qi v. Other benefits both physical and Importance of Acupressure:
mental
2) State the importance of acupressure, v Promotes health
acupuncture and massage 4) Acupuncture point
Point of increased sensitivity and powerful v Prevents disease and disorders
3) Discuss briefly the history, theories, effect located along a meridian
goals of: v Indentifies aliments
Acupuncture 5) Acupoint
Acupressure Any of the specific sites for needle insertion v Gives a feeling of relaxation
Massage in acupuncture; also used in other
therapies, including acupressure and v Balances the physical and psychological
4) Discuss acupuncture, acupressure, moxibustion. aspects of a person’s being in a holistic way
and massage as to: Most are areas of high electrical of life
Factors involved conductance on the body surface.
Advantages and disadvantages A pressure point stimulated in acupressure. v Used conjunction with diet, exercise, and
Indications and contraindications medication
Scientific principles involved 6) Yin
Guidelines involved Represents shade, cold, and inhibition
Represents inner part of the body
5) Identify the different acupuncture Importance of Massage:
points and enumerate the different
techniques used in present-day i. Liver, heart, spleen, lungs, kidneys ü Develops a stronger heart
acupuncture
7) Yang ü Improves oxygen supply to the cells
6) Discuss the different massage Represents fire, light, and excitement
technique and strokes Represents outer part of the body ü Improves nutrients supply to cells

7) Demonstrate beginning sills in ü Decreases blood pressure

acupuncture, acupressure, and massage.
i. Bowels, stomach, bladder
ü Relieves tension
8) Shiatsu
Japanese origin ü Relieves restlessness and insomnia
A form of healing massage in which the
hands are used to apply pressure at ü Promotes sense of well-being
acupuncture points on the body in order to
stimulate and redistribute energy ü Relieves pain

9) Meridian ü Relaxes or stimulates the muscles

Acupuncture, Acupressure, and Massage Invisible human energy pathway existing in
various members inside the body that ü Assists in proper breathing
Define: connect the different acupressure and
acupuncture points and the internal organs ü Provides comfort
1) Acupressure
Type of oriental therapy 10) Qi ü Treatment of impaired body functions
A form of touch therapy that treats disease Vital force of the body
and alleviates pain by applying pressure or Energy force
massaging certain points on the body’s Also known as Chi
surface The History of Acupuncture:
Comes from the Latin word “acus” (needle)
2) Acupuncture and “purgere” (to prick)
An ancient oriental therapy that uses fine Importance of Acupuncture: Originated from China more than 500,000
needles inserted into the body at points Controls pain years ago.
along the body’s meridians to relieve pain Strengthens immunity Bian shi (sharpened stones) were used to
and treat various ailments. Promotes health treat diseases
Used as anesthetics Legend of Acupuncture
3) Massage Prevention of diseases When soldiers were wounded by arrows in
System, manual, or chemical manipulations Promotes relaxation battle, these soldiers experienced a relief of
of the soft tissues of the body by such Relieves pain pain in other parts of the body.
Earliest recorded “Huang Neijing” (Yellow
Emperor’s inner cannon)
1844 – Emperor Tau-Kuang prohibited the
practice.
Mao Tse Tsung’s army was a key factor in
revitalizing the art of Chinese Medicine in
1935.
The History of Acupressure:
Practiced art for 5000 years
Philosophy is the same as acupuncture
Earliest evidence of acupressure was in
Europe
Otzi the iceman showed evidence of
acupressure
is part of the Six codes of the Tang Dynasty
Massage is used for treating diseases
caused by wind, cold, summer heat, damp,
hunger, over eating, overstrained,
excessive leisure
The History of Massage:
v 1500 BC
Paintings of massage techniques found on
cave walls
v 1800 BC
Art of life book that included massage
techniwue
v 2500 BC
Egyptians created reflexology
v 2760 BC
Nei Ching described therapeutic touch
v 3000 BC
China: Cong-Fu of the Toa-tse.
The oldest book about massage.
Translated in French in 1700’s
v 4500 BC
Imnotep recorded in his knowledge of
aromatic oils for massage purposes.
v In India
Focus of massage was sensual massage
v 500 BC
Herodicus prescribed gymnastics for healing
purposes
v 100 – 44 BC
Julius Ceasar used massage
Factors involved in Acupuncture:
ü Environment
ü Client’s tolerance to pain
ü Emotional factors
ü Cultural and religious beliefs
ü Location of acupoint
ü Angle of insertion
ü Acupuncture needle
ü Insertion of needle
Factors Involved in Acupressure:
v Location of acupuncture points
v Posture
v Manipulation
v Frequency
v Amount of pressure
Use light pressure when feeling weak and
tired
v Direction of flow
You are advised to work in the direction of
the flow of acupressure meridian on which
the point is located
v Breathing
It is important to be relaxed and in a
comfortable position during the procedure
v Selection of prescribed points
Factors Involved in Massage:
Duration
The duration of any massage will depend
upon the following
The area to be treated
Should be indicated in the prescription
Treatment should not be limited to the
diseased or injured area only
Rate of movement
Massage movements should be slow,
gentle, and rhythmical so that the desired
effects can be obtained
Age and size of the patient
A shorter length of time will be necessary
to treat a comparatively small person
because the amount of tissue being
manipulated is less than for a large person
Changes in symptom
Duration of the massage may be gradually
shortened
Frequency
It depends on the pathological condition in
which is to be heated
Type of movement
Selection of the movements and strokes
used should be based upon its effect
The pathological effects and results must be
taken into consideration in order to achieve
the desired effect
Advantages of Acupuncture:
v Does not require one to be admitted into
the hospital
v Affordable as compared to conventional
medicine
v Incidence of adverse effects is
substantially lower than that of many drugs
or other accepted medicinal procedures
used for some conditions
Disadvantages of Acupuncture:
v Can result in rupturing blood vessels
v Can expose the patient to other diseases
if the needles are infected
v It only reliefs the pain with out
ascertaining the underlying cause
Advantages of Acupressure:
Based on the proven efficiency of
acupuncture
Non-invasive
Simple to learn and teach to lay
practitioners
Can be used when invasive techniques are
contraindicated
Disadvantages of Acupressure:
Personal experience is not as effective as
acupuncture
Constant presence at the patient’s side
during treatment, which means that only
one patient at a time can be treated
Advantages of Massage:
ü Relieves stress
ü Relieves depression and anxiety
ü Decreases the levels of cortisol in the
body
ü Increases the levels of dopamine and
serotonin
ü Promotes a healthy perception of one’s
body image
ü Triggers emotional responses and
releases
ü Provides a safe atmosphere
ü Heightens a person’s awareness and
sensory perception
ü Relieves mental and physical fatigue
ü Promotes a good night’s sleep and reliefs
insomnia
ü It feels good
ü Increases oxygen capacity in the blood
by 10 – 15%
ü Pain can be alleviated and eliminated
ü Increases circulation of arterial blood
Improves the delivery of oxygen and
nurtirents to local areas on the body
 v Pregnant women in first trimester
ü Increases venous flow ü Vomiting
v Swelling areas
ü Encourages lymphatic flow ü Fever
v Patient with allergy to stainless steel
ü Prevents edema that often occurs with ü Recent fractures and spasms
inactivity, surgery, and other conditions. v Pierced and infected tissue
ü Inflamed joints
ü Can treat acute edema
Decreases swelling
Indications for Acupressure:
ü Loosens and softens scar tissues Body pains Scientific Principles involved in
Tennis elbow Acupuncture:
ü Improves muscle tone GI disorders
Eye disorders 1) Anatomy and Physiology
ü Stimulates receptors in the skin and Urinary disorders The practitioner should know where the
muscles Headache acupoints are located
Stiff neck The practitioner should know where the
ü Increases joint flexibility Edema and allergy needles should be inserted
Dysmenorrhea
ü Increases range of motion Asthma 2) Microbiology
Profuse sweating Needles should be sterile since they will be
ü Relieves constipation Vomiting inserted in the skin
Fainting Contaminated needles may cause infection
Dizziness
Restlessness 3) Psychology
Disadvantages of Massage: Paleness Practitioners should provide comfort and
Confusion privacy to the cline to avoid embarrassment
ü Some people rely on massage instead of
seeking medical treatments Contraindications for Acupressure: 4) Body Mechanics
Hypotension Proper posture and position of the body is
ü It can be expensive Hypertension needed to prevent muscle strains
Direct cuts and wounds
ü Can cause light-headedness and Patients with sever diseases 5) Time and energy
dizziness Patients who have poor general condition Prepare all the necessary materials needed
Sever skin disease in the procedure
ü Can have mild pain if sensitive Presence of acute disease and infection
Pregnant women 6) Safety
ü Can cause the person to feel warm or Selection of proper acupoints
“flushed” for a short time

ü Some people are shy to show their body Indications for Massage:
to the massage therapist Scientific Principles Involved in
Possible sense of awkwardness due the to ü Bedridden patients Acupressure:
level of intimacy
ü Shoulders, neck, and back pains 1) Anatomy and Physiology
ü Can be time consuming Knowledge and understanding of the
60 – 90 minutes ü Immobilized patients structure and functions of the body.

ü Can cause accidental injuries ü Stressed patients 2) Microbiology

Medical hand washing is necessary so as to
ü Mental and physical fatigue prevent or lessen the spread of
microorganisms in the body.
Indications for Acupuncture: ü Joint stiffness
3) Psychology and Sociology
v Disease or illness ü Headache Establish good rapport with the patient

v Respiratory disorders ü Eye strain 4) Physics

In applying pressure, one should know the
v Masculo-skeletal problems ü Patients with insomnia specific way and direction of the points on
the body
v Restores the imbalance of the energy of ü Poor blood circulation
the body 5) Chemistry
ü Have muscle spasm Acupressure regulates body functions and
v Patients with abnormalities pertaining to involves chemical reactions and metabolism
respiratory and urinary problems Contraindications for Massage:
6) Body mechanics
Contraindications for Acupuncture: ü Internal and/or external bleeding Proper body posture and position is needed
to prevent muscle strains.
v Patient with hemorrhagic disorders ü Skin problems
Rashes, lesions
v Patient with acute infections at the site of
the puncture ü Newly formed scar tissue, wounds and Scientific Principles Involved in Massage:
burns
v Patient with heart disease / ailment 1) Microbiology
ü Nausea
Hands should be washed before every
treatment
2) Body mechanics
Good posture is essential to avoid back
strains
3) Anatomy and Physiology
One must know the different parts of the
body and the locations of the nerves and
muscles.
4) Physics
Appropriate force must be observed so as
to prevent the worsening of patient;s
condition
5) Chemistry
Purpose of the lubricant is to avoid
uncomfortable friction between the hands
of the operator and the body he/she is
massaging
Guidelines in Acupuncture:
v Care must be taken by the practicioner
to cover any cuts or abrasions on their own
hands prior to treating the patient
v Discarded needles should be put in a
needle safe, which is then sealed and
enumerated, if blood is drawn, a sterile
swab should be ready to clean the area.
Guidelines in Acupressure:
Room should be warm and well ventilated
Practicioner’s arms and hands should be
clean and warm
Consider the patient’s pain threshold
Stay at the patient’s side while performing
the procedure
Let the patient relax in a comfortable
position
Loosen the patient’s clothing but always
ensure privacy
Bathing is allowed after two hours of
therapy
Guidelines in Massage:
ü Do medical hand washing before giving
the client the massage.
ü Reduce any noise present in and near
the room
ü Ensure the client is comfortable
ü Ask the patient if he/she likes the idea of
having a massage
ü Consult the medical records for any
contraindications for massage
ü Make sure that the patient is not allergic
to the lubricant
The Different Acupuncture Points:
Wringing
Transporting points:
Jing (well) 3) Deep tissue strokes
Xing (spring) Heel of hand pressure
Shu (stream) Thumb – rolling
Jing (river) Finger tip pressure
He (sea)
4) Percussion
v Belongs to the 12 meridian points and Cupping
are located below the knees and elbows Plucking
Pummeling
Jing (well) points:
Located on the fingers and toes of 4 Major Techniques of Massage
extremities
Incations: Effleurage
Fullness in the chest and mental disorders Consists of a variety of stroking
related to the yin organs movements, usually carried out with the
whole palm of the hand and fingers
Xing (spring) points: May be used with varying pressure
Located distal to the meacarpophalangeal according to the purpose and stage reached
joints or metatarsophalageal joints during the massage.
Are used for febrile diseases Always used at the start of massage.
The therapists' hands maintain, light
Shu (steam) points: contact and avoid the path taken on the
Located proximal to the metacarpalangeal upward stroke.
or metacarsophalogeal joints The hands must be relaxed and molded
Used for disorders related to heaviness in round the natural contours of the recipient's
the body or painful joint conditions body.
Always used to commence any massage
Jing (river) points: session
Located around the joints of the wrist or Should be:
ankles and are used for cough and asthma Carried out in a rhythmical and relaxed
due to pathologic cold and heat. manner starting with light touch at the start
of a session and building up to deeper
He (sea) Points: pressure for increased circulation and
Can be used when a lot of organs are stretching of tissues later in the massage.
problematic Taken at moderate pace and not rushed.
The client cannot relax if a tender area is
Lud (connecting) points: missed or massaged the wrong way
Connects with the interiorly / anteriorly because the therapist or the nurse was
related meridian or organ system rushed in performing massage therapy.
Used to complete the massage with light
Yuan (source) points: strokes that relax clients.
Indicated for diseases to the 3 yin organs
and are responsible for the regulator of Guidelines in Effleurage:
source Qi (Chi) in general Introducing touch to the client
Putting the client at ease
Warming the tissues
Increasing blood flow
Different Techniques used in Present-day Stimulating peripheral nerves
Acupuncture: Muscle relaxation
Palpating tissues
1) Intradermal
Petrissage
2) Shigo (single point) Needling Also known as kneading
Used on deeper tissues for mobilizing fluids,
3) Fire needle stretching muscle fibers, and inducing
relaxation.
4) Touching needle (hifushin) A powerful technique that is effective in
mobilizing fluids in very deep muscles.
5) Application of opposite needling Applies a good stretch to fibers involved.
technique
Types of Petrissage:
6) Gokavi Transverse Technique (GTT) Muscle Squeezing
Squeezes or compresses the muscle
The Different Massage Techniques and between the palm of the hand and the
Strokes: fingers.
Pressure is directed slightly upwards.
1) Glinding strokes Should be done slowly at the beginning of
Long strokes treatment.
Feathering Pressure will increase with each
Broad circling compression - within your client's pain
tolerance.
2) Medium – depth strokes Muscle stripping
Pulling Can be performed on a number of surfaces
Kneading using the fingertips, the ulnar border of the
hand (little finger side), the thumb or the
elbow.
Pressure is applied along the muscle fibers
usually from origin of the muscle to
insertion.
Picking up
Done using the fingers and thumbs, or
with the palm of the hand.
Squeezes the muscle and lift it from the
underlying tissue.
Begins slowly and progresses to a deep,
firmer pick up.
Skin Rolling
Lifts the skin between the thumb and
fingers and gently rolls over the area, very
slowly.
Allows a release in the superficial
restrictions between the skin and
underlying tissue.
It may be necessary to repeat rolling a few
times over the same area in order to
release any long term adhesions.
Stroking
This is one of the lightest petrissage
techniques.
The skin alone is stroked, so that the
underlying tissue is not directly affected.
Any part of the hand or fingers can be used
to perform this rhythmic stroke.
Produces a stimulating effect with its
multidirectional strokes, random rhythm
and rate.
Commonly used to end a treatment.
It can be a soothing stroke if the client
whishes to relax and stimulating if the
client wishes to be alert.
Wringing
Is a rhythmic picking up the tissue.
Fills the hand and tosses the tissue back
and forth between in opposition.
Your hands will conform to the tissue and
the depth of the pressure will increase
when tissue is lifted and torqued.
The pressure eases when the hands return
to their original starting position.
Vibrations
Applied lightly to the surface of the skin
and vibrated or moved at a rapid rate.
Performed statically (in one place) or
running (along the skin's surface).
The trembling action of the hands and
fingers transfers to the client rendering
various results.
Stimulating when done briskly
Relaxing when done gently and helps
reduce any tension.
Tapotement
Also known as percussion movements
Involves a series of light, brisk, striking
actions applied with alternate hands in
rapid succession.
Two of the main percussion strokes:
Cupping
Performed with your palms facing
downwards
Forms a hollow curve
Sometimes known as clapping
You bring your cupped hands down on the
body in a quick succession
Creates a vacuum that’s released when you
bring your hands up.
Sounds like a horse trotting and a hollow
sound.
Hacking
The best-known massage stroke
The movement which is always shown in
films
Achieved with the edge of the hands (the
ulnar border).
Hold your hands over the body with the
palms facing each other, the thumbs facing
uppermost. Then, flick your hands
rhythmically up and down in a rapid
succession.
May be performed on many areas of the
body
Especially effective when used on fleshy
and large muscular areas of the body such
as the thighs.
Other tapotement movements:
Flicking
Similar to hacking
“Finger hacking”
Flex your wrists slightly and bring only the
sides of your little fingers into contact with
the body
Note: do not bring the end of the hands in
contact with the body
It is a much lighter, softer movement than
the usual hacking movement
Beating
Applied with your hands in a closed position
with your fists lightly clenched
Performed with the ulnar border of the
closed fists
Closed fists are applied to the body in quick
succession
Pounding
Applied with your hands in a closed position
with your fists lightly clenched
Performed with the palmar surface of the
hands
Closed fists are applied to the body in quick
succession
When performing tapotement movements,
the action originates from the wrists and
not from the elbows or shoulders, which
remain still throughout.
Many beginners make the mistake of
practicing percussion movements from the
elbows and shoulders
Results in frustration and clumsiness.
Benefits of Tapotement
Percussion movements are very
stimulating.
It is extremely useful for athletes before an
event.
Improves circulation
Cupping is beneficial when performed over
the upper and middle back area
Percussion movements are valuable in
inducing muscle tone and strengthening
muscles
They are also useful in reducing fatty
deposits and flabby muscle areas and are
often used over the buttocks and thighs.
loosens mucus in the lungs aiding
expectoration
stimulates the muscles to contract.
Types of Tapotement:
Gentle tapotement or Light Tapotement
given over the abdomen increases
peristalsis, thereby aiding conditions such
as constipation.
Pincement and plucking of the superficial
tissue and light tapping with the use of the
finger tips
Heavy Tapotement
Consists of clapping/cupping, and hacking
Used for respiratory conditions to help
loosen mucus
Demonstrate Beginning Skills in
Acupuncture, Acupressure, and Massage
Reflexology: An Overview (Additional
Information)
Define:
Reflexology
The practice of massaging points on the
feet to relieve tension and treat illness
Reflex
An involuntary or automatic movement in
response to a stimulus
Benefits:
Increases Energy
Inner peace and a feeling of warmth within
and/or around the body
Gentle tingling sensations, especially in the
hands which may also feel hot
A sense of energy flowing in and/or around
the body
Clearer senses
Lessens stress and emotional problems
Improves physical health
Increases abilities to deal with stressful
situations in a positive manner
Increases clarity of the mind and deepens
intuition or inner wisdom
Brings a sense of “coming home” and being
in touch with “the flow” of life
Deepens one’s sense of spiritual awareness
and experiences
Brings a general feeling of being more
whole, healthy and happy
Provides a more complete sense of one’s
being or self
Relation to Acupuncture, Acupressure,
Massage
Reflexology uses pressure points in reflexes
to alleviate pains in the body.
Without the knowledge or awareness about
reflexology, one may not understand why
massage, acupressure, and acupuncture
relief pains felt in the body.
Reflexology brings a more spiritual and
cleansing effect to the body.