Hand Therapy Massage

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Although there are many therapeutic methods used for hand therapy, only the most common are discussed in this chapter. They include massage, acupuncture, hand bath, qigong and several miscellaneous methods including holding herbs, pressing and kneading the border of second metacarpal bone, arm swinging and other exercises.

I. Hand Therapy Massage
In hand therapy massage, stimulation is applied by hand to the regular and extra acupoints or reflective points and reflective areas closely related to various internal organs and tissues in the body. Particular maneuvers are employed to adjust their function, treat diseases, improve life quality, and maintain health. The basic maneuvers of massage include pressing, digitpressing, kneading, pushing, pinching, twisting, rotating, pulling, rubbing, and grinding methods.

1. Pressing maneuver:
A vertical pressure is applied by the tip or pad of thumb at the acupoints, reflective areas, and reflective points (Fig. 18).
Indications: The pressing maneuver is usually applied at the acupoints on a flat area (such as thenar and hypothenar prominence) combined with a kneading maneuver to prevent and treat various chronic diseases and pains and maintain health.
Principle of manipulation: The thumb should be firmly applied on the skin to produce a steady and persistent pressure in a small area. The pressure should be gradually increased in intensity, and not suddenly applied with a violent action. The frequency and intensity of pressure should be even.

2. Digit-pressing maneuver:
A pressure is applied at the acupoints of the hand by the tip of thumb or middle finger; or by the lateral border of tip of little finger supported by thumb and ring finger; or by the knuckle of proximal interphalangeal joint of index finger (Fig. ! 9).
Indications: The digit-pressing maneuver is usually applied with a heavy pressure at acupoints in a fissure between bones, or in a limited area to treat acute or painful diseases.
Principle of manipulation: Compared with the pressing maneuver, this maneuver can produce a stronger stimulation in a smaller area. The pressure should be applied at an accurate location without any sliding movement. The intensity of pressure may vary over a wide range.

3. Kneading maneuver:
The pad of thumb or middle finger is placed at the acupoint of the hand to receive treatment, and the forearm is actively swung to and fro with the elbow as a fulcrum and the wrist, palm, and finger as a transmitter to produce a gentle rotating and kneading movement to the acupoint with the pad of finger ( Fig. 20).
Indications: The kneading maneuver is usually applied at acupoints situated superficially over a broad area to produce an adjusting and toning effect for treatment of chronic, deficient, and wasting diseases as well as for maintenance of health and relief of local swelling and pain.
Principle of manipulation: The pressure applied by the kneading maneuver should be gentle and the movement of finger, hand and arm should be coordinated, rhythmic, and persistent for a longer period of time.

4. Pushing maneuver:
The single or multiple finger(s), root of palm, thenar or hypothenar prominence is used to produce an unidirectional linear pushing movement over certain parts of the hand (Fig. 21).
Indications: The pushing maneuver is usually applied along the longitudinal direction of the hand or over various sides of the fingers, and it may be followed by a rubbing maneuver to maintain health and treat chronic diseases, pain, and soreness due to soft tissue strain or diseases caused by deficiency and cold.
Principle of manipulation: To apply the pushing maneuver, the pushing force must be steady and strong enough, with the finger or palm placed firm on the skin of the hand. The pushing speed should be slow and even. The direction of the pushing maneuver is along the bones of the hand, and the force of the pushing maneuver may be freely adjusted, but it should be maintained at a fixed depth.

5. Pinching maneuver:
The free border or radial corner of the thumb nail or free border of the nails of other fingers is used to apply a vertical, heavy stimulation to the hand acupoints; or the free border of the thumb nail and the free border of the nails of other fingers are used to pinch the acupoint from both sides (Fig. 22).
Indications: The pinching maneuver is usually applied between metacarpal bones or between metacarpophalangeal joints together with pressing, kneading, and twisting maneuvers (or alternately applied) to treat acute or painful diseases, epilepsy, and neurasthenia.
Principle of manipulation: This is a maneuver designed to produce a heavy and deep stimulation and response. After the heavy and deep pinching manipulation is held for half a minute, gentle pressing and kneading maneuvers should follow for half a minute to relieve the discomfort produced by the pinching maneuver. This manipulation is repeated a second time. The pinching maneuver may be applied for a shorter duration and with a quicker rhythm. The nail must be steadily applied at the acupoint without any sliding movement to avoid causing injury to the skin.

6. Twisting maneuver:
The pads of thumb and index finger are used to hold and twist the injured finger back and forth to promote blood circulation through collaterals and stop pain (Fig. 23).

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