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Spring 2013 / Tui Na Hand Techniques > wk11 - upper limb protocol > Flashcards

wk11 - upper limb protocol Flashcards

1
Q

What are the effects of the Upper Limb Protocol?

A

· Regulatory protocol for neck & upper limb
· Normalizes movement at the neck, shoulder, elbow, wrist, and fingers
· Relaxes & realigns soft tissue
· Uses traction & foulage to enable joint mobility
· Facilitates qi & blood flow to and through the upper limb
· Affects all meridians on the upper limb

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2
Q

What are the clinical applications / indications for the Upper Limb Protocol?

A 
·  Scapular pain
·  Neck pain
·  Upper back pain
·  Bursitis
·  Rotator cuff tear / tendonitis
·  Frozen shoulder
·  Bicepital tendonitis
·  Tennis / Golfer's elbow
·  Arthritic elbow / shoulder / wrist / hands / fingers
·  Carpal tunnel syndrom
·  Wrist / forearm pain
·  Trigger finger
·  De Quervain's tendonitis
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3
Q

What are the 14 steps of the Upper Limb Protocol?

A

1) Press / Round Rub SI 11
2) Pluck lats & pecs
3) Grasp & Pull anterior deltoid
4) Grasp & Pull posterior deltoid
5) Roll shoulder: superior, anterior, posterior
6) Grasp / Pinch / Knead biceps & triceps
7) Dig / Press brachialis
8) Pinch / Grasp / Knead forearm
9) Wipe Yin side & Yang side of forearm to wrist
10) Sinew Divide Yang side of forearm
11) Round Rub thenar & hypothenar
12) Dig LI 4
13) Traction / Foulage / Knead (3x) and Nip (1x) the fingers
14) Foulage the arm

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4
Q

What is the benefit of step 1: Press / Round Rub SI 11?

A

Energizes & moves qi through the shoulder & upper limb

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5
Q

What is the benefit of step 2: Pluck lats & pecs?

A

· Relaxes tension & spasm in lats & pecs
· Relieves stagnation
· Moves qi & blood

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6
Q

What is the benefit of steps 3 & 4: Grasp & Pull anterior deltoid & posterior deltoid?

A

· Relax tension & spasm in deltoid

· Moves qi & blood

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7
Q

What is the benefit of step 5: Roll shoulder (superior, anterior, posterior)?

A

· Moves qi & blood through the shoulder
· Relaxes spasms & breaks adhesions
· Frees movement of the shoulder joint

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8
Q

What is the benefit of step 6: Grasp / Pinch / Knead biceps & triceps?

A

Moves qi & blood through the meridians of the upper arm (LI, LU, SJ, SI)

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9
Q

What is the benefit of step 7: Dig / Press brachialis?

A

· Relax tension in the brachialis

· Facilitate normal extension at the elbow

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10
Q

What is the benefit of step 8: Pinch / Grasp / Knead forearm?

A

· Relax tension & spasm in the flexor, extensor, and other muscles of the forearm
· Moves qi & blood through the Yin & Yang channels of the forearm

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11
Q

What is the benefit of step 9: Wipe Yin side & Yang side of forearm to wrist?

A

· Moves qi & blood through the superficial layers of the forearm
· Moves Wei Qi
· Relaxes tightness & spasm

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12
Q

What is the benefit of step 10: Sinew Divide Yang side of forearm?

A

· Strongly courses qi through the Yang channels of the forearm
· Releases tension in the interosseous membrane & extensor muscles

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13
Q

What is the benefit of step 11: Round Rub thenar & hypothenar?

A

Relaxes tightness & spasm in the hand

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14
Q

What is the benefit of step 12: Dig LI 4?

A

· Courses qi in the hand & the limb

· Relieves pain

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15
Q

What is the benefit of step 13: Traction / Foulage / Knead (3x) and Nip (1x) the fingers?

A

· Relieve tension & free the joints of the fingers

· Flash energy through the channels of the upper limb

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16
Q

What is the benefit of step 14: Foulage the arm?

A

· Frees up the joints of the upper limb

· Unblocks stagnation & moves qi through the upper limb

17
Q

How do you perform step 1: Press / Round Rub SI 11?

A

· Stand at patient’s side
· Supporting hand on front of shoulder
· Press thumb perpendicularly into SI 11

18
Q

What is the location for SI 11 (aka “Limb Gate point”)?

A

in a depression on the scapula 1/3 down on a line drawn from the midpoint of the scapular spine & the inferior angle

19
Q

How do you perform step 2: Pluck lats & pecs?

A

· Lift patient’s arm in neutral position ~45 degrees off center (patient’s arm should be relaxed)
· Pluck lats with your thumb on posterior axilla
· Pluck pecs with your thumb on anterior axilla

20
Q

How do you perform steps 3 & 4: Grasp & Pull anterior deltoid & posterior deltoid?

A

· Stand slightly behind patient to grasp & pull anterior deltoid
· Stand slightly in front of them to grasp & pull posterior deltoid
· No need to move hands; keep pulling at same spot using both hands

21
Q

How do you perform step 5: Roll shoulder (superior, anterior, posterior)?

A

· Lift patient’s arm in neutral position ~45 degrees off center
· Apply light traction while rolling over pecs, deltoid, and shoulder joint
· Rotate pt’s arm externally to expose pec minor
· Rotate pt’s arm internally to expose teres muscles

22
Q

How do you perform step 6: Grasp / Pinch / Knead biceps & triceps?

A

· Lift patient’s arm to a neutral position
· Grasp / Pinch / Knead with your thumb on Yang side of arm
· On the biceps, pinching is safer bc of HT channel (don’t dig finger tips under medial border of biceps)

23
Q

How do you perform step 7: Dig / Press brachialis?

A

· Find the depression just lateral to the biceps brachii tendon
· Dig / Press with towards humerus

24
Q

How do you perform step 8: Pinch / Grasp / Knead forearm?

A

· Hold onto patient’s wrist/hand, start near elbow and move down to wrist
· Pinch / Grasp / Kneed flexors, extensors, and brachioradialis muscles

25
Q

How do you perform step 9: Wipe Yin side & Yang side of forearm to wrist?

A

· You can be seated for step 9 onward

· With thenar and thumbs together, wipe outward

26
Q

How do you perform step 10: Sinew Divide Yang side of forearm?

A

· Start near elbow and move down to wrist
· Feel for depression between muscles
· With thumbs back to back, press deeply and rotate outward slightly (thumbs stay back to back throughout, and hold Yin side of forearm with other eight fingers)

27
Q

How do you perform step 11: Round Rub thenar & hypothenar?

A

Round Rub thenar & hypothenar using your thumb

28
Q

How do you perform step 12: Dig LI 4?

A

Two techniques:

1) Place your thumb on Yang side of webbing and your index finger on Yin side of webbing, then press the two fingers towards each other
2) With the patient’s thumb & index finger close together, hold their entire hand from the Yang side and press down with your thumb

29
Q

What is the location for LI 4?

A

in the web between the index finger & thumb, closer to the 2nd metacarpal bone (technically at the midpoint of the 2nd metacarpal)

30
Q

How do you perform step 13: Traction / Foulage / Knead (3x) and Nip (1x) the fingers?

A

· Place your stabilizing hand over the metacarpals
· Hold each finger between your thumb & index finger, and traction / foulage / knead on the same pass
· Nip nips of fingers using the middle phalanges of your 2nd & 3rd fingers

31
Q

How do you perform step 14: Foulage the arm?

A

· Have the patient’s arm hanging slack (they may need to side bend)
· Make sure patient’s arm won’t knock against side of chair

Spring 2013 / Tui Na Hand Techniques (16 decks)

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