The clinical application of massage in the supports of tendon injuries and bone and joint wellness is mainly manifested in two aspects: “tendon regulation” and “reduction”.
1.Tendon-regulating
The application of tendon-regulating manipulation techniques yields favorable therapeutic effects in supports various tendon injuries, such as acute soft tissue injuries, chronic strain, and meridian obstruction caused by exposure to external pathogenic wind-cold factors.
In traditional Chinese medicine, it is believed that “pain results from obstruction.” The so-called obstruction refers to the blockage of meridians and the inability of qi and blood to flow normally under the influence of various pathogenic factors. The main causes of blood vessel obstruction are as follows in three aspects:
Firstly, when a certain part of the limb is subjected to external violent blows, collisions, falls, or sudden twists, resulting in injuries such as hematomas or edema at the injured site, it can cause meridian blockage and subsequently lead to pain.
Secondly, sudden climatic changes or prolonged exposure of the body to cold stimuli from external pathogenic factors such as wind, cold, and dampness can cause vasoconstriction, blood coagulation, and vascular obstruction, leading to pain. This is primarily because blood “circulates when heated and coagulates when chilled,” and blood vessels exhibit the property of “expanding when heated and contracting when chilled.”
Thirdly, pain arises due to the influence of pathogenic factors within the body, leading to increased blood lipid levels, an increase in foreign substances within the blood vessels, excessive blood viscosity, impaired blood flow, or occlusion.
In long-term clinical practice, various tendon-regulating techniques are often applied according to different conditions to induce muscle contraction or relaxation, thereby regulating the pressure between tissues. This promotes blood circulation around the injured tissues, increases blood perfusion flow to the damaged area, and achieves the goals of activating blood circulation, resolving blood stasis, promoting qi flow, and relieving pain. The implementation of all tendon-regulating techniques can be summarized by three key principles: warming, regulating, and mobilizing. “Warming” refers to using thermal methods to warm and transform stagnant blood, dilating constricted blood vessels to promote blood flow. “Regulating” involves applying various tendon-regulating techniques to smooth and dredge obstructive foreign substances within the blood vessels. “Mobilizing” refers to using movement and activity to dredge blocked channels, including promoting activity of the injured limb, enhancing the flow of qi and blood, and facilitating passive movement of limb joints.
Promoting limb movement and the flow of qi and blood is of extremely vital significance in accelerating the repair of soft tissues. In clinical practice, we often observe that long-lasting unilateral low back pain can lead to contralateral low back pain; prolonged low back pain can also cause back pain or pain in the buttocks and lower limbs. This is due to the uncoordinated mechanical relationships between muscles, which is referred to as “wellness transmission and transformation” in traditional Chinese medicine and is considered a manifestation of blocked meridians and worsening of the condition. Tendon-regulating techniques can dredge the blocked meridians and balance the uncoordinated mechanical relationships between muscles, thereby facilitating the recovery from injury-related conditions.
In muscle-regulating manipulation, there is also a type of passive movement. The so-called passive movement refers to the massage therapist assisting the patient in moving, which is also an important part of muscle-regulating manipulation. For those with joint adhesions and stiffness, appropriate passive movements can help loosen the adhesions and smoothen joint movement; for those with local soft tissue degeneration, it can improve the nutritional supply to the local tissues, promote metabolism, increase muscle extensibility, thereby improving or repairing the degenerated tissues.
In summary, in the massage therapy for tendon and muscle injuries, the core issue that primarily needs to be addressed is making an accurate assessment. It is essential to have a detailed understanding of the injured area, nature, type, and severity of the condition to make correct judgments, which will facilitate supports and yield satisfactory results.
It should be noted that: After the body suffers from external force injury, massage therapy should not be applied within 4 to 6 hours at the site with obvious hematoma to helps maintain aggravating the hematoma and causing difficulties in supports.
2. Reduction
By carefully touching the injured areas of bones and bone joints with fingers, one can determine the location and morphological changes of the injury, thereby understanding its severity and nature. As stated in the general discussion of Zhenggu Xinfayao Zonglun in Yizong Jinjian (Golden Mirror of Orthopedics), “Touch with the hands to understand the condition thoroughly.” Today, although X-rays are widely used and can clearly show the morphology of bones, it is difficult to accurately observe many soft tissue injuries through X-rays. Therefore, palpation assessment still holds significant clinical importance, especially for blind massage therapists. For dislocations and wellness of different tissues and forms discovered during palpation assessment, timely reduction methods should be employed to restore and correct them, ensuring the smooth connection of meridians, proper alignment of joints, and unobstructed flow of qi and blood, thereby achieving the goal of “pain relief when circulation is unobstructed.” Conditions such as dislocation of the biceps brachii tendon, injury to the intra-articular cartilage plate, cervical and lumbar intervertebral disc herniation, spondylolisthesis, spinal joint dislocation, sacroiliac joint subluxation, and other bone joint misalignments, as well as ligament injuries, require active measures to restore order and return everything to its proper place, facilitating the relief of muscle spasms and the recovery of joint function. It is important to note that during manual manipulation, one must ensure that “the application of techniques causes no pain to the patient.”