Seated Massage Techniques for Carotid Health and Brain Nourishment

1. Dredge the carotid artery and promote cerebral blood supply – Neck Rubbing Method

Manipulation Technique: The patient assumes a seated massage posture, and the massage therapist stands to the front right of the patient.

Manipulation: The masseur supports the patient’s left head with the left hand, and uses the index and middle fingers of the left hand to perform finger-kneading from the high bone behind the right ear to the supraclavicular fossa (i.e., along the sternocleidomastoid muscle), focusing mainly on the areas where the internal and external carotid arteries are located. Repeat the finger-kneading in this manner until the stagnant carotid arteries feel soft or there are mobile changes within the blood vessels. Then, the masseur stands in front of the patient’s left side and performs finger-kneading along the left sternocleidomastoid muscle in the same way as on the right side.

After massaging both sides of the sternocleidomastoid muscles, use the right hand’s thumb and index finger, spread apart like pincers, to grasp and knead along both sides of the cervical spine starting from the bilateral Fengchi (GB20) points. Move from top to bottom, relaxing the neck and shoulder area, repeating this process 3 to 5 times.

Key Points: When massaging the neck muscles, be sure to avoid pressing too close to the throat. This is because there are two important structures, the carotid sinus and carotid body, at the branching point of the carotid artery in the neck (where it divides into the internal carotid artery and external carotid artery). Excessive stimulation at this location can cause severe hypoxia or a sharp drop in blood pressure, leading to dyspnea or hypotensive shock.

Function：It has the function of dredging the carotid artery and promoting intracranial blood supply.

2.Promoting the Mobility of Cervical Joints – Cervical Rotation Manipulation

Technique & Position: The patient assumes a seated massage posture, and the massage therapist stands behind.

Manipulation: The masseur supports the patient’s left shoulder with the left hand, spreads the fingers of the right palm and places it on the top of the patient’s head, then gently rotates the patient’s head several times to the left and right respectively. Then, grasp Fengchi (GB20) and press Fengfu (GV16) 3 to 5 times each.

Key Points: When performing the neck-rocking technique, the range of rotation should be controlled within the physiological traction range, and the frequency should be slow. Violent force must not be used. Most patients may hear a “crackling” sound during neck rocking, which is an indication of cervical spondylosis.

Function：Neck-rocking manipulation has the functions of promoting qi circulation and regulating tendons, activating meridians and facilitating joint movement.

3. Clearing heat and benefiting the head and eyes, improving hearing and enlightening the orifices – Method for Improving Hearing

Technique & Position: The patient adopts a seated massage posture, with the massage therapist standing in front.

Manipulation: The masseur uses both thumbs to apply a light-heavy-light pressing technique on both sides of the taiyang (EX-HN5) acupoint for 3 to 5 repetitions. Then, the masseur quickly places both palms on the temporal regions on both sides of the head and performs a light-heavy-light pressing motion on the head in sync with the patient’s breathing for 3 repetitions. Next, the masseur places both palms tightly against both ears (with the palms facing the ear canals), and overlaps the fingers of both hands, placing one hand above the other, on the lower part of the back of the head and the upper part of the neck, covering the fengchi (GB20), fengfu (GV16), and yamen (GV15) acupoint areas. First, the fingers of the hand placed on top tap the fingers of the hand placed below in a 3×3 rhythm (i.e., a total of 9 taps in three sets of three: thump-thump-thump, thump-thump-thump, thump-thump-thump). After that, the hands switch positions, and the same tapping method is repeated for another 9 taps. Then, the middle finger of the upper hand taps the middle finger of the lower hand in the same 3×3 rhythm for 9 taps. After switching hands again and repeating the tapping for another 9 taps, the masseur quickly lifts the hands and uses the tips of the ten fingers of both hands to peck at the head for about half a minute. Then, the masseur uses the two-finger tapping technique of both hands to tap for another half a minute. Finally, the masseur concludes by vibrating the ears 15 to 20 times using the ear-vibrating technique.

Key Points: When pressing both Taiyang acupoints (EX-HN5 tai yang xue) with both thumbs in opposition, the force should not be too heavy and should be within the patient’s tolerance. When performing head counter-pressure, the force should follow the patient’s breathing, that is, press slowly during exhalation and relax the hands gradually during inhalation. When promoting hearing acuity, the hands attached to both ears should not press too hard or too lightly. After the completion of this method, the patient should have a special feeling of refreshment.

Actions：This method has the actions of clearing and benefiting the head and eyes, calming the mind and improving intelligence, and restoring consciousness and opening the orifices.

4. Promoting Blood Circulation to helps with occasional Pain, Dredging Meridians and Activating Collaterals – Kneading and Rubbing the Upper Limbs

Technique & Position: The patient adopts a seated massage posture, and the massage therapist stands to the right front side of the patient.

Manipulation: The masseur supports the patient’s right hand (with the palm facing downward) with his left hand. Starting from the patient’s right thumb, the masseur’s right hand kneads and pinches along the radial side of the patient’s right upper limb all the way up to the anterior part of the shoulder. When reaching the anterior part of the shoulder, the masseur quickly changes the finger-palm kneading and pinching technique to the finger-palm rubbing technique, moving along the upper edge of the anterior scapula, the lower edge of the clavicle, the inner edge of the chest, the upper edge of the breast, and then back to the upper anterior part of the shoulder. After that, continue moving slowly along the medial edge of the upper limb and the medial edge of the forearm, returning to the tip of the right thumb. After completing this, perform the same manipulation on the patient’s right index and middle fingers.

After the above operations on the three fingers are completed, the masseur supports the radial side of the patient’s right hand with the right hand, and uses the left hand to perform the same kneading manipulation as above on the patient’s ring finger and little finger. The difference from the above method is that when kneading to the shoulder, the kneading manipulation is changed to finger-palm rubbing manipulation. Starting from the posterior-superior border of the scapula, passing through the medial border of the scapula, the inferior border of the scapula, the lateral-inferior border of the scapula, and then returning to the lateral-superior border of the scapula, and returning along the lateral border of the upper limb to the original position of the fingers. Then, the masseur quickly moves both hands and places them on the anterior and posterior parts of the shoulder respectively, embracing the shoulder from front to back and pushing downward in a刨 (scraping-like) motion, slowly moving to the palm and fingers, and sliding out from the tip of the finger. This can be done continuously for 2 – 3 times.

After that, form the index and middle fingers into a pincers shape, and perform finger-勒 (a kind of massage technique, here translated as “pinching-pulling”) on each finger of the patient in sequence starting from the thumb, 1 to 2 times each. Then, press the acupoints such as Hegu (LI4), Shousanli (LI10, caution should be exercised in women during menstruation for the above two acupoints), Quchi (LI11), and Jianyu (LI15) in sequence.

After acupoint stimulation, apply the palm-opposing rubbing manipulation from top to bottom on the upper limb for 2 to 3 times, and then perform the shaking manipulation on the upper limb for 2 to 3 times. Subsequently, use the same methods to manipulate the left hand. The techniques are exactly the same as those for the right hand, except that the manipulation starts from the little finger of the left hand.

Key Points: When performing kneading and rubbing on the upper limbs, operate along the meridian pathways. When performing double-handed scraping and pushing, the movements should be slow and the pressure even, allowing the patient to feel a warm current moving downward along the upper limbs.

Functions：This method has the functions of promoting menstrual flow and activating blood, harmonizing the collaterals and relieving pain.

5. Relieving Cough and Asthma – Rotary Pushing on the Scapula with Finger and Palm

Technique & Position: The patient assumes a seated massage posture, and the massage therapist stands behind.

Operation: The masseur places the palmar sides of both hands on the left and right shoulders respectively, with the thumbs of both hands positioned at approximately the BL15 (Xinshu) points on the medial borders of the scapulae. The masseur then simultaneously performs a rotating and separating pushing motion with the thumbs of both hands moving upwards, gradually rotating and separating-pushing from the medial borders of the scapulae to the outer superior borders of the scapulae, repeating this action 3 to 5 times.

Key Points: When performing the rotating and separating pushing manipulation with the thumb pointing upward, the technique must be gentle, steady, and profoundly forceful, providing the patient with a sense of relaxation and comfort.

Functions：This method has the effects of relaxing tendons, promoting qi circulation, relieving cough, and alleviating asthma.

6. Concluding Method of Seated Massage

Technique & Position: The patient assumes a seated massage posture, and the massage therapist stands behind.

Manipulation: The masseur places both hands on the patient’s shoulders respectively, with both thumbs pressing on the Jianzhongshu points (BL11), located 2 cun lateral to the Dazhui point (GV14). The middle fingers are placed on the Quepen points (ST12) in the supraclavicular fossas on both sides, while the remaining three fingers are positioned casually. During the manipulation, first press the right Quepen point (where the brachial plexus runs) with the right middle finger for 1 minute, then pluck the brachial plexus once, causing a strong electric – shock – like sensation throughout the upper limb (including the fingers). After finishing on the right side, perform the same procedure on the left Quepen point.

Then quickly raise both hands, press Jianjing (GB21) acupoint 3 to 5 times, then lift and flick each shoulder tendon 1 to 2 times respectively, press and point at Bingfeng (SI12), Jianzhongshu (SI15), Tianzong (SI11) and other acupoints, knock on the shoulder and back with both hands for 1 minute, and then use the knee-pressing spine method, that is, use the right knee joint to start from the patient’s back center and slowly slide down to the coccyx, and end after 1 to 2 times.

Key Points: When pressing the Qupen (ST12) points for a long time, gradually increase the pressure. After pressing the Qupen (ST12) points on both sides, there should be a radiating sensation of soreness and distension in the upper limbs. When plucking the brachial plexus deep within the Qupen (ST12) points respectively, there should be a strong radiating sensation like an electric shock in the upper limbs on both sides. When pressing the Jianjing (GB21), Bingfeng (SI12), Jianzhongyu (SI15), and Tianzong (SI11) points, start with light pressure and gradually increase it, resulting in a sensation of soreness and distension. When tapping with the combined index and middle fingers of both hands, apply force at the wrist with a uniform rhythm, light, brisk, and elastic movements. When pressing the spine with the knee, apply consistent pressure without sudden changes in intensity or speed. After the operation, there should be a feeling of relaxation and comfort in the upper part of the body.

Functions：This method has the effects of relaxing tendons and promoting qi circulation, harmonizing qi and blood, and dredging meridians to helps with occasional pain.