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On centre stage in this article are Tui Na – Chinese Massage, Shiatsu, Traditional Thai Massage and Indonesian Massage. To a casual observer they seem to have little in common. Tui Na, which means 'push and grasp' presents an endless range of soft tissue and manipulation techniques that are applied with lots of movement and vigour to the clothed body, using a chair and couch. Shiatsu is also done through the clothing but on a mat on the floor and by comparison seems rather still and static. It offers many techniques which focus sustained pressure on the soft tissues. Thai massage resembles Shiatsu in its soft tissue techniques which are also slow, often sustained presses applied to the clothed body. Thai manipulations come in a bewildering variety and look rather like applied yoga.

Indonesian massage seems to be the odd one in this company. It is an extremely vigorous form of bodywork performed directly on the skin using oil as a lubricant. Soft tissue techniques are backed up by a whole arsenal of manipulative ones.

What clearly defines each of these systems in its own right is the way the masseur's hands move and press as they track the meridians and specific energy points. For an understanding of the similarities and differences between them, it is useful to look into their origins.

Two great systems of medicine are the progenitors of our chosen therapies – Chinese Traditional Medicine (TCM) and Indian Ayurvedic Medicine. They are the oldest forms of medicine for which extensive documentation still exists and both date back over 4000 years. As you can see from the diagram, Tui Na is the modern hands-on branch of TCM and owes nothing to Ayurveda. Some 1200 years ago Tui Na was taken by the Japanese and modified to suit their culture and temperament to become Shiatsu. In recent times it has found its way to the West, undergoing further change in the process. The roots of Thai Traditional Massage also go back over one thousand years. Not surprisingly in view of its geographical location, Thailand has experienced many influences from both India and China. Those familiar with Thai massage can immediately recognise a strong Indian Yogic character in its impressive range of manipulations. Energy channels called 'Sen' that are effectively massaged as if they were classical meridians of TCM betray the Chinese influence. Indonesian massage has a history dating back 4000 years linking it firmly with Ayurvedic massage. Only the precise manner in which the massage follows the Chinese meridians suggests any relationship with Tui Na or Shiatsu.

Oriental Holistic Approach

Western medicine seeks to identify the organic cause of any health problem and to treat those parts of the body that are affected.

Chinese medicine pays little regard to the physiological causes of ill-health. Instead, it focuses on the need to identify patterns of disharmony relating to the body's intrinsic energies called Qi – pronounced 'Chi'. Treatments aim at restoring balance and harmony. The Chinese view is that any imbalance of Qi within and between the main organs spells pain and sickness. It affects not only the physical body but also the mind and emotions. Correcting Qi flow so that balance and harmony are restored, provides the right conditions for the body to heal itself. For the Western doctor the body is the sum of its individual parts but for the TCM doctor it is a single functioning whole. The four types of bodywork in this article are all truly holistic in their application and the benefits they bestow.

Tui Na and Shiatsu achieve this by following the guide-lines provided by the complex underlying theory. A practitioner of Thai or Indonesian massage lacks this type of theoretical background but nevertheless seems to possess an almost intuitive awareness of it.

Oriental massage maintains good health and can also treat a wide spectrum of health conditions. The four systems that are under discussion here differ widely in their techniques and methods of application and each one excels in the treatment of particular types of condition.

Here are some of them:

Headaches, neck and shoulder pain, sciatica and back pain, dysfunctional joints, arthritis, irritable bowel syndrome (IBS), pre-menstrual tension, tension, stress, insomnia, emotional problems and sports injuries.

TUI NA Pressing and Kneading Qi-points: Your partner lies on his left side with a small pillow supporting his head. The left leg is straight. Bend his right leg and draw it up in front so the thigh is at right angles to the body. Standing behind your partner and leaning over the right hip, or sitting beside his abdomen, elbow knead GB 30 for at least two minutes with small, circular movements. Start lightly and gradually put more bodyweight behind it. Then squeeze with the whole hand, and knead with the whole of the hand, down the bent leg. Press and knead GB 31. Deep kneading of GB 30 can be uncomfortable but strongly relieves sciatica, however severe.
From Step by Step Tui Na by Maria Mercati.Gai Books 1997.

Tui Na

In its purest form as practised in thousands of departments of traditional medicine throughout China, Tui Na is a very comprehensive healing system. It even includes a branch of specialist bodywork for babies and infants. The Chinese use it for all those conditions that in the West would be treated by physiotherapists, sports injury therapists, osteopaths and chiropractors as well as some that would be treated with drug therapy. The highly successful Chinese Olympic teams rely on Tui Na for all their bodywork requirements. As an aid to sports performance and for treating sports injuries it is without equal.

Those seeking an occasional massage for deep relaxation and the feeling of being pampered, should not choose Tui Na; it is far too vigorous, and anyway, that is not its purpose. It is serious therapy for all the conditions listed above. After receiving it for the first time it is possible to feel a little sore. This usually wears off after a day or two and subsequent treatments become progressively less uncomfortable.

Most people who are prepared to try it two or three times become addicts! Not only does it provide effective treatment for pain but it leaves the recipient with a feeling of lightness and of being energised. Many use it as regular health care. During a session of Tui Na the practitioner does not discourage the patient from talking.

Some perceptive listening combined with powerful Qi moving techniques can peel away layer upon layer of pent-up emotions to leave the patient feeling happier and more at one with him/herself and the world around.

Tui Na is performed with the patient seated or on a massage couch.

Clothing, other than shoes need not be removed. To receive maximum benefit it is best to wear thin cotton clothes. A T-shirt and light trousers are ideal. Those planning to have Tui Na for the first time should be prepared to answer lots of questions about the condition of their health and any medical history.

Shiatsu

The practise of Shiatsu, especially as seen in the West, has departed far from its Chinese roots although much of the underlined theory has been retained and even added to. Hara diagnosis has become an important component of Shiatsu. The hara is the intrinsic energy nucleus of the body and it is located in the abdomen.

SHIATSU: Palpating the Hara
From The Book of Shiatsu by Paul Lundberg. Gaia 1992.

It is believed to reflect the energetics of the whole body and is used in diagnosis. Modern Shiatsu has relatively few techniques compared with Tui Na, especially manipulations. This has lead to the borrowing of some Thai massage stretches which are becoming more and more common place in today's Shiatsu. Slow sustained pressure techniques dominate the massage interspersed with stretches and joint rotations. All of this is done on a mat on the floor and as with Tui Na, the patient is fully clothed except for shoes.

Shiatsu is usually performed very slowly in near silence and one reason for this is that it is essentially the application of intuitive touch. It requires deep concentration and fine tuning of the practitioner's sense of touch for correct 'reading' of the tactile clues that guide the course of the massage. As with Chinese massage, the ultimate aim is to create harmony and balance in the body's vital energies so that it can heal itself.

Shiatsu really is the definitive relaxant. For this reason it can be particularly effective for treating emotional problems and tension due to stress. For the treatment of chronic and acute musculo-skeletal problems it is often less effective than the other three therapies.

Thai Massage

This type of massage provides the recipient with an advanced yoga work-out that requires no self discipline, practice or effort on his/her part. It is much more than this, however, because before using any yoga type stretches the practitioner presses along all the energy channels called "Sen" and all the muscles through which they pass, from every conceivable angle. The pressing is done with thumbs, palms and soles of the feet. Hardly a single muscle manages to escape this treatment. The pace of the massage is slow and rhythmical. One technique blends into the next almost imperceptibly and there is never the slightest suggestion of haste.

THAI MASSAGE: The Corkscrew. This treatment is for dysfunctional thigh, pelvic and lower back muscles.

Deep, sustained pressure makes the myofascia, which is the muscle's connective tissue skeleton, soften and relax so that Sen energies can flow through it easily, preparing it for the large scale stretches that will follow.

On receiving a Thai massage for the first time some people find the pressing techniques a little too penetrating but most adapt to it very quickly. A skilled practitioner will be able to adjust all the soft tissue and manipulation work to suit those who are frail or stiff.

Effortless and spectacular though it appears, Thai massage places far greater physical demands on the practitioner than any other kind of body work. Correct positioning of the body and control of posture are of vital importance if injury – particularly to the back – is to be avoided. The scale of leverage involved in some of the large scale manipulations requires great skill and sensitivity if over-stretching the patient is to be avoided.

When performed correctly Thai massage is both relaxing and spiritually uplifting. It gives the muscles a comprehensive work-out that is unique and rehabilitates stiff and painful joints at the same time. No written description can convey the 'floating on air' feeling that 1½ hours at the hands (and feet) of a Thai master can bestow on you. Even young adults who feel fit and strong should try it to discover what real flexibility means. Sports injuries that affect joints and muscles can also be treated effectively with this type of bodywork.

Indonesian Massage

This is the ultimate oil-based massage with some very effective manipulations included for good measure. It is deep! Watching a typically small and gentle Indonesian doing a full body massage on another Indonesian gives no clue to the incredibly penetrating nature of what looks like a smoothly flowing massage along the length of each muscle. Europeans are wimps and usually find Indonesian massage rather painful on first acquaintance. Like Tui Na and Thai massage, however, it is addictive. Pain soon becomes 'good pain' and before long, sheer pleasure!

The soft tissue techniques of Indonesian massage particularly affect the connective tissue of the muscles – the myofascia and tendons.

Tense, shortened muscles and contracted and fibrotic myofascia quickly yield to smooth, deep thumb pushing along the course of each individual muscle. All soft tissue work intuitively follows the courses of the Chinese energy meridians. It is done more briskly than a typical Thai massage but just as thoroughly. Indonesian manipulations focus very much on the spine and mostly involve spinal twists. A one hour session of this kind of massage is enough to leave you feeling relaxed, refreshed, rejuvenated and re-energised. It really is powerful medicine.

As a therapy, it excels in the treatment of stiff and painful muscles and is also very effective for conditions affecting the abdominal organs such as constipation, indigestion, bloating, heartburn and irritable bowel syndrome (IBS).

Rehabilitating Muscles

The muscles in our bodies work in teams and never in isolation. The hamstring muscles are a good example of this.

All three muscles in this team can flex the knee joint but only one of them can also extend the hip. Since each muscle has a slightly different effect from the other two, the hamstrings are able to flex the knee, for example, in several slightly different ways.

Every muscle has the ability to contract but none can extend under its own effort. This means that every team of muscles in the body must have an opposing or antagonistic team of muscles that can stretch its members back to their normal resting length when they stop contracting – and vice versa, of course. For the hamstrings, the antagonistic team is made up of the quadriceps muscles.

When the hamstring muscles contract they pull the quadriceps back to their normal resting length and when the quadriceps contract they do the same for the hamstrings. All our muscles work on this principle.

If the whole system is to function effectively, very precise balance must be maintained between the strengths of muscles in opposing teams.

Suppose, for example, that we have two antagonistic teams of muscles called A and B. They control the movement of a joint. If team A muscles are constantly exercised and team B muscles are not, the balance between them is slowly affected. With repeated use, muscles become over-toned and shortened. This makes it ever more difficult for the antagonistic muscles to pull them back to their normal resting length – in fact, they do not. To add to the problem, the brain regards over-toned muscles as contracting and automatically reduces the contractile ability of those in the opposing team in an attempt to maintain balance between them. The result, unfortunately, is just the reverse. As team A muscles get over-used and thus over-toned, team B muscles get weaker. It is this kind of imbalance caused by repetitive strain that results in the muscular pain and stiff joints that are all too common in the West. Playing sports, driving cars with badly positioned controls, using a computer for hours at a time – all of these are likely to cause such problems.

The treatment for tense, shortened and even spasming muscles is to stretch them. They must be stretched just a little more than would be possible without help and always to a length slightly greater than their normal, healthy resting length. This deceives the brain so that it stops reducing the contractile ability of antagonistic muscles.

After a few treatments in fairly quick succession these conditions can be corrected.

The oriental therapies under review here can all be used to treat these problems. Tui Na and Thai massage are particularly effective but Shiatsu and Indonesian massage also work well if somewhat more slowly.

Muscle shortening caused by repetitive strain is always accompanied by some pathological changes in the muscle's connective tissue which must also be addressed when treating these conditions. These therapies are effective because they balance the intrinsic energies so that the damaged tissues can heal themselves at the same time as the muscle fibres are mechanically stretched.

In the fight against chronic pain – both physical and emotional – Tui Na, Shiatsu, Thai and Indonesian massage are all powerful weapons.

Each one is capable of making you feel good – in every way.