Balancing the Body Without Needles

Chinese medicine is most well known for acupuncture, using very thin, flexible needles inserted at specific points on the body to heal from any number of diseases and health issues. What is not as well known is that acupuncture can also be performed without inserting needles.

There are ancient methods including non-inserting needles in the Japanese tradition, moxibustion, and acupressure massage, and modern methods such as lasers, vibrational tuning forks, point injection therapy, and essential oils.

Ancient Methods

One of the oldest books of acupuncture called the Ling Shu describes nine different types of needles, only one or two of which were actually meant to pierce the skin. When the Ling Shu and other classical Chinese medicine texts made their way to Japan the medicine adapted in that particular culture.

Whereas acupuncture in China has focused on the filiform (insertive) needle, acupuncture in Japan has mastered the non-insertive needles in the many schools of traditional Japanese medicine, such as Shonishin, and Toyohari.

Teishin

There are many dimensions to the methodology and practice of traditional Japanese acupuncture, but I want to just to touch on a personal favorite tool of mine, the teishin.

A teishin is an elegant non-inserting tools made from copper, silver or gold. It is meant to gently stimulate acupuncture points, relieve muscle tension and knots, and to help balance the whole body. Gold and copper can be more tonifying, silver more sedating, but often it depends the method used that determines the result.

Teishin can be used very gently on points, brushed along channels, and even as a diagnostic tool for the practitioner to “read” the state of the given points or channels.

Minimal Intervention

Any practical medicine should be a good balance of science and an art. There is a science and methodology of acupuncture, it has its own complex system of anatomy, physiology, pathology, diagnosis, and treatment.

The art of practicing the medicine is connecting with the patient through listening, empathy, and touch. I am in continual awe of the human body, and its ability to respond to minimal intervention in the form of gentle stimulation of the acupuncture points.

What is a Scar?

A scar is fibrous connective tissue that patches up an area of skin or muscle that has been injured in some way either from a burn, cut, infection, or other damage. Scar tissue is the body’s way of healing after a trauma but it does not function quite as well as skin or muscle. However, scars do not have to be permanent. Connective tissue can be softened, broken down, changed, integrated, and healed.

Types of Scars

A keloid scar. This would be considered a yang scar in Chinese medicine.

From a Chinese medicine perspective scars can be yin or yang. Yin and yang are always relative, but in general a yin scar will be pale, sunken, and soft. A yang scar will be darker, raised, and more rigid. Some scars are a combination.

In Western physiology scars are categorized as keloid, hypertrophic, and contracture, and also acne scars. Keloid scars are raised above the skin and usually darker or redder than the skin tone. Hypertrophic scars are similar to keloids but not raised above the surface of the skin. Contracture scars can occur with burns and cause the skin and fascia to tighten which can affect muscles, nerves, and even organs. Acne scars are also common and appear as small pits in the skin.

Why Treat Scars?

Scars come in all shapes and sizes from small and barely noticeable to life-altering scar tissue that covers the body. If a scar is causing discomfort, pain, or dysfunction it is important to get scar therapies.

Any scar is on some level restricting the free flow of movement and function in the body (aka qi). Most of the time this will not impact quality of life, but larger, deeper, older scars can be a source of localized or radiating pain, restricted movement, and depending on the location and depth, interference with proper organ function.

Although often scars will fade with time, they also have a tendency to harden over time and continue to restrict the surrounding fascia without treatment.

The Goal of Scar Therapy

The goal of scar therapy is to return the scar to as much normalcy as possible in terms of appearance, movement, sensation, and function. It depends on the size, depth, and age of the scar, and the general health of the skin and the body. But therapeutic interventions can resolve pain and numbness in the area, help bring back movement in a joint, reduce the appearance of the scar, and make the scar itself more integrated and functional with the surrounding tissues.

Methods

Acupuncture

A yin scar from multiple surgeries on the lateral left leg. Acupuncture needles are surrounding the scar bringing about increased blood circulation and gently breaking up the scar tissue.

One acupuncture technique for scars is “surrounding the dragon” where needles are inserted all around the perimeter of the scar with the goal of bringing qi and blood circulation to the areas. This also serves to loosen the surrounding fascia and relieve radiating pain and tension.

A more assertive technique to to actually insert acupuncture needles underneath the scar to further break down the scar tissue.

Massage

Massage will help soften scars and also free the restricted fascia surrounding the scar tissue. with consistent treatments. Touch itself is very important for healing the emotional trauma around scars. Part of the goal of scar therapy is to integrate the scar tissue with the surrounding area, the same goes for integrating the experience that caused the scar into our life to be able to move on..

Cupping

Cupping can be used directly on the scar or around it to loosen the fascial layers and encourage circulation.

Gua sha

Gua sha may be used around or on the scar. My preferred method is to use a Japanese tool called a chokishin made of silver and do a spreading or gliding stroke over the scar to gently encourage circulation without aggressively trying to break up the scar. But it depends on the scar and what is needed.

Topicals

Vitamin E oil, or grapeseed oil which is high in vitamin E, are both helpful for scars. Castor oil softens hardened areas and masses and is useful for scars. Zheng Gu Shui is an herbal liniment formulated to help heal bones and tendons, but it is helpful for scars by increasing blood circulation and reducing pain.

Conclusion

Scars can heal and it is worth it to seek out simple therapies that can treat your scars and improve your quality of health and life.

Cupping as Medicine

Cupping is a healing modality with ancient roots that is still widely practiced today. Traditionally cupping was used to treat disease by pulling pathogenic factors such as excess cold, heat, wind, or stagnant blood and fluids to the surface of the skin to clear out through the pores.

In Chinese medicine cupping is used to treat disease, including arthritis, chronic pain, colds, flus, and liver disorders. Cupping is also practiced as manual therapy to resolve pain and tension, decompress restricted fascia, and increase circulation.

Mechanism of Action

Cupping uses a negative pressure created by a pump, suction, or vacuum. Cupping draws stagnant blood and fluid to the superficial vessels, thereby increasing circulation and lymph flow within the layers of the fascia.

The Discoloration/ Cupping Marks/ Sha

Cupping draws blood and fluids to the superficial vessels, temporarily filling them and creating a mark that looks like a bruise or rash. This discoloration is temporary and usually fades in a couple of days to a week. Unlike a bruise, the treated area feels immediate pain relief and resolution of tension.

Even if the discoloration does not appear there are still beneficial changes in the texture, temperature, and appearance of the skin and myofascia.

Styles of Cupping

All cups have a way to create a negative pressure. The most common styles of cups we see today are fire cups, external pump cups, silicone cups, and facial cups.

Fire Cupping

How Fire Cupping Works

Fire cupping uses simple cups made of non-flammable material, usually glass but sometimes bamboo or ceramic. A vacuum is created by removing the oxygen in the cup with a controlled flame, such as a lit cotton ball soaked in rubbing alcohol or a small charcoal on a metal handle. The flame is inserted into the cup and quickly removed and the cup placed on the skin. The vacuum created inside the cup causes the muscle tissues to be pulled up inside.

Fire Cupping and Traditional Chinese Medicine

Fire cups are necessary in order to use several techniques of traditional Chinese medicine including bleeding cupping, herbal medicinal cupping, and combined moxibustion or needling with cupping. Fire cups are the most traditional form and that style has a special place in the heart of many practitioners.

Practical Considerations

Tthe glass cups can get very warm and can create a very strong suction, arguably the strongest potential suction of all the types of cups. The glass cups are easy to clean and disinfect, but can break when dropped, or the rim can become chipped..

Fire cupping is somewhat difficult to learn at first and requires some practice, and there is a danger of burning when not done properly, mostly from the possibility of the cup getting too hot.

Glass cups can glide on the back but do not glide very well on other parts other body, and they are difficult to control the suction level. Overall fire cups are best used by acupuncturists using traditional techniques.

Fire Cupping and Massage Therapy

While cupping is in the scope of practice for massage therapists in most states, fire cupping in particular is not covered by many of the professional massage liability insurance carriers. To find out if this applies to you check with your state massage board and professional liability insurance carrier.

External Pump Cups

This style of cups usually come in a set of multiple size cups made of either plastic or polycarbonate, with an external pump. Suction is created by using the pump to draw the muscle tissues inside the attached cup. The most common type is the hand pump or pump gun, but there also exists a machine pump.

How External Pump Cups Work

The cups pop right into the pump and suction is created by squeezing the pump or setting the machine. With the pump it is possible to control the suction easily, and without taking the cup off the body. External pump cups can be used for self-care even on the back and shoulders. They attach easily to areas around joints such as elbows, wrists, the lateral and posterior neck, knees, and ankles.

These cups are somewhat difficult to clean and properly disinfect because of the valve in the cups and the possibility of body fluids entering the pump. The cheaper plastic cups are breakable, the polycarbonate cups are much more sturdy. With their thin rim and domed shape these cups are difficult to do gliding techniques.

The biggest cups in the sets still tend to be smaller than the large fire cups or silicone cups. However in the machine pump sets there are very large cups.

Silicone Cups

Silicone cups are made of medical-grade silicone and are self-suctioning. The common types are the mushroom shaped cups and the dome shaped cups.

The technique of squeezing and applying the cup to the body can be mastered in minutes. These cups contour to the body and glide easily. They can be easily cleaned and disinfected, and do not break down, fray, or lose shape over time.

Amplifying the Suction

Even though silicone cups have limited suction compared to other styles, it is possible to amplify the suction by placing multiple cups in one area, or by pulling up on the cup when gliding. The mushroom shaped cups are easier to glide and provide greater suction than the dome shaped cups.

The quality varies somewhat, which is true of all the styles of cups. Be wary of silicone cups that have a visible center seam, which shows a cheap manufacturing process and compromises the smoothness of the cup.

The mushroom shaped silicone cups are better to use in clinical practice because they get strong suction than the dome shaped cups and are easier to grip for gliding. The silicone cups are easy to clean and disinfect, they never break when dropped, and are not destroyed by oil like equipment made from vinyl.

Facial and Jaw Cupping

Facial cupping requires specialized cups with very limited suction. Facial cups are either very small cylindrical glass cups with a small rubber bulb, or small conical silicon cups. The technique can be a gentle pumping suction to mimic the lymphatic system or gliding along the face. Facial cupping is meant to improve circulation of blood and fluid and is generally for cosmetic purposes.

Jaw cupping uses a slightly larger cup, usually the largest in the glass facial cupping set and is applies to the muscles of the jaw for therapeutic decompression. This technique is more likely to leave discoloration on the face but is very effective for TMD, facial tension, neck pain, and headaches.

The Emperor

“The Heart is the emperor, the supreme controller. The Heart is the fire at the center of our being, from which the spirit radiates.” 
-Neijing Suwen (Yellow Emperor’s Classic of Internal Medicine)

From a Chinese medicine perspective, the organs of the body are not just physical but include functional, emotional, and spiritual aspects.

The Heart is called the Emperor because it is the seat of the most important part of our being- the shen, or spirit. According to Chinese medicine and its Taoist roots, humans are of an earthly nature and the divine cosmos. The shen is the divine spark within and governs the individual spiritual aspect of all the other organs.

Shen literally translates to “heart-mind” and mental illness is considered to be a disorder of the shen.

Fire Element

In the body, as in nature, the fire element warms, burns fuel, transforms fluid into vapor, and energizes. In its grossest state it provides metabolic function and in its more rarified state it is the fire of the spirit and of love.

There are two pairs of organ systems classified as fire element: Heart and Small Intestine, and Pericardium and Triple Burner.

Small Intestine

Just as the Heart is the throne of the shen, the Small Intestine is the repository of the blood which is the substance that allows the shen to interface with the body’s function.

“The link with the Heart is key to understanding the subtle levels of the Small Intestine function. The Shen, or pure awareness housed in the Heart and whose influence is distributed throughout the body via the Blood, arrives in the physical body at birth like a ‘stranger in a strange land’. In order to be rooted in the physical confines of the human condition and function appropriately within human existence, it must perform the massive task of assimilating the experience of the physical environment and its conditions.” [source]

Pericardium

Also called the Heart Protector. The Pericardium acts as an intermediary between the Heart and the outside world, functioning on the emotional level as interpersonal love and warmth. Because the Heart is considered sacred and the repository of the divine spirit, in some earlier traditions of acupuncture the Heart channel is not needled. The Pericardium is paired with the Triple Burner organ.

Triple Burner 

Also called the Triple Warmer, Triple Heater, Triple Energizer, or the Chinese term San Jiao. This organ has important functions within the body of metabolizing fluid and regulating temperature.

There is discussion that the Triple Burner corresponds to the lymphatic or fascial systems, but it really has no physical biomedical counterpart.

Chinese Medicine and the Heart

Disorders of the Heart in Chinese medicine are related to anxiety, sleep disorders, and mental illness. Basically an over or under-functioning fire element in relation to general enthusiasm about life. The Heart can be treated directly, or through supporting the Pericardium or Small Intestine systems.

Love and the Heart

“I am certain of nothing but the holiness of the heart’s affections, and the truth of imagination.”
-John Keats

A broken heart is not just an expression but a real understanding that the heart is affected physically by emotional turmoil and trauma. Loving involves an opening of the heart, a connection of the fire element to another person, and even an electromagnetic connection. Loss and heartbreak affects us on an electro-magnetic level and takes time and therapies to heal.

A connection to something greater than ourselves is crucial for a healthy heart whether it is a spiritual, humanistic, community, family, or creative connection.

Cupping is an ancient practice used almost universally in traditional healing arts. It is still practiced today in many forms of holistic medicine.

Cupping uses specialized glass or rubber cups to draw out congested fluids, blood, and localized toxins, making it very useful to resolve colds, flus, and other acute respiratory disorders. Acupuncturists apply cupping to treat acute colds based on the principle that a pathogenic factor such as Cold or Wind has penetrated the tissues causing stagnation, and therefore the achiness, fatigue and other symptoms.

Massage therapists and manual therapists can use cupping as a bodywork modality to provide relief from pain and tension by separating stuck muscle and connective-tissue layers. Cupping acts as a myofascial release technique and is an effective treatment for large areas of sore muscles. It is excellent in combination with massage to treat soreness and tension in the back, hips and legs.

As the cups draw congested fluids and toxins to the skin surface there is often a discoloration called “sha” that can look like a rash or a bruise. This is a normal part of the process of resolving stagnation in the muscles, and the sha typically fades in a few days.

Although cupping is an ancient technique there is some current research for its effectiveness including this article from the Mayo Clinic on cupping therapy for fibromyalgia.

The most traditional style of cupping is fire cupping which uses a simple glass cup that looks like a small fishbowl where a vacuum is created using a flame that is inserted briefly into the cup, the flame never contacts the client’s skin. Also commonly used are rubber or silicon cups with built-in suction. More info about styles of cupping here.