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Traditional Tui Na vs Zang Fu Tui Na – by Tom Bisio

One question I get a lot is what is the difference between Traditional Tui Na and Zang Fu Tui Na?

An Fa (Pressing) Hand Method

Generally when must people think of Tui Na, or mention Tui Na, they are talking about what we call Traditional Tui Na, which is known for the use of hand methods whose purpose and function are delineated by Chinese medicine theory about the channels and collaterals (meridians) and the actions of the internal organs. Usually Traditional Tui Na methods contain 24-30 “hand methods.” Each Hand Method creates different mechanical and energetic signatures whose action occurs at a specific depth and produces different effects inside the body. These hand methods elicit different diagnostic information, and can also be combined into mixed techniques, in order to adapt to different clinical situations.

However, originally Traditional Tui Na also included Zheng Gu (“Correct the Bone”) Methods, commonly known as Bone-Setting, which realign and restore integrity to the joints and soft tissue. Originally Zheng Gu methods were completely intertwined with and inseparable from Hand Methods.

When I learned Tui Na as part of martial arts training, from day one we also learned Zheng Gu techniques as part of clinically adaptable Tui Na sequences that can be employed in a wide variety of situations.

            Zheng Gu Method for the Ribs

Currently Zheng Gu techniques are not taught in most schools of Traditional Chinese medicine, and even in China they have unfortunately been separated out from the hand methods to create separate specialties in Tui Na and Zheng Gu. Removing the Zheng Gu methods and focusing on only the use of hand techniques has also led to treatment protocols that are derived from acupuncture and fail to take advantage of the full power of Tui Na. This also defies common sense because many hand methods are Zheng Gu methods, and many Zheng Gu techniques are simply a specific application of one or more hand methods. Hand Methods and Zheng Gu Methods are therefore inseparable and should not be isolated from one another.

To go back to the difference between Traditional Tui Na and Zang Fu Tui Na, we can say that Traditional Tui Na (TTN) works with the fascial system and the soft tissue and bone to realign the body, open the channels and affect internal organ function, while Zang Fu Tui Na (ZFTN) works more directly with the internal organs and the tissues around the organs to improve organ function, which in turn affects the sinews, bones and other tissue structures.

Zang Fu Tui Na offers a direct, hands-on method of diagnosing organ imbalances, while simultaneously eliciting effective, immediate, and profound changes in the body. ZFTN is an important and largely forgotten part of Tui Na as a global treatment method. ZFTN teaches methods of regulating the function of the internal organs through direct and indirect energetic visceral mobilization techniques.  This important and rarely taught aspect of Tui Na can be more effective than herbs and acupuncture in regulating the Qi Dynamic, calming the spirit and harmonizing the functions of the internal organs.

In reality, Zang Fu Tui Na (ZFTN) and Tradiational Tui Na (TTN) are not separate. They are really one complete integrated method. In this sense Zang Fu Tui Na and Tradiational Tui Na are like two sides of a single coin, and ideally during a Tui Na treatment one seamlessly moves between Zang Fu Tui Na and Traditional Tui Na methods in order to adjust to the clinical situation and the changing circumstances. Together ZFTN and TTN form a single unified method of treatment.

Regulating & Harmonizing the Liver

Therefore the division between these two “types”, or two aspects, of Tui Na Tui Na is largely artificial. In our classes, the division exists in order to simplify the learning process, as it is very difficult to learn both methods simultaneously in a single class. A student can begin by learning either Zang Fu Tui Na or Traditional Tui Na and then go on to learn the other later, all the while gaining understanding of how the various techniques and methods interweave.

As a simplification, we could say that Tradiational Tui Na regulates and restores integrity and proper function to the soft tissue, joints and the bones, and that this way of treating in effect uses the “outside” to affect and treat the “inside” (the internal organs), while Zang Fu Tui Na treats the inside (the internal organs and internal Qi Dynamic, which in turn can have effects on the “outside” (soft tissue, joints etc.). Zheng Gu techniques which realign bones can create effects at the Jing level – the deepest energetic level of the body – while organ regulating techniques that work with organ Qi can create effects at the superficial level of the body.

Clinically we see the two sides of a coin analogy in action quite frequently. Sometimes that intractable shoulder problem only gets better when one regulates the liver. I recently had a case where the patient failed to tell me she had adhesive capsulitis and could not raise her arm all the way. She complained instead of indigestion and chest and diaphragm tension. After regulating and releasing restrictions to the Liver’s natural movement – regulating the Organ Qi of the Liver – I decide to rotate her shoulders because they looked stiff. The patient’s friend, who was watching the treatment, gasped when I rotated the patient’s right shoulder through its full range of motion without any problem. Only then did they tell me that she had been diagnosed with adhesive capsulitis in that shoulder, and had not been able to move the shoulder through a full range of motion for quite some time.

This dynamic can also operate in reverse. When Liver Qi is stuck it can limit rib movement, affecting breathing, and create diaphragmatic tensions and restictions. I have had several cases where simply adjusting the alignment of the ribs and rib heads behind the liver using a  Traditional Tui Na Zheng Gu Method opened up the diaphragm and moved the stuck Liver Qi.

Similarly, a dropped kidney can manifest as ankle pain or hip pain. In this kind of case, simply realigning the ankle or the hip is only a temporary fix, while lifting the dropped kidney and realigning the ankle creates an effective and lasting treatment. Conversely, I have seen how realigning an ankle that was chronically injured, aided a problem with frequent urination that was due to the Bladder Meridian being impacted by the misaligned ankle.

The pericardium has suspensory ligaments that connect to the cervical vertebrae so many neck problems can be improved by freeing restriction and lines of tension in these ligaments. However, if the patient also has a compressed cervical disc, then Traditional Tui Na Hand Methods that relax the neck muscles and neck Zheng Gu Methods that realign the soft tissue and bones will also be necessary to take pressure off the disc.

These are only a few of endless examples that illustrate the unity of these two aspects of Tui Na.

Diagnostically Zang Fu Tui Na and Traditional Tui Na are also interwoven. Misalignments of the joints and soft tissue can lead us to discover and correct internal organ imbalances, and internal organ imbalances can lead us to discover and resolve joint and soft tissue problems. ZFTN and TTN allow us to see that seemingly diverse and separate problems are interconnected within the whole-body unity. So the complete method is the unification of Zang Fu Tui Na and Traditional Tui Na.

The real beauty of using this kind of unified Tui Na method as a primary treatment modality (perhaps supported by acupuncture and herbal medicine) is that Tui Na works on many different levels at the same time, and as you are working, you are constantly adjusting techniques and modifying and rethinking diagnosis from moment to moment as changes unfold under your hands. Rather than creating a fixed diagnosis and then treating, diagnosis and treatment are not only happening at the same time, they are ongoing from moment to moment. This aspect of Tui Na is what makes it a very special treatment, truly in touch with what is happening in the moment, and changing in accordance with the changing circumstances.