Eastern Massage - Traditions and Practice
Eastern bodywork traditions are based on ideas about how the body functions that are somewhat different from that of Western massage. In general, Eastern bodywork therapies are based on the idea that the body contains energy. This energy flows through the body along certain pathways. The energy and the pathways may have different names in different types of therapies, but the theory behind the therapies is the same. These types of therapy purport to either strengthen energy flow or to restore energy flow where it has been blocked. Most of these therapies do not claim to be "cures" in the traditional sense. Rather, these therapies focus on enhancing the quality of life. Most of these therapies are presented as therapies designed to complement other therapies, be they traditional or alternative.
Shiatsu
Shiatsu is a Japanese form of massage that has its' roots in Chinese medicine. The practice of Shiatsu combines traditional massage with acupuncture. Through this therapy, the practitioner seeks to restore the body's energy balance. The energy, or "qi" as it is called, flows through the body on pathways known as meridians. There are points along these meridians where the qi will gather. If there is tension, injury or illness, these points can become blocked and the qi will not flow freely. In Chinese medicine, these sites are called acupuncture points, and they would be treated with needles, moxibustion or possibly cupping. In shiatsu, these points are called tsubos and they are treated with a finger pressure massage. According to Traditional Chinese Medicine the qi comes in two forms, yin and yang. In this tradition, yin is a quiet, deep, female energy, while yang is surface, active and male. Too much or too little of either, throughout the body or in specific sites in the body, can cause illness or injury. In Traditional Chinese Medicine, balance between the two types of qi is obtained through various treatments, herbal preparations, diet and exercise. Shiatsu strives to balance these two types of energy, as well as release blocked energy. The third aim of shiatsu is to bring about balance among the Five Elements. The Five Elements in Chinese medicine are Fire, Earth, Water, Wood and Metal. These are the same elements which make up the universe according to Chinese tradition. The human body, according to Traditional Chinese Medicine, is a microcosm of the universe. Different organs, characteristics and meridians are associated with each element. An imbalance among the Five Elements will result in a weakness within the body, which will leave it more susceptible to disease or injury.
Shiatsu uses gradual, gentle, rhythmic pressure on the tsubos and the meridians to release the qi and balance the various energies. Usually applied with the fingers, this pressure can also be applied with the elbows, hands, and feet. While there may be a feeling of pressure as the muscle releases, there should be no sudden or severe pain. Unlike Western or Swedish massage, the client remains fully clothed and there is no oil used. The treatment will usually take place on the floor or on a very sturdy table. The practitioner will first treat the Hara, which is the area between the pelvis and the ribcage. This is considered to be the seat of the energies in the body. Then the practitioner will move on to treat the meridians and the tsubos with pressure. The practitioner will end the session by returning to the Hara. The client is encouraged to breath deeply throughout the treatment, and pressure is applied during the exhalation period. Some shiatsu pressure points can be stimulated by oneself. There are a number of books that show the various points and will show the reader how to apply pressure.
Shiatsu practitioners do not usually diagnose illness or injury. Shiatsu is used primarily as prevention therapy and does not purport to cure illness. There are certain conditions for which shiatsu may be contraindicated, such as contagious diseases, heart conditions, disorders of the lungs, kidney or liver, cancer and infectious skin diseases. Many massage therapists are trained in several type of massage, shiatsu being one of the more common modalities practiced. Anyone interested in finding a massage therapist who specializes in shiatsu can contact the American Massage Therapy Association.
Acupressure
Acupressure is sometimes confused with shiatsu, but in fact they are two different systems. They operate from the same philosophical basis, but acupressure predates shiatsu. While shiatsu is used primarily as a preventive therapy, acupressure purports to treat specific diseases or conditions. Acupressure is basically the same as acupuncture, but acupressure applies pressure to the points of therapy, while acupuncture uses needles to stimulate the variouspoints. Different practitioners make different claims regarding both acupuncture and acupressure. Some claim that they can cure diseases, combat obesity and improve circulation. Others view them as preventive therapies, while others concentrate on their uses as a methods of relieving pain.
In order to fully understand the theories on which both acupuncture and acupressure are based, one would need to study the entire system of Chinese medicine. This system has a long tradition, well over two thousand years, and is very complex, combining elements of cultural beliefs as well as medicine. Like shiatsu, acupressure is based on the concept of qi, or energy. The purpose of both acupuncture and acupressure is to relieve blockages of qi that occur alongthe meridian. The meridians are channels of qi which flow through the body. When these are blocked, or the flow is not balanced, illness or susceptibility to injury and illness can occur. Pressure applied to acupoints or along the meridians will restore or balance the qi, thus relieving the condition that troubles the patient.
There have been studies on acupressure, some of which have shown it to be effective for pain relief and relief of nausea. Research has also shown acupressure to be effective in treating headaches and chronic backache. 37
While research has shown acupressure to be somewhat effective, it has yet to determine why the treatment is effective. It could simply be the endorphins released by the pressure, or the relaxation from a hands on treatment. In cases of serious disease or injury, acupressure should be used as a complementary therapy, that is one that is used in conjunction with other therapy. Pregnant women and those with open wounds or varicose veins must communicate these conditions to the therapist. To find a therapist in acupressure, one can contact the Acupressure Institute in Berkeley California or the American Oriental Bodywork Association in Syosset New York.38
The book Finger Acupressure: Treatment for Many Common Ailments, has a section on wrist pain. This volume is very succinct. It has a short section at the beginning of the book that explains how to perform the technique. It also has several warnings, explaining those conditions, such as pregnancy or severe cardiac conditions, for which this technique is contraindicated. Then the volume has various conditions listed in alphabetical order and the corresponding acupressure points. Wrist pain is the last entry and one point is indicated for treatment. The book is illustrated with photographs to help the reader locate the acupuncture point.
The book Performing Arts Medicine, edited by Robert Sataloff, Mary Shaheen and Alice Brandfonbrenner mentions the use of both acupressure and shiatsu in the chapter entitled "Therapeutic Management of the Instrumental Musician." There is no explanation, just a brief sentence that state "Muscle energy and acupressure or shiatsu massage are other forms of manipulative treatment used to strengthen weak muscles, stretch tight myofascial structures, and mobilize joint restrictions."39
Lomilomi
Hawaiian Lomilomi massage does not use the Chinese system of meridians, but it was influenced by the Chinese system and is used as a therapy by the Hawaiian people who developed it. There are many components to, and versions of, Lomilomi. The physical component includes different massage techniques that can be compared to those used in Swedish massage, although Lomilomi predates that technique. It should be noted that this is a traditional Hawaiian form of massage and that there was no written language in Hawaii for many years. Therefore, the practice was passed from teacher to student. The practice was outlawed for a period of time prior to the 1970s, due to laws that discriminated against the native Hawaiians and their traditional beliefs and practices. Therefore, it was only kept alive in secret. Not until the 1980s was this practice "discovered" and research and study began to take place.
Lomilomi uses massage strokes, but it also uses herbs, heat, and salt in treatments. There is also a strong spiritual component to traditional Lomilomi. The practitioner must clear all negative thoughts, as these are believed to contribute to physical problems. The goal is that the recipient of the treatment also break all negative connections and relationships and correct wrong thoughts. A traditional Lomilomi practitioner always calls upon a higher power forspiritual guidance. "Lomi-lomi always encompassed body, mind and spirit."40 Lomilomi resembles European massage more than Eastern massage, as the strokes that are used tend to focus on the circulatory systems (blood, lymph and interstitial) rather the meridians. The practitioner uses oil on the skin to aid in the process. Before the session, a healer will pray and center themselves in order to be able to serve "as a conductor of... energy, and direct it into the tissue or body part that seems blocked or is in a state of distress."41 The recipient is also expected to try to get into the "proper state of mind." There are exercises that the patient can do to assist in this process.
When the session begins, the practitioner "assesses" the patient. The practitioner uses the art of haha (to feel or palpate) to assess or diagnose the patient. After identifying the problem, the practitioner concentrates on the healing process and the desired result. There is no one set routine for lomilomi. Each practitioner develops his or her own style. There are certain strokes and techniques that are used, though the application may differ from practitioner to practitioner. These strokes have traditional names from the Hawaiian language. Many of these are similar to the strokes used in Swedish massage. The Hawaiian name and the Swedish equivalent will be included where applicable. If no comparison is appropriate, there will be a short description.
kahi - comparable to "therapeutic touch" or light efflurage
opa - kneading
kupele - comparable to petrissage
kaomi - pressing down - also used to indicate compressed thought
lomilomi - the tissue is moved in every possible direction
la'au kahea - breathing life or mana (energy ) into the person
hamo - to anoint with oil
The patient may also do an internal cleansing, eating a diet of high fiber fruit to cleanse the small and large intestine, followed by a drink of diluted sea water to complete the cleansing. The practitioner may also employ the use of hot stones wrapped in leaves placed on areas of the body, or the use of sticks that are curved to massage areas. The practitioner may also use ho'upu'upu, which is the implantation of a positive thought or idea, before, during, and after the physical treatment. There are also various herbal remedies, using plants native to Hawaii, that are used by Lomilomi practitioner. These could be taken internally are applied externally, as with a poultice.
The book Hawaiian Lomilomi: Big Island Massage, is an excellent introduction to the practice of lomilomi. While making no reference to any of the conditions that trouble musicians, it explains the techniques and has photos which illustrate the various strokes used in the practice. It also addresses the spiritual component of the practice. There is an interview with a lomilomi practitioner in the appendix of the paper, and in that interview the therapist addresses some of the problems experienced by musicians. With that information, this book takes on a greater significance.
Massage and acupressure are recommended in more books that are written specifically for musicians than any other form of therapy. They are also recommended frequently in other books that have a program of self care that is not necessarily directed specifically to the musician. In the chapter titled Self Care, the following material either recommends or mentions one or both of the therapies: Shoulder, Upper Back and Neck: Free Yourself from Pain (page 69 ) and Carpal Tunnel Syndrome: How to Relieve and Prevent Wrist Burnout (page 71) both by Rosemary Atencio, recommend massage and acupressure; How to End Your Carpal Tunnel Pain Without Surgery (page 72) by Kate Montgomery recommends massage and acupressure; Susan Weiss in The Anatomy Book for Musicians (page 74) recommends massage; The Musician as Athlete (page 81) recommends massage; Play It Safe (page 86) by Christine Zaza recommends massage; and the website Musicians and Injuries (page 92) by Paul Marxhausen recommends massage. Lomilomi massage is listed by Dr. Wynn Steinsnyder as one of the massage therapies that can be useful for musicians. (see appendix for interview with Dr. Steinsnyder and a Lomilomi practitioner.)
