Acupressure
Health and Vitality, at Your Fingertips
It's the start of a new school day and in classrooms across China, school children are practicing preventive health.
Sitting at their desks, they press their index fingers between their eyes, pull their fingers down below their cheekbones, and press. With the middle three fingers of each hand, they press between their brows, pull out to their temples and press once more.
In China, no one is too young to learn the fundamentals of acupressure, an integral element of centuries-old Traditional Chinese Medicine.
More than 2,500 years ago, the Chinese concluded that they could relieve pain, lessen other symptoms of illness and promote health by pressing their fingers and hands on strategic points on the body. Pressing a point two inches above the wrist crease, on the inside of either wrist, between the tendons, it turned out, relieves and helps prevent nausea. Pressing the webbing between the thumb and index finger helps soothe and prevent headaches.
Today, millions of Chinese rely on acupressure to alleviate and prevent stress-related aches and pains, migraines, allergies, sinus problems, premenstrual syndrome (PMS), menstrual and breast pain, nausea and constipation as well as to help heal sports and other injuries and lessen fatigue, stress, eyestrain, wrinkles, anxiety, depression and insomnia.
"Anyone who has grown up in China in the last 30 years has learned simple self-acupressure techniques in school," explains Mark Nolting, licensed acupuncturist, naturopath and associate professor and chairman of the Department of Acupuncture and Oriental Medicine at Bastyr University of Naturopathic Medicine in Seattle.
Though it's less well-recognized in the United States than acupuncture, which uses needles rather than fingers and hands on strategic points, acupressure is gaining ground here. Thousands of practitioners, from massage therapists to acupuncturists and even some physicians, practice acupressure in the United States. Though the American Medical Association considers both acupressure and acupuncture to be unproven, research designed to test claims that acupressure relieves nausea has found that it works quite well. A growing number of medical doctors are using acupressure, acupuncture or a combination of the two in their practices.
"With acupressure and acupuncture, you assist the body in healing itself," says Glenn S. Rothfeld, M.D., clinical instructor in the Department of Community Health at Tufts University School of Medicine in Boston and a practitioner in Arlington, Massachusetts. Dr. Rothfeld uses both acupuncture and acupressure in his practice. "I like combining Western and Eastern techniques. With Western medicine, you treat a specific illness but don't address the body's ability to heal itself."
Like acupuncture, acupressure is virtually side-effect-free, Dr. Rothfeld and other practitioners point out. And though it isn't generally regarded as being as potent as acupuncture, it's something that patients can learn to use on their own.
For women in particular, that's a bonus, says Dr. Nolting. "Many practitioners find that a large percentage of their patients are women," he explains. "Acupressure can do a lot to assist women with problems associated with menstruation and childbirth."
| Getting Started Acupressure Acupressure is widely practiced by acupuncturists, massage therapists and other health professionals, including physicians. Number of practitioners in the United States: Unknown. Qualifications to look for: Membership in the American Oriental Bodywork Therapy Association (AOBTA) is helpful but not required. Licensed acupuncturists may also be qualified to practice acupressure. Massage therapists and other alternative practitioners may be qualified as well. Professional associations: American Oriental Bodywork Therapy Association, Glendale Executive Campus, Suite 510, 1000 Whitehorse Road, Voorhees, NJ 08043. To find a practitioner: Contact the AOBTA at the address listed above. Approximate cost: $40 to 100 per hour, depending on where you live. |
WHY IT WORKS--THE EASTERN VIEW
Acupressure is an offshoot of acupuncture. According to legend, acupuncture originated with China's Yellow Emperor and his ministers in 2500 b.c. Historians, however, suspect that it evolved gradually. When the Chinese realized that they could achieve similar results simply by pressing on, rather than needling, specific points on the body, acupressure emerged as another way to stimulate healing.
According to traditional Chinese theory, both acupuncture and acupressure aid healing and promote health because they establish balance. Maintaining good health, the Chinese believe, is a matter of maintaining a harmonious balance of vital energy, or qi (also written as chi and pronounced "chee"), throughout the body. Qi is believed to flow through invisible, interconnected internal channels called meridians, which run from head to toe. (To see where meridians are on the body, see page 14.)
Normally, qi flows freely, but stress, poor nutrition, injuries, lack of exercise, poor attitude and exposure to the elements can cause blockages in the meridians and interfere with the flow of qi. Like a river that's been dammed, qi may flood some parts of the body and barely trickle into others. The resulting imbalance eventually leads to disease. Acupressure helps because pressure applied to appropriate "acupoints" along the meridians breaks up obstructions, allowing qi to flow freely and the body to begin healing itself, according to theory.
"When the energy is moving freely through the body, all of the body's systems are balanced," says Michael Reed Gach, Ph.D., acupressurist, director of the Acupressure Institute in Berkeley, California, and author of Acupressure's Potent Points and a series of acupressure audiotapes for women.
A TYPICAL VISIT, AND VARIATIONS
At the Jin Shin Do Foundation for Bodymind Acupressure in Felton, California, Judy lies on a table, cushions under her neck and knees.
Judy has been suffering from pelvic pain and constipation for several years, she tells Iona Marsaa Teeguarden, a certified acupressurist, the Foundation's director and author of The Acupressure Way of Health. Teeguarden listens, asks additional questions about Judy's medical history, then begins with pulse reading and point "palpation" (inquiring touch) to locate the main tension points and tender spots in Judy's neck, shoulders and torso.
Jin Shin Do, developed by Teeguarden, is one of several different schools of acupressure now practiced in the United States. Different schools concentrate on different points on the body, some focusing primarily on acupoints along the meridians, others concentrating on tender points that turn up during palpation. According to these schools, tender points mark obstructions that interfere with the free flow of qi.
Full Body Acupressure Points
Acupressure points are found throughout the body and correspond to 12 main meridians (or energy channels), plus 2 extra meridians called the conception vessel and the governing vessel.
Depending on which school and which philosophy they train in, practitioners will use different therapeutic techniques as well--either holding, rubbing, kneading or vibrating points, or using a combination of those techniques--and will apply pressure to points for different periods of time.
Jin Shin Do practitioners use both meridian and tender points and hold pairs of points with a gentle but firm pressure. Also known as Bodymind Acupressure, Jin Shin Do emphasizes the interrelationship of mental, emotional and physical health, so treatment may include counseling.
While holding points in Judy's neck and shoulders, together with related "distal points," which help release the tension, Teeguarden asks Judy to pay attention to how her body feels. When Judy says that a point in her neck feels tender, Teeguarden suggests that she come up with an image or word to describe the feeling. "A tunnel," says Judy. "Stuck . . . frustration." Teeguarden uses body-focusing techniques to encourage Judy to describe the feeling more deeply. "Loneliness . . . sadness . . . a tight chest." While chest and arm points are held, Judy realizes a need for comfort and then grief for her father, who always supported and encouraged her. Though he died 20 years ago, Judy had only been able to cry a little once, 10 years ago. Working with acupoints in the abdomen, lower back and legs, Teeguarden reassures Judy that she can find the strength that she needs within herself.
Jin Shin Do practitioners sometimes lead you through visualization exercises during sessions. In other schools, including several schools of shiatsu, practitioners may also guide clients through deep-breathing exercises, meditation and stretching and offer dietary advice, explains Denise Shinn, certified practitioner of macrobiotic shiatsu and president of the American Oriental Bodywork Therapy Association in Voorhees, New Jersey.
After about an hour on the table, Judy says that her pelvic pain has disappeared. Alleviating the constipation problem, Teeguarden tells her, will probably require more sessions.
Long-standing health problems require more sessions, Dr. Gach explains. For chronic conditions, practitioners may begin with frequent sessions, once a week or more, then taper off once symptoms lessen, scheduling a "booster" session once a month. The typical session lasts about an hour, he says. "A session will leave you in a very deeply relaxed state. So it's beneficial to take a short nap afterward, if possible, to heighten the results," he adds.
Shiatsu: Press and Stretch to Release
Blocked Energy If it weren't for shiatsu, says Lise Ste-Marie, M.D., she might never have made it through natural childbirth. Fortunately, she was able to have a natural birth and shiatsu helped her to prepare for it. A general practitioner in Quebec, Dr. Ste-Marie took a shiatsu therapist with her to the delivery room when her daughter was due. She was counting on shiatsu to help relieve labor pain, but it did more than that. "My gynecologist said that the labor was taking so long that I might need a caesarean," recalls Dr. Ste-Marie, who started studying shiatsu shortly after finishing her medical degree. She recommends it to her patients who complain of pain, premenstrual syndrome, stress and breast tenderness. "But the shiatsu therapist kept working on the meridians and she helped the baby descend--and the birth was normal." Shiatsu, the Japanese word for "finger pressure," is one of the best known forms of acupressure in North America. Though similar to other forms of acupressure in technique, shiatsu has a slightly different focus, says Robbee Fian, a licensed acupuncturist who practices acupuncture and teaches shiatsu in New York City. While acupressurists focus on specific "acupoints" along the body's meridians--the invisible energy channels that run from head to toe--shiatsu therapists cover entire meridians, Fian says. "You tend to work the whole meridian--movement along the whole meridian is important." There are several types of shiatsu. Some incorporate visualization, deep breathing, stretching, meditation and dietary advice. Others, like Five Element shiatsu, come with their own special diagnostic techniques as well. Another form, called Ohashiatsu, is designed to benefit both the person giving the shiatsu and the person to whom it's given. "We teach how to move your body and how to let your body work so that you don't strain it" while you do shiatsu, says Wataru Ohashi, creator of Ohashiatsu; founder of The Ohashi Institute in 1974, a non-profit educational institute in New York City; and author of The Ohashi Bodywork Book and Do-It-Yourself Shiatsu. "The giver is very much exercising in a very natural way. You limber your body. You are stretching places that Americans tend not to stretch, and you become more
flexible." Though some massage therapists offer "shiatsu massage," that's a misnomer, according to Fian. What they're offering is really massage with a little shiatsu technique on the side--not true shiatsu, she says. If you want to see what shiatsu can do, you're best off visiting a trained practitioner since it takes time and training to master the therapy, says Fian. You can, however, do some simple shiatsu on your own. One way that shiatsu opens meridians and stimulates the flow of energy is to stretch. Specific shiatsu stretches use the body's own weight, applying pressure to the meridians as you lean this way and that way. By stimulating meridians, shiatsu stretches may assist in freeing up blocked energy and drawing it toward areas of weakness, thus releasing tensions and limbering you up for yoga or aerobic exercise--even if no practitioner is available to apply pressure to the shiatsu acupoints. Interested? Fian, creator of Five Element shiatsu, recommends Makko-Ho, a daily five-step routine that takes five to ten minutes. "When people do this on a regular basis, everything seems to function much better," she says. "It helps relieve stress, and people say that they have more energy." It is important to remember, when practicing the Makko-Ho exercises, that what matters is the action of beginning the stretch, not how far you can stretch. If in this exercise you can only lean back onto your palms, simply hold that position and stretch, breathe and relax. The more you practice, the easier the positions will become, adds Fian. Shiatsu stretches are shown on the following five pages. Do these stretches each morning, before breakfast. |
 | Shiatsu Stretch 1:
Bend Forward, Arms behind Back Begin in a standing position. Inhale and place your hands behind your back and interlock your thumbs. Exhale as you gently allow your body to hang forward from your waist, allowing your arms and thumbs to raise up behind you, toward the ceiling. (You'll feel as though you're hanging from the ceiling by your thumbs.) Exhale as you hold this position. Inhale and straighten up. Repeat this stretch three to five times. |
| Shiatsu Stretch 2:
Sitting, Legs Tucked Under Sit on your heels with your feet crossed, toes over toes, and with your back straight. Relax and breathe. |  |
 | Put your arms behind you and your palms flat on the floor, then lean back, keeping your buttocks touching your feet and your knees together. Avoid arching your back. You should feel a stretch along your thighs as you hold this position. Relax and breathe. |
 | If you don't feel the stretch, then bend your arms and rest on your elbows. |
 | If leaning back on your arms is easy to sustain, try to sit between your legs with your buttocks touching the floor and then lean all the way back until your back is resting on the floor. Relax and breathe. Then sit up in stages: First prop yourself up on your elbows, then up to your palms and then back to a full sitting position. (If you suffer from any weakness or pain in the knees, skip this exercise.) |
 | Shiatsu Stretch 3:
Sitting Position Sit on the floor, with your legs drawn in and the soles of your feet touching. Inhale deeply and relax as you press your knees to the floor. If this seems difficult at first, gently push your knees with your hands or elbows. |
| Next, exhale and bend forward until your head comes as close to the floor as possible. (Skip this step if you are pregnant, since bending forward will compress the area around your uterus.) Relax and hold this position for 15 to 30 seconds, then sit up and inhale. Repeat this stretch three to five times. |  |
 | Next, sit on your heels, bring your palms together in front of your heart, with your elbows out and fingers touching. Breathe in. |
 | Exhaling, extend your arms out to your sides and flex your fingers as though you are pushing away ten-ton weights. Then inhale as you return your hands to the original position. Repeat this three to five times. |
 | Shiatsu Stretch 4: Bend Forward, Legs Out Sit on the floor with your back straight and stretch your legs out in front of you, keeping your feet flexed toward your body at a 90-degree angle. Inhale when settled in this position. |
| Exhale as you allow your body weight to pull you forward, and gently reach out to grab the soles of your feet--or your calves or knees, if that's as far as you can comfortably reach--so that you feel the stretch in your upper thighs. (If you are pregnant, stretch forward from your buttocks, without letting your torso collapse, bend or sag over your legs, so that you feel the stretch in your upper thighs.) Inhale and straighten up. Repeat this stretch three to five times, each time holding the stretch for 15 to 30 seconds, while continuously relaxing and breathing slowly and deeply. |  |
| Shiatsu Stretch 5:
Legs to Sides, Bend Forward Sit on the floor with your legs as far apart as possible. Inhale and extend your arms toward the floor. (If you're pregnant, stretch forward without letting your torso collapse, bend or sag over your legs and without rounding your back.) Exhale and bend forward so that your head touches the floor (or in that general direction). Hold and relax for 15 to 30 seconds. Inhale and return to an upright position. |  |
| Exhale and stretch to the side, over your left leg, and stretch your right arm over your head, to your left. Breathe deeply as you relax for 15 to 30 seconds. Then inhale and return to the center position. Repeat on the opposite side. |  |
| With your legs in the same position, exhale and turn your torso to the left. Leaning across your left leg, stretch and exhale. Hold this position and breathe, for 15 to 30 seconds. Inhale and return to an upright position. Repeat on the opposite side. Then repeat these step 5 stretches three more times. |  |
WHY IT WORKS--THE WESTERN VIEW
Western science has yet to uncover hard evidence that qi exists. Oriental theory is that qi is the flow through two opposing forces, yin and yang. An imbalance signifies disease. Acupressure attempts to re-establish this balance by pressure along specific points and meridians.
Some of the most intriguing research suggests that acupressure relieves symptoms of illness by triggering production of neurochemicals, chemical messengers that ferry information between your brain and the rest of your body. Several studies have shown that acupuncture prompts the body to produce neurochemicals responsible for relieving pain, producing feelings of well-being, reducing the inflammation that contributes to asthma and arthritis and regulating appetite.
Acupressure may do the same, says Bruce Pomeranz, M.D., Ph.D., neurophysiologist, professor at the University of Toronto School of Medicine and one of the world's foremost acupuncture researchers.
Acupressure's tension-relieving potential may also explain its effect on pain and other symptoms, suggests Dr. Gach. Numerous studies find that the body's physiological response to stress--increased blood pressure and an outpouring of adrenaline--can contribute to heart disease, depression, irritability, insomnia, headaches, difficulty concentrating, dampened immunity and other problems. "And it's often stress and anxiety that make us want to overeat, and worsen PMS as well," adds Dr. Gach.
Finally, acupressure improves circulation, says Dr. Rothfeld. And that may explain why it helps alleviate related problems, like muscle aches and pains, in people with poor circulation.
THE SCIENTIFIC EVIDENCE
The best documented benefit of acupressure is relief from nausea and dizziness. Studies show that it relieves queasiness and vomiting both during pregnancy and after anesthesia. In a North Carolina study, pregnant women who wore wristbands fitted with buttons that pressed against the antinausea acupoint reported a 50 percent reduction in queasiness and vomiting. And in a British study, men and women reported less severe postoperative nausea when wearing the wristbands.
Early research into acupressure's effect on pain has also been promising. Michael I. Weintraub, M.D., advocate of shiatsu, clinical professor of neurology at New York Medical College in Valhalla and head of neurology at Phelps Memorial Hospital in Tarrytown, New York, says a small study that he directed found that 86 percent of patients with herniated disks experienced pain relief with a combination of shiatsu and Swedish massage.
"And these were people who failed to respond to other treatments, such as drugs, physical therapy and chiropractic," says Dr. Weintraub, who teaches his patients simple shiatsu techniques for alleviating headaches, nausea, dizziness and spine pain.
Though there have been few controlled scientific studies examining acupressure's efficacy in alleviating symptoms other than nausea and pain, practitioners say that they get good results with a wide range of symptoms like headaches, menstrual cramps and stress.
"In general, anything that's caused by or exacerbated by stress and tension responds well," says Dr. Gach. The illustrations that follow demonstrate some of the most common uses for acupressure.
Lower Back Pain Pressing two points located two inches from each side of your spine, on your lower back, can help relieve lower-back pain caused from sitting for too long or from menstrual cramps. If you have a weak back, these points may be tender, so see your doctor before trying acupressure on your lower back. |  |
 | Disk and Hip Pain Using your index and middle fingers of each hand, press on either side of your tailbone, about where the crease in your buttocks begins. These points can relieve sciatica, resulting from inflammation of the sciatic nerve that runs from the buttocks through the leg, or from a slipped or herniated disk. These points also ease hip pain. |
Headache--Between the Eyes Pressing a point called the Third Eye, located at the bridge of your nose between the eyebrows, balances the pituitary gland and relieves hay fever, headaches, indigestion, ulcer pain and eyestrain. |  |
 | Headache--Sides of Forehead Pressing the index finger of your left hand to your left temple and the index finger of your right hand to your right temple can treat headaches. |
Menstrual Discomforts Pressing a point called the Sea of Energy, located two finger-widths below your belly button, aids premenstrual syndrome, menstrual cramps, irregular vaginal discharge, irregular periods and constipation. Use your index and middle fingers. |  |
Menstrual Pain To help combat menstrual cramps, press your index and middle fingertips to the point outside your knee, about three finger-widths below your kneecap. |  |
 | Leg and Back Pain Pressing both thumbs at a point called the Supporting Mountain, located in the center of the base of your calf, eases leg cramps in your calf and can help fight knee pain, lower-back pain and swelling in the feet. |
Insomnia and Anxiety Applying acupressure to the Spirit Gate point, located on the outside of your wrist, below the first crease and in line with your pinkie finger, relieves anxiety, cold sweats and insomnia brought on by being overexcited. |  |
 | Insomnia and Pain To ease arthritis, headaches and neck pain that can cause insomnia, press your left index finger against your hairline about one-half inch to the left of your spine and your right index finger against your hairline about one-half inch to the right of your spine. |
Coughing and Congestion Pressing the acupoints located below your collarbone and alongside your breastbone relieves coughing, chest congestion and breathing difficulties. |  |
 | Out-of-Control Coughing To control coughs, press the point located at the bottom of your biceps and slightly to the outside of your arm. |
Hiccups Pressing the point called Heaven Rushing Out, in the hollow at the base of your throat, eases hiccups, bronchitis, throat spasms, sore throats, chest congestion and heartburn. |  |
 | Toothache and TMJ Pain To relieve jaw pain and spasms, toothaches or temporomandibular disorders, press this point, called the Jaw Chariot, located above the end of your jaw, on the side of your face that hurts. |
Tennis Elbow To relieve the pain of tennis elbow, press the outside of your knuckle on the pinkie finger of your opposite hand. |  |
| An alternate way to relieve tennis elbow is to locate the point of greatest pain near your elbow, then press the same point but on the opposite elbow. |  |
 | Hamstring Pain Some people find that they can relieve hamstring pain by pressing the point midway between the back of the knee and the bottom of the buttocks, on the leg opposite the one that hurts.
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