一指刀手法治疗软组织损伤

World Journal of Traditional Chinese Orthopedics l49 世界中医骨科杂志 Finger Surgery treatment for Soft Tissue Injury 一 指刀手法治疗软组织损伤 Xiao Ping W ang Vice—President of American Institute of Acupuncture President of American Institute of Finger Surgery Orthopedics& Traumatology 王 啸 平 美 国 中 医 骨 伤 研 究 院 院 长 美 国一 指 刀 手法 研 究 院院 长 Pain caused from SOft tissue iniury iS one of the three most complicated diseases in the world．At present． doctors still have no acute and effective solution to cure it． The invention of Finger Surgery created a brand new path of treatment．W ith its outstanding curative effect and result．Finger Surgery treatment for SOft ti ssue injury has been recognized at the medical field as a surprised breakthrough in the 2 l century． 1．W hat is Finger Surgery? Finger Surgery uses one or two thumbs to treat at a specific spot of the SOft tissue．which iS similar to use steel knife to operate at the iniured area．it also be called “External Body Operation”． 2．What are the major manipulations to compose the Finger Surgery? Finger Surgery combined 33 types of manipulations， the most important two of them are BO and Shun．Pro perly used BO and Shun becomes the essential part for curing SOft tissue injury．With some other maniDulations， makes Finger Surgery a perfect solution for curing the softtissueinjury． 3．What is the difference among Finger Surgery． Tui Na．Massage and Acupressure? Massage．TuiNa and Acupressure are the traditional manipulations．Generally speaking，massage and acu pressure are appropriate for relaxing and taking care of health．TuiNa iS appropriate for treating externa1．interna1． women or children’S illness．ACCOrding to the latest the pry，it is necessary to separate the treatment of soft tissue injury from traditional maniDulations and to specialize in “Finger Surgery”treatment． Finger Surgery focused on the pathologic change of injured SOft tissue by combined using the 33 anipulations to cure the patients effectively． Right after the organ ism injured．it iS at the first stage of pathologic change．If appropriated manipulations were used，the swelling may quickly reduce．spasm may immediately alleviate and pain may disappear fight away． If the manipulation did not foCUS on the pathologic change．it iS very possible to make patient’S symptoms moved to second stage；swe— lling increased，the external region of spasm or scars NO．1VO1．6 软组织损伤疼痛被认为是世界三大疑难病症 之一， 目前还没有极具针对性且特别有效 的治疗 方法。 指刀手法的发明为软组织损伤开辟了一个 崭新的治疗途径，且有着令人瞩 目的卓越疗效， 是廿十一世纪医学界对软组织损伤治疗的一大突 破 。 1．什么是一指刀手法? 一 指刀手法 就是用一个或两个拇指代替钢刀 在软组织损伤的特定部位操作进行类似手术治疗 的一种特殊手法，也可以称为体外开刀法。 2．一指刀手法由多少手法组成? 一 指刀手法 由三十三种手法 组成 ，其中最主 要的手法为拨法和顺法。拨顺手法 的恰 当运用就 构成了治疗软组织损伤最精华的部分，另外再配 合其它的一些活动法 ，就使得这个方法更完善 ， 治疗更精确 ，实际恢复更迅速 ，效果最好 。 3．一指刀手法与推拿、按摩 、指压有何不 同? 按摩、推拿、指压是传统的治疗手法。一般 来说按摩、指压适用于保健放松，推拿用于治疗 内外妇儿等科疾病。根据最新理论，有必要将软 组织损伤 的治疗从推拿 中分出来 ，专 门用一指刀 手法治疗。 一 指刀手法能针对受伤 的软组织 的病理状况 进 行不 同的手法运用，使之早 日痊 愈。当机 体受 伤 以后 ，我们称为病 理变化第一期，如果此 时手 法运用得当，可以使肿胀迅速消除，痉挛即刻缓 解 ，疼痛立即消失；但 如果没有针对此种病理状 态做对正施法，则易造成人 为的病理变化第二 期，使水肿加重，痉挛或疤痕上层也肿胀，疼痛 万分 ，从而增加了治疗的恢复时间 。 例如：按摩作用浅不够深入，在肿胀的部 位按摩，按揉，则势必造成水肿 、炎症 、淋 巴 液、组织液、血液的渗出增加，甚至造成皮内水 第6卷 第 1期 维普资讯 http://www.cqvip.com ????? www.tengtongsl.com ????????????? World Journal of Traditional Chinese Orthopedics 15O 世界中医骨科杂志 would be swollen with severe pain，the additional treatment and recovering process will be needed． M assage works only on the surface of the soft tissue， which is not deep enough． Massage at the swollen part would cause injured tissue more swelling，inflammation， lymphatic fluid， tissue fluid and blood flood， even develop swelling underneath skin and caused patient’s unbearable pain．Under these circumstances，taking any medicine could not relief the pain． “TuiNa”is not directed and specific at the iniured area，could not reach precised result． The area of TuiNa is wide；if patient injured a sma1)area，it is very possible to injure the surrounding soft tissue with Tui Na and gets no directed curative effect at the iniured spot．Generally speaking，after many years of TuiNa，soft tissues become loose．once it iniured．inflammation will follow the fascia and spread over from one point to a whole piece． Acupressure at swelling spot is appropriate，which often used at spasm and stiffed soft tissue areas． However slight press can not obtain a curative effect， people usually pressed at the spasm spot very hard in order to relax the muscle an d continuously pressed the soft tissue for hours until patient could not bear the pain． People do not realize that fibre would be adhered and become more stiffness after prolonged pressure，it would take much more treatments to recover．Pressing at the far point．the local injured area can not get completely treatment，which will cause scars and difficulty for a future treatment． Finger Surgery follows the fibre movement to operate at the swelling or painful spot．Use the“Shun’’ man ipulation as the first cut，patient may feel slight pain， pain will be immediately reduced after the second cut； pain and swelling will be relieved after the third cut． Th e spasm and scar of the soft tissue will be relaxed very fast． 4．Characteristic of Finger Surgery Learning an d catching are easy，healing period is short with very good curative effective，no sequela and scars． 5．The important revolution of Finger Surgery (1)．Finger Surgery works on small and deep area． set the spot and point．will not iniure the closed tissue． Th e operating thumb and skin of the treating area will not move or with very little movement，which moves under． neath，but the external area are static．fDeep soft tissue such as"Vein，muscle，tendon and ligament all move) (2)．The operating angle is 15 ．30 ．60 ．which is different from the vertical pressure point or rounded massage in the past． (3)．Usage of Sonigel：Its application is a big invent— tion．Sonigel has a great effect for curing deep iniured softtissue．Most Chinese medicine doctors use towel over the skin，which will limited the function only on the sur· face，can not deep into the source． W estern medicine doctors use ointment，it is too slippery ，function will be limi ted at the surface，can not go to deep inside tissue． No．1 Vo1．6 肿，使之疼痛难忍，服任何止痛片也不能进入皮 内止痛 。 又例如：在受伤部位推拿，因其手法没有针 对性、特殊性，不能及时达到特殊效果。又因为 推拿面积大，如只是一个小面积的损伤，反而使 得损伤部位得不到针对性的治疗，其周围组织反 而因此受伤。一般推拿多年后，软组织均呈松散 结构，一旦受伤，炎症沿筋膜从一点到一片，而 不能达到 即刻见效的 目的。 再如 ：指压在肿胀 部位 是不适 宜的，多用在 痉 挛、僵紧 的软组织部位 。但 轻压得 不到很好 的 效果，一般人都用重压法， 以为重压后肌痉挛可 以得到缓解 ，甚至压之数小时之久，直至患者疼 痛难忍才罢手。殊不知久而久之肌纤维逐渐粘连 在一起形成更僵更硬的条索反而很难再恢复正 常。在远端点穴时活动患部，受损局部没有得到彻底 治疗，以至留下后遗症，对 日后治疗带来困难。 一 指刀手法在肿胀，疼痛部位沿肌纤维走行 方 向用其顺法第一刀疼一下 ，第二刀疼减轻 ，第 三刀后这个部位疼痛肿胀即解除，并对痉挛、疤 痕僵 紧的软组织达到快速松解 的作用 。 4．一指刀特点 简单易学，容易掌握，疗程短，见效快，治 疗后且不易复发，没有后遗症。 5．一指刀手法的重大改革在于 (1)一指刀面积 小，作用深 。定位 ，定 点，不损伤邻近组织。主力拇指与治疗部位皮肤 不动或少许移动 ，即上不动而下动 (深层软组织 如：筋膜，肌肉，肌腱，韧带在移动)。 (2)角度呈 15。～30。～60。，改变 以往垂 直指压，圆形按摩 。 (3)超声波润滑剂 Sonigel的使用：gel的 使用也是一大发明。对治疗深层软组织损伤起了 很大 的作用。一般 中医用 治疗 巾治疗 ，作用表浅 且不能彻底根治，而西医用油治疗，太滑，作用 同样表浅而不深入。如果用水来治疗，作用力可 以深些，但对医者手指损伤较大，而 Sonigel为 水性的胶质，不滑且可以保护医者手指又能作用 到深部，因没有酒精、药物、盐、染料、非常安 全 ，不会引起过敏。 总之，一指刀简便易行，效果显著且没有副 作用 。 6．一指刀手法的治疗根据 皇帝内经 《 灵枢 ·经筋 》 “以痛为输” 为理论依据 。即筋病的 治疗是以局部手法为主。经筋所主的病症主要有 痹痛、拘挛 、强急 、转筋、痿软等 。 7．软组织损伤病理变化 急性、亚急性期充血炎症水肿，肌肉痉挛。 第 6卷 第1期 维普资讯 http://www.cqvip.com ????? www.tengtongsl.com ????????????? World Journal of Traditional Chinese Orthopedics 1 5 1 世界中医骨科杂志 If a doctor uses water as the supplement instrument in仃eatment．the curative effect may be deeper．but it is very easy to the practitioner’s fingers．Sonigel is water based glue，is not slippery，can protect the practitioner’s thumbs．plus it can works into deep inside tissue．Use Sonigel is safe，it includes no alcoho1．meditation。sodium， colors，and will not cause any allergy to patients． Finger Surgery is simple and works very wel1．The curative effect is obvious an d fast．There is no side effect． 6．The source of Finger Surgery treatment Ancient King’s NeiJing<>，Basis on the theory：“painfu1 area is the injured area”．which means treatment the local injured area is the principal for soft tissue injury． Soft tissue related diseases include numbness，muscle spasm，severe muscle straiBed／sprained，muscle／ligament twisted or shrinking。 etc． 7．Pathologic changes in soft tissue injury： Acute or Semi—acute stage：bruise，inflammation，swelling or muscle spasm． Chronic stage： soft tissue starts to be stiffness， fibrosis，SCarS adhesive formed． 8．Examination soft tissue injury： The degree of swelling，swelling on the surface and stiffness underneath，tight，fiber，scar，knots。muscle spasm，numbness。function，the range of motion，etc． 9．Pathologic stages of Finger Surgery Acute stage，serfll‘acute stage，chronic stage，chronic stage of acute attack，chronic stage of semi—acute attack， function recovering stage，recovery stage． 10．The Basic principle of Finger Surgery B ased on the different anatomy structure of the local injured areas to provide variOUS techniques and will not damage the normal soft tissue．For example．after muscle injured，the doctor needs to make accurate diagnosis to find out that it is swelling or muscle spasm．it is at the fascia or the muscle fiber；after ligament injured。the doctor needs to find out that it is swelling on surface and stiffness in the deep inside tissue or it is muscle spasm with scars；the tendinous sheath iniured is acute．semi — acute，or chronic．With the various techniques combined used，the doctor needs to pay special attention on the strength of manipulation． 11．Symptoms apply： Specialize in orthopedic soft tissue injury．To the diseases of the department of internal／externa1．gynec— ology，pediatrics，five sense organs，and dermatology are all have amazed effects 12．Function Relieve inflammation。swelling an d pain；relax mus． cle and ligament，decomposition adhesive scars of the soft tissue． 13．Principles of treatment (1)Acute stage：The strength of manipulation should from light to hard，stop treatment as soon as swelling relieved． No．1VoI．6 慢性期软组织开始僵硬，纤维、疤痕化，粘连形 成 。 8．软组织损伤检查 肿胀轻重、上肿下僵，质地僵硬纤维疤痕结 节、条索、麻木区、功能范围等。 9，一指刀手法病理分期 急性期、亚急性期、慢性期、慢性期急性发 作 、慢性期亚急性发作、恢复期、痊愈期。 10．一指刀手法基本原理 按局部不同病理解剖结构而施不同手法，而 不损伤正常软组织。如：肌 肉损伤后要诊断出是 肿胀还是条索疼 ，在筋膜还是在肌纤维 如：韧 带损伤后，上肿下僵还是条索疤痕。又如：肌腱 腱鞘损伤是急性、亚急性还是慢性。因为选择治 疗手法不同，施法力度轻重亦不同。 11．适应症 尤其用于骨伤科软组织损伤，对内、外、 妇、儿、五官、皮肤科亦均有特殊效果。 12．功效 消炎，消肿，止疼，松筋散结，分解疤痕粘 连 。 13．治疗原则 (1)急性期：手法应从轻而重，待水肿 已 消 即停手法。 (2)慢性期：视不同病理组织手法从轻亦 可稍重，但不可过重。尤其拨法轻手法为检查之 法，稍重为治疗手法，过重则造成疼痛及炎症渗 出 。 (3)慢性期急性、亚急性发作：应分二次 施法，先用轻手法消除上层之肿胀，再用中等力 度解除下层之僵紧软组织。慢性期急性发作应第 一 次消肿，下一次再治疗僵紧；慢性期亚急性发 作可以同一次即治上肿又治下僵。 14．治疗手法 一 指刀手法如同体外开刀法，需要各种手法 技巧，本文大约列举了 33种方法，分为拨法和 顺法，拨法有八种不同手法，顺法又分为静顺法 和动顺法，共有 24种手法。拨法垂直于肌纤维 方 向施法 ，顺法沿肌纤维方 向施法 。 另外，还有不少组合手法，可随症选用。同 时，还应牢记 5O个四字诀，手法才能运用得当， 做到了熟能生巧，随症施法。 15．注意事项 每次手法治疗后应及时用中药冷湿敷袋敷于 患部，急性期每次 20～30分钟，每 30分钟或 60分钟一次；慢性期每次 15～20分钟，每天 3～5次即可 。 16．禁忌 热敷、冰敷、按摩推拿、贴膏药、拨罐、刮 痧、提拿重物 。 第6卷 第 1期 维普资讯 http://www.cqvip.com ????? www.tengtongsl.com ????????????? World Journal of Traditional Chinese Orthopedics 1 5 2 世界中医骨科杂志 总之，一指刀手法发明二十年以来，效果非 凡 ，屡屡受到病忠好评 ，真 正填补 了医学界对软 组织损伤最佳治疗的空白。希望，今后能为人类 做更多贡献 。 病例一：xxx，女，患前头痛一个月，经西医 MRI，x—Rav检查均属正常，但头痛依旧， 影响睡眠，只得服止痛药及安眠药，但只能暂时使症 状缓解一、两天，不能维持很久。 经检查：框内肌韧带水肿及僵紧，追问病史，其 儿子在晚上睡眠时曾用足跟踢过眼睛，因此确诊为外 伤性框内肌损伤。 用一指刀手法治疗一次，炎症立即 消失，疼痛即解除，第二次来复诊时主诉眼框已不痛 而痊愈了。 病例二：XXX，男，打喷涕时猛然扭伤腰部，须 由人搀扶才能行走，马上前来急诊。 经检查： 腰部各个角度活动受限，左腰肌痉挛且 压疼明显，诊断为急性腰肌扭伤。 用一指刀手法治疗一次当即活动 自如，腰肌疼痛 缓解。 病例三：XXX，男，玩滑轮时不慎跌倒在地，左 肩 能抬举，疼痛万分。经检查：三角肌、二头肌腱 炎，压疼明显，左肩前伸，外展各角度均明显受限， 急性左肩部关节损伤。 经过一指刀手法治疗一次， 左肩即活动正常，疼痛也消失了。 病例四：XXX，男， 上起后颈部抽痛，僵紧不 能活动，且一转颈部即疼痛加重。 经检查：胸锁乳突肌、斜角肌条索改变，压疼明 显。诊断为左颈肌痉挛 (落枕)；经过一指刀手法治 疗一次，颈部肌痉挛缓解，颈部活动正常。 拨法 直拨法：双拇指或单拇指指端垂直向下并沿肌纤 维 90度方向垂直置于僵紧的软组织部位，先适当向 下施压，然后再左右来回拨动。此法适于大面积僵紧 的软组织损伤部位，如背部。 斜拨法：一拇指或双拇指指端与治疗部位呈 30~60度斜角，并垂直肌纤维90度方向置于僵紧软 组织部位，先斜方向下施压，再左右来回拨动。此法 适用于中、小面积僵紧的软组织部位，如四肢部、颈 部。 平拨法：双拇指或单拇指指端与治疗部位呈0— 10度角，并垂直肌纤维 90度方向置于僵紧的软组织 部位，先向水平方向施压，然后再左右来回拨动。此 法适于颈部、四肢部软组织损伤。 颤拨法： 一拇指指端置于患部细小僵紧条索部 位，向下施压并做高频率、快速度的来回颤动。此法 第6卷 第 1期 f21 C：hronic stage：The strength of manipulation should be light or slightly harder．it should not be very hard．W hen“Bo”is used．the light manipulation is for examination，the slightly harder man ipulation is for treatment．Th e excessive strength was used may cause Painful and exudation of inflammation． f31 Chronic stage of acute and semi ．acute attack： Th e treatment should be separated into two steps． First． use Iight strength of manipulation to reduce swelling at the external area，then use medium strength of manipula． tion to relax the stiffness of deep inside soft tissue．Th e semi．acute attack of chronic stage can do the treatment for the swelling and stiffness the same time／ 14．Therapeutic manipulation techniques： Finger Surgery works as doing an operation at external area of the body，it requires various manipulation techniques．This paper listed 33 techniques．which include Bo and Shun method，Bo includes 8 different techniques， Shun includes 24 techniques，which were divided as JingShun(body stil1)and DongShun(body movement)． Bo follows tendon fiber working at vertical direction， Shun works at the direction of tendon fiber． ODe could combined using the techniques based on the symptoms．It is important to remember the 50“four． words colloquialisms” in order to apply the techniques properly． 15．Attention After each treatment，the herbal pack should be applied at the affected area． For acute stage，use the herbal bag for about 20．30 mi nutes for every half an hour until the swelling and inflammation part are relieved．For Chronic stage．use the herbal bag 1 5．20 minutes each time for 3-5 times a day． 16．Prohibition Heat／ice treatment，massage／TuiNa，medicated patch， cupping，scarping，lifting／carrying heavy stuffs． 0verall，Finger Surgery created the amazed thera— peutic effect since it has been invented for the past 20 years． It has received highly evaluations from the pati— ents． Finger surgery has fulfilled the empty spot in medical field for the best therapeutic way in treating the soft tissue injury．We expect it would bring an extraor— dinary contribution to human beings in the near future． Diagnostic example 1 A female had forehead ache for a month．M RI and X．ray done by M ．D．showed all are normal。but patient’s headache still existed，her sleeping was affected． Th e pain—reliever and sleeping pills prescribed by M ．D．could slow down the disease for only one or two days，then her forehead ache repeated． 0n physical exami nation．the ligament of M．orbicu． 1aris oculi had swelling and stiffness very much． 乃en illness history was asked，patient states that her eye was accidentally kicked by her son one night at sleeping，since then．she has experienced frequently forehead ache．This patient then was diagnosed as soft tissue iniury at M． orbicularis oculi． No．1 V01．6 维普资讯 http://www.cqvip.com ????? www.tengtongsl.com ????????????? World Journal of Traditional Chinese Orthopedics 1 53 Atier the first time finger surgery treatment，the swelling， inflammation and Pain immediately relieved．When patient came back for the follow up，she states that her forehead ache has recovered she could sleep very wel1． Diagnostic Example 2 A male accidentally twisted his lumbar area when sneezing．he needs to learl on other person to walk in for emergency care． On physical examination．very limi ted range of motion at lumbar area．1eft side muscle spasm and very stiffness．he was diagnosed as acute lumbar sprain．After the Finger Surgery treatment one time，the range of motion of lumbar area has back to norma1．the pain reduced very much． Diagnostic Example 3 A male，fell down when playing roller—skate．his left shoulder has severe pain an d could not lift． On physical examination：The tendenitis symdrome at M ．deltoideus．an d M ．biceps brachii with severe tenderness．The range of motion of nexion and abduction was limi ted．This is a typical acute stage of left shoulder ioint injury．After Finger Surgery treatment one time，the range of motion of left shoulder back to norm a1．pain on left shoulder has relieved． Diagnostic Example 4 世界中医骨科杂志 适用于小面积的僵 紧条索软组织损伤。 顶拨法：主力拇指手指指端与皮肤呈 l0—45度 角，并与患部肌纤维呈90度角，置于僵紧条索的外 侧或内侧，另一中指或拇指固定其后，令主力拇指由 一 方向另一方做均缓轻巧或重力整条肌纤维的拨动。 此法特别适用于僵紧的肌条索软组织损伤。 倒拨法：主力拇指指端置于受伤软组织的远端， 另一手中指固定其近端，主力拇指指端垂直肌纤维 90 度角，由远端向近端做左右来回拨动，固定之中指亦 向近端牵拉移动。此法：适用于颈部、四肢软组织损 伤。 切拨法：将主力拇指指甲呈90度角立指于僵紧 且细窄的肌条索部位，并向下施压，在垂直肌纤维 90 度方向时做左右的来回拨动。此法适用于细窄且僵紧 的软组织损伤。 勾拨法：主力拇指屈曲大于90度，指端、指甲 勾住僵紧的软组织，另一手握住患肢。令主力拇指垂 直于肌纤维90度的方向做左右来回的拨动，另一握 患肢的手同时向远端轻轻牵拉。此法适用于关节部位 的软组织损伤。 扇拨法：顶拨法通常用于每一条索的治疗，而当 治疗腕、踝部细小肌腱和韧带时，因其细小而紧密靠 得很近，所以可用顶拨法一起拨动二、三个条索，类 似在扇子上划动一样。此法适用于腕、踝部几条肌腱 和韧带同时损伤。 静顺法 分顺法：将两手拇指指腹压定体表皮肤及深部软 组织，双肘部及前臂在远端固定，拇指在保持原有向 下施压力度同时，逐渐平行向两端移动，适用于： 四 肢部位。 单顺法：用单手或双手拇指置于痉挛组织体表近 中心部位，向一侧平行加压移动。 适用于：头、背、 腰、腹部和四肢部位。 回顺法：用单手或双手拇指置于关节附近痉挛或 疤痕粘连的肌腱、韧带、滑囊部位，向起点或止点的 方向加压移动。适用于：关节部位肌腱炎，滑囊炎韧 带粘连条索。 横顺法：双手拇指垂直下按于范围较小的僵紧结 节条索部位，在保持体位不变时，双手拇指向上或下 方移动的方法。应用于：疼痛明显且面积较小的结 节、条索。多用于背部及四肢部。 顿顺法：单手或双手拇指压住僵紧的肌纤维条索 部位，用暴发力，由近端向远端移动数次，适用于较 硬的陈旧性的肌痉挛。此法适用于颈部和腰部。 摆顺法：用双手拇指按压住僵紧的肌肉肌健部 第 6卷 第 1期 A male had very stiffness neck with severe pain after get up in the morning；when turning his neck．will cause his headache． 0n physical examination，M ．sternocleidomastoideus an d M ．scalenus posterior are unusually stiff with severe tenderness．Patient was diagnosed as left stiff neck (1uozhen)．After Finger Surgery one time，pain and neck muscle spasm relieved，the range of motion of neck has backto norm a1． Dong Shan Fa fMotion Shan Method) 1．Xuan Shun Fa(Rotate Shun Method)：Use elbow an d forearnl hold patient’s man dibular area for head，an d slightly tract head．At same time，use one thumb to press the tight muscle，while slightly rotate the head in small degree，another thumb move an d press the tight muscle upward．This method is very useful for cervical muscle spasm． 2．Qian Shun Fa fTraction Shun Method)：Use one thumb to press on the pain or trigger point。another hand tract the distan t end in opposite direction．This method is very useful for head and limbs． 3．Ban Shun Method fFirm．holding Shun Method)： Use one thumb to press on tight muscle，another hand firmly hold patient’s leg，the thumb starts to move and press on the tight muscle．This method is very useful for low back injury． 4．Shen Shun Fa(Stretching Shun Method)：Use one thumb on injury tissue，another middle finger support the back of injured area，or hold patient’s shoulder，hand and foot、Patient is asked to stretching the ioint backward，at same time．doctor apply Shun method on iniured tissue． This method is useful for lumbar．wrist and ankle injuries． 5．Ou Shun Fa(Flexion Shun Method)：Use one thumb on injury tissue，another middle finger support the back of injured area，or hold patient’s shoulder，hand and foot．Patient is asked to nex the ioint backward，at same N0．1V01．6 维普资讯 http://www.cqvip.com ????? www.tengtongsl.com ????????????? World Journal of Traditional Chinese Orthopedics 154 世界中医骨科杂志 time．doctor applies Shun method on injured tissue．This method is useful for lumbar．wrist and ankle injuries． 6．Ce Shun Fa(Side—bending Shun Method)：Use one thumb on iniury tissue。another middle finger support the back of iniured area，or hold patient’s shoulder，hand and foot．Patient is asked to bend the ioint into side，at same time．doctor applies Shun method on iniured tissue． This method is useful for lumbar．wfist and ankle injuries． 7．He Shun Fa(or He Jin Fa．Harmonizing Tendon’s Method1：Use one thumb on the end of iniured tendons， an other han d hold the salne distant limb，while flex and iniured ioint，apply Shun method from down to upward． This method is useful for injuries