Sports tuina is an ancient healing art and a hands-on technique implementing combinations of acupressure, acupoint identification, soft tissue massage and bonesetting techniques. In this literature review, modern Westernized diagnosis and its nomenclature is synthesized with Eastern oriental views of energy systems and treatment management.
Sports tuina prevents and treats disease by applying manual methods to remove obstructions in the meridian pathways (traditional Chinese healing philosophy) by promoting an increase of vital energy or life force (ch'i) and blood circulation; reducing slight displacement of joints and healing soft tissue injuries; adjusting the functions of the internal organs and nerve regulation; joint mobility; and cellular tissue flushing. The philosophy of tuina stems from direct experience. People who practice this art in depth are said to be in touch with the inner mechanisms of their bodies. Their beliefs are derived from subjective experiences, from an inner assurance of truth. The Chinese philosophy of Tao is grounded on awareness, rather than strictly based on logical theories and rational premises.
Since running biomechanics has been studied extensively, the following information is nothing new. During foot strike, the initial contact is made with the lateral aspect of the shoe and the foot is supinated and the tibia externally rotated. After foot strike, the foot is loaded, where pronation of the subtalar joint occurs (this being a maximal load approximately 40% of the support stance phase). This is followed by an obligatory internal rotation of the tibia and the femur at pronation of the subtalar joint. The femur and tibia externally rotate just after the swinging leg passes the stance, causing a return to supination of the subtalar joint and locking or stabilization of the transverse tarsal joint. Normally the foot must not remain pronated during heel rise, but an inversion of the heel must occur.
Pronation is a normal occurrence allowing adaptation to the running surface by unlocking the midtarsal joint and making the foot more flexible. Limitations of pronation are due to the shape of the subtalar joint and the ligamentous support and to a less degree the support of intrinsic and extrinsic muscles. Excessive or prolonged pronation may occur due to anatomic reasons: for example, pes planus (flat feet), pes cavus (high arch), weakness of the gastrocnemius-soleus musculature, or a compensatory leg length discrepancy. Plantar fascitis can be caused either by abnormal pronation or supination. In pes planus with excessive pronation, the plantar aponeurosis is subjected to repetitive stretch, resulting in fascial strain.
Biomechanical alterations also contribute to the development of stress fractures in particular. Gymnasts, for example, often develop stress fractures of the foot. Vaulters are particularly susceptible to foot fractures due to repetitive approaches and take-offs from the vaulting board. Long jumpers and triple jumpers are also prone to stress foot fractures.
Anatomically, the foot with its numerous bones, tendons, nerves and arches is a complex area. Most instances of tendinitis and arch strain result from repetitious actions whereby muscular endurance was not efficient.
Rou is a gentle and slow stationary circular movement made on acupoints by the thumb or fingers or palm of the doctor's hand to press the subcutaneous tissues to move together. The frequency is about 120 to 160 times per minute. Rou is commonly applied to the foot to break up blood stasis and muscular spasms due to traumatic injury. The action of rou is to regulate the vital flow, remove stagnation, activate blood circulation, subside swelling and stop pain.
Plantar fascitis is still another cause of heel pain. The plantar fascia is inserted at the tuberosity of the calcaneus, causing inflammation and eventual degeneration. Often a hard cord-like mass can be palpated.
The treatment plan has the patient in a prone position with the patient's knee on the affected side bent in 90 degrees and the sole facing upwards. The practitioner stands on the involved side and applies tui or pushing by the thumb in the direction from the heel to the toes along the plantar fascia for a couple of times while fixing the patient's foot with the other hand. Next the practitioner applies rou or stationary circular pressing strongly (deep) on the tenderness around the tuberosity of the calcaneus for a couple of times. This is followed by ji or beating with the practitioner's fist on the bottom of the heel about five times.
An Rou for these Acupoints of the Foot
When sports chiropractors first appeared at the Olympic Games in the 1980s, it was alongside individual athletes who had experienced the benefits of chiropractic care in their training and recovery processes at home. Fast forward to Paris 2024, where chiropractic care was available in the polyclinic for all athletes, and the attitude has now evolved to recognize that “every athlete deserves access to sports chiropractic."
It is estimated that 61% of patients with CTS avoid taking surgical options due to postoperative complications and costly surgical procedures. Chiropractic care offers a comprehensive and effective treatment for carpal tunnel syndrome, addressing the condition from multiple angles. Recent studies also have unveiled a game-changing adjunct to chiropractic treatments for CTS: nerve flossing.
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
