Wrenching Neck in Chinese Tuina

Thrusting-wrenching Manipulations of Tuina

Introduction to Thrusting-wrenching Manipulations of Tuina

1. Flexion-Wrenching Neck for Stretching Tendons
The patient is in the supine position. Standing before the patient’s head, the practitioner crosses the arnls to support the patient’s occiput, and touches the patient’s opposite shoulder with his hands to form a pair of labor-saving levers, then raises the forearm to drive the patient’s cervical vertebrae to be flexed to the limit position and then retums to the original position. Repeat the movements 3 to 5 times (Fig．203). This manipulation can stretch the convulsive muscles and tendons of the neck and expand the space of the cervical facet joint. It is suitable for the treatment of stiff neck and restricted flexion of the neck. Click to read Hypertension (High Blood Pressure) in TCM.

2. Lateral Flexion-Wrenching Neck for Stretching Tendons
The patient is in the sitting position．Standing by the poster lateral side, the practitioner holds the patient’s head and keeps it against the chest with one hand, and touches the opposite shouhler with the other hand. Then his two hands deliver force coordinately to make the patient’s cervical vertebrae laterally flexed to the limited position slowly, and then returned to the middle position. The above movements are repeated 3 to 5 times (Fig 204). This manipulation is applied to stretch the convulsive cervical muscles and tendons of contraside, and to separate the heterolateral Luschka’s joint. It is suitable for the treatment of pain, stiffness and restricted flextion of the neck. Click to read Chinese medicine Treatment for Hypertension.

3. Lateral Flexion Thrusting-Wrenching Neck
The patient is in the sitting position. The practitioner touches the projected spinous process of the suffered cervical vertebra with one thumb and the opposite temporal region with the other hand, then makes the cervical vertebrae laterally flexed to the elastic barrier position under slight flexion of the neck. When the thumb is resisting against the spinous process, the other hand makes a sudden and controlled lateral wrenching to expand the range of the lateral flexion 3 to 5 degrees so as to utilize the rotation that is accompanied by the lateral flexion of the neck to cause restoration(Fig 205). This manipulation is applicable to the reduction of lower or middle cervical vertebral subluxation．

4. Lateral Flexion Thrusting-Wrenching Neck in Prone Position
The patient is in the prone position with his head rotated twoard the side on which the suffered spinous process of the C2 is projected. Standing in front of the patient, the practitioner touches the temporal region to fix the head with a hand, spinous process of the C2 with the other hand, with the thumb putting above the spinous process of the C2 and the rest fingers under those of the lower cervical vertebrae．Then the practitioner pulls the spinous processes of the lower cervical vertebrae upward so that the cervical vertebrae is laterally flexed to the elastic barrier position, then makes a sudden and controlled wrenching to expand the lateral flexion range 3 to 5 degrees. At the same time, the practitioner thrusts the spinous process of the C2 downward with the thumb and wrenehs that of the rest fingers upward to turn the two vertebrae of the same motion segment oppositely. In this way, the aubluxation is usually reverted to their anatomical relation(Fig 206). This manipulation is applicable to the reduction of C 1, C, vertebral subluxation or the subluxation above the C4．Click to read Thromboangiitis Obliterans in TCM.

5. Lateral Flexion Wrenching Neck in l raction in Supine Position
The patient is in the supine position. The practitioner stands before the patient’s head and opens the parts between the thumb and the index finger of the hands, keeps the thumbs upward and the rest fingers downward to hold the patient’s chin and occiput, then keeps the cervical vertebrae in traction for a while, and then laterally fiexes the neck twoard the suffered side to its elastic barrier position. It should be noted to keep the frontal plane of the head in horizon during lateral flexion while keeping in slight traction. Then the practitioner makes a sudden and controlled movement to flex the cervical vertebrae 5 to 10 degrees, so that the subluxation segment is shocked and restored (Fig 207). This manipulation is applicable to the reduction of lower cervical subluxation. Click to read TCM Treatment for Thromboangiitis Obliterans.

6. Oblique-Wrenching Neck in Sitting Position
The patient is in the sitting position with the neck slightly flexed to relax the neck muscles. The practitioner supports the patient’s chin with one hand and the occiput with the other hand to rotate the head toward the side of the limited rotation. Then the practitioner makes a sudden and controlled wrenching to expand the rotation range 3 to 5 degrees(Fig 208). This manipulation can fully stretch the upper portion of the muscle trapezius and sternocleido-mastoid, and restore upper cervical vertebral subluxation. It may cause injury of the neck when being applied to restore lower cervical vertebral subluxation due to its deficiency in accurate location. Click to read Premature Heart Beat in TCM.

7. Oblique-Wrenching Neck in Supine Position
The patient is in the supine position．The practitioner holds his chin and occiput to pull the head in the posterio-superior direction for a while with two hands．Then keeping traction, the practitioner makes the patient’s head rotated twoard the affected side．When the neck reaches its elastic barrier position．the practitioner makes a sudden and controlled movement to expand the rotation range 3 to 5 degrees．Thus the facet joint is restored(Fig．209)．This manipulation is applicable to the reduction of middle and upper cervical vertebral subluxation．

8. Lateral Flexion-Rotation-Wrenching Neck in Supine Position
The patient is in the supine position. The practitioner holds the chin and occiput to pull posterio-superiorly with two hands. In this way the patient’s head is laterally flexed and rotated about 45 degrees to the eontra side. When the neck reaches its elastic barrier position, the practitioner makes a sudden and controlled movement to shake the head from superior to inferior to cause the cervical vertebrae restoration(Fig 210). This manipulation is suitable for subluxation accompanied by flattened cervical curvature. But for those accompanied by cervical lordosis, applying this manipulation may cause injury of vertebral arteries, and so it should be applied carefully. Click to read Chinese medicine Treatment for Premature Heart Beat.

9. Rotating—Wrenching Neck in Sitting Position
The patient is in the sitting position with his lower limbs stretched forward and the spine flexed slightly so as to fully relax the sacrospinalis muscles. The practitioner holds the patient’s chin and cheek with one hand, props the projected spinous process with the thumb of the other hand, then rotates the patient’s head in a narrow range and adjusts the flexion-extension position of the neck step by step until a suitable posture is found in which the practitioner can feel the nape muscles being fully relaxed．At the very time when the head is rotated to its elastic barrier position of the suffered side, the practitioner wrenches the head and thrusts the spinous process sire ultaneously to expand the rotation range 3 to 5 degrees．Thus the facet joint may be restored(Fig 211)．This manipulation is applicable
to the reduction of the middle and upper Cervical vertebrae subluxation. Click to read Arrhythmia in TCM.

10. Rotating—Wrenching Neck on Selected Site
The patient is in the sitting position. The practitioner supports the patient’s chin with his flexed elbow and holds the occiput with one hand, touches against projected spinal process of the suffered segment with the thumb of other hand. Then the practitioner guides the patient to flex neck gradually. When the thumb feels the above space between spinous processes is broadened, the practitioner stops flexing and keeps the neck in this position, then pulls the head upward for a while to get rid of the reflective contraction of the muscles; later, rotates the neck toward the affected side to its elastic barrier position, then makes a sudden and controlled wrenching to expand the rotation range 3 to 5 degrees. At the same time, the thumb thrusts the spinous process to cause the facet joint to be restored(Fig 212, Fig 213)．This manipulation is applicable to all the cervical vertebral subluxation. Click to read Chinese medicine Treatment for Arrhythmia.

11. Rotation-Wrenching Neck in Traction in Prone Position
The patient is in the prone position with his neck stretched out of the bed end．An assistant holds the shoulders or the neck bottom to keep the cervical vertebrae steady. The practitioner sits in front of the patient’s head, crosses his fingers of the two hands and flexes the elbow to hold the head around with his hands and forearms, then guides the patient to relax, and pulls the cervical vertebrae for a while in a slight flexion position. When the patient’s reflection spasm of muscle has been relieved, the practitioner rotates the neck toward the projected side to its elastic barrier position at first, then makes a sudden and controlled wrenching to expand the rotation range 3 to 5 degrees and then loosens the neck immediately. When the manipulation is repeated at the contraside direction, the sub-luxation can be restored(Fig．214). This manipulation is applicable to the reduction of all the cervical vertebral subluxations. Click to read Angina in TCM.