Tui Na推拿（すいな）推拿

Tuina is taught in the context of Chinese medicine, with systems using terms such as meridians, points and pattern differentiation. Schools and fields of practice can differ in techniques and scope.

Names such as tui, na, an, mo, rou and gun describe movements including pushing, grasping, stroking and rolling. Their particular use should be understood through teaching materials and instructors.

Traditional accounts of illness are not offered here for self-diagnosis. Tuina’s value is also not explained by dismissing another practice as merely muscular massage.

In the second half of the 20th century the People's Republic of China institutionalised Chinese medicine, and tui na became a speciality at the universities of Chinese medicine founded from 1956. The tui na faculty of the Shanghai University of TCM is the centre of the rolling school, and much of today's textbook tui na was organised there. Hospitals have tui na departments, and treatment protocols are studied for lumbar disc herniation, cervical spondylosis, and infant indigestion and night crying.

Tui na divides into specialities: orthopaedic tui na for joint correction and spinal adjustment; paediatric tui na for infants who cannot easily take medicine; internal-medicine tui na treating digestive and gynaecological complaints through abdominal and back points; and sports tui na for athletes' injury prevention and recovery.

Abroad, tui na is taught in TCM colleges in the United States, Europe and Australia and has spread as a supporting technique for acupuncturists. Japan's 'Chinese seitai' is a lay version of tui na, but licensing differs greatly between countries.

Tui na is practised today as medicine in China and as complementary therapy abroad. Treatment is given over clothing or through a thin cloth, with talc or a small amount of medicated ointment or oil where needed. Sessions of 30 to 60 minutes usually concentrate on areas chosen by the diagnosis.

Cupping (baguan) and gua sha are external treatments of the same Chinese medicine and are often combined with tui na. In recent years tool-assisted methods resembling gua sha have spread in Western sports, so tui na's techniques are also entering the world under other names.

Contraindications include acute fractures and dislocations, tumours, bleeding tendency, severe osteoporosis and skin disease. Joint manipulation of orthopaedic tui na is reserved for trained TCM physicians and is omitted in lay practice abroad.