Elemental Acupressure and Reflexology
Alternative Health Care - Body Mind and Spirit
Acupressure/Cupping/Guasha Info and FAQ

Q. What is Acupressure?

A. Acupressure is the application of pressure to acupoints with fingers, palms, elbows, knees, feet or non-puncturing instruments in order to promote a healing response. Acupressure predates acupuncture as a treatment modality. The earliest acupuncture needles were made of stone, and were not used to pierce the skin, but rather to press acupoints.

Two simple acupressure techniques that anyone can use are pressing the acupoint hegu (Large Intestine #4) to relieve a headache, and wearing an acupressure wristband, to apply continuous pressure to the acupoint neiguan (Pericardium #6) for relief of morning or motion sickness.

There are simplified acupressure books that illustrate acupoints to press for different ailments. (For example, ten acupoints to press for headaches.) This unsophisticated cookbook approach to acupressure does not deal with the underlying blockage or imbalance that predisposes an individual to certain ailments.

Advanced practitioners perform acupressure in a highly sophisticated and individualized manner, based on a thorough understanding of Eastern Medicine theory, and expert diagnosis of the underlying imbalances in the organs and meridians. I use the same diagnostic procedures for both my acupuncture and acupressure patients. The diagnosis determines my treatment approach.

For example, Patient A and Patient B both suffer migraine headaches.

Patient A is a young female smoker who has insomnia and menstrual problems. During diagnosis I determine that she has deficient lung and kidney yinand ascending liver yang. . During the treatment session, I first tonify specific acupoints on the lung and kidney meridians, and then disperse other acupoints on the liver and gallbladder meridians.

Patient B is a middle-aged male, who also has cervical and low back pain because of unresolved injuries from previous whiplash incidents. While palpating diagnostic points on Patient B’s abdomen, I discover a blockage in the extraordinary meridian called dai mai (or “girdle vessel”). During the treatment session, I balance acupoints on the dai mai and yang wei mai meridians.

Acupressure alleviates the migraine headaches of both Patient A and Patient B, as well as some of their secondary complaints, even though the acupoints I treated on each patient were different. This is because the root cause of Patient A and Patient B’s symptoms was different.

When an acupoint is pressed, the energy flowing in the meridian below is attracted to the surface. Generally, acupoints are held until a pulsation is felt under the practitioner’s finger. The pulsation confirms that qi and blood are flowing freely. Acupressurists typically move one hand along a series of acupoints, waiting for the pulsation to arrive. The other hand is held still on a point selected for its ability to assist the other points in releasing.

By holding, pressing or massaging acupoints in a specific sequence, qi and blood can be increased or tonified where they are lacking and decreased or dispersed where they are overabundant. Because the acupressurist’s hands are in constant contact with the acupoints, changes in the flow of qi can be immediately detected, and treatment strategy can be modified to accommodate the body’s response.

There are various styles, methods and schools of acupressure. Those that originated in China are called tuina. Those that were developed in Japan are called shiatsu.

Q. What are acupoints and meridians?

A. Qi circulates throughout the body via the meridians. Meridians are like channels or pathways. Each main meridian begins where another main meridian ends, connects with an internal organ, transverses specific musculoskeletal structures, and ends where another main meridian begins. Thus the main meridians form a continuous circuit for qi to pass through every tissue and organ in the body. There are secondary meridians that branch off the main meridians like tributaries and extend between muscles, tendons and joints. Other meridians, called luo vessels connect one meridian to another.

There are eight extraordinary meridians: Two go up the center of the body, one in front and one in back. Another circles the waist, and the rest are more complicated pathways. The extraordinary meridians serve as reservoirs of qi for the main meridians. Acupoints on the extraordinary meridians serve as master regulators of the brain, spinal cord, endocrine and other systems of the body.

As qi flows through the meridians, it nourishes and regulates each meridian’s associated tissues and organ. Any misdirection, blockage or other derangement of the amount, flow, or balance of qi in the meridians may result in pain, dysfunction and ill health.

The meridians surface at the acupoints. The Chinese liken an acupoint to a chimney or vent hole that extends from the meridian up to the surface of the skin. They discovered that the body’s qi could be accessed and manipulated at the acupoints in order to correct aberrations of flow and positively affect health.

Discovery of meridians and acupoints may have been conceived during deep meditation as practiced in Chinese monasteries. Over centuries of trial and error and meticulous observation, the Chinese accurately mapped the locations of the meridians and identified hundreds of acupoints. Today, the meridians and acupoints can be scientifically observed using high-resolution microscopes that are used to map magnetic fields and electric currents.

Q.How much pressure is in acupressure?

A. The amount and type of pressure varies. The practitioner determines the needs of the patient and provides an appropriate combination of pressure and movement along the meridians. Pressure can be applied to both wide areas and precise points. Sometimes the pressure is experienced as gentle and calming, other times as deeply stimulating.

I use light pressure on children, and on patients who are frail, elderly, or have yin (sensitive, delicate) constitutions. I use a vigorous approach on people with yang (active, robust) constitutions.

Q. What is qi?

A. The idea of qi is fundamental to Chinese medical thinking, yet no one English word or phrase can adequately capture its meaning. English translations of the word qi (pronounced “chee”, and alternatively spelled “chi”) means “vital force inherent in all things” or “circulating life energy”.

However, Chinese thought does not distinguish between matter and energy. The Chinese perceive qi functionally—by what it does.

  • Functions of Qi
  1. Qi is the source of all movement in the body ( voluntary and involuntary)
  2. Qi protects the body (like the immune system—it keeps pathogens and toxins out)
  3. Qi is the source of harmonious transformation in the body (metabolic processes & digestion)
  4. Qi governs retention of the body’s substances and organs (preventing prolapse & leakage)
  5. Qi warms the body (it regulates our body temperature and sweating)

One’s good health depends on a balanced distribution of qi throughout the meridian network. This influences the organs as well as the bodily systems: skeletal, muscular, endocrine (hormonal), circulatory, lymphatic, immune, digestive, respiratory, urinary, reproductive and nervous. When qi flows smoothly and harmoniously throughout the meridians, each bodily system and organ interacts with and affects all the other systems and organs, which in turn are interdependent, interrelated, and integrated. Everything works together to make us feel whole and healthy, thanks to qi.

  • West Meet East

Prior to the twentieth century, Western scientists considered energy and matter to be separate and distinct substances. Einstein’s theories of quantum mechanics launched the field of modern physics, which considers energy and matter to be the same. The modern scientific view is that energy fields constitute the fundamental unit of the living and the non-living. Energy fields are infinite, paradimensional (beyond shape or form) and in continuous motion. They comprise the interconnected whole of the universe, of which human consciousness is a part.

In other words, thousands of years after the concept of qi originated in China, Western physicists have “discovered” a very similar concept. Human and animal bodies are now seen as dynamic electromagnetic fields existing in an electromagnetic environment. It is now known that changes in the electromagnetic field precedes growth and structural change. Acupuncturists manipulate this electrical field to restore proper form and function to the body.

Q. What is Sha?

A. In order to understand how cupping and gua sha work, it is essential to understand the concept of sha (pronounced “shaw”, which means “sand”).

When blood, qi and lymph circulation is sluggish or compromised in an injured or diseased area of the body, insufficient oxygen gets to the cells, and there is a local build-up of waste products. When the skin is pressed, the blanching that occurs is slow to fade.

The Chinese call this blood poison. Symptoms include pain and decreased range of motion.

In Chinese Medicine, there are three types of bad qi. Dead qi is where there is severe oxygen deprivation. It is the most harmful form of qi. Cancer cells grow in anaerobic—or dead qi environments. Stagnant qi is sluggish qi that is not flowing smoothly--it causes pain. Toxic qi is caused by exposure to poisons in the food and environment, or manufactured by the body from long-term stagnant qi.

Cupping and Gua Sha push bad qi, toxic fluid and blood poison from deep within the tissues to the skin’s surface. This toxic fluid is called sha. Sha typically looks like a red, purple or green skin rash. Often tiny raised bumps will appear. Sometimes a clear fluid will draw to the surface. These are all signs of disease being removed from deep within the tissues. If Gua Sha or Cupping is performed where there is no sha or disease, no discoloration or rash will appear.

The Western term for sha is petechia. Petechia is a slight subcutaneous discharge of blood from the vessels, which resembles bruising. The discharged blood helps flush toxins out of the area. Although sha looks painful like a bruise, it is not. Sha fades in about a week. The length of time it takes for sha to fade indicates the severity and toxicity of the patient’s condition.

Receiving cupping and gua sha feels mildly uncomfortable or deeply pleasurable, depending on the individual. There is a sensation of warmth as the blood comes to the surface. It is important to keep warm and avoid drafts for 48 hours after receiving Cupping or gua sha, because these techniques temporarily strip the wei qi (the body’s protective layer) in order to vent toxins.

Most patients who receive these treatments feel an immediate improvement in their condition. A small percentage of patients with severe blood poisoning feel temporarily worse due to the release of toxins. These patients often experience the most dramatic improvement in their condition within a short period of time.

Gua sha and cupping are not used on patients with bleeding disorders.


What is Tuina?

Tuina (pronounced “tway-nah”) originated in China in 1700 BC and is the oldest form of massage.

By 600 AD, tuina was included in the Imperial Medical College as a separate department. Today tuina is taught as a separate-but-equal field of study in major traditional Chinese medical colleges. In hospitals throughout China, tuina is used in conjunction with acupuncture and herbal medicine.

The word “tuina” means “push” (tui) and “pull” (na). Tuina techniques include an (rapid and rhythmic pressing), tao (strong pinching), nie (kneading), nien (nipping or light plucking), moa (rubbing) and pai (tapping). Gentle shaking, joint mobilization, and stretching are also included in a tuina treatment.

Acupressure is incorporated to treat internal disase and revitalize depleted qi.

In China, Tuina practitioners also practice “bone setting” (chiropractic-style adjustments). Western-trained Tuina practitioners do not perform bone setting. However, they do use other techniques to gently and indirectly realign musculo-skeletal and ligmentous relationships and thereby relieve nerve pain.

Superficially, tuina is the form of Asian bodywork that most resembles a Western (deep tissue) massage. However, the advantage of tuina is that it treats specific problems, especially chronic pain associated with the muscles, joints and skeletal system. In addition, tuina restores and improves the flow of qi, blood and lymph. Treatments benefit the whole body-mind-spirit, in addition to the specific area of complaint.

The tuina practitioner performs standard Chinese Medicine diagnosis and also applies extensive hands-on touch to locate areas of the body that are out of balance. Unlike shiatsu, tuina focuses on specific problems rather than on balancing the whole body. Treatment duration is shorter, so tuina can be incorporated into a shiatsu or acupuncture session to augment the treatment.

For example, a patient with chronic neck and shoulder tension may receive a treatment that begins with a 15-minute tuina module, which includes a variety of strokes, stretches and other techniques applied directly to the neck and shoulder area to relieve pain and increase mobility. For the remainder of the session, shiatsu or acupuncture may be used to further unblock affected meridians and address underlying imbalances in the flow of qi.

What is Ashiatsu?

Ashiatsu is a Japanese term for “Foot Pressure”.

During an ashiatsu massage, the massage professional uses their feet to deliver a smooth, therapeutic massage experience.

Ashiatsu is derived from Eastern forms of barefoot massage, but has been adapted to imitate Western forms of massage (Swedish, Deep Tissue) and accommodate mainstream massage goers. Ashiatsu combines elements of Thai Massage, Shiatsu (Japan), and Keralite/Chavutti Thirummal massage (India), but with a Modern, American touch.

What to Expect

Ashiatsu is like most other massages you have received. Other Eastern forms of massage are performed on a floor mat while the client remains fully-clothed.

Ashiatsu, on the other hand, is performed on a standard massage table. Clients undress to their comfort level and are covered/draped with a sheet throughout the massage.

Before the massage, the massage professional will warm, cleanse, and sanitize their feet.

Overhead bars on the ceiling allow the massage therapist to maintain balance while standing on the table and also regulate pressure during the massage.

Ashiatsu is great for those who enjoy deep pressure, but it can range from light to deep, according to the client’s preference for pressure. Pressure is consistent and smooth.


The benefits of ashiatsu are the same as other massage techniques, such as Swedish and deep tissue massage. Massage therapy has been shown in research studies to reduce stress and pain.

Ashiatsu allows the massage professional to use consistent pressure, compression, and gravity. Clients feel stretched, relaxed, with less pain and dreaming about their next appointment.

As with any massage, certain contraindications (times when you should not get a massage) exist. Discuss any health care issues, health changes, or medications with your massage professional.

There are benefits for the massage professional, too. Ashiatsu can help the massage professional reduce repetitive hand and wrist movements and injuries.

But what massage practitioners enjoy most about practicing ashiatsu are the results they see in their clients (pain and stress relief). Results they have not seen from traditional massage techniques. This is what makes ashiatsu really great.

Most ashiatsu practitioners agree that clients who try ashiatsu have a hard time going back to a “regular” hands-on massage. These ashiatsu enthusiasts have led to increased public interest and demand for barefoot massage.

There is just something about ashiatsu that clients and practitioners cannot put their finger on; something that keeps clients coming back for more, and leaving a traditional massage behind.

Published with permission from Advanced Massage Techniques.

What Is Cupping?

Cupping uses heat or suction to create a partial vacuum in cups placed on the skin. This draws up the underlying tissues. The cups are left in place on the skin for a few minutes, causing local congestion.

Cupping has been used for thousands of years in many cultures. Originally, animal horns, then bamboo cups and kitchen glasses were used. Traditionally, a flammable substance is soaked in alcohol, then lit and held briefly inside the cup. The fire consumes the oxygen inside the cup, which anchors the cup to the skin, and pulls the flesh upward inside the glass. In my own practice, I used traditional fire cups for several years but then switched to cupping sets that come with hand pumps. Using the hand pump instead of a flame allows me to control the amount of pressure and suction inside the cup with greater precision.

  • What are the benefits of cupping?
  1. Promotes the free flow of qi and especially blood in the meridians
  2. Dispels wind, damp and cold to treat muscle and joint pain, stiffness, and arthritis.
  3. Treats headaches, neck pain and backaches.
  4. Resolves menstrual problems.
  5. Dispels colds and respiratory infections.
  6. Benefits the lungs for cough and asthma.
  7. Strengthens the immune system by promoting the flow of lymphatic fluid.
  8. Improves circulation to reduce inflammation.
  9. Relieves gastrointestinal symptoms such as stomachache, vomiting and diarrhea.
  10. Activates the skin, clears stretch marks and wrinkles and improves varicose veins.
  11. Sliding cups (cups are fastened and then slid back and forth over a lubricated area) treats excess heat conditions, fever, stress, depression and anxiety.
  12. Cupping affects the body down to a depth of four inches beneath the surface--thus, it is the best deep tissue massage available.
  13. The suction created by cupping pulls stagnant intercellular fluid to the surface, removes toxic debris and replaces it with fresh oxygenated, nutrient rich fluid.

What Is Guasha?

Gua sha (pronounced “gwah shaw”) means “scrape sand”. This technique is commonly used throughout Asia by practitioners and lay people as a safe and effective way to maintain health and prevent illness. The Chinese government promotes the practice of Gua sha through media campaigns in order to reduce health care costs.

To perform Gua Sha, the area to be treated is first lubricated with thick oil or petroleum jelly. The skin is then rubbed with a round-edged instrument in downward strokes. A soup spoon—the type used in Chinese restaurants is used. (In other cultures, different implements are used—for example, in Vietnam the technique is called cao yio, or coining, because the edge of a coin is used).

As the body is rubbed the spoon pushes a build-up of fluid ahead of it and leaves an indentation or vacuum behind which draws toxic fluid out to the skin’s surface from deep within the tissues.

  • The benefits gua sha and cupping are identical, except:
  1. Gua sha is better for reducing fevers and excess heat conditions.
  2. Gua sha can treat certain areas of the body that cups cannot, because of their shape.
  3. Cupping works at a deeper level in the body.



© Copyright 2020 Elemental Acupressure and Reflexology . All rights reserved.