Hand Techniques in Amma Therapy


Circular Pressure

Circular pressure, the most commonly used technique in Amma therapy, involves the application of pressure and movement in small circles at a given point on the body. The technique is repeated in a smooth and rhythmic pattern that follows a channel pathway or the direction of muscular fibers. The novice practitioner, who has yet to develop fine coordination, will frequently execute large circles that cover a large surface area. The advanced Amma therapist creates minimal circles, the motion often looking as though it is going in an up-and-back direction.

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Circular Thumb Pressure

In this technique the whole hand is in contact with the patient's body while the thumb performs circular pressure. The thumb is directly aligned with the radius of the practitioner's working arm and does not abduct or adduct unnaturally. This maintains a proper direction of force through the forearm and into the hand. Depending on the area being treated, this technique can be executed with either the pad of the thumb, the arch of the thumb, or the thumb in combination with the thenar eminence. Minimal tension should be experienced in the working hand and arm, as the muscles of the upper back and shoulder initiate the movement. This technique is used in the manipulation of specific points on the body, the manipulation of channels, and in particular for deeper pressure on the Bladder Channel.

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Circular Digital Pressure

In this technique the pads of the four fingers are used. However, depending on the size of the area being treated, you may use as much as the entire palmar aspect of the four fingers up to and including the metacarpophalangeal joint. Although the four fingers are used, the major direction of force comes through and from the middle finger.In a more advanced technique the pad of the distal phalange of the index or the middle finger is used to provide directed circular pressure to a specific point. In this case the palm is held in contact with the body, with force being directed into the pad of the finger.

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Circular Palmar Pressure

In this technique the entire hand is used in the manipulation. The palm focuses the movement while the fingers remain relaxed and in complete contact with the body. Pressure is disseminated evenly throughout the hand rather than being applied at the heel of the palm or the distal pads. The thumb is held beside the digits.This technique is used in the manipulation of large muscle groups and at those places where more gentle treatment is required.

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Circular Ulnar Pressure

In this technique the ulnar aspect of the hand, the so-called blade, is used to apply force. The direction of force is into the area of the hand from the pisiform to the metacarpophalangeal joint. Movement of the hand is in small circles, This technique is most frequently used in the area surrounding the scapulae to release the deeper muscles.

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Circular Palm-Heel Pressure

In this technique circular pressure is -applied with the heel of the palm. Circular palm-heel pressure is frequently used in the release of larger muscle groups.

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Direct Pressure

Direct pressure refers to either steady direct thumb pressure or direct digital pressure to a specific area or point. The amount of pressure varies with the area of the body being manipulated and the patient's needs and sensitivities. This is a technique that is used in the direct stimulation of points and in the release of muscle spasms. It is generally followed by circular pressure to the area or point.

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Direct Thumb Pressure / Direct Digital Pressure

This technique employs the use of the distal aspect of the pads of the five fingers. Typically used for the stimulation of specific points, either the whole pad or portions of the most distal aspect of the pad are used, depending on the area of the body being manipulated. Because this technique requires that the hand be perfectly controlled, the appropriate administration of this technique requires great strength in the completely relaxed hand.

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Stroking

The stroking technique involves a single uninterrupted movement repeated over an area of the body. The force is distributed equally throughout the whole hand or the aspect of the hand that is being used. Pressure remains constant and even throughout the movement.

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Thumb Stroking

Thumb stroking involves the use of the entire palmar aspect of the thumb-the pad, the arch, and the proximal phalange. Pressure is distributed equally throughout the thumb. This technique is most commonly used in the treatment of the muscles of the forehead, the face, and the medial aspect of the foot.

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Digital Stroking

This technique employs the use of the palmar aspect of the fingers. A large surface area may be covered with a gentle pushing movement. There is light contact between the hand and the patient, with little pressure applied. Digital stroking is frequently used to reduce edema in the extremities; the direction of movement is with the venous flow, that is, toward the trunk of the body, in order to facilitate lymphatic drainage.

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Palmar Stroking

Palmar stroking involves the use of the entire palmar aspect of the hand in full contact with the body. A gentle gliding motion covers the surface of the area being manipulated. In the correct administration of this technique the relaxed hand molds to the contours of the body This technique is often employed on the posterior surface of the body in long sweeping motions.

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Loose-Fist Stroking

A very relaxed fist is formed with virtually no tension in the forearm. The fingers of the hand are flexed toward the palm, allowing the dorsal aspect of the middle phalange of the fingers to come in contact with the patient. The thumb is held in a relaxed fashion beside the index finger. Either a short up-and-back motion or circular pressure is used.

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Fore-knuckle Technique

This technique requires forming a relaxed fist by flexing the fingers of the hand toward the palm without flexing the metacarpophalangeal joints. Contact with the patient's body is made with the proximal interphalangeal joints of the fingers. The foreknuckle can be applied using circular pressure, direct pressure, or a stroking technique when deeper manipulation is appropriate.

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Embracing

In this technique the hand is molded to the contours of the body and a drawing or suction motion is applied with the palm. Because this is a palmar technique, no fingertip pressure is applied.

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Palmar Embrace

In this technique the thenar and the hypothenar areas of the hand are used in opposition to one another in a drawing motion that produces a vertical suction effect. The focus is in the palm of the hand, though some contact is made by the proximal phalange of the fingers. No fingertip pressure is applied. The palmar embrace is effectively used in the release and relaxation of muscle groups.

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Palmar/Thenar Embrace

In this technique the thenar and the hypothenar areas of the hand are again used to produce a vertical suction effect; however, in this manipulation the thumb is drawn toward the fingers at the end of the stroke. This technique is effectively used in the release and relaxation of larger muscle groups.

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Percussion

With percussion movements, a light tapping motion is applied in a rhythmic manner to the surface of the body, producing a stimulating effect. Care should be taken to produce a vibratory effect rather than producing pain from incorrectly applying the techniques. Percussion techniques should never be used directly over the spine.

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Cupping

In cupping, the hand is held in a relaxed pyramid form. The four digits are held together with the fingers extended; the thumb is held beside the index finger. A slight bend at the metacarpophalangeal joint creates a hollow at the center of the palm. When executed properly, the palm never contacts the body. This technique is applied in a continuous rhythmic manner, with the two hands alternately striking the body. As a result it produces a highly stimulating yet relaxing effect. This technique can be used on the back, buttocks, thighs, legs, and shoulders. When applied to the posterior aspect of the thorax, it stimulates the release of mucus and mucopurulent material from the lungs.

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Chopping

The blade or ulnar aspect of the hand is used in chopping. The wrist is held in a relaxed manner, allowing the hand free movement at the joint. The fingers, while held together, are also relaxed.. The striking area extends from the pisiform bone to the distal aspect of the fifth digit. The two hands strike in an alternating fashion in a continuous and rhythmic manner. This produces a stimulating yet relaxing effect when administered properly. Like cupping, this technique can be used on the back, buttocks, thighs, calves, and shoulders.

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Taken from the book, Amma Therapy by Robert & Tina Sohn ; This book is available for purchase from our school or through an online book-seller such as Amazon.com. It is highly reccomended!