The therapeutic results of hand and foot massage are markedly affected by the maneuvers selected and the skill of the practitioner. Sometimes, an incorrect selection of maneuvers or poor skill may produce an adverse effect. In doing self-massage, supplemental instruments and tools are very helpful, if one has the basic knowledge of the proper techniques. These instruments and tools can help to compensate for less than perfect ability. The supplemental instruments can partially replace the function of the hand m directly performing massage; and the supplemental tools can strengthen and maintain the effects of hand and foot massage. It is worth emphasizing that the supple-mental instruments and tools are also very useful in applying hand and foot massage to other people.

The supplemental instruments and tools, including the Tbar, hammer, pestle, massage board, balls and bracelets for maintaining health, and pebble or sand container are discussed as follows. The reader can prepare and modify them for use as needed.

1. Massage T-bar:

Shape and properties: The T-bar look like the handle of a stick. The handle of the bar should be easy to hold firmly with

Fig. 3-12 Massage T-bar

a comfortable feeling, neither too slippery nor too rough. The body of the bar is about 5 cm long and gradually narrows to form a blunt tip, which may be covered with a rubber cap to avoid sliding away from the acupoint when pressure is applied by the bar to the acupoint. The T-bar is best made of hard wood or hard plastic (Fig. 3-12).

Usage: The T-bar can be used as a finger to apply pressing, digit-pressing, finger-pushing and finger-rubbing maneuvers to many places on the hand and foot. The rubbing and pushing maneuvers should be applied along the longitudinal direction of the bones, because rubbing and pushing with the Tbar across the bones may cause local injury if the maneuver is violently applied. The bars may be manufactured in different sizes of various diameters to fit the local anatomical nature of the acupoints or reflecting areas.

2. Massage hammer:

Shape and properties: The massage hammer has a similar

Fig. 3-13 Massage hammer

shape as the common carpenter's hammer. The head of the hammer may be separated from the handle for easy handling by the practitioner. The hammerhead is 1-2 cm in diameter and 4 cm long with a cone-shaped end and a blunt end which may be wrapped with a rubber cushion. The hammerhead should be made of metal or hard wood and be heavy enough to produce the necessary momentum. The handle of the hammer should be slender with good elasticity (Fig. 3-13)

Usage: The massage hammer can take the place of the hand to apply quick knocking, grinding, rubbing, and pushing maneuvers to the acupoints and reflecting areas on the palm of hand and sole of foot. The intensity of force and the frequence of manipulation applied with the hammer should be adequate and even.

3. Massage pestle:

Fig. 3-14 Massage pestle

Shape and properties: The massage pestle is an oval shaped sharpened bar with a wider upper end and a narrower lower end of adequate length for holding in the hand; and 1-2 cm of its upper end may show above the hand. The pestle may be made of smooth stone, wood, or the horn of cattle or sheep (Fig. 3-14).

Usage: After soaking or steaming with a boiled herbal decoction, the hot pestle may be used to push, rub or iron the acupoints over a wide area on the hand and foot. Stone is the best material for the pestle because it can retain more heat energy and better absorb the herbal ingredients. The heat of the pestle should be tolerable for the patient.

4. Massage board:

Fig. 3-15 Massage board

Shape and properties: The massage board is made of thick wood or plastic with many protruding papillary eminences carved out from the upper surface of the board in an uneven distribution. The board must be longer than the palm and foot (Fig. 3-15).

Usage: The massage board can be used to perform step-ping and kneading or digit-pressing over a wide area of the hand and foot. It is also very useful for maintaining health and doing self-massage.

5. Health balls:

The health ball is a common instrument for exercising the hands, developed and modified from the traditional walnut for

Fig. 3-16 Health balls

hand exercise. The balls are made of crystal, stone, glass, or metal and sold in pairs of different sizes. It is best to choose balls made of natural material for obtaining better results. The balls can be constantly rotated in the palm through the skillful and active movement of the joints to produce a massaging effect (Fig. 3-16). Some people can manipulate as many as 3-5 balls at a time in one hand, or combine the ball exercise with general body exercises.

This is a very helpful exercise for middle-aged and older people to facilitate joint movements, adjust the locomotive function of the whole body, improve mental activity, and slow the aging process.

6. Health bracelet

This is another common instrument for hand exercises. It is a rubber bracelet that comes in different sizes, and is arrayed with small bead-like granules over its outer surface. With the aid of the rebound effect of its elasticity, the user may repeated-

Fig. 3-17

ly squeeze the rubber bracelet as a hand exercise of hand; at the same time, the granules apply pressure to stimulate the acupoints over a wide area of the palm, producing a massage effect for adjusting and maintaining health ( Fig. 3-17 ). Squeezing the rubber bracelet can also promote the circulation of qi and blood, improve the joint movements, and refresh the mental faculties. Both hands can use the bracelet alternately, and more exercise may be done with the weakest hand. This is a good exercise for youths and people who do mental work and must sit at a desk all day. It is also useful for middle-aged and older people.

When using the exercise bracelet, it is more important to fully squeeze the bracelet each time than to do many repititions. The bracelet can be used anywhere, and persistent exercise can promote growth and development, prevent diseases, retard the aging process, and treat neurasthenia, disturbances of the digestive function, and kidney essence deficiency.

7. Pebble container:

This is a wooden box arranged with 3-4 layers of natural round pebbles. It should be big enough to allow an adult to stand on it. A plastic basin may be used instead if a wooden box is not available; and glass balls may be used instead if pebbles from a seashore or riverbank are not available. Broken bits of glass should be carefully removed from the container to avoid damaging the skin (Fig. 3-18).

Fig. 3-18

This instrument is also very simple to use. Both hands may be used to rub the pebbles or one hand is used to squeeze the pebbles with an adequate force and at a proper speed; and the user may stand on the pebbles with bare feet. If this is not tolerable, they may sit on a stool with their feet in the pebbles, and then stand after gradually adapted to it. The process of gradual adaptation is more important for overweight people. If available, it is better to do this exercise in a natural surrounding. The pebbles may be gradually changed from larger to smaller sized, after the user becomes adapted to this exercise.

This is a self-exercise for the hand and foot producing good therapeutic effects. The extent of exercise is adjustable and the pebbles may be boiled or steamed with herbal decoction for even better results.

8. Sand container:

Sand used in building construction or collected from the seashore is put into an adequate container after it is washed clean and sun dried. The sand in the container should be about

Fig. 3-19 Sand container

5-10 cm deep (Fig. 3-19). Exercise with the sand container is similar to that with the pebble container. In addition, the sand may be used to repeatedly rub the foot, especially the spaces between the toes, the joints, and the sole until redness and hotness of the skin is produced. This massage may be carried out at noon or at night to relieve fatigue and produce a sedative and hypnotic effect. It is most useful for chronic patients and senile people with difficulty getting out-side. The sand may reused after washing and sun drying.

Besides the supplemental instruments and tools for hand and foot massage mentioned above, there are many ordinary objects around us easily adopted for use if we are familiar with massage principles and techniques. Consistent practice is the important thing for treating chronic diseases and maintenaning health.

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