1.2　Rolling manipulation

Place the dorsal aspect of the hand or elbow over the treatment area and roll the forearm and dorsum of hand back and forth continuously. This is called rolling manipulation. It can promote blood circulation, relax the tendons, unblock the collaterals, relieve spasm, alleviate pain and relax tight, stiff and fatigued muscles.

Treatment requirements

When performing the rolling manipulation, fix on the affected area with the back of hand or forearm. The upper limb should remain relaxed. The frequency should be fixed and the speed should not too quick. The stimulation should be performed with light and heavy force alternately.

(1) Elevated rolling manipulation

Press the affected area with the dorsal aspect of proximal interphalangeal joints of the index, middle and ring fingers. Replace the complex rotation of the forearm with simple movement of extension and flexion of the wrist joint. The force and stimulation is stronger, so it is often applied to the areas with thick muscles on a person with strong physique. (Fig.1-6)

(2) Side rolling manipulation

With naturally-bent fingers and a relaxed upper limb, press with the dorsal aspect of the 5th metacarpophalangeal joint over the treatment area. Roll the hypothenar and dorsum of the hand back and forth continuously. The rolling movement is achieved by the flexion and extension of the wrist joint, coupled with a rotation of the forearm by using the elbow joint as a pivot. The force is slight and the stimulation is soft, so it is often applied to joints and on people with a small physique. (Fig.1-7; Fig.1-8)

(3) Forearm rolling manipulation

With naturally-bent fingers in a claw shape and a relaxed shoulder, press the affected area with the ulnar side of forearm close to the elbow. Drop the elbow with the wrist joint flexed naturally to 90° and roll back and forth continuously. The forearm rotates outwards while swaying the arm externally, and inwards while swaying the arm backward. (Fig.1-9 to Fig.1-13)

The main applicable regions

This manipulation is often applied to the areas with thick muscles like shoulders, back, lower back and limbs.

Cautions

Manipulator should rotate the forearm in coordination with the flexion and extension of the wrist. Lower the shoulder and drop the elbow to fix on the affected area. Do not lift the elbow and stay close to the skin. This helps to avoid rubbing the body surface which may damage the skin. Manipulator should pay close attention to the patient’s posture and use gravity from the upper body swiftly. When performing rolling manipulation, the force used should be increased gradually. Brute force is strictly prohibited to avoid rib fracture or thoracolumbar vertebral fracture.