In physiotherapy, the twain do seem to meet
'Oh, East is East and West is West, and never the twain shall meet,' writes Rudyard Kipling in his 1889 poem The Ballad of East and West. Never did he get it more wrong than in the case of 21st-century physiotherapy in Hong Kong.
For the past few years, a few therapists here have mixed elements of traditional Chinese medicine (TCM) with their Western repertoire. I recently discovered this when I hurt myself at the gym.
My symptoms: numbness in one arm and hand, and pain and swelling around a shoulder and shoulder blade. The cause: a prolapsed upper spinal disc putting pressure on a nerve, plus three torn tendons around the shoulder area. I was ordered off to physiotherapy.
The first physiotherapist I saw was at a private hospital. She used electro-pad therapy, ultrasound and short-wave diathermy (a heat-generating machine), as well as some manipulations. Some of the machinery prompted more numbness and discomfort.
The second physio I saw, at a private clinic and recommended by my doctor, dished out similar treatments.
But at a small clinic, Perfect Pointe, run by Jenny Chan Lai-nga, I was offered acupuncture, alongside manipulations of the hand and elbow - which served to avert a potential spine operation. Chan, a certified practitioner of Western-style physiotherapy, had done a course in acupuncture to enhance her capabilities.
'I believe that traditional Chinese medicine can add some benefits that help certain injuries,' says Chan, who also uses cupping and scraping in some treatments.
With injured ankles, for example, it's difficult to reach some areas with fingers, especially when there is a lot of deep scar tissue, she says. Acupuncture can treat such spots easily and help release tension.
Australian native Judith Gould, a 25-year physiotherapy veteran, says Western therapists are now using needles to treat similar localised ailments. Her clinic, Posture Plus, offers 'dry needling', which she says is a relatively new technique outside China. It involves introducing fine needles into the skin and deeper into the muscles, fascia (connective tissue) and occasionally joints, tendons and bone/tendon junctions.
'Unlike acupuncture, which taps into meridian lines, this technique seems to help relieve stress build-up in joints and spasmed muscle,' she says.
Gould believes that good Western physiotherapy, like TCM, should be holistic (take into account a patient's overall state of health). She began incorporating this belief into her practice 14 years ago by treating clients with a curative form of Pilates. 'A good therapist will treat as much of a person as they can, setting them 'homework' between sessions, such as exercises and stretches,' she says.
Alex Leung Ka-ho, a registered Chinese medicine practitioner at Kerry Fung & Associates Physiotherapy Services, begins every consultation with a check of the client's pulse. He asks about general lifestyle and examines meridian pathways to evaluate qi - the vital life force - and blood circulation. 'Then I press relevant acupoints to probe for the pathway conditions,' he says. 'Are they congested or smooth? Strong or weak? This information helps me estimate the severity of the injury.'
He says most injuries are due to the body being too 'cool' or 'hot'. A deficiency of qi, and cool syndrome or 'blood stasis' (the abnormally slow movement of blood), are believed to lead to joint and muscle pain. In these cases, Leung says moxibustion (burning of compressed medicinal herb sticks) and cupping therapies are given at various acupoints to boost qi.
Rubbing also generates heat and is believed to enhance qi and meridian blood movement. It is a technique of tui na, a distinct TCM massage that includes alignment manipulation.
But despite the effectiveness of some TCM techniques, many people fear them, according to Manual Care Rehabilitation Clinic's Wong Chee-long, a registered Western-style physio who is trained in acupuncture. For example, scraping, a harder form of 'rubbing' that's done with a wooden spatula, can be useful to make muscles more relaxed but can be quite painful. 'A lot of people don't want to have it done,' says Wong.
Chan adds: 'Many won't allow cupping, as it leaves marks on the skin.' She says that's a pity, as the technique is an excellent way to relieve muscle tension and stimulate the fascia.