Zheng Manqing performs snake creeps down.

I have compiled a list of the names of the postures of Zheng Manqing’s 37-Posture Simplified Yang Style T’ai Chi form. The names are listed in Hanzi, in Pinyin (with tones), and in English. In order to preserve the formatting of the columns and the Chinese characters, I have provided a link to a PDF file.

This is a Level I handout my T’ai Chi class.

click HERE to download the PDF file

I get this question from people often, especially from new patients on their first visit. I usually give my typical smiley smirk and say, “I’m going to be putting needles into your body. Of course it is going to hurt.” I realize that this is not funny in the classical sense, especially to the patient, but that small bit of absurdity in the midst of the new patient jitters often provides some levity. I follow up with, “Really, though, it’s not that bad.” I then go on to explain in more detail. It is a common enough question, so I thought I would share this information with you now.

There seems to be a popular misconception, especially in America, and perpetuated by mass media, that acupuncture is painless. Well, it is, but it isn’t. It all has to do with the definition of pain and, more specifically, with the Chinese definition of pain as it relates to acupuncture. Acupuncture is from China, after all, and the original phrase stating that acupuncture should not be painful is from China. In China, painful acupuncture would be having a continuous sharp or a continuous burning sensation that does not go away on its own after about one minute. If this happens, it should be brought to the attention of the acupuncturist so that the needle can be adjusted, and then the pain will go away. This does happen on rare occasion, and is just a normal part of the process. So, if it happens to you, do not be alarmed or discouraged, just let your practitioner know when it occurs.

That being said, acupuncture is definitely not sensationless. In fact, some of the normal sensations involved with acupuncture would be thought of as pain sensations by those in American culture. However, those sensations are actually referred to as qi reactions (deqi in Chinese) and are not considered pain by the Chinese definition.

What sensations are involved with acupuncture, then? I will explain, but keep in mind that this is all based on the acupuncture that I do which is based largely on the Chinese TCM model. There are other types of acupuncture with different needling methods, some of which involve no insertion at all.

First, let’s talk about the needles. They are single-use, sterile, disposable, stainless steel needles. I tend to use 32 gauge needles for most applications. That means the needles are 0.25 mm thick, which is very thin. Acupuncture needles are different than the hypodermic needles which are used when we get shots or blood tests. Because they are so thin, around 5 to 10 acupuncture needles can fit inside the tip of a hypodermic needle, depending on the gauges used. Hypodermic needles are hollow and sharp; they cut through the skin and puncture structures (veins, arteries, nerves, etc.) beneath the skin. Acupuncture needles are solid and the tips are relatively dull; they push through the skin and, instead of puncturing structures, will nudge structures out of the way with careful needling. So, do not expect insertion of an acupuncture needle to feel like getting a shot or blood test.

Insertion of the needle is a 2 step process. First, the needle is quickly inserted shallowly so that it gets through the skin. This is done either free-hand, which I do, or with a guide tube, which is also common. It is this initial part of insertion that feels like a pinch. Some people do not even feel the pinch, but the pinch-like sensation usually happens. In sensitive and thin skinned areas, the pinch feeling tends to be more prevalent. In less sensitive and meatier areas of the body, the pinch is less noticeable.

After the initial part of the insertion, the needle then gets inserted deeper into the body to the depth and at the angle that is appropriate for its location and for its purpose. While this happens, a variety of sensations are possible. Some people even feel nothing at all, which I always find surprising because I am very sensitive and feel absolutely everything when being needled. Sometimes only the movement of the needle itself can be felt. However, a common sensation is an ache, pressure, or distended feeling around the needle, as if the needle is much thicker.

This ache is one of the more notable qi reactions. It can come on gradually and be mild, or it can come on suddenly and be very strong for an instant, fading gradually after that. In particular, when it is sudden and strong, Americans categorize it as pain. They typically do not like the sensation. In China, however, it would be typical for a patient to be disappointed if they did not feel that sensation. In fact, once elicited, a Chinese doctor might continue stimulating the needle to prolong and propagate that sensation to the point of having the patient yell at times. Again, the patients expect this as part of a good treatment. It is a different story here. Heavy needling like that would make the majority of American patients question whether or not they should come back for another treatment. Therefore, a much lighter type of needling tends to be done here, and even though I follow the Chinese model, my needling is lighter and more suitable for our culture.

In addition to the ache, there are other common sensations that may be felt. Coolness, warmth, itchiness, and tingly sensations are all possible, too. Also, any of the sensations may be: 1) local, just where the needle is; 2) referred, meaning the needle is one place, but it is felt someplace else; or, 3) radiating, meaning the sensation can travel in any direction away from the needle (most commonly in the direction of the acupuncture channel on which it is located).

Not everyone feels these types of sensations with every needle. Also, what a patient feels during one treatment may not be the same thing felt during the next treatment even if the needles are in the same points. Furthermore, even though these sensations are qi reactions and are an indicator that the acupuncture is doing what it is supposed to be doing, it is actually more important for the practitioner to feel the qi through the needle after insertion. It is because of this that the needle may be manipulated by twisting or pushing and pulling in order to call the qi to the needle and to deliver the proper treatment intent for that point. So, even if a patient feels nothing from a particular needle at a point, as long as I feel what I need to feel, I continue on to needle the next point.

After I feel the qi reaction, in many cases (particularly for functional complaints rather than musculoskeletal or structural complaints) there is no need to leave the needles in place in the patient. They can be removed at that point. However, I tend to leave the needles in, generally anywhere from 10 to 30 minutes depending on many factors. I do this because it is part of the Chinese TCM model, is what I learned in school, and is what is expected by patients getting acupuncture. There is a reason for this.

It is thought that the qi in the body cycles though the various acupuncture channels as connected from beginning to end in about 15 minutes, give or take depending on many factors. Therefore, if an acupuncture needle is positioned properly, but a qi reaction is not felt by the practitioner, the qi will still naturally arrive at the needle at some point during the treatment if the needle is retained.

Many practitioners, especially new ones, are not skilled at connecting the qi to the needle. It is not something that is easily taught. It is a sort of intangible skill that must be experienced in order to fully understand and to replicate. Therefore, needle retention can allow for a more effective treatment. Because of my long-time martial arts, t’ai chi, and qigong backgrounds before I studied acupuncture, I was already familiar with qi, how it felt, and how to manipulate it. This knowledge and experience easily flowed over into my acupuncture practice.

Usually, there is little or no sensation when removing a needle. The patient will often feel either nothing or just the movement of the needle. Sometimes there is discomfort, but it is more or less instantaneous. Also, I occasionally and intentionally elicit another qi reaction as I am removing a needle.

More often than not, there is no blood. In the few instances where there is blood, it is often not more than a small drop and is blotted clean with a cotton swab. Even rarer, a bruise and / or small swelling can occur. If there is a swelling, it can be immediately rubbed out to the point that it will not return, but the bruise will run the normal course of a bruise for you.

It is possible that with certain types of needling, particularly with deep and / or strong needling for structural complaints, the patient will experience some muscle aching for a day or two at the most, very similar to the type of muscle ache one would get from working out too much. This is normal, will go away, and does not take away from the effects of the treatment.

These are the notions that I like to get across to my patients before needling them so that they know what to expect. I try to be thorough, but I keep it basic. I think I have included everything here, but if you have any questions, please let me know.

I’ve neglected this blog for far too long. Part of the reason for that is that I have so many different topic and tidbits to share that I never know where to begin, so I put it off.

However, a student recently asked me if she could practice qigong too much. While giving my answer, I decided that I should include that information here. After all, my blog is supposed to be an extension of my website which contains only basic information about what I do and offer at OHMS. My blog gives me a chance to expand and further reveal.

The qigong that I teach is general in a way that works the entire body evenly, and when practiced correctly, there are no dangers of creating blockages or stagnations. Though qigong practices that are specific to certain areas of the body or to certain acupuncture channels do have their uses and benefits, I feel a general qigong practice is going to be more beneficial overall, a better long-term strategy for health, and safer.

So, can one practice qigong too much? The short answer is yes and no. Let me explain.

If you are practicing correctly and the qigong that you are practicing is a safe one (not all qigong practices cultivate health or healthy mental states), then you cannot practice too much providing the following circumstances are considered and met also.

1. You need to sleep. Is your practice interfering with your ability to achieve good sleep? Are you practicing when you should be sleeping? Good sleep is very important and should not be sacrificed for practice.

2. You need to eat. Is your practice interfering with your appetite or digestive abilities? Are you practicing so much that you neglect eating? Eating good food at regular intervals is another important aspect of a healthy life and should not be sacrificed for practice. Drinking (mostly water) is also included in this notion.

3. Do not neglect personal hygiene. Practicing to the exclusion of personal hygiene is not acceptable. Personal hygiene plays an important roll in good health that should not be overlooked.

4. Do not ignore your social, fiscal, or educational duties. We are social creatures, and though some people have more active social lives than others, this edict still applies. If you have friends and family that you normally talk to or hang out with, do not isolate yourself from them or cut ties with them just because of qigong practice. Interactions with friends and family are part of good mental health. Also, if you work, keep working. Do not miss work because of your qigong practice. Do not forget to pay your bills, either. If you are in school, definitely keep up with your studies. Qigong practice can be fit into your free time, even if free time is scarce and at irregular intervals.

5. Basically, numbers 1 through 4 can be over-simplified as “do not become obsessed.” This is an actual danger of practice. There is also a validly recognized physiological disorder called “qigong psychosis” (aka qigong deviation syndrome). This comes about from too much incorrect practice or from too much or non-supervised practice of more specific (and possibly dangerous) qigong exercises. I will not go into all of the details here, but a decent read on the topic can be found at http://www.iari.ru/qigongileng.html .

6. Do not practice while you are ill. OK, that sounds a little strange because qigong is supposed to make us healthier, right? Basically, one should not practice during the acute stages of a disease process or illness. For instance, if you are coming down with a “cold,” then do not practice qigong during that time. However, if the acute symptoms of the “cold” are gone but you have a lingering productive cough, you may practice. In fact, the right kind of practice can help to open the lungs and clear the phlegm.

7. Do not wear yourself out. If you are practicing so much that you are physically worn out and lacking energy most of the time, then you have practiced too much. Even easy, gentle exercises can eventually take their toll. There is nothing wrong with getting a good workout if that is your intention, but you must allow for recovery time.

Those are the main points, and to many they will seem like common sense. However, the above issues are all worth enumerating and explaining. Qigong is a great practice and can do us much good, but there are potential negative results.

My suggestions for practicing qigong are as follows:

1. Set aside at least 30 continuous minutes to practice qigong. If time and your physical condition allows, 60 minutes or even 120 minutes would be better. This large continuous block of time should constitute your main practice for the day. If you are able to do this twice a day, then that is fine also. Do not let this guideline scare or discourage you. If you can only find 10 or 15 minutes, then use that time to practice because a little bit is better than nothing.

2. Not everyone can manage to provide for such a block of continuous time each day. Whether you can or not, you can practice more, at shorter intervals, throughout the day. If you have 5 free minutes here, and 10 there, and 3 at another time, then you can utilize those minutes to work on specific aspects of your qigong practice. For instance you can just work on keeping a clear mind, or you can just work on relaxed, slow abdominal breathing. You may choose to just stand and work specifically on relaxing your hips and waist area. You get the idea. Use the small amounts of free time that you have throughout the day to help fine-tune your practice or to help you get over those sticking points. That way, when you do have a larger continuous block of time, your practice can be more meaningful.

That’s about it. Qigong has tremendous depth. There is much to be discovered in even the simplest of exercises, and the more correctly it is done, the more benefits you will get from your practice. Also, practice is the key, so spend as much time practicing as you can. Like I said above, the things I stated here are fairly basic, but I think it helps to have it all spelled out and in one place. I hope this helps you.

If you have any questions about these points, please let me know.

I guess it all started when I was in kindergarten.  I already could read some words and I knew the letters of the alphabet.  However, I didn’t really know the alphabet.  I mean, I didn’t realize they had to be in a certain order.   The teacher pointed to the list of letters above the blackboard and asked the children to recite the alphabet.  There they all were reciting the alphabet, and I felt clueless.  They all had a jump on me, and now, at age 4, I was faced with the monumental task of having to quickly memorize a 26 item sequence – not cool.

I begrudgingly accepted the duty of rote memorization.  I shouldn’t be too down on it.  Rote memorization has its purposes, and it is important.  It is, however, the lowest form of learning and speaks nothing of actual understanding or one’s ability to apply knowledge.

I should point out that only one other person was able to read in my kindergarten class, and she was at least 6 months older than me.  I understood letters and knew how to use them; I just had some initial problems with the rote memorization.

Let’s fast forward to 7th grade.  I took the SATs that year and scored better than the average high school student.  That opened a few educational doors for me:  special classes, accelerated programs, etc.

In high school, I was already taking college calculus in the 10th grade.  I was the guinea pig for the development of the college level physics class at my high school as well.  The rest of my classes were college prep and advanced placement classes.  I did very well in school, but I never developed good study skills.  I understood everything and could figure out anything that was placed in front of me, but I still hated memorization.  More importantly, by this point in my life, I hated the structured environment of the education system, and I hated jumping through hoops.  I hated having to show up for class.  I hated having to read what book they told me to read (I am a very slow reader, also), and to add insult to injury, they would make me write a book report which I also hated to do.

OK, so I was an angry youth.  I really was.  Everybody assumed that I would just go to college and do great things, but I just couldn’t do it.  I was sick of it all.

High school graduation came and went.  September came, and I did not go to college.  However, by the time that February came around, I decided I really had to go college and do something with my life.  I was always a science nut, so I signed on the line and declared my major:  a B.S. in Biology (Biotechnology).  I chose this over physics, which I loved, because I was still totally fed up with math.  Math was easy for me, but it was sort of shoved down my throat, and I was still sick of it.  Biology was cool, but my real plans were for graduate school where I would switch my track to Neuroscience.  The human brain fascinated me, and I wanted to do research work.

Well, I only lasted a year and a half.  I was going to school full-time.  I was working 35 hours a week to pay for it all while living on campus.  I got burned out.  Unfortunately, I was still an angry youth, and I still hated memorization and jumping through hoops.  I knew I could handle the courses and the information, but I had to do it when they said and how they said, and I couldn’t handle that.  In retrospect, I realized that I lacked the maturity required for success at college.

So, from that point I went into the workforce.  I spent a few years working as a bookkeeper (computers + math = easy) at a law firm.  Then, I got into computer aided design, CAD, work and then worked as a technical illustrator (computers + math + art = easy).  However, those were just jobs that paid the bills.  My real life was martial arts.

I worked out anywhere from 2 to 6 hours per day, 6 days a week.  I both practiced and taught kung fu and t’ai chi, did light weight training, and did aerobics.  My goal was to one day have my own business, a large martial arts school.  All along, since early childhood, I was fascinated with Chinese culture.  Martial arts had introduced me to and peaked my interest in the healing arts of the Asian countries also.

Then, one day it happened.  All of a sudden, I realized that a career in Oriental Medicine (Acupuncture and Chinese herbs) was possible.  I never realized that there were Chinese medical colleges in our country.  I always thought that one would have to go to and live in China in order to learn such things.  I was wrong.  There were about 40 accredited Acupuncture or Oriental Medicine colleges across the country.

I investigated the colleges and found out that the ones located in California had the most comprehensive programs, almost double the hours of some of the colleges located elsewhere.  California had its own licensing standards which were higher than those of the National standards.  Acupuncture is well integrated into the medical insurance system in California, and Acupuncturists enjoy primary care physician status.  I figured that if I was going to put in the time, effort, and money (too much money) into this, I wanted to get the most out of it.  I chose the Pacific College of Oriental Medicine (PCOM) located in San Diego, California because its graduates consistently achieved the highest percentage of passing scores on both the California certification exam and the National certification exams.

It was a 4-year, 3400 hour Masters of Science in Traditional Oriental Medicine degree program.  However, I learned that I needed at least 2 years of undergraduate college in order to be admitted.  So, I went back to college.

I was more mature this time around.  Also, I changed my major from Biotechnology to Philosophy.  I figured that if I were going to take classes that weren’t going to matter in my career, I may was well take courses that were 1) very interesting to me, and 2) easy.  I knew I had a lot of work ahead of me in San Diego, so I thought I would take it easy in Delaware.

I was working full time, still working out, and teaching kung fu and t’ai chi.  So, I attended college part-time.  My original plan was to finish the whole Philosophy degree before moving on.  I should note that I had several minors as well:  East Asian Studies, Chinese Language, and Religious Studies.  That plan changed.  The part-time pace was too slow, so with just one year left to finish, I gave up again.  Already having more than enough credits to gain admittance at PCOM, I packed up and moved to San Diego.

The full-time course load at PCOM was quite intense. Originally, I planned on a more normal pace, taking 6 years to finish the 4 year course.  However, I decided to take a full load my first trimester there:  7 classes.  Yes, the full-time schedule consisted of 7 to 8 classes per trimester, with 3 trimesters a year, with a 2 week break between trimesters.  There were 75% more courses than a standard 4 year undergraduate degree.  I found that I was able to handle it that first trimester, and full of passion and excitement, I continued onward at the full-time rate.  It did, however, take me 5 years to finish, instead of 4, because I took a lot of extra courses, mostly in bodywork, but also pediatrics and external herbal applications.  In the end, I graduated with 211.5 credits and a 3.9 GPA.  The only reason it was not a 4.0 is because, once again, I got very burnt out, my health suffered, and I decided on occasion that my health and peace of mind was more important than an “A”.

Sadly, during my time at PCOM, I found myself fighting those old demons.  I found myself hating the process.  I did not want to keep jumping through hoops.  I just wanted to be a practitioner.  Really, I am not a good student.  I enjoy learning, but in my own way and in my own time.  Attendance policies were very strict; tests and assignments were frequent and numerous.  The amount of memorization required was insane.  Have I mentioned that I hate memorization?  This was killing my passion for Oriental Medicine and made me question my dream.

I did find a remedy, however.  I just did even more work.  While everyone else was in study groups working on memorization, I was reading.  Rather than just memorizing the ingredients of an herbal formula, I would read all the commentary on that formula that I could find, not just in the required texts, but in any other texts I could find.  I found myself reading translations of old Chinese medical texts as well as newer texts by some of the great minds in the field today.  None of this was required, but I needed it.  I needed to understand the medicine and know how it all worked, rather than just memorize everything about it.  This helped keep my passion alive.

Ultimately, I found the work easy, but the process was very hard on me.  I guess I am just not wired that way.  I really tried to be the good student.  In the end, though, I am glad that I still did it my way.  I came out of PCOM both learning and understanding much more than what the standard program could offer.  It is also worth mention at this point that out of the approximately 40 people that started the program when I did, only about 5 actually made it through to the end.