Routine One: Liu Fang He He, Gathering Qi from Six Directions
Routine 1 begins with a relaxed standing posture. The practitioner attempts to relax the muscles in the head, face, neck, shoulders, arms, and digits, followed by attempts to relax the thorax, abdomen, hips, knees, ankles, toes, skin, organs, and so forth. He also attempts to adapt an upright posture with an elongated spine. The first movements of Routine 1 involve lifting the arms straight up to 90 degrees with the elbows extended. This is followed by wrist extension; next the elbows are drawn back and flexed, and the hands are relaxed. The arms are then pushed forward again and the scapula protracted as the wrists and digits are extended.
This movement is repeated, this time with the arms abducted 90 degrees in the horizontal plane. If one compares these movements to the nerve tension maneuvers for the median nerve, one can see that there is significant overlap. In addition, the author believes that the scapular movement takes that nerve glide or tension maneuver a step further.
In the next sequence, the hands are brought down to one side, then the wrists and digits are flexed; this is followed by extension at the shoulder with the elbows straight. This stretches all the extensors of the forearm. This is followed by a movement whereby the hands are brought up to the axilla and then supinated and brought forward to the waist. This maneuver incorporates a posture similar to the radial nerve stretch in dynamic nerve stretching. This movement is highly effective for stretching the forearm extensors and the radial nerve. It may help in the treatment of patients with hard-to-document posterior interosseous nerve entrapment syndrome, and also help treat patients with epicondular symptoms. Certainly these maneuvers should help to prevent the onset of lateral epicondylitis.
The next sequence in Routine 1 has the patient move on to a posture in which the hands are clasped overhead; this stretches the lower trapezii, the latissimus dorsi, the wrist and digit flexors, and the rotator cuff.
The next movements of Routine 1 are difficult to describe and can best be learned by studying. These movements involve the sequential release of tension from the cervical, thoracic, and lumbar areas in a type of autotraction maneuver. The patient reaches up to the sky with the hands clasped and arms upward, letting the body weight sink downward. Frequently during this maneuver, a pop is felt in the sternoclavicular or first rib regions. These maneuvers, which involve movements driven by the scapula, help loosen the scapula and periscapular musculature. They are followed by forward flexion and bending over each foot to stretch out the entire spine and the hamstrings. Finally, closing maneuvers are performed and the patient returns to the resting posture. Before beginning Routine 2, a relaxation sequence and visualization is once more performed.
Routine Two: Zhu Di Tong Tian, Penetrating Heaven and Earth
Routine 2 involves moves that are more challenging to the median nerve and that also involves alternating upper extremity movements. This places greater demand on performing symmetric, smooth mechanics of the scapula and thoracic areas. The movements of Routine 2 are done with the pulp of the thumb over the fourth and fifth nail beds, while the second and third digits are in extension. This is similar to the median nerve stretch used to check for carpal tunnel syndrome.
The next posture of Routine 2 involves the practitioner standing on his toes and extending the spine while his hands are held facing upward; this maneuver challenges balance and stretches the internal rotators of the shoulders.
The next posture involves trunk rotation and the stretching of the shoulder rotators and pectoralis muscles. This posture flows into one that emphasizes spinal elongation and uses a component of the ulnar nerve tension test. The closing movements of Routine 2 are then performed. Before beginning Routine 3, the patient repeats sequential relaxation, a check of alignment, and visualization exercises.
Routine Three: He Shou Tong Guan, Crane's Head Carrying Qi through Du Mai and Ren Mai
Routine 3 begins with cervical movements. The practitioner slides his head forward and brings it down until the chin touches the sternum. He then glides his chin along the sternum into the neutral position. This movement is repeated a number of times; the author believes this is a very safe way to stretch the cervical spine without compromising the neural foramina. This exercise is accompanied by a progressive squat-like posture that involves the maintenance of proper alignment and also somewhat affects the legs. The practitioner then comes to a standing position while doing alternating lateral and cervical flexion maneuvers that attempt to isolate the lower, middle, and upper cervical spine. This cervical spine sequence is probably safe for patients of any age. The next move in Routine 3 involves stretching the hips, knees, and ankles in a flexed posture. It also involves spinal stabilization and challenges the practitioner to maintain an upright posture while squatting. The closing movements are once again performed, followed by the relaxation routine and visualization exercises before going to Routine 4.
Routine Four: Xian He Dian Shui, Crane Touching Water
Routine 4 incorporates movements from many of the previous routines; however, it also involves numerous single-leg postures and movement up and down in the vertical plane on one leg. Upper extremity movements are performed with the shoulder abducted and the thumb held over the fourth and fifth digits, which is similar to Routine 2. However, the leg position is different. In Routine 4, one leg is placed directly behind the other. In addition, there is the challenge of going up and down while bearing the entire body's weight on one leg.
The hands are held out in front and the upper extremities moved in coordinated motions up and down. These movements are repeated lateral with the hands out to the side. These movements involve stabilization of the spine and the scapula. In addition, Routine 4 demands smooth, symmetric, coordinated motion of the upper and lower body. It puts stress on the supporting leg as well.
By the end of Routine 4, the practitioner has had his hands up for quite a while, and a good amount of cumulative strengthening has occured. The conscious relaxation of unnecessary muscles is emphasized while doing these maneuvers. This is an important concept for any individual with a musculoskeletal problem, especially those with CTD. Many people develop tension in muscles that are not necessary for the task at hand. This leads to shortening and myofascial pain. Unless the patient becomes aware of this posturing and unnecessary tension, he cannot learn to break the cycle of muscle tension and pain and develop smooth, normal movements.
Before beginning Routine 5, the closing moves, relaxation exercises, and visualizations are once again performed.
Routine Five: Hun Yuan Gui Yi, Mingling with the Source of All Qi
The movements of Routine 5 involve cervical and trunk rotation in combination with specific hand motions. These positions are in some ways similar to the ulnar nerve dynamic stretch posture. The addition of cervical and trunk rotation add to the stretch. The following moves in this routine involve lower extremity maneuvers that are similar to the lower extremity nerve tension motions. The final maneuvers of Routine 5 involve drawing a circle with the arms and stretching out the hamstrings, spine, and shoulder girdle to help relax any tension that has built up in all the scapular stabilizers and back muscles. After finishing Routine 5, the closing routine is performed and the patient relaxes.
As can be seen from the illustrations and descriptions, the five routines of Soaring Crane Qi Gong incorporate a comprehensive and healthy stretching program that mobilizes the cervical, thoracic, and lumbar spine, the scapula thoracic area, and all of the joints. The five routines include a form of postural education, spinal stabilization, and multiple complex nerve stretches that are very similar to dynamic nerve stretching; which leads to muscle re-education, facilitating healthy movement patterns and the ability to experience a relaxation response. A significant amount of strengthening of the scapular stabilizers occurs. In addition, the instructor provides a valuable form of biofeedback to the practitioner.