Having just finished the CTCMPAO Practitioner exam, I’ve spent some time reflecting on what I found most helpful throughout my educational history – for the exam and in clinical practice. First has to be the amount of clinic hours required for my program, which luckily enough for me included clinics at a hospice. Second has to be one of my teachers who always said to look at the tongue and pulse first, which at a beginner level gives an indication of excess/deficiency, hot/cold, yin/yang, etc. that will point treatments in the right direction. And third has to be the Western Medicine acupuncture course that I took, whose focus was knowing your anatomy – knowing which structures you are in and close to that not only give you restrictions as to dangerous areas, but also allows you to hit the exact spot you want and gives you confidence in needling depth and techniques. For example, do you know how to needle LI 16 to target the glenohumeral joint for shoulder pain? Do you know the names of the artery in the lower abdomen that could be hit using SP 12?
As of this week we are starting an acupuncture course in which anatomy is some of the content. Here are some examples of needling of points on the lower leg: gynecologically related of course:
ST 34: Liang Qiu – Ridge Mound
- Xi Cleft point of the Stomach channel
- Function: pain and numbness of the lower limbs, harmonizes Stomach for epigastric pain, acid regurgitation, breast abscess, hiccup, nausea, vomiting belching
- Location: on the thigh, on the line that joins the lateral border of the patella and the anterior superior iliac spine, in the depression 2 cun proximal to the superior border of the patella
- Musculature: vastus lateralus muscle, lateral border of the tendon of the rectus femoris muscle
- Innervation: femoral nerve – anterior cutaneous branches, lateral cutaneous branch, and motor branches
- Needling: Perpendicular 0.5-1.0 cun
ST 36: Zu San Li – Foot Three Miles
- He Sea point of the Stomach Channel, Lower He Sea point of the Stomach
- Function: main function is for cold in the Stomach, though with all of its applications it is said that this point can treat all diseases.
- Harmonizes the Stomach, tonifies the Spleen, resolves dampness for gastric pain, vomiting, hiccup, abdominal distention, gas, diarrhea, dysentery, constipation, edema
- Tonifies Qi, nourishes Blood and Yin, strengthens the body, regulates nutritive and defensive Qi for prevention against external pathogen attach, general deficiency of Qi, Blood and Yin such as fatigue, shortness of breath and dyspnea, and brightens the eyes
- Raises yang for prolapse of internal organs, dizziness, insomnia and heart palpitations
- Gynecological Functions: raises yang for prolapse of pelvic organs and postpartum dizziness due to general weakness
- Location: 3 cun below the inferior border of the patella, in the depression one finger lateral to the anterior crest of the tibia.
- Musculature: tibialis anterior muscle belly, extensor digitorum longus
- Vasculature: recurrent anterior tibial artery
- Innervation: peroneal nerve both recurrent articular branch and the motor branches of the deep peroneal nerve
- Needling: Perpendicular 0.5-1.2 cun
ST 40: Feng Long – Abundant Bulge
- Luo Connecting point of the Stomach Channel; the strongest point in the body for phlegm
- Function: Transforms and clears phlegm and dampness for copious phlegm, fullness and oppression in the chest, stabbing pain in the chest, headache, dizziness, vertigo, lump in throat, heaviness of the body, shortness of breath, asthma with phlegm, mania, depression, restlessness, epilepsy, constipation, difficulty passing urine, pain and stiffness of the leg
- Location: midway between the tibiofemoral joint line and the prominence of the lateral malleolus
- Musculature: peroneous longus muscle belly; peroneous brevis, preoneous tertius, extensor digitorum longus
- Innervation: deep peroneal nerve
- Needling: Perpendicular 0.5-1.0 cun
SP 3: Tai Bai – Great White
- Shu Stream and Yuan Prime point of the Spleen Channel
- Functions: primary Spleen deficiency with a subsequent excess of dampness for poor memory, fuzzy mind, dampness in the head, chest, lungs, abdomen and uterus; strengthens the spine for chronic back pain
- Gynecological Functions: dampness in the uterus
- Location: on the medial side of the food in the depression proximal and inferior to the head of the 1st metatarsal joint at the junction of the red and white skin
- Musculature: flexor hallucis brevis muscle belly
- Innervation: medial plantar nerve (branch of the tibial nerve)
- Needling: Perpendicular 0.3-0.5 cun
SP 4: Gong Sun – Grandfather (SP) Grandson (ST)
- Confluent point of the Chong channel, Luo Connecting point of the Spleen Channel
- Functions: Regulates the Spleen and Stomach, dispels fullness, and removes obstruction for acid regurgitation
- Gynecological Functions: this is the confluent point of the Chong channel and therefore the sea of the 12 regular channels for regulating the menses and stopping bleeding
- Location: on the medial side of the foot in the depression distal and inferior to the base of the 1st metatarsal at the junction of the red and white skin.
- Musculature: abductor hallucis muscle, medial head of flexor hallucis brevis, tendon of flexor hallucis longus
- Innervation: medial plantar nerve (motor branches)
- Needling: Perpendicular 0.5-0.8 cun
SP 6: San Yin Jiao – Three Yin Intersection
- Crossing point of the Liver, Spleen and Kidney channels
- Functions: harmonize all of the functions of the Spleen: tonify, resolve dampness, benefit urination; calm the mind, activate channel alleviate pain
- Gynecological Functions: Promote Liver Qi flow for abdominal pain, dysmenorrhea, irritability
- Tonify Kidneys, especially Kidney Yin
- Nourish Blood and Yin, move and invigorate Blood, cool the Blood, regulate the menses, induce labor
- Resolve dampness for damp accumulating in the vagina
- CONTRAINDICATED FOR — USE DURING PREGNANCY
- Location: 3 cun above the medial malleolus in the depression on the posterior border of the medial aspect of the tibia
- Musculature: between medial margin of tibia and soleus muscle; needled deeply with enter flexor digitorum longus and flexor hallucis longus
- Innervation: tibial nerve
- Needling: Perpendicular 0.5-1.0 cun
SP 9: Yin Ling Quan – Yin Mound Spring
- He Sea point of the Spleen Channel
- Functions: resolve dampness and fluid retention, especially in the lower jiao for damp heat or damp cold in the urine, stools, limbs, abdomen and intestines
- Gynecological Functions: damp heat or damp cold accumulating in the vagina
- Location: on the lower border of the medial condyle of the tibia in the depression on the medial border of the tibia
- Musculature: tibial origin of the popliteus muscle, medial head of gastrocnemius muscle, tendon of semitendinousus muscle
- Innervation: infrapatellar branches of the saphenous nerve, motor and deep branches of the tibial nerve
- Needling: Perpendicular 0.5-1.0 cun
SP 10: Xue Hai – Sea of Blood
- Mainly used for gynecological and dermatological conditions; one of very few points that treat the blood directly
- Gynecological Functions: Regulates, invigorates, cools & tonifies Blood, especially in the uterus
- Location: when the knee is flexed, the point is 2 cun above the medio-superior border of the patella on the bulge of the medial portion of the quadriceps femoris muscle
- Musculature: motor point of the vastus medialis obliques muscle
- Innervation: femoral nerve – muscular branch and anterior cutaneous branch
- Needling: Perpendicular 0.5-1.2 cun
UB 60: Kun Lun – Kun Lun Mountain
- Jing River point of the Urinary Bladder channel
- Functions: expels wind, removes obstruction from channels, relaxes sinews, strengthens back, clears heat, leads down excess Yang
- Gynecological Functions: invigorates the Blood for menstrual problems due to stasis
- Promotes labor and placental retention and is CONTRAINDICATED IN PREGNANCY
- Location: in the depression between the external malleolus and the calcaneous tendon
- Innervation: sural nerves
- Needling: Perpendicular 0.5-1.0 cun
UB 67: Zhi Yin – Reaching Yin
- Jing Well point of the Urinary Bladder channel
- Functions: clears fullness and heat from the head, nasal congestion, nose bleeds and eye pain
- Gynecological Functions: use moxa to turn the fetus and facilitate labor
- Location: on the lateral side of the small toe, 0.1 cun to the posterior corner of the nail
- Innervation: proper plantar digital nerve, cutaneously the branch of dorsal lateral cutaneous nerve
- Needling: moxa or superficially 0.1 cun
KI 3: Tai Xi – Supreme Stream
- Shu Stream and Yuan Prime point of the Kidney channel; for Kidney Yin and Yang deficiency (no excess conditions)
- Functions: nourish Kidney Yin and clear empty heat, tonify Kidney Yang, anchor Qi, benefit the Lung, strengthen the back
- Gynecological Functions: seminal emission, impotence, premature ejaculation, sexual taxation, and irregular menstruation
- Location: in the depression between the medial malleolus and the calcaneous tendon, level with the prominence of the medial malleolus
- Musculature: between tendons of flexor digitorum longus anteriorly and flexor hallucis longus posteriorly
- Vasculature: posterior to the pulse of the posterior tibial artery
- Innervation: tibial nerve
- Needling: Perpendicular 0.3-0.5 cun
KI 6: Zhao Hai – Shining Sea
- Confluent of the Yin Qiao channel
- Functions: nourishes Yin, moistens dryness, benefits the throat and eyes, calms the mind, cools the Blood, regulates the Yin Qiao channel, opens the chest, regulates water passages and the lower jiao
- Gynecological Functions: promotes the function of the uterus for menstruation problems, post partum problems, leucorrhea, and uterine prolapse
- Location: 1 cun below the prominence of the medial malleolus in the groove formed by the 2 ligament bundles
- Musculature: tibialis posterior tendon
- Innervation: saphenous nerve
- Needling: Perpendicular 0.3-0.5 cun
GB 30: Huan Tiao – Jumping Circle
- Qi Stagnation or deficiency in the hip region
- Functions: obstruction in the hip, back and leg, especially for pain along the buttock and leg
- Gynecological Functions: dispels wind damp in the lower jiao such as itchy anus or groin and vaginal discharge
- Location: with the thigh flexed, it is in the junction between the lateral 1/3 and medial 2/3 of the greater trochanter and sacral hiatus
- Musculature: gluteus maximus
- Innervation: sciatic nerve trunk
- Needling: Perpendicular 1.5-2.5 cun
GB 34: Yang Ling Quan – Yang Mound Spring
- He Sea and Lower He Sea points of the Gallbladder channel, Influential point of the tendons
- Functions: promotes the flow of Liver Qi, subdues rebellious Stomach Qi due to Liver Qi stagnation, resolves damp heat, removes obstructions from the channel, benefits the tendons
- Location: in the depression anterior and inferior to the head of the fibula
- Musculature: origin of peroneus longus, extensor digitorum longus
- Innervation: common peroneal nerve; this point coincides with the point for peroneal nerve block
- Needling: Perpendicular 0.8-1.2 cun
LV 3: Tai Chong – Great Rushing
- Shu Stream and Yuan Prime point of the Liver channel; for excess and deficiency
- Functions: subdues Liver Yang, pacifies Liver wind, calms spasms, soothes Liver Qi, calms the mind, nourishes Liver Blood and Liver Yin for headaches, muscle spasm, distention of the hypochondriac region, anger, irritability, stress, Blood deficiency in the head, eyes and sinews
- Gynecological Functions: Regulates menstruation for all types of menstrual disturbances, sagging of the testicles, pain of the genitals, and Blood deficiency in the uterus
- Location: on the dorsum of the foot in the depression distal to the junction of the 1st and 2nd metatarsals
- Musculature: 1st interosseous muscle, between tendons of extensor digitorum longus and extensor hallucis longus, lateral to the tendon of extensor hallucis brevis
- Vasculature: 1st dorsal metatarsal artery
- Innervation: lateral plantar nerve, medial dorsal cutaneous nerve (terminal part of deep peroneal nerve)
- Needling: Perpendicular 0.3-0.5 cun
LV 5: Li Gou – Wormwood Canal
- Luo Connecting point of the Liver channel; for excess and deficiency in the genitals
- Functions: promote Liver Qi flow, clear damp heat, benefit the lower jiao, treat plumstone Qi for depression, sighing and belching
- Gynecological Functions: for the genitals – itching, pain, swelling, retention of urine, enuresis, hernia, irregular menstruation, leucorrhea
- Location: 5 cun above the tip of the medial malleolus on the medal aspect of the lower leg near the medial border of the tibia in the depression between the medial crest of the tibia and the gastrocnemius
- Innervation: tibial nerve
- Needling: Subcutaneously 0.3-0.5 cun
LV 8: Qu Quan – Spring at the Crook
- He Sea point of the Liver channel
- Main function is to clear damp heat from the genitourinary area
- Functions: clear damp heat, benefit the lower jiao, relax sinews, nourish Liver Blood for burning pain and retention of urine, lower abdominal pain, headaches, dizziness, pain of the medial leg
- Gynecological Functions: pain and itching of the genitals, uterine prolapse, menstrual disorders
- Location: with the knee flexed, in the depression above the medial end of the transverse popliteal crease, posterior to the medial epicondyle of the femur on the anterior part of the muscles
- Musculature: medial head of gastrocnemius, posterior boder of distal tendons of Sartorius and gracilis muscles
- Innervation: saphenous nerve
- Needling: Perpendicular 0.5-0.8 cun
So, looking for something new to study and master? Try anatomy and see what it does to your needling techniques. For more information, please contact us!
Caroline Prodoehl, R.Ac, R.TCMP