A Discussion on Anatomically Significant Points of Acupuncture
Introduction
One of the most uncomfortable moments for many practitioners is when the patient asks the simple, well-intentioned, and reasonable question: “How does acupuncture work?” There are many ways to proceed, but this is not necessarily an easily answered inquiry.
Over the course of 40 years of clinical practice, specializing in acupuncture sports medicine, I have developed a framework for responding to this question, and ones similar in nature. It involves integrating traditional acupuncture with western anatomy, modern physiology, and the principles of orthopedic medicine.
The question is much more easily addressed with this response: “It depends on which point or points we use in the treatment”. I then introduce the patient to the concept of “anatomically significant points”. I explain that each acupuncture point is located in specific tissues of the body that tend to have predictable clinical effects on both structure and function. Certainly this explanation in western anatomy is the basis for a much more easily understood discussion. As we all know, attempting to explain the science of the jing-luo pathways is not always easy and clear.
Discussion
Emphasis on anatomically significant points of the musculoskeletal system opens up a whole new and interesting conversation. Used to treat injury and pain, as well as to harmonize the biomechanics and movement patterns of the body, these are the “access points” in orthopedic and sports acupuncture. Each has some sort of anatomical individuality, such as being located at a muscle-tendon junction or in the region of a major ligament. More examples will be covered below, but for the purpose of this article, these points are based upon surface anatomy. They are structures that we can palpate, muscle test, distract or compress. We are not using the language of neural pathways, reflex arcs, or points that in some studies alter neurotransmitters and other humeral agents. It is not that these physiological responses are insignificant; they just are not always an easy explanation in the clinic room.
We are assuming that many of the traditional acupuncture points have anatomically significant features, giving them a unique set of actions and indications. We don’t know every point, and what its anatomical and physiological characteristics are. With some, we may speculate, and with others, we may make wrong assumptions. Obviously more research is needed. That will all come in time, as acupuncture continues its inclusion into the western medical community.
Examples of Points on the Meridians of the Body:
Points in the belly of the muscle
Bladder 57 Chengshan
In the belly of the gastrocnemius and soleus muscle group
Bladder 37 Yinmen
In the belly of hamstring muscle group
The hamstring, showing the motor points (diamonds) and trigger points (Xs) in the region of Bladder 37.
Points at the tendinous attachment to bone
Bladder 36 Chengfu
At the superior hamstring tendon attachment to the ischium
Large Intestine 15 Jianyu
At the supraspinatous tendon attachment to the humerus along with the other muscles of the rotator cuff.
Points at a Muscle-Tendon Junction
Large Intestine 16 Jugu
At the muscle-tendon junction of the supraspinatous
Large Intestine 10 Shousanli
At the region of the muscle-tendon junction of the wrist extensors
Motor Points
Small Intestine 12 Bingfeng
In the region of the motor point of the supraspinatous muscle
Small Intestine 12, located in the belly of the supraspinatous, is the motor point for the muscle.
Trigger Points
Small Intestine 11 Tianzong
Located in the region of the muscle belly of the infraspinatous, at the common site of multiple trigger points
Points at the “Opening” of a Joint Space
Liver 8 Ququan
At the medial joint space of the knee
Points at or Along the Tendon and Tendon Sheath
Bladder 59 Fuyang
In the region of the tendon sheath of the achilles
Points Located at or Adjacent to Ligamentous Tissue
Liver 8 Ququan
At or just posterior to the medical collateral ligament of the knee
Points Located at Significant Neurological Sites (based upon the anatomical location of the nerve)
Gall Bladder 30 Huantiao
In the region of the gluteus maximus, at or adjacent to the sciatic nerve in the deeper tissues
Bladder 37 Yinmen
In the region of the belly of the hamstring muscle, at or adjacent to the sciatic nerve and its branches, in the deeper tissues
Points Located at Significant Neurological Sites (based upon the course of the nerve as it affects adjacent, distal, or proximal tissues)
Small Intestine 9 Jianzhen
In the region of the posterior shoulder, where a branch of the axillary nerve continues to the posterior shoulder capsule.
Points Located at Significant Neuro-vascular Sites (where the course of the nerve, artery, and/or vein has it affects adjacent, distal, or proximal tissues)
Kidney 7 Fuliu
In the region of the posterior tibial nerve, artery, and vein, superior to structures in the heel and plantar fascia
Examples of Extraordinary Points, as Well as Points and Zones not Defined in the Texts:
Jiankua (posterior to Gall Bladder 29 Juliao) N-LE-55
At the muscle belly or the muscle-tendon junction of the gluteus medius, halfway between the crest of the ilium and the greater trochanter.
Large Intestine 15.5
Halfway between LI 15 Jianyu and LI 16 Jugu, directly over the acromial-clavicular joint space and the acromial-clavicular ligament
Other Courses By This Teacher
Acupuncture Sports Medicine Webinar Series - Course 1
The Treatment of Stiff Neck and Levator Scapulae
with Whitfield Reaves
See In StoreOverview
This 1.5 hour webinar features the use of advanced acupuncture techniques in the treatment of stiff neck and pain due to levator scapulae syndrome.
The levator is the cause of neck and shoulder pain for a significant number of patients, and is often overlooked by the acupuncture practitioner. While levator dysfunction might not be the entire cause of pain - other points, treatments, and techniques may be necessary - the simple techniques covered in this webinar benefit many patients. As well, levator dysfunction is often a component of treatment to other injuries, such as strain to the supraspinatous and infraspinatous and other dysfunctions of the shoulder.
Included in this webinar is a short introduction to the Four-Step Approach used by Whitfield Reaves in the treatment of sports injuries. These include the tendino-muscle meridians, distal points, and strategies using the opposite side and opposite extremity.
Then, the anatomy of the levator scapulae, including correct patient positioning and palpation is covered. Finally, precise treatment techniques at the site of injury and the most effective acupuncture points are covered. This includes local, adjacent, and distal points.
Having spent over 25 years specializing in the treatment of musculo-skeletal disorders, Whitfield's clinical experience is invaluable for practitioners working with pain.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- Name the major point used to directly treat the levator.
- Identify the origin, insertion, and action of the levator scapulae muscle
- Name 3 signs and symptoms of levator dysfunction
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 10
Lateral Knee Pain: Ilio-Tibial Band
with Whitfield Reaves
See In StoreOverview
Lateral Knee Pain: Ilio-Tibial Band Syndrome
Ilio-tibial band syndrome is the most common cause of lateral knee pain, and involves pain in the lateral knee and thigh. It is a sports injury that every acupuncturist should become proficient in treating, as it is common, and responds well to acupuncture treatment. Tight ilio-tibial bands can be seen in the non-athletic population, and they respond well to the techniques discussed in this webinar.
The injury is at the level of the muscles and tendons, with qi and blood stagnation in the channels and collaterals. This case is clearly Gall Bladder meridian pathology. Sometimes the diagnosis of wind (feng) may be used for the “popping” and “snapping” pain at the lateral knee. Local points including Gall Bladder 34, Gall Bladder 33, and Gall Bladder 31 often work well, especially when combined with distal points. However, treatment of the gluteus medius muscle is essential. This may be one of the most effective and reliable treatment protocols, according to the clinical experience of webinar instructor Whitfield Reaves. The location of the extraordinary point Jiankua will be described, which the practitioner will find extremely useful in this condition, as well as other hip and gluteal conditions.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To know two non-local treatments that may be used in the treatment of the condition.
- To use palpation in order to diagnose involvement of the distal ilio-tibial band.
- To be able to describe needle technique at the site of the gluteus medius and point Jiankua.
- To be able to describe needle technique on the local zone of the distal ilio-tibial band and point Gall Bladder 33.
- To use palpation in order to diagnose involvement of the gluteus medius.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 11
Anterior Knee Pain: The Patello-Femoral Joint
with Whitfield Reaves
See In StoreOverview
Dysfunction of the patello-femoral joint produces pain in the anterior knee in the region of the patella and the extraordinary points, Xiyan. It is a repetitive stress injury characterized by inflammation and irritation of the undersurface of the patella. This may progress to chondromalacia or anterior compartment osteoarthritis.
Knee pain from patello-femoral joint dysfunction is the most common knee disorder encountered by the orthopedic physician. Patients with this complaint are very common to the acupuncture clinic. And while they may be runners, jumpers, or cyclists, patellar pain can be seen in all ages – even with moderate levels of activity. Understanding the complexity of the causes, and the available western treatments is important knowledge to add to the relatively simple and straightforward treatments of acupuncture. In this webinar, Whitfield Reaves will discuss some useful acupuncture sports medicine techniques to treat and manage this commonly seen condition.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To know three common signs and symptoms of patello-femoral joint involvement.
- To know two non-local treatments that may be used in the treatment of anterior knee pain.
- To use palpation and orthopedic tests in order to diagnose involvement of the patello-femoral joint.
- To be able to describe needle technique at Xiyan and the sub-patellar region.
- To be able to describe needle technique on two important zones of the quadriceps.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 12
Knee Pain: The Medial Compartment
with Whitfield Reaves
See In StoreOverview
Knee Pain: The Medial Compartment (Acute and Chronic)
Acute pain, inflammation, and swelling in the medial knee is often experienced after injury or trauma in sports. It may involve sprain of the medial collateral ligament (MCL) or tear to the medial meniscus. From a meridian (jing-luo) perspective, we usually think of the three leg yin meridians – the Spleen, the Kidney, and the Liver. However, medial knee pain should be understood in terms of western orthopedic diagnosis. Your treatment plan, rehabilitation and prognosis for the patient all arise from this assessment. But most importantly, prognosis – what you communicate to the patient – is what is unique to each diagnosis.
Pain, inflammation, swelling, and stiffness of the medial knee, at the joint space, is also seen as a chronic condition. This pain is often due to medial compartment osteoarthritis. Sources suggest that over 30 percent of individuals between the ages of 60 and 90 are affected by this condition in one of the three compartments of the knee. That percentage will likely increase over the next decade, and therefore its inclusion in this webinar. Commonly diagnosed as a Bi syndrome, the three leg yin meridians encompass the medial joint space. Webinar instructor Whitfield Reaves will discuss a very useful technique of “threading the opening of a joint space” in the region of Liver 8.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To perform the valgus stress test in order to diagnose the MCL involvement.
- To use palpation of the medial joint space.
- To know two signs and symptoms of medial collateral ligament sprain, and two signs and symptoms of chronic medial joint space arthritis.
- To know two non-local treatments that may be used in the treatment of the medial compartment of the knee.
- To be able to describe needle technique on the local zone of the medial joint space of the knee, in the region of Liver 8.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 13
The Hamstring Muscle
with Whitfield Reaves
See In StoreOverview
Hamstring strain is most commonly diagnosed under the category of accident/trauma, and is a sports injury frequently seen by the acupuncturist. The trauma is at the level of the muscles and tendons, with qi and blood stagnation in the channels and collaterals. Hamstring strain is clearly Bladder meridian pathology, although the Kidney meridian may also be involved. Occasionally, strain and muscle tightness may be a repetitive stress disorder due to the accumulation of micro-trauma. Both cases are treated with similar points and techniques.
Treatment of the hamstring demonstrates the diversity of point selection for local and adjacent treatment in acupuncture sports medicine. Often, the point Bladder 37 is useful in releasing the entire hamstring group. This point is an example of “yin” techniques, needling into the space between the medial and lateral hamstrings. However, sometimes both the motor points and the trigger points are necessary. This is a “yang” technique, and involves treatment to ashi points located in the taut bands of muscle, slightly medial or lateral to the Bladder channel. Hamstring treatment is also is a good example of how simple orthopedic assessment, including manual muscle testing and passive stretching, can be integrated into the diagnostic process.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To perform manual muscle testing that assist in the assessment of hamstring involvement.
- To be able to describe needle technique on the taut bands of the motor points and the trigger points.
- To use palpation in order to diagnose hamstring involvement, differentiating between the lateral and the medial portions of the muscle.
- To know two non-local treatments that may be used in the treatment of the hamstring strain.
- To be able to describe needle technique on the point Bladder 37
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 14
Shin Splints: The Anterior Compartment
with Whitfield Reaves
See In StoreOverview
Shin splints is a repetitive stress injury characterized by strain or inflammation of the anterior tibialis or other anterior compartment muscles of the leg. The site of injury may be the muscle, the tendon, or at the attachment to the periosteum and bone. The patient presents with pain and tenderness along the anterior lateral aspect of the leg just lateral to the tibia.
Shin splints is the common term for anterior tibial stress syndrome. It is a frequent sports injury, as it comprises approximately 60 percent of all leg pain injuries. In this webinar, Whitfield Reaves will discuss the injury with its relatively easy diagnosis, assessment, and treatment techniques. This case is clearly Stomach meridian pathology, and sometimes the zang-fu organs are involved. It is an important injury to learn as a practitioner, as even walking and hiking can produce the symptoms.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To know two non-local treatments that may be used in the treatment of the shin splints.
- To know location and needle technique for the motor point of the tibialis anterior.
- To diagnose the shin splints from analysis of the patients signs and symptoms.
- To use palpation in order to diagnose shin splints.
- To perform manual muscle testing of the anterior compartment-- resisted dorsiflexion-- as part of the assessment procedures.
- To describe the needle technique on the local zone of ahshi points between the tibia and the anterior compartment muscles.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 15
Achilles Tendonitis
with Whitfield Reaves
See In StoreOverview
Achilles tendonitis is a repetitive stress injury characterized by pain, inflammation, and swelling of the achilles tendon and its sheath. The entire calf muscle group may be affected. Achilles injury is usually mid-tendon, about 2 to 6 centimeters proximal to its attachment to the calcaneus. This is usually a repetitive stress disorder due to the accumulation of micro-trauma. However, it may occur as an acute strain.
In general, acupuncture is beneficial for most patients using proper treatment described in this webinar. Instructor Whitfield Reaves will discuss the use of local needling using the “threading the tendon”, along with other adjacent and distal points. The practitioner should become much more familiar and confident with achilles tendonitis from the instruction and information of this webinar.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To know two points proximal to the achilles tendon and two points distal to the tendon useful in treating this condition.
- To describe the needle technique of “threading the tendon” on the local zone of the achilles tendon.
- To perform manual muscle testing and palpation that assists in the diagnosis of the achilles tendonitis.
- To be able to name two important symptoms commonly reported by the patient with achilles tendonitis.
- To know two points proximal to the tendon that may be used in the treatment of achilles tendonitis.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.
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Acupuncture Sports Medicine Webinar Series - Course 16
Lateral Ankle Sprain (Inversion)
with Whitfield Reaves
See In StoreOverview
Inversion ankle sprain is characterized by pain, swelling, and bruising of the lateral ankle and foot. This common sports injury results in ligament sprain and joint inflammation from inverting or inward rolling of the ankle. It is one of the most common of all sports injuries.
Ankle sprains involve injury at the level of the tendons, ligaments, and the joint. There is qi and blood stagnation in the channels and collaterals. The Gall Bladder is usually the primary meridian involved, although the Bladder and Stomach channels may also be affected. Local needling, in the region of Gall Bladder 40, may aggravate and is often avoided during the early stages of acute symptoms. Various options in the Four Step approach that Whitfield Reaves utilizes will give the practitioner numerous alternatives to local needling.
This series was introduced in 2011, and is based upon single individual sports injuries. Each course provides simple and direct video for first time viewing as well as to increase precision through repetition. Even if you have taken the newer series, Mastering the Treatment of Injury and Pain, this old series is still an excellent resource for review and is filled with clinical gems.
Learning Objectives
- To use palpation in order to assess the severity of a lateral ankle sprain.
- To name and locate two points on or adjacent to the peroneus longus muscle.
- To describe needle technique on the local zone of the talar sinus at Gall Bladder 40.
- To know two distal point treatments that may be used in the treatment of the ankle sprain.To know two proximal point treatments that may be used in the treatment of the ankle sprain.
Your Teacher
Whitfield Reaves
In practice for over 40 years, Whitfield Reaves, OMD, L.Ac., specializes in the field of sports medicine. Being in the forefront of the acupuncture sports medicine field, Whitfield's experience includes working with athletes at the 1984 LA Olympic Games at the 1984 LA Olympic Games and countless other sport competitions since. He is an author, he teaches internationally as well.