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
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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 30 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 and other sport competitions; an author, he teaches internationally as well.