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Master Tung's Acupuncture and the Balance Method for Pain

By

Jean-Sylvain Prot, L.Ac.

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Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine. 1

Master Tung's Acupuncture and the Balance Method for Pain

Jean-Sylvain ProtLicensed Acupuncturist

Lotus Institute Of Integrative MedicineTel: (626) 780-7182 Fax: (626) 609-2929

Website: www.eLotus.org Email: [email protected]

© Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine

Optimal Acupuncture and The Channels Test

© Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute of Integrative Medicine

« Yin Shui, Si Yuan »When you drink water, remember the source

Acknowledgments

• Graduated in TCM & Medical Qi Gong (2005)• 2 years as Dr Zhang Yun assistant (Paris)• Have studied with many different masters, teachers but

also extensively researched on my own, not onlychinese medicine but also Greek philosophers, the hermetic western tradition, alchemy, astrology, numerology, geometry and music – syncretism isessential and achievable through perseverance.

• Still studying with great teachers & masters:– Dr Robert Chu – optimal acupuncture (Tung’s style,

microsysytems, chrono-acupuncture, Yi Jing Ping Heng Acupuncture methods …)

– Dr Wang Ju Yi – channels palpation– Dr Yoshito Mukaino – M-Test (or meridian test)– Dr Zhang Yun – TCM acupuncture

Background informations

• 20 years experience in Korean Yoga & Martial Arts

• Private practice in Ibiza, 30-40 patients per week

• Integral coaching, retreats, seminars (Qi Gong, Daoist Yoga, Natural Fitness Training)

• CM teacher in France (http://mtc-qigong.fr) – 3rd largest TCM school in France (350 students) with strongemphasis on Medical Qi Gong (ZhinengQigong)




Dr. Mukaino is a medical doctor and a professor of Sports Science at Fukuoka University.

"The M-Test (Meridian Test) is an easy and quick method to find the meridian that needs treatment.

I developed it for acupuncturists who have just graduated from school and started to practice. It is easy to learn and always accurate. You can

say goodbye to your guessing work in your diagnosis."

Yoshito Mukaino

Dr. Mukaino found that the distribution of meridians is closely related to body movement and when there is abnormality in a meridian, movement of our body is restricted somewhere along this meridian.

“Any symptom that appears along with an abnormality of the body, accompanies some abnormality in movement of

the body. We observe clinically that the loss of smooth movement of the body is not limited to disorders of the

organs of locomotion, but also to many disorders of internal organs."

Yoshito Mukaino

What is the Channels Test ?

It is a simple method that elucidates the abnormalities in channels and points in terms of a series of physical movements.

Anyone can learn to use the Channels Test because it is easy to understand and it can serve as a valuable first step for treating pain and maintaining health.

Channels, Points and Movement

The channels system is a « signal transmission system » which is involved in movement.

Same mechanism applies to pain and symptoms that come from movements in daily life.

The pathological mechanism of channel imbalance causing restrictions and pain in movement in other parts also applies to symptoms that cannot be explained by modern medicine.

59-year-old man who had pain in bothshoulders for over a year• Pain was not relieved no matter how many places he

received treatment, and the cause of the pain wasunknown.

• Lateral rotation of the arm in a horizontal position aggravated the pain, and in this case PC-9, PC-7, TB-3 and TB-10 were candidates for treatment.

• PC-7 and TB-10 reduced the pain. • After treating these points, I also stimulated the 5

Phases combination points SP-2 and ST-41• This immediately relieved the shoulder pain.

59-year-old man who had pain in bothshoulders for over a year• I asked the patient: “By the way, what have you been

doing everyday?”• He told me he had been doing 50 pushups everyday

from a year ago. • The points I treated were in areas that are stressed by

pushups.• Examining the effect of 5 Phases point

combinations on various patients, often the stimulation of points that are located in areas stressed by movements that aggravate the pain ismost effective.

• The insight possessed by the ancient acupuncturists isastounding !!!




Nei Ke and the Channels Test

• Some practitioners tend to think that thisapproach is useful only for musculoskeletalproblems because the diagnosis and treatment isbased on movements of the body.

• It is my experience, however, that imbalance in physical movements are often associated with diseases other than musculoskeletal problems.

• In this way, the chain reaction of abnormalities in movement is related to the occurrence of symptoms.

Examples

Low back pain did not resolve for a long time even after the patient received laser surgery for a herniated disk.

Patrick’s test on the right and posterior flexion exacerbated the back pain

The abnormal channels can be identified justfrom these two findings, and giving acupuncture to the corresponding points cured the back pain.

More examples

Burning pain during urination and nocturnal polyuria after three laparoscopic surgeries for prostatic hypertrophy.

Patrick’s test on the left side was positive and needling points on the channels associated withthis movement alleviated the symptoms in justtwo treatments.

Movement, channels, and points

Looking the 12 regular channels, their pathways and their points basically consist of 3 groups that are located on the anterior, posterior, and lateralaspects respectively.

Each of these aspects can be divided into superiorand inferior halves, so basically there are 6 sectors.

By designating movements that stretch the channels and points in each of these sectors, we can identify the channels and areas that are abnormals.

Movement, channels, and points

We can determine which sector has a problem by noting reactions of pain, tightness, fatigue, or any other abnormal sensations with each movement. Other positive findings are when a movement causes dizziness or

shaking, or when note a difference between the right and left sides in range of motion or resistance to movement.

The findings are each rated on a scale of 1 to 10, and treatmentof the findings with the highest score takes precedence. Often the various minor findings naturally resolve when the most significant

findings are treated.

Four Types of Abnormal Reactions

Pain and stretched feeling are attributed to Excess (Shi) of Yang channels.

In addition, these are two Yin channels can exhibit Excess symptoms (pain and stretched feeling). They are Pericardium and Liver channels (Jue Yin).

The Excess symptom of a Yin channel suggests Blood Stasis (Yu Xue).

Dullness and malaise are attributed to Deficiency (Xu). Dullness and malaise in the anterior-posterior parts of the four

extremities are Yin Deficiency. Dullness and malaise in the posterior torso (neck, back and

waist) are Yang Deficiency. Dullness and malaise in the anterior torso are Qi Deficiency.




The five steps

The channels test protocol1)Perform the test : check for abnormalities in movement with the channels test findings chart.2)Identify abnormal areas or aspects : find abnormal areas based on abnormal movements.3)Select the acupuncture points to treat : select the primary points from those in the abnormal areaApproach to treatment4)Confirm the effect of the points : check the effect of the points and choose the most effective ones.5)Treat using the chosen approach : treat the affected area by stimulating points or by other means.

Perform the channels test

Neck Movements

1.Extension1A. Rotation

2. Flexion3. Lateral Flexion

Perform the channels Test

Arm Movements

4. Extension5. Medial Rotation6. Flexion7. Lateral Rotation


Arm Movements

8. Horizontal flexion9. Elbow flexion10. Horizontal extension11. Elbow extension


Wrist Movements

12. Ulnar flexion13. Radial flexion14. Flexion15. Extension


Leg Movements

16. Extension17. Knee flexion18. Flexion19. Hip & knee flexion




Leg Movements

20. Lateral rotation21. Adduction22. Abduction

Perform the channels Test Perform the channels Test

Ankle Movements

23. Plantar flexion24. Dorsiflexion25. Supination26. Pronation


Torso Movements

27. Extension28. Flexion29. Lateral flexion30. Rotation

Even when the channels test movements are done carefullyto confirm abnormal findings, they can be completed in about 10 minutes.

All Channels Test movements are combinations of basic movements that stretch the meridians and points• The movements that we make can be called a

combination of basic movements that stretch the meridians.

• A movement that is repeated over and over generates fatigue in the aspect that is stretched, and influences the linked movements in the same meridian group.

• It follows that the occurrence of pain and decline in performance among athletes, as well as the exacerbation and amelioration of various symptoms and diseases of working people are most likely under the influence of imbalance in movement linked by the meridians.

The five steps





Anatomy and acupuncture

• The deeper you dive into anatomy, the more relationships you see between acupuncture and the physical structure of the body.

• A good place to begin is with fascia. Fascia is a type of connective tissue primarily made up of collagen.

• It spreads through the body providing form and stabilization for muscles and organs.

• This complex structure holds the body together, providing unity, and interconnectedness.

Fascia and channels of acupuncture

Fascia located in one area – can affect tissue located in another more distant area. When the body is dissected along "lines of tension and pull" we can see patterns incredibly similar to acupuncture channels.

The more refined images of fascial dissections show the familiar branching we are accustomed to within acupuncture. The primary acupuncture channels, which branch into smaller more delicate channels, share a similar structure to what is seen with fascia.

What Does It Mean?

• To see and realize the channels have a physical and tangible underpinning is powerful — powerful for working acupuncturists, students of acupuncture, and clients alike.

• When talking to potential clients who are skeptical about acupuncture, explaining the fascial connections in the body helps them see how acupuncture can be a helpful treatment option.

• Likewise, when discussing my clinical work with a medical doctor, nurse or physical therapist, this fascia discussion gives me solid footing.

Do these findings about fascia explain everything about acupuncture?• Not at all. Qi, Blood, Shen, Yin, Yang, all of these remain

powerful and independent concepts separate from fascia and the patterns they produce.

• Traditional Chinese herbal medicine has lost nothing acknowledging the existence of chemical compounds. In the same manner, nothing is lost by embracing the similarities between fascial connections and the channels of acupuncture. The fascial patterns outlined by Mr. Myers are wonderful, powerful tools which can be used by acupuncturists and acupuncture students alike.

What is Fascia?

• Fascia is a connective tissue. – It connects things, it separates things, and plays a crucial role in movement.

• It is like a spider web wrapping around and running through the internal body.

– Just as you cannot move part of a spider web without affecting the whole web, you cannot move any part of your body without affecting the entire fascial web.

• Fascia wraps around everything in the body, bones, muscles, arteries, veins, and organs.

• It provides support for tissues and organs while also separating the individual components in our bodies.

• Through the web of fascia, everything in the body is connected.

The “Saran Wrap” of the Body• Like saran wrap wraps around a

sandwich, fascia wraps around muscle, tendons, ligaments and organs.

• It is strong but it can stretch, moving with the various body parts. It can stretch to the point of tearing.– Over stretched fascia can cause binding

and restriction, limiting movement of structures.

– Torn fascia will cause pain and inflammation.

• Unlike saran wrap, fascia is wet and slippery, allowing individual parts of the body to slide against each other.

• It can move with various body parts or it can initiate its own movement.




Fascia and medical history

• Fascia has been largely ignored throughout medical history. • It was considered the messy, slick, tough gristly stuff that stood

between doctors and the internal body. • Anatomists cut it away from muscles and organs during dissections

thinking it was a covering that was not important.

• “While every anatomy lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundredpockets of the fascial webbing. The ‘illusion’ of separate muscles is created by the anatomist’s scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole.” Tom Myers from his book Anatomy Trains

Fascia and Biomechanical Regulation

From http://www.anatomytrains.com/fascia/•« Our fascial fabric constitutes one single biomechanical regulatory system.”•“Fascia is, in fact, our system of Biomechanical Regulation – just as our circulatory system is a chemical regulator and the nervous system is a timing regulator – and needs to be studied and treated as a system, not only as a series of parts.”•“Our single fascial system starts about 2 weeks into development as a fibrous gel that pervades and surrounds all the cells in the developing embryo.”

Fascia and Biomechanical Regulation

• “Structure without function is a corpse. But function without structure is a ghost. It is now abundantly clear that fascia is part of the whole picture, and a part less studied than muscle or nerve, therefore the need to include it to get the complete picture. ‘Individual muscles acting on bones across joints’ simply does not adequately explain human stability and movement.”

Fascia and the San Jiao

• The current bio-medical explanation for how Acupuncture and Moxibustion is able to affect change in the body is leaning heavily towards a theory based upon the stimulation of the micro-currents of electricity which exist in the fascialtissue.

• When stimulated with Acupuncture, at the correct depth, and at the key points, in the fascia, which re-connect or enhance the existing electrical circuits, systemic change results.

The San Jiao according to the Classics

• Su Wen, chapter 8: “holds the office of irrigation and water pathways issue from it”

• Nan Jing, chapter 66: “the pathway of source qi”

• Nan Jing, chapter 38: “has a name but no form”

• Nan Jing, chapter 38: “the disseminator of source qi and determiner of all other qi”

The San Jiao Space• Consists of the 3 specific environments in the

torso:– UJ = mist– MJ = fermentation pot– LJ = drainage ditch

• Dr. Wang Ju Yi expands this idea of the San Jiao to include the spaces within the whole body.

• Regular channels reside within the San Jiao throughout the body.

• From the perspective of Chinese Medicine, the formation of channel abnormalities involves the five tissues: skin, vessel, muscle, sinew, and bone.

• Modern medical explanation of these abnormalities involves changes in the composition of metabolites, interstitial fluids, skin, subcutaneous connective tissue, adipose tissue, blood vessels, muscles, tendons, fascia and ligaments.




Identify Abnormal Areas

ANTERIOR UPPER BODY

SternocleidomastoidPectoralis major

Biceps brachii (lateral)Brachioradialis

Extensor carpi radialisMuscles of 1st and 2nd digits

SternocleidomastoidSternal Head:Origin: Upper part of the anterior surface of the manubriumClavicular Head:Origin: Superior surface of the medial one third of clavicle

Insertion: Lateral surface of the mastoid process of the occipital bone, from its apex to its superior border, and by a thin aponeurosis to the lateral half of the superior nuchal lineAction: Bilaterally: flexion of the head and neck, extension of the head and neckUnilaterally: rotation of head to opposite side, lateral flexion

You use the SCM muscle to bend your head down and side to side, turning your head and the SCM assists with chewing and swallowing.

What pain and symptoms are associated with the SCM ?Sternal Division•Pain maybe felt in these areas: Cheek and jaw, Sinuses, Back of head at the bottom of the skull, Around one eye, Top of head.•May also be associated with these symptoms: Tearing of eye, Visual disturbances when viewing parallel lines, Chronic “sore throat” when swallowing, Chronic dry cough.

Clavicular Division•Symptoms maybe felt in these areas: Pain across the forehead, Frontal sinus-like headache, Ear ache, Nausea, Dizziness, Car-sickness, Faulty weight perception of held objects, Hearing loss in one ear.

Clinical diagnoses to which the SCM symptoms may contribute

• Spasmodic torticollis (Wryneck syndrome)• Headaches, Whiplash• Ménière’s disease• Dizziness• Vertigo• Motion sickness

• The sternocleidomastoid muscle is the muscle most injured in whiplash and as such can cause a number of symptoms and refer pain to many areas of the upper body.

• The SCM muscle should be examined anytime you have pain in the head or neck area.

• If dizziness, nauseous, loss balance and falling are present and have eluded diagnoses, the clavicular branch of the SCM should be examined. Trigger points in the clavicular branch of the SCM can cause problems with balance, vision and hearing.

Pectoralis MajorOrigin: Clavicular Head: Anterior surface of the medial half of the clavicle.Sternal Head: Lateral aspects of the manubrium and body of the sternum, the upper six costal cartilages and the aponeurosis of the abdominal oblique.

Insertion: Clavicular Head: Lateral lip of the bicipitalgroove of the humerus and anterior lip of the deltoid tuberositySternal Head: Lateral lip of the bicipital groove of the humerus and the anterior lip of the deltoid tuberosity.

Action: Shoulder flexion, Internal rotation, Adduction

You use the pectoralis major muscle to raise your arms in front of your body, twist the arms in toward the body, and move your arms across the body.

What symptoms and pain are associated with the pectoralis major muscle?

• Chest pain• Pain in the front of the shoulder• Pain in the inner arm, inner elbow traveling down

to the middle and ring fingers• Breast pain• Upper back pain between and around the

shoulder blades• Rounded shoulder posture




Clinical diagnoses to which this muscle symptoms may contribute• Bicipital tendonitis• Costochondritis• Supraspinatus

tendonitis• Subacromial Bursitis• Medial epicondylitis• Lateral epicondylitis• Pleurisy• Osteoarthritis• Osteoporosis• Ankylosing spondylosis

• Angina pectoris• Esophagitis• Gastroenteritis• Hiatal hernia• Gallbladder dysfunction

Biceps brachii (lateral)Origin:Long head: supraglenoid tubercle and the superior portion of the glenoidlabrumShort head: lateral aspect of the apex of the coracoid process of the scapula

Insertion: Radial tuberosity and the bicipital aponeurosis.Action: Flexion of forearm, Supinatesforearm, Flexion of the arm at the shoulder

You use the biceps brachii muscle when you lift something, rotate your arm, bend your elbow and raise your arm.

What symptoms and pain are associated with the biceps brachii muscles?

• Pain in the front of the shoulder• Pain in the crease of the elbow• Weakness in the arm• Difficulty straightening arm with palm facing

down• Pain at the top of the back of the shoulder

(between the neck and shoulder joint)

Clinical diagnoses to which the biceps brachii muscle symptoms may contribute

• Bicipital tendinitis• Subdeltoid bursitis• C5 or C6 radiculopathy• Shoulder pointer (a separation or sprain of

the acromioclavicular joint)

Radiculopathy (from Wikipedia)• Radiculopathy refers to a set of conditions in which one or

more nerves are affected and do not work properly (a neuropathy). The location of the injury is at the level of the nerve root (radix = "root"). This can result in pain (radicular pain), weakness, numbness, or difficulty controlling specific muscles.

• In a radiculopathy, the problem occurs at or near the root of the nerve, shortly after its exit from the spinal cord. However, the pain or other symptoms often radiate to the part of the body served by that nerve.

– For example, a nerve root impingement in the neck can produce pain and weakness in the forearm. Likewise, an impingement in the lower back or lumbar-sacral spine can be manifested with symptoms in the foot.

• Polyradiculopathy refers to the condition where more than one spinal nerve root is affected.

UB13

UB15

UB18

UB20UB21

UB23

UB25UB27UB28

UB12UB11

UB14

UB17

UB19




BrachioradialisOrigin: Upper lateral supracondylarridge of the humerus (between triceps brachii and brachialis.

Insertion: Superior aspect of the styloid process of the radius and the lateral side of the distal half to one-third of the radius.

Action: Flexion of the forearm at the elbow.

You use the brachioradialis to bend your elbow.

What symptoms and pain are associated with the brachioradialis?• Pain in the back of the forearm near the elbow• Pain in the back of the hand at the base of the

thumb extending into the web of the thumb and up toward the wrist

• Pain is noticeably pronounced when you twist your hand

• Numbness on the thumb side of the hand• Noticeable weakness in grip strength

Clinical diagnoses to which the brachioradialismuscle symptoms may contribute

• Lateral Epicondylitis (tennis elbow)• Carpal tunnel syndrome• Thoracic Outlet Syndrome• Tenosynovitis• C5 or C6 radiculopathy• Ganglion Cyst• Sprain/Strain of the elbow, wrist, or thumb

Extensor carpi radialis

Origin: Proximally to the lateral supracondylar ridge of humerus.

Insertion: Distally, to the back base of the second metacarpal bone

Action: Extension of the wrist

You use the extensor carpiradialis longus muscle to straighten the wrist, and twist the wrist.

What symptoms and pain are associated with the Extensor Carpi Radialis Muscle?

• A burning sensation or constant ache is felt just above the elbow going down the forearm into the wrist, back of the hand, and into the first finger.

• Pain becomes worse when twisting the arm and wrist.

• Weak unreliable grip.




Clinical Diagnoses To Which The ExtensorCarpi Radialis Muscle May Contribute

• Lateral Epicondylitis• Carpal Tunnel Syndrome• Tennis Elbow

• Interesting Facts About The Extensor Carpi RadialisLongus Muscle:– It is one of three muscles that support the wrist. Without these muscles

the wrist would hang limply from the forearm.– It as well as the extensor carpi radialis brevis muscle are known as the

fist clenchers muscles.– It is a prime contributor to tennis elbow

Anterior Channels and Loads of Movement in the Upper BodyLung-Large Intestine channels and movement (METAL) Lung and Large Intestine channels relate

to movement of the anterior upper body. Movement of the neck extends the anterior

neck and chest. The movement of shoulder and elbow

extends the anterior shoulder and elbow. The movement of the wrist extends the

anterior (Radial side) wrist. Any of these movement extends Lung and

Large Intestine channels.


POSTERIOR UPPER BODYSplenius capitis

Trapezius

Triceps brachii (medial)Anconeus

Extensor carpi ulnaris

Muscles of 5th digit

Nuchal ligament

The nuchal ligament extends from the external occipital protuberance on the skull and median nuchal line to the spinous process of the seventh cervical vertebra in the lower part of the neck.

The trapezius and splenius capitis muscle attach to the nuchal ligament.

Splenius CapitisOrigin: Lower half of the nuchalligament, the spinous processesand supraspinous ligaments of C7 to T3

Insertion: Lateral occipital bone, between the superior and inferior nuchal lines

Action: Extends the head and cervical spine, Lateral flexion of the head and cervical spine

You use the splenius capitismuscle to straighten the head and neck, turn your head and bend the head and neck toward the shoulder.

What pain and symptoms are associated with the splenius capitis muscle?

• Pain at the top of the head can be an indication of splenius capitis muscle dysfunction.

• Pain at the crown of the head• Blurred vision• Occasionally neck pain

• Interesting facts about the splenius capitis muscle:– The splenius capitis muscles are a major contributor to tension

headaches. These muscles should also be examined and treated in all whiplash injuries.




Clinical diagnoses to which the splenius capitis muscle symptoms may contribute

• Herniated disc• Bulging disc• Prolapsed disc• Whiplash• Migraine headaches• Military neck• Eye Strain• Cervical Spine Hyperlordosis• Post Concussion Syndrome

Trapezius

Origin: Upper part: External occipital proturberance, medial third of the superior nuchal line, the ligamentumnuchae, and the spinous process of C7Medial Part: Spinous processes of T1 to T5.Lower Part: Spinous processes of T6 to T12

Insertion: Upper Part: Lateral third of the clavicle and the medial aspect of the acromion process of the scapulaMiddle Part: Medial edge of the superior surface of the acromion process of the scapula and the superior edge of the scapular spine.Lower Part: Tubercles of the apex of the scapular spine

Action:Upper Part: Upward rotation of the scapula, elevation of the scapulaMiddle Part: Retraction of the scapulaLower Part: Upper rotation of the scapula, depression of the scapula

You use the trapezius muscle to raise and lower your shoulders, lift and lower your arms, tilt your head side to side, turn your head side to side, and straighten your neck.

What pain and symptoms are associated with the trapezius muscle?• Headache in the temple area• Pain in the jaw that travels down into the neck and over

behind the ear• Pain behind one eye• Tension headache• Contributes to dizziness• Pain at the base of the skull• Stiff neck• Ache or burning sensation in the middle of the back• Pain or tingling during raising or lowering the arms

Clinical diagnoses to which the trapeziusmuscle symptoms may contribute• Degenerative disc

disease• Tension headaches• Eye strain• Whiplash• Sprain/Strain injury• Shoulder pointer• Shoulder separation• Glenohumeral

separation• Adhesive capsulitis

(Frozen shoulder)

• Spasmodic torticollis(Wryneck)

• Temporomandibulardisorder (TMD)

• Thoracic outlet syndrome• Spondylosis• Stenosis• Concussion and Post

Concussion Syndrome

Triceps Brachii (medial)Triceps Long HeadOrigin: Infraglenoid tubercle of the scapulaInsertion: Posterior surface of the olcranionprocess of the ulnaAction: Extension of the arm at the shoulder, adduction of the arm at the shoulder, extension of the forearm at the elbowTriceps Lateral HeadOrigin: Superior half of the posterior surface of the humeral shaft, lateral to the spiral grooveInsertion: Posterior surface of the olecranonprocess of the ulnaAction: Extension of the forearm at the elbowTriceps Medial HeadOrigin: Posterior shaft of the humerus, medial and distal to the spiral groove (deep to the long and lateral heads of the triceps brachii)Insertion: Posterior surface of the olecranonprocess of the ulnaAction: Extension of the arm at the elbow

Triceps Brachii (medial)

The triceps brachiimuscle connects the shoulder and upper arm to the elbow. You use it to straighten the elbow, pull the arm back behind the body and bring the arm down from raised position.




What symptoms and pain are associated with the triceps brachii muscles?

• Pain in the back of the shoulder• Pain at the base of the neck• Pain on the outside of the elbow• Pain throughout the back of the elbow• Pain in the back of the upper arm• Can make elbow hypersensitive• Pain down into the fourth and fifth fingers• Difficulty straightening and bending the elbow• Pain is usually dull and aching, rarely is the pain sharp or

stabbing

Clinical Diagnoses To Which The Triceps Brachii Muscle May Contribute

• Tennis elbow• Golfer’s elbow• Olecranon bursitis• Cubital tunnel syndrome• Thoracic outlet syndrome • C6, C7 or C8 radiculopathy

AnconeusOrigin: Posterior aspect of the lateral epicondyle of humerus.

Insertion: Lateral aspect the olecranon process extending to the lateral surface of the ulna body.

Action: Extension of the elbow

You use the anconeus muscle when you straighten the elbow.

What symptoms and pain are associated with the Anconeus Muscle?• Pain is localized toward the outside and

around the point of the elbow.• The anconeus is a prime contributor to

tennis elbow.• Some anatomists believe that the

anconeus is part of the triceps brachiimuscle and not a separate muscle.

Clinical Diagnoses To Which The Anconeus Muscle May Contribute• Lateral Epicondylitis (Tennis elbow)• Carpal Tunnel Syndrome• Cubital Tunnel Syndrome• C6 or C7 radiculopathy

Extensor carpi ulnaris

Origin: Lateral epicondyle of humerus via the common extensor tendon.Insertion: Tubercles on the medial side of the base of the fifth metacarpalAction: Extension of the wrist

You use the extensor carpiulnaris when you straighten your wrist and side bend the wrist toward the pinky




What symptoms and pain are associated with the Extensor Carpi Ulnaris Muscle?

• Sharp pain and aching on the outside of the wrist, feels like a sprain.

• Weak unreliable grip.• Pain can be intense when twisting the wrist.• Prime contributor to writers cramp.

Clinical Diagnoses To Which The ExtensorCarpi Ulnaris Muscle May Contribute

• Carpal Tunnel• C8 radiculopathy• Charcot’s Joint (progressive degeneration of

a weight bearing joint, a process marked by bony destruction, bone resorption*, and eventual deformity).

*Bone resorption is the process by which osteoclasts break down bone and release the minerals, resulting in a transfer of calcium from bone fluid to the blood.

Abductor Digiti Minimi

Origin: Volar surface of the pisiform, the tendon of flexor carpi ulnaris, and the pisohamate ligament

Insertion: Medial aspect of the base of the proximal phalanx of the fifth digit and, occasionally, a slip to the ulnar side of the extensor apparatus of the fifth digit

Action: Abduction of the fifth digit

You use the abductor digiti minimiwhen you move the little finger away from the other fingers.

What pain and symptoms are associated with the Abductor Digiti Minimi?

• Pain is located on the outside of the back of the hand just below the little finger

• Pain extends up into the lower half of the little finger

Clinical diagnoses to which the abductor digitiminimi muscles symptoms may contribute:

• Thoracic outlet syndrome• Carpal tunnel syndrome• Cubital tunnel syndrome• Peripheral neuropathy

Posterior Channels and Loads of Movement in Upper Body

Heart-Small Intestine channels and movement (IMPERIAL FIRE)

Heart and Small Intestine channels relate to movement of extending the posterior upper torso.

The flexion of the neck (Illustration 1 and 2) extends the posterior neck and shoulder.

Movement of the shoulder and elbow extends the posterior shoulder and elbow.

Movement of wrist extends the posterior wrist.

Any of those movements extends Heart and Small lntestine channels.


LATERAL UPPER BODY

Splenius capitis*

Triceps brachii (lateral)*

Extensor digitorium communis

Muscles of 4th digit




Extensor digitorium communisOrigin: Lateral epicondyle of the humerus via the common extensor tendon.

Insertion:Main attachment: dorsal aspect of the base of the proximal phalanx of each of the four digits.Central slip: dorsal aspect of the base of the middle phalanx of each of the four digits.Lateral bands: via two slips to the dorsal aspect of the base of the distal phalanx of each of the four digits.

Action: Extension of the fingers

You use the extensor digitorumwhen you straighten your fingers and wrist.

What symptoms and pain are associated with the Extensor Digitorum Muscle?

• Pain in the middle finger extending into the back of the hand

• Pain can extend up the back of the forearm toward the elbow

• Pain is occasionally felt in the front of the wrist just below the palm

• Weak unreliable grip• Finger stiffness

Clinical Diagnoses To Which The ExtensorDigitorum Muscle May Contribute

• Pain and stiffness caused by the extensor digitorum muscle in the fingers is often thought to be arthritis

• It is a contributor to tennis elbow• Lateral Epicondylitis• Ganglion cyst


MEDIAL UPPER BODY

Biceps brachii (medial)*

Palmaris longus

Muscles of 3rd digit

Palmaris longus

Origin: Medial epicondyleof the humerus via the common flexor tendon

Insertion: Central portion of the flexor retinaculumand superficial portion of the palmar aponeurosis.

Action: Assists with flexion of the wrist

You use the palmaris longuswhen you cup the hand and bend the wrist.

What pain and symptoms are associated with the Palmaris Longus muscle?• Pain is a burning or tingling sensation, not aching or pounding pain• Pain is felt in the palm of the hand extending toward the thumb pad,

but pain is not felt in the thumb itself.• Cupping the hand will cause pain• Pain is felt in the palm when gripping items with the hand• Pain will sometimes extend up into the forearm• Interesting facts about the palmaris longus muscles:

– Because of the burning and tingling pain in the hand palmaris longus dysfunction is often diagnosed as cervical radiculopathy

– Dysfunction in this muscle can cause the ring and little finger to curl into the palm of the hand. This condition is associated with Dupuytren’s contracture

– Muscle is absent in 10% of the population




Clinical diagnoses to which the palmarislongus muscle symptoms may contribute

• Carpal tunnel syndrome• C7, C8 or T1 radiculopathy• Peripheral neuropathy• Dupuytren’s contracture

Lateral-Medial Channels and Loads of Movement in Upper Body

Pericardium-San Jiao channels and movement (MINISTERIAL FIRE)Pericardium and San Jiao channels relate to extension movement of the lateral upper torso.Movement of the shoulder and elbow extend the lateral shoulder and elbow.The palmar flexion of the wrist extends the lateral wrist. Any of those movements extends San Jiao channel.

Lateral-Medial Channels and Loads of Movement in Upper Body Movement of the shoulder and elbow

extend the medial shoulder (axilla) and the medial elbow.

The dorsal flexion of the wrist extends the medial wrist.

Any of those movement extends Pericardium channel.

Latero-flexion of the neck is affected by Pericardium AND San Jiao channels.


ANTERIOR LOWER BODY

Rectus abdominis

Internal oblique

Quadriceps femoris

Tibialis anterior

Muscles of 1st & 2nd digit

Rectus abdominisOrigin: Pubic crest and the pubic symphysis

Insertion: From the fifth to seventh costal cartilages, and the inferomedialcostal margin and posterior aspect of the xiphoid process of the sternum

Actions: Flexion of the vertebral column, posteriorly tilts the pelvis, compresses abdominal contents, assists with forces expiration.

You use the rectus abdominis to bend over and straighten the trunk. It also helps with breathing.

What pain and symptoms are associated with the rectus abdominis?• Pain that runs horizontal across the mid back under

the shoulder blade• Pain that runs horizontal across the low back• Pain around the sternum between the breasts• Pain in the low abdomen• Feeling bloated• Heartburn and indigestion• Testicle pain• Pain in the pelvic area




Interesting facts about the rectus abdominis• The rectus abdominis muscle extends from the bottom of the ribs to

the top of the pubic bone without attaching to bone. The horizontal bands of connective tissue called tendinous intersections helps the muscle maintain proper length.

• The abdominal muscles can cause a range of symptoms that can be worrisome and mimic other medical conditions such as appendicitis, gallbladder disease, irritable bowel syndrome, colitis, endometriosis, and urinary incontinence.

• Lingering or sudden onset of abdominal pain should be checked out by a physician.

Pain in the middle and low back, abdominal pain, heartburn and indigestion can indicate rectus abdominis muscle dysfunction. Pain can occur in one area or multiple areas.

Clinical diagnoses to which the rectusabdominis muscle symptoms may contribute

• Degenerative disc disease

• Painful rib syndrome• Costochondritis• Stenosis• Appendicitis• Ulcer• Gallbladder disorder• Colic• Constipation

• Urinary tract disease• Endometriosis• Hiatal hernia• Inguinal hernia• Pancreatitis• Diverticulosis• Ovarian cyst• Pelvic pain

Internal oblique

Origin: Lumbar fascia, anterior two-thirds of the iliac crest, and the lateral two-thirds of the inguinal ligament

Insertion: Costal margin, aponeurosis of the rectus sheath, conjoined tendon to the pubic crest and pectineal line, 10-12 rib

Action: Compresses abdomen; unilateral contraction rotates vertebral column to same side.

Internal oblique

• Primary Actions of the Internal Obliques:1. Lateral flexion of the thoracic spine when acting unilaterally2. Lateral flexion of the lumbar spine when acting unilaterally3. Ipsilateral rotation of the trunk when acting unilaterally

• Secondary Actions of the Internal Obliques:1. Assists with flexion of the thoracic spine when acting bilaterally2. Assists with flexion of the lumbar spine when acting bilaterally3. Assists with forced expiration

External Obliques• Origin:

Anterior fibers: external surfaces of ribs 5 to 8, interdigitating with serratusanterior.Lateral fibers: external surfaces of 9th rib, interdigitating serratus anterior, and those ribs 10 to 12, interdigitatingwith lattissimus dorsi.

• Insertion:Anterior Fibers: into a broad flat aponeurosis, terminating at the lineaalba.Lateral fibers: into the anterior iliac spine and pubic tubercle, and into the external lip of the anterior half of the iliac crest.

• Action: Flexion and rotation of the spine

External Obliques

• Primary Actions of the External Obliques:1. Lateral flexion of the thoracic spine when acting unilaterally2. Contralateral rotation of the lumbar spine when acting unilaterally3. Lateral flexion of the spine when acting unilaterally

• Secondary Actions of the External Obliques:1. Assists with flexion of the thoracic spine when acting bilaterally2. Assists with flexion of the lumbar spine when acting bilaterally4. Assists with forced expiration




What pain and symptoms are associated with the external and internal oblique muscles?

• Pain in the side, in the waist area• Pain in the groin area• Pain in the low abdomen• Heartburn and indigestion• Testicle pain• Bladder pain and incontinence• Pain in the pelvic area

Interesting facts about the obliques muscles

• The oblique muscles can contribute to pain and discomfort in the abdomen and groin area. It can also contribute to burning and discomfort in the urinary tract, bladder and can contribute to incontinence.

• Pain and symptoms of the oblique muscles mimics many acute and chronic conditions, some of which can be life-threatening.

• It is important that a medical evaluation is conducted to rule out what could be serious medical conditions.

Clinical diagnoses to which the oblique muscles symptoms may contribute• Painful rib syndrome• Slipped Rib• Costochondritis• Acid Reflux• Heartburn• Appendicitis• Gallbladder Disorder• Hiatal Hernia• Inguinal Hernia• Colic

• Constipation• Urinary Incontinence• Urinary Tract Infection

and Disease• Pancreatitis• Diverticulosis• Testicle Pain• Ovarian Cyst• Endometriosis• Prostatitis

Quadriceps femoris

• Origin:Straight head: from the anterior inferior iliac spineReflected head: on a curved line along the upper part of the acetabulum at the ilium

• Insertion: The quadriceps tendon along with the three vasti muscles, enveloping the patella then by the patellar ligament into the tibialtuberosity.

• Action: Extension of the leg at the knee

What symptoms and pain are associated with the rectus femoris muscle?

• Knee pain• Pain in the front of the thigh extending

down into the inside of the knee• Inability to fully straighten knee• Pain walking down stairs• Restless Leg Syndrome• Sharp pain deep in the front of the thigh

while sleeping

Interesting facts about the rectus femoris: Knee Bugs• The rectus femoris is responsible for the

condition known as ‘knee bugs’. Knee bugs is a creepy crawly type feeling and pain that occurs under the knee cap.

• This condition is often caused by a trigger point in the rectus femoris.




Clinical diagnoses to which the rectusfemoris muscle symptoms may contribute

• Patella femoral dysfunction• Floating Patella• Subluxation / Dislocation of the knee• Buckling knee (trick knee)• Anterior Cruciate Ligament sprain or tear• Posterior Cruciate Ligament sprain or tear• Torn meniscus (cartilage)• Quadriceps muscle tear• Sprain / Strain of the thigh or knee• Iliotibial tract friction syndrome• Phantom limb pain

Tibialis anterior• Origin: Lateral condyle and proximal

half to two-thirds of the lateral surface of the tibial shaft, the adjoining anterior surface of the interosseousmembrane and the intermuscularseptum between it and the extensor digitorum longus.

• Insertion: Inferomedial aspect of the medial cuneiform and base of the first metatarsal.

• Action: Inverts and adducts the free foot, assists in plantar flexion. Prevents excessive pronation of the foot during walking.

You use the tibialis anterior muscle when you turn the bottom of your foot inward and when you bend your foot up toward your body.

What pain and symptoms are associated with the tibialis anterior muscle?

• Pain in the big toe• Pain in the front of the ankle going up the

front of the shin• Occasionally there will be swelling along

the shin bone• Can contribute to shin splints• Can be a cause of weak ankles• Can contribute to drop foot

Clinical diagnoses to which the tibialisanterior muscle symptoms may contribute

• Trigger points and a tight shortened tibialis anterior can make it difficult to pick up the foot and can contribute to ‘tripping over your own feet’.

• Is often the primary cause of “growing” pains in the feet and ankles of children.

• Anterior compartment syndrome• Shin splints• Diabetic neuropathy• Hammer toe• Claw toes• Gout

Anterior Channels and Loads of Movement in Lower BodySpleen-Stomach channels and movement (EARTH)

Spleen and Stomach channels relate to movement of extension of the anterior lower extremities.

Lumbar extension, extension of the hip joint and flexion of the knee in the prone position, and the plantar flexion of the ankle joint extend the anterior lower extremities.

Any of these movement extends Spleen and Stomach channels.


POSTERIOR LOWER BODYErector spinae

Latissimus dorsi

Semitendinosus & semimembranosusPopliteus

GastrocnemiusMuscles of the 5th digit

Biceps femoris




Erector spinae

• Origin : Spinous processes of T9-T12 thoracic vertebræ, medial slope of the dorsal segment of illiac crest.

• Insertion : spinous processes of T1 and T2 thoracic vertebraeand the cervical vertebrae.

• Actions : extends the vertebralcolumn.

• Antagonist : rectus abdominismuscle

Latissimus dorsi• Origin: Spinous processes of thoracic

T7-T12, 9th to 12th ribs, the lumbar and sacral vertebrae (via the thoracolumbarfascia), and the posterior third of the external lip of the iliac crest. Occasionally by a slip from the posterior surface of the inferior angle of the scapula.

• Insertion: Ends as a flattened tendon in front of the attachment of teres major to the floor of the bicipital groove of the humerus. As the muscle curves around the inferolateral border of teres major, the fiber bundles of latissimus dorsirotate around each other, so that fibers that originate lowest insert highest on the humerus, and fibers that originate highest insert lowest on the humerus.

• Action: Adducts, extends and internally rotates the arm at the shoulder

The lats are responsible for movement of the arms, bending at the waist, and tilting the hips.

What pain and symptoms are associated with the latissimus dorsi muscles?• Pain reaching forward with the arms• Pain lifting arms overhead• Pain in the front of the shoulder• Pain around and under the shoulder blade• Pain on the side of lower abdominal area• Pain down the arm into the hand including the fourth and fifth fingers• Difficulty Breathing• Pain along the top of the hip bone (ilium).

Pain in the shoulder, upper arm, lower abdominal area, hand and difficulty breathing can signal latissimus dorsi muscle dysfunction. Pain in the low back around the top of the hip bone can also be a result of a lat dorsi strain.

Clinical diagnoses to which the latissimusdorsi muscle symptoms may contribute• Thoracic outlet syndrome• Brachial plexus entrapment• Adhesive capsulitis (Frozen shoulder)• Ulnar Neuropathy• C6 C7 or C8 radiculopathy• Bicipital tendinitis• Charcot’s joint• Slipped rib syndrome• Bruised ribs• Kidney Infection• Gallbladder Pain

Long head of the Biceps femoris

• Origin: Upper and inner surface of the posterior side of the ischial tuberosity, conjoined with semitendinosus

• Insertion: The main attachment is to the styloid process of the fibula, forming a semicircle around the lateral collateral ligament. The remainder splits into three laminae: the intermediate lamina fuses with the lateral fibular collateral ligament, the others pass superficial and deep to the ligament to attach to the lateral condyle of the tibia.

• Action: Flexes knee joint, laterally rotates knee joint, extends hip joint

Short Head of Biceps Femoris

• Origin: Middle third of the lineaaspera, lateral to the supracondylarridge of the femur.

• Insertion: Joining with the long head in the distal thigh, it attaches to the styloid process of the fibular head forming a semicircle around the lateral fibular collateral ligament. Remaining splits into three laminae. The intermediate lamina fuses with the fibular collateral ligament while the other two pass superficial and deep to the ligament to attach to the lateral condyle of the tibia.

• Action: Flexes knee joint, laterally rotates knee joint




What pain and symptoms are associated with the biceps femoris?• Pain in the back of the knee• Pain toward the outside of the knee going

up the outside of the thigh• Pain worsens while walking• Pain in the back of the leg when rising from

a sitting position

Clinical diagnoses to which the biceps femoris muscle symptoms may contribute

• Pulled or torn Hamstring• Bruised ischial tuberosity• Cauda equina syndrome• Sprain/Strain

• Interesting facts about the biceps femoris:– Like the biceps in the arm, the biceps femoris splits

into two heads, the short head and the long head. The short head of the muscle is absent in some people.

Semimembranosus• Origin: Upper outer quadrant of the

posterior surface of the ischial tuberosity, deep to the conjoined tendon of the semitendinosus and the long head of the biceps femoris.

• Insertion: The posterior aspect of the medial condyle of tibia, below the joint line, sending fibers into the fascia over popliteal ligament.

• Action: Extension of the thigh at the hip, flexion of the leg at the knee, internal rotation of the knee when knee is flexed

You use the semimembranosus muscle to straighten the thigh and bend the knee.

What pain and symptoms are associated with the semimembranosus muscle?

• Pain just below the buttock• Pain down the back of the thigh and into the

knee, occasionally going into the upper calf• Pain intensifies while walking• Deep aching pains in thigh and knee while

sleeping• Deep pain in the back of the thigh when rising

from a seated position

Clinical diagnoses to which this muscle symptoms may contribute• Interesting facts about the

semimembranosus muscle:– Pain and stiffness in the semimembranosus is often diagnosed as

hamstring tendinitis or sciatica.

• Pulled or torn Hamstring, Sprain / Strain injury• Bruised ischial tuberosity• Deep vascular thrombosis• Cauda equina syndrome

Semitendinosus

• Origin: Upper inner quadrant of the posterior surface of the ischial tuberosity, conjoined with the long head of biceps femoris

• Insertion: Upper part of the medial surface of the tibia, behind the attachment of the sartorius and distal and slightly anterior to the attachment of the gracilis.

• Action: Extension of the thigh at the hip, flexion of the leg at the knee, internal rotation of the knee when knee is flexed.

You use the semitendinosus muscle to straighten the thigh and bend the knee.




What pain and symptoms are associated with the semitendinosus muscle?

• Pain just below the buttock• Pain down the back of the thigh and into the

knee, occasionally going into the upper calf• Pain intensifies while walking• Aching pain down the back of the thigh while

sleeping• Deep pain when rising from seated position

Clinical diagnoses to which the semitendinosusmuscle symptoms may contribute

• Interesting facts about the semitedinosus muscle:– Pain and stiffness in the semitendinosus is often diagnosed as

hamstring tendinitis or sciatica.• Pulled or torn hamstring• Sprain / Strain hamstring• Hamstring tendinitis• Bruised ischial tuberosity• Deep vascular thrombosis• Cauda equina syndrome

Popliteus

• Origin: The lateral surface of the lateral condyle of the femur.

• Insertion: Medial 2/3rds of the triangular area above the solealline on the posterior surface of the tibia.

• Action: Internal rotation of the knee; Assists with flexion of the leg at the knee

Popliteus muscle unlocks the knee joint allowing the knee to bend.

What symptoms and pain are associated with the popliteus muscle?• Pain in the back of the knee• Pain behind the knee when straightening the leg• Inability to lock the knee• Pain in the back of the knee when walking or

running• Pain behind the knee when crouching or bending

the knee deeply• Pain is worse walking down an incline or stairs

Clinical diagnoses to which this muscle symptoms may contribute

• Popliteus tendinitis• Baker’s cyst• Deep Vein Thrombosis (DVT)• Avulsion of popliteus tendon• Injured meniscus and other knee ligaments

and tendons

Gastrocnemius• Origin: Medial head: the depression at the

upper and posterior part of the medial condyle of the femur and continuing behind the adductor tubercle to a slightly raised area on the popliteal surface of the femur, just above the medial condyle.Lateral head: area on the lateral surface of the lateral condyle of the femur and to the lower part of the corresponding supracondylar line.

• Insertion: Receives the tendon of soleus on its deep surface to form the Achilles tendon to attach to the middle of three facets on the posterior surface of the calcaneus

• Action: Plantarflexion of the foot at the ankle, assists with flexion of the leg at the knee.

You use the gastroc muscle when you stand on your toes, point your toes and bend your knee




What symptoms and pain are associated with the gastrocnemius?• Pain toward the outside of the back of the knee• Pain toward the inside of the back of the knee• Pain going down the inside of the inside of the lower leg• Pain around the inside ankle• Pain on the inside of the foot in the high arch

Interesting facts about the gastrocnemius– Trigger points and a short tight gastroc muscle is a prime source

of lower leg cramps or ‘charley horses’.– Chills when you are sick will cause the gastroc to shorten and

tighten causing lower leg pain.

Clinical diagnoses to which the gastrocnemius muscle symptoms may contribute

• Leg cramping at Night• Tennis leg• Post exercise soreness• Posterior compartment

syndrome• Buckling knee syndrome• Dislocation/Subluxation of the

knee• Torn lateral meniscus• Peripheral vascular disease

(PVD)• Thrombophlebitis

• Deep vein thrombosis (DVT)• Superficial vascular thrombosis

(SVT)• Varicose veins• Rupture or torn Gastrocnemius• Muscle sprain/strain of the calf• Baker’s cyst• Rupture Achilles tendon• Achilles tendinitis• Plantar fasciitis

Posterior Channels and Loads of Movement in Lower BodyKidney-Bladder channels and movement (WATER)

Kidney and Bladder channels relate to extension movement of the posterior lower body.

Kidney channel runs the posterior extremities and the anterior torso.

Thus movement that extends Kidney channel differs in the lower extremities and in the torso. Even though, movement of the lower extremities affects whole Kidney channel.

Flexion of the hip joint, flexion of hip joint and knee joint in the supine position and dorsiflexion of foot extend the posterior body.

Any of those movements extends Kidney and Bladder channels.


LATERAL LOWER BODYIntercostals

External oblique*

GluteusTensor fasciaelatae

PeroneusMuscles of the 4th & 5th digit

Transverse abdominis

Iliotibial tract

Intercostals

• Origin: From the first to the eleventh ribs, on the inner surface and inferior border, from the tubercles of the rib posteriorly to the costocartilage anteriorly.

• Insertion: The rib immediately below the level of proximal attachment, on its superior surface.

• Action: Draw adjacent ribs together, elevate and depress the ribs in inspiration

The intercostal muscles help you breath and assist with upright posture.

What pain and symptoms are associated with the intercostal muscles?

• Pain in between or under the ribs• Can cause a ‘stitch’ or sharp pain in the

side• Pain in the rib area when lying on your side• Pain when twisting the body side to side• Sharp pain while taking a deep breath,

sneezing, coughing and laughing




Clinical diagnoses to which the intercostalmuscles symptoms may contribute• Interesting facts about the intercostal muscles:

– Pain around the bottom of the ribs is often diagnosed as inflammation of the ribs, separated ribs, ulcers or gallbladder trouble. This symptom can be trigger points in the diaphragm and intercostal muscles

• Rib Subluxation/dislocation• Rib separation• Costochondritis• Bruised ribs• Rib fracture• Slipping rib syndrome• Pleurisy• Cardiac disease• Intrathoracic disease

Transverse abdominis

• Origin: Iliac crest, inguinal ligament, thoracolumbar fascia, and costal cartilages 7-12

• Insertion: Xiphoid process, lineaalba, pubic crest and pecten pubis via conjoint tendon

• Actions : Compresses abdominal contents

The transverse abdominal helps to compress the ribs and viscera, providing thoracic and pelvic stability.

Gluteus Minimus

• Origin: Outer surface of the ilium, between the anterior and inferior gluteal lines, and the edge of the greater sciatic notch.

• Insertion: Anterior surface of the greater trochanter of the femur.

• Action: Abduction of the thigh, internal rotation of thigh.

You use the gluteus minimus muscle when you move the thigh sideways away from the body and when you twist the thigh in toward the body.

What pain and symptoms are associated with the gluteus minimus?• Pain in buttocks• Pain in the outside of the hip• Pain in the back and outside of the thigh• Pain in the back of the calf down to the ankle• Numbness in buttocks, hip and thigh traveling down to

ankle• Pain while walking• Difficulty rising from a sitting position• Pain while laying on affected side

Interesting facts about the gluteus minimus• Three combined symptoms that point to

gluteus minimus problem:1. Difficulty crossing the legs2. Limping because of hip pain3. Pain is excruciating and constant

• Trigger points in the gluteus medius are often misdiagnosed as sciatica

Clinical diagnoses to which the gluteusminimus muscle symptoms may contribute

• Sciatica• Trochanteric bursitis• Intervertebral stenosis• Hip dislocation• Hip Pointer• Piriformis syndrome• Tensor fasciae latae syndrome• Sacroiliac joint displacement• Ankylosing Spondylitis• Cauda equina syndrome




Gluteus Medius

• Origin: Outer surface of the ilium, between the iliac crest and the posterior gluteal line above and the anterior gluteal line below

• Insertion: Posterolateral surface of the greater trochanter of the femur.

• Action: Abduction of the hip, internal rotation of thigh.

The gluteus medius muscle moves the thigh sideways away from the body and twists the thigh in and away from the body.

What pain and symptoms are associated with the gluteus medius muscle?

• Pain in the lower back around the beltline• Pain in the hip• Pain in the buttock• Pain can extend down the outside of the leg• Pain can extend into back of the leg• Pain when laying on the affected side• Pain will prevent sitting on the afflicted buttock• Pain worsens when sitting or standing for extended

periods of time• Pain when sitting slouched

Interesting facts about the gluteus medius• As you walk, the two gluteus medius

muscles take turns supporting your full upper body weight. Every one pound of extra body weight adds two pounds to the gluteus medius workload.

• The gluteus medius stabilizes the hip to allow you to stand on one leg.

Clinical diagnoses to which this muscle symptoms may contribute• Sacroiliac joint dysfunction• Sacroiliac joint displacement• Inflammation of the sub gluteus medius bursa• Trochanteric bursitis• Hip Pointer• Hip dislocation• Piriformis syndrome• Tensor fasciae latae syndrome• Intervertebral stenosis• Ankylosing spondylitis• Cauda equina syndrome

Gluteus Maximus• Origin: From a broad area on the posterior surface of

the ilium, the posterior gluteal line, the rough area of bone superior and inferior to this line, upward to the iliac crest, the aponeurosis of erector spinae, the dorsal surface of the lower part of the sacrum and the side of the coccyx, the sacrotuberous ligament, and the fascia that covers gluteus medius.

• Insertion: The muscle has both an upper portion and a lower deep portion. The upper part of the muscle, along with the more superficial fibers of the lower part, end in a thick flat tendon that passes lateral to the greater trochanter and attaches to the iliotibial band of the fascia lata. A bursa is usually found between the greater trochanter and the muscle-tendon unit. The deeper fibers of the lower part of the muscle attach to the gluteal tuberosity, a raised portion of the bone between the attachments of vastus lateralis and adductor magnus.

• Action: Extension of the thigh at the hip, Abduction of the thigh at the hip.

What pain and symptoms are caused by the gluteus maximus muscle?• Low back pain• Outer hip pain near and or around the joint• Pain around the tailbone• Pain and burning in the buttocks• Increased pain when walking uphill or up an

incline• Interesting facts about the gluteus maximus:

– The gluteus maximus is the muscle that allowshumans to walk upright.




Clinical diagnoses to which the gluteusmaximus muscle symptoms may contribute

• Trochanteric bursitis• Sacroiliac Joint Dysfunction• Sacroiliac Joint Displacement• Inflammation of the Sub Gluteus Medius Bursa• Sciatica• Hip Dislocation• Hip Pointer• Intervertebral Stenosis• Ankylosing Spondylitis• Tensor Fasciae Latae Syndrome• Cauda equina syndrome

Tensor fasciae latae

• Origin: Outer surface of the anterior iliac crest, between the tubercle of the iliac spine. A thick fascia covers the outer surface of the muscle, making it appear to be sandwiched between the layers of fasciae latae.

• Insertion: By the iliotibial band anterior surface of the lateral condyle of the tibia.

• Action: Assists with flexion of the thigh at the hip, assists with adduction of the thigh at the hip.

The TFL Muscle (red) and the IT Band (orange) twist the thigh toward the body, lifting the thigh and moving the thigh forward.

What pain and symptoms are associated with the tensor fasciae latae muscle and iliotibial band?

• Pain in deep in the hip going down the outside of the thigh

• Pain at the front of the hip joint• Discomfort sitting• While standing knees and hips tend to be

flexed (bent)• Pain intensives when foot hits the ground

while walking or running

Interesting facts about the tensor fasciae latae muscle and iliotibial band muscle

• Pain from trigger points in the tensor fasciae lataemuscle is often diagnosed as bursitis of the hip or thinning of the hip cartilage.

• Iliotibial Band Syndrome– ITBS is the most common pain syndromes in runners,

weightlifters, dancers, tennis players and basketball players. Pain or a stinging burning sensation is felt on the outside of the thigh down to the lower knee. Pain is more pronounced when the foot hits the ground while walking or running.

Clinical diagnoses to which this muscle symptoms may contribute

• Trochanteric bursitis• Iliotibial tract friction syndrome• Sacroilitis• Peripheral Nerve entrapment

Peroneus Longus and Peroneus Brevis

You use the peroneuslongus and brevismuscles to turn the bottom of your foot outward and when pointing your toes downward.




What symptoms and pain are associated with the peroneus longus and peroneus brevismuscles?

• Pain all around the outside ankle bone• Pain going down the outside of the foot• Can cause numbness in the lower leg, ankle and

top of the foot• Pain on the outside of the leg just below the knee• Weak ankles• Interesting facts about the peroneus muscles:

– A tendency of ankle sprains can be an indication of trigger points in the peroneus muscles.

Clinical diagnoses to which the peroneus longusand peroneus brevis muscles symptoms may contribute

• Peroneal Nerve Entrapment Syndromes• Diabetic neuropathy• Morton foot structure• Lateral Compartment Syndrome• Ankle Sprain/Strain Syndrome• Gout• Plantar fasciitis• Achilles tendon rupture or tear


MEDIAL LOWER BODY

Abductors

Soleus & tibialis posterior

Muscles of the 1st & 2nd digit

Abductor Brevis

• Origin: Inferior ramus and body of the pubis, between gracilis and obturatorexternus.

• Insertion: Along a line from the lesser trochanter to the linea aspera, the upper third of the linea aspera, downward along the upper third of the linea aspera, immediately behind the pectineus and the upper part of adductor longus

• Action: Adduction of the thigh at the hip, assists with internal rotation of the thigh at the hip.

You use the adductor brevis muscle to move and twist the thigh inward toward your other leg.

What pain and symptoms are associated with the adductor brevis muscle?

• Groin pain during activity, pain subsides with rest• Pain in the front of the outer upper thigh near the hip joint• Deep pain in the hip joint• Pain above the knee• Restricted movement in the hip and thigh• Interesting facts about the adductor brevis muscle:

– Because of the common attachment to the pubic bone and it’s attachment into the adductor longus muscle, the pain pattern of the adductor brevis is the same as the adductor longus. Both muscles are treated simultaneously.

Clinical diagnoses to which the adductor brevis muscle symptoms may contribute

• Floating Patella• Obturator or Genitofemoral nerve

entrapment• Pubic stress fracture• Pubic stress symphysitis• Muscle strain (groin pull)• Inguinal hernia




Adductor Longus

• Origin: Anterior surface of the pubis, in the angle between the crest and pubic symphysis.

• Insertion: Lower two-thirds of the medial lip of the linea aspera on the posterior surface.

• Action: Adduction of the thigh at the hip, assists with internal rotation of the thigh at the hip, assists with flexion of the thigh at the hip

You use the adductor longus muscle to move the thigh in toward the other leg and to twist the thigh inward.

What pain and symptoms are associated with the adductor longus muscle?

• Groin pain during activity, pain subsides with rest• Pain in the front of the outer upper thigh near the

hip joint• Deep pain in the hip joint• Pain above the knee• Restricted movement in the hip and thigh• Interesting facts about the adductor longus

muscle:– Trigger points in the adductor longus is the most

common cause of groin pain.

Clinical diagnoses to which the adductor longus muscle symptoms may contribute

• Floating Patella• Obturator or Genitofemoral nerve

entrapment• Pubic stress fracture• Pubic stress symphysitis• Muscle strain (groin pull)• Inguinal hernia

Adductor Magnus• Origin:

Anterior: Inferior pubic ramus and the ramus of the ischiumPosterior: Inferolateral aspect of the ischial tuberosity

• Insertion:Anterior: Medial margin of the glutealtuberosity of the femur, medial to gluteus maximus.Posterior: By a broad attachment into the linea aspera and the proximal part of the medial supracondylar line and by a small tendon to the adductor tubercle.

• Action: Adduction of the thigh at the hip, extension of the thigh at the hip

You use the adductor magnus muscle to pull and twist the upper leg inward toward the other leg.

What pain and symptoms are associated with the adductor magnus muscle?

• Groin pain during activity, pain lessens at rest• Pain in the front of the inner upper thigh• Pelvic pain• Interesting facts about the adductor magnus

muscle:– Trigger points in the adductor magnus can cause pain

deep in the pelvic area. Pain may present as a dull ache, or a sharp stabbing pain.

– Those suffering with adductor magnus symptoms often sleep with a pillow in between the knees to ease pain.

Clinical diagnoses to which the adductor magnus muscle symptoms may contribute

• Obturator or Genitofemoral nerve entrapment• Inguinal Hernia• Iliac or femoral thrombosis• Pubic stress fracture• Prolapsed Uterus• Endometriosis• Ovarian Cyst• Hemorrhoids• Constipation• Muscle Strain (groin pull)




Soleus• Origin: Posterior surface of the head and

proximal quarter of the shaft of the fibula, spanning over to the soleal line and the middle third of the medial border of the tibia, and a fibrous band, which arches over the popliteal vessels and tibial nerve, between the tibia and fibula

• Insertion: Joins with the tendon of the gastrocnemius to form the tendo calcaneusto attach to the middle of three facets on the posterior surface of the calcaneus. The muscle is covered proximally by gastrocnemius and is accessible on both sides.

• Actions: Plantarflexion of the foot at the ankle

You use the soleus muscle when you stand on your toes and point your toes.

What pain and symptoms are associated with the soleus muscle?• Pain in the heel often to the point of not being able to put

weight on the heel• Pain in the ankle• Pain in the calf sometimes extending into the back of the

knee• Deep aching in the back of the knee• Deep pain in the low back• Hypersensitivity to touch in the lower back• Poor circulation in the lower legs and feet• Pain in the jaw and on the side of the head

Interesting facts about the soleusmuscle• The soleus is sometimes called the second heart

because it helps pump blood up from the feet and lower leg.

• A trigger point in the soleus muscle can cause jaw pain and pain on the side of the face and head. If you are suffering with pain in the under eye, cheek and jaw area and cannot find relieve, you should consider examining the soleusmuscle.

Clinical diagnoses to which the soleusmuscle symptoms may contribute

• Heel spur• Posteromedial Shin splint• Bruised periosteum of the

tibia• Baker’s cyst• Rupture Achilles tendon• Achilles tendinitis• Plantar fasciitis• Plantars wart• Bone spur• Sciatica• Hip rotator dysfunction• Temporomandibular joint

Dysfunction (TMD)

• Peripheral vascular disease(PVD)

• Thrombophlebitis• Deep vein thrombosis (DVT)• Superficial vascular thrombosis

(SVT)• Varicose veins• Nocturnal cramping• Tennis leg• Post exercise soreness• Posterior compartment

syndrome• Buckling knee syndrome• Dislocation/Subluxation of knee

Tibialis Posterior

• Origin: Proximal two-thirds of the posterior surfaces of the tibia and the fibula and the interosseus membrane.

• Insertion: Passing behind the medial malleolus to attach to the bones that form the arch of the foot: the navicular, each cuneiform and cuboid the calcaneus and metatarsals 2,3,4

• Action: Inverts and adducts the free foot, assists in plantar flexion. Prevents excessive pronation of the foot during walking.

You use your tibialis posterior muscle when you rotate your foot inside and stand on your toes or point your toes.

What pain and symptoms are associated with the tibialis posterior muscle?

• Pain in the back of the lower leg, just above the heel

• Pain can go into the heel and down into the bottom of the foot

• Pain will sometimes radiate up into the calf• Interesting facts about the tibialis posterior

muscle:– Pain from trigger points in the tibialis posterior is

sometimes misdiagnosed as Achilles tendinitis.




Clinical diagnoses to which the tibialisposterior muscle symptoms may contribute• Diabetic neuropathy• Posteriomedial Shin splints• Deep posterior compartment

syndrome• Tibialis posterior tendon

dysfunction• Tarsal tunnel syndrome• Hammer or claw toes• Plantar fasciitis• Plantar wart• Gout• Sprain/strain of the ankle• Peripheral vascular disease

(PVD)

• Deep Vascular Thrombosis(DVT)

• Ruptured Achilles tendon• Achilles tendinitis• Calcaneal spur syndrome• Overuse syndrome

Lateral-Medial Channels and Loads of Movement in Lower Body

Liver-Gallbladder channels and Movement (WOOD)

Liver and Gallbladder channels relate to extension movement of the both lateral and medial side of the body.

Movement of the hip, knee and ankle joints extend the lateral side of hip, knee and ankle.

Any of these movement extend Gallbladder channel.

Lateral-Medial Channels and Loads of Movement in Lower Body Another movement of the hip, knee

and ankle joints extend the medial side of the hip, knee and ankle.

Any of these movement extends Liver channel.

The movements below increase the extension load on both of Liver AND Gallbladder channels.

Ren channel is related to all movement that extend Lung, Large Intestine, Spleen and Stomach channels.

Ren channel and Movement

Diagnosing Ren Mai (Dr Wang)

• Ren21 xuan ji– Soreness = heat in the lung (upper respiratory tract)

• Ren14 ju que– Tension, spams, tightness = disorders of the diaphragm which are often manifested as “heart”

pain

• Ren12 zhong wan - Ren13 shang wan– Softness/weakness = chronic stomach issue, lowgrade inflammation due to spleen deficiency.– Strong pulse = excess condition affecting the spleen and/or stomach.

• Ren11 jian li - Ren10 xia wan– Hardness = heat in the middle/lower burners (stomach, or duodenal ulcers, colitis,

diverticulitis,Crohn disease …)

• Ren6 qi hai– Soreness = cold stagnation in the ren mai or womb– Nodules = cold phlegm in the ower burner (womb)

• Ren6 qi hai - Ren4 guan yuan area– Softness/weakness = kidney deficiency– Hardness = chronic lower burner (blood) stasis– Strong pulse = cold stagnation in the lower burner

Du channel is related to all the extension movements of Heart, Small Intestine ,Kidney andBladder channels.

Du channel and Movement




Diagnosing Du Mai (Dr Wang)• Du21 qian ding – Du19 hou ding

– Tenderness = Qi stagnation in the Du Mai– Pain = Cold and Blood stagnation in the Du Mai (chronic lumbago, back and nape pain, headache, dizziness,

insomnia).

• Du14 da zhui– Soreness, thickening of the area = exterior cold condition or chronic blockage of multiple yang channels

affecting Du (back pain, stiffness of the spine, sensation of cold in the body)

• Du12 shen zhu– Tenderness = upper burner excess condition (heart or lung)

• Du11 shen dao – Du9 zhi yang– Tenderness = external condition (often heat) affecting pericardeum or stomach– Swelling (located more between spinous processes) = excess heat affecting internal organs (heart, stomach

or pericardeum)– Nodules (located more on the spinous process) = chronic heat condition in organs, often involving fire-toxin– Grainy = Qi stagnation, often liver overacting on stomach-type pattern– Any change between T5-T8 could be related to emotional disorders leading to digestive problems.

• Du9 zhi yang – Du7 zhong shu– Nodules = qi stagnation (liver)

• Du8 jin suo – Du6 ji zhong – Du4 ming men– Nodules = cold accumulation or blood stasis in Du, often with back pain.– Pain = qi deficiency or cold, lack of circulation in the lower burner.– Grainy = acute qi, blood stasis in local collaterals or organs of the lower burner.

• Sacrum– Any palpable change = gynecological and /or emotionnal troubles (including insomnia) (gān yù (肝郁)– Cold and swelling = qi stagantion with kidney yang deficiency

Ren Mai, Du Mai and the RegularChannels

17

12

10

7

4,3

2

Shao Yin

Jue Yin

Tai Y

inREN DU

Yang

Ming

Shao

Yang

Tai Y

ang

28

26

24

14

1

13

20

17

13

24KI

SP

SJSI

ST

BLST

SISTST

SJSI

BL

LVBLKI

KILV

SP

LV

BL

GBKI

SP

Dai channel and Movement

Dai channel is a transverse axis that governs Pericardium, San Jiao, Liver and Gallbladder channels, which are distributed in the lateral and medial sides of the body.Dai channel relates to all extension movements of Pericardium, San Jiao, Liver and Gallbladder channels.

Dai Mai

Palpate the following points :•Du4•Liv13•GB26•GB27•GB28•GB41

Chong Mai

Palpate the followingpoints :•Ren7•KD11-21•ST30•SP4

Yin Qiao Mai

• BL1• ST12,9• Ren9• KD6 =Jiao Hui• KD8 = Xi-Cleft• KD2




Yang Qiao Mai

• BL1• ST1,3,4• GB20• SI10• LI15,16• LI10• GB29• BL61• BL59 = Xi-Cleft• BL62 = Jiao Hui

Yang Wei Mai

• ST8• GB13-21• Du15,16• SI10• SJ13,15• SJ5 = Jiao Hui• GB35 = Xi-Cleft• BL63

Yin Wei Mai

• Ren22,23• PC6 = Jiao Hui• SP12,13,15,16• LV14• KI9 = Xi-Cleft

Things to Remember

It is important to remember that the stretchedchannel decides the affected channel, not the location of any abnormal reactions.

Abnormal reactions can appear on any part of the body along the affected channel when an affectedchannel is stretched.

If the channel shows any abnormality (pain, stretched feeling, dullness or malaise), thischannel is affected.

This finding allows you to decide the channel youhave to treat.

The five steps


Locating Effective Points

• First we use the Five Phases points, and if thisdoesn’t resolve the problem we use LuoConnecting and Xi Cleft points.

• Then we try points in large muscle groups of the upper arms or thighs, and then points on the torsolike Front Mu and Back Shu points.

• Finally we try cranial points, and points in the spineand pelvic area as well as auricular points.

• In order to increase the effect we may use a combination of these points.




Locating Effective Points

• We also use Yin-Yang crossover point combinations as much as possible.

• The point location and combinationsvary by the condition treated, but the Five Phases points are most useful in terms of understanding the effect.

Five Phases (Wu Xing)

• The Five Phases point selection based on chapter 69 of the Classic of Difficulties (Nanjing) uses a total of 24 points, two points each from each of the 12 channels.

• Treating five phases points on the opposite side of channels in a generating cycle serves to counterrestore Normal Channel function the treatment on the affected areas and channels. • There is no need for any abnormal finding associated with

the channels that follow in the generating cycle.

Ling Shu Chapter 4 (‘Disease Patterns of Zang Fu as Caused by Pathogenic Qi’)

• “The Divergent branches of the Yangchannels reach into the interior and connect with the Fu ... the Ying-Spring and Shu-Stream points treat the channel, the He-Sea points treat the Fu.”

Ling Shu Chapter 6 (‘Longevity, Premature Death, Strength and Weakness’)• Distinguishes when to needle particular Shu points depending on the

site/depth of the disease: “There is Yin within Yin and Yang within Yang ... Internally the five zang are Yin whilst the six Fu are Yang. Externally the sinews and bones are Yin whilst the skin is Yang.”

• Thus it is said:– When the disease is at the Yin within Yin (zang), needle the Ying-Spring and the

Shu-Stream points of the Yin channels.– When the disease is at the Yang within Yang (skin), needle the He-Sea points of

the Yang channels.– When the disease is at the Yin within Yang (sinews and bones), needle the Jing-

River points of the Yin channels.– When the disease is at the Yang within Yin (fu), needle the Luo points.

Ling Shu chapter 44 (’The Sequence of Qi and the Four Seasons Within a Single Day’)• According to Season:

– The five zang correspond to Winter, in Winter needle the Jing-Well points.– The five colours correspond to Spring, in Spring needle the Ying-Spring points.– The seasons correspond to Summer, in Summer needle the Shu-Stream points.– The musical sounds correspond to Late Summer, in Late-Summer needle the Jing-

River points.– The flavours correspond to Autumn, in Autumn needle the He-Sea points.

• According to Symptomatology:– When the disease is at the Zang, needle the Jing-Well point.– If manifesting as a change in the colour, needle the Ying-Spring point.– When the disease attacks intermittently, needle the Shu-Stream point.– When the disease manifests as changes in the patient’s voice, needle the Jing-

River point.– If there is disease of the stomach and irregular appetite, needle the He-sea point.

Nanjing (68th Difficulty)

The 5 Shu-Points are indicated in the following situations:•Jing-Well points for fullness below the heart,•Ying-Spring points for heat of the body,•Shu-Stream points for heaviness of the body and pain of the joints,•Jing-River points for dyspnea, cough, chills and fever,•He-Sea points for rebellious Qi and diarrhea.




(Wood)Medial & Lateralaspects of legs

(Fire)Posterior & Medial

aspects of arms

(Earth)Anterior aspect

of legs

(Metal)Anterior aspect

of arms

(Water)Posterior

aspect of legs

Yuan Source points move the qi along the channels• They are in control of the Qi of the San jiao

and control the Yuan Qi in the channels.• If one needs to activate the channels, the

Yuan Source point is utilized.• The Jia Yi Jing states that the Yuan Source

points combine with the Jing River points to correspond with the season and treat problems in the season.

Luo Connecting points transfer qi from one channel to another channel• In TCM acupuncture, they are used to transfer qi

from the internal and externally related channels, for example, the Lung to the Large Intestine.

• In Optimal Acupuncture, because we are very flexible in the interrelationships of the channels, we know we can always direct Qi to an affected channel through the use of the Luo connecting points.

Xi-Cleft points are used for pain

• Xi Cleft points are underutilized in TCM Acupuncture.

• In Optimal Acupuncture, the Xi Cleft points are used for any type of pain and bleeding.

• They are our trauma points, used for any pain, whether acute or chronic.

Five Phases (Wu Xing)

YinWood & Fire LV-2 HT-9 & PC-9Fire & Earth HT-7 & PC-7 SP-2

Earth & Metal SP-5 LU-9Metal & Water LU-5 KI-7Water & Wood KI-1 LR-8

YangWood & Fire GB-38 SI-3 & SJ-3Fire & Earth SI-8 & SJ-10 ST-41

Earth & Metal ST-45 LI-11Metal & Water LI-2 BL-67Water & Wood BL-65 GB-43

Yin-Yang crossover

• Yin-Yang crossover point combinationis the use of points on the opposite meridian in a Yin-Yang and Five Phases relationship.




Yin-Yang crossover

YinWood & Fire LV-2 SI-3 & SJ-3Fire & Earth HT-7 & PC-7 ST-41

Earth & Metal SP-5 LI-11Metal & Water LU-5 BL-67Water & Wood KI-1 GB-43

YangWood & Fire GB-38 H-9 & PC-9Fire & Earth SI-8 & SJ-10 SP-2

Earth & Metal ST-45 LU-9Metal & Water LI-2 KI-7Water & Wood BL-65 LR-8

Anterior points

• LU9, LU5, LU8, LI2, LI11, LI1• SP2, SP5, SP3, ST45, ST41, ST36• Front Mu points : LU1, ST25, LR13, Ren12• Back Shu points : BL13, BL25, BL20,

BL21

Posterior points

• HT9, HT7, HT8, SI3, SI8, SI5• KI1, KI7, KI10, BL67, BL65, BL66• Front Mu points : Ren14, Ren4, GB25,

Ren3• Back Shu points : BL15, BL27, BL23,

BL28

Lateral points

• PC9, PC7, PC8, TB3, TB10, TB6• LR2, LR8, LR1, GB43, GB38, GB41• Front Mu points : Ren17, Ren5, LR14,

GB24• Back Shu points : BL14, BL22, BL18,

BL19

The five steps


Confirm the Effect of the Points

• Apply finger pressure successively to the points selectedin Step 3, as the patient performs the problem movement, to determine wether there is an improvement in the movement or the symptom.

• If there is no change or improvement on pressing the first point, then the other points and their relatedabnormal areas are pressed, one point at a time, to see if there is any improvement.

• If there is no change at all with finger pressure on any of the points, the patient should be referred for orthopedicexamination.




Example

Problemwith neck extension

Check LU9

Check LU5

Check LI11

Check LI2

Abnormal Areas

Refer to Doctor

Step 5: Treatwithchosenapproach

Change / Improvement

No change / Improvement

1

2

3

4

The five steps


Treat Using the Chosen Approach

• Acupuncture & moxibustion (for acupuncturists and medicalprofessionals)– Filiform needles or intradermal needles (press tacks)– Press tacks are recommended from the standpoint of safety– For moxibustion, products that do not leave a burn on the skin are

recommended (stick-on moxa cones with adhesive)• Stretching (for the general public and sports trainer)

– Appropriate stretching can be effective for self-conditioning and prevention of injury.

– Apply finger pressure on corresponding points during the stretching iseffective for increasing the ROM.

• Massage (for the general public, sports trainers and massage therapists)– When the channels test is performed first to identify the area most in

need of treatment.

Stretching Anterior Aspect

Stretching Posterior Aspect Stretching Lateral Aspect




LV2 / SI3 & SJ3 (Wood/Fire)

Liver Foot Jue Yin is medial aspect of the leg•Tong Ming Jing is PC•Yin/Yang Related Channel is SJ•Zi Wu is SI

•Add SI5, SJ6•Add LV3 (shu-stream), LV6 (xi-cleft)•Add BL18 and LV14•Medial aspect is governed by Chong Mai, addSp4, then points from regular channels crossingChong Mai, for example Ren7, then PC6 if there isany abnormal reaction while moving the trunc.

SI3, SI5(HT9)

SJ3, SJ6(PC9)PC6

LV2LV3LV6SP4

LV2 / SI3 & SJ3 (Wood/Fire)

• Tung ‘s points : – 11.10 Mu Huo (Pc channel)

• Knee & calf pain

– 11.20 Mu Yan (SJ channel)• Hepatomegaly, hepatitis, liver cirrhosis,

hypocondriac pain

– 66.03 Huo Ying (Lv channel, Lv2)• Chin pain, TMJ pain, … commonly used with

Huo Zhu (Lv3)

– 88.15 Huo Zhi, 88.16 Huo Quan (Lvchannel)

• Back pain, cholecystitis (stop pain fromgallstones), heel pain

• RA : Lv/GB/HT/Spine

SI3, SI5(HT9)

SJ3, SJ6(PC9)PC6

LV2LV3LV6SP4

HT7 / ST41 (Fire/Earth)

• HT Hand Shao Yin is posterioraspect of the arm– ST Jing Bie goes through the Heart

• Add ST36• Add HT5, HT6• Add BL15 and Ren14• Posterior aspect is governed by Du

Mai, add SI3 then Du Mai points and BL62 if there is any abnormal reactionwhile moving the trunc.

HT7HT6HT5SI3

ST41, ST36(SP2)BL62

PC7 / ST41 (Fire/Earth)

• PC Hand Jue Yin is medial aspect of the arm– Bie Jing is Yang Ming– Sp and Pc connects through the

extraordinary vessels• Add ST36• Add PC6, PC4• Add BL14 and Ren17• Medial aspect is governed by Yin Wei Mai,

after adding Pc6 add points from regularchannels crossing Yin Wei Mai, then Sp4 if there is any abnormal reaction while movingthe trunc. You can also add Kd9.

PC7PC6PC4

ST41, ST36(SP2)SP4

HT7 or Pc7 / ST41 (Fire/Earth)

• Tung’s points : – 22.06 Zhong Bai, 22.07 Xia Bai (SJ

channel; SJ3 + Yao Tong Xue)• LBP, Sciatica d/t Kd patterns, edema of

the limbs, blurry vision, hypertension

– Yi/Er/San Zhong (between ST and GB channels)

• Migraine, mastitis, rib-side pain

HT7HT6HT5SI3

ST41, ST36(SP2)BL62

PC7PC6PC4

ST41, ST36(SP2)SP4

SP5 / LI11 (Earth/Metal)

• SP Foot Tai Yin is anterior aspect of the leg

– Yin/Yang Related Channel is LI– Tong Ming Jing is LU

• Add LI1• Add Sp3, Sp8• Add BL20, LV13• Anterior aspect is governed by Yin

Qiao Mai, add KI6 then points fromregular channels crossing Yin QiaoMai, for example Ren9 or Kd2, and LU7 if there is any abnormal reactionwhile moving the trunc. . You can alsoadd Kd8.

LI11, LI1(LU9)LU7

SP5SP3SP8KI6




SP5 / LI11 (Earth/Metal)

• Tung’s points : – Hua Gu Yi (opposite Lv channel)

• Nasal pain, headache, toothache

– Yi/Er/San Zhong• Pain in the shoulder, arm, wrist,

neck– Bi Yi

• Sciatica, pain in the limbs, general vacuity patterns …

LI11, LI1(LU9)LU7

SP5SP4SP8KI6

LU5 / BL67 (Metal/Water)

• LU Hand Tai Yin is anterior aspect of the arm– Bie Jing is BL

• Add BL66• Add LU9, LU6• Add BL13, LU1• Anterior aspect is governed by

Ren Mai, add Lu7, points on the Ren Mai, then add KI6 if there is any abnormal reactionwhile moving the trunc.

LU5LU6LU9LU7

BL67(KI7)BL66KI6

LU5 / BL67 (Metal/Water)

• Tung’s points : – Bi Yi– Ma Jin Shui (SI18)– Zu Wu Jin, Zu Qian Jin (between ST

and GB channels)• Pain in the shoulder region (supraspinatus

tendinitis) and back, Mei He Qi

– Si Hua Xia, Fu Chang (ST channel)• Bone spurs when needled against the

bone, dyspnea, edema

– Liu Wan, Shui Qu (GB41, 43)• Migraine, LBP, swelling (removes fluids

from the body), neck pain

– Li Bai (between LI and LU channels)• Calf pain, foot pain

– Mu Guan, Gu Guan• Heel pain

LU5LU6LU9LU7

BL67(KI7)BL66KI6

KI1 / GB43 (Water/Wood)

• KI Foot Shao Yin is posterior aspect of the leg

– Bie Jing is Shao Yang

• Add GB41• Add KI3, KI5• Add BL23, GB25• Posterior aspect is governed by Yang

Qiao Mai, add BL62 then points fromregular channels crosing Yang Qiao and SI3 if there is any abnormal reactionwhile moving the trunc. . You can alsoadd BL59.

SI3

KI1KI3KI5

BL62

GB43(LV8)GB41

KI1 / GB43 (Water/Wood)

• Tung’s points :– Huan Chao (SJ channel)

• Dysmenorrhea, reproductive disordersrelated to Lv and Kd patterns.

– Zhi San Zhong (SJ chanel)• Mastitis, migraine, wei syndrome

(muscular atrophy)

– Zhi Shen (SJ chanel)• Back pain, thirst

– Chang Men (SI channel)• Pain ofthe lower leg, thigh pain, various

diseases of the LI

– Zhi Tong, Luo Tong (SI channel) • LBP, dizziness, fatigue, HTA

SI3

KI1KI4KI5

GB43(LV8)GB41BL62

GB38 / H9 & PC9 (Wood/Fire)

• GB Foot Shao Yang is lateral aspect of leg– Zi Wu or Bie Jing is HT – Yin / Yang Related Channel is PC

• Add HT8, PC8• Add GB37, GB36• Add BL19, GB24• Lateral aspect is governed by Dai Mai,

add GB41 and SJ5 if there is anyabnormal reaction while moving the trunc.

HT9(SI3)HT8PC9(SJ3)PC8SJ5

GB38GB37GB36GB41




SI8 / SP2 (Fire/Earth)

• SI Hand Tai Yang is posterior aspect of arm– Bie Jing is Tai Yin

• Add SP3• Add SI7, SI6• Add BL27, Ren4• Posterior aspect is governed by Du Mai,

add SI3 and BL62 if there is anyabnormal reaction while moving the trunc.

SI8SI7SI6SI3

SP2(ST41)

SP3BL62

SJ10 / SP2 (Fire/Earth)

• SJ Hand Shao Yang is lateral aspect of arm– Zi Wu is SP

• Add SP3• Add SJ3, SJ6• Add BL22, Ren5• Lateral aspect is governed by Yang Wei

Mai, add SJ5 and GB41 if there is anyabnormal reaction while moving the trunc.

SJ10SJ6SJ3SJ5

SP2(ST41)

SP3GB41

ST45 / LU9 (Earth/Metal)

• ST Foot Yang Ming is anterior aspect of leg– Yin / Yang Related Channel is PC– Tong Ming Jing is LI

• Add LU8• Add ST43, ST34• Add BL21, Ren12• Anterior aspect is governed by Yin Qiao

Mai, add KI6 and LU7 if there is anyabnormal reaction while moving the trunc.

LU9(LI11)LU8LU7

ST45ST43ST34KI6

LI2 / KI7 (Metal/Water)

• LI Hand Yang Ming is anterioraspect of arm– Zi Wu is KI

• Add KI10• Add LI3, LI7• Add BL25, ST25• Anterior aspect is governed by Ren

Mai, add LU7 and KI6 if there is anyabnormal reaction while moving the trunc.

LI2LI6LI7LU7

KI7(BL67)KI10KI6

BL65 / LV8 (Water/Wood)

• BL Foot Tai Yang is posterior aspect of leg

• Add LV1• Add BL63, BL58• Add BL28, Ren3• Posterior aspect is governed by Yang

Wei Mai, add BL62 and SI3 if there isany abnormal reaction while movingthe trunc.

SI3

LV8(GB43)

LV1

BL65BL63BL58BL62

14 scenarios are missing …

… but now you’re getting the idea !•Needling the same channel in succession iscalled Dao Ma in master Tung’s acupuncture.•You would use it all the time.•In Optimal Acupuncture, we are able to combine the functions of all the 5 phases points.




The paradigm of Optimal AcupunctureExample : Shu stream point combos• Shu Stream/Yuan Source - weakness of the joints,

arthritis, fibromyalgia, fatigue, heaviness of the body• Shu Stream/Luo Connecting - chronic joint problems

and pain• Shu Stream/Xi Cleft - acute joint pain with internal

bleeding/bruising• Shu Stream/Jing River - cough with joint pains,

lingering cough• Shu Stream/He Sea - chronic organ diseases and

rebellious Qi patterns, diarrhea with joint pains

Other Acupuncture Methods

• You can use ANY of the Yi Jing Ping HengACUPUNCTURE (AS DR. CHEN CHAO CALLED IT) methods to restore normal channel function.

• You can use ANY logical method you likeas soon as you are able to diagnose the diseased channel(s) correctly.

• Use Optimal Acupuncture (Dr Robert Chu).

How do you know if you're a good acupuncturist? (Dr Robert Chu)• Fewer Points selected• Careful selection of points• Needling not applied at the diseased site• Instant results for acute or painful cases• Flexibility in strategies• Compassionate• Problem Solver• Able to research problems• Uses Time, Day, Month, Season, and Year• No need to Tonify or Sedate• Pricking, Bloodletting, cupping, Gua Sha, Moxa, Tui Na, all done

appropriately• Use of the Penetrating or threading method

Blueprint for acupuncture efficiency

• Diagnose the diseased channel(s).• Select the channel(s) to balance the most diseased

channel first.• Select points on those channels according to the skills at

hand and that pertain to the disease.• If needed, select any secondary channels and treat the

channels accordingly to the secondary disease.• Remove the needles, and check with the patient

regarding their signs and symptoms.

Applying the channels test with Optimal Acupuncture

• Perform the channel test to diagnose the most diseased channel• Select an acupuncture method that pertain to the disease• Use micro-systems, holography, multiple imaging as you would

normally do• Exemple : sacro-illiac pain.

– Channels test is positive for Patrick’s Test => GB/LV issue– GB43 is alleviating pain and restriction to movement so you know that GB

is diseased and must be restore Normal Channel functiond :• You could use KI1/BL65 of course• You can use GB, LV, SJ, HT right ?• SJ is great because using San Cha San for example you could treat SJ3/SI3/HT8 and

then get both GB, LV, BL and KI channels …• Imaging strategies like Shou Ju Ni Dui Fa - Hand and Body opposite Flow Image or Deng

Gao Gui Ying - Imaging the same height also suggest using these points

7 Rules

1) Check all of the movements first.2) Treat the channel with the greatest restriction first.3) When the abnormality affects both an arm and a leg,

always begin with treatment of the leg. 4) Do not forget to stimulate the central axis.5) Before treating a point, first check its effect by striking

or applying pressure to see if it improves the movement.

6) Stimulation of the local area should be done last.7) If there is no effect with treatment, refer to an

orthopedist or other health professional.




Case Studies

Case 1 : Shoulder Pain

• Chief complaint: pain in anteriorright shoulder.

• Right shoulder pain increased by lateralrotation with fixedelbow.

• Some resistancefelt with 6, 7, 8 and 14.

Case 1 : Shoulder Pain

• Restriction in stretching posterior aspect of right arm (right H & SI channels)– SI4,8,9,11, H3 on the right side

• Restriction in stretching lateral aspect of right arm (right TB channel)– TB10,15 on the right side

• Sp2 on the left side• Two sessions with the same points.

Case 2 : long distance runner withknee pain

• Chief complaint : pain in the right knee.

• Positive findings:– Anterior : 1 righ & left, 4

right & left, 16 right & left, 23 right, 27 right & left

– Posterior : none– Lateral : 3 right, 20 right &

left, 26 right, 29 right– Pain was especially

pronounced withmovements 23 & 26

Case 2 : long distance runner withknee pain• 1 & 4 : LU1,5• 3 : TB10• 16 & 23 : ST36,41• 20 & 26 : GB38,41• 27 : CV12• 29 : (Girdle vessel) GB26• Knee pain improved after first treatment. One

month treatment, twice a week.

Case 3 : sprinter with leg pain

• Chief complaint : pain in posterior right leg.

• M-Test positive findings:– Anterior : 1-A left,16

right, 27 right & left– Posterior : 2 right & left,

18 right & left– Lateral : 3 right & left,

20 right




Case 3 : sprinter with leg pain

• 1-A : left LI4• 27 : right & left ST36• 2 : left SI8• 16 : right ST41, left TB10• 18 : right & left K1, LR8• 3 : right & left GB21• 20 : right LR2• Seirin Red (0.16mm) 30mm needles were inserted just a few mm in

each of the above points and the needles were not retained.• First treatment the pain was decreased and it did not bother the

patient while running. After 4 more treatment in 6 days, the pain disapeared.

• Note: we probably could have done right ST41 => left TB10, Pc7, SI8, H7 and K1 => LR8, GB43.

Case 4 : violonist with cervicalgia

• Female, 32 years old, professional violinist with chronic cervicalgia. Pain is aggravated while flexing the neck.

• Hears a creak when she turns her head left. • Also expresses pain in the left hip and sciatica in the path of the

bladder channel.• Chronic fatigue. • Treatment :

– UB67 on the left + Lu5/LI2 on the right– Ren12 area with special technique (consecutive needling – 5 needles in

total) to take care of the “cracking” noise.– When we re-mention sciatica, puncture of UB2 left takes care of residual

pain.– I add Lu8, Xia San Huang, St36,37 to help with chronic fatigue.– No more pain or creak after only one session, patient also reported a

noticeable increase in her vitality. Qi Gong exercises is recommended as the main treatment strategy.

Jean-Sylvain Prot

• https://www.facebook.com/acupunturaibiza• http://www.acupuncture-ibiza.com• [email protected]

• Images are from Wikipedia • Case study charts are from Dr. Mukaino

• To read articles by today’s speaker, watch online videos, or to see his/her complete seminar/webinar schedule for this year, please visit www.elotus.org

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