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LEARN THE SCIENCE. PRACTICE THE ART. HEAL.
www.eLotus.org
Master Tung's Acupuncture and the Balance Method for Pain
By
Jean-Sylvain Prot, L.Ac.
Leading Acupuncture CE Provider For On Demand CEU/PDA in the office, at home or on the go. Choose from videos, audio, articles or streaming Live webinars.
Lotus Institute of Integrative Medicine PO Box 92493, City of Industry, CA 91715 Tel: 626-780-7182 • Fax: 626-905-6887 Website: www.eLotus.org • Email: [email protected]
LEARN THE SCIENCE. PRACTICE THE ART. HEAL.
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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
« 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
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. 2
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 !!!
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. 3
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.
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. 4
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.
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. 5
Leg Movements
20. Lateral rotation21. Adduction22. Abduction
Perform the channels Test Perform the channels Test
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
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.
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. 6
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.
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. 7
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
• 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.
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. 8
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
• 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.
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. 9
Clinical diagnoses to which this muscle symptoms may contribute• Bicipital tendonitis• Costochondritis• Supraspinatus
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.
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. 10
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.
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. 11
Clinical Diagnoses To Which The ExtensorCarpi Radialis Muscle May Contribute
• 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.
Identify Abnormal Areas
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.
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. 12
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
• 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.
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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
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
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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:
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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
Identify Abnormal Areas
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
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Clinical diagnoses to which the palmarislongus muscle symptoms may contribute
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.
Identify Abnormal Areas
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
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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
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
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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
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.
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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 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.
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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.
• 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.
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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.
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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
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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.
Identify Abnormal Areas
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,
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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
• 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
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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.
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. 26
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
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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
• 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
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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
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
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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
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
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. 30
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
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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)
• 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.
• 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
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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
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.
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.
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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.
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(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.
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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
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.
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.
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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
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.
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
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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.
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.
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– 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
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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.
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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
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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,
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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.
• Images are from Wikipedia • Case study charts are from Dr. Mukaino
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