Points Database

Location Guides:

: Yanglingquan : Yang Mount Spring

GB-34 : Foot Shaoyang Gall Bladder 34

Classifications:
He-Sea and Earth point

Hui-Meeting point of Sinews
Ma Dan-yang Heavenly Star point
Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)

Location:
Below the lateral aspect of the knee, in the tender depression approximately 1 cun anterior and inferior to the end of the fibula.

Needling:
Perpendicular or slightly oblique posterior insertion 1 - 1.5 cun, or through needles to Yinlingquan Sp-9, in which case locate in a slightly more distal position, or transverse insertion inferiorly for "Yang penetrating needling".

TCM Actions:
Benefits the sinews and joints
Activates the channel and alleviates pain
Spreads liver qi and benefits the lateral costal region
Clears liver and gall bladder damp-heat
Harmonises shaoyang

TCM Indications:
  • Disorders of the sinews, contraction of the sinews, contraction and pain of the calf muscles in sudden turmoil disorder, contraction of the sinews of the foot, stiffness and tightness of the muscles and joints, numbness, hemiplegia, stiffness of he neck and shoulders, pain of the shoulders, pain of the elbow, atrophy disorder and painful obstruction of the lower limb, swelling, pain and redness of the knee, cold painful obstruction of the hip and knee, sciatica, numbness and pain of the thigh and knee, coldness and pallor of the feet, leg qi.
  • Diseases of the Gall Bladder, fullness and pain of the lateral costal region, frequent sighing, fear of people as if about to be apprehended, constipation, enuresis, epilepsy.
  • Bitter taste in the mouth, dry throat, vomiting, jaundice, chills and fever, malaria, swelling of the face and head, hypertension.

    Neuroanatomy:
    Superficial Innervation: Lateral cutaneous nerve of the calf (L5 - S2)
    Dermatome Segment: L5
    Deeper Structures: Common peroneal nerve (L4 - S1)

    Trigger Point Associations:
    Muscle: Peroneus longus
    Myotome Innervation: Superficial fibular (peroneal) nerve from common peroneal nerve (L4 - S2)
    Pain Referral Pattern: On that lateral malleolus
    Indications: Strain of foot evertors ; Ankle sprain

    Notes:
    The principle point for pain, cramping, contraction, stiffness or sprain of muscles and sinews anywhere in the body.

    Ling Shu Ch. 6 suggests piercing the He points of the Yang channels if a disease is in the Yang of the Yang realm (e.g. the skin). This would mean using this point, presumably needled at a very superficial level, to treat skin level disorders relating to this channel.

    Combining this with the needling techniques described in Chapter 7 we could suggest using either superficial needling here to influence pathogens in the skin, or leopard spot needling (three needles aimed at letting blood from each side) for pathogens in the Blood.

    Ling Shu Ch. 9, On Ends and Beginnings, advises that in the case of Heat associated with receding Yin Qi the Yang conduit should be pierced once and the Yin conduits twice. Based on other recommendation to use the He-Sea of the Yang conduits (Ch. 19) and the Yuan-Source with the Ying-Spring points (Chs. 6, 19 and 24) to clear Heat from the Zangfu, that would suggest this point, Taiching Liv-3 and Xingjian Liv-2 as a protocol to clear Heat in the Liver/Gall Bladder. Next it advises that in Cold associated with receding Yang Qi the Yang should be pierced twice and the Yin once but no such obvious protocol is evident for this situation.

    Ling Shu Ch. 19, on the Four Seasonal Qi, advises using the He-Sea points in autumn when diseases are in the Fu organs.

    Another Tung point, Ce San Li, Side of the 3 Miles (77.22), is located midway between thjis point and Zusanli St-36, 0.5 - 1.5 cun anterior to this point. It is often combined with a second point, 2 cun inferior called Ce Xia San Li, Beside and Below 3 Miles (77.23) and together they are indicated for all problems of Yangming and Shaoyang channels (Chu, 2015).

    In "Yang penetrative needling", to promote flow of qi through the foot shaoyang Gallbladder meridian, needle transversely through Yangqiao GB-35, Guangming GB-37 as far as Yangfu GB-38 (Liu Yan, 2008, Diagrams of Acupuncture Manipulations, p.140).

    Lad and Durve (2008) in Marma Points of Ayurveda call this point lateral Charana and associate it with Apana Vayu, Vyana Vayu and Shleshaka Kapha.

    They give the following functions:
    - Promotes circulation in lower extremities
    - Acts locally to relieve knee pain
    - Supports the kidneys, bladder and adrenals

    A medial Charana is located at Ququan Liv-8.

    In Thai massage:
    Acupressure point along the Sahatsarangsi (left) and Tawaree (right) sen lines. Probably the same as Zusanli St-36.
    Indicated for gastrointestinal ailments, indigestion, insomnia, menstruation disorders, PMS, reproductive ailments and stomach ache.
    (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)


    Reference Notes: (click to display)