Points Database

: Xuanzhong : Suspended Bell

GB-39 : Foot Shaoyang Gall Bladder 39

Classifications:
Hui-Meeting point for Marrow
Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Location:
Above the ankle joint, 3 cun superior to the prominence of the lateral malleolus, between the posterior border of the fibula and the tendons of peroneus longus and brevis.

Needling:
Perpendicular insertion 1 - 1.5 cun. The practitioner should use the index finger from one hand to separate the peroneal tendons from the fibula and emphasise the groove, then needle into the groove, at first slightly posteriorly for 0.5 cun and then perpendicularly, to avoid hitting the fibula.

Warning:
Movement of the patient's ankle after needling can result in a bent needle. For this reason the point should be needles last and the patient instructed not to move the leg after needling.


TCM Actions:
Benefits the sinews and bones
Benefits the neck
Dispels wind-damp
Clears gall bladder fire
Activates the channel and alleviates pain

TCM Indications:
  • Stiffness and pain of the neck, atrophy disorder, chronic painful obstruction, wind-taxation with heaviness of the body, injury by cold pathogen leading to taxation, deficiency-taxation, contracted sinews and pain of the bones, hip pain, numbness and pain of the knee and lower leg, sciatica, leg qi, sprain of the ankle joint, flaccidity of the foot.
  • Hemiplegia, headache, dizziness, throat painful obstruction, nosebleed, dryness of the nose.
  • Distension and fullness of the chest and abdomen, counterflow qi and cough, soreness and pain of the lateral costal region, swelling of the axilla.
  • Fullness of the abdomen in children with inability to eat or drink, fullness and distension of the Heart and abdomen, heat in the Stomach, no pleasure in eating, watery diarrhoea.
  • Injury by cold leading to heat with persistent fever, haemorrhoids, agitation and fullness, mania, anxiety, indignation and anger, the five types of painful urinary dysfunction.

    Neuroanatomy:
    Superficial Innervation: Superficial fibular (peroneal) nerve (S4 - S1)
    Dermatome Segment: L5

    Trigger Point Associations:
    Muscle: Peroneus tertius
    Myotome Innervation: Deep fibular (peroneal) nerve (L4 - S3)
    Pain Referral Pattern: To heel and dorsum of foot
    Indications: Strain of foot evertors ; Ankle sprain

    Notes:
    As hui of marrow this point is used mainly for weakness, flaccidity, contraction and pain of the limbs.

    In Tung acupuncture the Yi Zhong, First Layer, point is located here. It is often combined with Er Zhong, First Layer, 2 cun above at Guangming GB-37, and San Zhong Third Layer, 4 cun above this point Waiqu GB-36, all anterior to the fibula. They are all used for symptoms of the Gall Bladder channel, especially those in the neck and throat (goiter, thyroid, soreness or pain), Wind or Yang rising (Bell's Palsy, migraine, Parkinsons) and problems of the liver and spleen (Chu, 2015).

    In Thai massage:
    Point along the Sahatsarangsi (left) and Tawaree (right) sen lines ascending up the outer leg (Salguero & Roylance, 2011, Encyclopedia of Thai Massage)


    Reference Notes: (click to display)