Friday, November 25, 2022

The Dai Mai and the Lumbar Plexus

What is it about the dai mai that would make a gallbladder channel point (GB 41 zulinqi) have such an influence on it? Or, stated another way, what is it anatomically that connects these? I feel there is a relationship when you look at the neuromyofascial anatomy. 

Dai Mai: Channel Images from A Manual of Acupuncture, by Peter Deadman

I hear many people say that the transverse abdominis (TrA) is the
 dai mai I think this is not too far off, but it is not technically correct. Interestingly, the TrA is one of the girdling structures of the core and is, in my opinion, a muscle associated with the kidney channel. For ease. I teach that it is part of the kidney sinew channel but actually the kidney luo-connecting channel describes this anatomy the best. The luo channel follows the primary channel in the abdomen. The depth is not described, but it is likely at the depth of the TrA which is the deepest abdominal muscle. The channel then follows as the TrA connects to the diaphragm. which takes it all the way to the central tendon of the diaphragm. The central tendon is a point just below the pericardium, as the pericardium attaches here from above.

The TrA also wraps around and connects with the lateral raphe. This fascial layer then separates into layers of the thoracolumbar fascia and connects with the lumbar multifidi. This is posterior to the spinal column and accessible at the huatuojiaji points. The TrA works with the lumbar multifidi to decompress and stabilize the spine. 

If I have convinced you that the kidney channel relates to the TrA, now we have three things that need to be connected. 1) the dai mai, 2) GB 41, and 3) the kidney channel. Fortunately, there is a really notable link to all of these and this is the lumbar plexus.

The lumbar plexus runs from L1-L4 and has contributions from T12 via the subcostal nerve. The subcostal, iliohypogastric, and ilioinguinal nerves all exit the lumbar plexus, wrap around the abdominal wall, pierce and innervate the lower portions of the abdominals such as the TrA, and obliques. and then become cutaneous.  To me, these nerves are a better representation of the dai mai. 

KID Divergent

Another link of the dai mai and lumbar plexus can be observed. The kidney divergent channel is said to intersect with the dai mai at L2. This channel traverses from the KID 10 region and travels cranially. The pathway, at least, the lower half, follows another nerve of the lumbar plexus which does come from L2. This is the obturator nerve. So, if the kidney divergent channel does have something to do with the obturator nerve (which I think it does) and the dai mai does have something to do with other nerves from the lumbar plexus (which, again, I think it does), then they literally do connect and intersect at L2. 

The final link is that the gallbladder sinew channel is a myofascial plane that runs up the lateral side of the body. It includes the obliques, which are muscles that are innervated from the nerves listed in the lumbar plexus. I think that it is a very plausible that acupuncture to the distal portion of this myofascial plane at GB 41 would communicate mechanical information in the channel, affecting the tone and tension in the obliques, thereby stimulating the nerve coming from the lumbar plexus and innervating these muscles at points such as GB 26 (the motor entry point of the internal obliques) and GB 27 (possibly also a motor entry point of the abdominals). 

I have taught this material at two conferences in 2022. The first was at the Neuroscience Acupuncture Conference and the recording is available through the Neuroscience Acupuncture Conference website.

I also taught a version of this class at the Pacific Symposium, but it was not recorded. 

Finally, the video below looks at activating and strengthening the gallbladder sinew channel, including the obliques. This is to improve the stabilization role of this channel, and balance the left and the right sides and, also the lateral and medial portions of the body. I will be recording another series for this channel soon that has more to do with the rotational role of this channel. While one series will focus more on stabilization and the other on rotation, They each have elements of both stabilization and rotation, You will see some rotation as I get my body into position to activate the channel. When you look at the biomechanics of the pelvic and spinal joints, you see how integrated these to movements are and this helps understand the role of the gallbladder sinew channel for both stabilization and rotation. This starts to highlight the dai mai and its coordinating role for these movements. 

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