SI 3 (Houxi), Du Mai, and the Small Intestine Sinew Channel

What is it about SI 3 (Houxi), a point along the Small Intestine channel, that makes it the master point for the Du Mai? I feel that the specific anatomy associated with the Small Intestine sinew channel, especially at the upper cervical region, helps give insight.

I interpret the Small Intestine sinew channel as containing the following myofascial structures:

• Abductor digiti minimi
• Flexor carpi ulnaris (ulnar head)
• Triceps
• Rotator cuff muscles (supraspinatus, infraspinatus, teres minor; subscapularis is not included in this channel)
• Levator scapula
• Atlantooccipital joint capsule
• Digastric and styloid muscles
• Hyoglossus
• Buccinator

Image adapted from Gray's Anatomy

The levator scapula, in particular, helps link the Small Intestine sinew channel to the Du Mai. This muscle attaches to the posterior tubercles of C1-C4. From these attachments, there exist many fascial connections to the ligamentous structures of the superior vertebral column. These structures include the joint capsules, transverse ligament, and the midline ligaments (supraspinous, infraspinous, and posterior longitudinal ligament). 

Even tone of the levator scapula at these attachments helps produce balance at the upper reaches of the vertebral column, thus linking the SI channel network to the Du Mai. SI-3 is the Shu-stream point of the Small Intestine channel and "Augment the qi and warm the yang, and transform dampness". These actions would be useful when there is degeneration and inflammation of the ligaments of the spine. Adding BL-62 (Shenmai), the master point of the Yang Qiao, also addresses the suboccipital muscles, which are also integral to balance along the upper the spine. 

When these structures are out of balance, fixation of the atlanto-occipital joint can occur. This can have a local effect at the occiptal region, and can have effects further away, especially at the lumbar spine. In SMAC (Sports Medicine Acupuncture Certification) we teach a protocol to address this which was developed by program founder Matt Callison. Assessment of this is beyond the scope of this post, but treatment involves specific needling techniques at BL-10 and GB-20 to address the short and fibrotic (excess) side and to address the more lengthened (deficient) side. This is combined with the extraordinary vessel point pair SI-3/BL-62. The treatment also includes mobilization of the atlanto-occiptal joint to return proper function.

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The Sinew Channels at the Pacific Symposium

I have not posted in a while and plan on starting up again. Below is a bit of a summary of what I have been doing and some thoughts on future posts.

On Saturday, October 29^th, Matt Callison and I presented at the Pacific Symposium. We presented on the work we have been developing on the sinew channels (some of which has been featured on this blog). This presentation covered background on sinew channel study from the Lingshu to the present, and discussed what we are using to further expand this concept. This includes modern functional anatomy, fascial research, ongoing cadaver studies, and clinical observation, among other things.

We then explored a few channels (Urinary Bladder sinew channel, Liver sinew channel, Gallbladder sinew channel, Small Intestine sinew channel) and looked at some clinical examples. We performed a few demonstrations on volunteers from the audience for Iliac Crest Syndrome (we referred to this as Yaoyan syndrome, as the pain presents at the extrapoint Yaoyan) and on Levator Scapula Syndrome. In both examples, we looked at the common muscle imbalances and, through the lens of the sinew channels the channel imbalances associated with these pain syndromes individually. These pain syndromes tend to be associated with an elevated ilium (with Yaoyan syndrome) and a elevator scapula (for levator scapula syndrome). 

Finally we discussed how these two syndromes are commonly seen together, and specifically how assessment and treatment of the quadratus lumborum (part of the Liver sinew channel, Fig. 1.) and the levator scapula (part of the Small Intestine sinew channel) represents a midday-midnight channel relationship (Fig. 2).

Recently (12/1-12/4), I retook a visceral manipulation course through the Barral Institute. I have been interested and influenced by this work for a long time and plan on studying it in earnest this coming year. While this blog focuses on the development of a more anatomically precise model for the sinew channels, I believe that visceral manipulation gives much insight into how the internals relate to the myofascia (how the primary channels nourish and influence the sinew channels). This will be discussed further in a future post. For now, I will share an image of the liver and its relationship to the diaphragm and the quadratus lumborum. Jean-Pierre Barral, the developer of visceral manipulation, feels that excessive energy in the liver disperses into the quadratus lumborum and psoas muscles (Fig. 3). Again, more discussion on this is to come.

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