Movement Organized by the Channel Sinews

The Channels Organize Movement

If you are an acupuncturist, then you learned a portion of the above image. You learned this as the circadian cycle where energy is at is peak during a 24 hour time period. You also learned various channel correspondences. For instance, the following are internally-externally related channels: LU-LI, ST-SP, HT-SI, KID-UB, P-SJ, LIV-GB. And, finally, you learned the following six divisions: Taiyang (UB-SI), Shaoyang (GB-SJ), Yangming (ST-LI), Taiyin (SP-LU), Shaoyin (KID, HT), Jueyin (LIV-P). You already know that the channels in each of the 3 grouping above share many relationships.  

What you have not been taught, at least in a Chinese Medical Curriculum, is that movement is integrated around these 3 groupings. To fully understand this, you need to dive into the sinew channels (jingjin) and this is exactly what I have been exploring for the last 20+ years. This started with my interested in movement (taiji, qigong, bodyweight calisthenics), developed with my interest in fascial systems such as Anatomy Trains, and continued with exploration on approximately 100 cadaver dissections. This has led to the development of a comprehensive sinew channel model that is taught in the Sports Medicine Acupuncture Certification program where I am a faculty member.

This past Spring 2023, I presented on channels and movement at the first annual Pacific Sports and Orthopedic Acupuncture Symposium (PSOAS). The info below is a summary of this presentation and work I am continuing to develop.

The Channel Sinew Groupings & Functional Movement Patterns

While you can explore what an individual sinew channel does in terms of movement, there is greater benefit in understanding that functional movement patterns are organized by the groupings above. Most movements, especially full body movements  are too complex to analyze with a single channel. Take, for instance, something relatively simple such as a pull up. This movement engages many muscles of the back and involves the UB sinew channel. But the external shoulder rotators are also engaged which would be part of the SI sinew channel. And, if your form is good, there is engagement of core structures such as the transverse abdominis, part of the KID sinew channel. This relatively straightforward movement primarily involves expansive movements that lift and propel the body forward. These movements lift the body up (literally, in the image below), but also lift you into an upright posture, and they also stabilize the spine. They are controlled by the Taiyang and Shaoyin channel sinews.

 

Photo by Ruslan Khmelevsky: https://www.pexels.com/photo/muscular-sportsman-doing-pull-up-exercise-in-gym-4608157/

Other movement patterns guided by the Yangming-Shaoyin channels compress and hollow the body. They protract the scapulae, depress the chest, and flex the torso and hip. Hollow body holds, L-sits, a front kick, and many other movements fall into this category. These movements balance the expansive ones described above and there are many exercises that move back and forth between these two groupings. For instance, rowers would move back and forth between these phases; going into a compression so that they have more range as they engage the back, expand and propel forward as they pull the paddle through the water. You have to compress and load the spring before you expand, especially if you want to do it explosively. The spinal wave from White Crane qigong is another example of this ebb and flow and you can watch my video by clicking here. 

Photo by Andrea Piacquadio: https://www.pexels.com/photo/photo-of-male-gymnast-practicing-on-gymnastic-rings-3763702/

The final grouping involves the Shaoyang and Jueyin channels which execute two very related movement patterns; sidebending and rotation. This involves trunk and neck sidebending, but also abduction and adduction of the limbs, along with rotational movements. A very simple example is in a video below where I am swinging on monkey bars. This exercise illustrates both rotation, but you will also see sidebending if you watch the video; all engagements of the Shaoyang and Jueyin channels. Note: I mention the Gallbladder sinew channel in this video, but all of the channels in this category are involved. I was simplifying since it is hard to describe these types of concepts in a video without being distracting.

Photo by Los Muertos Crew: https://www.pexels.com/photo/woman-doing-sports-at-sports-hall-10039561/

Check out my Youtube channel where I will be exploring many of these concepts. If you do visit, especially if you find the information useful, please subscribe, like the videos, and comment on the videos. All of this helps build my channel and allows me to put the time into producing more content. Besides this, I appreciate the comments since it helps be continue to organize this information and we can all learn together!

---

Medical Qigong Schedule for June

I will be uploading some more posts soon and will find another place to post my class schedule. If you have found your way to my blog, scroll down for content regarding the sinew channels. In addition to acupuncture and manual therapy, qigong and other movement systems are the primary way I work with the sinew channels, and this is why I have my class schedule up on my blog.

Class Schedule for June

Monday	Tue	Wednesday	Thur	Friday	Saturday	Sun
Eight Pieces of Brocade 9:30-10:15am est		Eight Pieces of Brocade 9:30-10:15am est		Eight Pieces of Brocade 9:30-10:15am est	Taiji Ball 10:00-10:30 am est
Core Strengthening for Qigong 10:30-11:15 am est		Five Animal Sports  10:30-11:15am est			Five Animal Sports Practice 10:30-11:30 am est
		Medical Qigong for Acupuncturists 12:00-1:00pm est
Low Back & Hip  2:00-3:00pm est		Neck & Shoulder 2:00-3:00pm est

Classes may be added for June. Check back and refresh the page to see updated schedule

Class Fee $20/class or $50/month unlimited classes

Medical Qigong for Acupuncturists $30 per class (includes unlimited classes)

Class Descriptions

Eight Pieces of Brocade: This sequence includes 8 moves, each working on a specific organ system. This form is easy to do (but there can be a lot of nuance), does not require difficult stepping or shifting of weight and can even be done seated. This form is very accessible, but has much to offer for all. It can be very meditative and calming, as there is some repetition and less difficulty in terms of learning the moves.

Five Animal Sports: This sequence includes 5 moves that are part of each "Animal" (25 moves total). Chinese physiology has many correspondences, and each Animal represents and organ that is being worked on. This form is a bit more difficult, but can still be modified for individual health challenges. It does involve stepping and shifting, but it can be modified to be seated if necessary. This form is very dynamic and a lot of fun!

Core Strengthening for Qigong: Effective qigong practice requires physical strength, especially in key regions. This class will focus on core strengthening, the neck and shoulder muscles, the arches of the feet, and the legs, hip and gluteal muscles — all regions that can become weak and lead to poor posture, a compressed spine and poor circulation in the internal organs.
Recommended: Some exercises will be done lying down or seated, an exercise mat and folding chair (or other chair or stool) is suggested.

Taiji Ball: Involves various Qigong patterns using one larger or two individual handheld balls to improve the connection of the spine to the arm movement. These patterns can then be applied to taiji, five animal sports, eight pieces of brocade, and other forms.

Medical Qigong for Acupuncturists: This class will allow an opportunity to explore concepts much more in depth regarding how the movements massage/mobilize certain acupuncture points and regions, engage the channel sinews (jingjin), and massage/mobilize the internal organs (zangfu). The class will feature multiple qigong sets such as the eight pieces of brocade and five animal sports. There will be opportunity to improve your own health and learn effective strategies for working with patients.

Low Back & Hip: This class focuses on low back and hip health and is excellent for those with low back and hip conditions. The class features various qigong and corrective exercises which increase flexibility, strengthen important structures for low back and hip stability, balance the pelvic alignment, and strengthen the core. This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

Shoulder & Neck: This class focuses on the shoulder and neck region and is excellent for those with neck and shoulder conditions, headaches, and jaw tension. The class features various qigong and corrective exercises which increase flexibility, strengthen important structures for neck and shoulder stability, balance the neck, shoulder and head alignment, and strengthen the core. This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

Knee, Ankle & Foot: This class focuses on the knee, ankle and foot region and is excellent for those with conditions of these regions. The class features various qigong and corrective exercises which increase flexibility, strengthen important structures for knee, ankle and foot stability, and balance the pelvis, knee and foot alignment. This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

---

Medical Qigong - May Schedule

Email brian@ideal-balance.net for the Zoom Meeting ID and password
See below for class schedule and class descriptions

Class Schedule for May

Monday	Tue	Wednesday	Thursday	Friday	Saturday	Sun
Eight Pieces of Brocade (F) 9:30-10:15am est		Eight Pieces of Brocade (F) 9:30-10:15am est	Five Animal Sports  (SG) 9:30-10:30am est	Eight Pieces of Brocade (F) 9:30-10:15am est	Five Animal Sports Practice (F) 10:30-11:30 am est
		Medical Qigong for Acupuncturists (MQA) $30 12:00-1:00 pm est
Low Back & Hip  (SG) $20 2:00-3:00pm est		Neck & Shoulder (SG) $20 2:00-3:00pm est

Classes may be added for May. Check back and refresh the page to see updated schedule

F – Free; classes are follow-along. Group instruction is given, but not individual, due to group size and class structure. Donations are welcome but not required. Participants can use the Paypal donation link below (paypal account needed) or send an email and we can invoice you via Square. 

 

SG – Small Group; limited to 5 participants. Sign up beforehand by email to brian@ideal-balance.net; an email address is necessary to register. Instructor can see participants and will give individual instruction. Classes include qigong and other corrective exercises to improve strength, flexibility and function and overall health and wellness. Classes are $20 (invoiced via Square; do not use the donation link).

MQA – Medical Qigong (for Acupuncturists); limited to 5 participants. Sign up beforehand by email or phone; an email address is necessary. Instructor can see participants and will give individual instruction. Class will include active qigong instruction and integrated discussion of acupuncture points, channel sinews (jingjin) and zangfu and how these relate to the movements. Classes are $30 (invoiced; do not use the donation link).

T – Telemedicine (by appointment). Private one-on-one session. A telemedicine appointment is private and HIPAA-compliant and a detailed history and assessment is performed. A detailed treatment is given which can include self acupressure and massage (sometimes with tools such as a foam roll or therapy balls), specific corrective exercises prescriptions, core stabilization exercises, herbal medical prescriptions. Call or email to request an appointment.

Class Descriptions

Eight Pieces of Brocade: This sequence includes 8 moves, done individually, each working on a specific organ system. This form is very accessible and easy to learn, does not require difficult stepping or shifting of weight and can even be done seated.  

Five Animal Sports: This sequence includes 5 moves that are part of each "Animal" (25 moves total). Each Animal represents an organ that is being worked on from the point of view of Chinese physiology. This form is a bit more challenging and does involve stepping and shifting, but can be modified to meet individual needs and can be done seated if necessary. This form is very dynamic and a lot of fun!

Strengthening for Qigong: Effective qigong practice requires physical strength, especially in key areas. This class will focus on strengthening the core, the neck and shoulder muscles, the arches of the feet, and the legs, hip and gluteal muscles — all areas that can become weak and lead to poor posture, a compressed spine and poor circulation in the internal organs.
Recommended: an exercise mat and folding chair (or other chair or stool) is suggested, as some exercises will be done seated or lying down.

Low Back & Hip: This class is excellent for managing low back and hip conditions and features diverse qigong and corrective exercises to increase flexibility, balance pelvic alignment, and strengthen the core and important structures for low back and hip stability. 

This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

Shoulder & Neck: This class is excellent for managing neck and shoulder pain, headaches, and jaw tension. It features diverse qigong and corrective exercises to increase flexibility, re-align the neck, shoulder and head, and strengthen the core and important structures for neck and shoulder stability. 
This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

Knee, Ankle & Foot: This class excellent for managing knee, foot or ankle pain. It features diverse qigong and corrective exercises to increase flexibility, properly align the foot/knee/pelvis structure, and increase strength for stability in standing and walking. 
This class is good for both prevention and for general conditions, but for more severe pain, the telemedicine sessions might be indicated.
Recommended: Loose fitting clothing, mat, folding chair (or other chair or stool)

Medical Qigong for Acupuncturists: This class for healthcare professionals will explore from an in-depth clinical perspective how the movements massage/mobilize certain acupuncture points and regions, engage the channel sinews (jingjin), and massage/mobilize the internal organs (zangfu). Students will work with multiple qigong sets such as the Eight Pieces of Brocade and Five Animal Sports, to improve their own health and understanding, and to learn effective strategies for working with patients.

---

Injection and the Sinew Channels

Tomorrow I am a guest instructor with Christina Captain's excellent injection certification in Sarasota, FL. I have taught this class for several years. Below is a description of what I will be teaching, and what my philosophy is when using injection and when teaching.

First, I think that it is fantastic that some states have injection in the scope of practice for acupuncturists, as Florida does. It is a worthwhile endeavor for the state professional organizations to work towards expanding the scope to include injections in the states that do not have this. However, I don't think that acupuncture physicians should get too allopathic when using injection. We have this wonderful and extremely advanced channel system that is easy to lose sight of when we are all of a sudden using a hypodermic needle, especially when treating musculoskeletal pain and injury.

When I teach as part of this injection certification in Florida, I am there as a guest instructor from the Sports Medicine Acupuncture Certification program (SMAC). As a guest instructor, I am teaching injection for musculoskeletal pain, sports injuries, and other orthopedic conditions. So, much of what I teach is very influenced by what is taught in SMAC.

In SMAC, we do not teach injection. Very few states have this in the scope of practice and this is an international program. We teach how to assess and treat orthopedic conditions and how to integrate these treatments with Traditional Chinese Medicine (TCM) to build a comprehensive treatment protocol. These treatments build on what acupuncturists already know. For instance, is this an excess or deficient pattern? Does the person have Blood deficiency, Spleen Qi deficiency and Dampness, Kidney Yin deficiency? All of the elements that make our medicine so powerful are included and highlighted. Added to this is a comprehensive ability to assess specific musculoskeletal injuries while understand the muscle imbalances that contribute to these injuries. This means that we teach how to diagnose the specific injury and assess the imbalances in the sinew channel (jingjin) that contribute to the injury and prevent proper healing.

Treatments include the following local, adjacent and distal approach:

1. Specific, advanced needle techniques for the condition.
2. Treatment to balance the sinew channels which entails balancing overactive (excess) muscles  and inhibited (deficient) muscles. This includes acupuncture to the motor points of the muscles involved and to distal points along the channel that these muscles are a part of.
3. Myofascial release techniques to support the treatment and increase the therapeutic outcome.
4. Prescription of corrective exercises to support the treatment and correct muscle imbalances and postural disparities. 

In my mind, nothing changes when using injection. I can use injection as part of the local treatment. Often, I will be using the same local, injury specific technique. These techniques were developed by the founder of SMAC, Matt Callison, and are extremely effective with an acupuncture needle and can easily be adapted for injection. Added to this will be placing a homeopathic injectable solution (I use Heel products such as Traumeel and Zeel) at the site of injury which, depending on the injectable,  can help reduce inflammation, reduce irritation of a joint, nerve or muscle, and stimulate lymphatic circulation.

However, I still want to use acupuncture, myofascial release techniques and corrective exercises to balance the sinew channels and I still want to treat any zangfu imbalances that present with the patient. What I do not want to do, and what I want to encourage acupuncturists adding injection to their treatments not to do, is simply to inject the local tissue that is affected and lose sight of the comprehensive, holistic, and advanced nature of our medicine.

---

Reunion Zones (Muscle Meridian Meeting Points) and Myofascial Anatomy

In Chinese medicine school, many of us have studied reunion zones, which have also been called "muscle meridian meeting points." They involve the following points:

• Three Arm Yang: The temporal region. Points are ST-8 or GB-13 (depending on the source).
• Three Arm Yin: Under the axilla. Point is GB-22.
• Three Leg Yang: Cheek bone. Points are SI-18 or ST-3 (depending on the source).
• Three Leg Yin: Above the pubic bone. Point is Ren-3.

If you are like me, you memorized these points in school, possibly seeing them on the "Big Picture" chart that you diligently memorized in preparation for the boards. Chances are, nobody explained the significance of these, where this information came from, or whether it was even relevant. Why, for instance, is GB-22, a Yang channel point, the muscle meridian meeting point for the three Yin arm sinew channels?

To answer these questions, it is important to understand where this information comes from in the first place. These reunion zones or meeting points first appear in a specific translation and commentary of the Lingshu, in Chapter 13, which discusses the sinew channels or Jingjin. I refer to paragraph 13 of this chapter, as translated by Vietnamese scholar Nguyen Van Nghi.

The interesting thing is that this paragraph from the Lingshu is quite short and Van Nghi extrapolates significantly more in his commentary than is explicit in the original information. The actual text (translated into English) of the paragraph reads:

"In cases where the Zu Yangming (ST) Jing Jin and the Shou Taiyang (SI) Jing Jin are concomitantly affected, with deviation in the face and eyes accompanied by visual disturbances... the treatment is the same as that which was previously indicated."

Leading up to this, paragraphs 1-12 have outlined the topography of the 12 sinew channels along with basic symptoms of dysfunction and treatment. Treatment mostly involves fire needling of ashi points.

Van Nghi gives four pages of commentary on this short passage. In it, he defines these reunion zones based on regions (temporal, below the axilla, etc.), but does not indicate specific points (though images he uses do show points). Looking at the basic topography allows one to see that these pairings of 3 arm and leg Yin and Yang channels would all involve the above reunion zones, as all of these channel end at these sites. Van Nghi further states that, when all of these channels are involved (all of the 3 arm Yang channels, all of the 3 arm Yin channels, etc.) together, then these reunion zones become painful. More specifically, he states that when there is invasion of pathogenic factors in these pairings, then these reunion zones are always painful.

So, what is the relevance of these points? First, it is important to note that they do not appear in the Lingshu or the classics of Chinese medicine. But they are brought forward and discussed by Van Nghi, a well-respected scholar and physician of the past century. His commentary, with its descriptions of reactivity and pain associated with these pairings of three sinew channels, appears to convey that the relevance is its value in diagnostic work. In his commentary, he further discusses the season in which disorders generally appear for these pairings (for example, "Disorders in the Jing Jin of the three Yin hand channels generally appear in the course of the three months of winter.")

I feel an understanding of the underlying anatomy gives some perspective on these regions or points, and can help guide you as to when and if to use them. At the least, the anatomy can help understand how these pairings of channels meet in these regions. Let's take GB-22 or the region under the axilla as an example.

In my listing, the three arm Yin sinew channels include the following muscles and fascia:

• Lung sinew channel includes the pectoralis minor and the clavipectoral fascia.
• Heart sinew channel includes the pectoralis major
• Pericardium sinew channel includes the serratus anterior

The clavipectoral fascia (which envelopes the pectoralis minor muscle), the fascia of the pectoralis major, and the fascia of the serratus anterior all blend together in the region of GB-22. This is seen in the diagram below in the region of the suspensory ligament of the axilla which unites all of these channels and helps form the base of the axilla. GB-22 is one of several motor points of the serratus anterior (SP-21 is another). It, therefore has a direct influence on this muscle, but I feel that it influences all three muscles and associated channels. Although GB-22 is a Yang channel point, it is a motor point of a Yin sinew channel muscle (Pericardium) and exists at a region where the other Yin arm sinew channels meet.

These images highlight the merging of fascial planes of the 3 arm Yin sinew channels. The image on the left is from Netter's Atlas of Human Anatomy. The two images on the right are from Functional Atlas of the Human Fascial System by Carla Stecco.

---

Acupuncture Treatment for the Spiral Line

A common treatment we utilize in Sports Medicine Acupuncture® when there is strain along a sinew channel involves the classical needle technique of multiple needles along a line (pai ci). This treatment can help release bound fascia and restore length and range of motion along this line. This post will discuss an acupuncture treatment for shortening along the upper portion of the spiral line (SPL) discussed in Anatomy Trains; it is a useful protocol for posterior neck pain (often unilateral) when there are shifts and rotations seen between the pelvis, ribcage, and neck.

The SPL is a myofascial structure that winds around the body. Posturally, it can be be associated with rotational distortions and shifts of major body structures. Often times, it is involved with more superficial counter rotations to deeper core rotational patterns, such as those caused by having one psoas shorter than the other.

First, a word about what the SPL is and how it relates to the sinew channels. The SPL is a myofascial meridian discussed in Thomas Myers' book Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. There are strong parallels between the sinew channels discussed in Chinese medicine and the Anatomy Trains (myofasical meridians) discussed by Myers. I have used this book, along with other sources, as one of my references as I determine which myofascial (muscles and fascia) structures belong in which channel. This sinew channel information is then taught in the Sports Medicine Acupuncture Certification program (which, for this certification cycle, is in Chicago).

While there are points in common, there are also key differences between which structures make up the sinew channels and which are discussed in Anatomy Trains. The spiral line, however, is not similar to any one sinew channel, and can be seen as a unique structure. Actually, it involves the interaction of multiple sinew channels, primarily the Urinary Bladder, Gall Bladder, and Stomach sinew channels.

The upper SPL travels from the ASIS of one ilium, crosses to the opposite ribcage, wraps around to the posterior torso and travels under the scapula, and crosses back around to the other side at the spine (on the same side as it started) to connect to the neck. For instance, if we started at the left ASIS, it would incorporate the left internal oblique muscle, the right external oblique to the right serratus anterior, and right rhomboids (see the last post on the rhombo-serratus sling), then crossing over to the left splenius cervicis and splenius capitis to attach at the left transverse processes of C1-C3 and head. There would be a parallel structure on the opposite side of the body starting at the right ASIS and ending on the right C1-C3 transverse processes.

When there is shortness in one SPL, the ASIS will be closer to the contralateral lower ribcage. This will be seen with a ribcage that is shifted left or right in relation to the pelvis (shifted towards the ASIS of the short SPL) and/or rotated in relation to the pelvis (rotated toward the ASIS of the short SPL). This will be caused by shortness in the fascial sling of one internal oblique and the contralateral external oblique and serratus anterior. In addition, the head will then be shifted in the opposite direction in relation to the ribcage and/or there will be lateral flexion of the cervical spine. This will be caused by shortness in the remaining portion of the sling, which includes the serratus anterior and rhomboids (rhombo-serratus sling) and the contralateral splenius cervicis and capitis. Assessment of this involves a visual observation of the patient's posture.

Once it is determined which side is short, the following acupuncture protocol can then be added to the treatment. This protocol will release the bound fascia and restore length to the shortened SPL. This shortened side will frequently correlate to the side of the neck pain that a patient comes in complaining about, and can include trigger points in the shortened splenius cervicis, trigger points in the levator scapula (which will also often be in a shortened position), facet joint pain on the side of the shortened splenius cervicis (and the side of lateral flexion compressing the cervical facets on that side, and many other cervical complaints.

The protocol includes the following points:

• GB-26 (the motor point of the internal obliques) and the contralateral LIV-13 (the motor point of the external obliques).
• Serratus anterior MP on the same side as LIV-13.
• Rhomboid major and minor motor points on the same side as LIV-13.
• Huatuojiaji points associated with attachments of the splenius cervicis and rhomboids (usually T2-T3 are reactive).
• Bailao (the motor point of splenius cervicis) and splenius capitis motor point (close to GB-20), both on the same sides as GB-26.

This entire protocol can be performed with the patient prone as GB-26 and LIV-13 can both be reached with the patient in a prone position. Adding distal points creates a more balanced treatment. These can vary based on other findings, but a typical protocol is included in the figure to the right and these points are highlighted in red. This includes:

• BL-62 and contralateral SI-3 (SI-3 on the side of cervical pain). This combination addresses the Yang Qiao and its paired Du mai. The Yang Qiao involves the coordinated interaction between the Urinary Bladder, Gallbladder and Stomach sinew channels.
• GB-41 and contralateral SJ-5 (SJ-5 on the side of the short rhombo-serratus sling). GB-41 and SJ-5 address rotational aspects of the pattern.
• LIV-5, Adductor longus motor point, Quadratus lumborum motor point (on the side of the elevated ilium). This combination addresses the deeper underlying core imbalance. This shortness in the Liver sinew channel on one side will often cause deeper rotations which will result in counter-rotations mediated by the SPL.

---

Fascia Fiber Direction, Myofascial Release, and Acupuncture

Fig. 1: Electron microscope view showing
the endomysial layer¹ 

The image to the right (Fig. 1) shows the endomysium, the )fascial compartment that wraps individual muscle fibers. A simplified schematic is shown below (Fig. 2). The cross-linking fiber direction is particularly worth noting, as this can inform clinical strategies. These strategies are especially relevant to tuina (particularly myofascial release), but can also inform acupuncture needle manipulation.2

Beginning with myofascial release, it is important to note what happens to the fibers of the endomysium as a muscle is locked into a lengthened position (locked-long) versus locked into a shortened position (locked-short).3

Fig. 2

When locked-long, the endomysium cross-linked fibers are pulled horizontally, and they become increasingly more parallel to the muscle fiber length. A slow, sustained myofascial release stroke in the direction of the muscle fiber would further move these fascial fibers into this parallel arrangement, which could ultimately be counterproductive for long-term change of the patient.

However, this same slow, sustained myofascial release stroke perpendicular to the fiber direction would result in a positive re-balancing of the fascia, which would enhance the ability of the muscle to return to its normal resting length. So, in effect, this stroke against the muscle fiber direction could be considered a tonification technique.

Fig. 3

For the locked-long muscle to optimally return to its resting length, it is important to also address its antagonist. This frequently involves muscles that are on the internally-externally related sinew channel. For instance, someone with upper cross syndrome would have an overlengthened lower and middle trapezius and rhomboids. These are part of the Large Intestine sinew channel and, in this case, would benefit from the tonification technique described above.4

However, the pectoralis minor, part of the Lung sinew channel, would be in a shortened position (excess) and would benefit from an MFR stroke in a direction with the muscle fibers; a sedating technique.4 This directional stroke would reorganize the fascia and provide the most precise communication to the tissue.

How does acupuncture fit into this? First of all, proper needling to the motor points of both the locked-long and locked-short structures would help reset the dysfunctional muscle-spindle relationship of these muscles, and the myofascial release would help reset the fascia. 

Fig. 4 Image showing collagen fibers
wrapping around the needle6 

Acupuncture needle technique can also involve moving fascia. After needling acupuncture points, the needle can be turned in one direction (just like we were taught NOT to do in acupuncture school) until the needle can no longer turn. Now the needle has wound a considerable amount of collagen fibers around it. Then, the needle can be pulled in the appropriate direction to reroute the fascia. Over time, the fascia will loosen around the needle and the needle can be removed, though it is important that you remember which direction you turned it in case there is difficulty*.5

Imagine a patient with overpronation of the foot. The peroneals are now in an overlengthened position and are pulled up fascially, much like a shirt sleeve that is pulled up on the arm. Needling the motor points of peroneus longus and brevis, winding the needle, and them pulling downward, will help reset the dysfunctional muscle and fascia. Following this with a deep cross-fiber spreading of the tibialis anterior will balance the relationship of the tibialis anterior with the peroneals. This will balance Earth (tibialis anterior/Stomach sinew channel) with Water (peroneals/Urinary Bladder sinew channel).

*This technique is best taught in a classroom setting. Please do not attempt unless you have practiced under supervision first.

References:

1. Purslow, Peter P. "Muscle Fascia and Force Transmission." Journal of Bodywork and Movement Therapies 14.4 (2010): 411-17. Web. 

 2. Spina, Andreo A. "The 'Direction' of Fascia." Web log post. Functional Anatomy Blog. 10 Mar. 2011. Web. 16 Feb. 2016. 

3. Myers, Thomas. "Lengthening Fascial Tissue: Working with the Grain." Web log post. Anatomy Trains. 25 June 2014. Web. 16 Feb. 2016. 

4. Lau, Brian S. "Anatomy of the Sinew Channels Module 2: Head, Neck, and Upper Extremities." Sports Medicine Acupuncture Certification: Anatomy, Palpation, and Cadaver Lab. Pacific College of Oriental Medicine, San Diego. Lecture. 

5. Callison, Matt. "Assessment and Treatment of Lower Extremity Injuries." Sports Medicine Acupuncture Certification. Marina Village, San Diego. 17 Oct. 2015. Presentation.

6. Langevin, Helene M. "The Science of Stretch." The Scientist Magazine. 1 May 2013. Web. 16 Feb. 2016. 

---