The SCM is an interesting muscle for many reasons. It can be a frequent contributor to muscle tension headaches, which is the primary reason I would include direct needling to this muscle. However, there are many other conditions that would lead me to include this muscle in treatment, such as positional vertigo, ear pain or ear stuffiness, and atypical facial pain.
I authored a post that that appears on the Sports Medicine Acupuncture (SMA) blog for July, 2020. This post features more specific information about the SCM muscle, along with information regarding its channel correspondences which will help the acupuncturists when putting together a comprehensive point prescription. Also, there is a video with demonstration of needling for the SCM muscle.
Below is a video that features a self-myofascial release technique for the SCM muscle. This is a pin a stretch technique which can be taught to patients following treatment. This muscle, when locked-short, frequently responds well to further intervention and it can be helpful for patients to perform the technique between treatments. Make sure that you are comfortable with this technique yourself. The pressure is not excessive and you are medial to the carotid artery, so this should not be a problem if the technique is performed correctly. However, you would want to make sure that patients know where the fingers are placed and that they stay on the muscle during the movement.
Below is a schedule for online medical qigong classes. Medical qigong uses movements that promote circulation of qi to prevent illness and help support the body for better healing potential when people are ill. The movements massage the internal organs and promote good circulation. The approach I teach uses traditional concepts, but integrates Western exercise and health concepts which address muscle imbalances, strengthen the core, and mobilize joints. These movements look to the channel sinews as the link between the Western and Eastern concepts. I will write more in future blog posts about this and highlight various movements and how they relate to the channel sinews and the organs.
Email brian@ideal-balance.net for the Zoom Meeting ID and password
Class Schedule for April
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Eight Pieces of Brocade (F)
9:30-10:15am est
Eight Pieces of Brocade (F)
9:30-10:15am est
Five Animal Sports
(SG) $20 9:30-10:15am est
Eight Pieces of Brocade (F)
9:30-10:15am est
Five Animal Sports Practice (F)
10:30-11:30am est
Opening the Breathing (F)
10:30-11:15 am est
Medical Qigong for Acupuncturists(MQA)
10:30-11:30 am est
Medical Qigong for Acupuncturists
(MQA)
10:30-11:30 am est
Low Back & Hip
(SG) $20
2:00-3:00pm est
Knee, Ankle and Foot (SG) $20
2:00-3:00pm est
Neck & Shoulder (SG) $20
2:00-3:00pm est
Classes may be added for April. 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, and participants can follow the donation link at the bottom of the page. SG – Small Group; 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. Classes include qigong and other corrective exercises to improve strength, flexibility and function and overall health and wellness. Classes are $20 (invoiced; 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. Classes will include active qigong instruction and integrated discussion of acupuncture points, the 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 sessions. This telemedicine appointment is private 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, 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! 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.
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)
Opening the Breathing. This class supports the other classes by focusing on proper use of the chest and shoulder girdle muscles, so that the chest can remain open during practice and breathing can be regulated.
Fig. 1: This myofascial release technique on the posterior intermuscular septum of the thigh (the fascial septum between the adductor magnus and the medial hamstings) is taught in the Assessment and Treatment of the Channel Sinews class in Sports Medicine Acupuncture Certification. It is a technique that could be used to treat the Kidney channel as discussed in this post.
I authored this month's SMA (Sports Medicine Acupuncture®) blog post, which is on assessment and treatment of the channel sinews for posterior and medial knee pain. It focuses common injuries associated with the Urinary Bladder and Kidney channel sinews (jingjin), including upper gastrocnemius strain, hamstring tenosynovitis (both of these are associated with the UB jingjin), and MCL injury (associated with the KID jingjin). Check it out.
At the end of the post, I discuss how treatment of the channel associated with the injury does not always yield lasting results. Obviously, acupuncturists know this. We have many channel relationships that help guide our clinical decision making. Sometimes we treat the channel that is associated with an injury; sometimes we treat the internal-external pair; sometimes we treat based on six divisions; sometimes we use midday-midnight correspondences; and sometimes our decision-making can be even more complex. The channel system is very interdependent and it is not always as simple as treatment including local, adjacent, and distal points where all of these are on the same channel.
In the SMA blog post, I gave an example of treatment of upper gastrocnemius strain and/or hamstring tenosynovitis (UB jingjin) when there is a loss of integrity of specific ligaments associated with the KID jingjin. In these cases, the gastrocnemius and hamstrings will need to make up for the loss of stability in the knee due to the loss of integrity of the ligaments. To get lasting results in this case, one must address the Kidney channel. There are many ways that one can accomplish this and I don't want to get into treatment in this post. Regardless of whether you are using acupuncture, regenerative injection techniques, manual therapy, or other tools, communicating with the Kidney channel will keep the UB structures from having to overwork as they attempt to stabilize the knee.
Fig. 2
There is another example that didn't get explored in the SMA blog post for space reasons. It has to do with the relationship of the UB and the KID jingjin and their associated myofascial structures, the hamstrings and the adductor magnus. The hamstrings are associated with the UB jingjin and the KID jingjin. The two superficial hamstrings (the biceps femoris long head and the semitendinosus) are part of the UB jingjin while the semimembranosus is part of the KID jingjin (Fig. 2).
Fig. 3: The semimembranosus removed on the right to reveal the '4th hamstring'.
There is also a '4th hamstring' which is comprised of the biceps femoris short head and the adductor magnus (Fig. 3). The adductor magnus is not technically a hamstring, but the middle fibers are fascially connected with the biceps femoris short head and this pair can be considered as a 4th hamstring. This '4th hamstring' is discussed both by Tom Myers in his book Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists, and by Janet Travell in her book Myofascial Pain and Dysfunction: The Trigger Point Manual.
To recap, there are two pairs of hamstrings; a superficial pair (biceps femoris long head and semitendinosus; both associated with the UB jingjin), and a deep pair (semimembranosus and biceps short head/adductor magnus; both associated with the KID jingjin). The video below explores the anatomy of these two channels in the foot, ankle, leg and thigh.
Back to the topic of this post; how one channel can influence another and how an injury associated with one channel might require treatment to a related channel. The hamstrings get their blood supply from perforating arteries which branch off of the deep femoral artery (femoral artery profunda), which itself is a branch off of the femoral artery. The name 'perforating arteries' implies that they perforate something, which they do. They perforate the adductor magnus on their way to the hamstrings (Fig. 4). If the adductor magnus is short and tight, this could definitely restrict blood flow to the hamstrings. If you have a patient that comes in with chronic hamstring problems, maybe it is worth assessing and treating the adductor magnus. You will be assessing and treating the KID jingjin to help with any work you do with the UB jingjin. The image at the top of this post shows a myofascial release technique which frees obstructions in the posterior intermuscular septum of the thigh (between the adductor magnus and the medial hamstrings)
Fig 4: Gray's Anatomy illustration showing perforating arteries perforating the adductor magnus on their way to the hamstrings. Hamstrings are not shown in this illustration so that the arteries can be seen.
Flexor carpi ulnaris manual muscle test,
a useful test for medial epicondylitis.
I have had a very busy Fall, and have not been able to post here lately. However, I did just finish a blog post for the Sports Medicine Acupuncture® blog. The link is below; the post includes a video of a recent Sports Medicine Acupuncture dissection highlighting the Heart sinew channel. Check it out! The title is Medial Epicondylitis and the Heart Channel Sinews.
September kicked off Module 2 of the Sports Medicine Acupuncture Certification (SMAC) in San Diego, CA. Updates and upgrades are an ongoing feature of the SMAC program, and in this Module we debuted a new class: "Assessment and Treatment of the Channel Sinews (Jingjin): Low Back, Hip and Groin." I will share some info from this class in an upcoming blog post and the upcoming classes for the Lower Extremities (Module 3) and Head, Neck & Upper Extremities (Module 4).
A picture I took with four practitioners who live near me in Tampa, FL. It is alwasy great to meet new people in SMAC, but is especially an honor to work with practitioners who I am already friends with!
After the September SMAC class, Sports Medicine Acupuncture® hosted a 5-day dissection class in Boulder, CO at the Laboratories of Anatomical Enlightenment. In this 5-day class, participants, including myself, worked in teams of 6, each with their own cadaver specimen. As in all Sports Medicine Acupuncture dissections, these specimens are non-chemically treated cadavers, which offers a superior experience for holistic practice as it keeps the fascia intact and you get a much better view of the real tissue quality. All acupuncturists should take the opportunity to do dissection such as this; there really is no substitute for it. I will share some specific experiences from this event soon, and we will be hosting another program, probably a 4-day, sometime in the Spring. Check the SMA page for updates.
After the Boulder dissection class, it was back to San Diego for the completion of SMAC Module 2: Low Back, Hip and Groin. The two remaining classes were Assessment and Treatment of Low Back, Hip and Groin injuries, and Postural Assessment and Corrective Exercises (PACE).That wraps it up for Module 2, and we will start back up with Module 3 in the new year.
In the first week of November, I attended a 5-day taiji and qigong workshop at the new International center of the Taoist Tai Chi Society. I won't go into detail about this workshop here, but I will say that my taiji and qigong practice (which I started in 1998) was the first experience I had with the channel sinews. In my practice, we discuss certain 'tendon changing and marrow-washing' exercises. These 'tendons' may run all the way up the body. Obviously, these are not what Western anatomists refer to as tendons, but are, instead, myofascial planes of tissue that fit the template of how I discuss the channel sinews. This practice was the foundation which led to my ongoing exploration of the channel sinews.
Finally, on November 14th, I was privileged to be a guest on the terrific podcast, "Qiological", hosted by Michael Max. This was a panel discussion on myofascial trigger points, orthopedic acupuncture, and dry needling; but also on channel theory, language, and continual learning. The panel included Michael Max, my friends and colleagues Josh Lerner and Fernando Bernall, and myself. This was a fascinating discussion and I am looking forward to its release on Qiological. It will likely be released early for subscribers. I recommend subscribing, not just to listen early, but as a great way to support the efforts that build and grow our profession; this podcast and its growing community are part of those fantastic resources!
This yoga pose (Parivrttha Janu Śirsāsana - revolved head of the knee pose) features rotation and movement of the ribcage, especially highlighting the lower ribcage and its ability to move in relationship to the pelvis. This movement is moderated by the Gallbladder sinew channel. Image of Tricia Amheiser used with permission, http://iy-sp.com/s-p
This will be the first in a series of posts looking at the channel sinews (jingjin) and their role in normal (and dysfunctional) movement of the pelvis, hip, and low back. This first post will explore the Gallbladder sinew channel and its role in both stability and movement between the pelvis and ribcage. These functions are necessary for balanced movement in the low back and hip region, and failure of this channel to perform these functions can be a cause, or at least a significant contributor, to pain of the low back and hip.
This post will specifically highlight the role of the movement between the ribcage and the pelvis, and also the pelvis and the sacroiliac joint. The reader is encouraged to visit a recent post on the Sports Medicine Acupuncture blog written by Matt Callison, L.Ac on the assessment and treatment of sacroiliac joint pain with acupuncture and Chinese medicine. For the most in-depth information on treating sacroiliac joint pain for the TCM practitioner, I recommend the upcoming Sports Medicine Acupuncture Certification classes which will cover this and other conditions affecting the low back and hip.
There is a video below which demonstrates a myofascial release technique for the Gallbladder sinew channel. This technique helps free the ribcage from the pelvis and can be used to round out a comprehensive treatment plan for sacroiliac joint pain, lumbar facet syndrome, and many other pain patterns of the low back and hip.
Fig 1:
Venus with the Apple, 1813-1816.
Contrapposto, or counterpoise, in visual arts refers to the pose of a figure with the weight on one leg and the various tilts, shifts and rotations of the pelvis, ribcage, shoulder girdle, neck and head that arise from it. While this is a bit of an exaggerated pose, many patients will exhibit some of these tilts, shifts and rotations. This will be evident in their normal standing posture and as they move, as an imbalance can be observed with the swaying, rocking and turning of the body.
Fig. 2
The myofascia of the Gallbladder sinew channel greatly influences this balance between the left and the right sides of the body, as it provides lateral stability to the body segments (such as the pelvis), but also allows movement between body segments (such as between the ribcage and the pelvis). In Sports Medicine Acupuncture® we include the following myofascial structures in the Gallbladder sinew channel:
Iliotibial band
Tensor fascia lata
Gluteus medius, minimus, maximus
External obliques and internal oblique
Serratus anterior and pectoralis minor
Upper trapezius
Note: this is not a complete list, and some of these muscles are shared in other channels.
In particular, the hip abductors such as the gluteus medius and minimus need to stabilize the pelvis on the weight-bearing leg so that the ilium does not excessively rise and the pelvis does not excessively shift laterally. The weight of the body as it is supported on one leg would drive the ilium on that side superior and away from the midline (think of the 'sway' seen when a model walks on a runway). Look again at the statue in Fig. 1 and note the failure of the gluteus medius and minimus on the right to stabilize the lateral pelvis. The hip abductors would be locked-long and the femur is adducted.
Fig 3: Gluteus medius and minimus manual muscle test. The practitioner pushes the patient's hip into adduction while the patient engages the hip abductors to resist. The practitioner is looking for a locking of the hip indicating that the gluteus medius and minimus are strong. Image courtesy Matt Callison/Sports Medicine Acupuncture
This supportive function of the Gallbladder sinew channel can be assessed with a gluteus medius and minimus manual muscle test (Fig. 3), examining the portion of this channel which stabilizes the pelvis on the lateral side and prevents excessive upward and outward movement of the pelvis during weight bearing. This resistive muscle test assesses the ability of these muscles to respond to added force applied to them, which demonstrates how they respond as weight is transferred into the leg during the weight-bearing phase of gait. This and other MMTs are taught in Sports Medicine Acupuncture Certification; they are a valuable assessment for muscle function and, therefore, sinew channel function and health.
Fig. 4
While there needs to be stability in the Gallbladder sinew channel, it also needs to allow expansion so that the ribcage can move away from the pelvis. This occurs in movements such as walking, reaching, standing up from a seated position, and climbing stairs. The ability of the ribcage to move away from the pelvis is controlled and stabilized by the internal obliques; this allows for expansion without an excessive flaring of the ribs, You can observe the loss of this function when you see patients excessively bend the torso from side to side as they walk (not enough movement) or patients with excessively flared lower ribs (not enough stability).
The ability of the pelvis to move away from the ribcage can be assessed as follows (Fig. 4): The patient stands with one leg forward and one back, with the weight initially on the back leg. As they stand up on the front leg, they reach forward and up with the opposite hand (shoulder flexion to 120 degrees). As they reach, you visually observe and/or feel whether the ribcage is able to move away from the pelvis without excessively leaning back (posteriorly tilting the ribcage) and compressing the lumbar region. You can also observe whether the scapula is able move away from the ribcage. In other words: is there expansion along the channel, allowing for differentiated movement?
It is not uncommon for one or both sides to have restrictions in this part of the Gallbladder sinew channel, binding the ribcage to the pelvis and/or binding the scapula to the ribcage. The abdominal obliques and the latissimus dorsi, part of the Gallbladder sinew channel, need to be supple and flexible to allow this independent, yet connected, movement of the body segments. See below for a myofascial release technique to free the ribcage from the pelvis. This can be done after acupuncture treatment.
Fig. 5: Cat Cow, image courtesy
Matt Callison/Sports Medicine Acupuncture
Observe as the ribcage moves with the pelvis: notice that it tends to move in a particular way. As the ilium goes into posterior tilt, the lower portion of the ribcage follows the inclination of the pelvis and moves posterior, causing the entire ribcage to tilt anterior (Fig. 5, top image). As the ilium goes into anterior tilt, the lower portion of the ribcage follows the inclination of the pelvis and moves anterior, causing the entire ribcage to tilt posterior (Fig. 5, bottom image).
This related movement of the ribs and ilium is normal, but fascial shortening and/or muscle inhibition can occur and prevent it from moving freely. Such restrictions might fix the lower ribcage in a position where it is held anterior or posterior. This could be a bilateral imbalance, or it might be different on the left and the right side. This twisting from side to side is frequently seen with sacroiliac joint pain. Why? The twisting in the lower ribcage (one side anterior, the other posterior) is a response to a twisting in the two ilia of the pelvis (one side anterior tilted, the other posterior tilted); the sacrum will also rotate in response to the twist between the two ilia. This means that there is a relationship between the holding patterns of the ilia, the sacroiliac joints, and the two sides of the ribcage. Unwinding one has an effect on the others.
Fig. 6
Let's state that again in a bit more detail, first highlighting the pelvic movement.The left and right ilia should be able to move in a contralateral motion, for example in walking and running. As one leg goes into hip flexion, the corresponding ilium rotates posteriorly. As the other leg goes into hip extension, the other ilium rotates anteriorly. This is vital for the health of the right and left sacroiliac joints, which move in conjunction with this contralateral motion of the ilia.
It is frequently the case that movement is easier in one direction than in the other. For instance, maybe the runner in Fig. 7 moves very easily as she swings her left leg back (left ilium rotates anterior as it follows the hip extension, right ilium rotates posterior as it follows the hip flexion), but less easily and with reduced range of motion as she swings her right leg back (right hip extension and left hip flexion). If this were the case, her left ilium would probably be anteriorly tilted and her right posteriorly tilted. This is sometimes referred to as pelvic torsion or a twisted pelvis. The sacroiliac joint is part of this twist and will often become painful on one side.
Fig. 7
The lower ribcage tends to follow the pelvis. The more anterior the ilium tilts, the more anterior the lower ribcage moves, and the more posterior the ilium tilts, the more posterior the lower ribcage moves. For the runner, it may be that the right lower ribcage moves back more easily (following the right arm swing) and the left lower ribcage moves forward more easily (following the left arm swing), but these sides do not move well when the position reverses.
Let's revisit the assessment illustrated in Fig. 4, which looks at the ability of the ribcage to move away from the pelvis. The left image below (Fig. 8) shows assessment of the ability of the ribcage to move away from the pelvis and the lower ribs to move forward. The one on the right shows assessment of whether the ribcage can roll back into line with the pelvis. Both are important movements.
With sacroiliac joint pain, the goal is often to balance the left and right sides. With acupuncture, corrective exercises and manual therapy, you would address the level of restriction at the sacroiliac joint, balance the pelvis (especially if there was a twist), and balance the ribcage (especially if there was a twist). The technique in the video below is just one part of this, and it would mobilize the ribcage away from the pelvis. To complete the treatment, one would work with any zangfu disharmony or other TCM patterns.
Fig. 8: The ribcage moves away and flares out on the left. The ribcage has difficulty rolling back on the right.
One last thought on the relationship of this channel to the organ network: as TCM practitioners know, the sinew channels do not attach to the zangfu. Nevertheless, there is a relationship of this sinew channel to the Gallbladder organ and its related yin organ, the Liver. Consider the movement we have been discussing regarding the lower ribcage movement. This forward and backward movement matches the mobility of the liver organ (and the gallbladder, which is structurally bound to the liver), which also rolls backward and forward as part of its movement (referred to as inspir and exspir). Freeing any stuck areas in the lower ribcage would allow these organs to have the freedom to move within their range of motion, something that is very important for their health. Conversely, if these organs are under duress, they will often become stuck and will limit the range of motion of the lower ribcage. Treating any signs of Liver or Gallbladder disharmony will help with the health of these organs; it will also make the manual technique below much easier to do and allow its effects to be longer lasting.
Fig. 1: A technique referenced below which can be used for pes planus
Last Fall, Matt Callison and I put together a presentation for the Pacific Symposium in San Diego, CA. We presented on pes planus, a condition where the foot rolls into excessive pronation during weight bearing due to a collapse of the medial arch.
In the presentation, we discussed assessment and treatment of pes planus and discussed some common injuries associated with it. The role the channel sinews (jingjin) play in proper support of the medial arch and how imbalances can contribute to pes planus was emphasized. This month, Matt Callison will be expanding on this presentation for the keynote presentation at the Sports Acupuncture Alliance. I won't be able to make this event, but thought I would write a bit of an intro for those attending. You can consider this a study guide.
For those not able to attend, you can get a small flavor of the class and start to play with some of the information. If you are interested in expanding on this, it is taught in the Sports Medicine Acupuncture Certification starting in San Diego, June 19-24.
Fig. 2 Pronation includes dorsiflexion, eversion, and abduction;
supination includes plantarflexion, inversion, and adduction.
During gait, the foot is in supination at heel strike. After heel strike and as the weight travels into the foot, it transitions into pronation as it absorbs the body's weight (Fig. 2).
Normal pronation causes an increase in tension (a good thing, in this case) as the elastic myofascial structures in the foot are lengthened. The result of this is an elastic recoil which helps propel the weight off the foot and back into supination.
Fig. 3
In pes planus, the foot over-pronates and cannot recover into supination for adequate push-off from the big toe (Fig. 3).
Due to the altered mechanics in the foot and into the leg, pes planus sets a person up for a host of potential injuries such as plantar faciosis, Morton's neuroma, tibialis posterior tendinopathy, tarsal tunnel syndrome, Achilles tendinopathy, shin splints, medial knee injuries and injuries into the low back and hip. Clinicians working with these conditions will achieve far better results if they help correct pes planus, thus reducing the mechanical strain that led to the injury.
For the acupuncturist, it is important to understand the channel relationships associated with pes planus. This can be facilitated by looking at the muscles and other fascial structures which support the medial arch and understanding which channel sinew they are part of. The two main channel sinews which support the medial arch are the Spleen and the Kidney. The relevant anatomy is below:
Fig. 4: Yellow line is tibialis
posterior (medial side) &
anterior (lateral side) - SP&ST;
blue line is peroneus longus
and brevis - UB;
black line is soleus and
abductor hallucis - KID.
Kidney jingjin - soleus, plantar fascia (main portion), abductor hallucis
The Stomach jingjin is also involved. A relevant structure is the tibialis anterior which also helps support the medial arch.
In pes planus these structure fail to lift the medial arch, they are inhibited and become over-lengthened as the foot overpronates. The qi of these structures is dropped and needs to be lifted.
In pes planus as the Spleen and Kidney jingjin fails to lift and support the medial arch, other structures become excessively shortened. These structures are part of the Urinary Bladder jingjin and include:
Urinary Bladder jingjin - gastrocnemius, peroneus longus and peroneus brevis, adductor digiti minimi, plantar fascia (lateral band)
In pes planus the Urinary Bladder jingjin is locked-short and is pulling excessively up. The qi of these structures excessively lifts and needs to be dropped and lengthened.
A technique that we teach in SMAC and Matt will be teaching at the Sports Acupuncture Alliance involves needling motor points of the involved structure and lifting, dropping, or lengthening the channel sinew. This is an advanced technique and can best be taught in a class setting. There is a sample in the image at the top of this blog post which involves lengthening the lateral band of the plantar fascia, a myofascial structure which becomes short and tight in pes planus.
