Chinese Medicine continued from page 26
3. Ahshi points Ahshi points reveal local areas of qi and blood stagnation (qi zhi, xue yu). Often, the intended needle technique is to increase microcirculation of blood to this specific tissue or zone. Ahshi points are usually a sub-set of the above categories, as they may be found in a variety of tissues, including muscles and tendons. Comments Each of these points above will have a different explanation as to “how it works”. For instance, needling the belly of a muscle, or the muscle-tendon junction may result in a release and a lengthening of the entire tissue. This reduces the likelihood of a shortened and tight muscle-tendon complex being a pain generator. Often, needling a trigger point or a motor point will “turn on” a muscle that is weak and shut down by trauma or dysfunction. Manual muscle testing reveals muscle weakness before treatment, and muscle strength after treatment. The patient may have a kinesthetic experience of this muscle release or a weak muscle becoming strong from needling. They are usually grateful, and appreciate that you can give them a Western explanation that underlies the treatment protocol. We won’t abandon our roots, as the basis is still qi and blood in the affected tissues, but treating the stagnation and increasing micro-circulation in a tissue-specific way, not only makes for a comfortable reply to the patient and their original question, but results in very effective acupuncture treatments. Embracing the language of anatomically significant points allows us to communicate with others in the medical profession. It makes the acupuncture practitioner less of an outsider and we have hundreds of points yet to be classified in terms of their anatomical individuality. For the clinician, as well as the researcher, a whole new opportunity awaits, on a point-by-point basis. Needle Precision This discussion would not be complete without commenting on needle technique and the need for precision. Sometimes, a millimeter or two of depth makes a significant difference in clinical outcome. For musculoskeletal purposes, the author is currently working with a point density system. Point density guides the practitioner as to what may be felt during insertion as the needle passes deep to the dermis and epidermis. Using a scale from 1 to 5, the more porous tissue, like needling
butter, has a density of 1. Hard, bone or bone-like tissues have a density of 5. Therefore, densities in the range of 2, 3, and 4 are the variations of moving from porous tissue with little resistance to more dense and taut bands of muscle. By adding needle depth and density to the discussion, the practitioner may significantly increase precision, and therefore enhance clinical results. Conclusion Many acupuncture points have anatomically significant features. They help the practitioner in choosing points and point combinations through analysis, palpation, and orthopedic testing. Actions and indications naturally result from this anatomical knowledge base. We need to embrace the language used to describe these points as an integration of traditional acupuncture with western anatomical and orthopedic practices. If future texts are integrated, they will include anatomy and orthopedics along with the traditional description of the points. This allows the profession to gain precision on the location and needling of these points as well as strength in communicating to our patients and colleagues. OM
Affordable
Acupuncture Malpractice Insurance • PCOM students covered by AAC policy • Special PCOM Student discount when starting with AAC after licensure • Most comprehensive coverage for a low cost. • Quality customer service
References on Anatomical and Orthopedic Acupuncture (This is a partial list of resources)
Callison, M: Motor Point Index. AcuSport Seminar Series LLC, San Diego, 2007. Gunn, C: Treating Myofascial Pain: Intramuscular Stimulation (IMS) for Myofascial Pain Syndromes of Neuropathic Origin. University of Washington, 1989. Guo Chang-Qing: Anatomical Illustration of Acupuncture Points. Beijing, China (2008). Legge, D: Close to the Bone, Second Edition. Sydney College Press, Australia, 1997. Legge, D: Jing Jin: Acupuncture Treatment of the Muscular System using the Meridian Sinews. Australia (2010).
0711-AAC-OM
See illustration #3 Between Large Intestine 15 and Large Intestine 16 lies the AC joint, which could be defined as Large Intestine 15.5.
Coverage underwritten by Allied Professionals Insurance Company, a Risk Retention Group, Inc.
A Discussion on Anatomically Significant Points of Traditional
Reaves, W & Bong, C: The Acupuncture Handbook of Sports Injury and Pain: A Four Step Approach to Treatment. Hidden Needle Press, Boulder, CO (2009). Seem, M: A New American Acupuncture: Acupuncture Osteopathy. Blue Poppy Press, Boulder, Colorado (1999). Travell & Simons: Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 1 (The Upper Extremities). Williams & Wilkins, Philadelphia, 1983. Travell & Simons: Myofascial Pain and Dysfunction: The Trigger Point Manual, Volume 2 (The Lower Extremities). Williams & Wilkins, Philadelphia, 1992.
Whitfield Reaves, OMD, LAc has been working in the field of sports medicine since he first began practice in 1981. His experience includes the 1984 Los Angeles Olympic Games, as well as numerous track and field, ski racing, and cycling events nationally over the last 25 years. Whitfield is the author of The Acupuncture Handbook of Sports Injuries and Pain (Hidden Needle Press, 2009). He lives and practices in Boulder, CO, where he teaches his Acupuncture Sports Medicine Apprenticeship Program. He can be reached at his website www.WhitfieldReaves.com.
Oriental Medicine • www.PacificCollege.edu
SUMMER 2012 31
www.acupuncturecouncil.com