I have been teaching anatomy and acupuncture point location for years. It has made me think a great deal about how acupuncture is related to the physical structure of the body. The deeper you dive into anatomy, the more relationships you see between acupuncture and the physical structure of the body.
A good place to begin is with fascia. Fascia is a type of connective tissue primarily made up of collagen. It spreads through the body providing form and stabilization for muscles and organs. This complex structure holds the body together, providing unity, and interconnectedness.
Fascia located in one area – can affect tissue located in another more distant area. This "one area affects another area" quality is similar to what is seen in many types of bodywork, including acupuncture.
There is growing research providing evidence that connective tissue fascia is important to health. I want to tackle each aspect research into fascia, piece by piece, in this blog.
A great place to start is with the work of Thomas Myers. Mr. Myers has a lifetime of studying the structure of the body and the fascial network. He is the author and creator of Anatomy Trains, a comprehensive study of fascia.
Part of the work Mr. Myers has done with Anatomy Trains is extensive dissections of the body — not muscle by muscle — but along lines of tension within the fascia.
Myers explains his work as follows:
“…all our muscles have been analyzed as if they were separate units within the body. This idea...is so pervasive, that it is hard to think in any other way. But in fact all the muscle tissue is embedded within the single, ubiquitous fascial webbing of the extracellular matrix (ECM).”
“The Anatomy Trains concept maps out these [connections] within the body — following the grain of muscle and fascia to see what links with what."
His dissection results are amazing, beautiful, and important for acupuncturists.
When the body is dissected along "lines of tension and pull" we can see patterns incredibly similar to acupuncture channels. In this published article we can clearly see similarities to the Urinary Bladder Channel, the Stomach Channel and the Gallbladder Channel.
The more refined images of fascial dissections show the familiar branching we are accustomed to within acupuncture. The primary acupuncture channels, which branch into smaller more delicate channels, share a similar structure to what is seen with fascia.
Note: the image above is based on this photo from Anatomytrains.com
What Does It Mean?
To see and realize the channels have a physical and tangible underpinning is powerful — powerful for working acupuncturists, students of acupuncture, and clients alike.
I have found when talking to potential clients who are skeptical of acupuncture, explaining the fascial connections in the body helps them see how acupuncture can be a helpful treatment option. Likewise, when discussing my clinical work with a medical doctor, nurse or physical therapist, this fascia discussion gives me solid footing.
Do these findings about fascia explain everything about acupuncture? Not at all. Qi. Blood. Shen. Yin. Yang. All of these remain powerful and independent concepts separate from fascia and the patterns they produce.
Traditional Chinese herbal medicine has lost nothing acknowledging the existence of chemical compounds. In the same manner, nothing is lost by embracing the similarities between fascial connections and the channels of acupuncture. The fascial patterns outlined by Mr. Myers are wonderful, powerful tools which can be used by acupuncturists and acupuncture students alike.
I sometimes find the traditonal sayings quoted in TCM distracting and even a little unhelpful. When I was a student I simply memorized these quotations. As a instructor, I now try to ground the quotes in concrete examples.
One of the most famous of these traditional sayings is:
This is a beautiful TCM concept: two distinct entities, Qi and Blood, linked together intimately. Throughout TCM, Qi and Blood are discussed as two different substances. At the same time tradition teaches that they are never isolated from one another. Giovonni Maciocia’s, The Foundation of Chinese Medicine clearly says, “Qi and Blood are inseperable.”
How are we to think of Qi and Blood? Are they one thing? Or are they two? How can two things be so inseperable?
This is where a houseplant can help.
A plant gets nourishment from a mixture of soil and water where it is planted. The soil and water are two distinctly different substances. The soil is full of nutrients which the plant needs. The water provides the mechanism by which the nutrients are absorbed through the roots. Both the soil and the water are indispensable to the plant. A big pot of just water does not help the plant. Neither does dry soil. Both soil and water need to be present for the plant to thrive.
Look at it from the plant’s perspective –— the soil and water are essential to life and linked together. If the plant could talk and write a TCM book, the plant could very well say, “Soil and Water are inseparable.”
If it was a very poetic plant it might even go so far to say,
In this sense we can see how two clearly distinct substances can be intimately linked together. The same is true of Qi and Blood. Each provides energy and structure for the other. Each needs the other to move through the body. Qi without Blood is soil with no water. Blood without Qi is a puddle of water. Together, Qi and Blood provide substance and energy to the whole body.
The traditional sayings of TCM have lasted hundreds of years because they express profound truths about the human condition. These sayings are beautiful and enduring, and when grounded in the real world, even more helpful.
All of the Inner UB Shu Points are located in muscle tissue above the lungs. As a result it is important to understand the anatomy of this space and needle accordingly.
It is recommended to needle the inner line of UB channel (11-23) with an oblique insertion towards the spine. The oblique insertion helps protect from deep needling. But why does the recommendation, “towards the spine," exist?
Consider a cross-section of the trunk. This allows one to see the shape of the ribs and lungs. The ribs are curved and form an arc between the scapula and the spine. The deepest aspect of this curve is near the spine.
The inner UB line is just medial to the highest and most superficial aspect of the ribs. If we needle medially from the inner UB line we are needling with the curve towards the area where the lungs are deepest and most protected.
The back Shu Points are wonderful and powerful points. Using the natural geometry of the body to our advantage we can needle these points safely and with confidence.
[Note: I discuss needling back UB points further in The Big Picture Book of Point Location V.2]