In this post, I will explore the role of tension in the myofascial system and how this relates to qi stagnation, meridians, and acupuncture.
Tension is a common word used in clinics to describe headaches, stress, bottled-up emotions, hypertension, pain, qi stagnation, liver yang patterns, and more. In the dictionary, tension is defined as 1) a pulling force or stretch and 2) mental or emotional pain.
Like the meridians, the myofascial lines connect the entire body.
Tensegrity
Tensegrity is a combination of the two words tension + integrity = tensegrity.
In the myofascial system, the tension within the muscles and fascia plays a fundamental role in maintaining the structural integrity of the body. The internal fasciae also play key roles in both the structure and functions of the organs and systems. As fascia connects the internal and external body structures, they are similar to the internal-external connections between the meridians and zang-fu organs. As such, a fascial model supports many of the traditional meridian theories.
Additionally, this is interesting to consider from a TCM perspective because we often equate tension with liver patterns and conditions such as pain at GB 21 and tight rigid muscles. To treat liver qi stagnation, our goal is to promote the smooth flow of qi and liver shu-xie function, thus restoring integrity and balance to the system. Many of the symptoms we associate with liver qi stagnation can also be viewed from the perspective of tension in the fasciae.
Tensegrity as used in Western terms describes a system of compressed parts in a net of tension, and how tension moves through the system. This is similar to our ideas about meridians, qi flow, and acupunctures therapeutic effects. When qi stagnation is present it results in diverse symptoms, and when we move the qi with acupuncture, beneficial results can be achieved.
Knowing how to move and release tension with acupuncture in the internal and external fasciae is vital to achieving better clinical results.
Thinking in terms of myofascial lines and tensegrity is extremely helpful to acupuncturists because it gives us an anatomical and mechanical way to diagnose and treat. It also broadens our perspective and can allow us to better understand how structural dynamics can be related to patients' symptoms. Additionally, equating meridians to myofascial lines allows us to comprehend the powerful effects of distal needling, and how we can combine movement with distal needling for added benefits.
Four Gates, LI 4 and LV 3
Let's consider this famous point combination for moving qi from a myofascial perspective.
In myofascial line anatomy, we can see that LI 4 is located on the Superficial Back Arm Line (SBAL) and that LV 3 is on the Deep Front Line (DFL). The muscles on the SBAL include the trapezius, deltoids, forearm extensors, and the muscles between the metacarpals. The DFL structures include the visceral fascia, diaphragm, inner thigh muscles, and tibialis posterior which is accessible through points like KI 7, KI 8, KI 9, SP 6, SP 7, SP 8, and SP 9. The dorsal interossei muscles between the toes will also affect the DFL, so points like LV 3, ST 43, and GB 41 will influence the DFL.
In meridian theory, qi moves through the meridians and when we needle a point like LI 4 or other points on the SBAL, it will affect the SBAL muscles and fascial connections. As LI 4 is on the SBAL, it can release tension held in the trapezius and at GB 21. Since the trapezius also extends up to the skull and down to the middle of the spine, LI 4 will also affect the neck, shoulders, and many of the back shu points.
This explanation may partially account for some of the reasons why LI 4 is so effective for moving qi through the body. Similarly, other points on the SBAL like Luo Zhen, SJ 3, and SJ 5 are well known for treating neck pain, and the effects of these points on the neck are likely occurring via releasing tension in the trapezius muscle. Anyone with extensive experience with these points may have noticed that they tend to work best for neck pain that is at the more superficial levels, and points like SI 3 and 77.01 - 77.03 are better for deeper-level conditions.
The Leg Yin Merdians and Deep Front Line
Examining the Deep Front Line more closely, we find that it includes deep pelvic structures, the diaphragm, the pericardium, and the fasciae that surround the organs. We should also remember that many of the leg yin points like LV 3, SP 6, SP 9, and KI 7 are known to affect the reproductive, digestive, respiratory, and circulatory systems. Both LV 3 and KI 7 are indicated for lung patterns, and while this is difficult to understand in Western terms, we see that the DFL provides a direct fascial connection between the lower leg muscle tibialis posterior and the thoracic diaphragm.
Similarly, LV 3 and SP 6 are used for reproductive, digestive, and heart disorders. The pericardium itself is part of the DFL and has direct connections to the diaphragm. When there is tension in the diaphragm, this could affect the pericardium and create disharmonies between the lungs and heart. Tension in the diaphragm can also get transmitted down the DFL, and needling points like LV 3, KI 7, and SP 6 will release tension through this myofascial line and restore integrity and balance to the system.
The next time you have a patient with shallow breathing, lung disorders, and tightness in the diaphragm, notice what can happen after just needling LV 3, KI 7, and/or SP 6.
Tension moves through the fasciae
and distal needling is highly effective for many disorders.
The Jue Yin and Liver-Lung Connection
The liver and pericardium relationship is also known as the jue yin and they are thought to be deep meridians. The liver and lung meridians also share a connection, as they represent the end and beginning of the cycle of qi in the body. Meridian theory states that this connection between the liver and lungs occurs at the junction of LV 14 and LU 1, as well as with the horary cycle at 3 am.
The myofascial model allows us to understand the anatomical relationships between the jue yin and the liver-lung association.
Anatomically, the liver is connected to the diaphragm via the triangular ligaments and coronary ligaments. Similarly, the pericardium attaches to the superior surface of the diaphragm. This reveals that the diaphragm is an essential link between the jue yin liver and pericardium organs. Additionally, this connection substantiates the traditional view of a connection between the liver and lungs.
Pericardium
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Diaphragm
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Liver
Tension in any of these structures can affect the connecting units along the myofascial line. Similarly, sticking a needle in the foot sends mechanical (myofascial signals) through the line to affect distant structures. This is the case with neurological signals that get sent from nerves in the foot to regions in the spine and brain, and while much of acupuncture can be understood through its effects on the nervous system, it is essential to understand how myofascial (mechanical) signals also get sent to distant connected structures.
Our job is to find where the patient holds tension and how to best release it. Myofascial anatomy has many insights about how to do this with distal points.
While some of the above explanations may sound complex, it is just a matter of following the anatomy of meridians and myofascial lines to understand how points on the limbs can affect internal organs and other non-local regions of the body. When this is understood and integrated with biomechanics and studies in structure, alignment, and posture, a whole new world opens up that allows acupuncturists to deeply comprehend how points work the way they do.
Additionally, this synthesis of myofascial lines with meridian theory, point functions, and various styles of acupuncture allows for a truly unified way to approach traditional medicine.
In seeking to unravel the enigma of acupuncture, and why points function the way they do, it is essential to understand the anatomical and myofascial basis for the meridians. This knowledge shines a light on many mysteries and contributes to a modern discussion about acupuncture and how to best use it to serve our clients.
Respectfully,
James Spears M.S.
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