Acupuncture & Myofascial Lines
for the Hips, Pelvis, & Low Back
James Spears M.S.
Intro
What meridians are affected?
The Anatomy of 4 for Treating the Tan’s 6 Systems
Hip. Posterior, Anterior, Lateral,
and Deep (Groin) Regions.
Movement is necessary for
getting good responses for
treating the hips.
Understand how to use arm and
leg points and when they will and
will not be effective.
Non-local (distal) needling vs.
local or direct needling.
Start with distal needling & move Images derived from:
Tom Myers, Anatomy Trains, Elsevier Publishing
proximally or toward the area of
pain.
3 Categories of Patients Based on Responsiveness
Hip Pain & System 6
Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. American Family Physician. 2014; 89(1): 27 - 34
From: Diagnostic Approach to Hip Pain: Zoe J. Foster, M.D., 2018
The Yin - Yang of
Contraction & Strain
Pain may be felt in areas of muscular contraction or strain. For any muscle that shortens there are
antagonists which lengthen. Chronic contractions and strains effect the opposing muscle groups.
Understanding these dynamics will allow you to have more accurate diagnoses, reduce adverse needle
reactions, and get you better clinical results,
Direct and local needling into contractions and strains vary according to:
Acute Sprains and Strains (lengthening of the muscles) & Acute Contractions and Muscle
Spasms - Don’t needle locally for most acute conditions. Start with non-local system 1.
Chronic Contractions & Strains and Trigger Points - These often respond with local needling, but
local needling may also aggravate some conditions, especially if it is a neuropathic condition
and in cases of hypertonicity. Structural and postural changes are often necessary. System 6.
1. Chronic contraction or strengthening in one group of muscles can cause the antagonist to
become weak and strained.
2. Discuss how this relates to various patterns and disorders of the hips and back.
3. Treatment Principle: Ease chronic contractions and strengthen where there is strain.
Tensegrity
Tensegrity = tension + integrity. Describes systems of
compressed parts in a net of tension, and how tension Chronic Contraction and Strain
moves through a system. Like the meridians the fascia are
an integrated system that connects the entire body.
Tension is a pulling force and creates strain.
Our job is to find where their tension is being held
and how to best release it. How does tension move in
each client? What group of 3 - 6 needles will best
release it?
Fascia connect the interior and exterior and play structural
and functional roles. Externally, junctions in the fascia often
correspond to meeting points in meridian theory. Internally,
the fascial connections relate to internal - external meridian
theories and Tan’s systems.
Dr. Helene Langevin’s research has shown that
acupuncture stretches fascia when grasp and twirling
occur. (1,2)
Myofascial Lines Images from:
Tom Myers
Anatomy Trains, Elsevier Publishing
Superficial Back Line Superficial Front Line Lateral Line
Myofascial Lines
Deep Front Line Spiral Line Back Functional Line
(DFL) (SL) (BFL)
4 Myofascial Arm Lines
Superficial Back Arm Line (SBAL) Superficial Front Arm Line (SFAL)
Deep Back Arm Line (DBAL) Deep Front Arm Line (DFAL)
Section 2
Common Hip Points &
a System for Treating the Hips & Pelvis
(Abbreviated Sample from Course)
Common Points for Hip Pain
TCM
LI 4, SJ 5 & GB 41 Tung’s Points for the Hips
GB meridian points: GB 29, GB 30, Shoulder Triplets - SBAL
GB 31, GB 34, GB 41 33.08, 33.09 - SBAL
UB points: UB 40, UB 57, UB 60 Thigh Nine Miles 3 - GB / LL
ST: ST 31, ST 40 Hip Triplets - Local
Groin Pain
ST TCM - LV 3 & Local Points on the LV and SP
Tung Style for Groin Pain
Ling Gu (22.05) / LI 4.5
33.08 33.12
33.09
TCM Styles
Primarily utilize the GB & UB meridians (LL & SBL). Liver and kidney
patterns may also be recognized, as in bi syndrome. (LV and KI are DFL).
Tung’s Points
The Shoulder Triplets and 33.08 & 33.09 are on the SBAL, and can effect
the glutes through the Back Functional Line. These only get to a
superficial level, and can be as effective as needling distal points on the
GB meridian like GB 31, Thigh Nine Miles, GB 34 - GB 39 region.
SBAL Back Functional Line
Mahar’s Hip Triplets are local points in the hip but needled on the opposite
side as the pain.
Local Points for Hip Pain
88.08 (Maher) Pacify the Spine Three Needles: From
UB 36 move medial and lateral 0.5, 1.5 and 2.5 cun.
88.09 (Maher) Fortify the Hip Three Needles: First
point 1/2 way between apex of iliac crest and greater
trochanter.
GB 29 + GB 30
Much like the shoulder locating the 3 - 5 of the
most sensitive points and surrounding the hip
is an effective local technique. Needling may
be done ipsilateral or contralateral.
For non-reactive clients local points with EA
may be necessary for optimum results.
Additional Points for Hip Pain
Leg Yin Meridians - DFL - LV 3 - LV 11, SP 6 - SP 9 (Lower Three Emperors), KI 7, KI 8 Xi - Cleft YQ, KI 9
Xi - YW, DFL Points for pelvic conditions, Yin Qiao indicated for hip and low back. Tung’s point groups
- feet, legs, thigh.
ST Meridian - Four Horses for LU deficiency back pain, anterior hip pain, and APT (system 6).
UB Meridian - UB 40, UB 57
Leg Lines for Hip Pain
Research Review
Acupuncture Provides Short-term Pain Relief for Patients in a Total Joint Replacement Program
Crespin D., Griffin K., et al. Pain Med. 2015 Jun; 16(6): 1195–1203.
Note: This study was done on patients with knee and hip replacements at the Joint Replacement Center in Abbott
Northwestern Hospital at Minneapolis, Minnesota from 2010 - 2012
Treatment Methods: Bilateral LI 4, LI 11, non-surgical limb ST 36, GB 34, SP 6, LV 3, auricular points - hip point and ear
shen men. For cases with bilateral surgery no leg points were done. Results: “Average short-term pain reduction was 1.91
points (95% Confidence Interval: 1.83, 1.99), a 45% reduction from the mean pre-pain score. Forty-one percent of patients
reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after
acupuncture.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478153/
Section 3
Hip Anatomy & Functional Movements
Hip Anatomy
Hip Muscles - Anterior View Posterior Hip Muscles Posterior Hip Muscles
Individual muscles vs. functional groups
Beth Ohara https://commons.wikimedia.org/ Working with functional groups allows for
wiki/File:Anterior_Hip_Muscles_2.PNG a holistic systems perspective.
Hip Muscle Groups
Hip Flexors
Hip Extensors
Hip Abductors
Hip Adductors
External Rotators
Internal Rotators
Anterior Pelvic Tilts To get optimum results when treating the hips
and pelvis it is essential to understand the
Posterior Pelvic Tilts functional anatomy of these muscle groups,
how they connect to myofascial lines,
Lateral Tilts in the Pelvis meridians and acupuncture points.
Hip Extensors
Gluteus maximis and hamstrings (biceps femoris,
semimembranosus, and semitendinosus)
Psoas is antognistic to the gluteus maximus. Chronic
contraction in the psoas can cause pain through the hips,
glutes, lumbar region, and tai yang - shao yang channels.
Contraction in the hip extensors can strain the hip flexors and
produce pain in the anterior hip.
When testing extension note if the pain is in the anterior,
lateral, or posterior regions.
Reduce chronic contractions and strengthen chronic weakness
in regions under excessive strain and stretch.
SBL Points
Hamstrings
Tai Yang - Shao Yang Patterns
Acupuncture for the Hips and Pelvis
Acupuncture for the Hips and Pelvis
By James Spears M.S.
When treating the hips it is essential to make baseline
structural assessments. While TCM and other traditional
methods can have benefits, many clients with hip pain will
only receive moderate results.
To achieve optimum benefits we can use traditional
points; however, it is essential to understand the anatomy
of the hips. My 214 level course allows for improved point
selections based in functional anatomy, traditional
methods, and prescriptive based movements.
To learn move visit:
https://www.ihsociety.com/acupunctureforhippain
