From Grant's Atlas of Anatomy, showing patellar surface where the patella tracks during knee movement. |
In many ways these two sinew channels, not unlike their respective
primary channels and organs, work more in unison compared to other internally-externally
related sinew channels. These channels contain the quadriceps; the Spleen
sinew channel including the vastus medialis (medial quadriceps) and the Stomach
sinew channel including the rectus femoris and vastus lateralis (lateral quadriceps). These work
together to perform knee extension.
So, how is it that these separate sinew channels balance the patellofemoral joint? To understand this, it is useful to look at the tensional pull the vastus lateralis and vastus medialis have on the patella. When looking at basic muscle anatomy texts, one sees that
the quadriceps tendon wraps around the patella and then attaches to the tibial
tuberosity. Actually it is called the patellar ligament from the patella to the
tibia as it connects bone to bone, but it is the same structure as the
quadriceps tendon. .
The vastus lateralis muscle blends in with the lateral
retinaculum and the vastus medialis blends in with the medial retinaculum and
both exert a pull on the patella. In balance, this influences the tracking of
the patella in the femoral groove. Often, the vastus lateralis becomes
overactive and the vastus medialis becomes inhibited, contributing to an
excessive line of pull in a lateral direction. This is referred to as
patellofemoral syndrome. It contributes to early degenerative changes in the
cartilage of the patella, femur and/or tibia. Looking from a sinew channel
perspective, this condition can be seen as a disorder between the Spleen and
Stomach sinew channels.
Simultaneous stimulation of xinfutu (upper left) and baichongwo (lower right). |
In addition, SP-6 and ST-36 can be added. The vastus
lateralis and lateral retinaculum blend in with the fascia of the tibialis
anterior. ST-36 is the motor point of this muscle and will help with the
release of the Stomach sinew channel. SP-6 is a good distal point to assist
with the ‘tonification’ of the vastus medialis. It has an interesting
anatomical aspect that is discuss in a previous blog post called Sanyinjiao (SP-6)–Three Yin Crossing.
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