The Sinew Channels (Jingjin)
and Vertebral
Fixations
By
Brian Lau, DOM, AP, C.SMA
This article will explore vertebral
fixations and their relationships to both extraordinary vessels (Qi
Jing Ba Mai) and the
sinew channels (Jingjin).
In Sports Medicine Acupuncture®, assessment of vertebral fixations
is an important part of overall assessment and treatment when working
with sports injuries and orthopedic conditions. Extraordinary vessel
(EV) point pairs are used in conjunction with local needling at the
M-BW-35 (Huatuojiaji)
points, and with mobilization techniques, to free restrictions
preventing proper vertebral movement. The Huatuojiaji
needle technique and the
mobilization are used to balance asymmetrical locking of the facet
joints, where one side is locked in a closed position in relation to
the other side. The EV point pairs regulate specific global strain
patterns that stress the spine in specific regions. These strain
patterns will be the focus of this article.
Vertebral
fixations are assessed by motion tests and by manual muscle tests.
Vertebral fixations at specific regions of the spine will cause
bilateral weakness of specific muscles when testing with manual
muscle tests.1
Interestingly, the muscles that become bilaterally weak are not
innervated by the spinal nerves at the level of fixation. To gain
insight into this phenomenon, it is useful to look at the sinew
channels, note their connection to the spine, and understand how they
can exert a negative influence on these spinal segments when
dysfunction exists. Bilateral muscle weakness can then be seen
through a channel relationship.
The
Spleen Sinew Channel, The Penetrating Vessel (Chongmai),
and Thoracic Vertebral Fixations
Fig 1: ©Brian Lau/drbrianlau.blogspot.com |
The
fascia which travels anterior to the rectus abdominis (that of the
external obliques and part of the internal obliques) comprises the
abdominal portion of the Stomach sinew channel while the posterior
fascia comprises the abdominal portion of the Spleen sinew channel.
This posterior abdominal fascia is continuous with the anterior
portion of the diaphragm at the inner surface of the anterior
ribcage.2,4
From here, one could follow the diaphragm around to its connection to
the lumbar spine. This connection, called the crus of the diaphragm,
attaches to the lumbar spine at L1 and L2.3
Restriction in this portion of the Spleen sinew channel can
contribute to fixations at the T11-L2 vertebral levels.
Fig. 2: © Matt Callison/ Sports Medicine Acupuncture |
When
the Spleen sinew channel does not have adequate length, the abdomen
becomes bowed and distended and the chest is depressed. This adds
tension to the thoracic region and contributes to fixations in this
region.
Vertebral
fixations of these regions cause bilateral weakness of muscles that
are part of the Urinary Bladder (Pangguang)
sinew channel.
These include the lower trapezius (for fixations of T11-L2), the
teres major (for fixations of T3-T9), and the gluteus maximus (for
fixations of C1-C3, which are not discussed in this article).1
This can be understood as a five element relationship involving the
Earth and Water elements. These channels create a dynamic balance, as
the Spleen and Stomach sinew channels consist of flexors of the legs
and torso and converge at the abdominal aponeurosis while the Urinary
Bladder sinew channel consists of extensors of the legs and torso and
converges at the thoracolumbar aponeurosis, when looking at fascial
connections, at least.2,4
When vertebral fixations are present, SP-4 (Gongsun)
and P-6 (Neiguan)
are added to the
treatment.
The Liver and Kidney Sinew Channels, The Yin Motility Vessel (Yin Qiao), and Lumbar Vertebral Fixations
The Liver and Kidney Sinew Channels, The Yin Motility Vessel (Yin Qiao), and Lumbar Vertebral Fixations
Fig. 3: © Brian Lau/drbrianlau.blogspot.com |
The Kidney (Shen) sinew channel includes the adductor magnus and the semimembranosus muscles. These structures link with the pelvic floor muscles which are then continuous with the anterior longitudinal ligament,2,5 which travels up the anterior portion of the spine.
The psoas
major attaches to the lumbar transverse processes, the vertebral
bodies, and even the intervertebral discs of the lumbar vertebrae.2,3
The psoas is more in a direct line with the Liver sinew channel, but
since it attaches to the vertebral bodies and intervertebral discs
and therefore links with the anterior longitudinal ligament, it also
converges with the Kidney sinew channel.
Fig. 4: © Matt Callison/ Sports Medicine Acupuncture |
Vertebral
fixations of the lumbar vertebrae cause bilateral weakness of neck
extensors.1
This can best be understood through the relationship of the Yin
Motility Vessel (Yin
Qiao)
and Yang Motility Vessel (Yang
Qiao). As
one becomes short and tight, the other becomes flaccid. This is
traditionally discussed in the context of their relationship to the
muscles of the legs, but the relationship can continue throughout the
entire channel.6
When vertebral fixations are present, KID-6 (Zhaohai)
and
LU-7 (Lieque)
are
added to the treatment.
The Urinary Bladder Sinew Channel, The Yang Motility Vessel (Yang Qiao), and Occiput-C1 Vertebral Fixations
The Urinary Bladder Sinew Channel, The Yang Motility Vessel (Yang Qiao), and Occiput-C1 Vertebral Fixations
Fig. 5: © Matt Callison/ Sports Medicine Acupuncture |
When the
suboccipital muscles do not have adequate length, there is capital
extension and restriction in movement at the atlanto-occipital joint.
This contributes to fixations of the occiput and C1.
Vertebral
fixations of the occiput and C1 cause bilateral weakness of the psoas
major.1
Again, this can be understood via the relationship of the Yin
Motility Vessel and Yang Motility Vessel.
When
vertebral fixations are present, BL-62 (Shenmai)
and SI-3 (Houxi)
are
added to the treatment.
Note:
Vertebral fixations at C4-C6 and sacroiliac fixations, all treated
with GB-41 (Zulinqi) and SJ-5 (Waiguan), are not discussed in this
article. Also not discussed are fixations at C7-T2, which are treated
with KID-6 (Zhaohai) and LU-7 (Lieque). These are left out to avoid
excessively lengthy discussion.
References
1.
Walther, David S. Applied
Kinesiology: Synopsis.
Pueblo, CO: Systems DC, 1988. Print.
2.
Myers, Thomas W. Anatomy
Trains: Myofascial Meridians for Manual and Movement Therapists.
3rd ed. Edinburgh: Churchill Livingstone, 2014. Print.
3.
Netter, Frank H. Atlas of
Human Anatomy. 6th ed.
Philadelphia, PA: Saunders Elsevier, 2014. Print.
4.
Stecco, Carla, and Warren I. Hammer. Functional
Atlas of the Human Fascial System.
Edinburgh: Elsevier, 2015. Print.
5.
Legge, David, and Karen Vance. Jingjin:
Acupuncture Treatment of the Muscular System Using the Meridian
Sinews. Sydney: Sydney
College, 2010. Print.
6.
Wang, Ju-Yi, and Jason D. Robertson. Applied
Channel Theory in Chinese Medicine: Wang Ju-Yi's Lectures on Channel
Therapeutics. Seattle:
Eastland, 2008. Print.
7.
Wilke, Jan, Frieder Krause, Lutz Vogt, and Winfried Banzer. "What
Is Evidence-Based About Myofascial Chains: A Systematic Review."
Archives of Physical
Medicine and Rehabilitation
(2015). Web.