Gallbladder 34, Tendons & Myofascial Lines

A myofascial approach to acupuncture and meridian therapies allows for an embodied perspective and a better understanding of point functions. In this post, we will look at this in the context of the gallbladder meridian, lateral myofascial line, and some of the key points on the GB meridian.

The acupuncture point GB 34 is known as the influential point for the tendons, and by examining the anatomy of GB 34 we can comprehend how it has systemic effects on the tendons, fascia, and connective tissues. A myofascial perspective will also allow us to have more mastery of point functions by understanding functional anatomy.

The Lateral Line is the Myofascial Equivalent of the Gallbladder Meridian

The traditional point location of GB 34 is anterior and distal to the head of the fibula; however, the late Dr. Richard Tan recommended needling GB 34 directly inferior to the head of the fibula and into the tendinous region. I often prefer Dr. Tan’s location as it has a direct effect on the tendons and strong actions on the channel. Needling into the tendons at Dr. Tan's GB 34 (GB34 T) can be especially effective for disorders such as IT band syndrome, excessive foot eversion, inner ankle sprains, hamstring tightness, lumbar and hip pain.

The use of GB 34 T for IT band tightness is apparent as the IT band is on the GB meridian and Lateral Line (LL), and traditional methods often needle the symptomatic meridian in both local and distal areas. However, using this point for chronic inner ankle sprains and other disorders related to excessive foot eversion is better understood through the mechanics of myofascial anatomy.

To begin, let's take a look at the peroneus longus muscle.

Contraction of Peroneus Longus Everts the Foot

The tendons of both the peroneus longus and peroneus brevis both attach to the head of the fibula. When these muscles are chronically tight it causes the foot to be in excessive eversion, and this predisposes the inner ankle to strain, sprains, and pain. By needling GB 34 T we are able to release chronic contraction in the peroneus muscles and help restore better alignment to the foot.

Biceps Femoris Attaches to the Head of the Fibula

The biceps femoris attaches to the head of the fibula, and when it is chronically contracted a person may feel pain and tightness in their hamstrings. Chronic contraction of the biceps femoris is also related to excessive external rotation of the leg and may result in foot, knee, and leg pain. Needling GB 34 T helps to release chronic tightness in the biceps femoris and IT band, and for some people it can be just the right point to alleviate pain in the feet, medial knee, hips, and back. This point is especially effective with excessive tightness in the IT band or biceps femoris, and when external rotation of the leg is a contributing or causative factor.

By knowing how meridians relate to myofascial line dynamics, acupuncturists can come to better understand acupuncture point functions. This also leads to comprehending body mechanics and knowing why needling a point like GB 34 T can be beneficial for inner ankle sprains, arch pain, medial knee pain, and other disorders related to chronic external rotation of the leg.

GB 34 & GB 41 for Hip and Lumbar Pain

The acupuncture point Gallbladder 41 (GB 41) is known as the confluential point for the Dai Mai meridian, which is believed to be an extraordinary meridian that encircles the waist like a belt. The point is indicated for hip and lumbar pain in addition to costal pain, breast tenderness, and various conditions of the head and eyes. From a myofascial perspective, this connection between GB 41 and the Dai Mai can be understood through the functions of the Lateral Line to maintain structural dynamics between the Superfical Front Line (SFL) and Superficial Back Line (SBL).

The Belt Channel and Lateral Line bind and

support the anterior and posterior meridians.

The Back, Front, and Lateral Myofascial Lines

The glute muscles and IT band play a fundamental role in maintaining the structural integretity of the back, hips, and legs. Additionally, the LL and its associated muscles in the hips and legs help maintain balanced movement and support between the SBL and SFL. The hamstrings and quads are antagonistic muscle groups that have opposing functions on the movments of extension and flexion in the hips and knee. Similarly, the LL assists in various movments of the hips, femur, and knee and provides additional support and balance for both the anterior and posterior lines.

The GB meridian points can be effective for hip and lumbar disorders because they directly affect the LL which helps maintain the relative balance between the front and back channels.

Needling GB 41 has numerous effects on the qi, nerves, and myofascia, and when it is paired with a point like GB 34, or other GB points on the legs, it can provide additional benefits for hip and lumbar pain.

GB 34 and GB 41 for Costal and Hypochondriac Pain

Both GB 34 and GB 41 are also indicated for hypochondriac pain, costal pain, and liver qi stagnation symptoms. The costal region has a strong relationship to the liver due to its location directly under the right ribcage.

Anatomically, we see that the costal muscles are part of the lateral line and this helps explain why GB 34 and GB 41 are indicated for ribcage pain. In the Master Tung system, the Lateral Three Passes (77.27) are indicated for lung cancer, and this three point unit is also located on the GB meridian and LL. Similarly, in TCM and zang-fu pattern identification we recognize a pattern where the liver overacts on the lungs to cause various respiratory disorders. Therefore, the use of GB meridian and LL points should be employed for lung patterns that are rooted in liver imbalances. Myofascially, we can see how points on the GB meridian can affect the intercostal muscles. This may have benefits for the respiratory system, as the intercostal muscles are secondary muscles of respiration.

Summary

In traditional systems of acupuncture there are adages that state, "to affect the muscles, needle the muscles; to affect the tendons, needle the tendons; to affect the bones, needle the bones." In this regard, we can understand how needling Dr. Tan's GB 34 point may have wide and systemic affects on tendons and connective tissues in general. This is also likely why GB 34 is listed for many kinds of pain disorders. Studies are also finding that fasciae are frequently involved in many kinds of pain, and by needling a point that powerfully influences the major tendons in the body, it may transmit beneficial effects via the fascia and nerves through much of the system.

To learn more, consider taking one of my online or live classes on acupuncture and myofascial lines. You can access discounts at the link below.

Acupuncture & Myofascial Lines

Sincerely,

James Spears