I recently received a great question from a surgeon in Canada regarding a post in which I mentioned my favorite acupressure point for hip flexor release. It affects the psoas muscle, which can cause significant compressive back pain. Here is his question:
“When talking of acupuncture, I know nothing about it, you mention psoas muscle and suggest rubbing an area three finger breaths below the elbow. Psoas is a muscle in the back, and deep in the back, inserting into femur. Please explain the connection between the ‘elbow rub’ and psoas to this ignoramus.”
His open-mindedness humbled me. Before digging into the scientific evidence, my response to this concept would have been, “Yeah, right.” But both my own experience and the evidence made a believer out of me. Acupuncture is on the short list of proven effective treatments for chronic back pain, and has been found to work in 20 physiologic ways so far.
Below is my answer as a skeptical scientist-turned believer juxtaposed against that of an expert in Traditional Chinese Medicine. Thanks to Kate Stewart, L.Ac., of Traditional Health Works, who generously volunteered her time!
Gillian: I know, it seems very counter-intuitive as Traditional Chinese Medicine doesn’t operate within typical anatomical boundaries. A TCM expert would describe the connection as a meridian, or energy pathway. Research has actually shown that these points tend to lie along fascial networks, and many are at the intersection of multiple fascial networks. [NOTE: fascia acts like scaffolding over muscles, tendons, ligaments, and organs throughout your body.]
That’s how I tend to think about these points. Since fascia acts like scaffolding, an action in one area transmits to distant ones, just like dominoes. The forearm point lies within an intestinal meridian, so in a way it makes sense to the anatomically-minded because the top of the psoas is so deep it sits right behind the small and large intestines.
Kate: Acupuncture and acupressure work by stimulating specific points, called “Acupuncture points,” on the body that go to particular areas. These Acupuncture points are electrically charged and measurable as different from non-Acupuncture points. They are a way to access the meridian pathways and do certain things in the body, like decrease inflammation in the back for example.
If we think of meridians as pathways of electricity (we call it “Qi,”) it is similar to the pathways of electricity that run through our homes. We don’t normally see these electrical pathways, unless we are home builders. But we know where to access the pathways to do what we want. We know the “points of access” for particular areas of the house. The light switch in our living room turns on the lights, while the switch in the bathroom turns on a fan. The point of access simply moves the electricity to where it needs to go.
So it is with acupuncture. A point to help with stomach pain is on a pathway that affects the stomach, which happens to be on the leg. There are points on the abdomen too, but they are no more or less effective that the ones on the leg. They are simply different access points.
Gillian: There you have it! Keep your questions coming.