Master Tung's Acupuncture Points - ling Gu (22.05)
Location: Ling Gu is located at the junction of the first and second metacarpals, right where the bones meet.
Needle Ling Gu towards LI 4.
Indications: This point shares many of the same functions as LI 4 but is generally stronger in its effects. It treats pain anywhere in the body. It is best well- known for treating headaches, migraines, menstrual pain, PMS, lumbar pain, and sciatica. It is also beneficial for myofascial pain syndromes, arthritis, knee pain, joint pains and injuries.
Since the LI and LU meridians share an internal - external relationship it is also used for respiratory disorders, and conditions affecting the nose, sinuses, head, face, mouth, and eyes.
Ling Gu is one of the most well-known points in the Tung system. On this page I will present some unique perspectives for using it, while comparing and contrasting it with other points. Like SI 3 or 22.08, Ling Gu is often used for low back pain. However, it works on a different myofascial level than SI 3, and understanding the differences and how to combine these points is essential to getting optimum clinical results.
Ling Gu is also used for urinary conditions affecting the kidneys and bladder. Traidtionally, this is thought of as a 5 -element relation between the metal and water. However, modern studies reveal a relationship between 22.05 and the lumbar region via the latissimus dorsi. Myofascial anatomy supports many of the traditional point actions while grounding traditional theories into a structural and functional framework with anatomical, mechanical, and neurological explanations. As Ling Gu is widely known for treating lumbar pain and sciatica let's look at this in more detail.
The image above shows Ling Gu (22.05) with 22.04 and 22.07. This is a famous point combination taught by Dr. Tan for treating lumbar pain. (Ling Gu, Da Bai, Xia Bai)
To get the most effective results it is best to have the patients do some simple movements while needles are retained in these three points. Needle on the opposite side of the pain.
I usually have clients do easy movements like standing and seated pelvic tilts and chair squats. I also have the patients walk around the room or down the hall for a few minutes. Rotate between a few simple movements like this and do 3 - 5 sets for the first 5 - 10 minutes of the treatment.
After the seated, standing, and walking movements have the client lay face up on the treatment table and do 8 - 10 repetitions of the bridge pose. This will place the lumbar spine and hips into a gentle extension which most clients need.
You can also have them alternate between dorsiflexion and plantar flexion of the foot. When tehy dorsiflex the foot also have them lock their knees and push them into the treatment table. This will straighted the legs and stretch the calves, hamstrings, sacral fascia, and superficial back line (SBL - Myofascial Line).
These points tend to work most effectively on acute and superficial level disorders. However, they can be invaluable for chronic patterns too. Often acute cases will quickly resolve with one or two sessions. Chronic cases will often need a combination of other point groups that get to the deeper level structures of the spine.
Ling Gu for Low Back Pain
This is a question I asked myself for many years when the points did not produce a result. While the Ling Gu, Da Bai, Xia Bai combination is so effective for many cases, there are some clients that don't respond to these points.
After a few years of practice, I discovered that this point combination was very powerful for acute patterns but often less effective for chronic cases. However, some clients with acute conditions did not respond to the Ling Gu combo; and conversely, there were clients with chronic disorders that got instant results even after suffering for many years.
After realizing how the point combo tends to work better for acute patterns, and less so for chronic disorders, I started to develop strategies to use if Ling Gu, Da Bai, and XIa Bai did not work. I experimented with different Master Tung points for low back pain, and isolated various groups by using only one point group at a time in community acupuncture settings. While I was making some advancements, such as discovering that overweight people and non-responders often got better results with San Cha, I was still not clear on when any certain point group would or would not work.
However, when I discovered the teachings of Tom Myers, the author of Anatomy Trains, I started understanding more about how to use Master Tung's points more effectively.
The Back Arm Lines
According to research by Tom Myers, the muscles, fascia, and connective tissues form myofascial lines. These fascial lines include muscle groups that are connected through the fascia, and they share structural and functional roles in supporting and moving the body.
On the left side of the image is the Deep Back Arm Line (DBAL), and the muscle group on the right is called the Superficial Back Arm Line (SBAL).
These myofascial lines give many insights about meridians and how Master Tung's points work.
Myofascial anatomy can even help us get better results for even the most difficult cases.
Tung's Points - What do you do if Ling Gu, Da Bai, and Xia Bai Don't work for low Back pain?
Tung's Points on the Superfical Back Arm Line
Comparing Master Tung's points to the arm fascial lines we find that Ling Gu, Da Ba, and Xia Bai are all on the SBAL. Other points indicated for sciatica and back pain like 22.06, 33.05, 33.08, 33.09, and the Gu Ci points are also on the SBAL line.
When I first started studying these fascial lines and comparing them to Tung's points, I had two significant cases that helped me to better understand what was going on with Tung's points - and why the Ling Gu combination sometimes didn't work.
I will get back to that, but I first want to point out that the points 22.08 and 22.09, near SI 3, are on the small intestine meridian and DBAL.
Ok, so back to the case studies. One was a 45 year old woman with sciatica in the lateral aspect of the leg (GB meridian), the pain was extremely severe, and she had the pain for about one month. The area of GB 30 was also very painful as was the sacral region. She was in menopause and had kidney yin and yang deficiency.
The other client was a long term patient that would come for group acupuncture every few months. His main complaint was low back pain, sometimes he would injure his back from work and sports related activities. My typical procedure was to use the Ling Gu combination, which always worked wonders on him. However, on one particular day he came in for acupuncture - in severe pain - and the Ling Gu combo didn't even touch the pain at all. There was no result. As this was a long term client, I wanted to make sure to get him good results. After the Ling Gu combo didn't work I was faced with the decision of what points to do next.
What do you do if the Ling Gu combo doesn't work?
With both the man and woman I started the treatments with the Ling Gu, Da Bai, Xia Bai combo, and in both patients the results were negligible.
With the woman I added 33.08 and 33.09 as they were sensitive to pressure, and they are also indicated for gallbladder meridian sciatica. The results were minimal after the first session but she did get some relief from using 33.08 and 33.09.
As I had been studying the myofascial lines and comparing them to the uses of Master Tung's points, I decided my next best move for both clients was to needle the DBAL. The points 22.08 and 22.09 on the small intestine meridian and near SI 3, are also indicted for back pain and sciatica. However, these points reach different muscle groups and fascial lines. I next used 22.08 and 22.09 on both clients.
With the man, I first used the Ling Gu combo and left them for 20 - 30 minutes, only to have him report no change in pain intensity. He was also having difficulty standing up and walking. Ok, try to time 22.08 and 22.09.
Guess what happened! Within 5 - 10 minutes the client reported a 70 - 80% improvement. With objective observations his posture was much improved, he was standing upright and walking around, and he had increased mobility in his legs and hips. Remarkable!!!
For the woman it was a much more complicated case. Her sciatica was very severe and she had numerous disc hernations in the lumbar region. However, when I started working with 22.08 and 22.09 we saw much better results. The pain in the sacrum improved faster than when I was using the Ling Gu combo. As I treated her several times over a short period of time, I was able to test the differences between using the Ling Gu combo and 22.08 and 22.09. In her case, because she also had sacral pain, the overall condition improved better when I used 22.08 and 22.09. I also continued to use points like 33.08 and 33.09 for the GB meridian sciatica, and they produced a better result than the Ling Gu point combination.
What defines your point selections and strategies?
Especially if your first point groups don't work.
3-D Pattern Identification
As acupuncturists we know the importance of doing pattern identification. We also know that getting great clinical results requires identifying the proper syndrome.
Do you remember how profound it was to start using Dr. Tan's six systems and the Balance Method as a form of pattern identification? It was life changing right?
Learning Dr. Tan's Balance Method helped me to grow to a whole new level of clinical skill. Sure I still use zang-fu and 5-elements, but for treating pain and doing acupuncture Tan's systems work much better. Zang-fu is great for herbs, 5-elements has its applications, but for treating pain in the meridians - the Balance Method and Master Tung's points are superior.
Integrated Sydrome Differentiation & Point Selections
I also like using Master Tung's points and the Balance Method for internal conditions, and certainly TCM patterns should be applied to the Balance Method and Tung style acupuncture. However, the point I want to make is that having various methods of pattern identification and diagnostic skills helps us to widen our diagnostic abilities.
Being able to work with zang-fu, 5-elements, and Tan's six meridian systems gives us increased fluidity and better diagnostic capabilities. Similarly, learning the fascial lines, and how they relate to Tung's acupuncture points, will widen your perspective and give you greater insight into how these points work. Knowing the fascial lines will also give you a greater command of Master Tung's points, and help you decide when to use one group of points over another group with similar indications.
With many groups of points available for all kinds of disorders, it is essential to have various methods of pattern identification available to us. It is also vital to have an intimate knowledge of the points, as well as the anatomy associated with the acupuncture points.
Knowing when to use 22.08 and 22.09 over the Ling Gu combo is vital for refining our clinical skills and effectiveness, and there are many other similar comparisons I could make.
For instance, how do we determine when to use the Lower Leg Emperors (77.17 - 77.19) over the Passing Through Kidney Points (88.09 - 88.11)? Remember that these points treat kidney and bladder disorders, and that the Lower Three Emperors are contraindicated in pregnancy, but the Passing Through Kidney points are fine for needling in pregnant women. How do you determine when to needle one group over the other? The fascial line model gives us detailed information about why these points work in similar ways, and why the Three Emperors are not to be used in pregnant women.
Seven Tigers (77.26) as Meeting Points for the Tai Yang and Shao Yang Meridians
The Seven Tigers are located between the UB and GB meridians and are indicated for scapular pain, lateral neck muscle pain, pleurisy, pain and inflammation in the clavicle, ribs, and sternum. They can also treat pain at SI 13, GB 21, and in the levator scapulae muscles.
Given their location these points relate to two fascial lines, and when we know the anatomy of these fascial lines we can understand why they treat the conditions they do.
In the Master Tung and Fascia Course I cover the most important Tung points, 10 fascial lines, and detailed anatomy which will help you to better understand the various actions and indications of these powerful points.
Whether you're at a beginner, intermediate, or advanced level, this course will give you the tools and knowledge to improve your clinical results. The course includes:
In depth coverage of over 50 points
6 PDF files on each of the fascial planes
5 hours of audio recordings
Immediate access to files
Master Tung's Points and myofascial lines Course
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