膝陽關 : Xiyangguan : Knee Yang Gate

Location Guides:

Classifications:

Trigger point (Travell & Simons, 1998, Trigger Point Manual)
Luo Harmonizing point

Location:

On the lateral side of the knee, in the depression above the lateral epicondyle of the femur, between the femur and tendon of biceps femoris.

Needling:

Perpendicular insertion 1 - 2 cun

Warnings:

According to several classical texts this point is contraindicated to moxibustion

Classical Needling:

"The Shaoyang usually has little Blood and much Qi" (Su Wen 素問 ch. 24) implying this channel should normally be needled.
"The foot Shaoyang is to be pierced 4 fen deep and remain inserted for five exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of five fen, and moxibustion is prohibited" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Relaxes the sinews and benefits the joints
Dispels Wind-Damp

TCM Indications:

• Redness, swelling and pain of the lateral aspect of the knee joint, inability to flex and extend the knee, wind Painful Obstruction (痹, Bi) with numbness, Painful Obstruction (痹, Bi) of the lower leg, Leg Qi (腳氣, Jiao Qi).

Neuroanatomy:

Superficial Innervation: Lateral cutaneous nerve of the thigh (L2 - L3)

Dermatome Segment: L3

Trigger Point Associations:

Muscle:
Vastus lateralis

Pain Referral Pattern:
Around lateral area of knee

Indications:
Strain of quadriceps ; Diseases of the knee

Martial Applications & Effects of Injury:

Listed in the Wu Bei Zhi 武備志 (Treatise on Armament Technology) by Mao Yuanyi 茅元儀 (1621), Article 21: Delayed Death Touches with Twelve-Hour (Shichen 時辰) Diagrams. This point along with Xinhui Du-22 and Weizhong Bl-40 are associated with Wu 午 Horse (11 am - 1 pm) and if struck during this time is said to cause indefinite paralysis from trauma to the inferior external articular artery (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

See Montaigue, Dim Mak Locations, Taijiworld.com for explanation of effects.

Major Combinations:

• Numbness of the lower leg:
    Xiyangguan GB-33 with Huantiao GB-30 and Chengjing Bl-56
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Contraction of the sinews and difficulty in flexing and extending the knee, with inability to walk:
    Xiyangguan GB-33 with Liangqiu St-34 and Ququan Liv-8
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).

Notes:

At the end of a Gall Bladder Luo treatment this point is needled, deqi grasped and removed immediately to normalize the circulation of blood (Cecil-Sterman, 2012, Advanced Acupuncture).

In Thai massage:
Point along the outer Kalatharee sen line running from the lateral malleolus, up the sides of the leg, along the outer bladder channel, over the shoulder blade and down to the hands.
Aslo point along the Sahatsarangsi (left) and Tawaree (right) sen lines ascending up the outer leg.
(Salguero & Roylance, 2011, Encyclopedia of Thai Massage)

Reference Notes:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here