髀關 : Biguan : Thigh Gate

Location Guides:

Classifications:

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

Meetings:

Meeting of Stomach with Stomach Divergent and Spleen Divergent

Location:

On the upper thigh, in a depression just lateral to the sartorius muscle, at the junction of a vertical line drawn downward from the ASIS, and a horizontal line drawn level with the lower border of the pubic symphysis, approximately level with the prominent point of the greater trochanter.

Needling:

Perpendicular or oblique insertion 1 - 2 cun

Classical Needling:

"The Yangming usually has much Qi and much Blood" (Su Wen 素問 ch. 24) implying this channel can normally be needled or bled.
"The foot Yangming is to be pierced 6 fen deep and remain inserted for ten exhalations" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of six fen and moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Activates the channel and alleviates pain
Dispels Wind-Damp

TCM Indications:

• Atrophy disorder and Painful Obstruction (痹, Bi) of the lower limb, hemiplegia, numbness of the legs, cold damp Leg Qi (腳氣, Jiao Qi), pain of the hip joint, pain of the thigh, sciatica, contraction of the thigh muscles, cold Painful Obstruction (痹, Bi) of the knees, inability to extend and bend the knee, lumbar pain, jaundice.

Neuroanatomy:

Superficial Innervation: Femoral branches of genitofemoral nerve from L1

Dermatome Segment: L1

Trigger Point Associations:

Muscle:
Iliopsoas, rectus femoris and sartorius

Location Notes:
Only accessible point of the iliopsoas muscle group. Other trigger points should be deactivated first to prevent increased soreness at this point. Sartorius trigger point would be slightly medial, on the belly of the muscle

Pain Referral Pattern:

Iliopsoas: To lower back and anterior of thigh
Rectus femoris: To knee
Sartorius: Local along the path of the muscle

Indications:
Low back pain (iliopsoas) diseases of the hip and knee (rectus femoris) or strain of sartorius muscle

Martial Applications & Effects of Injury:

Striking this point drains the Qi to the legs causing the recipient to have to sit down or fall down! It can be used as an excellent set up point for a physical leg strike, making bones break more easily once this point has been struck first (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Numbness of the knee:
    Biguan St-31 with Dubi St-35 and Yanglingquan GB-34
    (Wang Zhizhong, 王執中, 1220: Zhen Jiu Zi Sheng Jing, 針灸資生經, Classic of Supporting Life with Acupuncture and Moxibustion).
  
  
• Weakness and paralysis of the legs:
    Biguan St-31 with Zusanli St-36, Yanglingquan GB-34, Xuanzhong GB-39 and Jiexi St-41 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).

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