Lower Leg Flashcards
List the 3 taught lower leg points and describe their location
Lower leg points
- BL57
On the posterior midline of the leg, at the apex of the inverted “V” of the musculotendinous junction of the gastrocnemius muscle and Achilles tendon, approximately 8 cun below the popliteal crease. Contract and relax the gastrocnemius to locate.
- SP6
3 cun superior to the most prominent point of the medial malleolus, posterior to the tibia and anterior to the Achilles tendon and soleus muscle.
- ST36
On the leg, 3 cun below the knee joint line with the knee in extension or 3 cun below the lower margin of the patella when the knee is flexed, 1cun lateral to the crest of the tibia.
BL57 location and needling technique
- Location
- Insertion
- Depth
BL57 location and needling technique
Location
On the posterior midline of the leg, at the apex of the inverted “V” of the musculotendinous junction of the gastrocnemius muscle and Achilles tendon, approximately 8 cun below the popliteal crease. Contract and relax the gastrocnemius to locate.
Insertion
perpendicular to the skin, posterior to anterior
Depth
0.5-1.5 cun
Describe relevant BL57 anatomy
- Muscles (1)
- Nerves (1; deeper - 1)
- Vessels (3)
BL57 anatomy
Muscles
- gastrocnemius
Nerves
- sural nerve S1 in the skin
* Deeper* - tibial nerve L4-S3
Vessels
- small saphenous vein
- & 3. posterior tibial artery and vein
List 7 neuroanatomical indications for BL57
BL57 indications
- sciatic pain
- low back/buttock pain
- spasticity in the posterior leg muscles
- myofascial strain/sprain of hamstrings, gastrocnemius and soleus
- Achilles tendonitis
- plantar fasciitis
- muscle cramp
SP6 location and needling technique
- Location
- Insertion
- Depth
SP6 location and needling technique
Location
3 cun superior to the most prominent point of the medial malleolus, posterior to the tibia and anterior to the Achilles tendon and soleus muscle.
Insertion
medial to lateral (perpendicular to the skin), posterior to the tibia. Avoid needling the tendons of flexor digitorum and tibialis posterior by having patient plantar & dorsiflex the foot to locate the tendons
Depth
1-1.5 cun
List relevant SP6 anatomy
- Muscles (4)
- Nerves (1; deeper - 1)
- Vessels (3)
SP6 anatomy
Muscles
- tibialis posterior
- flexor digitorum longus
- plantaris
- soleus
Nerves
- saphenous nerve L3-4 in the skin
* Deeper* - tibial nerve L4-S3
Vessels
- & 2. posterior tibial artery and vein
- great saphenous vein
List 3 neuroanatomical indications for SP6
SP6 indications
Nb Parasympathetic switch
- Pain and inflammation of the medial aspect of the leg
- Problems with tibialis posterior or flexor digitorum longus: shin splint syndrome
- Immune point for rheumatoid arthritis
ST36 location and needling technique
- Location
- Insertion
- Depth
ST36 location and needling technique
Location
On the leg, 3 cun below the knee joint line with the knee in extension or 3 cun below the lower margin of the patella when the knee is flexed, 1cun lateral to the crest of the tibia.
Insertion
anterior to posterior, aiming between the tibia and the fibula towards the interosseus space, on a horizontal plane
Depth
1-1.5 cun
List relevant ST36 anatomy
- Muscles (2)
- Nerves (1; deeper - 1)
- Vessels (2)
ST36 anatomy
Muscles
- tibialis anterior
- extensor digitorum longus
Nerves
- lateral sural nerve L4-S1 in the skin
* Deeper* - deep peroneal nerve L4-S2
Vessels
- & 2. anterior tibial artery and vein
List 8 neuroanatomical indications for ST36
ST36 indications
- Pain anywhere in the lower extremity
- Autonomic dysfunction anywhere in the body
- Chronic Regional Pain Syndrome (CRPS)
- Disorders of the anterior aspect of the leg e.g. anterior compartment syndrome
- Rheumatoid arthritis immune point
- Hemiplegia, motor dysfunction of the leg
- Energy promotion
- Mood modulation helps with depression
