肘髎 : Zhouliao : Elbow Crevice

Location Guides:

Classifications:

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

Location:

When the elbow is flexed, this point is located in the depression 1 cun proximal to and 1 cun lateral to Quchi L.I.-11

Needling:

Perpendicular insertion 0.5 - 1 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 hand Yin and Yang receive their Qi via nearby paths so their Qi arrive swiftly. The depth of piercing must not exceed 2 fen and must not remain inserted for longer than one exhalation" (Ling Shu 靈樞 ch. 12).
"It is needled to a depth of four 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
Benefits the elbow joint

TCM Indications:

• Wind-taxation with somnolence, contraction, numbness and immobility of the upper arm, pain and stiffness of the elbow.

Neuroanatomy:

Superficial Innervation: Lower lateral cutaneous nerve of the arm (C5 - C6)

Dermatome Segment: C5

Trigger Point Associations:

Muscle:
Triceps brachii

Pain Referral Pattern:
To lateral elbow and along radial side of forearm

Indications:
Posterior shoulder and upper arm pain

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 24: Bronze Man Statue, which divides the body into zones associated with the Twelve-Hour branches (Shichen 時辰) going from top downwards, the lower bicep and elbow (He-3, SJ-10, SI 8, LI 10, LI 11, LI 12 & Lu 5) and the xiphoid process (Juque Ren-14) are the vital points of Wu 午 Horse (11 am - 1 pm) and considered most vulnerable to a palm thrust during this time (McCarthy, 2016, Bubishi: The Classic Manual of Combat).

Causes great Qi drainage when struck downwards into the elbow. This point is struck with the knife-edge of the palm with the palm facing slightly downwards and then rolling over to palm up as it strikes, thus causing more of a cutting action on the point. This point works so well that not many will be able to continue after being struck here (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Swelling and redness of the arm with elbow pain:
    Zhouliao LI-12 with Jianyu LI-15 and Wangu SI-4
    (Yang Jizhou, 杨继洲, 1601: Zhen Jiu Da Cheng, 針灸大成, Great Compendium of Acupuncture and Moxibustion).
  
  
• Pain and inability to raise the arm:
    Zhouliao LI-12 with Binao LI-14
    (Preserving Life).

Notes:

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

In Mayan medicine:
Used to treat pain in the upper extremities (Garcia, Sierra, Balam, 1999: Wind in the Blood)

Medieval phlebotomy point (John de Foxton, 1408: Liber Cosmographiae, maa.cam.ac.uk)

In ayurvedic medicine:
Ani marma point
Size: 1/2 angula (cun)
Structure: Tendon
Effect of Injury: Disability (vaikalyakar marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

Lad and Durve (2008) in Marma Points of Ayurveda locate a point near here at the body protuberance of the lateral epicondyle called Bahya Kurpara and associate it with the doshas: Prana Vayu, Vyana Vayu and Shleshaka Kapha.

They give the following functions:
- Harmonises the movement of elbow and arm
- Relieves pain locally
- Improves circulation

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