In Chapter 11 you were introduced to Chinese massage therapy and some of its varieties. Acupressure is one of the easiest to apply to oneself. While there are many techniques that may be used by a professional, only a very few techniques are necessary for you to achieve a broad range of benefits. While acupressure is a gentler, milder therapy than acupuncture, it provides a significant advantage, since you can perform acupressure on yourself daily at no financial cost.
For the purposes of this book, acupressure is a necessary substitute for acupuncture. Acupuncture is not something you can learn to do safely and effectively from a book. Since the insertion of needles can cause serious harm if done incorrectly, acupuncture requires professional licensure to be legally performed, even on oneself. You can get many of the benefits of acupuncture through acupressure, which only requires directed pressure from your fingertips.
The points for acupressure self-care have been selected with a few purposes in mind:
1. Safety. Each point presented is safe for you to use. While acupressure is generally a very safe practice with little possibility of causing harm, it’s wise to remember that anything that is powerful enough to cause healthful changes in your body if performed properly is powerful enough to cause harmful changes if done improperly. (See Appendix 2, Note 12.1.) There’s no danger of causing any harm to yourself with these points, and any cautions will be noted when necessary.
2. Ease of access. There are many points located on the back of your body, for example. They are difficult or impossible to reach by yourself, so they are not included here.
3. Easy to locate. Some points are very close together. They are easy enough to distinguish by the fine point of a needle but harder to separate by the much broader tip of a finger. Pressing on more than one adjacent point at a time is not harmful, but it may dilute the focus of the treatment. Conversely, some points are spread across your body away from convenient anatomical landmarks, so they are more difficult to find accurately. Again, it will not cause harm to apply pressure to a nonacupuncture point, but you will not be effectively addressing your purpose.
4. They must either have a broad range of effects or one or two very focused effects that can address a variety of common ailments and therefore benefit the greatest number of people. There are over 360 acupoints in common use by professionals and hundreds more that are less common. It would be overwhelming and impractical to include all those possibilities here. In fact, many acupuncturists select their everyday treatment points from a pool of about sixty points, since they can address the widest range of common patient complaints. The points selected here include most of those highly effective points. This is a useful, practical way to start your acupressure self-care. As you get more familiar with each point, you’ll enjoy a wider, deeper range of benefits. Nearly one hundred points are included here, and you’ll learn how to combine a few at a time in different ways. Each point has it primary effects, but the combination of points produces many different sets of effects, and it greatly expands the range of benefits to use the same points in different combinations.
Point combinations for common conditions are provided in Chapter 18. These are not the only possible prescriptions for those conditions, but they are among the most widely used. You may find points in Chapter 13 that seem useful for a condition that have been left out of the prescription. Feel free to experiment after you’ve acquired a little experience. That’s why you have so many point options.
Methods of Locating the Points
Whenever possible, the simplest everyday language is used to help you identify the point location. Most of the time that will get you to exactly the place a physician would use when selecting that point. The precise anatomical location may also be provided. Sometimes more technical language may be necessary, and this is what you’ll need to know.
The Chinese use an anatomical unit of measure called a Cun, roughly translated as a “body inch,” in order to accurately locate points. As a body inch, a Cun is not a fixed distance but a relative distance, based on the size of any individual body. For example, on a person who is five feet tall, a vertical Cun would be a shorter objective distance than it would be on a person who is six feet tall.
There are two standard ways that Cun are measured. One is proportional distances, and the other is hand and finger measurements. Some points are located by anatomical landmarks only. We’ll primarily be using hand and finger measurements and anatomical landmarks.
Proportional measurements require knowing the standardized, set number of Cun present in any body part and then dividing that body part in order to find the point location. For example, the distance between the elbow crease and the wrist crease is always 12 Cun. So if you wanted to find a point exactly 3 Cun above the wrist, you would need to mentally divide the forearm into four equal parts, 3 Cun each, and select the point a quarter of the way up from the wrist crease toward the elbow. Whether a person is four feet or six feet tall, that would be precisely 3 Cun, even though the objective inches would be different on each person. (See Figure 12.1 on next page.)
Hand and finger measurements are a little easier to use, are still individualized units of measure, and are just about as accurate as proportional measurements. There are two commonly used hand measurements.
The first is the width of the knuckle joint closest to the tip of the thumb. This is a 1-Cun measurement (Figure 12.2). This is useful in measuring short distances between two points or between an anatomical landmark and a point.
Figure 12.1 (Standard Cun Measurements)
Figure 12.2 (1-Cun Measurement)
The second is the width of the four fingers held together. This measures 3 Cun. This measurement is taken at the proximal interphalangeal joint, the set of knuckles closest to the hand (Figure 12.3 on next page). This is useful for measuring larger distances between two points or between an anatomical landmark and a point.
Anatomical landmarks are very obvious anatomical structures, such as nipples, the nose, the navel, kneecaps, and elbow tips. They are also slightly less obvious ones, such as bony protrusions like the greater trochanter (the large, bony prominence at the outside of your upper thigh) and the head of the ulna (the bony prominence on the little-finger side of the back of your wrist) or depressions in bones (like the depressions in your sacrum and in facial and skull bones). With just a little practice, even the less obvious ones will become easy to find, and they will be clearly described whenever they may be used.
Some Western anatomical language is used in describing a point’s location. That will be kept to a minimum, and illustrations are provided to make it as easy for you as possible. Here are some simple terms that you will encounter, along with their meanings:
Figure 12.3 (3-Cun Measurement)
• Lateral: Lateral means away from the midline of the body or toward the sideward outside edge of the body. For example, the tip of each shoulder is lateral to the notch at the base of the throat. This is a relative term. The eyes are lateral to the bridge of the nose. The top of the right ear is lateral to the right eye. On an arm or leg, lateral may be relative to the midline of the arm or leg.
• Medial: Medial is the opposite of lateral and means toward the midline of the body. So the bridge of the nose is medial to the eyes or to either eye if only one eye is being discussed. This is also a relative term, requiring at least two body structures in relation to each other. The right eye is both lateral to the bridge of the nose and medial to the tip of the right ear. On an arm or leg, medial may be relative to the midline of the arm or leg.
• Anterior: Toward or at the front of the body or body part.
• Posterior: Toward or at the back of the body or body part.
• Superior: Above or upward, usually in the general direction of the top of the head. The navel is superior to the pubic bone.
• Inferior: Below or downward, usually in the general direction of the bottom of the feet. The anterior superior iliac spine (ASIS), or hip pointer, is inferior to the tip of the eleventh rib.
• Distal: This term relates to the four limbs: the arms (along with hands and fingers) and the legs (along with feet and toes). Distal means away from the torso and toward the fingertips or toe tips. The wrist is distal to the elbow; the knee is distal to the hip.
• Proximal: This relates to the four limbs, is the opposite of distal, and means toward the torso and away from the fingertips and toe tips. The shoulder is proximal to the elbow; the ankle is proximal to the toes.
These are relative terms, requiring at least two body structures in relation to each other. For example, the wrist is proximal to the fingers but distal to the elbow.
Chinese massage therapy has an extensive array of techniques, each intended for a specific therapeutic purpose. Acupressure techniques are less extensive, yet we can get an impressive variety of outcomes by learning to master just a couple.
Tonification techniques are used to draw Qi to the targeted acupoint to strengthen its functions or to encourage Qi to flow in the appropriate direction within its meridian. In general terms, this is the best approach to take for a person who is weak, is recovering from an illness or injury, is usually tired or with little energy, tends to be very quiet, withdrawn, or depressed, catches colds frequently or is easily chilled, has poor digestion with loose stool, or is very elderly. Any or all of these presentations may apply.
To tonify a point, use relatively light pressure. You want to engage the point: use enough pressure so that you feel it, with enough depth that you may feel resistance from the muscle tissue below the skin, but you don’t want to go deep into the muscle. There should be no discomfort (beyond what you might feel in a painful body part even if you were not touching the point) and definitely no pain.
You can enhance the tonification by maintaining that depth, that engagement of the point, and make very small clockwise circles with your fingertip. The only exception is if you are working on an abdominal point, in which case counterclockwise circles will be most effective for tonification.
An alternate method of tonification can be used anywhere on the body but may be especially useful in tight-spaced, narrow areas—between two very close tendons, for example. Here, place your fingertip on the acupoint firmly enough to engage the muscle under the skin, so your fingertip does not slide over the skin. Keeping on the point, move your fingertip back and forth along the line of the meridian. Use more force in the direction of normal Qi flow for that meridian and less force when moving your finger against the meridian flow. Remember that in Chinese anatomical position (hands above the head in an “I surrender” pose), Yang Qi normally flows downward, from the fingertips toward the toes, and Yin Qi flows upward, from the toes toward the fingertips.
Sedation techniques are used to disperse Qi that is stuck around an acupoint or body region or to encourage Qi to flow counter to its normal direction for a brief period of time. (This is a little like unclogging a drain: you have to make the water flow opposite to its normal direction to dislodge the obstruction, after which it can freely return to its normal direction.) Generally, this is the best approach to take for a person who is fairly strong and robust, is excitable, is agitated or easy to anger, feels warm or hot much of the time, is suffering acute pain from an injury or other obstructive circumstance, or has a big appetite with frequent constipation. Any or all of these presentations may apply.
To sedate a point, use relatively deep pressure, going well into the muscle tissue below the skin, unless you are working on a bony area where that is not possible. You may feel some discomfort or mild to moderate pain that you recognize as beneficial—a “good kind of pain.” You should not press so deeply that you feel a sharp or strong pain.
You can enhance the sedation by maintaining that depth and make very small counterclockwise circles with your fingertip. The only exception is if you are working on an abdominal point, in which case clockwise circles will be most effective.
An alternate method of sedation can be used anywhere on the body but may be especially useful in tight-spaced, narrow areas of the body, as between two very close tendons. Here, place your fingertip on the acupoint, firmly enough to engage the muscle under the skin, so your fingertip does not slide over the skin. Keeping on the point, move your fingertip back and forth along the line of the meridian. Use more force in the direction against normal Qi flow for that meridian and less force when moving your finger with the meridian flow.
The pressures and depths may seem counterintuitive at first glance, since a deep pressure seems strong, working at deep levels of the body, and so should be more tonifying, while a light touch is soothing and calming, the kind of touch you might use instinctively to comfort a troubled child. On a strictly physiological, neurological level, that makes sense and is sometimes appropriate. But on an energetic level, that is not the case. Think of what happens if you strongly push your hand into a basin of water. The water will splash over the side of the basin, dispersing. If you lightly place your hand on the surface of the water, though, and slightly lift your hand for an even lighter touch, the water’s adhesive property will make it “stick” to your skin, and it will be drawn toward your hand. In this example, Qi behaves much like water.
Harmonization techniques are used to provide balance and clear communication among the points being treated and, by extension, throughout the entire body. They neither tonify nor sedate but may do both in equal measure. This is the best approach to use when a person has no particular health challenge but wants an energetic tune-up to facilitate optimal functioning, when someone may feel out of sorts or out of sync (emotionally a little off but with no obvious ailment), or when there is no clear need for either tonification or sedation.
To harmonize a point with the entire body or to harmonize a group of selected points, use moderate depth, clearly getting into the muscle tissue without going very deep. That pressure is maintained with little variation throughout the treatment.
You can enhance the harmonization by maintaining that depth and making an equal number of small clockwise and counterclockwise circles with your fingertip, first in one direction and then in the other. This technique is the same for abdominal points as for the rest of the body.
An alternate method of harmonization can be used anywhere on the body but may be especially useful in tight-spaced, narrow areas of the body. Here, place your fingertip on the acupoint, firmly enough to engage the muscle under the skin, so your fingertip does not slide over the skin. Keeping on the point, move your fingertip back and forth along the line of the meridian. Use equal force in both directions.
Since harmonization techniques are balancing, there is never a concern of harming yourself, and the treatments are always beneficial, if milder, in cases where tonification or sedation is best. Try to select the technique that closely matches your condition. Even if you select tonification when sedation is needed, for example, you won’t do yourself any real harm. You may feel a little more stimulated, a pain or discomfort might be more noticeable, or you might feel a little more tired, but any such effect will pass within one to three days, leaving you about where you were before the treatment. Even among health professionals, these sorts of trial-and-error outcomes are typical when one is first learning and acquiring the necessary skill and sensitivity.
In the point prescription sections of Chapter 18, you’ll find recommendations for tonification and sedation to fit the conditions being treated. These will guide you in the right direction, but because everyone is unique, some people may have a different cause of the condition from what is most typical, so some experimentation may be required. Again, you won’t cause yourself any harm, but for greatest benefit and peace of mind, you may want to consult your acupuncturist for recommendations regarding technique selection.
The effects of an acupressure treatment peak in about two days on average and then begin to decline. If you are trying to improve a specific health problem, self-treatment every two to three days is recommended, before much of a decline has occurred. If you want to treat yourself daily, that’s optimal, as your improvements will accrue more quickly. For general health maintenance or a periodic boost in energy and performance, once a week is fine.
Selected Acupressure Points
The following Chapter contains some of the most potent and versatile acupoints, selected from among the 360 common meridian points and hundreds of other possible extra points, as well as their location, main functions, and conditions they commonly treat. They’re arranged according to the meridian they’re found on.
In addition to point number, the Chinese name is provided, along with an English translation. The point names are open to various interpretations. The ones given here are among the most commonly used. While many of the names are poetic, they either give clues to the point’s location by referring to anatomical landmarks or clues to its function, although many of those functions may be obscured by cultural, historic, or alchemical metaphor. To more deeply explore the meaning behind the points’ names, consult Grasping the Wind by Ellis, Wiseman, and Boss or Acupuncture Points: Images and Functions by Arnie Lade. (See Recommended Reading.)
After the point name, you’ll find its location, described according to the methods outlined above. When necessary, alternative methods will be provided, along with illustrations, to make location as easy as possible.
After the location, you’ll find its TCM function(s), the way the point is able to work in the way that it does. This will use the traditional terminology introduced to you in Chapter 7.
After the function, you’ll find its indication(s), the symptoms for which it’s commonly used. While these are presented in familiar Western terms, be careful not to assume they are a one-to-one correspondence with a Chinese diagnosis. For example, you’ll find points with indications for headache on the Liver, Gall Bladder, Urinary Bladder, and Stomach meridians, but a headache can arise from many differing sources. If your headache is primarily related to a Urinary Bladder disharmony, selecting headache points from the Stomach meridian will likely not do you much good. The good news is it won’t likely do you any harm either, as these are all safe points. So, if you’re not clear on your diagnosis before you begin, some trial and error can be useful. Don’t get discouraged. A little effort while you learn will pay off tremendously over time.
While most of these points have a wide range of effects and applications even beyond what is presented here, some are known to have an especially beneficial effect on just one or two of the many conditions they may treat. When applicable, those will be noted after the indications as “especially helps.”
For the reader already familiar with Chinese medicine, you may freely combine these points according to your experience and understanding. For everyone else, it’s fine to experiment by selecting points that address your needs. You will get the best results by selecting points that best match your condition or goals. The diagnostic methods introduced in Chapter 10 can help you with that.
Point prescriptions for common Western-defined diseases are provided in Chapter 18. In most cases, those prescriptions will be very helpful, since they are based on the most typical Chinese diagnoses for those conditions. If the prescription does not exactly match your condition, you will still get some beneficial results.
In all cases, spend some time familiarizing yourself with the locations of the points and the way they feel when you apply pressure to them using different techniques. Getting acquainted that way first will give you another advantage in your self-care.
All points are bilateral (located on both sides of the body) except where noted, specifically in the Du and Ren meridians.