Tiaokou Point (ST-38 / Strip Opening)
Relaxes the sinews and unblocks the collaterals, regulates qi and activates blood circulation. Based on its properties, it is clinically used for chronic strain disorders of the neck and shoulders.
Indications
Lower limb flaccidity/bi-syndrome, and shoulder and back pain. (1) Shoulder-arm pain: Fifty-shoulder (frozen shoulder), inability to raise the shoulder and arm. (2) Lower limb conditions: Calf spasm, cold pain, numbness, foot/ankle swelling, polyneuritis, sciatica, knee swelling and pain.
Precise Location
On the lateral side of the lower leg, 8 cun below Dubi (ST-35), on the line connecting Dubi and Jiexi (ST-41). First locate Zusanli (ST-36) and measure 7 finger-widths downward – the point is in the depression.
Location Method
Sit upright with the knee flexed – locate the point at the midpoint of the line connecting Dubi and the prominence of the lateral malleolus (8 cun below Dubi, 4 cun below Zusanli).
Massage Method
Massage: Press and knead with the thumb. Press and knead Tiaokou with the thumb about 200 times, or for 3–5 minutes, to treat lower limb flaccidity/bi-syndrome. Therapeutic actions: Relaxes the sinews and unblocks the collaterals, regulates qi and activates blood circulation, regulates qi and harmonizes the middle.
Compatibility
Shoulder-arm pain (fifty-shoulder): Combine with Jianyu (LI-15) and Jianliao (TE-14). Fifty-shoulder (frozen shoulder): Needle from Tiaokou toward Chengshan (BL-57), also combine with Jianyu (LI-15) and Jianliao (TE-14). Abdominal pain and diarrhea: Combine with Tianshu (ST-25) and Qihai (RN-6). Lower limb flaccidity/bi-syndrome: Combine with Jiexi (ST-41). Regulate Yangming qi deficiency: Combine with Zusanli (ST-36). Foot weakness with difficulty walking: Combine with Xuanzhong (GB-39) and Chongyang (ST-42).
Efficacy & Actions
Tiaokou belongs to the Foot Yangming Stomach Meridian. It relaxes the sinews and unblocks the collaterals, regulates qi and harmonizes the middle. It is mainly used to treat sinew disorders and regulate Yangming qi and blood. Reducing or even reinforcing-reducing techniques are commonly used. First documented in Zhenjiu Jiayijing. Located between Shangjuxu and Xiajuxu, in the gap between the tibia and fibula, at the site of a strip-shaped muscle resembling a strip opening – hence the name Tiaokou (Strip Opening). It is also said to be a point for treating wind disorders. (1) Effective Point for Frozen Shoulder (Scapulohumeral Periarthritis): Tiaokou is widely used clinically for frozen shoulder, especially "fifty-shoulder" – often with immediate results. The usual method is to needle from Tiaokou toward Chengshan (BL-57). Fifty-shoulder often occurs due to Yangming meridian deficiency – by age fifty, liver and kidney yin deficiency fails to nourish the sinews, and Yangming qi deficiency fails to warm them, resulting in shoulder-arm pain and limited movement. Qi and blood deficiency is the root cause – when Yangming qi and blood are sufficient, wind-cold pathogens cannot invade, and qi and blood flow freely. (2) Treats Lower Limb Flaccidity/Bi-Syndrome and Foot/Ankle Swelling with Pain: As a Stomach Meridian point, Yangming is rich in qi and blood – "treat flaccidity by treating Yangming alone." Located centrally in the lower limb, needling dilates local blood vessels and improves circulation, achieving therapeutic effects. Clinically used for calf cold pain, spasms, foot swelling, and foot weakness with inability to control. The Zhenjiu Jiayijing records: "Shin pain, foot weakness causing loss of shoes, damp bi-syndrome, heat in the soles with inability to stand for long." The Beiji Qianjin Yaofang records: "Cold shins with inability to lie down; knee and thigh swelling, shin soreness with spasms." (3) Treats Gastrointestinal Disorders: Belonging to the Stomach Meridian, it treats gastric disorders such as epigastric and abdominal pain and diarrhea – especially effective for spleen-stomach cold deficiency. Needling Tiaokou enhances middle jiao transportation and transformation, regulates the spleen and stomach, regulates qi and dispels cold, thereby relieving pain.
Contraindications
The point should be located at the midpoint between Dubi and the prominence of the lateral malleolus. Needling should be deep – especially for frozen shoulder treatment, generally 2–3 cun deep.
