Brian Lau and Matt Callison

Foot Over-Pronation and the Spleen and Kidney Channels – Brian Lau and Matt Callison

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The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Welcome. Thanks for attending today. So we are recording, uh, prerecording, this video, uh, I’m visiting Matt in San Diego. We’re doing some, uh, dissection and we’re doing some, uh, techniques and putting them on video for some future classes that we’re working on. So this will be prerecorded and, uh, hopefully it’ll be an enjoyable experience for everybody. Good morning, everybody. So Brian and I presenting today, a brief clinical discussion on foot overpronation and the spleen and kidney channels. This topic is in depth in a 30 minute webinars highlighting only a portion of the content. However, we felt that the information in this presentation is providing the viewer some ideas that can be integrated into your own clinical practice. And we’re going to start this presentation with three primary, uh, with three primary biomechanical components of foot pronation that also leads to foot overpronation. So, Brian, do you want to talk about the video?

Yeah, sure. So, uh, put this video together and it uses a flexible foot model. You’ll see the video in just a moment, uh, just a little bit of, um, information on the video when I’m demonstrating and I’m pushing this foot down on a hard surface so that it takes the foot into pronation so that we can look at the components of pro nation, but I really flattened that foot down to the surface to, to highlight those particular movements in real life. And there’s a disclaimer that says this in real life, this would really be more like foot over pro nation, but it helps that helps visualize those particular movements. And that’s why it’s really flattened. And you’ll see what I’m talking about in just a second. Yeah. So just so you know that it’s not going to be on your end, this video, the first five seconds there pauses just a little bit after that, it Rose really quite smooth. So here we go, Normal footprint nation occurs.

And the longest pause that we’ve had in walking and running during the impact and weight bearing phase of gait, the foot falls into pro nation. This movement helps absorb shock and builds elastic, tension and structures such as the plantar fascia, which much like a trampoline will create an elastic recoil. During the next phase of gait, normal pro nation involves a combination of foot abduction emotion in the transverse plane. E-version at the subtalar joint emotion in the frontal plane, an ankle dorsiflexion, a movement in the sagittal plane during ankle dorsiflexion. There is also a medial rotation of the tibia during these movements, the spleen and kidney channel send use become lengthened. They also help control the motion and prevent the foot from over pronating. So proper tone in these channels send use necessary for support.

All right, so the video, it can, it’s very biomechanical. It’s an important thing to understand when you’re a sports acupuncturist, then you’re working with athletes or you’re working really with anybody who has injuries that have a component of foot overpronation that’s influencing the condition. But, uh, so I would argue just understanding the biomechanics is important, but even from a channel perspective, understanding the different components of the biomechanics is important because it tells us a little something about the channel sinews, and it tells us a little something about the position of those channels and the influence and relationship of one channel to the next. So this slide is going over a little bit of that and talking about an over pronated foot, really what you saw in the video as much of a collapse as we saw on that foot arch. Um, and with that overpronation number of things happen that caused really a downward collapse in the yin channels.

We saw that on the video with the spleen and kidney channel in particular, um, where those channels are kind of collapsed and dropped down and an excess excessive upward polling from the young related channels, like the urinary bladder channel in particular. So we see this in the image that she collapses downward on the inside and the, she has pulled upwards on the young side. This can lead to a number of injuries of the foot in particular plantar fasciitis, or plant our past Geosys. It can influence things like shin splints because of the collapse and the excessive polling of the muscles that attach onto the tibia. It can be a component of medial knee pain because of the internal rotation that occurs in the tibia. And really that can transfer all the way up into the hip and back and neck and upwards. You know, I mean, it really has a global influence on the body when the foot over collapses like that.

So we have

Another image here. That’s showing this in a little bit more detail on the inside and yellow, we have the spleen and stomach cheek collapsing downward, both of those that the, um, yellow on the inside of the tibia re referencing the tip posterior is a really major influence of a particular muscle that holds up the arch. That if that muscle is weak at the spleen, she is weak in particular, there’s going to be a tendency for that muscle to be weak and not lift and hold up the arch in the proper way to, by anterior on the stomach side, it is also a big part of that, cause it crosses over and attaches to the medial arch. Both of those will really help lift the medial arch. And then you have the upward Pauline from the urinary bladder channel send you, especially through the protea, as long as the brevis, which we’ll look at

Brian, next slide. And

This is looking at it from the back. So if you look at the right side of the foot image, you can see that the calcaneum tilt. This is part of the aversion that we saw in the video, the calcaneus tilts medial, the top of it kind of falls medial, and you can see a bowing of the Achilles tendon. So we can see a dropping of the kidney sinew channel and a lifting of the urinary bladder in particular, the soleus part of the kidneys. So new channel has more fibers that attach to the medial part of the calcaneus. Whereas the gastrocnemius, the more superficial muscle, we can see that on the left, where it’s kind of splayed back, um, and kind of off to the side, the gastrocnemius attaches on the lateral side, they both form the Achilles tendon, but if you tease those fibers away, the gas track would attach to the lateral portion solely based on the medial portion, the medial portion is going to be dropped and pulled access to be long in relationship to the lateral portion.

So another influence of the channel send news, right? And this next slide, I’m sorry, go ahead, Matt. I think the next one’s going to be the navicular drop. Yes. So let’s go back. The image on the right, you can see as Brian was discussing the imbalances of the sinew channels, this particular view poster is called helping sign that we’re going to be discussing here in just a second. There’s another way of actually looking at this as well, because the tibialis posterior spleen sinew channel attaches to the navicular bone using the navicular drop test is really quite efficient and looking at the lengthening of that tendon and the spleen channel. So when the person is a non weight bearing position, which is the top image you can measure to see how high the navicular bone is that that kidney, to which we know, can you choose located just underneath inferior border of the navicular bone? The bottom image is going to be a full weight bearing position. So you can see that blue dot has dropped significantly indicating that the bones being dropped as well as the tibialis. Most tutor attended spleen sinew

Channel becoming lengthened. The medial arch is collapsing. So here we’ve got being signed. The calcaneum e-version. So the calcaneus is tilting into an every position. You’ve got a bowing of the Achilles tendon. As, as we discussed before, this can lead to a number of different injuries, tarsal tunnel syndrome, Achilles tendinopathy, et cetera. So looking at this helping sign is an indication for foot overpronation. Now there’s a lot of people in the population that are walking around like this, and they don’t have any pain whatsoever, but with overuse, eventually pain will come just because it’s such a mechanical problem. In addition to the spleen kitty channels, being lengthened. And as we’ll discuss in just a little while or momentarily, the effect that the actual organs have play into this as well.

So with this particular one, you can see this test foot abduction, or it’s also a foot flare sign. You can look at this from an anterior view, or you can look at it from a posterior view. In the anterior view, you can see how that kidney sinew channel is long. And it’s dropped going from kidney for kidney five, kidney six. You can see how kidney two has dropped is a foot flare sign, so that foot’s going into abduction, lengthening that kidney send you. So the, the tissues involved in the kidney sinew are, are lengthened, and they don’t have very much integrity here at all. They’re not supporting the arch. Whereas on the other side, the bow, the are they internal extra relationship to the kidney, urinary bladder sinew channel is in a shortened position. So we’re going to talk a bit more about how to be able to treat that.

Is there anything that you want to say that before we go to the next line? Yeah. You know, that the lines that are representing the medial and lateral side, of course, the kidney and UV, um, it’s the channel, but it’s also the channel send news, which, uh, the, on the inside of the foot as the abductor hallucis. So it really does, uh, um, kind of go along the medial side to the big toe like that. And, you know, for that matter, the primary channels also over length and like that, but, uh, but in particular, this is showing the channel send use, and then the abductor digit, I minimize for the urinary bladder channel, which attaches to the minimize the little toe. So it’s also, um, uh, you know, follows that UV channel. So in a moment, we’ll show you some needle techniques and myofascia work for these two muscles in particular.

All right. So then the intrinsic foot muscles are out of balance of the abductor. Hallucis is Brian just to discuss on the kidney channel is locked long and it fails to support the medial arch and the abductor digital Mattamy is going to be locked short. Uh, Brian, do you want to take it away? And we’ll comment on both of these, these slides. So this, uh, again, very, uh, that in and of itself is going to increase people’s ability to work with, uh, uh, with flat with flatfoot, with Pez playing this and put over pro nation and many injuries that might come from that. But, uh, bringing that back into a holistic view, that’s in Chinese medicine, we can start to look at some relationships of something called acquired. Flatfoot something that develops later in life, usually in the 40 plus age group, especially more common with women.

Um, and there’s usually relationships. This is a very Western discuss discussion, but we’re going to bring it back into the Chinese medicine discussion here in a second, but this, uh, usually is involved with a number of types of injury. I mean, uh, uh, illnesses such as hypertension, diabetes, obesity. Um, so there’s a correlation with those types of illnesses and acquired flatfoot where people start having a loss of integrity and the tip posterior muscle and a collapse of the foot. Yeah. So the unusual or prolonged stress that’s going to attack spleen cheat and kidney cheat, faulty, biomechanics, ligament laxity in particular, that’s going to be kidney churchy as well, and the normal aging process. And as we know, uh, kidney cheese on the decline, the older that we get. So let’s move on to the next slide. Go ahead and be, uh, well, uh, just, um, some, uh, information from research, actually, Matt one to take this one.

Yeah. So posterior tibial tendon dysfunction is the most common cause of adult acquired foot. So basically we’re just kind of backing this up with acquired flat foot deformity, Beals States that poster tibial tendon insufficiency. Remember that’s what attaches to the vicular bone. That drops is the most common cause of acquired adult flat foot deformity. The exact etiology of this disorder is still unknown, but for a TCM practitioner, I think it really gives a lot of credit to looking at kidney chia and spleen to you when you’re treating somebody with PEs planus, because they’re coming in with an injury.

So what we did is we looked at two different references, the clinical handbook of internal medicine by McLean, and also the treatment of modern Western medical diseases with Chinese medicine by flaws and Phillips who now, um, we just jotted these down here. You can see in the bulleted points, hypertension, yes. Liver, young rising you’ve got phlegm fire. Well, the spleen and the kidney is going to be associated with phlegm liver and kidney yin deficiency. Absolutely. You’ll see that also with hypertension. So when somebody has hypertension and flat feet, we’re looking at the kidney channel there, there’s also the pattern of Chong and Wren dysregulation, which is interesting because you see the master points of Chong being explained for, and then red being right being lung seven, kidney six, blood Stacey, this is something else with hypertension and then obesity. What these two authors with these are talking about stomach key with food stagnation will stomach, stomach being tibialis, anterior, which can be in a lengthened position in PEs, planus, phlegm, dampness.

You’ve got your spleen there. You’ve got spleen deficiency being cheat efficiency, as well as Yong deficiency. I’m allowing that collapse of the medial arts. So the strength of the organ itself being reflected within that channel primary channel and gene, Jen, I’m not giving enough cheesy to be able to support that medial arch at obesity. You’ve got liver and kidney inefficiency as well, as well as CHAM blood basis, then diabetes, there’s your stomach heat systemic channels and paying the fact that diabetes, spleen and stomach cheat efficiency. There’s your tibialis, posterior spleen tibialis, anterior not getting enough to within the channel because of the organs overall chain blood deficiency flam, again, being spleen. Liver is fleeing disharmony with heat. There’s your spleen channel again? Kidney, heart, and liver yin deficiency. There’s your kidney channel, kidney and heart yang deficiency, kidney channel again, and kidney in acuity. So there’s a lot of support with the spleen of the kidney channels here. Um, Brian brought up a really good point about this. If we were able to do some kind of, of, um, research with it. Brian, do you want me to describe your idea that you and I were talking about yesterday?

Yeah. So, you know, in the acquired flat foot discussion from Western circles, they just basically say that there’s correlation with hypertension, there’s correlation with obesity and diabetes. What would it be? Very curious and, and, uh, I think it’d be great to, to study it w it would take some time and resources. Of course, let’s say you took hypertension and you took all the people with hypertension who had acquired flatfoot, it’d be curious to see how many of those people had, if you differentiate them into patterns from a Chinese medicine standpoint, how many of those people had really more correlation with the spleen and kidney patterns? Um, based on the fact that those are going to have it,

I change in those related channels

And that my hypothesis, my guess would be that, that if you found the people with hypertension who have acquired, flatfoot, you’d have more phlegm fire more,

And kidney yin deficiency, maybe not so much liver young. Right.

Who knows, I’d be curious to find it, but that would be my guess. Yeah.

The takeaway from this, everybody is that, and this is something that we teach a lot in our education and our school is that when you’re looking at musculoskeletal, it’s never just musculoskeletal. There’s always some kind of zone food component, and we are TCM practitioners. So always look at that [inaudible] component, being able to supplement the musculoskeletal treatment, it should be held together. So this is something that a sheet for you guys to be able to take a look at. This is going to be just for the local muscles themselves, that you can be able to treat in addition to the person’s constitutional points and zone food. So, um, the peroneus longus and the peroneus brevis, these are going to be locked short. They’re going to be accessed. These muscles are going to be real, uh, primary in treating this. So you want to reduce the access so that the deficiency starts to come up. So we’ll address the deficiency as well. But since we don’t have a heck of a lot of time on this webinar, we are going to be showing you the peroneus longest and the prone peroneus brevis needle technique. We’ll also going to be showing you the abductor hallucis and flexor hallucis brevis needle technique as well. Um, there’s also an image I believe of the abductor digital me that you can be able to use. So, Brian, anything you want to say before?

Yeah. I’m sure there’s people watching this who are going Fronius longest and breakfast. That’s on the gallbladder channel. Uh, this is interpretation, but go back and open up Deadman or any book that has image of the channel send news. Of course, they just show topography. They’re not showing him in particular muscles, but you’ll see that the urinary bladder send you channel has a lateral branch that could be interpreted. We interpret it as pretty, as long as in brevis those muscles have a much stronger fascial connection to the hamstrings. I’m in link with the urinary bladder channel. Whereas we put the gallbladder, send new channel more with the extensor digitorum longest, which is just in front of the fibula. And really, if you look at it from primary channels, you’d see the gallbladder 34 and many of the gallbladder points along the lower part of the channel would actually go right into extensor digitorum longest. So yeah, go back and check out those images and you’ll see there’s a lateral branch. And that’s what we’re interpreting is plenty as long as some brevis

In addition, Brian and I actually, we proved this relationship on a cadaver specimen and it’s on our YouTube video channels, sports medicine, acupuncture, where we put a needle into the Proteus longest motor point. We put a needle into gallbladder 34, and then we put a needle into the biceps for more the hamstring motor point. We pulled on the biceps for Morris motor point. You could see where the force tension was going, and it was moving the Proteus longest needle substantially, but not gallbladder 34. So this is a really linking that urinary bladder sinew channel that’s on the YouTube channel sports medicine acupuncture. If you guys want to check that out, let’s go into the video showing the peroneus longest. And the peroneus brevis, I’m going to set this up a little bit. So you can see is that we have one needle in the peroneus longest motor point, which is located just two stone below the head of the fibula. And then we have a needle in the peroneus brevis that’s angled upward. So we’re wrapping the twist, the needle. We wrapped the fibers around the brevis and we’re pulling down so that you’ll see the needle moving on the Proteus longest because we want that. She took me moving downward in PEs planus with every step, as we talked about earlier in this, that she is moving upward on that lateral side, being the young side, we want to pull it down. So here we go.

Peroneus longest motor points too soon down from the head of the fibula peroneus brevis motor points. One soon above gallbladder, 35, this needle technique for the perennials that are in a shortened position from foot overpronation. We want to try to be able to pull the muscle fibers downward in order to be able to change the cheesy within the channel change, the appropriate perception. When I wrapped the fibers around the peroneus brevis and I start to pull down, you can see the movement in the peroneus longest motor point. So I’m going to maintain the traction. You can see how that needle is moving. So therefore the muscles, the fascia, all the proprioception here is starting to change and I’ll hold this. So the muscle can get used to being in its new position.

Alright, so that needle technique is in combination with something that we talked about earlier, lifting up the medial arch. So this is a needle technique that you can apply to everyone, but it is very useful to apply to those people that can handle the strong cheese sensation I’m using a thinner needle is also useful, but you, in my experience, you need to have this as a Chinese needle. Um, some of the needles that are coded, um, will not allow the fibers to wrap around that. So, um, it’s a good idea to be able to have our Chinese, you know, I’ll watch, those are my favorite to use in this particular case. But again, you can use a thinner gauge needle, but two muscles are the abductor hallucis in the flexor. Hallucis brevis that we’re needling here. The motor points of each muscle found on the kidney and the spleen sr channels are needle to lift the collapsed tissue at increased proprioception. So you’re needling there underneath kidney too. And then also you’re needling halfway between spleen three and spleen for going into the muscles themselves, twisting the needle to patient tolerance, and then gently just lifting that arch so that you are starting to change the proprioception with that. Then you would leave those needles in place. In addition to all the rest of the needles that we have in that formula, treating adjacent points, distal points, and also constitutional zone crew. Yeah. I might add something to that. As Matt mentioned, you’re leaving those needles in, uh, so usually

If they’re in for 10 minutes and you go to bring the needle out, no problem that comes out, the tissues relaxed, you know, it might be the case that the needle wouldn’t come out right away. That’s the point is you’re trying to lift that tissue, but it usually will come out, no problem, but do pay attention to which direction do you turn the needle on case? Uh, it really doesn’t happen with me this way, but in case of where to get stuck, you’d want to unwind it. And the other directions of your going clockwise, you know, make a note of that. And if you, if the person can’t tolerate this type of treatment, it’s not too bad that you’re, you know, you’re going slow and gentle and to patient tolerance, but needling, the motor points would still be useful on their own. But it’s going to give a little bit more bang for the buck by doing this lifting technique.

Yeah. Sure. All right. So here’s the needle technique. That’s kind of based on the same idea. Brian, do you want to go ahead and discuss that?

Yeah. The image I’m just kind of glancing at this now and noticing that the little black line for UV 63 and UV 64 is a, is a, um, just a pointer. The needles are a copper kind of colored. So, uh, take note where you can see my thumbs holding onto those needles. So same idea. Uh, the needles are put into UV 64 and UV 63 64 is the motor point for the abductor digit I minimize, which has a strong connection to the lateral band of the plantar fascia. So you’d be 62 would be into that lateral plantar fascial band. And then the needles are twisted gently. And until they catch the tissue until they catch the fascia and then pulled away from each other to help widen that, uh, lateral portion of the, uh, urinary bladder send you a channel, the part they get shortened as the foot goes into abduction. And that whole side of that lateral plantar fascia become shortened. You’re widening that lateral band of the plantar fascia. So it reduces, you know, reducing technique.

Yeah. So this technique followed by a really good, mild fascia technique. They were going to show you an image here in just a second is really quite good doing this technique and then the mild fascia. So Brian would take away some of the myofascial work.

Yeah. So myofascial work is really going to be, um, following the same principles. So a, this, you can see the two knuckles on the urinary, excuse me, on the peroneus longus. And brevis going down that, uh, lateral band of the urinary bladder send you a channel. It’s kind of widening that lateral band, but each time you’re, tractioning this issue down and then widening kind of like making little Chevron type, uh, positions and move down a little bit, bring the tissue down, widen, go down next step. So the whole time you’re, you are widening that, that portion of the lateral compartment, which is containing the, the peroneus longus and brevis, but you’re bringing that tissue down. That’s the key takeaway from this as you’re helping, uh, encourage the fascia and muscle and all the appropriate sectors downward in the same way you were with the needle technique.

Yeah. Starting top pending at the bottom. Yeah. Good. That lateral band would be pulling the foot into, um, into IE versions that you’re helping correct that by, by dropping it very useful after the needle technique and see what the next myofascial release, Oh, it’s an exercise. Right? So inchworm exercise, this is a very useful exercise for helping to restore some of the integrity in that medial arch. Um, it’s warm. You can actually Google that if you wanted to, and you can get this step by step, you can see with the foot on the left. Um, this is I think, prions foot. So he doesn’t have a Pez plaintiffs on there, but if it was a flat foot, um, you can see as what he’s doing in the middle of the images, he’s bringing the first metatarsal and the big toe up toward the calcaneum as the calc Aeneas stays in place.

So he’s increasing the integrity of that medial arch. Then he puts his way on the forefoot and he brings the cow Kanyes back, which will flatten the foot again. And then he repeats the exercise. This is an exercise that you could probably find step by step. I would think on Google, this is also something that we teach in its entirety. I think though, a usually in Google, it’s not going to be under insure. Um, it’s uh, and cause usually people don’t walk it back like this and it’d be called a, uh, short foot exercise, but we modified that. Okay. Yeah. So the short foot exercise is going to be a little simpler than this one. So, and that would be probably, you know, you can find videos of that, uh, curls probably to take it away on this one. Yeah. This one that is, if you look at the, the, the kind of ghost image on the top little corner portion, that is your, you are taking the foot and you’re dropping the medial arts, you’re taking the foot into abduction and just, you know, basically collapsing your weight into the medial arch.

And then you’re starting from a position, I guess, a dysfunction and then you’re curling the foot and lifting the medial arch. Um, so this one would also strengthen those, um, intrinsic muscles of the foot along the, the kidney and spleen channel. But it would also be calling on things like the tip posterior, because it starts to take the foot into a position that, that, uh, engages the tip posterior. So this is, uh, training, both the intrinsic and extrinsic flip muscles. Yeah. Good. Yeah. So the ghost image is the, before the, not the fall images the after, and it’s not a ghost image because it’s so white, it’s actually because the right funnel doesn’t move on. Okay. There’s a references, right? So you guys thank you very much for attending this. We want to thank the American acupuncture council for having us. This has been really a lot of fun. We hope that with this very complicated and in depth topic, we just took some portions of it actually. And hopefully we gave you some useful insights or clinical pearls that you can be able use to be able to help other

People to help your patients. Uh, Brian, thanks very much, Matt. I do want to highlight that there is also on the YouTube channels, sports, medicine, acupuncture, uh, full needle treatment, uh, that shows both before and after for changes in the foot that was done in one of our classes that covers this whole whole protocol, basically without the myofascial and corrective exercises, but just the needle abortion. Yeah. Good point. Okay. Well thanks very much. Appreciate it. Yeah. Thank you. Alright. Take care everybody.

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