Anatomy. Specific for the low back. That’ll give us a little bit of focus when we go into the movement.
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Hello. Welcome. Thanks for coming. Thanks for taking the time outta your day to attend, and as usual, it’s always a pleasure to do these webinars with the American Acupuncture Council. So thank you to American Acupuncture Council for having me back. So you might be able to tell that I’m leaning, or excuse me, kneeling here.
And that is because pretty soon I wanna be standing and showing some some Qigong movement. Hopefully if you’re at a place that you can get up and do it along with me, that’d be great. So better to be a little bit interactive with it than just standing and watching or sitting and watching. So feel free to get up.
I’ll try to orient the instruction around the idea that you’re gonna be at taking part with me. But I do have a few things to cover first and we’ll look at a couple things. A couple things. Anatomy. Specific for the low back. That’ll give us a little bit of focus when we go into the movement. So let’s go to the PowerPoint and then we’ll go ahead and start that.
The picture here of the image is from eight pieces of brocade. We’re gonna be looking at four of the eight movements of eight pieces, bro of brocade. Each of these movements really could be quite good for the low back, but I picked four that are representative. of certain concepts that I wanna show.
Maybe we’ll get to four of those. Maybe we’ll just get to three of ’em. We’ll see how time goes, but I’d like to get to all four of these. So let’s look at a couple things anatomy wise first. So what we’re gonna focus on with the low back, it’s a pretty comprehensive, pretty big region, lots of structures.
I wanna focus on a particular part of the thac lumbar fascia. So thac, lumbar fasha. If you look at anatomy illustrations, that’s that diamond shape structure that sits in the low back usually illustrated in white, which is a fossil structure. If you’re doing dissection, it all looks the same.
But for illustrations they really highlight that diamond shaped thera lumbar fasa. , which looks like a sheet Thac. Lumbar faia is an asis, which means it’s a wide flat tendon, but those illustrations don’t quite highlight the multi-dimension, multi-layered quality of the thoraco lumbar fasa.
We wanna zoom into a particular part of the thoraco lumbar fasa called the Lateral rap. So let’s look at that structure on this illustration. I have my pointer here, so I wanna highlight this portion of the Thoraco lumbar fasa. That sits over on top superficial, maybe I can say posterior to the erector spinna.
So here’s the erector spinna muscle group part of the urinary bladder channel as we start talking about the channels. So that layer of the thac lumbar fasa is what you’d see in the illustrations. That diamond shape structure is what sits over the erector bna, but there’s another component of it that goes deep to the erector bna between it.
and the quadratus lumbo. So there’s names to all this. We don’t have to get too Huang up on that. That’s the posterior lumbar fascia that sits on top of the erector spinna. It’s the middle lumbar fascia that sits between the erector spinney and the quadratus lumbo. There’s another layer that goes in front of anterior to the quadratus lumbo.
Some models talk about three layers of that Tharco Mumbar faa. I think most of the direction it’s going now is that. More anterior layers considered a different fossil layer. It’s different embryologically. So I kinda like this two layer model of the one that’s superficial to the erector bna in between the erector bna and the quadri lumbar very deeply integrated with both of those muscles.
So the lateral rap is that seam, that meeting point where those two layers come together, or I guess if you’re in a three layer model where those three layers come together, but we’ll stay with the two layer model. So there’s the lateral rap. It’s at that lateral edge of the Quadra slum in the erector spin aid.
Deeply integrated with both of those muscles. If we follow that fossil structure going more around the body, that links up with the abdominal layers, especially the internal obliques and the transverse sub Dominus wraps around to the front forms another seam where those fossils layers come together.
This is referred to as a semi lunar line. Just lateral to the rectus abdominus part of the stomachs in new channel. So rectus Abdominus, deeply integrated with the lateral rap and deeply integrated with these two structures that are part in, in linked with the lateral Rafa urinary bladder sinu channel, the quadri slum part of the liver and kidney Sinu channel.
So a lot of channels going on. We’ll come back to that and look at it. But I just want you to have an appreciation at this moment for how this lateral rap communicates with a whole ton of structures in the low pack, a pivotal point. It’s like a lever that everything attaches to and communicates through and helps coordinate movement, helps the body know when the quadri alarm contracts.
The rectus of Dominus knows that, and it can link its contraction, link, its activity with it. So all of those structures can work together through the lateral Rae, through the mechanical pole of the lateral Rae. So we’re gonna look at movement to highlight that, but let’s look at a quick video that’ll show some palpation, some acupuncture ideas, some manual therapy ideas.
So for those acupuncturists who are wanting to link maybe some prescriptive exercises for their patients, With their acupuncture and manual therapy treatments, this will help with that. So we’ll go over, look at a video and then we’ll come back and start doing some movement.
Palpation of the low back can be complex. One of the key unifying structures to consider with palpation is the thoraco lumbar fasa. , especially a region within it where the abdominal fasha wraps around and joins with the lateral rae.
The lateral rap is a fasci seam at the lateral edge of the erector spin in the quad slum. From here, the fascia splits and goes superficial to the erector spna, and the other layer goes between the erector spna and the quad slum. It’s a pivotal part of the fassal system of the low back as it moderates forces such as side bending, rotation, inflection, and extension.
Start by finding the lateral edge of the ilio costal luum. This will be your window into the lateral press on the lateral edge of the ilio costal towards the quads.
From here I can palpate more superficially towards the erector, spiny, or change my angle and press towards the quad slum. I’m looking for areas of maximum tension. I can press towards the 12th rib or press down towards the iliac attachment again, looking for regions of maximum tension.
At the lateral, I can mobilize by lifting and decompressing, or I can press and de rotate the tissue. I can also apply a shearing force either up or down
for acupuncture. I need to transition from my palpating hand to my needling hand. I need to press and find the region of maximum tension. Assess the angle, put the needle in the exact angle, and then advance the needle to the depth that I was palpating.
I can use a lifting and thrusting technique until I find the region right there where there is a ation.
You can also palpate partial structures in the front of the body as they relate to the low back. The fasha from the abdomen wraps around to connect with the lateral in the back, but it also continues as it wraps around to the front to the semi lunar line. And then a portion of that fasha wraps over the rectus of Dominus and another portion of the fasha dives deep to the rectus of Dominus.
From the semi lunar line, I can press into the rectus abdominus and feel for Todd Bands within this muscle. I can move slightly up palpating across the bands of the rectus Abdominus, looking for areas of maximum tension.
I’m also looking for regions that might refer back into the low back.
From the semi lunar line, I can press into the rectus of dominance, feeling for depth, transition from palpation to the needle, and then advance the needle in the same angle to the depth that I palpated. And there was a culation.
Due to its strong foal connection, reducing tension of the rectus of dominance will translate to reduced tension in the back since the wraps around and unites at the lateral.
All right, so let’s look at some movement for that. We’re gonna be looking at, like I said, four movements from eight pieces of brocade. Maybe we’ll run outta time and just do three movements. There’s three main ones I wanna cover, but we might get to a fourth one. But I want you to have this idea that we’re working with the channels when we’re doing particular movements, when we’re doing more expansive movements where the body’s opening.
Lifting and stabilizing. In the core, we’re primarily using the shall the tie y and shao yin channels. I guess for low back we’d be primarily looking at urinary bladder and kidney in channel. But for this first movement, we’ll also be using small intestine and heart sinu channels, especially small intestines in you channel.
So we’re using whole body exercises to really zero into this area of the lateral Rafa and improve back health. We also wanna do some compressive forces using the, a lot of the abdominal movement. So y young Ming Tain channels specifically for low back. We’ll be thinking about the stomach and spleen sy channels, and then the Shell Young Jok channels are gonna have much more to do with rotation and with side bending movements.
So we have some expansive aspects, some compressive aspects some rotational movements and some side bending movements. All to be able to work. Paul on the fasha, Paul on various muscular structures, the Paul on the fasha of the lateral rap, and improve that communicating and supporting nature of that structure.
These are something that I work quite a bit with in Zoom class. I teach eight pieces of brocade and some other Qigong and strengthening type exercises. So if it’s something you’re interested in, feel free to get in contact with me about that. We’ll be covering at least a good portion of those movements here.
So last thing and then we’ll go to movement is I do have a series of online classes that I teach with Matt Callison as part of the sports Medicine acupuncture certification, but also just the some some smaller classes on actually the Quadra Andor, which covers a lot of this information that we’re talking about in the lateral rap.
We also have a class on the, so ads. Both of those ha are. Linked and will be some crossover information from what we’re covering today. Not as much the Qigong movements, but some of the anatomy and the acupuncture manual therapy ideas. So I think I’m done with the PowerPoint. I’m gonna move it.
We’ll go and get set up for some movement. Gimme just a second. And there we go.
All right, so I’m gonna back up, get into position. So we’re gonna start with, let’s start with a movement. It’s actually the second move in eight pieces of brocade, and it is called Drobo and Shoot Hawk. It’s gonna highlight much more of this opening, expanding aspect where we’re stabilizing and getting a lot of core strength.
This movement, innate pieces of brocade actually specifically is discussed as working with the kidneys. So we wanna get a lot of movement in the low back so that the kidneys can roll and move along the SOAs, which is what they do, but it’s also gonna start opening. And expanding that lateral rapha on both sides.
So we’re gonna start this movement in a wider stance or stance. There’s gonna be a lot of aspects of compression to give us full range of movement, so we can come outta that compression and expand. Just to give you a quick summary of that, or maybe you can try this with me. You can put a hand on the lower ribcage, another hand on the low lower Dion, just below the belly button.
And I wanna have this sense that those two come together, which means I need to tuck my pelvis under a little bit and bring my ribcage down so that there’s a compression. If I were to look at that from the side, I’m not leaning forward, I’m compressing. So that’s position one. Then as I come out of that and start to expand, I want to lift the chest, neutralize the position of the pelvis as I’m opening and as I start opening the hands, which I’ll look at in a second, there’s gonna be a tendency for the pelvis to go into an anterior tilt.
So I have to support with my kidney sinu channel, part of the core structures of the body to keep the pelvis neutral, keep the expansion, keep the decompression of the spine. So position two, we’ll look at it with the arms in a second, but it’s expanded. So we’re going from a compressive position to an expanded position.
So primarily using in the urinary bladder and the kidney channels to expand. So I’m gonna come back to facing the camera. Hands are down. I’m gonna compress. Hands are gonna come up the midline. One hand towards the opposite shoulder, almost like a boxing position. Then I wanna open like I’m drawing a bow open, pull the chest open, chest faces forward.
Elbow of the straightening arm faces down, so I have to externally rotate, broaden the chest, straighten the body. Hands come in, compress
and back up. Go to the other side. Compress hands come up the midline, hand to the opposite shoulder, like I’m drawing a bow open. I have to expand, lift the chest. Turn the elbow down towards the floor, open the chest, straighten the body,
hands in and back up
again. We’ll go a little faster this time. Hands up the center line of the body opposite shoulder. Straighten the body, pull the chest open, drop the elbow, broaden the chest. Everything’s straight, hands in
and back to neutral. So the diaphragm actually attaches to the lateral rfa. At least it has fossil communication. So let’s see if we can put breathing into it. So I’m gonna start here. Neutral. Inhale
hand to the opposite shoulder. Exhale, pull open.
Elbow faces down.
Inhale, hands come in.
Exhale, helps you create force. Open, expand, lift, chest open, inhale, everything comes together.
Exhale. All right, quick thought about the breathing, and then we’ll move on to another move. So you might find the opposite of what I said. So breathing, I don’t get too Huang up on. I know it’s talked about a lot in Qigong. It’s definitely important for low back health because things like the rated slum, lateral rap are deeply integrated with the diaphragm.
Interestingly enough, in some places you can get your 12th rib removed, completely cosmetic, creates a streamlined waste. Some people go, I think you can get it done in Mexico and not recommending it. But the idea when you do that is they cut the rib at the spine, tease the fibers away, and pull the rib out.
And what you’re left with is that seamless continuation of the quadr and the diaphragm. . They don’t have to cut the diaphragm and cut the QL and sew ’em back together. They’re already together. You just have to tease the fibers away from the bone, bring the rib out, not recommending it. But I want you to understand that, to have an idea of how integrated those structures are.
So breathing’s important, but breathing’s also really tied into our core. So if we don’t have the tone in the transverse sub dominance, maybe it feels odd to have that inhale when I’m compressing. and that exhale as I’m expanding. So maybe you have the opposite. No problem. The idea that you’re linking the breathing to the movements good.
Over time, you might find that it changes and you can have it more like I’m telling you in this particular demonstration. But the breathing can be flexible, so you want it to feel natural. All right, so draw, bow and shoot Hawk. We have that opening expansion. Everything’s lifted. Elbows down, so we’re engaging at the shoulder, but we have a lot of movement in the low back to be able to work with the low back pain patients.
Let’s look at another move. This is the sixth move in eight pieces of brocade. It’s called turn head and sway tail. This one will have a lot of rotation and it one of the key movements that we will have for a lot of people with low back pain sake. Reac joint pain. Just multiple types of low back pain facets, trigger points in the quadri slum trigger points in the rectals, pna, et cetera.
It’s gonna involve much more of our liver sinu channel and our gallbladder sinu channel. So those rotational aspects are very pivotal. Pivotal for a lot of low back movement. I’m gonna keep this horse stance. You might find a little narrower works for you. I need to bring myself down. Hands on the knees, if that’s challenging for you.
You can be up a little higher, but I’m gonna be down at the knees. My fingers are on the inside of the thigh. Thumbs on the outside of the thigh. I can spend a moment to get the back comfortable. I have that hollow body curved back. I’m not leaning forward, so my hole from the pelvis up to the spine’s curved.
Okay. First thing is I want to turn my whole body hips low back up through the chest, shoulder girdle. So turn, lift the chest. Imagine I have a little beam that I have to get under here and I have to roll under that beam compress turn. Lift the chest up under that beam. I have to let the spine curve duck under lift.
Chest up. Common mistake. Is I’m just turning my shoulders and cranking the neck around. I wanna turn at the hips. If I’m doing it correctly, I should feel one knee slide forward just a little bit. As this hip opens up, this other knee pulls back. I keep the structure, I’m not collapsing, but there’s movement in the legs as one turns that’s gonna transfer to a turn in the legs.
So we’ll go back down. We’ll do it again. Keep that in mind. Do you wanna turn the hips, turn the spine, turn the torso and ribcage, turn the shoulders. So it’s equal turn coming all the way up the body. If you do it properly, you should even feel it in the feet. You should feel that rotation. Drop into one arch, lift the other arch, and then as you go the other way, it changes.
So again, we’re gonna come down
spine’s, curved. I have a hollow body. I can warm up, get comfortable in that position. Fingers on the inside of the thighs, thumbs on the outside. Something I need to get under, like a beam or something. So I can duck under that. Turn from the hips. Turn from the low spine, lift the chest. Rise. Part of me stays down.
Another part of me comes up underneath.
under turn lift. So this one in eight pieces of brocade, they actually talk about working on the lungs, which it does. Also, if you look at the upper body, you can talk about that another time, but I’m thinking of that rotation and how that’s integrating with the low back. All right, so turn head and sway.
Tail challenge of that one is leg strength. You have to work on it to where you’re comfortable in that position, but really an excellent move for low back problems. Next one. Let’s look at, this is actually the first move of eight pieces of brocade. This is called two hands, left to heavens. We’re not in a horse dance.
We’re gonna be shoulder width stance.
Hands are gonna be overhead, so I’ll be reaching up. So I’ll give you an idea of where I’m going with that. Not much happens with the lower body. I can start with my hands out. This one works with the San organ. So we’re looking at triple burner san gel, but it also works quite a bit with the gallbladder sy channel, as you’ll see.
So hands curve up. My whole spine is slightly hollow.
Point the hands towards the ceiling. Lift the chest optional as I can come up on my toes. Fully stretch up. Hold for a second. There we go. And then back down.
Turn to the side. Her bend to the side. My chest faces forward.
So definitely stretching the lateral on the side that I’m bending away from back up. Now I’ll compress the lateral on that same side that it was stretching a second ago. Obviously stretching on the other side.
Chest relaxes, spine bows, chest rises. Okay, do it a few times, but let’s look at where people tend to. Get a little off on this move sometimes if they don’t have the flexibility to pull the chest back to pull the shoulder blades back in particular, I should say. Then when they go to rotate, they turn so they turn what should be a side bend into flexion, A different move.
I wanna keep the chest facing forward and side bend. If I need to compromise the straight arm position, no problem. I can have my arms down. That might help me keep my arms open, my shoulder blades together. But I want to get up as high as I can comfortably without distorting the move. So you want nice, clean side, bend stretch.
Stretch. So it’s like fabric being pulled. The minute you start going into deflection, then you lose that. Okay, so hands down,
Inhale, chest lifts.
Keep the chest lifting. Exhale, fully stretch. You don’t have to straighten the arms. That’ll be individual. Then down,
exhale, side bend.
Inhale back to the center.
Exhale, side bend.
Inhale back to the center.
and up. One more time. Inhale, compress everything slightly curved. My hands are going up only because my chest is going up. Chest is rising. Chest is rising. Exhale up on the toes. You don’t have the balance for that. No problem. You can skip that part. Inhale. Back to the center. Chest open, neck, relaxed,
exhale, side bend, stretching all the way through the hip to the feet.
Inhale to the center
All right, so we had draw, bow, and shoot hawk. Working a lot with the tissues, a lot of movement in the low back to work on the structures we’re talking about, but there’s also mobilization of the kidneys as we bend forward, straighten up, those kidneys are able to rise and fall and we get a nice little massage on the kidneys.
Very important for back health. We had that turning one turn, head, sway tail. A lot of movement in our liver. Also really deeply integrated with the low back lateral rap, quad slum. So there’s a lot of rolling and moving of the liver. I guess we could say. The other side also the spleen, not sure with webinars, sometimes you get a mirror image.
So this is my left side spleen, this is my right side. I’m not sure if it’s s playing that way on your screen. . So a lot of movement mobilization of the liver side bending. We also get a lot of mobilization of the liver and spleen cuz the liver’s able to rise up, the liver’s able to come down. So lots of movements with structures that are deeply integrated with the low back.
This next one really works a lot with the stomach. So this is separate heaven and earth one hand down. , one hand points up. My wrists are on the midline. I can only get up so far where my chest is up before I need to change, and I can change just by letting the hand turn towards the opposite side. This hand pushes down.
This one turns a little bit and back down. Chest bow slightly. Spine curves, chest opens as my hands pass.
Exhale, stretch. Inhale together.
Exhale, open and stretch.
And exhale. Okay, we’ll do a couple more times, but I wanna show something. So it’s like a washing machine for the stomach. As one hand moves, they get this little kind of movement through the center to help mobilize and turn the stomach integrated with the abdominals, integrated with the low back. So as the hand lifts a little bit more, that’s gonna pull the ribcage up.
As the hand pushes down, that’s gonna push the ribcage down. So I get a little bit of side bend, but I’m not side bending, so to speak. Just pulls me into a little bit of a position of slight expansion on one side, closing on the other side, then neutral. So don’t side bend, but just let the ribcage move. So as I get farther up and I continue to stretch, I get that little bit of expansion on one side, little bit of compression on the other side, and I’m able to move the lower ribcage, move the stomach, move the 12th rib, move the lateral expands on one side,
compresses on that same side as it starts to expand on the other side.
Okay. One more time each side. Chest bows. Chest opens,
chest bows, chest opens.
Chest. Those chest opens.
All right, very nice. So all four of those exercises move the low back in a different way. None of ’em are extraordinarily. Stretchy we stretch pretty decently on that. Two hands lift, the heaven, the side bending, but they’re mostly just moving. It’s like a stretch, compress, stretch, compress, engaging structures, relaxing structures, engaging structures, relaxing structures.
Those are the types of things that really help. create a gentle mobilization of the low back in a way that really improves the flexibility, elastic elasticity, and ability to stabilize for the fossil system. Especially things like the lateral rap that are so integrated with the front of the body, with the back of the body, with the core of the body.
With the rib cage and with the pelvis. So it’s of a lever in some ways that helps integrate movement between all of those structures. And we wanna be able to take it inflection, extension, side, bending, rotation, so each of those offers a window into one of those particular movements so we can be holistic in our movement of the low back and improving health of the low back.
All right, I think we’re good. Good timing. Four more moves, maybe another time. But also, like I said, I have some Zoom classes. You’re welcome to, to come into those. If you’re interested, just shoot me a message. But those four movements I thought were really key for low back health, simple to apply, easy to give to patients.
I work with them quite a bit. I use ’em myself. They’re great exercises. So thanks again to the American Acupuncture Council. And maybe another time we’ll cover the next four moves.