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Introduction to the San Jiao Channel Sinew (Jingjin)

 

 

So we are going to discuss a St Joe’s sinew channel today, a little bit of the typography, a little bit more of the anatomies to start off with, and then we’ll, um, have a chance to talk about a representative injury of the channel. So that’ll give you a little preview of what’s to come in the next 20 minutes or so,

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Disclaimer: 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.

Hello, everyone. Welcome to the American Acupuncture Council podcast. My name is Matt Callison. Hi, I’m Brian Lau. We’re from Accu sport education and the sports medicine acupuncture certification program. Uh, we want to chat with you today about the San Jiao channel. So can we get into that first slide please? Alright, so go ahead, Brian. Yeah.

So we are going to discuss a St Joe’s sinew channel today, a little bit of the typography, a little bit more of the anatomies to start off with, and then we’ll, um, have a chance to talk about a representative injury of the channel. So that’ll give you a little preview of what’s to come in the next 20 minutes or so,

Matt, were you going to say something? I was just going to introduce that you did a great job.

All right. So this’ll actually also give a flavor of what we teach in the sports medicine, acupuncture certification, each module, we haven’t anatomy, palpation cadaver lab. Uh, so there’ll be some elements of the anatomy that we’re going to be teaching and actually have a class you’re watching this live there. We’re going to be starting tomorrow, uh, for the upper extremity. So the San Jo channel will be one of the many channels that we’re looking at, obviously for the upper extremities. Um, and, uh, some opportunity to look at some, uh, dissection that we’ve done, that we’ll be presenting in our class. Uh, so we’ll remind about this, but if you are watching this around other people, we’ll give you a heads up before the dissection stuff comes on and give a couple thoughts on that, but you just want to make sure that there’s nobody, uh, around you that might be, um, you know, it might be disturbing for some people, if they’re not medical providers and they’re not used to seeing cadaver images. So we’ll give ample warning before those videos come on.

All right. So let’s go to the next slide and we’ll start looking at some of the entry, uh, anatomy for the channel sinew of the Sanjay channel. So this is from a translation of Vietnamese scholar Vanji, uh, from, from the link Shu chapter 13. And if you kind of glance through it, uh, you can see that it gives a description of the typography. It’s kind of vague, you know, the, uh, very open to interpretation and, and vague some of the anatomy descriptions and the link shoe from chapter 13 for the channel send news channel, send sinews have maybe been a little bit less, um, explored than the primary channels and some of the other secondary channels, like low connecting, et cetera. So the channel send you is probably in the history of Chinese medicine. Haven’t been explored as thoroughly, and we’ve been doing a lot of work within the sports medicine acupuncture program to, um, further define and be a little bit more specific on the anatomy of each channel, uh, including which structures are involved with, with channels, how they link with other channels in terms, um, parents, you know, like internal, external related channels, how they communicate and work with those, how they work mid David died, et cetera.

So just to be a little bit more, um, specific with the anatomy and a little bit more specific with some of the functional anatomy in particular, so you can kind of glance through and see some, some aspects of the original description at least translate in English and this translation. So anything dad, Matt? Yeah,

This is good. Let’s go into the next slide there.

Yeah. So yeah, here we have, uh, our interpretation of the, um, San Jo send you channels. Sometimes we referred to them as sinew channels, channel sinews, DJing, Jenn musculotendinous channel, a lot of different translations DJing. Jen would be the, um, the opinion version from the Chinese. So here’s our interpretation of that. The sand shout send new channels a little bit, um, harder to interpret as it gets higher up into the traps and starts, uh, including some of the, um, the cervical fascia. And we’ll go over that when we get to it. But if you just glance through the list, that’s pretty channel like we have the fingers, finger extensors on the back of the, uh, kind of posterior surface of the forearm. Uh, deep to that, uh, included is the super Nader. Uh, then the medial head of the triceps, the triceps are three muscles, but there’s two that are superficial belong had in the lateral head are more superficial.

And then deep to that is a shorter tricep muscle, which is in a different sort of compartment. I’m still a tricep, but it’s a deeper one and that’s the medial head. And that’s part of the San Josten new channel, the more superficial as part of the small intestines, any channel then as that travels up and connects with the lateral intermuscular septum that goes into the deltoids into the superficial deep cervical fascia, superficial layer, upper trapezius, SCM dye, gastric, and up into the scalp. We’ll go through that in a little bit more detail in the next several slides and that you were going to add something to this also.

Yeah, I think it’s important for us to remember that each one of these muscles in these tissues are all interconnected. So this is why when we can treat something, put an acupuncture in distal, how it can signal along that model of fascial chain and soften or change pain at a proximal area. For example, if somebody has pain in the SCM, how we can treat some of these different tissues, a distal from the SCM and start working towards softening that SCM. And is that, uh, the bottom line here is that each one of these tissues are fascially connected and they can be able to carry signals. So I think that’s, that’s good. So we’ll move on to the next slide.

Yeah, sure. Yeah. That’s a good point, Matt, because then that includes, um, both channel points that can regulate tension in the sinew channels, but also, uh, points that are off channel and maybe include, uh, she points or muscle motor points and et cetera. Yeah, let’s go onto the next.

Yeah. Good. Okay, good.

So if we kind of look at the forearm, we have a more superficial layer of the San Angeles and new channel. And like I kind of already alluded to that. Is it going to start at the, uh, the hand with the tendons of the extensor digitorum commuting as muscle? So that’ll travel then up the posterior part of the forearm, and it’s going to attach to the lateral epicondyle, uh, that fascial linkage. And that was referring to then from the lateral epicondyle goes right into the lateral intermuscular septum. A lot of people might not be familiar with the lateral intermuscular septum. It’s highlighted in green in this image that I, we put the highlights in, but the image itself is from an anatomy Atlas from a German author Tillman. So you can see that little thin green line, just, just between the biceps and the triceps.

So this lateral intermuscular septum is the kind of fascial September wall between the biceps and the triceps, and it can transmit force. And in this case for the San jab sinew channel, it’ll transmit force up into the deltoids, particularly into the middle head of the deltoids. So that’s a more of an overview of that superficial aspect. Um, but also, uh, the medial head of the triceps can put tension into the lateral intermuscular septum. So there’s a lot of communication between the medial head of the triceps lateral intermuscular septum, uh, extensor digitorum communis. So those are all facially linked.

Good. All right.

So I guess we can go on to the next one

Next slide.

All right. So we have two more images from the same Atlas. So the first one on the left, we have, you can kind of see the little tools that are there to move apart. Um, and we’re going to see this on that cadaver video that we did. So in any of these types of things, everything’s so facially connected that you’d have to have a scalpel to kind of tease the way that fascia so that you can then come and move away those compartments, and then see deep, uh, below in this case, the extensors, the wrist extensors, especially extensor digitorum communis. And what you’re seeing is the super Nader, which then on the image on the right is a much cleaner image, cause it has all of that other stuff taken off. So you can see kind of the relationship on the picture of the left and then the deeper structure of the super Nader, uh, on the picture, on the right, also part of the sand Jassen you channel, and it especially links, you know, everything has a fascial linkage. This one has a fascial linkage that has a name, uh, into the lateral intermuscular septum. And that’s a radial collateral ligament. So you can see the image on the right really nicely shows that radial collateral ligament that has splashes spreading over the super Nader and then up above it, into that lateral inner muscular septum.

Yeah. Excellent. So let’s go back. Let’s say somebody

Has that sternocleidomastoid pain just to be able to keep it consistent. We could create the supernate or we could treat the lateral intermuscular septum. We could also treat San Jo one. We could treat the extensor digitorum communis and all of those points would end up affecting that part of the SEM that is affected by the sand Jobson channel.

Yeah. Yeah. That’s the hems is interesting too because, uh, the San Justin channel particularly seems to affect the GLA vicular head and then there’s any trigger point people, uh, listening and you might know, Oh yeah, the curricular had kind of refers oftentimes pain into the ear. It can be a headachy, uh, pain into the forehead and different places, but it often refers into the ear and can cause, um, positional vertigo. So then, you know, for me, I started thinking, well, geez, what, what would that make sense for the sand Dow channel to have some kind of effect in the ear and any, and any acupuncturist here? Of course they, yeah, of course you have John three, Sandra five, there’s a lot of, uh, relationships, the points on the San job channel with the, uh, with the ear. So that’s one that has, has an interesting correlation, but it, you know, like Matt, the sand supinate or other ones could be really involved.

I was just thinking San Joe seven, also being the sheet cleft point of that channel is the motor point for the extensor and dices. So that would be another point there too. Yeah.

And that one’s in the channel. We have that one listed in the list above, but it should be

All right.

We’re ready to move on to the next slide.

Sure. All right. So from the

Deltoids and especially the sand Dow channel has a relationship to the middle deltoids that then, uh, deltoids then go to the spine of the scapula and the chromium. And they pick up the, uh, superficial layer of the deep cervical fascia. Because if you look at the trajectory of the Sanjenis in your channel, it kind of comes from the back and it goes up the neck and then binds to the jaw. There’s really no muscle that has that trajectory that way, I guess the [inaudible] more superficial might, but it’s, it doesn’t seem to make sense for the San Joslin new channel. But if you look at this fascial layer of this superficial layer of the deep cervical fascia, it does have that trajectory and binds and connects them to the mandible, to the sort of angle of the mandible and then, um, ramus or the body of the mandible.

Um, so it sort of follows that trajectory and it wraps around the trapezius and wraps around the sternocleidomastoid. So it’s very intimately involved with both the upper trapezius and the sternocleidomastoid the digastric is in this region also. Uh, so if you think about the channel as being more of that cervical fascia, um, it might cross and include muscles that aren’t going in the, in the trajectory, in the pathway of the channel, but still has tensional relationships with the SCM seems like particularly the clavicular head of the SCM and then the upper trapezius and upper trapezius is a big muscle. Uh, I would say that particularly relevant are those fibers of the, uh, upper trapezius that go from the, a chromium to C seven, which are what you would be needling if you needle the motor point, uh, in maths book book, the motor point index it’s referred to as the part two fibers that many people needle from sand gel, 15 kind of angling upwards into gallbladder, uh, 20, 21, excuse me

Now, which is nice, that new technique is safe. It’s you, you’re not going to create a pneumothorax with that and linking the shower Yom channels, which is nice. Something that we take the teach in the smack program is acupuncture as an assessment. And this is going back, let’s go back to the SCM clavicular pain, so to speak, maybe somebody who’s having a cervicogenic headache is going to the side of the head in the sand jaw channel. We’ve provided already a list of different points that we could use that would help to say change range of motion, or start to decrease that headache. So acupuncture is an assessment. If somebody has that type of headache and maybe they have limited range of motion, they have a forward head posture. If we put the acupuncture needle into the extensor digitorum communis motor entry point, and then had the purse move to see if that actually changed the cheat within that San Jo myofascia channel, or we could use of course, San Jo one San gel seven, the lateral intermuscular septum. So we’re providing a number of different tissues that you can use for either a proximal injury or a distal injury using acupuncture as assessments. Really nice because it’s just giving you some ideas of what points actually make the greatest effect on that orthopedic evaluation on that range of motion on that pain, then you would take that needle out. And then when you’re actually going to be needling, the patient you’ll include that needle back in as part of the point prescription. Okay. Hope that was clear.

You already saw immediately that it had an effect on the dysfunction. Yes. CSS.

Yep. All right. So do we now go into the next conversation about the cervical fascia?

So this is a image that’s put together from this, uh, professional softwares. I go body, uh, they don’t have that little lines that are drawn. I, I painstakingly put them through, uh, through a illustrator like program, but, um, but cause I wanted to show the fascia because these programs, these 3d programs are very clunky and not as a muscle like the deltoids and traps and they’re like putting Legos on, um, which is not how the body is when you see the cadaver dissection. Obviously you’ll see this very clearly. So I put those white lines on the sort of show the fascia coming up from the middle deltoids, sweeping through the, uh, upper trapezius going across the SCM I say across, but it actually both the, um, STM and the traps are embedded kind of surrounded in that superficial layer of the deep cervical fascia. So it goes on both sides of the SCM and then goes to the mandible and links up with some of the fascia and the jaw and up into the temporality, uh, fascia, which would include the temporalis muscle.

In that case, you can also see those little, uh, your muscles that move, uh, and stabilize that region of the, uh, of the ear. Um, but the temporary, temporary Alice fashion, uh, the temporary, temporary Alice muscles. Interesting because that’s another point. And I think Maddie, you have the send the motor index as, as having, you can treat the motor point for headaches and various reasons, but this one has a, um, empirical use of, of, uh, reducing tension in the upper trapezius ipsilateral is another. Yeah. And you can see through the fascia, how that would be, be very much linked and help communicate that, that the attentional relationships between the two. So, you know, the take home, there’s a lot of things that are surrounded by this fascia, but really clinically the upper trapezius, especially those fibers that are kind of horizontal connecting to C7 as part two fibers and the [inaudible] head of the SCM that you haven’t, you can access from the motor point kind of in the region of stomach nine and angling through the muscle, but you can also get really good access to it through sand gel 16 and angling from Sanjay 16 cross Valley into the posterior portion of the SCM and, and, uh, um, connecting into that clavicular head.

We have a video on, um, the YouTube channel sports medicine, acupuncture, YouTube channel that shows both of those, um, both, uh, both the needle directions for the motor point and through that Sanjay 16.

All right. So the next slide is going to be, sorry, Brian, go ahead.

I said, I think that’s the, a it for the intro. Yeah. And I think we’re getting ready for the cadaver. Why don’t you set this up that? Sure. Yeah. So let’s just make sure that again, some people, if they do see this, um, passing by your computer or sec are really not going to enjoy it very much. It can actually really affect them deeply. So let’s be really careful of where we’re observing the following video, which is going to be of a cadaver dissection. Um, let’s make sure that there’s no screenshots, no sharing of the recordings and no downloading, please with this, we don’t want to share this kind of information. This is just for us medical professionals to be able to learn from. So then can we now see the video please? And then I believe there’s,

So we’re look at the sand house in your channel, starting with the forearm. We have the extensor digitorum communis exposed extensor digitorum, communis in a different fascial compartment. Then the extensor indices, so different fascial compartment than the extensor indices. Here we go. And a different fascia compartment. Then the extensor digit I minimized. So indices digitized minimize. So we’ll put those back into place so we can see them in relationship extensor, digitorum communis comes up. The arm attaches to the lateral epicondyle it also communicates into the lateral intermuscular septum, but has a communication into the medial medial head of the triceps, which there’s a little part of it on the lateral aspect there, medial aspect of the triceps also puts tension into that lateral intermuscular septum. So San Jo has more to do with the medial head of the triceps all the way up communicating with the deltoids. We feel that that communicates more through the middle fibers of the deltoids and then into that portion of the upper trapezius that attaches to C7. So those part two fibers of the upper trapezius and another point we’ll be able to do a little bit more dissection and start to look underneath these structures to see the, a super Nadir, which we’re starting to see a little bit of the super Nader right there, part of the sand gel channel.

All right, great. So let’s get to the next slide. All right. So some of the common injuries associated with this particular manufacturer, Jean Jim will be distal the EDC tenure synovitis. So the, on the wrist itself, the tendon that is going to be in the middle of San John for an extra point zone Tron. This is a common area for risk tenure, synovitis of the extensor digitorum communis and also super Nader syndrome. So the super Nader being deep to large intestine nine, and we’re going to actually talk quite a bit about the SuperNet. We’re going to highlight it in this podcast because it’s a great mimic for lateral epicondylitis. Um, this particular podcast also, um, will parallel the blog that we have on the sports medicine, acupuncture website, sports medicine, acupuncture.com, where we discuss supinate or syndrome. And we’ve got a couple of videos also, including a mild fascia release technique.

That’s very effective for helping to release the Supernanny. And we’ll talk about that in a little bit more. So another injury that you can get in the Sandra Jean Jean will be lateral epicondylitis in particular, when the extensor digitorum communis is involved, which it commonly is. However, with lateral epicondylitis, we also have the extensor carpi radialis longus and brevis, and those will be more in the large sinew channel. So the lateral epicondylitis will be the EDC or the extensor digitorum communis involvement. Then we have our tricep strain, which can occur around San Jo 10 and actually go all the way, even the lateral, following that Sanjay channel toward the Antonius, the medial head of the triceps, which is involved or categorize within the San jar. Gene gin is one of the more frequent muscles out of the three triceps that become strained. That can cause, um, a tendinopathy there around San Jo 10. Then of course, as we discussed earlier, any kind of muscle tension headaches, they might be contributed from that cervical fascia and also the, um, um, looking at the clivia head, the SCM. So let’s, let’s focus a little bit more now on the super Nader syndrome. Like I said, which it can, it can mimic lateral epicondylitis because it does attach to the lateral epicondyle. So let’s go to the next slide, please.

So the supernate or being in the deep layer that you saw in Tillman’s images. So if we took the extensors off on this image, you’re going to see that supinate or that you also saw on the cadaver dissection. So the radial nerve, as it comes down from C5, C6, C6, C7 follows along the sand job channel around large intestine 11 region. It actually bifurcates. So the superficial radial nerve travels along the large intestine channel. And then the other bifurcation is the deep branch of the radial nerve. It’s also called the poster interosseous nerve. So deep radial nerve and post interosseous nerve is synonymous that posterior interosseous nerve dives down through the supinate or through this fibers canal card that called the arcade of fros. Now with overuse in the super Nader, either being in a lock long or a lock short position, it can entrap that poster interosseous nerve and cause a parasthesia along that sand jaw channel, but it can also mimic lateral epicondylitis. So lateral epicondyle can actually be a little bit tender in that region, but most of the pain is going to be around large intestine nine region. Let’s go to the next

Slide.

So this is from a previous dissection that we’ve had. You can see that the radial nerve is there on the left, the, the blue ribbon there, which is actually a surgical glove, just cut up tied around. So you can see that bifurcation. So the elbow is going to be where that blue glove, that blue little ribbon there that’s the bifurcation. So you can see that post interosseous nerve traveling through the super Nader muscle and then exits and follows along the sand jaw channel. If that muscle, like I said, from overuse and traps, that nerve, and that can cause a parasthesia within that region within the sand jog channel will cause pain, raw, large intestine, large intestine, nine large intestine, 10 deep, but it can also cause around lateral epicondyle. So it could mimic lateral epicondylitis. So a differential diagnosis is going to be needed. Lateral epicondylitis will not have a parasthesia if there is pain at the lateral epicondyle and there is a parasthesia, especially traveling in the super Nader region, San Angelo channel, then you think super Nader syndrome probably want to say anything about that, or should we jump right into assessment

Simple. And it’s not as relevant for super Nadir syndrome, but that a superficial branch of the radial nerve then travels down the ally channel. As Matt said, it goes deep to the brachioradialis. So you can kind of see on that left edge of the slide, you can kind of see the brachioradialis pulled off to the side. So then that, that, uh, branch of the nerve goes deep to the brachioradialis. Just that that’s all just to add that in.

Okay. Cool. All right, let’s go to the next slide. Let’s talk about some assessment. So when a patient comes in with lateral elbow pain with possible parasthesia into the lateral forearm, along the course of the San Angelo channel, you’re starting to think more supinate or syndrome than true lateral epicondylitis. Now palpation of the supernatural muscle will be very tender and possibly listed parasthesia. You want to compare symptoms to the supernatural muscle on the opposite side, that’s always going to be very important. The supinate or manual muscle tests repeated four to six times will often create pain in the large attest nine region Garcia, Tencent 10 region, maybe even lung five. And it might extend along to the lateral epicondyle as well. So we’re going to actually go over that manual muscle test, a mills test and cousins tests. Those tests are for lateral epicondylitis. So therefore if you use mills tests and cousins tests and they do elicit pain at the lateral epicondyle then possibly there is some extensor involvement as well. However, if there’s parasthesia please think about the [inaudible].

Now the patient may also report that the forearm and hand feel weak, heavy, or also uncoordinated because of this nerve entrapment. It can cause muscle weakness. So let’s go to the next slide if we would please. All right. So cousins tests and mills tests, most people already know what those are. If not, it’s very simple to be able to YouTube that Google it. Um, it’s, they’re, they’re common tests. Now, the supinate or manual muscle test is not so common by putting the patient into this particular position. And you’re going from a supinated position. You’re going to try to break them out of super nation and going into nation. Now, if you do this four to six times, if the person does have supinate or syndrome, many times, it it’ll become sore in the large intestine and larger test 10 region. And it may also start to elicit that parasthesia so you can use this manual muscle test as confirmation.

All right. So let’s talk about where the actual motor entry points are, the radial nerve into the supernatant. Next let’s go to the next slide. Okay. So there’s two, one’s going to be approximately one to one and a half soon distal, and one soon, our half a soon radio to lung five. So if you take your finger and put it on a lung five, please, in that cubital crease, you’re going to be on the radial side of the biceps tendon in the elbow crease lung five. Now move about one to one and a half soon distal toward the wrist. Now go half assume to the radial side, deep to this region here is going to be one of the motor entry points onto the SuperNet or which we’re going to have a video. That’s going to describe this a bit more in detail. Now, if you can go too deep to larger test and nine, so large intestine nine is going to be three soon down from large intestine 11.

All right. So we’re going to separate the breaker radiologists and the extensor digitorum, uh, uh, extensor digitorum readouts, longest separate those tissues to large intestine nine press against the radial bone, which is usually a great sensation. And that will cause quite a bit of sensate caught quite a bit of pain in that area. That’s going to be another motor entry point for the super Nader. So let’s take a look at the next video, which is going to describe location and then also the needle technique. And then after that, we can take any questions that you guys may have, or we can have some, uh, closing comments,

The supernate or muscle has two motor points. One’s going to end up being distal from lung five on the other. One’s going to actually be located a large intestine nine. So let’s take a look here. So from lung five, we know that’s going to be in the cubital crease here on the radial side of the bicipital tendon. If we drop inferior one to one and a half. So, and just depending on the size of the patient, and then we go to the radio side one soon. Now, palpating you’ll feel the break your radiologists, when that break your radiologists at this location, you’ll divide the brachioradialis and you’ll fall right into a space. Now from this space here, we just keep massaging that tissue, keep massaging that tissue. Okay. Separating the brachioradialis. Okay. Now I can have the patient who, which is in supine. He’s in super nation right now.

He’s going to go into pronation and now going into superannuation, and I can feel that tissue popping up. I’m going to adjust my finger. I feel a little bit more here from super nation now into pronation. There we go. Okay. So then the needle technique would be looking at the supernatant from this location, which is one, one and a half and a half soon lateral separating the space between, between the brachioradialis and opening that tissue up toward that bone. So you’re going to be kneeling perpendicular, and you saw how I found that super near by going to pronation and supination to the skin directly toward that radius. Now let’s be mindful that the brachial artery is going to be traveling along that pericardium channel. So I want to make sure that we’re not kneeling deep in the pericardium channel in this region. So the needle technique for this particular point, be right toward that radius.

Now we can also need the supernate are based on large intestine, nine large intestine nine. We find large intestine 11, which is going to be at the end of the transverse cubital crease to large intestine five. We know that this is going to be 12 soon. So large intestine nine is going to be three soon inferior because the space between 11 and 10 is too soon. So from large destined five to large intestine 11 let’s divide that in half. There’s our six Mark. All right. So then now if we divide 11 and the halfway point and half, that will be three soon, which will be large test and nine large destined nine, three soon down from large intestine 11. So again, let’s feel for that break here, radiologists, I can quickly do a little manual muscle test or resistance test for the breaker radiologists. I’m going to have the patient just press up against me here and that break your radiologists a little bit harder, buddy. And that break your radius pops right up here. All right. So then now I’m just going to separate between the brachioradialis and the extensor carpi radialis longest and press right into that radial bone, which is going to be pretty darn tender for him. And I can feel that re the supernatural muscles start to pop up. When he goes into super nation, pronation is lengthening super nation. There it is right there. I’m going to needle here, large intestine nine directly toward that radius.

So we’ve located large intestine 11, we’ve located large, large intestine nine, which is three down from 11 we’ve identified where the brachioradialis is. Now we’re going to just slide our finger right into that crevice between the brachioradialis and the extensor carpi, radialis longest separate that tissue there, separate the tissue, and I can feel that radius. All right. So then now moving into superannuation, I feel the muscle popup pronation. I feel it sliding. I feel the muscle pop-up into super nation. All right. So the needle technique is going large intestine nine directly towards

The radius. And then we propagate

This muscle is innervated by the poster interosseous nerve or the deep radial nerve, which is a branch. The superficial nerve goes to the large intestine channel and the deep branch comes down to the posterior interosseous nerve or deep radios synonymous, which then goes into the arcade or fros for the super Nader syndrome. And that’s a lecture that we have in this particular program and this particular module, this is going to be super Nader at large test nine. Let’s take a look at how we’re going to needle the super Nader from the, uh, lung channel.

[inaudible]

Lung five, we dropped down one and a half. We moved to the radio side a half, maybe three quarters of sun. Sometimes it’s one soon, depending on the size of the patient, feel for the radius, that’s going to be your key. Now we’re going to separate the brachioradialis here. All right. So on this side of the brachioradialis Okay. And I can have the patient pronate and supinate, and I can fill the muscle pop-up with super nation. We insert directly toward the radius

[inaudible] and propagate.

Okay. So the two motor points for the SuperNet, and that’s how we would treat that. But of course, that’s just treating the supernatural. We’d have to include more points to be able to soften that, that Sanchez senior channel, and also look at the person’s posture as well. Um, those were just two points to be able to be the super Nader. Again, we can go into extensively SCORM communis [inaudible] St. John for lateral intermuscular septum, the medial head going into the curricular head of the SCM to help, to connect to the entire San Jiao channel with that. Then of course, giving exercises that will help with the pronator, Terese and opera off in the supernatural. Many times the pronator chairs will be in a locked short position. I need to be stretched and the supernatural will be strengthened, but of course there’s never an always with all of this.

So it has to be assessed properly with that. And the pronoun Terry is part of the pericardium sinew channel. So it makes sense to treat that for both reasons. Yeah. Good. So internally and externally related of course. Awesome. Well, that’s it for our sand job channel quick question. Just cause I think other people might have it too. Um, and I think you said it you’re treating both of those points or is there a clinically a reason why you treat one or the other of them? Um, or is it really both for supinate or syndrome? I like to treat both of them because it is such a, a long muscle with a number of different attachments to it. So usually I’ll try to be able to get both because if I miss one, then I’ll probably get the other yeah. Got it. Yeah. Good question. Thanks for saying that.

All right. Well, Brian, was there anything else that you want to close this out with? No, no. As usual, of course, thanks to American Acupuncture Council, having the opportunity, do these webinars. Yeah. Thank you everybody for attending. We really, really appreciate this. And also, Oh, you just see that coming up. Lauren Brown is going to end up being here next week. If you have not heard Lauren speak before, he’s very energetic. He’s very knowledgeable. He’s a great person as well. So that’s going to be a good show for next week. Um, Brian, thank you very much. It’s always a fun time with you and thanks everybody. Really appreciate it. Have a great one. Bye-bye

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