I have been so inspired by Ann’s weekly blogs and wanted to share a case with you all that will hopefully expand that inspiration. The cosmos has recently once again taken me to school on the sinew channels with case after case coming in the door. We are so fortunate to have these amazing channels to help people with their struggles.
I had a new patient last week with ongoing, severe neck pain resulting from a motor vehicle accident one year ago. I will walk through my treatments as an aid for those who are grappling with sinew channel principles.
Day 1- The triggering event for her pain was a car accident which occurred in her hometown just blocks from her childhood home. An interesting feature of the event was that she lifted her left hand in self defense as the collision occurred and her hand was carried into her forehead by the airbag at 200 miles an hour, effectively a high-speed whiplash. She was a dance major in college and her neck strength likely protected her from a more severe neck injury. Imaging showed 3 protruding cervical discs. Even though the injury was one-year-old, I chose treatment with the sinew channels because there was pain and limited range of motion on movement. Divergent channels passed through my mind but there were no pulses to support their use. Even decades-old injuries where the original insult was to the sinew channels can be helped dramatically with Sinew Channel techniques.
The first step was to assess movement. She had two problematic positions, the first rotation from side to side, the second flexion of her head chin to chest. I considered too that she was in a seated position when the accident occurred. Position at time of accident can be a good clue as to which sinew channel is involved. These two movements indicate first shaoyang TH/GB for rotation, and second yin channels, shaoyin, Ki in this case based on trajectory and being seated at the time of injury. I encourage you to look closely at the picture of the kidney sinew trajectory in the red book and see that it encompasses all of the connective tissue and muscles of the spine.
I next asked her if she received emotional support at the scene of the accident. Yes, her father had arrived within 10 minutes, as she had somehow managed to answer her phone when he called just after the incident. I then asked how she felt about the driver of the other car. “It was clearly their fault and I feel like they robbed me of my life. It was also the last time that I remember my father being healthy, he died 8 months later.” I feel that this question was the key to the success of the treatment, bringing her feelings about the moment into consciousness.
Next I assessed her pulses and found them weak and tight in all positions. Kidney yang was weak, liver was not wide, spleen was tight and not wide, lung pulse was weak with little dispersion. There was in this case a kidney sinew pulse, right cun at 4-5 beans. Having recently made the mistake of treating a patient with sinew channels and exhausting them due to a lack of resources before the treatment, I was careful to build these resources before releasing the channels. I did moxa on BL23, GV4, GV14 and CV4 to increase Ki yang, I needled Li3, St42, and Lu7 (flying technique) to increase fluid status and lung dispersion. I left the needles in for 20 minutes.
Next I considered the sequence of the indicated sinew channels and placed them in order. First Ki, then TH, then GB. I first inserted the leg-yin reunion point at CV 2-3, then Ki 1 bilaterally. (reunion points can be seen as doing two things, they activate/wake up the channels that join there, and/or they close the door between the related Sinew Channel’s so that pathology cannot cross out of its current location. It is like having an unwanted bird in your house, if you first close the door to the room it is currently in, it is easier to encourage the little tweeter out of that one room than allowing it to cross into other rooms and fly throughout the house as you give chase, opening windows randomly as you go). Next I checked the area from her navel to pubic bone for tension and found none. I then removed the CV 2-3 needle and had her lie face down. I began at the base of her skull searching for areas of tension and released them with twisting needle technique. The tension was all in her neck and thoracic spine and I found no more in the lumbar spine or legs. Next she sat up and we gauged the Improvement which was substantial, with less pain, more ROM. I then had her lie on her left side and I inserted ST8 (arm yang reunion) and TH1 bilaterally. I released the trajectory of the TH, again finding tension only in her neck area and none down her arms. I had her sit to gauge the improvement which was again substantial. She suddenly reported, by moving a finger along the trajectory, a sensation moving from ST8 to her cheek, (SI18). The pathology was already moving to the leg channels. I added SI18 and GB44 and her range of motion improved immediately. I then had her report areas of tension, pain or other sensation. First she pointed to Bl1. I released this point and with great relief and a large exhale she exclaimed “wow my life just became clear again.” Next a pain point at her right scapula, then on the left side of her neck appeared. I released these points and with each release range of motion increased and pain decreased. Following these sensations as they arise is called “chasing the wind”. She was very expressive, oooing and ahhhhing with each release, clearly feeling the pain of the needles but more so the release and relief. No more sensations appeared so I removed the needles and ended the treatment. She was 100% pain free and at 90% ROM. All of this took 1 hour 15 minutes due to the intake conversation preceding the treatment.
I then explained to her that wei qi has an instinctive but not rational intelligence. It can be anywhere instantaneously to do its work but sometimes gets so into the job that it forgets to leave. Wei needs a more frequent reminder to change course so treating three days in a row would give us the best chance to help her long-term. She readily accepted the suggestion and we found a time for the next day. I also described how an epsom-salt soak that evening would be helpful to perpetuate this treatment’s improvement because it helps the channels return to their original state. She agreed to add this.
Day 2- The patient arrived on time and was clearly much brighter in her face. She reported that she had been pain-free for 8 hours after the treatment then slowly some pain had returned and was now at about 50% of yesterday’s pre-treatment level. Again rotation and flexion where the main limits in ROM and no new movement challenges had appeared. Her pulses showed improvement in resources but not sufficient to skip addressing them. I repeated the same sequence, first building resources, then beginning the sinew releases with Ki sinew channel. I find it very valuable to have the patient sit or stand after each release to gauge improvement. She could now freely touch her chin to chest, “I haven’t been able to do that in a very long time.” Then with her lying lateral recumbent, the shaoyang TH/GB sinews were released and then sitting there was complete freedom of movement on rotation. She identified several points of sensation in her scapular area which I released and we were done. I reminded her to again do an epsom- salt soak that evening.
Day 3- The patient had driven 4 hours to her hometown after yesterday’s treatment and spent the night. She described luxuriating in an epsom-salt soak and on waking this morning had told her mother that her neck was radically better, almost normal. The drive there and back had previously been a struggle due to pain but this time had created only minor stiffness. There was again minor difficulty touching chin to chest, minor discomfort with rotation, and this time I put my hand on top of her head and asked if bearing weight was uncomfortable, it was. I should have asked this question the first day but no matter, yangming was currently affected. Also for the first time, extension of her neck was uncomfortable implicating taiyang. Again her pulses showed clear strengthening but still insufficient strength, width, and dispersion. I built resources for 10 minutes then released Ki, TH, GB, LI, St, SI, Bl. (writing this I see that based on the sinew channel sequence I should have proceeded in this order: Ki, LI, TH, SI, St, GB, Bl). After each release I had her sit and move her neck and each time there was improvement in ROM and decrease in pain. At the end she was ecstatic about how she felt and had a dancer’s spring in her step. She repeatedly moved her shoulders and neck in a rolling dancer-like manner as if there were new life there.
2 thoughts on “by Burton Moomaw (North Carolina, USA)”
Thanks for sharing this case. Very helpful.
My only question would be about the movement of bringing chin to chest or neck flexion. I thought that would be a Yang Ming diagnosis and in a way you ended up doing the Yang Ming on the third session.
But great job of staying with it and seeing the whole thing unravel.