I know what you are thinking. “What? move with needles? Is it even safe? Just thinking about it makes me scary” If you put needles anywhere and move around, it will be very painful, and also there can be a danger of bent needle, or tissue damage. If you are brave enough try yourself, insert needle on LI10(shu-shamri) and raise your wrist like doing Fielkenstein’s test. Needle must move following the muscle contraction and release, and probably you will feel some amount of pain. Personally I like this feeling. But, Kinetic acupuncture is safe and effective as long as you follow the principles.
First principle, unrelated location with movement
Needle is inserted at the location unrelated with movement. LI4 location is unrelated with above movement. Try it. Needle will be there as it is.
Second principle, needle is inserted at the point of pivot, or axis of movement.
If you well insert the needle radio-carpal space, above movement will not affect the needle. This pivot point is located at the end – radius side – of snuff box(LI5), wrist line can be a good landmark. Likewise LI11 is the pivot point for elbow movement, unrelated point with wrist movement.
Third, isometric exercise.
even though needle is inserted in muscle belly like shu-shamri, movement do not involve muscle length change. Yes, by applying isometric movement, you can minimize the needle movement.
Fourth, limit the movement within full ROM
But, also remember that pivot point, and isometric exercise do not completely remove the movement of needle. Tendons locate crossing the pivot point, and muscles change the length even with isometric exercise. So limiting the movement within 20–40% of full range of motion is very safe at first. And major movement with pivot point is oscillation, and movement with muscle is isometric exercise, so range of motion is extremely small amount.
Fifth, patients should be fully relaxed.
When they start movement with needles, even with length of explanation, patents get tensed at first. To prevent muscle spasm with pain or fear, you should let patient fully relaxed, especially the target part. When you treat frozen shoulder, that arm should be without any tone. You can check this by grabbing patient’s hand and shoulder before starting oscillation. If they are not fully relaxed, try only with unrelated points, or heat and gentle massage can helpful.
Try it yourself NOW! Insert needles at LI4, LI5(on the biggest line of wrist), and LI10. Try wrist abduction(Fielkensteins’ test) LI4,5 won’t move, and LI10 will dance. Then hold your wrist with other hand not to move, and try to wrist abduction. Movement of needle on LI10 will be very lessened, but you will still feel the strong sensation. Simple as it is!
In the other hand, wrist flexion with needle on the location of HC6 will bend the needle, and giving patients extreme pain, and tendon will be injured.
If patients and you are still worried, start with fine needles under 0.15mm diameter, if there is a rigorous movement, needle will come out naturally without pain. You can try it. Put the needles on LI4,5,11 and try dynamic movement, one of them will be fallen even without notice. (Please do not try with LI10, if you already did, stop swearing with pain, and read this article again from the start.)