myofascial meridian stimulation therapy case study (the mmst( 經筋動穴針法 ) on shoulder pain)...

Myofascial Meridian Stimulation Therapy

Case Study(The MMST( 經筋動穴針法 ) on sho

ulder pain)

Dr.Seonghyung Cho,M.D.

The following case study is a fairly typical type of response seen with the MMST

Korean Integrative Medicine Institute


The MMST on shoulder painA 57 years old housewife female presented with left shoulder pain referred to left elbow and chronic knee pain

Pain on left shoulder appeared spontaneously

Pain on left shoulder was aggravated by shoulder elevation and lying on that side at night

The problem started 5 months ago

She has had various treatments including medication, physiotherapy, traditional acupuncture and steroid injection which was not effective.



Physical Examination

Limitation of Passive lateral rotation > abduction > medial rotation : Capsular pattern

Initial range of active left shoulder abduction: 35 degree



Initial range of abduction on left shoulder before the MMST: 35degree

Abnomal on scapulohumeral rhythm



1. Improvement of autonomic nervous dysfunction

Sympathetic switch points: -bilateral LI4, LI11, LV3, ST36 -GV14, GV26

-duration of treatment: 20-30 min

-acupuncture or subcutaneous taped acupuncture



2. Maintenance of myofascial meridian balance



The MMT Evaluation

Cervical :1.superficial back line:( + / - ) -neck flexion: UB, SI , GV 2.superficial front line:( +/ - ) -neck extension: LI, ST, CV3.lateral line: Rt( + / - ), Lt( + / - ) -neck side-bending: GB, TE

Thoracolumbar : 1.superficial back line:( + / - ) -trunk flexion: UB, GV 2.superficial front line:( +/ - ) -trunk extension: CV 3.lateral line: Rt( + / - ), Lt( + / - ) -trunk side-bending: GB4.spiral line:Rt( + / - ), Lt( + / - ) -trunk rotation: both GB, UB

Upper extremity1.deep front arm line: Rt( + / - ), Lt( + / - ) -shoulder extension: LI, LU2.superficial front arm line: Rt( + / - ), Lt( + / - ) -wrist extension: PC3.deep back arm line: Rt( + / - ), Lt( + / - ) -shoulder elevation: HT, SI4.superficial back arm line: Rt( + / - ), Lt( + / - ) -wrist flexion: TE Lower extremity1.superficial back line: Rt( + / - ), Lt( + / - ) -leg elevation: UB 2.superficial front line: Rt( + / - ), Lt( + / - ) -leg extension: ST3.lateral line: Rt( + / - ), Lt( + / - ) -fabere test: GB, LR ,KI, SP

Axis Extremities

Examine limitation(tightness) or pain on passive movement



The result of the MMT

Cervical 1.superficial back line:( + ) -neck flexion: UB, SI , GV 3.lateral line: Rt( + ), Lt( + ) -neck side-bending: GB, TE

Thoracolumbar 1.superficial back line:( + ) -trunk flexion: UB, GV 2.superficial front line:( +) -trunk extension: CV 3.lateral line: Lt( + ) -trunk side-bending: GB4.spiral line:Rt( + ), Lt( + ) -trunk rotation: both GB,UB

Upper extremity1.deep front arm line: Rt( + ), Lt( + ) -shoulder extension: LI, LU3.deep back arm line: Lt( + ) -shoulder elevation: HT, SI4.superficial back arm line: Rt( + ),Lt( + ) -wrist flexion: TE

Lower exremity1.superficial back line: Rt( + ) -leg elevation: UB, 2.superficial front line: Rt( + ), Lt( + ) -leg extension: ST3.lateral line: Rt( + ), Lt( + ) -fabere test: GB, LR, KI, SP

Axis Extremities



LI 11

LI 4

LU10TE 5

deep front arm line: Rt( + ) -shoulder extension: LI, LU

superficial back arm line: Rt( + )-wrist flexion: TE



SI 3

TE 5

LI 11

deep front arm line: Lt( + ) -shoulder extension: LI, LUdeep back arm line: Lt( + ) -shoulder elevation: HT, SI

superficial back arm line: Lt( + ) -wrist flexion: TE

LI 4

LU 5



GB 21

LI 15

LU 2

deep front arm line: Lt( + ) -shoulder extension: LI, LU

superficial back arm line: Lt( + )-wrist flexion: TE

lateral line: Lt( + )

-trunk side-bending: GB

TE 14



CV 12

CV 4

superficial front line:( +) -trunk extension: CV



SP 9

ST 36

SP 6

KI 3

LR 3

superficial back line: Rt( + ) -leg elevation: UB superficial front line: Rt( + ) -leg extension: STlateral line: Rt( + ) -fabere test: GB, LR, KI, SP

UB 60

GB34



ST 32

ST 36

superficial front line: Lt( + ) -leg extension: ST



GB 26

GV 3

GB26

GV 14

superficial back line:( + ) -trunk flexion: UB, GV lateral line: Lt( + ) -trunk side-bending: GBspiral line:Rt( + ), Lt( + ) -trunk rotation: both GB,UB

GV 6



3. Restoration of segmental dysfunction

Somatovisceral Points(SVP): Stimulate T5/6 interconnected to lateral column of lateral horn

comprised in cell bodies of preganglionic fibers toward extremities(C5/6) by magnetic therapy

Somatosomatic Points(SSP): combined area points of C5/6 dermatome, myotome and sclerot

ome: LU2, LI15, TE14 (deep dry needling)



T5

T6

Magnetic therapy on UB line

(paraspinal dermatome area) onT5-6

Somato-Visceral Point

C5/6

vasodilation (decrease sympathetic tone )

Secondary segmental relation

In the selection of points for treating abnormal somatovisceral reflex on common C5 segment area, we used magnetic therapy on UB meridian line of trunk related to anatomy of autonomic nervous system and secondary segmental relation (C5/6-T5/6) instead of using acupuncture needle. SomatoVisceral Points (SVP) consisted of UB meridian points on surrounding T5-6 dermatome area. In using acupuncture needle on T5-6 segment of UB meridian line, the blood vessel tone was increased on C5-6segment area. But in using magnetic therapy, we found the blood vessel tone was not incr

eased in our clinical observation.



LU2

LI15

TE14

Somato-Somatic Point

Deep dry needling

Stimulate meridian points (combined area of dermatome,myotome and sclerotome on C5/6) by deep dry nee

dling

Stimulate skin, muscle and periosteum in order

Combined area of dermatome,myotome and

sclerotome on C5/6

In the selection of points for treating abnormal somatosomaic reflex on left shoulder pain, we applied SSP to common C5 segment area (dermatome,myotome and sclerotome). These points consisted of LU2, LI15 and TE14. Also, we stimulated these points by deep dr

y needling



She received the MMST three times a week for 2 weeks

After 2 weeks, post treatment range of abduction on left shoulder is 85 degree and there was nearly no pain on left shoulder. And right knee pain is also decreased significantly.



left shoulder elevation increased to almost normal range without pain.



“We have to know about effects of neuro-physiology on acupuncture as well as effects of biomechanics on acupun

cture.”

Dr.Cho



Thank you !

E-mail: [email protected]

[email protected]

myofascial meridian stimulation therapy case study (the mmst( 經筋動穴針法 ) on shoulder pain)...

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