ST-38

Tiaokou ST-38

Ribbon Opening · 条口 · Tiáo Kǒu

Stomach Meridian

Needle Depth

1.0-1.5 cun

Needle Angle

90° (Perpendicular), 45° (Oblique)

Body Area

Lower Leg — Anterior

Location

8 cun below Dubi ST-35, midway between Dubi ST-35 and Jiexi ST-41, one middle finger-width from the anterior crest of the tibia.

Previous on channel

Shangjuxu ST-37

Next on channel

Xiajuxu ST-39

Main Actions

Removes Obstructions from the Channel by expeling Wind-Damp
Benefits the Shoulder

Indications

Leg pain Cold legs Weak legs Leg atrophy Leg numbness Leg swelling Shoulder pain Shoulder stiffness

Commentary

Tiaokou ST-38's main functions is to removes Obstructions from the Channel by expelling Wind-Damp of the legs and shoulders.

when used as a distal point to treat Painful Obstruction Syndrome of the shoulders, it is normally needled first with Reducing Needling Method while the patient slowly rotates the shoulder. Then other locate shoulder points should be used afterwards.

Classical Sources

Zhenjiu Jiayijing (針灸甲乙經 - Systematic Classic of Acupuncture and Moxibustion): ST-38 first appears in this foundational text by Huangfu Mi (3rd century CE), establishing its location between the upper and lower large intestine points (Shangjuxu and Xiajuxu).

Name Etymology: Tiao (條) means "strip" or "ribbon," referring to the long, narrow shape of the muscle depression between the tibia and fibula where the point is located. Kou (口) means "opening" or "mouth," describing the gap-like anatomical feature at this location.

Classical Indications: Traditional texts indicate this point for numbness, soreness, and pain of the knee and leg; weakness and motor impairment of the foot; abdominal pain; and pain and motor impairment of the shoulder.

How to Locate

First locate Dubi ST-35 in the depression below the patella and lateral to the patellar ligament. Then locate Jiexi ST-41 in the depression between the tendons of the extensor digitorum longus and the hallucis longus, level with the tip of the lateral malleolus. Draw an imaginary line between these two points and locate Tiaokou ST-38 in the midway and one middle finger-width lateral to the anterior crest of the tibia.

Caution

When performing the threading technique toward BL-57 (Chengshan), ensure proper angle to avoid needling the tibial artery or deep peroneal nerve which runs in the interosseous membrane area. The anterior tibial artery and vein run in the vicinity; perpendicular insertion at the standard depth is generally safe. Use caution with patients who have poor circulation or peripheral neuropathy in the lower limbs.

Needle Angle

90° (Perpendicular) / 45° (Oblique)

Depth Category

Medium

Standard Depth

1.0-1.5 cun

Needling Directions

Vertically or obliquely 1–1.5 cun

Expected Deqi Sensation

Deqi sensation typically manifests as distension, heaviness, or soreness radiating along the anterior lower leg. When needling toward BL-57 for shoulder treatment, a strong propagating sensation may extend through the calf muscles. Achieving strong deqi has been shown to be important for therapeutic effectiveness in treating shoulder conditions.

Moxibustion

Recommended

Duration: 5-15 minutes

Cupping

Recommended

Bloodletting

N/A

Gua Sha

Recommended

Commonly Combined Points

Chengshan

Jianyu

Jianzhen

Zusanli

Yanglingquan

Classical Point Combinations

Penetrating to Chengshan for Frozen Shoulder

ST-38 (Tiaokou) threaded obliquely toward BL-57 (Chengshan) is a classical technique for treating frozen shoulder (adhesive capsulitis). The needle is inserted at ST-38 and directed posteriorly through the interosseous membrane toward the Bladder channel. This combination stimulates both Yangming and Taiyang meridians simultaneously, powerfully moving Qi and Blood to release shoulder stiffness. The patient moves the affected shoulder during needle manipulation for enhanced effect.

Distal Point with Local Shoulder Points

ST-38 combined with local shoulder points such as LI-15 (Jianyu), SI-9 (Jianzhen), and TE-14 (Jianliao) for comprehensive treatment of shoulder pain and restricted movement. ST-38 serves as the primary distal point while the local points address the specific area of pathology. This combination follows the principle of treating both root and branch simultaneously.

ST-38 with GB-34 for Musculoskeletal Disorders

ST-38 combined with GB-34 (Yanglingquan), the Hui-Gathering Point of Sinews, for treating muscle and tendon disorders of both shoulder and lower limb. This pairing effectively addresses conditions involving muscle weakness, atrophy, cramping, and stiffness throughout the body.

With Zusanli for Leg Weakness and Atrophy

ST-38 combined with ST-36 (Zusanli) for lower limb weakness, numbness, and atrophy. Both points strengthen the Yangming channel energy to nourish the muscles and sinews of the leg, addressing conditions such as leg paralysis and muscle wasting.

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