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Original Article
Myofascial Meridians as Anatomical Evidence
of Acupuncture Channels
Peter T. Dorsher, MD
ABSTRACT
Background: Conceptually, acupuncture Principal Meridians course through the myofascial layer of the body
and send branches to one another and the organs they influence. Recent literature has described the concept of
‘‘myofascial meridians’’ as anatomical pathways that transmit strain and movement through the body’s muscle
and fascia.
Objective: To qualitatively explore the relationship of acupuncture Principal Meridians to myofascial me-
ridians that have been identified by analysis of human anatomy.
Design and Setting: The 12 acupuncture Principal Meridians were qualitatively compared by visual estimation
(using computer software with human figure outlines) with the 9 myofascial meridians to determine whether
any correlations existed in their described distributions.
Main Outcome Measure: Overlap of Principal Meridians and myofascial meridians on the simulated human
anatomical model.
Results: In 8 (89%) of 9 comparisons, there was substantial overlap in the distributions of the anatomically
derived myofascial meridians with those of the acupuncture Principal Meridian distributions. In addition, the
‘‘spiral’’ myofascial meridian can be described as a combination of 2 acupuncture meridians.
Conclusions: The strong correspondence of the distributions of the acupuncture and myofascial meridians
provides an independent, anatomic line of evidence that acupuncture Principal Meridians likely exist in the
myofascial layer of the human body.
Key Wo rds: Acupuncture, Anatomy, Meridians, Myof ascial
INTRODUCTION
E
xperimental evidence of acupuncture channels
has been documented by identifying reduced electrical
resistance between acupuncture points along the principal
acupuncture channels.
1
Pathologic studies have shown the
anatomical presence of small myelinated and unmyelinated
nerve fibers, lymphatics, arterioles, and venules at acu-
puncture points.
2
Conceptually, acupuncture Principal
Meridians have 2 parts: a superficial one coursing under the
skin and between muscles and tendons, and the deep portion
that extends to the organs.
3,4
Langevin and Yandow dem-
onstrated that 80% of 24 acupuncture points in cadaveric arm
anatomical sections entered intermuscular or intramuscular
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida.
MEDICAL ACUPUNCTURE
Volume 21, Number 2, 2009
# Mary Ann Liebert, Inc.
DOI: 10.1089=acu.2009.0631
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tissue planes.
5
They postulated that acupuncture meridians
may course through interstitial connective tissue planes, al-
though this work has not been extended to other body regions
to determine whether acupuncture points also enter fascial
planes there.
5
No studies have definitively d emonstrated an
anatomic substrate of acupuncture channels, although some
researchers have noted a degree of overlap of meridians and
the peripheral nervous system in the extremities.
6–8
In 2001, Thomas Myers, a therapeutic massage and
bodywork specialist certified in Structural Integration
(Rolfing), introduced the concept of ‘‘myofa scial meridi-
ans,’’ which are defined as anatomical lines that transmit
strain and movement through the body’s myofascia.
9
These
myofascial meridians were discovered through his analyses
of human cadaver dissections that examined the intercon-
nections of the body’s fascia, tendons, and ligaments, which
form anatomical grids postulated as integral to the support
and function of the locomotor system.
Some of the myofascial meridians extend the entire
length of the body, whereas others are regional (e.g., from
chest to fingers). Myofascial meridians are postulated to
occur along body paths where connective tissues (including
myofascia, tendons, and ligaments) not only have anatom-
ical continuity but also exhibit only a gradual change in
tissue orientation (i.e., direction and=or depth of connecting
fiber structures) along the entire pathways. This anatomical
configuration conceptually allows strain to be transmitted
across the structures in a given myofascial meridian. Al-
though an individual myofascial meridian may attach at
skeletal sites along its course to anchor these pathways (i.e.,
‘‘bony stations’’), a portion of its fibers continue onward to
the next part of its myofascial track (meridian).
9
An example of the lateral line myofascial meridian is
shown in Figure 1, with its ‘‘myofascial tracks’’ and ‘‘bony
stations’’
9
listed in the Table. Depiction of an actual ana-
tomical dissection demonstrating this meridian is shown in
Figure 2. The Table presents correlation of the different
portions of the lateral line myofascial meridian diagram to
the picture of the actual anatomic dissection of this meridian.
The existence of these anatomically derived myofascial
meridians has clinical importance as well. Myers
9
discusses
how optimal treatment of musculoskeletal pain requires
attention to the site of the patient’s presenting pain com-
plaint as well as to potential musculoskeletal problems
anywhere along the myofascial meridians that course
through the painful region. For example, a patient may
present with recurrent posterior neck pain despite frequent
neck manipulations. This patient may be found to have
untreated hamstring and plantar fascia restrictions. Treat-
ment of those musculoskelet al issues (on the same
Table. Myofascial Tracks and Bony Stations
of the Lateral Line Myofascial Meridian
Bony stations No.* Myofascial tracks
Occipital ridge and
mastoid process
18
16, 17 Sternocleidomastoid,
splenius capitis
First and second ribs 14, 15 External and internal
intercostals
Ribs 13
11, 12 Lateral abdominal
obliques
Iliac crest, ASIS, PSIS 9, 10
8 Gluteus maximus
7 Tensor fasciae latae
6 Ilitotibial tract=abductor
muscles
Lateral tibial condyle 5
4 Anterior ligament of head
of fibula
Fibular head 3
2 Peroneal muscles, lateral
crural compartment
First and fifth
metatarsal bases
1
Abbreviations: ASIS, anterior superior iliac spine; PSIS, posterior
superior iliac spine.
*Points for the tracks and stations along the lateral line myofascial
meridian. Modified from and used with permission by Myers.
9
FIG. 1. Lateral line myofascial tracks and bony stations. Mod-
ified from Myers.
9
Used with permission.
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‘‘myofascial meridian’’) in conjunction with localized neck
pain therapy may lead to sustained improvement in the
patient’s neck pain. Clinically, this treatment concept is
analogous to the use of distal extremity acupuncture points
to influence pain and function in other areas of the body.
The purpose of this study was to evaluate whether the
distributions of the anatomically based myofascial meridi-
ans are similar to those of the acupuncture Principal Mer-
idians. If such a correspondence exists, it would provide
independent anatomic evidence from manual medicine re-
search that suggests acupuncture Principal Meridians exist
in the myofascial layer of the body and could elevate me-
ridians from being conceptual constructs to having a po-
tential anatom ic substrate.
METHODS
The 12 acupuncture Principal Meridians as outlined
by Deadman et al
10
were qualitatively compared by visual
estimation to the 9 myofascial meridians described by
Myers
9
to determine whether any correlations existed in
their described distributions. With Adobe Photoshop Ele-
ments software (Adobe Systems Inc, San Jose, CA), the
distributions of corresponding acupuncture meridians were
applied to the same human figure outlines used in Myers’
text to allow direct side-by-side comparisons of the acu-
puncture and myofascial meridians. The accuracy of
placement of the Principal Meridians in these graphics
was independently confirmed by a physician-acupuncturist
with more than 10 years’ acupuncture experience using
the meridian descriptions in the text by Deadman et al.
10
These relationships are graphically demonstrated in Figures
3 to 13.
RESULTS
In 8 (89%) of 9 comparisons, there was substantial
overlap in the distributions of the anatomically derived
myofascial meridians with those of the acupuncture Prin-
cipal Meridian distributions.
The correspondences of these distributions were near
complete for the Bladder (BL) meridian to the ‘‘superficial
back line’’ myofascial meridian (Figures 3 and 4), the
Gallbladder (GB) meridian to the ‘‘lateral line’’ myofascial
meridian (Figure 6), the Lung (LU) meridian to the ‘‘deep
front arm line’’ myofascial meridian (Figure 8), the Triple
Energizer (TE) meridian to the ‘‘superficial back arm line’’
myofascial meridian (Figure 9), and the Small Intestine (SI)
meridian to the ‘‘deep back arm line’’ myofascial meridian
(Figure 10).
The Stomach (ST) meridian distribution has near com-
plete overlap with the ‘‘superficial front line’’ myofascial
FIG. 2. Lateral line cadaveric dissection photograph. Courtesy
of T.W. Myers. Used with permission.
FIG. 3. Lateral view of superficial back line. Left, myofascial
meridian; right, acupuncture Principal Meridian (here and in
Figures 4–12). Left panel modified from Myers.
9
Used with per-
mission. Right panel copyrighted and used with permission of
Mayo Foundation for Medical Education and Research.
MYOFASCIAL MERIDIANS 3
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meridian in the lower extremity and anterior neck region, but
courses more laterally in the trunk (Figure 5). The Peri-
cardium (PC) meridian distribution has essentially complete
overlap with the ‘‘supe rficial front arm line’’ myofascial
meridian in the chest, forearm, and hand regions, but is
distributed slightly more laterally in the brachial region
(Figure 7). The Kidney (KI) meridian distribution has
marked overlap with the ‘‘deep front line’’ myofascial me-
ridian in the lower extremity and throat region, and partial
overlap in the chest cavity (Figure 12). The KI meridian
distribution in the abdominal region, though, is distributed
more anteriorly.
The ‘‘spiral line’’ myofascial meridian distribution did
not correlate closely with any single acupuncture meridian,
but it could be viewed as a combination of the courses of the
BL and ST meridians (Figure 11).
There are only 9 myofascial meridians described by
Myers,
9
so, the Principal Meridians whose distributions
were judged closest to those myofascial meridians were
chosen for comparisons in the Figures 3–12. The distribu-
tions of the Heart (HT), Large Intestine (LI), Liver (LR),
and Spleen (SP) Meridians did not correspond as well to the
myofascial meridians. The HT Meridian would be the only
other acupuncture meridian aside from the PC Meridian that
could correlate to the ‘‘superficial front arm line’’ myo-
fascial meridian. The HT Meridian distribution, however, is
FIG. 6. Lateral line. Left panel modified from Myers.
9
Used
with permission. Right panel copyrighted and used with permis-
sion of Mayo Foundation for Medical Education and Research.
FIG. 7. Superficial front arm line. Left panel modified from
Myers.
9
Used with permission. Right panel copyrighted and used
with permission of Mayo Foundation for Medical Education and
Research.
FIG. 4. Posterior view of superficial back line. Left panel
modified from Myers.
9
Used with permission. Right panel copy-
righted and used with permission of Mayo Foundation for Medical
Education and Research.
FIG. 5. Superficial front line. Left panel modified from Myers.
9
Used with permission. Right panel copyrighted and used with
permission of Mayo Foundation for Medical Education and Re-
search.
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more medially distributed on the anterior surface of the
forearm relative to that myofascial meridian than is the PC
Meridian, thoug h its distribution in the brachium corre-
sponds better. The forearm segment is physically longer
than the upper arm segment, so that the overall degree of
correspondence of acupuncture meridian distribution to that
of the ‘‘superficial front arm line’’ myofascial meridian is
best for the PC Meridian.
The LI Meridian would be the only other acupuncture
meridian aside from the LU Meridian that could correlate to
the ‘‘deep front arm line’’ myofascial meridian, but the LI
Meridian distribution runs posteriorly to this myofascial
meridian on the dorsa l surface of the upper extremity. The
LR Meridian would be the only other acupuncture meridian
aside from the KI Meridian that could correlate to the ‘‘deep
front line’’ myofascial meridian. It has a similar amount of
correspondence of its distribution to this myofascial me-
ridian except in the ankle and foot region where the LR
Meridian distribution is more superiorly distributed relative
to the ‘‘deep front line’’ meridian than is the KI Meridian
(Figure 13).
The SP Meridian would be the only other acupuncture
meridian that could correlate to the ‘‘superficial front line’’
myofascial meridian, but the SP Meridian distribution is
more medially distributed on the anterior surface of the
lower extremity and more laterally distributed in the ante-
rior trunk relative to this myofascial meridian than is the ST
meridian.
DISCUSSION
The marked degre e of correspondence noted in this
qualitative study between the distributions of the anatomi-
cally derived myofascial meridians to those of acupuncture
Principal Meridians is unlikely to be coincidental.
Each acupuncture Principal Mer idian has 2 parts: a su-
perficial one (on which acupuncture points exist) that
courses under the skin and between muscles and tendons, as
well as a second deep path that extends inward to the or-
gans.
4
Myers’ ‘‘deep front line’’ myofascial meridian has
FIG. 10. Deep back arm line. Left panel modified from Myers.
9
Used with permission. Right panel copyrighted and used with
permission of Mayo Foundation for Medical Education and Re-
search.
FIG. 11. Spiral line. Left panel modified from Myers.
9
Used
with permission. Right panel copyrighted and used with permis-
sion of Mayo Foundation for Medical Education and Research.
FIG. 8. Deep front arm line. Left panel modified from Myers.
9
Used with permission. Right panel copyrighted and used with
permission of Mayo Foundation for Medical Education and Re-
search.
FIG. 9. Superficial back arm line. Left panel modified from
Myers.
9
Used with permission. Right panel copyrighted and used
with permission of Mayo Foundation for Medical Education and
Research.
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superficial and deep pathways similar to those of the KI and
LR Meridians.
9,10
The other 8 myofascial meridians do not
have deep connections to internal organ fascia.
9
Though it
could be postulated that the myofascial meridians might
more appropriately be compared to muscle channels
rather than Principal channels (meridians), the ‘‘deep front
line’’ myofascial meridian’s deep connections to organ
fascia is not consistent with characterist ics of a muscle
channel.
4,6
Muscle channels are not distinct anatomic structures but
instead represent a description of the body’s tendinomus-
cular system within the overall framework of the traditional
channel (meridian) system; furthermore, the muscle chan-
nels not only carry the same names as the Principal Mer-
idians but also generally follow the same superficial
pathways.
6
Muscle channels are termed ‘‘Jing Jin’’ in the
Nei Jing, which can be translated as ‘‘cha nnel-like muscles’’
or ‘‘muscles of the channels.’’
4
Thus, trying to distin-
guish whether myofascial meridians should best be com-
pared with Principal channels vs muscle channels is likely
more an academic, intellectual exercise than an anatomic
issue.
Myers
9
states that the anatomically derived myofascial
meridians are distinct from acupuncture meridians. Myers is
not familiar with the acupuncture tradition (personal com-
munication, DATE), and the fact that he has physically
demonstrated each of the myofascial meridians in anatomic
dissections (Figure 2, for example) clearly supports his
myofascial meridians as anatomic structures. The present
study, however, demonstrates that these myofascial merid-
ians have distributions that are very similar to those of
acupuncture merid ians.
CONCLUSIONS
Myofascial meridians,
9
anatomic structures that derive
from study of the body’s myofascial system in cadavers,
have strong correspondence to the distributions of acu-
puncture Principal Meridians. This is still consistent with a
nervous system basis of acupuncture’s clinical effects,
6–8
since neurovascular bundles in the extremities course in
connective tissue planes.
ACKNOWLEDGEMENTS
Thanks to Thomas W. Myers, LMT, NCTMB, ARP, for
his assistance in reviewing this article and contributing
images from his Anatomy Trains text. Thanks to Adria
Johnson, MD, for her assistance in reviewing this article and
validating the accuracy of the images. Editing, proofread-
ing, and reference verification were provided by the Section
of Scientific Publications, Mayo Clinic.
DISCLOSURE STATEMENT
The author states that no competing financial conflict
exists.
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FIG. 12. Deep front lines and the Kidney Meridian. Left panel
modified from Myers.
9
Used with permission. Right panel copy-
righted and used with permission of Mayo Foundation for Medical
Education and Research.
FIG. 13. Deep front lines and the Liver Meridian. Left panel
modified from Myers.
9
Used with permission. Right panel copy-
righted and used with permission of Mayo Foundation for Medical
Education and Research.
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Address correspondence to:
Peter T. Dorsher, MD, MS
Department of Physical Medicine and Rehabilitation
Mayo Clinic
4500 San Pablo Road
Jacksonville, FL 32224
E-mail: dorsher.peter@mayo.edu
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