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Articularis Genu Needling to Improve Knee Flexion, Gait Pattern & Pain: A Hidden Treasure

Articularis Genu Needling to Improve Knee Flexion, Gait Pattern & Pain: A Hidden Treasure

What is an Articularis Genu?

O: Anterior, distal femoral periosteum.
I: Cephalic portion of the synovial membrane of the knee (joint capsule)
A: Pulls the cephalic knee capsule cephalically to facilitate knee extension.

I never learned about this muscle in school, and let me tell you, I didn't go to school just to eat my lunch... Now, I don’t know if needling the articularis genu is the actual cause, or part of the cause, of significant improvements in knee flexion and pain.

However, inserting a needle directly above the patella, to the periosteum, through the rectus femoris, vastus intermedius and articularis genu, is a magical needle to reduce knee pain, improve knee flexion, LBP, gait pattern, autonomic nervous system homeostasis and more.

The knee range of motion and pain improvements totally may be because the needle is going through the rectus and vastus intermedius tendons. The causative factor may be the articularis genu. It may be the periosteum. It’s probably an amalgamation of numerous factors. Whatever it is, this needle placement works wonders for just about any knee impairment out there.

Related: Click here to read "Dry Needling: Benefits of Low-Frequency Stim for the Autonomic Nervous System"

Make sure to incorporate needles targeting the parasympathetic portion of the autonomic nervous system (PANS), along with whatever other areas you are needling, including the articularis genu. Remember, the majority of our patients present with SANS hyperactivity. Needle down to the periosteum over the sacral plexus, S2-S4, the base of C2 spinous or suboccipital periosteum, and the most direct placement to target the PANS, the concha of the ears. The concha of the ears is directly innervated by the auricular branch of the vagus nerve, the primary nerve of the PANS. Add about 2 Hz stim in various ways, connecting the PANS needles directly to each other, along with connecting the various distal points to their corresponding spinal nerve root levels.

Targeting the nerve roots, I place needles to the base of the vertebral spinous processes, through the multifidus, at an inferior medial angle, starting no more the 0.5 inches lateral to the center of the spinous process. This safely accesses periosteum adjacent to the nerve root exit. This is key. There is some type of increased cerebral and peripheral neuroplastic effect when needles are placed from nerve root to distal impairment. Especially when needles are placed bilateraly, to the periosteum (if safe), with low frequency microcurrent. I like to cross the left spinal segments to the right distal treatment zones and vis versa. Again, there is something that happens in the brain and nervous systems when you do this that dramatically improves treatment efficacy and patient outcome.

Remember: Low frequency stim, 1-5 Hz (I like 2 Hz), is the best, as far as we know, at stimulating endogenous opioid release (beta-endorphin), sympathetic depression, pain reduction and patient relaxation.

Don’t forget about needling the adductor attachments on the pubis. This is a counterintuitively comfortable area to be needled. You hardly feel it. And it's super important. Normalizing adductor length is an essential aspect to manipulating the pelvis to neutral, which is necessary to achieve maximal knee health. Pelvic homeostasis is key to all health, if you think about it. The adductors typically form latent trigger points and are often unnoticed by the patient. This may be secondary to worse pain in other areas, such as the low back, or because they attach and blend with some of the pelvic floor musculature, or some other reason. Regardless, the adductor attachments on the pubis, especially the gracilis, blend with the pelvic floor musculature. The pelvic floor musculature is innervated by the PANS dominant S2-S4 spinal nerves. If the adductors are not addressed, the pelvic floor, along with the ANS, will continue to dysfunction.

In summary:
Needle the articularis genu, just above the patella, down to the periosteum, through the rectus femoris and vastus intermedius tendons. This has a magical effect on knee pain, knee ROM, LBP, gait pattern and numerous other impairments. Make sure to needle the adductor attachments at the pubis. This will regulate the ANS, reduce knee pain, LBP, pelvic alignment and improve knee flexion. Needle bilaterally, connect the nerve root levels, target the PANS and add low frequency microcurrent.

Test out the effect of needling the articularis genu by performing knee ROM measurements, then needle, then perform the measurements again. You will see some awesome improvements.

Let me know if anyone has any questions about anything.



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