For centuries, the impetus behind discovery has been both necessity and competition. Making it to a destination is always deemed best when one gets there first. Controversy brews from questionable calls, tied points, and poorly kept records. We, as humans, want a mother of quality creations, someone to point to and say, “There’s the reason this exists”.

Not so different from hip hop music, creators are prone to sampling. Or, as comedians like to put it, stealing from the best. Sampling can, in fact, help things evolve, since something that is static will likely fall out of date. Similarly, acupuncture requires continued study and exploration so it will evolve. Researchers seek out its mechanism and modern translations of its ancient language.

The question of the acupuncture’s efficacy is dissolving. Abbreviated courses are available to Medical Doctors and Physical Therapists for a simple reason: acupuncture works and people in the practice of helping people want to use it. Of course, abbreviated courses are appetizers with no immediate promise of a meal. One of my instructors at Yo San University had been a general practitioner for thirty years who found himself in a four year acupuncture program after experimenting with the skills he had acquired in his abbreviated class. He told us, “I knew two things after using a few acupuncture points for one year: one, this stuff worked. And two, I had no idea what I was doing.”

The work to make this ancient medicine more intellectually accessible is exciting, such as transposing terms like “San Jiao” to the fascial system, or the “Liver Channel” to the saphenous vein, thus unveiling connections that are more readily comprehensible. Language, tradition, and all that’s lost in centuries of war, trade and industrialization lead to a quandary of: who created this? How was it used or practiced?

In the United States, one practice we employ in an effort to “understand” something, is to Westernize it, or repackage it. It also provides an opportunity to put our name on something, or to be hailed the creator of something new, since the actual “creator” is unknown or steeped deeply in a foreign culture.

So, this brings me to my focus for this article, the case of Dry Needling, Graston Technique, and Myofascial Decompression.

Let’s start with dry needling.

Dry Needling vs Acupuncture
“Dry needling” was a term made famous by pioneer Janet Travell who published her first book about myofascial pain and dysfunction in the 1980s. There were physicians experimenting with dry needling, the practice of inserting a needle into a motor point, before her, but she went on to produce the most comprehensive work on the subject. “Dry Needling” was coined in reference to “Wet Needling”, which included injecting a saline solution or an anesthetic into the motor point. Motor points have been written about since the 1800s, and are described at palpable balls of wadded up fascia that have a pain referral pattern.

“Motor points” were considered unscientific in their infancy, but Travell’s work was so comprehensive, that she put them on the Western medical map. Now, approximately 70% of classical acupuncture points coincide with motor points, but the debate between acupuncture and “dry needling” lies heavily with these questions: who discovered the therapeutic benefit of needling “motor points”, the emphasis leaning towards of who coined the term motor point and who discovered said motor points? One argument for “dry needling’s” uniqueness is that of acupuncture point location descriptions. American research claims that acupuncture point descriptions are immutable, thus the coincidence of, say, the point Tian Zong being a centimeter away from the motor point of the infraspinatous means that Tian Zong is not the motor point. But sadly, the practice of acupuncture is not so uniform as its textbooks. The location of the points is not immutable, it varies with style, lineage (Northern China, Southern China, Taiwan), and cultural origin (China, Japan and Korea since the 6th century). For example, the use of palpation. Some acupuncture styles use palpation and some do not. But, again, American research claims that no palpation is used in the practice of acupuncture, and that is simply wrong.

Let me briefly explain the textbook version of classical acupuncture. Acupuncture began well over five thousand years ago in what would become China during the clan commune period. The medicine thrived and evolved through many dynasties and different regions of the country, until The Revolution of 1911, the end of the Qing Dynasty. This period brought the infiltration of Western Culture and with it, Christianity. According to historians, traditional medicine was denounced, the leaders of New China stating, “Western medicine is the vanguard of Christianity and Christianity is the forerunner promoting the sale of goods”. Acupuncturists and Moxibustionists were shunned, run out of major developing regions and pushed off into rural areas where common people still utilized their services.

Of course, the growing number of people needing medical care led to the reintroduction of traditional practitioners to modern society by the mid 1900s, the most favorable qualities of the medicine being “effectiveness and low cost”. It was in 1950 that thousands of years of acupuncture practice and theory were systematized for the purpose of propagation and study. Thus was born the “classical” system that we study today. Point locations and point formulas were created to minimize variants. But how it is practiced does not follow that suit. It’s understood among acupuncturists that “textbook” point locations are often guidelines, and that the “clinical” location may be different by a dime size radius. It is also understood that different styles of acupuncture subscribe to different variants in practice. Examples of styles include Five Elements, Zang Fu, Muscle and Sinew Channel, Eight Extra Vessels, and more.

So when we say “acupuncture”, we are simply saying thin needle penetrating the skin at a chosen location. Locations vary, systems are similar but not the same, and “dry needling” is acupuncture.

Graston vs Gua Sha
Graston Technique is another challenging subject. Though I’ve been unable to find a solid date associated with its “creation”, Graston technique seems to be a very modern term. It is a scraping modality that causes microtraumas to promote the body’s healing process. It bears an uncanny resemblance to Gua Sha, an Asian modality dating back about 700 years ago, that also uses a scraping technique to cause a microtrauma that promotes the body’s natural healing process. Traditional Chinese Medicine doctors have been treating patients in the USA since the 1800s. It was illegal then, of course. Acupuncture was brought to the attention of New York Times readers in 1972 when reporter James Reston published an article about his personal experiences receiving acupuncture when accompanying Henry Kissenger in China that year. Now while I cannot attend a Graston seminar and witness its originality for myself (acupuncturists are not invited to Graston Seminars), I can certainly attest that he created magnificent tools for the practice of Gua Sha, ones that are far kinder to the practitioner than the animal horns, jade pieces and Mason Jar lids we’ve been making do with all these years.

Cupping vs Myofascial Decompression
Then, of course, there’s the matter of Michael Phelps in the 2016 Olympics. His cupping marks had my email inbox overflowing with joyful shares from patients. However, the very same incident brought my attention something called “Myofascial Decompression”, a technique that looks exactly like cupping, though its uniqueness has been explained to me as “not using the meridians during application”. The only things that perplexes me about that informative defense is that I don’t use the meridians when cupping either. I never have, nor was I ever taught to exclusively do so.

This Brings me to my Point
The point I’m making is this: I’m glad that people want to learn about acupuncture and gua sha and cupping. So did I, because its effectiveness moved me to do so. And as a caucasian American, I consider the knowledge a privilege, because it was neither my right nor my heritage to learn this incredible practice. From where I stand, the trouble arises when associating oneself with Chinese Medicine is a means of discrediting oneself. The conflict I see is staking claim to something because the true origin has no name on it, or the one it bears is foreign. When people simply repackage something and claim it as their own, it is opportunistic theft, or by its other name, it is cultural appropriation. It is yet another way to devalue those whose shoulders we stand upon.

by Kari Napoli, L.Ac.

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