He Ding Crane's Summit

What does He Ding do?

He Ding is an extra point on no channel, so it carries no channel-theory actions — everything recorded here is drawn from documented clinical use rather than from channel or organ mechanics. In that documented use it is a knee point and nothing else: it exists for the knee joint, it is chosen because the complaint is in the knee, and it has no recorded use anywhere else in the body.

• Relieves pain and swelling of the knee — the defining documented use and the reason the point was recorded. It is used for painful, stiff, swollen and weak knees, and it is one of the standard local points of that joint.
• Improves movement of the knee — recorded for difficulty bending and straightening the joint, and for the stiff knee that will not fully extend.
• Eases weakness and heaviness of the leg and foot — recorded for legs that feel heavy or give way, and for weakness of the muscles above the knee.
• Used for cold and damp presentations of the knee in particular — the presentation the reference literature and the trial evidence both associate most closely with this point, and the reason it is so often treated with moxibustion rather than with a needle. The one randomised trial devoted to this point studied precisely that presentation.

A correction worth stating plainly. Our own earlier record opened by describing He Ding as "activating qi and blood in the knee joint". That phrase has been removed. Activating qi and blood is channel theory, and He Ding is on no channel — queried directly, our records place it among the extra points with no channel affiliation and no point classification of any kind, so there is no channel at this location whose qi and blood could be moved. The points at the knee that genuinely carry that reasoning are all held in Sacred Lotus sources & references: ST-35 Du Bi, the Stomach-channel point in the outer hollow below the kneecap, whose recorded actions are exactly to dispel wind-damp, reduce swelling and activate the channel; ST-34 Liang Qiu, the Xi-Cleft point of the Stomach channel just above the kneecap on the outer side, and therefore the channel point for an acute, painful, swollen knee; SP-10 Xue Hai, "Sea of Blood", two cun above the kneecap on the inner side, the knee-region point that genuinely carries a blood action; GB-34 Yang Ling Quan, the He-Sea point of the Gall Bladder channel and the Hui-Meeting point of the sinews, which is the point for the tendons and ligaments of the body; and SP-09 Yin Ling Quan, the He-Sea point of the Spleen channel and the principal point for resolving dampness. What the sources actually document at He Ding is a local effect at a joint, arrived at empirically — and that is what is set out above. This is the same correction our Xi Yan record makes from the other side of the same kneecap.

Source: Sacred Lotus sources & references (existing action and use records, corrected as described; extra-point status, absence of channel and of any point classification, and the ST-34, ST-35, SP-09, SP-10, GB-34 and Xi Yan records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 582); Chinese Acupuncture & Moxibustion (pp. 252–253); cross-referenced against multiple online sources.

What is He Ding used for?

He Ding is used for the knee, and only for the knee: pain, swelling, stiffness and weakness of the joint, and weakness of the leg and foot below it. The indications carried in Sacred Lotus sources & references are knee pain, weakness of the foot and leg, and paralysis; the wider reference literature sets them out as follows. They describe traditional use, not proven treatment.

• Knee pain
• Swelling of the knee
• Stiffness of the knee and difficulty bending or straightening it
• Knee osteoarthritis — the modern condition this point is most used for
• Cold and aching of the knee
• Weakness of the leg and foot
• Weakness of the thigh muscles above the knee
• Paralysis and impaired movement of the lower limb
• Heaviness of the leg
• Difficulty walking or climbing stairs because of the knee

Source: Sacred Lotus sources & references (existing indication record); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 582); Chinese Acupuncture & Moxibustion (pp. 252–253).

Where is He Ding, and how is it used in practice?

He Ding lies in the hollow at the middle of the upper edge of the kneecap — directly above the centre of the patella, at the top of the bone rather than at either side of it. Sacred Lotus sources & references give it in exactly those terms. It is easiest to find with the knee straight and the thigh muscles relaxed, when the kneecap can be moved and its upper border felt as a distinct ridge; the soft depression immediately above that ridge is the point.

In practice He Ding is a purely local point. It is chosen because the knee hurts, it is used alongside the other knee points rather than instead of them, and it is treated at least as often with moxibustion as with a needle — the trial evidence for this point is largely evidence about ginger-insulated moxibustion. Its position at the top of the kneecap is what gives it its role in the standard local prescription: with Xi Yan below and He Ding above, the joint is bracketed from both ends.

Which points is He Ding combined with?

• With Xi Yan — the standard pairing, and the one our own records have carried for this point all along. Xi Yan, "Knee Eyes", is the pair of hollows either side of the patellar ligament below the kneecap, held here. He Ding above and Xi Yan below bracket the joint, and naming the two together is the conventional way of indicating that the whole front of the knee is being treated. Our Xi Yan record names He Ding from its own side, and the two pages agree.
• With ST-35 Du Bi — the Stomach-channel point that occupies the lateral member of the Xi Yan pair. This is worth stating carefully, because it is the most mis-stated relationship in the extra-point repertoire: the outer knee-eye is ST-35, a channel point; the inner one is the extra point proper, often distinguished as Nei Xi Yan. Our Xi Yan record sets the whole overlap out in detail, and a reader who wants the channel reasoning at the knee should be reading ST-35's record rather than either extra point's.
• With Xue Hai SP-10 and Liang Qiu ST-34 — the two points two cun above the kneecap, SP-10 on the inner side and ST-34 on the outer, flanking He Ding at roughly the same height. ST-34 is the Xi-Cleft point of the Stomach channel, which makes it the channel point for an acute and painful knee; SP-10 is "Sea of Blood". Both are held here.
• With Yang Ling Quan GB-34 and Yin Ling Quan SP-09 — the two "mound spring" points below the knee on the outer and inner sides. GB-34 is the Hui-Meeting point of the sinews and the tradition's principal point for tendons and ligaments anywhere in the body; SP-09 is the He-Sea point of the Spleen channel and the principal point for dampness. Together with the local points they make up the standard knee prescription.
• With Zu San Li ST-36 — three cun below the knee on the Stomach channel, added almost invariably, both as a local point of the region and as the tradition's general strengthening point.
• With moxibustion, and specifically ginger-insulated moxibustion — not a point pairing but the technique this point is most associated with, and the one its own randomised trial tested. See the research under the notes.

The combination our own records name. Sacred Lotus sources & references have long recorded He Ding as combined with Xi Yan, Xue Hai SP-10, Liang Qiu ST-34, Yang Ling Quan GB-34 and Yin Ling Quan SP-09 for knee pain and weakness. That grouping is confirmed from an independent direction by a validation study which compared sixteen randomised trials of acupuncture for knee osteoarthritis pain against what acupuncturists actually do in practice, and found the most frequently used points to be ST-34, ST-35, ST-36, SP-06, SP-09, SP-10, GB-34, Xiyan and tender points (Acupunct Med 2012;30(3):187–194, PMID 22759902). Our own combination and the published one are effectively the same list.

Source: Sacred Lotus sources & references (existing use and note records, location, extra-point status, and the Xi Yan, ST-34, ST-35, ST-36, SP-06, SP-09, SP-10 and GB-34 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 582); Chinese Acupuncture & Moxibustion (pp. 252–253); PMID 22759902; cross-referenced against multiple online sources.

Where is He Ding located?

• A Manual of Acupuncture (p. 582): In the depression at the midpoint of the superior border of the patella.

How is He Ding needled in the textbooks?

Reference record only — this sets out what the standard texts document, not instruction for a reader. Sacred Lotus sources & references record perpendicular insertion of 0.5 to 1 cun at He Ding, with moxibustion widely recorded and, at this point in particular, heavily used. He Ding carries none of the hazard that governs points over the chest, the upper back or the abdomen: there is no body cavity, no lung and no internal organ anywhere near it. What bounds it instead is the knee joint, which lies immediately beneath — and the specific structure at this point is worth naming precisely, because it is not the same one that lies beneath the knee points below the kneecap.

The angle and depth the texts record

• Sacred Lotus sources & references record perpendicular insertion of 0.5 to 1 cun. For comparison within our own holdings, the Xi Yan record carries 1 to 2 cun and ST-35 carries 0.7 to 1.0 inch — both deeper, and both below the kneecap where there is more soft tissue between skin and joint.
• Deadman & Al-Khafaji (p. 582) and Chinese Acupuncture & Moxibustion (pp. 252–253) record a comparable perpendicular range at this point.
• Moxibustion is the technique this point is most associated with. Ginger-insulated moxibustion at He Ding — a slice of fresh ginger between the moxa and the skin — is recorded in the reference literature and is the intervention tested in the one randomised trial devoted to this point (see the research under the notes). Warm needling and electroacupuncture at the point are also recorded.

What actually lies beneath

• The suprapatellar pouch — and it is part of the knee joint. Immediately deep to the hollow above the kneecap lies the quadriceps tendon and, behind and above it, the suprapatellar bursa or pouch: a fold of synovial membrane that in almost everybody communicates directly with the cavity of the knee joint. That is the single most useful anatomical fact about this point. A needle at the recorded depth is at or close to a space that is continuous with the joint itself, which is why the considerations below are joint considerations rather than soft-tissue ones. Below the kneecap, at Xi Yan and ST-35, the corresponding structure is the infrapatellar fat pad and the front of the joint capsule; above it, at He Ding, it is the suprapatellar pouch.
• Joint infection is the theoretical serious event at any point overlying a synovial joint or a space communicating with one, and strict clean-needle technique is the standard practice that addresses it. A review of the acupuncture safety literature lists infections among the small number of genuinely serious adverse events and attributes them to contaminated needles and inadequate skin disinfection rather than to needling as such (Am J Chin Med 2024;52(6):1555–1587, PMID 39460372). A knee that becomes hot, swollen and increasingly painful after any needling requires immediate medical assessment.
• Existing joint disease and joint replacement change what lies beneath the skin. The reference literature treats a prosthetic knee as a reason for particular caution at local points, on infection grounds — and a knee replacement changes the anatomy at the top of the patella more than almost anywhere else in the joint.
• Bleeding and bruising — the region is well supplied with vessels and bruising at the knee is among the commoner minor events after needling anywhere on the limb. Minor bleeding, bruising and residual soreness are the most frequently reported acupuncture adverse events overall (PMID 39460372).
• Honest limit. We could not source any published case report of injury at He Ding, and no imaging study measuring a safe depth at it. None is asserted. The joint-space consideration above is an anatomical fact about the location, not a record of anything having happened at this point.

Risk in proportion

A meta-analysis of prospective clinical studies estimated serious acupuncture-related adverse events at approximately 1 per 10,000 patients and about 8 per million treatments, with roughly half of all recorded events being bleeding, pain or flare at the needle site (Bäumler P et al., BMJ Open 2021;11:e045961, PMID 34489268). The large randomised trial of acupuncture for chronic knee pain reported no serious treatment-related events (JAMA 2014;312(13):1313–1322, PMID 25268438). He Ding is one of the straightforward points of the repertoire, and the accurate summary is that its considerations are hygiene considerations rather than depth ones.

Source: Sacred Lotus sources & references (existing needling record; the Xi Yan and ST-35 needling records queried directly for comparison); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 582); Chinese Acupuncture & Moxibustion (pp. 252–253); PMID 39460372; PMID 34489268; PMID 25268438 — each verified resolvable and checked for retraction status before citation.

What does the name He Ding mean?

He Ding means "Crane's Summit" — he, the crane, and ding, the summit, crown or top of something. Sacred Lotus sources & references translate it exactly that way; "Crane's Top", "Crane's Crown" and "Top of the Crane" are the other renderings in circulation. The image is anatomical and, once seen, hard to unsee: the bent knee with its rounded kneecap and the tendon running down from it resembles the head and long neck of a crane, and this point sits at the very top of that head — the crown of the bird.

The image is part of a family. The hollows either side of the tendon just below the kneecap are the "Knee Eyes" (Xi Yan), and the outer one of them, on the Stomach channel, is the "Calf's Nose" (Du Bi, ST-35). The front of the knee in classical naming is therefore an animal's face: crown at the top, eyes below, muzzle between them. Reading the three names together is the easiest way to remember where all of them are.

The point is designated EX-LE 2 in the modern extra-point numbering; older texts write M-LE-27. Both appear in the research literature, and readers will meet the name transliterated as Heding or Hoting.

Is He Ding a channel point?

No. It belongs to no channel and carries no point classification of any kind. Queried directly, our own records place He Ding among the extra points, with no channel affiliation and no five-shu, Yuan-Source, Luo-Connecting, Xi-Cleft, Back-Shu, Front-Mu or Confluent classification. Two consequences follow, and both matter:

• It has no channel-theory actions, and any source that gives it some — "activates qi and blood", "dispels wind-damp", "frees the channel" — has borrowed them from the channel points around it. Our own earlier record carried one such phrase and it has been removed; the correction, with the points that genuinely carry each action named, is set out in full under this point's actions.
• Its standing is empirical, and that is not a weakness. He Ding earned its place by being useful at the knee, and the modern research reflects that: it appears among the highest-frequency points in studies of what is actually done for knee osteoarthritis, and it has a randomised trial devoted to it by name — which is more than most classified points can claim.

Is He Ding the same as Xi Yan?

No — they are two different extra points at the same joint, and the distinction is simply above or below the kneecap. Both are held separately in Sacred Lotus sources & references and both were queried directly:

• He Ding — a single point in the hollow at the middle of the upper border of the kneecap. This page.
• Xi Yan — a pair of points in the two hollows either side of the patellar ligament, below the kneecap. Its lateral member occupies the same place as the channel point ST-35 Du Bi; its medial member, often distinguished as Nei Xi Yan, is the extra point proper. Our Xi Yan record sets that overlap out in full, including the genuine inconsistency in how the published literature codes it — the same name appears as EX-LE 4, as EX-LE 5 and as ST-35 across different trials of the same condition.

The two are used together far more often than separately, and the reason is geometric rather than theoretical: one above and two below bracket the front of the joint.

Is there research on He Ding?

Yes — including one randomised trial of ninety patients in which He Ding was the point that distinguished the three treatment arms, which is unusual for an extra point. All of it concerns the knee.

• The trial devoted to this point. Ninety patients with knee osteoarthritis of the pattern classical theory calls yang-deficiency with cold stagnation were randomised into three groups of thirty. All three received the same background acupuncture at Liang Qiu ST-34, Xue Hai SP-10, Du Bi ST-35, Nei Xi Yan, Yang Ling Quan GB-34, Zu San Li ST-36, Yin Ling Quan SP-09, San Yin Jiao SP-06, Xuan Zhong GB-39 and Tai Chong LIV-03 on the affected side. What differed was the treatment at He Ding (EX-LE 2) alone: needling, ginger-insulated moxibustion, or moxibustion following needling. All three groups improved on knee function, pain scale and pain intensity. The combined group did best (cured-and-markedly-effective rate 73.3 per cent), the needling group next (46.7 per cent), and the moxibustion-only group last (20.0 per cent), with each difference statistically significant (Zheng J et al., Zhongguo Zhen Jiu 2017;37(6):594–598, PMID 29231499). This is a genuinely well-designed question — the background treatment is held constant and only the technique at one point varies — and it is the closest thing in the literature to a study of what He Ding itself contributes. Its limits are real: ninety patients, single centre, unblinded, and a composite "cured and markedly effective" outcome rather than a validated scale.
• He Ding is among the most-used points for knee osteoarthritis in actual practice. A large study of acupoint sensitisation screened the highest-use-frequency points for knee osteoarthritis from the literature and from expert consensus, and the resulting list opens with Heding (EX-LE 2), followed by Liang Qiu ST-34, Ming Men DU-04, Nei Xi Yan (EX-LE 4), Qu Quan LIV-08 and Du Bi ST-35. Those points were then examined in 814 patients with knee osteoarthritis against 217 healthy subjects for pressure-pain and heat sensitisation (Zhongguo Zhen Jiu 2022;42(1):51–57, PMID 35025158). That He Ding heads a list generated independently of any single author's preference is a meaningful piece of evidence about its standing.
• A trial in which He Ding was on the losing side, reported for balance. Ninety-two patients with knee osteoarthritis were randomised to a distal point group (Qu Chi LI-11, Shao Hai HT-03 and Tian Jing SJ-10 — all on the arm), a proximal point group (Yang Ling Quan GB-34, Yin Ling Quan SP-09 and He Ding EX-LE 2), or a sham group, each receiving a single treatment. All three groups had significant pain reduction. The distal group showed the greatest change in pain score and significant improvement in both active and passive range of movement, while the proximal group improved only in passive range; the authors concluded that distal points outperformed proximal ones (Yu WZ et al., Evid Based Complement Alternat Med 2021;2021:4827123, PMID 34457022, PMC8387169). It is a single-session study of 92 patients and does not settle anything, but a page about this point should report the trial in which it came second as readily as the one in which it did well.
• Point-selection studies. The validation study comparing sixteen randomised trials of acupuncture for knee osteoarthritis against real-world practice found the most-used points to be ST-34, ST-35, ST-36, SP-06, SP-09, SP-10, GB-34, Xiyan and tender points — one of the few published confirmations that trial protocols and everyday practice broadly agree at this joint (PMID 22759902). He Ding is not in that particular list, which is worth noting rather than glossing: its prominence is greater in the Chinese-language literature than in the English-language trial corpus.
• What is not here. There is no sham-controlled trial of He Ding alone, no imaging or anatomical study naming it, and no research on any use of it outside the knee. Where it appears in larger protocols it is one point among many and nothing in those studies is attributable to it.

How does He Ding compare with the points around it?

Xi Yan is the extra point below the kneecap and He Ding's standard partner — the two bracket the joint. ST-35 Du Bi is the channel point occupying the outer of the two Xi Yan hollows, and it is the point to read for the channel reasoning at this joint, since it carries recorded actions that neither extra point can. Liang Qiu ST-34 lies two cun above the kneecap on the outer side and is the Xi-Cleft point of the Stomach channel — the channel's point for acute, severe, painful knee complaints, and the nearest classified point to He Ding. Xue Hai SP-10 lies two cun above the kneecap on the inner side, flanking He Ding from the other direction. Yang Ling Quan GB-34 below the outer knee is the Hui-Meeting point of the sinews and the single most important point at this joint for tendons and ligaments; Yin Ling Quan SP-09 below the inner knee is the He-Sea point of the Spleen channel and the point for a swollen, damp knee. Xi Yang Guan GB-33 sits above the outer knee joint line, and Qu Quan LIV-08 at the inner end of the knee crease is the Liver channel's He-Sea point, which appears alongside He Ding in the sensitisation study above. All are held in Sacred Lotus sources & references.

Source: Sacred Lotus sources & references (name, translation, extra-point status, absence of channel and of any point classification, location, existing combination record, and the Xi Yan, ST-34, ST-35, ST-36, SP-06, SP-09, SP-10, GB-33, GB-34 and LIV-08 records queried directly); Deadman & Al-Khafaji, A Manual of Acupuncture, extra points (p. 582); Chinese Acupuncture & Moxibustion (pp. 252–253); PMID 29231499; PMID 35025158; PMID 34457022 (PMC8387169); PMID 22759902 — each verified resolvable and checked for retraction status before citation; cross-referenced against multiple online sources.