Stomach 36 (ST36, ST-36), also known as Zusanli, or “Three Leg Mile”, is one of the most commonly used acupuncture points. It is celebrated for its remarkable effects on overall health, immune system function, and digestive well-being in Traditional Chinese Medicine (TCM). ST36 is often considered a foundational point for boosting vitality and managing a variety of conditions, ranging from digestive complaints to fatigue. This point is versatile and frequently used by practitioners to promote longevity and improve general wellness.
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ST 36 Acupuncture Point Location
ST36 is located on the lower leg, about four finger-widths below the bottom edge of the patella (kneecap) and one finger-width lateral to the anterior crest of the tibia. The point lies in the medial portion of the tibialis anterior, making it relatively easy to locate. To identify ST36, you can also palpate proximally along the tiba until you reach about 4 cun, or a slight change in protrusion of the tibia. Once found, applying acupressure or acupuncture to ST36 can produce profound results for a variety of conditions.
Functions of ST36
TCM Functions
According to Giovanni1
- Tonifies the Qi and Blood
- Tonifies Original Qi (Yuan Qi)
- Brightens the eyes
- Raises Yang
- Expels Wind
- Expels Cold
In TCM, Stomach 36 is associated with the Stomach meridian and is considered a He-Sea point, which makes it powerful for regulating digestion. It is known for its ability to tonify Qi, nourish Blood, and fortify the Spleen and Stomach. By enhancing digestive function, ST36 helps in converting food into Qi and Blood, ensuring proper nourishment of the body.
Stomach 36 also plays a crucial role in supporting the immune system, as it is commonly used to strengthen the body’s defenses, especially during seasonal changes or times of weakened immunity. Additionally, this point is used to relieve digestive issues like nausea, vomiting, bloating, and abdominal pain, and it can alleviate fatigue, weakness, and even shortness of breath by promoting the proper flow of Qi and Blood throughout the body.
Biomedical Functions
Acupuncture at Stomach 36 has been shown it may provide various benefits including:
- Anti-inflammatory effects
- Anti-oxidation effects
- Enhancing the immune system
- Promoting the restoration of postoperative gastrointestinal functions
and can be utilized in the treatment of
- Gastric disorders
- Stroke
- Pain2
- Sleep disturbances
- Psychological diseases
Recent studies have highlighted the neuroanatomical basis of ST36 in driving the vagal–adrenal axis, leading to anti-inflammatory responses in animal models.
Research involving healthy individuals demonstrated the effects of acupuncture at ST36 on multiple brain areas, including:
- Somatosensory and motor areas
- Cerebellum
- Limbic system
Research on Stomach 36
There is a moderate amount of information and research on Stomach 36.
Stomach 36 and Inflammation
Let’s look at a 2022 research review on the anti-inflammatory effects of acupuncture at the ST36 point, focusing on animal studies. Acupuncture at ST36, which is located on the lower leg, has been found to help reduce inflammation through several mechanisms. These include activating the vagus nerve, regulating immune cell behavior, and affecting different signaling pathways in the body, such as the TLR4/NF-κB and MAPK pathways. The researchers analyzed 69 studies and found that acupuncture helped decrease levels of certain inflammatory markers and improved overall immune response in various organs, suggesting potential therapeutic Stomach 36 Acupressure and Post operative benefits for inflammatory conditions.3
Stomach 36 and MRI
A 2022 meta-analysis using block-design fMRI, involving both patients and healthy individuals, found that acupuncture at ST36 with deqi sensation specifically activates regions in the right hemisphere of the brain, such as:
- Right orbital part of the inferior frontal gyrus (IFG)
- Right median cingulate and paracingulate gyri
- Right supramarginal gyrus
- Pons
Stomach 36 and Colorectal Cancer
There are a few studies available demonstrating the effects of stomach 36 on postoperative colorectal cancer.
Nurse Applied Acupressure on Stomach 36 for Postoperative Gastrointestinal Patients Undergoing Colorectal Surger
A study published in a 2023 issue of the Asia-Pacific Journal of Oncology Nursing examined Nurse-delivered acupressure on early postoperative gastrointestinal patients undergoing colorectal cancer surgery. 112 Adult patients where randomized into two groups. Acupressure was applied at Stomach 36, as opposed to the other group that received gentle skin rubbing.
The study showed that acupressure significantly shortened the time to have first flatus passage as opposed to the control group. The results also showed that the first time of defecation, along with abdominal distention and bowel motility in the acupressure group had some improvement though differences were not significantly different.4
Stomach 36 and Postoperative gastrointestinal recovery from Colorectal Cancer
In a study published in the Oncology Nursing Forum in March 2013, researchers evaluated the effects of ST-36 acupressure on postoperative gastrointestinal recovery in patients with colorectal cancer. The study found that ST-36 acupressure significantly improved bowel motility and shortened the time to first flatus passage and oral liquid intake compared to a control group.5 This suggests that ST-36 acupressure could be a useful adjunct in postoperative care to enhance gastrointestinal function.
Stomach 36 Recap
Hopefully this provides better insight into the point I use regularly.
This information is for educational purposes only. Please consult with your healthcare provider for any diagnosis or treatment.
- Maciocia G. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. 2nd ed. Churchill Livingstone; 2005:931-932. ↩︎
- Huang H, Yue X, Huang X, et al. Brain Activities Responding to Acupuncture at ST36 (zusanli) in Healthy Subjects: A Systematic Review and Meta-Analysis of Task-Based fMRI Studies. Front Neurol. 2022;13:930753. Published 2022 Jul 22. doi:10.3389/fneur.2022.930753 ↩︎
- Oh JE, Kim SN. Anti-inflammatory effects of acupuncture at ST36 point: A literature review in animal studies. Front Immunol. 2022;12:813748. doi:10.3389/fimmu.2021.813748. ↩︎
- Liu Y, et al. Nurse-delivered acupressure on early postoperative gastrointestinal function in patients undergoing colorectal cancer surgery. Asia Pac J Oncol Nurs. 2023;10(5):100229. ↩︎
- Chao H-L, Miao S-J, Liu P-F, Lee HH-C, Chen Y-M, Yao C-T, Chou H-L. The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer. Oncol Nurs Forum. 2013;40(2) ↩︎
Carlo St. Juste II, MAOM has a background in acupuncture with over 10 years of clinical experience, published author, and over 16 years in the Martial Arts. He has worked with various organizations to implement employee wellness programs and workshops including The City of West Covina, The City of Brea, Broadcom, University of Southern California (USC), American Suzuki, and Pomona College. He is dedicated to promoting integrative health and has seen the benefits of knowledge and implementation first hand.