Heding (EX-LE2): The Point Above the Kneecap for Knee Pain and Weak Legs

Where Heding Sits

This point is the small dip at the middle of the top edge of the kneecap, on the front of the knee. You find it with the leg straight and the thigh relaxed, by tracing the top rim of the kneecap and stopping halfway across.

Most points on the traditional map sit on one of fourteen channels, the lines that run the length of the body. A smaller group sit off those lines. They are called extra points, and each was added because generations of practitioners found it useful on its own. This is one of them. The international code marks it as the second extra point of the lower limb. It does not belong to a channel, and its place is set entirely by the kneecap.

The point sits in the small dip at the middle of the top edge of the kneecap. The kneecap is a flat, rounded bone set into the large tendon at the front of the thigh. Its top edge is broad and its bottom edge comes to a blunt point. With the leg straight and the thigh relaxed, you can trace the top edge with a fingertip from one corner to the other. At the middle of that edge, the fingertip sinks a little. That dip is the area.

Underneath lies the tendon of the large muscle at the front of the thigh (the quadriceps), which wraps over the kneecap and continues below it. Under the tendon is a pocket of the knee joint's lining that reaches up above the kneecap (the suprapatellar pouch). It allows the kneecap to glide when you bend and straighten. When the knee fills with fluid, this pocket is where the swelling shows first, as a soft puffiness above the kneecap.

The skin here is served by branches of the femoral nerve, the main nerve at the front of the thigh, carrying fibres from the second to fourth lumbar roots. Those same roots serve the front of the thigh and the inner side of the knee. That shared wiring is one plain reason why pressing here can be felt as a dull ache spreading up the thigh or around the kneecap.

Why This Spot

From the anatomical side, the front of the knee is where many knee complaints are felt. The large thigh muscle passes all its pull through this tendon to straighten the leg. Climbing stairs, rising from a low chair and getting out of a car all load it heavily. When the thigh muscle weakens with age, or the joint under the kneecap wears, the tendon and the tissue around the top of the kneecap are often tender.

The landmark is also very easy. The kneecap is the most obvious bone of the leg, and its top edge can be found by anyone, even with stiff fingers and poor eyesight. The point can be reached sitting on a bed with the leg out straight, without bending forward far.

In this tradition the point is used almost entirely for the knee itself and for the legs below it. It is described as warming and loosening a joint that has gone cold, stiff and weak, the kind of knee that aches in damp weather and complains on the stairs. Its name is an image. A crane stands on thin legs with a knobbly knee, and the kneecap is the summit of the leg seen from the front. The Vietnamese name, Hạc Đỉnh, means the same.

What the Old Texts Say About Heding

The kneecap has been a landmark for as long as points have been measured. The proportional units recorded in the Lingshu, the Spiritual Pivot, a text from the Han dynasty, set the distance from the top of the pubic bone to the top edge of the kneecap at eighteen equal units. The World Health Organization still uses that measurement in its 2008 standard for point locations. Several points on the front of the thigh are counted upward from the very edge where this point sits.

This point itself came into the books later than the channel points. Extra points were added over the centuries, as practitioners recorded places outside the main channels that served them well. When the World Health Organization drew up its standard list of names in 1991, it gave this one its code and its standard name, and placed it at the midpoint of the top edge of the kneecap. That standard is why the same point now carries the same name in Hanoi, Beijing and London.

In the tradition this point belongs to, its uses have stayed narrow and steady: pain and stiffness of the knee, weakness and heaviness of the legs, and difficulty walking. That narrowness is itself informative. Points that drift from one use to another over the centuries tend to collect long lists. This one kept to the knee.

We do not quote any classical text for this point, because the handbooks we work from do not record one for it. What we can say plainly is that it is a knee point, used for knees, in ordinary hands, over a long time.

Points That Work With Heding

The first two partners are the dips below the kneecap. Bend the knee a little and feel the thick tendon running down from the lower tip of the kneecap. On each side of it there is a soft hollow, the eyes of the knee, one on the outer side and one on the inner side. They are the usual partners for this point, and many people work all three in turn: above the kneecap, then the outer dip, then the inner dip.

The third partner sits on the inner thigh. Sit with the knee bent and place your palm over the kneecap, fingers pointing up the thigh. On the inner side, about three finger-widths above the inner top corner of the kneecap, there is a bulge of thigh muscle; the point is on it. It is used with this one when the ache sits on the inner side of the knee, or when the thigh feels weak.

How to Find and Press Heding

Getting Into Position

Sit on a bed or sofa with the leg straight out in front of you and supported along its length, or sit on a chair with the heel resting on a stool of the same height. The thigh must be relaxed, so do not tighten the muscle or press the knee down. If you can wiggle the kneecap gently from side to side, the thigh is soft enough.

How to Find It

Find the kneecap and place a fingertip on its top edge at the outer corner. Trace the edge across to the inner corner, feeling the rounded rim of bone. Then come back to the middle. At the midpoint of that top edge, right above the bone, the fingertip sinks into a small dip in the tendon. That is the area.

Now probe it with a rounded-tip pressing tool, or the tip of your thumb with the nail cut short, in small steps around the dip. Most of it will feel like firm tendon. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. On a knee that has ached for a while it is often easy to find. If the area above the kneecap feels puffy, soft and warm, do not press; that is fluid in the joint, and it needs to be checked.

How to Press It

Keep the tip of the tool or thumb on the stinging spot and rub in small circles, about the size of a fingernail, roughly one each second. Aim the pressure straight down toward the back of the knee, and a little downward toward the kneecap, not up the thigh. Rest your other hand on the thigh above to keep it relaxed. Keep the tip on one spot; do not let it slide onto the bone.

How Much Pressure

Sharp under the tool is right. That small sting means you are on the point. The test comes when you lift off: the sting should fade within moments. If the pain stays after you lift the tool, if it spreads, or if the knee turns swollen, hot or red, stop and leave it for several days. Stop at once for any electric or numb feeling. If you find yourself tightening the thigh or holding your breath, you are pressing too hard. Ease off until you can breathe slowly through the sting.

How Long

Work each knee for one to three minutes. In the first sessions keep to about one minute, because the point is often tender at the start. As the days go on, add a little time, up to three minutes. Do both knees, even when only one aches, because people tend to lean on the better knee. Once or twice a day is plenty. Pressing longer does not help more.

When to Do It

Morning suits a knee that is stiff and slow on waking; a minute here before you stand up and walk can be part of getting going. Late afternoon suits a knee that aches after stairs, shopping or gardening. Before bed is a good time too, as part of winding down. Do not press in the middle of the night. If an aching knee wakes you, pressing then tends to wake you further. Keep the work for the day and the evening.

What This Won't Do

It will not remove the reason your knee aches. Knee pain in later life usually comes from wear in the joint, a thigh muscle that has weakened, extra weight, or an old injury that changed the way the knee moves. A dip above your kneecap will not out-argue any of that. The measures that make the most difference are plain ones: strengthening the thigh muscle, keeping active, managing weight, using a stick on the opposite side when needed, and wearing supportive shoes. Pressing sits alongside those as a comfort measure.

It will not replace a diagnosis either. A knee that is suddenly hot, red and swollen, especially with fever or feeling unwell, needs a doctor that day. So does a knee that swells after a fall or a twist, that locks or gives way, or that will not take your weight. A swelling behind the knee, or one calf that is suddenly swollen, warm and painful, needs urgent assessment, because it can mean a clot in a deep vein. Pain that wakes you every night, or worsens week on week, also belongs with a doctor. Time spent pressing is time not spent getting those looked at.

Safety First

Skip this point if the knee is hot and swollen, if the area above the kneecap feels puffy and warm, or if you had knee surgery or a knee replacement recently; ask your surgeon when you may start. Do not press over skin that is broken, burned, infected, badly bruised or rashy, or over a scar that has not fully settled. Leave the area alone with a recent fracture or a fresh sprain. If you take blood thinners, bruise easily, have a bleeding disorder, or have reduced feeling in your legs, use lighter pressure, keep sessions short, and talk to your doctor first.

Stop at once if the pain stays after you lift off, spreads, or if the knee becomes swollen, hot or red. Stop too for any electric or numb sensation. Nothing here requires you to push through pain. For the full list of cautions and the situations where pressing on yourself is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Heding (EX-LE2) pressure point? Heding (EX-LE2) sits at the front of your knee, in the small dip at the middle of the top edge of the kneecap. Straighten the leg and relax the thigh, trace the top edge of the kneecap with a fingertip, and stop at the middle. Probe the dip there until one spot stings. In English it is called the Crane's Summit; in Vietnamese, Hạc Đỉnh.

Why should my leg be straight when I press it? With the leg straight and the thigh relaxed, the kneecap and the tendon above it go soft, and the dip opens up. With the knee bent, the tendon is pulled tight over the spot and it is harder to find. Support the leg on a bed or a stool so the thigh muscles can let go.

How long should I press Heding? One to three minutes on each knee. Keep the first sessions to about a minute, then add a little as the days go on, up to three. Once or twice a day is enough. Do both knees, even if only one aches.

Can I press it if my knee is swollen? No, not if the knee is hot and swollen. The pocket of the knee joint lies under this spot, and when the joint fills with fluid, this is where it bulges. Have a hot, swollen knee checked, and come back to the point once it has settled.

What is the Heding (EX-LE2) point used for? In Vietnamese traditional medicine it is used almost only for the knee, for an aching, stiff knee, a knee that complains on stairs or when rising from a chair, and weak, tired legs. It is an extra point, off the fourteen main channels; its code reads as extra point number two of the lower limb. It will not change wear in the joint; use it as a comfort measure alongside thigh-strengthening exercises.

Can I use it with the dips below the kneecap? Yes. The two dips on either side of the tendon below the kneecap are its usual partners. Many people work the three in turn, above and then below the kneecap, for an aching knee.

Other Points in This Library

Each of these sits within reach of the same hand. They are often worked in the same sitting.

This page shares general information about a traditional practice. It is not medical advice and does not replace what your doctor has given you. If you are pregnant, managing a health condition, or unsure whether this applies to you, check with your doctor first.

The whole inner edge of the foot, laid out on one page with photographs, is in The Foot Map — the free book. For every point in this library, see the full pressure point index.

(Point shown: EX-LE2 · Heding · The Crane's Summit · Hạc Đỉnh.)