Neixiyan (EX-LE4): The Inner Knee Eye for a Sore, Stiff Knee

Where Neixiyan Sits

This point is the soft dimple right below the kneecap on the inner side, between the kneecap tendon and the top of the shinbone. You find it with the knee bent at a right angle, when the dimple opens.

Most points in this method sit on one of the fourteen traditional channels. This one does not. It belongs to the extra points: spots that teachers found useful over many generations and recorded on their own, outside the main lines. Its twin on the other side of the knee does belong to a main channel. Together the two are known in Vietnamese as the eyes of the knee.

Sit with the knee bent at a right angle and look at the front of it. At the bottom of the kneecap a thick, firm tendon runs straight down to a bump at the top of the shin bone. On either side of that tendon there is a soft dimple. This point is the inner one, on the big-toe side, toward your other leg. It lies right below the kneecap, in the hollow bordered by the kneecap above, the tendon on the outer side and the top of the shin bone below.

Under the skin of the hollow is part of the soft fat pad that sits in front of the knee joint and cushions it. Behind that pad lies the inner part of the joint, where the inner side of the thigh bone rests on the inner side of the shin bone. Between the two bones sits a curved pad of cartilage, the inner meniscus, which takes much of your weight when you stand and walk. The inner part of the knee carries more load than the outer part in most people. That is one reason inner knee pain is so common in later life.

The skin over the hollow is served by a small branch of the nerve that runs down the inner leg, the saphenous nerve. Its branch below the kneecap curves across exactly this area. Deeper twigs from the femoral nerve and others reach the front of the joint. Most draw from roots in the lower back, the third and fourth lumbar roots. Occasionally pressure here gives a tingle over the front of the shin; that is the small skin nerve, and a sign to shift slightly.

Why This Spot

The inner hollow gives direct access to the front of the inner knee. There is no bone or thick muscle in the way, only skin and a soft pad. You can see it and feel it with no measuring at all. When the knee is bent, the hollow opens; when it straightens, it fills in. That makes it one of the easiest points in this whole method to locate on your own.

It also sits where many people feel their knee. The inner side of the knee is the part that aches first on stairs, on rising from a low chair, and on the first steps after sitting. If you press here and find a sore spot, you are often pressing close to the place that complains when you walk.

In this tradition the name is a plain description: the inner eye of the knee. The two hollows below the kneecap, with the kneecap above them, were said to look like a pair of eyes, or like the nostrils of a young ox. The outer hollow was given to the Stomach line, which runs down the front of the leg. The inner hollow stayed an extra point, used for one job: the knee itself. Teachers reached for it when a knee was stiff, ached when bent, or worsened in cold, damp weather.

What the Old Texts Say About Neixiyan

For a long time the two eyes of the knee were described together, as a single pair of hollows below the kneecap, used for a painful knee. Over time the tradition split them. The outer hollow became a named point on a main channel. The inner hollow was recorded on its own among the extra points. Its use stayed the same throughout: an aching knee, a knee that will not bend or straighten freely, and a knee that worsens with cold and damp.

The Vietnamese handbook used in this method, Ngô Trung Triều's Points and Channels of the Human Body (Huyệt vị kinh lạc cơ thể người), covers the fourteen main channels and so describes the outer eye, not this one. Its finding method for the outer hollow applies equally here, with the side changed. Sit upright, bend the knee to a right angle, and find the hollow beside the tendon below the kneecap. Here you take the inner side.

The World Health Organization's location guide of 2008 covers only the points of the main channels, so it describes the outer eye and not this one. It places the outer eye on the front of the knee, in the hollow on the outer side of the kneecap tendon. This point is its mirror image across the tendon, and the WHO's earlier standard list of names, from 1991, gives it its code among the extra points of the leg. That agreement across schools proves nothing about how pressing it works. It does show that people with sore knees, in many countries and over many generations, kept returning to the same pair of small dimples.

Points That Work With Neixiyan

The closest partner is the outer eye of the knee, the matching hollow on the other side of the same tendon, toward the little toe. The two are so often used together that they are thought of as a pair. You can press both at once: thumb in one hollow, first finger in the other, the tendon between them.

The second lies below the inner knee. Run your fingertip up the inner edge of the shin bone, from the middle of the shin toward the knee. Your finger stops in a hollow under the bulge of bone at the top of the shin, on the inner side. In this tradition it is commonly used for an aching inner knee and a heavy, puffy-feeling lower leg.

The third sits above the knee. Find the middle of the upper edge of the kneecap and press into the small hollow right above it. In this tradition it is a point for the knee itself, and with the two eyes below it, it surrounds the kneecap.

How to Find and Press Neixiyan

Getting Into Position

Sit on a firm chair with your back supported, feet flat on the floor, and the knee bent at about a right angle. This opens the hollows and makes the tendon stand out. Let the thigh rest on the seat and the lower leg hang relaxed. If you tense the thigh, the tendon pulls tight and the hollow closes.

How to Find It

Run your fingertip down the front of the kneecap to its lower edge. Below it you will feel the thick, firm tendon heading down to the shin. Slide off the tendon toward the inner side, the big-toe side, toward your other leg. Your fingertip drops into a soft dimple, with the kneecap above, the tendon beside it and the top of the shin bone below. That dimple is your area.

Search inside it. Use a rounded-tip pressing tool, or the tip of your thumb with the nail cut short. Probe around the hollow in small steps, a few millimetres at a time, pressing in and slightly toward the centre of the knee. Most of the hollow feels soft and dull. One spot will sting: a sharp, pinpoint tenderness that makes you notice it. That is the point. It may sit close to the kneecap edge or closer to the tendon. If the hollow feels puffy, warm or full of fluid, leave it alone; see the safety notes below.

How to Press It

Stay on the spot that stings and rub it in small circles, no wider than a grain of rice. Let the skin move with the tool. Aim inward and slightly up and out, toward the middle of the knee behind the kneecap, not straight back into the bone.

To work both eyes at once, place the tip of your thumb in this hollow and the tip of your first finger in the outer hollow, the tendon between them. Squeeze gently and circle together. That grip is stronger than it feels, so use less force than with one tip alone. Never use anything sharp or pointed in these soft hollows.

How Much Pressure

On this point, sharp under the tool is right. The sting should be clear but bearable, and it should fade within a few seconds of lifting off. If you are holding your breath or pressing your other foot hard into the floor, ease off. Stop if the pain stays after you lift off, if it spreads through the knee, or if the knee turns swollen, hot or red. Stop too for any electric or numb sensation, including a tingle running down the front of the shin. A knee that feels stiffer or puffier the next day means lighter pressure next time, or a few days off.

How Long

One to three minutes per point, on each knee. Keep the first sessions near one minute. As the days go on and the spot becomes less touchy, build up toward two or three minutes. Work both knees, even if only one complains, because people often shift weight onto the better knee without noticing. One or two sessions a day is plenty.

When to Do It

A morning session suits a knee that is stiff on getting up. Rub the hollow, then bend and straighten the knee slowly a few times before you stand. A session before a walk or a trip to the shops is another good time. An afternoon session suits a knee that aches after a long day. A short session before bed is fine too. Do not press in the middle of the night. If knee pain wakes you, change position, put a pillow between the knees if you sleep on your side, and leave the point until the morning. Working a sharp spot while half-awake is easy to overdo, and it tends to leave you more alert, not less.

What This Won't Do

It will not rebuild the inner knee. Inner knee pain in later life usually comes from wear in the joint, a worn or torn cartilage pad, a strained ligament on the inner side, or weak thigh muscles that no longer steady the knee. A hollow under the kneecap cannot change any of those. What pressing can do is ease a tender spot for a while and make it easier to get moving. Regular walking, standing up often, keeping your weight in a comfortable range, and the strengthening exercises a physiotherapist gives you matter more over time. This point sits alongside them as a comfort measure.

It will not replace a diagnosis. A knee that is suddenly hot, red and swollen, especially with fever, needs a doctor the same day. A knee that locks, gives way, or cannot take your weight after a twist or a fall needs to be checked. A calf that is swollen, hot and painful needs urgent attention, because it can signal a blood clot. Knee pain that stops you walking, gets worse week after week, wakes you every night, or comes with weight loss you cannot explain should be seen by a doctor, not managed alone.

Safety First

Skip this point on a knee that is hot and swollen, after recent knee surgery, or while a knee replacement scar is still settling; ask your surgeon or physiotherapist before you start. Do not work over skin that is broken, burned, infected, badly bruised or rashy. If you have varicose veins or have ever had a blood clot in the leg, ask a doctor first, and never press on a bulging vein. Veins often show on the inner side of the knee, so look before you press. If you take blood thinners, bruise easily, have a bleeding disorder, advanced diabetes or reduced feeling in your legs, use lighter pressure and shorter sessions, and talk to your doctor first.

Stop at once if the knee or shin goes numb, if the pain stays after you lift off, or if the knee turns swollen, hot or red. For the full list of cautions and the situations where self-applied pressure is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Neixiyan (EX-LE4) pressure point? Neixiyan (EX-LE4) is the hollow below the kneecap on its inner side, beside the thick tendon that runs from the kneecap to the shin. Sit with the knee bent and look for the two small dimples either side of the tendon. The inner one, toward the big-toe side, is the area to search. In English it is called the Inner Eye of the Knee; in Vietnamese, Nội Tất Nhãn.

Is this the same as the outer knee eye? No, it is its twin. The outer hollow, on the little-toe side of the tendon, belongs to one of the main channels. This inner hollow is counted as an extra point. They are often pressed together, one with the thumb and one with the first finger.

How long should I press Neixiyan? One to three minutes on each knee. Stay near one minute in the first sessions, then lengthen a little as the days go on. One or two sessions a day is enough. Work both knees, even when only one complains.

My pain is on the inner side of the knee. Is this the right point? It is one of the points most often used for inner knee ache in this tradition, because it sits right at the front of the inner part of the joint. It will not change wear in the joint, but it is easy to reach and costs nothing to try alongside the exercises a physiotherapist gives you.

Can I press Neixiyan (EX-LE4) after a knee replacement? Not while the scar is still settling, and not without asking your surgeon or physiotherapist first. Once they are happy, use only light pressure and stop if the knee becomes warm, swollen or more painful afterward.

What is the Neixiyan (EX-LE4) point used for? In Vietnamese traditional medicine it is used for the knee itself, for an aching inner knee, a knee that stiffens after sitting, and pain on stairs or when rising from a chair. It is an extra point, off the fourteen main channels. On the right spot you feel a sharp, pinpoint sting that fades within seconds of lifting off. It will not change wear in the joint; use it as a comfort measure.

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-LE4 · Neixiyan · The Inner Eye of the Knee · Nội Tất Nhãn.)