Qiuxu (GB40): The Outer Ankle Point for a Stiff Ankle and an Aching Outer Leg

Where Qiuxu Sits

This point sits on the outer side of the ankle, in the soft hollow in front of and below the round ankle bone, on the outer side of the tendons that run to the toes.

The line this point belongs to runs down the side of the body like a seam. It starts at the outer corner of the eye, winds back and forth across the side of the head, drops behind the ear, crosses the top of the shoulder, and runs down the side of the ribs and hip. It follows the outer thigh and the outer side of the leg down to the ankle. Here it passes in front of the outer ankle bone before crossing the top of the foot to the fourth toe. Vietnamese and Chinese texts call it the Gallbladder channel. This is its fortieth stop.

The old texts place it in front of and below the outer ankle bone, in a dip. No measuring is needed. The round bone on the outer side of the ankle is the lower end of the thin outer leg bone. The World Health Organization standard of 2008 describes the place the same way: in front of and below that bone, in the dip on the outer side of the tendon that straightens the toes. Find the bone, slide forward and down, and your fingertip sinks into a soft hollow.

That hollow is a real anatomical space. It is the opening of a small channel between two bones of the hindfoot, the heel bone and the ankle bone above it. Over it lies a small, soft muscle on the top of the foot that helps straighten the toes, and in front of it the tendons running to the toes cross the ankle under a strap of tough tissue. Lift your toes and you will feel those tendons tighten on the inner side of the hollow.

The skin here is served by branches of the nerve that runs down the outer front of the leg and spreads over the top of the foot, together with a nerve that comes down the back of the calf and around the outer ankle. The skin of this part of the foot is served mostly by the fifth lumbar and first sacral roots. That is why the outer ankle can ache along with the outer leg and the lower back.

Why This Spot

On the anatomical side, the outer ankle is where most sprains happen. When the foot rolls inward on a kerb or a step, the ligaments on the outer side stretch or tear, and this hollow sits right over them. Years later many people still feel stiffness and a tender spot here, especially in cold weather or after a long walk. The small muscle and the tendons nearby work with every step to lift the toes and steady the foot. That is why this corner is often tender in people who walk carefully, shuffle, or favour one leg.

In this tradition the point is the source point of its channel, a place where the core strength of the channel is described as surfacing and can be reached most directly. Source points are among the most used points in the whole system. That is why the old books turn to this point not only for the ankle but for complaints along the whole channel: an ache down the outer leg, tightness at the side of the ribs, and a sense of the whole side of the body being stiff.

The name describes the landscape. Hill refers to the round ankle bone, which rises like a mound; ruins are the low, broken ground in front of it, where the hollow lies. Its Vietnamese name, Khâu Khư, carries the same picture.

What the Old Texts Say About Qiuxu

The Lingshu, the Spiritual Pivot, a Han-dynasty text, lists this point in its chapter on the transporting points as the source of the Gallbladder channel, placed in front of and below the outer ankle bone. That listing is one of the oldest records of the point, and its role has not changed since.

The Systematic Classic of Acupuncture and Moxibustion, the Jiayi Jing, from the third century, repeats the location and adds uses along the side of the body. The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for stomach ache, sour belching, pain along the side of the chest and ribs, and pain along the outer side of the leg. The same book gives the way to find it used in this page: with the knee bent and the foot resting flat, in the dip in front of and below the outer ankle bone, on the outer side of the tendon that straightens the toes.

In the wider tradition the point is a favourite for the outer ankle that never quite settled after a sprain, for a leg that aches down its outer side, and for tightness under the ribs. Teachers have long described it as a point that loosens the whole side of the body from below. That reputation comes from long use rather than proof. It tells you the point was trusted for the stiffness and side aches that many people in their sixties carry.

Points That Work With Qiuxu

The first partner sits behind the same ankle bone, in the hollow between the bone and the thick heel cord at the back of the ankle. In this tradition it is commonly paired with this one for a stiff, aching ankle, and the two can be worked one in front of the bone and one behind it, in the same sitting.

The second sits on the top of the foot, a little forward on the same line, in the groove between the bones that lead to the fourth and little toes, where those bones meet. It is used with this one when the ache spreads from the ankle across the outer top of the foot.

The third sits higher, below the knee. Find the small round bony knob on the outer side of the leg, a little below the knee, then slide down and forward into the soft dip in front of it. It is used with this one when the stiffness runs up the whole outer side of the leg.

How to Find and Press Qiuxu

Getting Into Position

Sit on a firm chair and rest one foot across the opposite knee, so the outer ankle faces you. If that is hard on the hips, put the foot on a low stool in front of you and turn the knee slightly inward, or sit sideways on a bed with the leg resting on a pillow.

How to Find It

Find the round bone that sticks out on the outer side of the ankle. Run your fingertip around its front lower edge, then let it slide forward and down off the bone. It will sink into a soft hollow, about the size of a fingertip, in front of and below the bone. Lift your toes: the tendons that tighten mark the inner edge of the hollow. The area is on the outer side of those tendons, in the hollow itself.

Now probe the hollow with a rounded-tip pressing tool, or the tip of your thumb with the nail cut short. Move slowly in small steps. Most of it will feel soft and ordinary. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. In people with an old sprain on that side it is often very tender, so begin gently.

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 into the hollow, slightly toward the inner ankle. Hold the heel with your other hand so the foot stays still. Keep the tip on the same spot; do not let it slide up onto the ankle bone.

How Much Pressure

Sharp under the tool is right. That small sting tells you that you are on the point. The test is what happens 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 ankle turns swollen, hot or red, stop and leave it for several days. If you are holding your breath or curling your toes, you are pressing too hard. Ease off until you can breathe slowly through the sting.

How Long

Work each ankle for one to three minutes. In the first sessions keep to about one minute, because the point is often most tender at the start. As the days go on, add a little time, up to three minutes. Do both ankles, even when only one side complains. Once or twice a day is plenty. Afterwards, draw a few slow circles with each foot. Pressing longer does not add benefit; it mostly adds soreness.

When to Do It

Morning suits ankles that are stiff on waking, before your first walk. Late afternoon suits the outer leg and ankle that ache after walking, standing 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 leg wakes you, pressing then tends to wake you further. Keep the pressing for the day and the evening.

What This Won't Do

It will not remove the reason your ankle is stiff or your outer leg aches. With ankles, the reason is often an old sprain that left loose ligaments, wear in the joint, weak muscles around the ankle, poor balance, or shoes that let the foot roll. An ache down the outer leg can also come from the lower back or the hip. A point at the ankle will not out-argue any of that. Pressing works best alongside the plain things: balance practice, gentle ankle strengthening, supportive shoes, and care on uneven ground.

It will not replace a diagnosis either. After a fall or a twist, an ankle you cannot stand on, or one with pain right over the bone, needs an X-ray before anything else. An ankle that is suddenly hot, red and swollen needs to be seen, especially with a fever. One calf that is suddenly swollen, warm and painful needs urgent assessment, because it can mean a clot in a deep vein. Swelling of both ankles that is new, or comes with breathlessness, belongs with a doctor. A foot that drops or drags, or numbness that does not go away, points to a nerve and needs to be checked, not pressed.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the ankle alone with a fresh sprain, a recent fracture, unexplained swelling, or a plate, screw or implant under the skin. If you had ankle surgery, ask your surgeon when you may start. If you take blood thinners, bruise easily, have a bleeding disorder, or have reduced feeling in your feet, 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 area becomes swollen, hot or red. 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 Qiuxu (GB40) pressure point? Qiuxu (GB40) sits on the outer side of your ankle, in the soft hollow in front of and below the round ankle bone. Find the bone, slide forward and down off it, and probe the hollow until one spot stings. In English it is called the Hill Ruins; in Vietnamese, Khâu Khư.

Which of the two dots in the photo is this point? The upper dot, labelled GB40, in front of and below the outer ankle bone. The lower dot, labelled BL61, sits on the outer heel and is a different point, shown only so you can get your bearings on the foot.

How long should I press Qiuxu? One to three minutes on each ankle. 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. Work both ankles.

I sprained this ankle years ago and it still feels stiff. Can I press here? Yes, once the sprain is long settled and has been checked. This hollow sits over the area that is often tender after old outer ankle sprains. Use moderate pressure and gentle ankle circles afterwards. Do not press a fresh sprain that is still swollen and bruised.

Is this the same as the point behind the ankle bone? No. The point behind the outer ankle bone sits in the hollow between the bone and the heel cord. This one sits in front of and below the bone. Many people work both in the same sitting.

Can I press it if my ankles are swollen? Not over swelling you have not had checked. Puffy ankles at the end of the day are common, but swelling that is new, on one side only, painful or warm, or that comes with breathlessness needs a doctor first.

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: GB40 · Qiuxu · Hill Ruins · Khâu Khư.)