Zhouliao (LI12): The Outer Elbow Point for a Sore, Stiff Elbow

Where Zhouliao Sits

This point sits on the outer side of the elbow, a thumb-width above the outer end of the elbow crease and a little toward the back, against the edge of the upper arm bone, right above the bony bump on the outer elbow.

The line this point belongs to starts at the tip of the index finger. It runs up the thumb side of the hand, crosses the wrist, climbs the outer edge of the forearm to the elbow, and continues up the outer upper arm to the front of the shoulder. From there it crosses the neck and ends beside the nose. Vietnamese and Chinese texts call it the Large Intestine channel. This is its twelfth stop, the first one above the elbow.

The upper arm bone, the humerus, widens at its lower end into two bony bumps, one on the inside and one on the outside of the elbow. The outer bump is the lateral epicondyle. Above it, a ridge of bone runs up the outer edge of the arm. The old texts place this point one body inch up and outward from the point at the end of the elbow crease, beside the outer edge of the bone's head. The World Health Organization standard describes the same corner: on the back-outer side of the elbow, above the outer bump, in front of the ridge that runs up from it.

Several forearm muscles begin here. One bends the elbow when the thumb points up, as when you lift a mug (the brachioradialis). Another pulls the wrist back and toward the thumb (the long radial wrist extensor). Their starting point sits right where you press. Below the point, on the bump itself, begins the shared tendon of the muscles that straighten the wrist and fingers, the tendon that becomes sore in tennis elbow. The radial nerve runs in front of this corner on its way to the forearm. The skin over the point is served by branches of the same nerve, fed from roots in the lower neck.

Why This Spot

On the anatomical side, this is the busy upper corner of the outer elbow. Every time you grip, twist a lid, carry a bag with the palm down, or pull weeds, the muscles that begin here and on the bump below take the strain. When that tendon on the bump is sore, the muscles above it often tighten to guard it, and this spot can become tender too. It is a little away from the sorest bump, so you can work near the trouble without pressing hard on the tendon itself.

In this tradition the elbow is a gateway on the channel, and the points around it are used for pain, stiffness and weakness of the arm. This one is mostly local: the old books use it for the elbow and the arm rather than for distant complaints. Its name describes the place. The first character means the elbow; the second means a crevice or gap at the edge of a bone, the kind of spot where a fingertip can sink in beside a hard rim.

Its Vietnamese name, Trửu Liêu, means the same: the crevice at the elbow.

What the Old Texts Say About Zhouliao

The course of this channel along the outer arm is laid out in the Lingshu, the Spiritual Pivot, a Han-dynasty text, in its chapter on the channels. The line passes the outer elbow and climbs the outer arm, and this point marks the place where it leaves the elbow behind. Later point books placed it carefully in relation to its better-known neighbour at the end of the crease, and the World Health Organization standard keeps that relationship.

The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for pain of the elbow, for pain of the bony bump at the outer elbow, and for an inflamed, painful arm. Its location in that book is measured from the neighbouring point at the elbow crease: one body inch upward and outward, at the outer edge of the head of the upper arm bone. The quick method is to bend the elbow, find the outer end of the crease, then move slightly up and out by one body inch, keeping close to the outer edge of the bone.

That is a short entry, and it is honest about what the point is for. Not every point in the old books carries a long list of uses. This one is a worker for the elbow, and the tradition has kept it that way for many centuries.

Points That Work With Zhouliao

The first partner is the closest. Bend the elbow and look at the outer end of the crease that forms at the inside of the bend. The point sits in the dip there, between the end of the crease and the bony bump. It is used with this one for almost every complaint of the outer elbow, and the two can be pressed one after the other in the same sitting.

The second sits lower on the same line, on the forearm. From the dip at the end of the elbow crease, measure three finger-widths down the outer forearm, toward the thumb side of the wrist. The point lies in the muscle there. It is used with this one when the ache runs from the elbow down into the forearm.

The third sits at the shoulder. Lift the arm out to the side. Two dips appear at the top of the shoulder; the point lies in the front one. It is used with this one when the whole outer arm feels stiff, from the shoulder to the elbow.

How to Find and Press Zhouliao

Getting Into Position

Sit at a table with your arm resting on it, the elbow bent to roughly a right angle and the thumb side up, as if you were about to shake hands. Let the hand hang loose. If the table is awkward, rest the forearm across your belly or on a cushion in your lap.

How to Find It

Look at the inside of the bent elbow and find the crease. Follow it to its outer end, on the thumb side. Next to that end you can feel a hard bump of bone on the outer elbow. Now move up from the end of the crease by one thumb-width and a little toward the back of the arm, and your fingertip meets the outer edge of the upper arm bone. That edge is the area.

Probe it with a rounded-tip pressing tool, or the tip of your thumb with the nail cut short. Move in small steps along the edge of the bone, up and down a little. Most of it will feel like firm muscle. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. If instead you feel an electric jolt into the forearm, you have drifted forward onto the nerve. Lift off, move back toward the bone, and press more 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 inward, against the edge of the bone, not down onto the bump. Steady the forearm with the table or your lap so the arm does not move. Keep the tip on the same spot; do not let it slide over the bump below.

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 area turns swollen, hot or red, stop and leave it for several days. Stop at once for any electric sensation or numbness into the forearm. If you are holding your breath, or your shoulder is creeping up toward your ear, you are pressing too hard. Ease off until you can breathe slowly through the sting.

How Long

Work each arm for one to three minutes. In the first sessions keep to about one minute, because a sore elbow is often most tender at the start. As the days go on, add a little time, up to three minutes. Do both arms, even when only one elbow aches. Once or twice a day is plenty. Pressing longer does not add benefit; it mostly adds soreness to a tendon that already has enough.

When to Do It

Morning suits an elbow that is stiff on waking and slow to straighten. Late afternoon suits an elbow that has worked hard, after gardening, cleaning, carrying shopping or using a screwdriver. Before bed is a good time too, as part of winding down. Do not press in the middle of the night. If an aching elbow 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 elbow hurts. Outer elbow pain in people past fifty usually comes from a tendon worn by years of gripping and twisting, from wear in the elbow joint, or from a nerve that is irritated in the neck and sends pain down the arm. A point above the elbow will not out-argue any of that. Pressing works best alongside the plain things: resting from the grip that started it, lifting with the palm up rather than down, a forearm strap if your physiotherapist suggests one, gentle strengthening once the worst has passed, and patience, since these tendons take months to settle.

It will not replace a diagnosis either. An elbow that is suddenly hot, red and swollen needs to be seen, especially with a fever, and a soft, swollen bag at the point of the elbow needs a doctor rather than pressure. An elbow that will not straighten or bend after a fall may be broken. Numbness in the fingers, a hand that is getting weaker, or pain that runs from the neck down the arm points to a nerve and needs to be checked. Pain that worsens week on week, or wakes you every night, belongs with a doctor.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the area alone with a recent fracture, a fresh injury, unexplained swelling, or a plate, screws or a joint replacement in the elbow. Skip this point if the elbow is hot and swollen, or if you had elbow surgery or a steroid injection there recently, and ask your doctor when you may start. If you take blood thinners, bruise easily, have a bleeding disorder, or have reduced feeling in your arms and hands, 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. Stop too for any electric jolt or numbness into the forearm. 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 Zhouliao (LI12) pressure point? Zhouliao (LI12) sits on the outer side of your elbow. Bend the arm and find the outer end of the elbow crease. Move one thumb-width up and a little toward the back, and you reach the edge of the upper arm bone, right above the bony bump on the outer elbow. In English it is called the Elbow Crevice; in Vietnamese, Trửu Liêu.

Is Zhouliao (LI12) the same as Quchi (LI11)? No, they are neighbours. Quchi (LI11) sits in the dip at the very end of the elbow crease. Zhouliao (LI12) sits one thumb-width higher and slightly further back, against the bone. They are often pressed together, one after the other.

Can I press it for tennis elbow? In this tradition it is commonly used for a sore outer elbow, and the Vietnamese handbook lists elbow pain first among its uses. Press beside the sore bump rather than hard onto it. If the elbow has hurt for months, or a grip as light as lifting a kettle is painful, let a doctor or physiotherapist look at it as well.

How long should I press Zhouliao? One to three minutes on each arm. 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 arms, even if only one elbow aches.

I feel a jolt into my forearm. Is that normal? No. Stop and lift off. A nerve runs in front of this spot toward the forearm, and an electric jolt means you have pressed onto it. Move your tool slightly back toward the bone's edge and use less force. The sensation you want is a small sting under the tip.

Can I press it if my elbow is swollen? Not if the elbow is hot, red and swollen, especially at the point of the elbow, or after a fall. Let a doctor look at it first. Once it has settled and been checked, you can come back to the point with light pressure.

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: LI12 · Zhouliao · The Elbow Crevice · Trửu Liêu.)