Shangqiu (SP5): The Inner Ankle Point for a Stiff Ankle and Heavy, Puffy Feet

Where Shangqiu Sits

This point sits on the inner side of the foot, in a small hollow below and slightly in front of the round inner ankle bone, where the ankle joint gives way to the top of the foot.

The line it belongs to starts at the inner corner of the big toenail. It runs along the inner edge of the foot, past the bump at the base of the big toe and along the arch. It passes in front of the inner ankle bone, here, and then climbs the inner side of the shin, the inner knee and the inner thigh before rising over the belly to the side of the chest. Vietnamese and Chinese texts call it the Spleen channel. This is its fifth stop, and the last one on the foot before the line turns up the leg.

The old texts place it in the dip below and in front of the inner ankle bone. The World Health Organization's 2008 standard puts it more exactly: midway between the tip of the inner ankle bone and the bony knob on the inner side of the foot, the one you can feel a couple of finger widths in front of the ankle. In practice you do not need to measure. The ankle bone is your landmark, and the dip in front of its lower edge is easy to feel once you know to look.

Underneath, the point lies over the front of the ankle joint, close to where the ankle bone meets the small boat-shaped bone of the arch. A strong tendon runs past it toward the arch: the tendon of the muscle that pulls the foot inward and holds the arch up (the tibialis posterior). In front of it runs the tendon that lifts the foot (the tibialis anterior). The point sits in the soft gap between them and the bone. The skin here is served by a branch of the saphenous nerve, which carries feeling down the inner leg to the arch, and a large vein, the great saphenous vein, runs up past the front of the inner ankle bone a little in front of the point.

Why This Spot

On the anatomical side, this corner takes a lot of strain. Every step loads the inner ankle and the arch. When the arch drops, when an old sprain has left the ankle loose, or when the knee or hip makes you walk unevenly, the tendons that run past this point work harder and the joint lining at the front of the ankle can stay irritated. That is why the spot is so often tender in people whose ankles ache after a walk or feel stiff and puffy by evening. It is also easy to reach. You can find it sitting in a chair with the foot across your knee.

In this tradition the point carries the name of the metal note in the old five-tone scale, shang, and each channel has one point linked to metal. On this line, that point is here. The Spleen channel is described as the one that moves fluids and keeps the legs from feeling waterlogged, so teachers reach for its ankle points when the legs feel heavy, damp and slow. The name, Shang Mound, describes a small hill: the ankle bone, with the point tucked at its foot.

What the Old Texts Say About Shangqiu

The Lingshu, the Spiritual Pivot, is a Han-dynasty text that lists the key points along each channel from the fingers and toes upward. In its chapter on these root points, it describes the flow of this channel reaching the Shang Mound, places the point in the hollow below the inner ankle bone, and names it a river point, the stretch where the flow is described as broad and steady. The location has barely moved since.

The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for leg qi, an old term for legs that feel heavy, swollen, weak or numb, and for pain in the leg and foot. It also lists stomach and bowel complaints and poor digestion. The pattern is clear. The point is used locally, for the ankle and the leg, and along its line, for the belly.

The same handbook gives a careful way to find it. Feel for the tendon that runs below the inner ankle bone by bending and straightening the foot, and feel for the joint line directly below the front edge of the ankle bone. The point is in the dip made by that tendon, right at the joint between the ankle bone and the boat-shaped bone of the arch. That is the method used on this page.

In the wider tradition, this point is one teachers think of when an ankle has gone stiff after an old injury, or when the feet feel puffy and dull at the end of the day. That reputation rests on long use rather than on trials. It tells you the point has been trusted for a long time for the kind of ankle and leg trouble that settles in during the later decades.

Points That Work With Shangqiu

The first partner sits on the inner side of the lower leg. Place the edge of your little finger on the tip of the inner ankle bone and lay four fingers above it; the point is right behind the shin bone at the top of your index finger. It is commonly paired with this one when the legs feel heavy and the belly feels slow, and the two are easy to work in the same sitting.

The second is the close neighbour behind the ankle bone. Slide your fingertip from the ankle bone straight back toward the heel and stop in the hollow in front of the heel cord. It is used with this one when the ankle aches and the legs feel tired and cold, especially at night.

The third is the mirror point on the outer ankle. Find the outer ankle bone and slide down and forward into the large dip in front of it. Many people work the inner and outer dips together, one with the thumb and one with the fingers, when the whole ankle feels stiff.

How to Find and Press Shangqiu

Getting Into Position

Sit on a firm chair and lift one foot onto the opposite knee, so the inner ankle faces up and toward you. If that is hard on the hip, put the foot on a low stool in front of you and lean forward, or sit on the bed with the leg stretched out and the knee falling outward. Let the foot hang soft. Do not curl the toes.

How to Find It

Put your fingertips on the round, hard bump of the inner ankle bone. Trace its front edge down to the lowest corner. From there, slide off the bone a little down and toward the toes. Your fingertip drops into a small, soft dip, about the size of a pea. If you flex the foot up and down slowly, you will feel the joint open and close under your finger and a firm tendon pass along the lower edge. The area is the dip in front of that tendon, right against the joint.

Now probe it with a rounded-tip pressing tool, or the tip of your thumb with the nail cut short. Move slowly in small steps around the dip. Most of it will feel like ordinary tissue or bone. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. If you feel the tool rolling over a soft cord, you are on the large vein. Move a little lower and back toward the bone.

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 joint, slightly back toward the ankle bone, not down toward the sole. Hold the top of the foot with your other hand so it does not wobble. Keep the tip on the same spot; do not let it slide over the bone or the tendon.

How Much Pressure

Sharp under the tool is right. That small sting tells you that 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, spreads, or 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 foot for one to three minutes. In the first sessions keep to about one minute, because a stiff ankle is often tender at the start. As the days go on, add a little time, up to three minutes. Do both feet, even when only one ankle complains. Once or twice a day is plenty. Pressing longer does not add benefit; it mostly adds soreness.

When to Do It

Morning suits an ankle that is stiff on the first steps out of bed. Late afternoon suits feet that have grown heavy and puffy after standing or walking; put your feet up for a few minutes afterward. Before bed is a good time too, as part of winding down. Do not press in the middle of the night. If an aching ankle 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 rebuild a worn ankle joint, tighten a ligament that was stretched years ago, or lift a fallen arch. Those come from the shape of the foot, old injuries, weight, and the shoes you stand in. A point in front of your ankle bone cannot out-argue any of that. Pressing works best alongside the plain things: supportive shoes, ankle circles and calf raises held on to a counter, a few minutes with the feet up in the afternoon, and walking a little every day.

It will not drain swollen legs either, or replace a diagnosis. Swelling that comes on over days, that affects both legs and leaves a deep dent when you press it, or that comes with breathlessness, needs a doctor soon. Swelling can come from the veins, the kidneys, other organs, or from medicines, and the cause matters. One calf or ankle that is suddenly swollen, warm and painful needs urgent assessment, because it can mean a clot in a deep vein. An ankle that is hot, red and very painful without an injury, which can be gout or an infection, needs to be seen. So does an ankle you cannot take weight on after a fall, or one that keeps giving way.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy, or over a vein that is swollen, hard or tender. Leave the area alone with a recent fracture, a fresh sprain, unexplained swelling, or a plate, pin or screw under the skin. 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. With reduced feeling, check the skin afterward, since you may not notice a bruise.

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 Shangqiu (SP5) pressure point? Shangqiu (SP5) sits on the inner side of the foot, in the small hollow below and a little in front of the round inner ankle bone. Slide your fingertip off the front lower edge of the bone toward the toes and it drops into the dip. In English it is called the Shang Mound; in Vietnamese, Thương Khâu.

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

Can I press it on an ankle I sprained? Not while the sprain is fresh, hot or swollen. Give a new sprain rest, cool packs and a doctor's look if you cannot take weight on it. Old ankles that ache and stiffen months after a sprain are a different matter; that is where people often find this spot tender, and light pressure is fine.

Will it reduce swelling in my feet and ankles? In this tradition the point is commonly used when the feet and lower legs feel heavy and puffy, and many people find the ankle feels lighter after rubbing it. It does not remove the reason for the swelling. Puffy ankles that are new, that affect one leg only, or that leave a deep dent when pressed need a doctor's check.

Is this the same as the point behind the inner ankle bone? No. That point, Taixi (KI3), sits in the hollow behind the inner ankle bone, toward the heel cord. Shangqiu sits below and in front of the bone, toward the toes. They are close neighbours and often worked one after the other.

Why does it feel sore on one foot and not the other? Most people favour one side when they walk, and an old sprain, a bunion or a flat arch on one side changes how the inner ankle is loaded. The point is often more tender on the foot that does more work. Press both sides anyway, and spend a little more time on the sore one.

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: SP5 · Shangqiu · Shang Mound · Thương Khâu.)