Dubi

What is ST35?

ST35 (Dubi) is a classical Stomach-channel point in the soft hollow just outside the kneecap tendon, at the front of the knee.

Its pinyin name, Dubi, means calf's nose. When the knee is bent, the two dips either side of the thick tendon below the kneecap look like a pair of nostrils. ST35 is the outer dip. The inner dip is a different point (an extra point usually called Neixiyan, or medial knee eye), and the two are often pressed together.

In traditional use ST35 is a local knee point. Texts list it for knee pain, stiffness, swelling and heaviness, and for what the tradition calls bi obstruction from cold and damp. It is taught in every acupuncture curriculum, so its traditional standing is about as solid as a point's can be.

That standing tells you nothing about whether it works, and nothing about whether it is safe for your knee. Those are separate questions, and this page answers them separately. You will not see that disclaimer repeated in every section below, but it applies throughout.

The honest verdict on evidence: ST35 appears in the needling formulas used in large knee osteoarthritis trials, and those trials give mixed results against sham treatment. Nobody has tested finger pressure on ST35 by itself in a trial worth quoting. So the realistic expectation is a bit of short-term comfort and a reason to pay attention to a sore knee, not a treatment for joint damage.

Everything described here is self-applied finger pressure. Nothing on this page involves needles, heat sticks or anything that breaks the skin.

Where is ST35 and how do you find it?

ST35 sits in the dip on the outer side of the thick tendon below your kneecap, found with the knee bent to about a right angle.

• Sit and bend the knee. Sit on a chair with the foot flat on the floor and the knee bent near 90 degrees. The hollows only open up when the knee is bent.
• Find the bottom of the kneecap. Run a fingertip down the front of the knee until you feel the lower edge of the kneecap, the movable disc of bone.
• Find the tendon. Just below that edge is a firm band running down to the bump at the top of your shin. That is the patellar tendon.
• Slide to the outer side. Move your fingertip sideways off the tendon, towards the outside of the leg (the little-toe side). You should drop into a soft hollow.
• Check it is the right hollow. The dip should feel squashy, not bony. Straighten the leg and tighten the thigh: the hollow fills in and almost disappears. Bend again and it returns.
• Know its twin. The matching dip on the inner side of the tendon is not ST35. It is the medial knee eye, a separate point.

In traditional measurements ST35 is level with the lower border of the kneecap, roughly one thumb-width out from the midline of the tendon. On most adults that is about 1.5 to 2 cm sideways from the centre of the tendon.

If your knee is swollen the landmarks blur, because fluid fills both hollows. In that case do not go hunting with hard pressure. Map the point on the other, comfortable knee first so you know what you are feeling for.

How do you apply pressure to ST35?

1. Set the knee up. Sit with the foot flat and the knee bent to about 90 degrees. This opens the hollow and relaxes the thigh muscle.
2. Place the thumb or finger. Use the pad of a thumb or index finger, nails short. Settle it into the soft dip, not on the tendon and not on bone.
3. Press in gently. Push straight back towards the joint with slow, steady pressure. Aim for a firm, dull ache around 4 out of 10 — noticeable, never sharp.
4. Hold or circle. Hold for 30 to 60 seconds, or make small slow circles for about a minute. Keep breathing normally.
5. Do the other dip too. Many people follow with the medial knee eye on the inner side of the tendon, using the same pressure.
6. Repeat sensibly. Two or three short sessions a day is plenty. Both knees can be done in one sitting.
7. Finish with movement. Straighten and bend the knee slowly a few times afterwards. Gentle movement usually does more for a stiff knee than pressure does.

Stop at once if the pressure causes sharp or electric pain, pins and needles down the leg, or more swelling afterwards. Stop also if the knee feels hot or looks red where you pressed.

Do not press through a numbed joint. If you have taken a strong painkiller or used a numbing gel, you cannot judge how hard you are pushing and you can bruise the area.

Any relief is usually short-lived, lasting minutes to an hour or two. That is normal for acupressure and is not a sign you should press harder or longer.

What is ST35 traditionally used for?

• Knee pain. This is the main traditional use, and ST35 appears in almost every classical knee formula. Human evidence comes from acupuncture trials for knee osteoarthritis (wear-and-tear joint disease) where ST35 was one needled point among several. Results are mixed: real needling usually beats no treatment, but often only matches sham needling. Nothing isolates ST35 or finger pressure.
• Knee stiffness. Tradition uses it for a knee that will not bend or straighten freely, especially in cold, damp weather. Evidence here is weaker still — stiffness is usually a secondary score in trials, and improvements are small and short-term.
• Swelling around the joint. Classical texts list ST35 for a puffy, heavy knee. There is no good human research showing that pressing it reduces joint fluid, and a newly swollen knee needs assessing rather than pressing.
• Leg heaviness and weakness. Described in tradition as part of bi obstruction patterns, where cold and damp block the channel. This is a traditional explanation, not a finding from any trial.
• Post-exercise ache. A modern, informal use: light pressure and massage around a tired knee after walking or sport. Plausible as general soft-tissue massage, but untested for this point specifically.

What the honest picture looks like: ST35 is a sensible place to put a thumb on a sore knee, and some people find brief relief. It does not repair cartilage, drain a joint or replace exercise, weight management, physiotherapy or medical care.

If knee pain is new, severe, or follows a twist or fall, treat ST35 as irrelevant for now and get the knee looked at.

Are there tips for using ST35 effectively?

• Always bend the knee first. With the leg straight the hollow closes and you end up pressing tendon or bone. A right-angle bend opens it properly.
• Warm the knee before you press. A few minutes with a warm pack or a short walk makes the tissue softer and the point easier to find.
• Press both knee eyes. Traditional practice pairs ST35 with the matching dip on the inner side of the tendon. Doing both takes an extra minute and feels more balanced.
• Use less force than you think. The front of the knee has little padding. Firm but comfortable pressure is the ceiling; grinding harder adds bruising, not benefit.
• Pair it with movement, not instead of it. Gentle bending, straightening and thigh-strengthening work have real evidence in knee osteoarthritis. Use the pressure as a warm-up or a wind-down around that.
• Give it a fair, short trial. Try it for two weeks and note pain before and after on a simple 0 to 10 scale. If nothing changes, drop it rather than drifting on out of habit.
• Watch the knee the next day. Extra swelling, warmth or stiffness the following morning means you pressed too hard or the knee is not a good candidate for pressure.
• Keep nails short and hands clean. A nail edge in a thin-skinned hollow can scratch, and broken skin over a joint is worth avoiding.

One practical note for older readers or anyone with arthritic hands: pressing your own knee with a thumb can hurt the thumb more than it helps the knee. A knuckle, or asking someone else to apply the pressure, works just as well.

What do people get wrong with ST35?

• Expecting a cure. The most common error by far. ST35 will not reverse osteoarthritis, regrow cartilage or remove the need for treatment. Expect short-term comfort at most.
• Pressing on bone or tendon. Landing on the kneecap edge or the firm central band instead of the soft dip beside it. Bone pressure just hurts and achieves nothing.
• Confusing it with the inner dip. The medial knee eye is a different point. Calling it ST35 does not matter much for self-care, but the outer hollow is the one labelled ST35.
• Working on a hot, swollen knee. A knee that is red, hot and painful can mean infection, gout or a flare that needs medical review. Pressing it is both useless and risky.
• Pressing with the leg straight. The hollow vanishes when the thigh muscle is tight, so people dig at the wrong tissue and give up thinking the point does nothing.
• Going too hard for too long. Ten minutes of heavy thumb pressure on a thin-skinned joint leaves bruising and soreness, especially for anyone on blood thinners.
• Using it to postpone a diagnosis. A knee that locks, gives way, or swells within hours of an injury needs assessment. Self-pressure is not a holding strategy for those.
• Dropping the exercises. Some people swap physiotherapy for acupressure because it is easier. The exercises have the better evidence; keep them.

One more quiet mistake: pressing only the painful knee. If one knee hurts, the other is usually doing extra work. Treating both takes little longer and is kinder to the good one.

What does the research on ST35 actually say?

There is no trial of finger pressure on ST35 on its own. Everything usable comes from needling studies where ST35 was one point in a larger formula for knee osteoarthritis.

Those studies exist in reasonable numbers. Large randomised trials of acupuncture for knee osteoarthritis have been run in Germany, the United States, China and Australia, several with hundreds or thousands of participants. The point prescriptions they used typically include ST35 alongside points such as ST36, SP9, SP10, GB34 and the medial knee eye.

The pattern of results is consistent and worth stating plainly. Real needling generally beats no treatment or a waiting list. Against sham needling, the gap shrinks a lot, and in some of the better-controlled trials it disappears. Systematic reviews of this body of work describe the benefit as small, short-lived, and hard to separate from placebo and from the attention of regular appointments.

For acupressure specifically, the literature is thin. There are small trials of knee acupressure in older adults, mostly with fewer than a hundred participants, no credible blinding, and self-reported pain as the outcome. Some report lower pain scores after a few weeks. Studies of that design reliably overstate effects, so they cannot carry much weight.

None of these studies lets you say what ST35 contributes. Removing one point from a six-point formula has never been tested, and pressing is not needling.

What this means for you: treat ST35 as a low-cost comfort measure with weak support, not as a treatment. Interventions with far stronger evidence for knee osteoarthritis — strengthening exercise, weight management where relevant, and advice from a physiotherapist or doctor — should come first. If pressing the point helps you move more comfortably, that is a fair reason to keep doing it.