After a stroke

After a stroke, one side of the body often stays weaker than the other for months or longer. The arm may hang heavy and slow, the hand may curl in, the leg may drag or swing stiffly from the hip, and the toes can catch on the floor. Some muscles go soft and floppy; others tighten and pull, holding the elbow bent, the wrist flexed or the ankle pointed. Doctors call that tightness spasticity, and it tends to rise and fall with tiredness, cold, worry, pain or a full bladder.

Swelling is common too. A hand that rests low and barely moves can puff up across the back of the fingers, and a shoulder that has lost its muscle support can slip a little out of its socket and ache, which therapists call subluxation. Skin on the weak side may feel numb, tingling or strangely distant. That matters a great deal for anyone touching it, because numb skin cannot warn of too much pressure, heat or a pinch.

Recovery itself is built in rehabilitation: physiotherapy, occupational therapy, careful positioning, practice and time. This page is written for a stroke survivor and the person who helps at home, and it sits alongside that work, never instead of it. It describes a short, gentle pressing routine on the weak side, the reasons the tradition gives for it, what the research found, and the rules that keep it safe.

Chinese medicine files stroke under wind-stroke, and it names the weakened half of the body as a side that no longer follows the will. In the recovery months the condition is read through a few patterns. The one most often met after the first weeks is qi deficiency with blood stasis: tiredness, breathlessness on effort, a pale face, drooling, and hands and feet that swell. Others describe phlegm and stasis blocking the channels, or a depleted yin that lets internal wind stir. Whatever the pattern, the shared picture is of channels that no longer carry qi and blood freely out to the limbs.

The national nursing protocol of the China Association of Chinese Medicine, revised in 2026, names points on the outer, yang face of the weak limbs for the recovery stage: jianjing (GB21) on top of the shoulder, quchi (LI11) at the elbow, waiguan (TH5) on the back of the forearm and hegu (LI4) on the hand, then weizhong (BL40), kunlun, xuanzhong (GB39) and yanglingquan (GB34) on the leg. These lie on the large intestine, san jiao and gallbladder channels, the yang lines classical teaching reached for when a limb would not move.

The catalogue's classical indications echo that choice. Quchi is traditionally used for painful obstruction and paralysis of the arm, jianjing for paralysis of the upper limb, waiguan for painful obstruction of the upper limb, and weizhong and yanglingquan for atrophy and paralysis of the lower limbs. Xuanzhong, the influential point of marrow, is recorded for hemiplegia and for stroke itself, and yanglingquan is the influential point of the sinews, which is why it so often anchors a leg routine.

This page presses seven of the protocol's eight points. It leaves out kunlun, which sits right beside the heel cord of a calf that is often tight after a stroke, and which tradition also avoids in pregnancy. Every description here reports what the tradition reached for, not a promise of results.

Measure with the survivor's own fingers, not the carer's, because the traditional finger-width scales to each body. Jianjing (GB21), the shoulder well, sits on the ridge of muscle on top of the shoulder, halfway between the bony knob at the base of the neck and the outer tip of the shoulder. It is the only shoulder point here, and it stays well above the joint itself. Quchi (LI11), the pool at the bend, appears when the elbow rests bent at a right angle: it lies at the outer end of the elbow crease, halfway towards the bony bump on the outside of the elbow.

Waiguan (TH5), the outer pass, is on the back of the forearm, about three finger-widths above the wrist crease on the back of the wrist, in the soft groove between the two forearm bones. Hegu (LI4), the joining valley, lies on the back of the hand, in the fleshy web beside the middle of the index-finger bone. If the thumb is pulled tightly into the palm, do not prise it open to reach the point; skip it that day.

Yanglingquan (GB34), the spring at the yang mound, sits on the outside of the leg just below the knee: find the rounded head of the slim outer leg bone, then the hollow just in front of and below it. Weizhong (BL40), the middle of the bend, is at the centre of the crease behind the knee, between the two tendons; large vessels pass beneath it, so it only ever takes a light, brief touch. Xuanzhong (GB39), the suspended bell, is four finger-widths above the outer anklebone, just in front of the outer leg bone.

Choose a calm moment after rest, not straight after a tiring therapy session. The survivor sits well supported in a chair or lies on their back, with the weak arm resting on a pillow. Explain each step before touching, and if speech has been affected, agree a stop signal first: a squeeze of the strong hand, a raised finger or a shake of the head.

Use the pad of a thumb or two fingers, or a flat palm, and press gently: light enough that the skin under the finger only pales a little and turns pink again at once. Hold each point for about half a minute with slow breathing, then release gradually. The weak side gets the lightest touch of all, because numb skin cannot report pain, so the carer watches the skin instead. Look before and after every point; redness that lingers, a scratch, a blister or a bruise means stop and leave that patch alone for several days.

Work from the shoulder down, then the leg. Start at the top of the shoulder with jianjing (GB21), then quchi (LI11) at the elbow, waiguan (TH5) on the forearm and hegu (LI4) on the hand. Move to the leg: yanglingquan (GB34) below the knee, weizhong (BL40) behind the knee, lightly and briefly, and xuanzhong (GB39) above the ankle. The full round takes eight to ten minutes. Once a day is plenty, and missing days costs nothing.

Three rules come before any point. Never press spastic muscle: if the muscle under your finger is hard, pulls against you or twitches, move off it, and never force a bent elbow, curled fingers or a pointed foot straight to reach a point. Never press firmly around a subluxed or painful shoulder; if the shoulder hurts or has slipped, leave the whole shoulder alone, jianjing included, and never pull on the weak arm. Never massage a limb that is newly swollen, warm, red or painful, because it can be a blood clot.

Leave out jianjing (GB21) and hegu (LI4) entirely if the person could be pregnant. Stop the routine at once if the person seems distressed, dizzy or unusually tired, and simply rest together instead.

The China Association of Chinese Medicine's 2026 nursing protocol for stroke in recovery names the seven points used here, plus kunlun, for the weak limbs. It is worth being exact about how: it lists them for gentle electrical stimulation given by nurses on a doctor's order, for limbs that are limp, weak or numb, with the explicit rule never to stimulate spastic muscle directly. In the same section it recommends meridian-point massage by hand, using kneading, pressing and pinching, to support limb function and keep joints from contracting, and it bars that massage where there is a vein clot. Its acute-stage section names hand-massage points for the weak side, including hegu, weizhong and yanglingquan.

The 2021 Chinese medicine rehabilitation guideline for ischaemic stroke, published in the Chinese journal Rehabilitation Medicine, says massage may be used in the recovery and later stages to help limb function and daily living. It names no particular points for limb massage. The same guideline asks therapists to check for a clot whenever a leg becomes painful, tender, swollen, warm or discoloured.

For research, a 2022 systematic review by Xie and colleagues pooled nineteen trials of meridian massage, done by hand, after stroke. Compared with conventional rehabilitation, massage came with small, short-term gains in movement, especially in the leg, along with daily activities, balance and spasticity scores, for courses up to two months. Two small nurse-led trials pressed points by hand: Yue and colleagues in China found better daily activities and movement scores at three months when pressure was added to routine care, and Kang and colleagues in Korea found better arm function, daily living and mood after two weeks of short daily sessions. Neither compared real pressing with sham pressing.

Reviews suggest that hand pressure or massage added to rehabilitation may bring small, short-term gains in movement and daily activities. For the swollen hand of shoulder-hand syndrome, the one review by Liu and colleagues used needles alongside rehabilitation and found gains in arm movement and pain, which tells a carer nothing about pressing a swollen hand at home. Kang's trial measured finger swelling among its arm outcomes but did not report it apart, so this page offers no point for swelling.

Any new weakness, a face that droops, an arm that will not lift, speech that slurs or will not come, sudden confusion, sudden loss of vision or a sudden severe headache means call emergency services now. Think FAST: face, arms, speech, time. Note the time the change began, do not wait to see whether it passes, and do not press any point.

Never massage an arm or leg that is newly swollen, warm, red or painful, especially in the calf: it can be a blood clot, a deep vein thrombosis, and it needs medical review the same day. If breathlessness or chest pain comes with it, or on its own, call emergency services straight away. A hard lump under the skin, or a bruise that spreads, needs checking by a doctor or nurse before pressing again, and that matters even more for anyone on blood thinners.

A shoulder that becomes newly painful, hot or misshapen, spasticity that suddenly gets much worse, a pressure sore, fever or a change in bladder habits all belong with the stroke team, the family doctor or the therapist promptly. Persistent symptoms belong with a licensed practitioner — Western medicine or East Asian medicine, whichever suits the complaint.

Hand swelling after a stroke, sometimes part of shoulder-hand syndrome, has no pressing-point finding in the studies above, so the help here is practical. Keep the weak hand raised on pillows so it rests above the elbow, avoid letting it hang over the side of a chair or bed, encourage the movements the therapist sets, and ask the occupational therapist or physiotherapist about splints, gloves or their own techniques for that hand. Their advice comes first.

Protect the shoulder in everyday handling. Support the weak arm on a pillow, an armrest or a lap tray when sitting, never lift or turn the person by that arm, and follow the lying positions the therapist shows. The nursing protocol's own advice describes a weak shoulder cushioned on a soft pillow, the arm resting out to the side on a pillow, and elbow, wrist and fingers kept as straight as comfort allows.

Beyond the points, the protocol encourages steady routines, a calm mood and gentle traditional exercise such as baduanjin or tai chi once the team agrees it is safe. Carers need rest as well; a shared few minutes of slow breathing and light touch can be a pause for both people, and that has value even before any question of points arises.

Can this routine replace physiotherapy or occupational therapy?

No. Recovery after a stroke is built in rehabilitation: practice, positioning, stretching and the exercises a therapist sets. A few minutes of gentle pressing sits alongside that work as a calm, shared ritual, never instead of it. If the routine ever eats into therapy time or leaves the person too tired for their exercises, drop the routine, not the therapy.

Should the carer press the weak side or the strong side?

The points are pressed on the weak side, by a carer, as lightly as the routine describes. Feeling on that side is often dulled, so the person may not notice a press that is too hard or a nail that digs in. That is why the carer keeps watching the skin, checks before and after each point, and treats any mark that lingers as a reason to stop.

What if the arm or hand is tight and pulled in?

Then leave the tight part alone. The national nursing protocol is plain that spastic muscle must never be stimulated directly. If the muscle under your finger feels hard, pulls against you or twitches, move off it, and never force a bent elbow, curled fingers or a pointed foot straight to reach a point. Ask the therapist how to position and stretch that limb instead.

The hand is puffy. Can we massage the swelling down?

Not with this routine. None of the studies behind this page reported a finding for pressing points on a swollen hand after a stroke, so this page offers no points for it. Keep the hand raised on pillows so it rests above the elbow, avoid letting it hang, and ask the occupational therapist or physiotherapist what suits that hand. A hand or limb that is newly swollen, warm, red or painful needs a doctor the same day.

Is light pressing safe for someone on blood thinners?

Many stroke survivors take medicine that thins the blood, which makes bruising easier. Keep the touch featherlight, never knead or dig, and look at the skin afterwards. A bruise that spreads, or a hard lump under the skin, should be shown to the doctor or nurse before pressing again. If you are unsure, ask the prescribing team whether any home massage suits this person.

Are any of these points avoided in pregnancy?

Yes. Tradition avoids jianjing (GB21) and hegu (LI4) during pregnancy, so leave both out entirely if the person could be pregnant. Stroke in pregnancy is uncommon, but when it happens the whole plan, including any self-care, belongs with the obstetric and stroke teams before anything is added at home.

1. 01WHO Standard Acupuncture Point Locations in the Western Pacific Region (2008) — landmark descriptions followed for jianjing (GB21), quchi (LI11), waiguan (TH5), hegu (LI4), yanglingquan (GB34), weizhong (BL40), and xuanzhong (GB39).
2. 02A Manual of Acupuncture (Deadman, Al-Khafaji & Baker) — point categories, name glosses, and general framing of wind-stroke and the weak limbs consulted for context.
3. 03aijiu-mpvue (MIT License), licensed dataset — recorded indications and cautions underlying the seven point identities.
4. 04China Association of Chinese Medicine, TCM nursing protocols for stroke and 12 other conditions (2026 edition), stroke recovery-stage section — https://www.cacm.org.cn/wp-content/uploads/2026/09/附件1.-中风等13个病种中医护理方案（2026年版）全文.pdf
5. 05TCM rehabilitation clinical practice guideline: ischaemic stroke (cerebral infarction), Rehabilitation Medicine 2021;31(6):437–447 — https://doi.org/10.3724/SP.J.1329.2021.06001
6. 06Xie Y et al. Efficacy of meridian massage for motor function after a stroke: a systematic review and meta-analysis. J Tradit Chin Med 2022;42(3):321–331 — https://doi.org/10.19852/j.cnki.jtcm.2022.03.001
7. 07Yue S et al. Effects of a nurse-led acupressure programme for stroke patients in China. J Clin Nurs 2013;22(7-8):1182–1188 — https://doi.org/10.1111/j.1365-2702.2012.04127.x
8. 08Kang HS et al. Effects of meridian acupressure for stroke patients in Korea. J Clin Nurs 2009;18(15):2145–2152 — https://doi.org/10.1111/j.1365-2702.2008.02522.x
9. 09Liu S et al. Acupuncture for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis. Front Neurol 2019;10:433 — https://doi.org/10.3389/fneur.2019.00433