Liv-4 Balance Method Video Guide: The secret for stubborn hip and wrist pain

Estimated reading time ⏱: 2 - 3 minutes

Last updated: April 2026

The "internal" secret for stubborn hip and wrist pain. LIV-4 (Liver 4) is your essential move for clearing pain in the hip and balancing the wrists.

LIV-4 is your structural mirror for stubborn wrist and hip pain that refuses local treatment. This powerful Balance Method point requires precise tendon identification and depth matching to get consistent results across six different systems.

In this 16-second demo, you'll see the exact ankle location, the foot flexion technique that makes the tibialis anterior tendon visible, and why matching needle depth to symptom depth determines success or failure.

Quick Stats

• Video Duration: 15 seconds

• Key Conditions: Ankle pain, hip pain, wrist pain, digestive issues, emotional oppression, male genitals

• Alternative Names: Zhongfeng, Middle Seal

Balance Method LIV-4 Logic

Here's the deal: LIV-4 isn't about "moving Liver Qi." In the Dr. Tan Balance Method, the Liver channel is a master balancer for the Gallbladder and Small Intestine channels. By targeting this point on the ankle, you're using the body's holographic mirror to switch off pain in the wrist or hip. It's a precise, structural correction that works across multiple systems.

Watch: The Full LIV-4 Needling Demo here

Needling demo Dr. Tan’s Balance Method Liv 4 in the tendon.

LIV-4 Treatment Applications (Systems 1-6)

One point on the ankle, 6 different clinical ways to win.

(Every Liver channel protocol and pairing is mapped step-by-step in The Balance Method Notebook—grab it here for the complete breakdown.)

• System 1: Pericardium (PC)

  • Treats: Opposite wrist pain, shoulder

• System 2: Large Intestine (LI)

  • Treats: Either side wrist, shoulder, throat, face

• System 3: Gallbladder (GB)

  • Treats: Opposite ankle, hip pain, neck pain, face

• System 4: Small Intestine (SI)

  • Treats: Either side wrist, shoulder, neck

• System 5: Lung (LU)

  • Treats: Opposite wrist, shoulder

• System 6: Liver (Liv)

  • Treats: Either side ankle, lower abdominal pain

Balance Method LIV-4 TENDON Protocol

Follow this step-by-step to ensure your treatment "takes" immediately.

Location

Find the medial side of the ankle. LIV-4 is located anterior to the medial malleolus, in the depression on the medial side of the tibialis anterior tendon.

Pro Tip: Have the patient flex their foot upward—the tendon will pop out, making it easy to find.

Which Side

For tendon pain on the LIVER meridian, always needle the opposite side of the pain (contra-lateral).

Depth (Matching Principle)

Use the depth matching principle.

• Is it surface-level tendonitis? Stay shallow.

• Is it deep, joint-level ankle pain? Go deeper into the depression (not needling the tendon).
  
  

Retention

Always leave the needles for 45 minutes.

Immediate Check

Have the patient move their wrist or foot or move their body right away. If the pain hasn't dropped by at least 20-50%, adjust your depth.

Illustration of tendon identification and depth matching technique

What You'll See (Expected Results)

• Immediate (on the table): You should see a noticeable increase in range of motion in the opposite wrist or ankle.

• 1-3 Sessions: Acute pain cases typically see the most dramatic shifts here.

• 4-7 Sessions: The standard timeframe for stabilizing chronic structural imbalances.

Watch Out For (Safety & Mistakes)

• The Tendon: Needle directly into the tibialis anterior tendon if necessary for depth matching; if not, stay in the soft hollow medial to it.

• Common Mistake: Needling too shallow. Many practitioners stay in the skin, but for deep joint pain, you need to reach the depth of the symptom.

• Reassess Now: If you don't get a result, don't wait. Re-palpate and check your system choice.

Want More?

Full Balance Method Notebook: Complete depth matching explanation and all Liver channel protocols
Get The Balance Method Notebook →

Caption: Full in-depth explanation of depth matching principles: Stop searching, start treating: Your go-to Balance Method resource

Related techniques: SI-4 for lateral foot pain and KID-3 for deep structural issues

New to the Balance Method?

Start with the basics in our complete guide or master the system through official training with the direct students of Dr. Tan.

To get clinical results like this every day, join our Global Community to discuss cases with experts, and grab your copy of The Balance Method Notebook to unlock every treatment combination.

Have you used LIV-4 for wrist pain yet? The results are usually instant—drop your clinical wins in the comments!

About the Authors: Laurence & Olivier

Laurence and Olivier are specialized Balance Method practitioners based in Terneuzen, Netherlands. Both were trained directly by Dr. Delphine Armand — one of Dr. Tan's appointed disciples and co-founder of Si Yuan. For 8 years, they were part of Si Yuan's core team as instructor and video director — teaching, filming, and documenting every aspect of the Balance Method's global training program. Today they treat up to 75 patients weekly using exclusively the Balance Method at Acusana Acupunctuur.

• →Laurence was an instructor at Si Yuan, teaching the Balance Method alongside Dr. Delphine Armand across international trainings. She developed the illustrated clinical notes used during these trainings — notes that became the Balance Method Notebook, now the go-to clinical reference for practitioners worldwide.
• →Olivier filmed and edited every Si Yuan training for 8 years — from live clinical demonstrations to the complete Video on Demand library. He founded this independent knowledge hub to make Balance Method education freely accessible to practitioners everywhere.

Through this platform, they continue to build on Dr. Tan's core philosophy: "Share everything, keep nothing, help everyone."