Ultra Marathon Running Meets Chinese Medicine©

by Will Wan, L.Ac., MSOM, Dipl.O.M. (NCCAOM)

Human beings evolve to run. In toddlerhood, we mastered walking on our own. In our youth, we started to run while playing and engaging in sports. As adults, running fosters our physical, mental and emotional, and spiritual well-being. The ultra-marathon runner, or ultra-runner, is a different type of runner. 

As runners, we still have this elusive love-hate journey for the glorious feeling of running “In the zone.”  When the body is running on all cylinders and the breath is in-sync with our body’s movements, there is the pure delight of feeling alive and happy. We share the same love of hitting the flats, the track work-outs, and the feeling of flying on the downhills. Where the ultra-runner takes a different path is the weekly training protocol.  The back-to-back-to-back long run is a unique training strategy that ultra-runners must develop and master (ex. 15miler-30 miler-15 miler, consecutively). By simulating a micro-ultra, the body experiences a concentrated dose of running while fatigued. Why do we do this? To develop the grit and tenacity of eventually running a 50, 100, 200, or self-transcendence 3,100 miler.  After all, it is not about masochism, it is about training. 

Let’s take a look at what happens to you during the course of a 100K trail run. Digestion has pretty much ceased back at 50K or so. You are at the half-way point and questioning how can you do another 50K?  Inflammatory cytokines, cortisol levels, lactate and H+ ions are off the charts causing the stiffness and muscle spasms in your legs.  Your stomach feels like it has turned into knots from constant muscle spasms due to the constant jostling of your abdominal organs. Your body temperature vacillates between being overheated and overcooled. Indigestion, nausea and vomiting are more of a reality when dehydration sets in.  By 70K, you have effectively pushed out every drop of sweat in your body. Your muscles, tendons, ligaments, and fascia are especially challenged by the smallest climb and any kind of technical downhill. By 90K, your mind is delirious with hallucinations and the grind up another hill causes pain throughout the entire body. Runners talk about physically and psychologically “hitting the wall” in the course of an ultra… many waves of inner walls that tell you to stop or else. This is where mental grit is worth its weight in gold. By the time you cross the finish line, you could be a blubbering mess of pain, joy, sadness, and shock. But by that point, who really cares? 

In ancient China, ultra-running was a duty as a courier to deliver messages and packages to and from royalty and high-ranking officials.  It is said that mileage averaged 100K per day for many days. How did couriers maintain their mileage day after day?  In Chinese Medicine, there is an acupuncture point called Zu san li (足三里 ), which is used to rectify all diseases of the body. This acupuncture point treats complete physical exhaustion, pain in the legs and knees, abdominal discomfort, nausea and vomiting, and mental/emotional/spiritual depletion. According to the classical texts of Chinese Medicine, this point can build up the material body, which is the Qi (Vital energy) and Blood. This acupuncture point is the proverbial “duct tape” that can fix anything!

Clinically, when I treat athletes at Zu san li with acupuncture needles and/or moxibustion (heating stick indirectly used above the point), there is a profound shift in one’s body. There is a sense of calm and a feeling of deep re-charging of one’s battery. I have used this acupuncture point before and after training runs and races. Consequently, I believe the couriers of ancient China utilized the acupuncture point Zu san li to support them in their ultra runs across the myriad terrain of China.


Koon, W, 2020, How postal services in ancient China and modern America have been used and abused, South China Morning Post, accessed 21 March 2022, https://www.scmp.com/magazines/post-magazine/short-reads/article/3098910/how-postal-services-ancient-china-and-modern.

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