In recent years, a Thai scrotal massage commonly called 'grabbing the dragon tendon' has become popular, claiming that massaging the scrotum, testicles, perineum, groin and other male anterior genital areas can unblock meridians and promote the flow of qi and blood, and that it can be used for men's health and to improve certain symptoms of the male urogenital system. However, be aware that if performed improperly, or if the recipient already has a urogenital disease, it may backfire.

I encountered a patient who had a varicocele and often felt a dragging, swollen discomfort in the scrotum when sitting or walking for long periods. At the urging of several friends he half‑heartedly tried 'grabbing the dragon tendon' at a local massage shop because his friends all thought this massage would help relieve his symptoms.

When the therapist began massaging, the patient immediately felt severe aching and pain in the anterior genital area, which made him tense. The therapist claimed this was a normal reaction after stimulating acupoints and meridians during the massage, reflecting the patient's poor qi and blood flow—where it does not flow there is pain. After a round of massage the therapist said the meridians had been unblocked, but the soreness, numbness, and swelling in the anterior genital area would remain for two to three days and then gradually disappear.

More than a month later he still felt a pulling pain

But the patient told me: "It's been over a month since the massage, and the scrotal soreness and swelling have not decreased at all; instead they have spread to the perineum and groin. Now I feel discomfort whether I'm standing, sitting, or walking, and even a pulling pain that severely affects my daily life. Although ultrasound examinations showed no abnormalities in the urogenital organs, I strongly suspect this massage may have caused an 'internal injury.' Will it always be like this from now on... I regret it so much..."

Regardless of whether this 'grabbing the dragon tendon' massage has any scientific basis, or whether the therapist's technique was inappropriate, the male anterior genital area itself is prone to qi and blood stagnation. According to traditional Chinese medicine meridian theory, the male anterior genital area is traversed by the Foot Jueyin Liver meridian. The Yellow Emperor's Inner Classic—Ling Shu, Jing Mai says: "The meridian of the Liver, Foot Jueyin, begins at the margin of the great toe... runs along the inner thigh, enters the pubic hair, passes the genitalia, and reaches the lower abdomen..." TCM theory holds that the liver governs dispersion and discharge and is responsible for coordinating the movement of qi; if, due to external pathogens, overwork, irregular diet, emotional blockage, injury, or other reasons the liver loses its dispersing function and qi becomes stagnant, one clinical symptom that may appear is that men easily feel soreness, swelling, or a heavy dragging sensation in the anterior genital area.

Some common male urogenital conditions, such as varicocele, chronic nonbacterial prostatitis, and erectile dysfunction, are often understood in TCM as related to liver qi stagnation and qi obstruction. Clinical experience tells me these patients' conditions are easily affected by emotional fluctuations; when they are anxious, tense, under great stress, or angry, anterior genital discomfort is easily triggered.

Male urogenital conditions are easily affected by emotions

In the case above, the male patient reluctantly underwent 'grabbing the dragon tendon', and the intense reaction during the massage and his subsequent regret left him highly anxious and tense. For someone who already had anterior genital discomfort due to qi stagnation, this very likely worsened the qi blockage and aggravated the symptoms.

I tried to explain to him that since the ultrasound showed no organ abnormalities, it was probably not an injury. To improve the movement of qi we could use some Chinese herbs that soothe the liver, regulate qi, and relieve depression, and I repeatedly advised him to relax and stop worrying. Gradually he managed to overcome the psychological distress caused by 'grabbing the dragon tendon', and his anterior genital discomfort finally began to ease.

For men who already frequently experience anterior genital soreness and a heavy dragging sensation, or who are prone to nervousness and anxiety, a word of advice: don't randomly 'grab the dragon tendon'!

(Written by: Registered Chinese medicine practitioner 邱宇鋒)