Koorcha Marma: Anatomical Location, Effect Of Injury

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Koorcha Marma is one of the delicate and vital points of the body located in the hands and feet.
क्षिप्रस्य उपरिष्टाद् उभयतः कूर्चो नाम, तत्र पादस्य भ्रमण वेपने भवतः।(सु.शा.६) 

Number

4 in Number –
1 each in the right and left hand = 2
1 each in the right and left foot = 2

Location

Location of Kurcha Marma in the limbs:
In the upper limb – Kurcha Marma is located on both hands, located at the root of thumb.
It lies proximal to Kshipra Marma, both in hands and legs.
In the lower limb – Koorcha Marma is located in both feet, located at the root of big toe.

Categories

Categories in which the Kurcha Marma is included
Koorcha Marma is classified into various categories. They are as below mentioned –

1. i) Shaka Gata Marma (Shaaka=Limb) – Since Kurcha Marma is located in both upper and lower limbs; they are classified under shaaka gata marmas i.e. Marmas located in the limbs. They are present in the hands and foot (on the palmar and plantar sides respectively).
2. ii) Snayu Marma – Kurcha marma is predominantly made up of Snayu i.e. tendons and nerves, which form the structural component of this Marma. Therefore it is classified under Snayu Marma. The other tissues are recessive are present in less proportion, namely Sira (blood vessels), Asthi (bone), Sandhi (joints) and Mamsa (muscles).

iii) Vaikalyakara Marmas – (Vaikalya – deformity, Kara – forming) – Koorcha Marmas on getting injured causes vaikalya or deformity of the structures in the hands (upper limb) or foot (lower limb) depending on the site of injury. Since Kurcha Marma causes deformity, it is classified under Vaikalyakara Marma (deformity forming Marma).

Measurement  

Koorcha Marma occupies a space of 4 angula dimension (1 angula is approximately equal to the breadth of middle segment of one’s own middle finger)

Effect of Injury

तत्र पादस्य भ्रमण वेपने भवतः।(सु.शा.६)
Injury to the Kurcha Marma causes Bhramana (irregular shape, twisting, twitching) and Vepana (tremors, convulsions) of hands or foot.

If the injury is in the Upper limb, the symptoms are seen predominantly in the upper portion of the body. If the injury is in lower limb, the symptoms can be seen predominantly in the lower portions of the body.

Modern perspective

Modern Perspective (Practical anatomy) of Koorcha Marma
Structures falling in the area of Kurcha Marma –

Upper Limb:

• Carpo-metacarpal and inter-metacarpal ligaments
• Tendons of Extensor pollicis longus, Extensor digitorum, Extensor indicis and Flexor carpi radialis brevis muscles
• Radial artery and its Dorsal metacarpal branches
• Interosseous muscles
• Carpo-metacarpal and inter meta-carpal articulations

Lower Limb:

• Tarso metatarsal and inter-tarsal ligaments
• Extensor digitorum brevis
• Dorsalis pedis and Dorsal inter-tarsal arteries
• Tendons of Extensor digitorum longus, Extensor hallucis longus and Peroneus tertious muscles
• Branches of deep Peroneal nerve

We can see the muscles, blood vessels and other tissues too being present in this area comprising of Kurcha Marma but it is rich in ligaments, tendons and nerves. Therefore it is a Snayu Marma.

When the Kurcha Marma is injured, all the structures involved in any place of marma i.e. sira (blood vessels), asthi (bones), mamsa (muscles) and sandhi (joints) may be susceptible to get damaged but the snayu (ligaments or tendons) which chiefly make up the structure of Kurcha Marma tends to get injured to a severe extent in comparison to other structures. The impact of injury too will be chiefly due to the effect of injury to the snayu component.

Just Before Finishing
Among various causes which cause the deformity of the upper and lower limbs, injury to the Kurcha Marma is an important one. We can put it in this way – ‘Whenever there is a deformity and tremors of upper or lower limbs, we can suspect the injury to the Kurcha Marma’. Being careful about our activities related to hands and foot and not ignoring the initial signals like loss of movements, tremors, pain or little deformity and seeking medical attention forms the crux of preventing permanent damage and deformity.
Click to Consult Dr Raghuram Y.S. MD (Ayu)