In the long history of traditional Chinese acupuncture, needle insertion technique is a crucial element and in order to provide a smooth insertion with stimulation that enables to create a powerful needle effect known as “Deqi” in Chinese, finger strength is an essential factor. That is why in ancient time even up to these days, most of the acupuncture masters practice martial arts or qigong to strengthen their fingers and also for building up their body resistance against invasion of pathogens. 

Skill level of an acupuncturist may influence treatment efficacy. A high level skilled practitioner may be able to insert the needles with finger strength without causing any pain or very minimal pain, (It depends in which area the needle is inserted) and no need to manipulate again the needle after the insertion, if “Deqi” response is achieved as what "Lingshu", the second volume of "Huangdi Neijing”, in the first chapter has stipulated:  “Without query, there are numerous needle insertions done without the arrival of “Qi”. If Qi arrives after needle insertion, then it will get dispelled and no need to repeat it again. Different kinds of needles have different appearance, with different purposes which has its own comparative advantage. What matters most is needling to enable the Qi to arrive so to acquire effectiveness.. If effectiveness is achieved, it is just like cloud blown by wind then you could see a clearer sky. This is an important doctrine and final conclusion for acupuncture.” Skill level of an acupuncturist can be seen by observing how swiftly he handled the needles during insertion without the aid of guide tube. In China, under state-level program, we were trained to handle and insert the needle correctly with power by activating our internal energy in order to generate a force that could travel through fingers while puncturing the needle on acupoint down to the needle tip with blasting effect that could release stagnation. 

A prominent acupuncturist in China who was given the highest rank as one of the top two best acupuncturists at the national level by the Chinese government during these past decades often mentioned, "Executing acupuncture without practicing qigong is equivalent to a doctor practicing in vain, just letting patients to suffer”.