Acupuncture Points Notebook

Location Guides:

: Tianzhong : Heavenly Gathering

SI-11 : Hand Taiyang Small Intestine 11

Classifications:
Trigger point (Travell & Simons, 1998, Trigger Point Manual; Melzack, Stillwell & Fox, 1977, Trigger Points and Acupuncture Points for Pain: Correlations and Implications, Pain 3, p3-23)
Homeostatic point 8 (Ma, Ma & Cho, 2005, Biomedical Acupuncture for Pain Management)

Location:
On the scapula, in a tender depression one third of the distance from the midpoint of the inferior border of the scapular spine to the inferior angle of the scapula.

Needling:
Perpendicular or oblique insertion 0.5 - 1.5 cun

TCM Actions:
Activates the channel and alleviates pain
Moves qi and unbinds the chest and lateral costal region
Benefits the breasts

TCM Indications:
  • Heaviness and pain of the shoulder, pain of the scapula, pain and inability to raise the elbow and arm, pain of the elbow, swelling of the cheek and submandibular region.
  • Fullness of the chest and lateral costal region, cough, pain and swelling of the breast, breast abscess, insufficient lactation.

    Neuroanatomy:
    Superficial Innervation: Suprascapular nerve, from posterior division of the superior trunk of the brachial plexus (C5 - C6)
    Dermatome Segment: T2

    Trigger Point Associations:
    Muscle: Infraspinatus and lower trapezius
    Myotome Innervation: Infraspinatus: suprascapular nerve (C5 - C6); trapezius: motor - accessory nerve (CN XI), sensory - cervical spinal nerves from C3 and C4
    Location Notes: There are three other trigger points near here that may become sensitized on the infraspinatus muscle. One lies superior, one superior and slightly lateral and one slightly medial
    Pain Referral Pattern:
    \nInfraspinatus: To shoulder with some spillover down radial side of arm and maybe to neck below occiput, or to medial side of scapula if located slightly medially
    \nLower trapezius: To medial border of scapula
    Indications: Shoulder and arm pain, especially with inability to reach arm behind ; Cardiac syndromes

    Notes:
    In Tung Lineage Acupuncture two points, known as the Essence Branch (Jing Zhi) located slightly lateral to point, 6 cun from the midline level with T2 and T3. They are indicated for pain and ongoing soreness in the lower legs (McCann, 2014, Pricking the Vessels).

    They are a subset of Tung's Five Mountain Ranges (Wu Ling) which would also be slightly lateral to this point. They are 6 cun from the midline level with T2 to T8.

    In ayurvedic medicine:
    Ansa phalak marma point
    Size: 1/2 angula (cun)
    Structure: Bone
    Effect of Injury: Disability (vaikalyakar marma)
    (Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, Marma Shastra)

    Lad and Durve (2008) in Marma Points of Ayurveda call this point Amsa Phalaka and associate it with Prana Vayu, Udana Vayu, Sadhaka Pitta, Avalambaka Kaph and Vyan Vayu.

    They give the following functions:
    - Facilitates optimal functioning of lungs and airways
    - Enhances flow of prana
    - Relieves lung congestion and bronchospam
    - Relieves pain locally
    - Benefits the heart
    - Releases unresolved emotions

    In Tibetan medicine:
    Moxa point (AMNH, Tibetan Medical Paintings)


    Reference Notes: (click to display)