Points Database

Location Guides:

: Quyuan : Crooked Wall

SI-13 : Hand Taiyang Small Intestine 13

Classifications:
Trigger point (Travell & Simons, 1998, Trigger Point Manual)

Location:
In the tender depression superior to the medial end of the scapular spine, midway between Naoshu S.I.-10 and the spinous process of T2.

Needling:
Perpendicular insertion 0.3 - 0.5 cun, or oblique lateral insertion 0.5 - 1 cun

Warning:
Too medial insertion or deep medial-oblique needling may puncture the lungs.


TCM Actions:
Benefits the shoulders and scapula

TCM Indications:
  • Generalised painful obstruction, painful obstruction of the shoulder and scapula, hot painful obstruction of the shoulder with contraction, pain and an oppressive sensation of the shoulder.

    Neuroanatomy:
    Superficial Innervation: Suprascapular nerve from C5 - C6
    Dermatome Segment: T1

    Trigger Point Associations:
    Muscle: Serratus posterior
    Myotome Innervation: 2nd through 5th intercostal nerves
    Location Notes: This point is located beneath the scapula and accessible only when the scapula is abducted. When needling Travell & Simons (1998) suggest putting fingers on the underlying rib to fix its location and needling at a tangent to the skin, keeping the needle directed towards the rib at all times. Melzack (1977) correlates this point to the infraspinatus trigger point but his diagrams clearly point beneath the scapular spine making Tianzhong SI-11 a better alternative.
    Pain Referral Pattern: To the entire scapula and through to the anterior chest wall. Also down the posterior aspect of the arm, the dorsal aspect of the forearm and to the little finger
    Indications: Deep ache at rest exacerbated by lifting objects with outstretched hands, but unaffected by unloaded movements


    Reference Notes: (click to display)