臑俞 : Naoshu : Upper Arm Shu

Location Guides:

Classifications:

Opening point of the Small Intestine Divergent channel (Cecil-Sterman, 2012, Advanced Acupuncture)
Confluent point of the Taiyang zone

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)

Meetings:

Meeting of Small Intestine with Bladder, Yang Wei Mai, Yang Qiao Mai and Small Intestine Divergent

Location:

On the posterior aspect of the shoulder, in the depression inferior to the scapular spine, directly superior to the posterior axillary crease when the arm hangs in the adducted position.

Needling:

Perpendicular insertion 1 - 1.5 cun

Classical Needling:

"The Taiyang usually has much Blood and little Qi" (Su Wen 素問 ch. 24) implying this channel should normally be bled.
"The hand Yin and Yang receive their Qi via nearby paths so their Qi arrive swiftly. The depth of piercing must not exceed 2 fen and must not remain inserted for longer than one exhalation" (Ling Shu 靈樞 ch. 12).
"Locate it with the" (patient’s) arm raised. It is needled to a depth of eight fen and it is moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Benefits the shoulder
Activates the channel and alleviates pain

TCM Indications:

• Pain and swelling of the shoulder that radiates to the scapula, weakness and pain of the arm and shoulder, inability to raise the shoulder.
  
• Chills and fever, scrofula.

Neuroanatomy:

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

Dermatome Segment: C4

Trigger Point Associations:

Muscle:
Teres minor or supraspinatus (attachment to glenohumeral joint)

Location Notes:
Teres minor trigger point may be slightly medial and inferior to classical location

Pain Referral Pattern:
Local to point around shoulder

Indications:
Shoulder pain, if supraspinatus especially when abducting the arm ; Cardiac syndromes

Martial Applications & Effects of Injury:

This strike will do great immediate physical damage due to the accumulation of tendons and muscles at this point. The damage is so great that it can cause knock out from the Qi drainage and pain in addition to extreme scapular damage to the deltoid (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Acute pain of the posterior of the shoulder:
    Naoshu SI-10 with Yanglao SI-6 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).
  
  
• Immobility and pain of the shoulder joint:
    First Tiaokou St-38, then Naoshu SI-10 with Jianliao SJ-14, Jianyu LI-15, Jugu LI-16, Quchi LI-11 and Yanglao SJ-6 (Deadman, Al-Khafaji and Baker, 2001, A Manual of Acupuncture).

Notes:

Jeffrey Yuen (2005, The Eight Extraordinary Vessels) suggests using this point and Juliao GB-29 to ground a person in the present as they are the meeting of Yang wei mai and Yang qiao mai.

He also recommends cupping on these two points combined with needling Ah shi points as part of a Qiao mai treatment for unilateral chronic Bi as Qiao deals with suffering and Wei deal with issues over time.

臑俞 consists of:

臑 Nao, consisting of the flesh radical and 需 Xu: "to need, to require; necessities" and is the fifth hexagram of the I Ching ䷄ with water over heaven.
俞 Shu, as in the Shu transport points.

It occupies an important position as the meeting point of the Yang Wei Mai and Yang Qiao Mai and being located at the level of Feishu Bl-13 and Pohu Bl-42. Therefore it represents moving on from a purely physical existence governed by the Po (Corporeal Soul) to the spiritual life of the Extraordinary Vessels. People with problems in this area often overdo their lifestyles, ending up with over strain from "Hercules Syndrome" or become overly manipulative as a result of being unable to understand traumas in their lives. The function of the Small Intestine is to "separate the pure from the impure" to offer to the Heart and let go of the impurities via the Lung, on which this point is level.

Navarra (2016). The Scapula - SI10 SI11 SI12. https://www.acupuncturesida.com/The-Scapula---SI10-SI11-SI12-eng.aspx

In Tung Lineage Acupuncture two points, known as the Essence Branch (Jing Zhi) located slightly medial 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).

The outer line of Tung's Five Mountain Ranges (Wu Ling) would also be approximately this area, slightly medial. They are also 6 cun from the midline level with T2 to T8.

This point is part of a group of seven on the Small Intestine channel which trace the Big Dipper constellation over the shoulder (Kim, 2020). This point would be equivalent to Dubhe (天樞 Tianshu, Celestial Pivot).

Alternatively, since there is already a point named 天樞 Tianshu St-25 on the front of the body, which may represent a set of points correlating to the Big Dipper, this set of points on the back may correlate to the Little Dipper instead which was known in the Han dynasty as 勾陳七星 Gouchen Qixing, the seven stars of the god Gou Chen ("Old Hook"). This point would be Kochab (帝星 Huang Xing, "Emperor Star" or 北極二 Beiji Er, "Northern Pole Two") and in the asterism of the Northern Pole (北極 Beiji) rather than Gou Chen. This was the Pole Star in 1100 BC but served as the Pole Star from around 1600 BC because the closest star, κ-Draconis (少尉, Shouwei, "Second Lieutenant") was too dim.

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

Reference Notes:

Basic information on location, needle depth, TCM actions, indications and combinations is taken from Deadman et al (2001): A Manual of Acupuncture with additional anatomical information researched by reference to Gray's Anatomy (38th Ed., 1995) unless otherwise referenced. Images were found on acupunctureschoolonline.com and can be traced back to Claudia Focks (2008) Atlas of Acupuncture originally. I cannot claim any credit or rights over them. Other sources should be quoted in the text.

For some of the more unusual terms I have created a glossary here