肩貞 : Jianzhen : True Shoulder

Location Guides:

Classifications:

Luo Harmonizing point
Binding point of the hand Taiyang Sinews

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 Small Intestine Divergent

Location:

On the posterior aspect of the shoulder, 1 cun 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).
"It is needled to a depth of eight fen and moxaed with three cones" (Huangfu Mi 皇甫謐, 3rd Century, Zhenjiu Jiayi Jing 針灸甲乙經).

TCM Actions:

Expels Wind and benefits the shoulder
Activates the channel and alleviates pain

TCM Indications:

• Pain of the shoulder and upper arm, inability to raise the arm, pain of the scapula, heat sensation and pain of the surpaclavicular fossa, wind Painful Obstruction (痹, Bi), numbness with inability to raise the hand and foot.
  
• Chills and fever due to injury by cold, tinnitus and deafness.

Neuroanatomy:

Superficial Innervation: Axillary nerve from C5 - C6

Dermatome Segment: T2

Trigger Point Associations:

Muscle:
Teres major

Location Notes:
Melzack (1977) correlates this point to the teres minor trigger point but it is far better suited to Naoshu SI-10

Pain Referral Pattern:
To shoulder and down dorsal aspect of forearm

Indications:
Shoulder pain

Martial Applications & Effects of Injury:

A strike here causes an immediate rush of energy to the head with great nausea and fainting, a build up of stagnant Qi at the base of the skull at GB 20 is also apparent causing the head to feel
like it is exploding (Montaigue, Dim Mak Locations, Taijiworld.com).

Major Combinations:

• Heat sensation of the shoulder with inability to turn the head:
    Jianzhen SI-9 with Guanchong SJ-1 and Jianyu LI-15
    (Sun Simiao, 孫思邈, 625: Bei Ji Qian Jin Yao Fang, 備急千金要方, Essential Prescriptions Worth A Thousand Gold).
  
  
• Tinnitus and deafness:
    Jianzhen SI-9 with Wangu SI-4
    (Haungfu Mi, 皇甫謐, 282: Zhen Jiu Jia Yi Jing, 針灸甲乙經, Systematic Classic of Acupuncture and Moxibustion).

Notes:

At the end of a Small Intestine Luo treatment this point is needled, deqi grasped and removed immediately to normalize the circulation of blood (Cecil-Sterman, 2012, Advanced Acupuncture).

The outer line of Tung's Five Mountain Ranges (Wu Ling) would also be approximately this area, slightly medial. They are located 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 Merak (天璇 Tianxuan, Celestial Jade).

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 Pherkad (太子星 Tai Zi Xing, "Prince Star" or 北極一 Beiji Yi, "Northern Pole One") and in the asterism of the Northern Pole (北極 Beiji) rather than Gou Chen.

In ayurvedic medicine:
Kakshadhara marma point
Size: 1 angula (cun)
Structure: Tendon
Effect of Injury: Disability (vaikalyakar marma)
(Harish Johari, 1996, Ayurvedic Massage, Sanatan Society; Anupama Bhattacharya, n.d. Marma Shastra)

In Thai massage:
Acupressure point along the outer Kalatharee sen line running from the lateral malleolus, up the sides of the leg, along the outer bladder channel, over the shoulder blade and down to the hands.
Indicated for shouder pain/injury/arthritis.
(Salguero & Roylance, 2011, Encyclopedia of Thai Massage)

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