Sichuan Tianxiang Orthopedic Hospital    He Junzhi
Advisor:     He Tianxiang

Explanation:  Employing professor of traumatology He Tianxiang’s hand techniques to regulate the sinew, pressing the points with sinew-soothing technique, using the rolling-rub (gunrou) technique to regulate the sinew, the moving waving-rub (yunyaorou) sinew technique, the shoulder-press (yajian) technique to unfurl the sinews, the pushing-upward relocation and pulling-shake (dingbanqiandou) techniques, while combining Dang Gui, Huang Qi, Fang Feng, Bai Zhi, Qiang Huo, Hai Feng Teng, Hai Tong Pi, Qing Ze Lan, Mu Gua, Niu Bang Zi, Shen Jin Cao, Shu Jin Cao, etc, in a Chinese herbal vapor wash to treat 200 cases of shoulder area inflammation, to satisfactory treatment effect.

Keywords:  He family hand techniques, shoulder area inflammation, biomechanics.


    In Chinese medicine, shoulder area inflammation belongs to the category of “sinew bi”. It is regularly seen in the orthopedic clinic. It mostly occurs at approximately age 50 in middle aged people, occurring in females more than men. Though this disease is inclined to resolve itself, despite present technological advancement and clinical diagnosis, treatment is relatively slow. The pain and suffering experienced by patients is often comparatively large. Self-recorded from June 1993 to June 1995, this is an examination of the utilization of Professor He Tianxiang’s hand technique to regulate the sinews complimented with the use of an herbal vapor wash, serving to condition and treat patients in 200 cases of shoulder area inflammation. After ½ to 2 years of follow-up visits, 189 cases achieved comparatively satisfactory results, comprising an efficacy rate of 94.5%. From the viewpoint of biomechanics we probe into the functional mechanism of hand technique treatment for shoulder area inflammation.

1. Clinical Data

    The group of shoulder area inflammation patients had 200 cases: Male 69 cases, Female 131 cases; Altogether 206 shoulders: Left 77 cases, Right 123 cases, both sides with shoulder pain 11 cases; Youngest age 37, oldest age 74; Longest disease course 2.4 years, shortest 3 weeks. Disease course length and perceived disease state are not in direct proportion. The majority of patients early on mainly have pain, while later on there is constriction of movement and flesh atrophy with pain conversely decreasing. In all of this group’s cases, the shoulder joints on the affected side all have spots that are painful when pressed and different degrees of functional limitation, nighttime pain, and flesh atrophy affecting the body. X-rays show shoulder joint osteoporosis in 47 cases, calcification of the joint in 6 cases, and joint space stricture in 12 cases.

2. Treatment Method

    All of this group’s cases were treated primarily with Professor He Tianxiang’s hand technique to regulate the sinews, also utilizing a Chinese herbal vapor wash and physical therapy treatments.

2.1 Chinese Herbal Vapor Wash Treatment Principle: Invigorate blood and transform stagnation, remove wind and eliminate damp, open channels and invigorate collaterals. Prescription: Dang Gui, Fang Feng each 10g, Huang Qi 20g, Bai Zhi, Qiang Huo, Niu Bang Zi each 12g, Hai Feng Teng, Hai Tong Pi, Shen Jin Cao, Shu Jin Cao each 30g, Qing Ze Lan, Mu Gua each 15g, take the herbs and crush to obtain a coarse powder, place inside an electric rice cooker, add water and boil. The patient lies flat upon the vapor wash tabletop and the affected shoulder is vapor-steamed for 20 minutes.

2.2 Hand Technique Treatment: The patient takes a seated position. The practitioner stands at the patient’s side and first proceeds to rub and press the patient’s shoulder with light hand technique, making the shoulder area flesh fully relaxed. Afterwards separately apply the 5-step hand technique treatment.

1)    Press the Points and Soothe the Sinew Technique: Use the thumb to press the points Jian Yu (LI 15), Tian Zong (SI 11), Jian Jing (GB 21), Ju Gu (LI 16), Nao Shu (SI 10), Jian Qian (M-UE-48), and Ah Shi points, etc. At the time of engaging and penetrating the points with hand technique, the practitioner wants regulated and settled breathing, relaxing on the inhale and pressing on the exhale. Make the hand technique full of elasticity, not causing injury to the tissue.

2)    Rolling-Rub Sinew Regulation Technique: The practitioner proceeds with the rolling-rub on the affected shoulder. The hand technique contact point is based on position and execution. If the shoulder blade or back area flesh is thick, or the area is large, use an oblique rolling method (using the distal end of the ulnar side of the back of the hand as the contact point). At the shoulder blade mound or on the small area of flesh above the scapular spine use Fish Border (Yu Ji, LU 10) for the rolling method. Around the shoulder joint area, in the bone opening and in the narrow and small bone concavities, use a small fist for the rolling method (using the proximal finger joints of the four fingers as the contact point).

3)    Moving Shaking-Rub Sinew Method: One of the practitioner’s hands supports the elbow on the affected side and proceeds with an outward twisting moving shaking to open from the inside out. The thumb of the other hand is in the affected shoulder joint space and proceeds to rub, soothing and regulating the muscles and sinews, opening the adhesion, and increasing the range of movement, using exertion from light to heavy.

4)    Press the Shoulder to Unfurl the Sinew: The practitioner supports the patient’s elbow with his shoulder, separately using both hands to restrict the shoulder while doing a rising and squatting shoulder pressing action. Afterwards use one hand to support the affected elbow, one hand to stabilize the affected shoulder, and carry out the outward unfurling twirl using the affected elbow. This will relax and unbind the adhesion, stretch and unfurl the elasticity of the flesh and sinew, and enable passive movement in each area of the affected shoulder.

5)    Upward Pushing Relocation and Pulling Shake method: The practitioner has one kneecap in the patient’s back, with both hands respectively restraining both of the patient’s shoulders. Apply slight force toward the back to relocate the shoulder. Frequently a springing sound can be heard in both of the patient’s shoulders, and the patient will immediately have a light, relaxed and loose sensation in the affected shoulder. Afterwards use both hands to grasp and support the suffering hand and perform the pulling shake.

2.3 Physical Therapy: The methodology of this technique is mainly based on the biomechanics of the shoulder area. The motivation of the conditioning is to meet the criteria of restoring functionality. The range of the movements increases progressively from small to large.

1)    Crawl the wall and Press the Shoulder Technique: The patient faces a wall and to the best of his or her ability makes the front of the affected shoulder bend and lift upward. The palm of the hand touches the wall and climbs upward to the greatest degree, then the body leans on the wall to the best of its ability, pressing the shoulder until there is a small degree of pain.

2)    Swinging in a Circle technique: The patient’s upper limbs hang down. Using the shoulder joint as the axis, close inward, open outward, bend forward and stretch backward. In every movement reach as far as possible to the best of one’s ability, and again perform the closing inward to opening outward and outward circular rotation movements. The range of movement increases, gradually increasing the size of the movements and the range of movement of the shoulder joint.

3)    Stretch Back and Feel for the Spine Technique: The patient’s upper limbs twist inward and stretch backwards, with the hands flipping back and the elbows bending. Keep the back of the hand close to the spinal column and use effort to move upward. If beginning causes pain or when there is apparent functional restriction, the strong hand can be used to pull the affected hand along, increasing the movement to the degree that the patient experiences slight pain.

3. Treatment Results

3.1 Treatment Evaluation Criteria:
Cured: Affected shoulder pain is eliminated, functionality is recovered.
Good Change: Affected shoulder pain is eliminated, functionality is recovered 2/3 or more.
No Effect: The condition of the symptoms and functionality all show no improvement.

3.2 Treatment Results: Of the 200 cases in this group, 189 cases were cured, 94.5%; 11 cases showed good change, 5.5%. Altogether there is a 100% rate of effectiveness.