Shoulder periarthritis, also known as "shoulder stiffness" and "leaking shoulder wind" in traditional Chinese medicine, often occurs in middle-aged and older people. It has a slow onset and most patients have a history of shoulder joint strain. A few patients may experience acute onset due to exposure to wind and cold. So, can massage therapy be used to treat shoulder periarthritis in traditional Chinese medicine?
Etiology and Pathogenesis of Shoulder Periarthritis
In traditional Chinese medicine, tendon and meridians belong to bones, which are governed by the kidneys. As people enter middle age, their physical condition gradually declines and kidney qi weakens. When kidney qi is insufficient to produce essence and nourish the marrow, the joints become loose. If there is excessive movement or falls and impacts, or strain and injury to the tendons and joints, qi and blood stasis can occur, leading to muscle and joint stiffness over time. It can also be caused by stagnation and obstruction of the meridians and collaterals due to qi and blood deficiency, or by invasion of wind, cold, and dampness evils, resulting in cold congealing and qi and blood stagnation. The tendons, muscles, and joints lose nourishment and become contracted, while the joints become stiff and inflexible. The meridians and collaterals become blocked, leading to poor nourishment of the tendons and muscles over time and resulting in stiffness. This is the pathogenesis of shoulder periarthritis.
Can Massage Therapy Treat Shoulder Periarthritis?
Massage therapy can treat shoulder periarthritis.
Shoulder periarthritis belongs to the category of "Bi syndrome" in traditional Chinese medicine, which is caused by liver and kidney deficiency, insufficient qi and blood, and invasion of wind, cold, and dampness evils or external trauma and strain.
Massage therapy can effectively promote meridian circulation, activate blood circulation, relieve pain, dissolve stasis, and reduce swelling. It has significant effects in relieving the symptoms of shoulder periarthritis.
Acupoints for Massage Treatment of Shoulder Periarthritis
Treatment principle: Promote meridian circulation, activate blood circulation, relieve pain, and relax joint adhesions.
Acupoints selection: Jianjing (GB21), Jianyu (LI15), Bingfeng (SI12), Tianzong (SI11), Hegu (LI4), upper limb region, Quchi (LI11).
Massage Techniques for Shoulder Periarthritis
1. The patient sits upright, or lies down if weak or with severe systemic diseases. Use kneading or one-finger Zen technique for shoulder or upper limb treatment, with passive movements of the affected limb, mainly focusing on abduction and external rotation.
2. Massage and knead Tianzong, Bingfeng, Jianyu, Quchi, Hegu, and Jianjing acupoints.
3. Use four-finger pushing or one-finger Zen technique to push the long tendon of the biceps brachii muscle, combined with small-scale abduction activities.
4. Use gentle tapping and plucking between the nodal grooves.
5. Use shaking, stretching, and manipulation techniques for the shoulder.
6. Use rubbing techniques for the shoulder joint, with appropriate heat penetration.
7. Use shaking of the upper limbs and stretching of the interphalangeal joints.
Precautions for Massage Therapy for Shoulder Periarthritis
1. The force used in the massage techniques should start from light to heavy, and then from heavy to light.
2. When dealing with adhesion of the shoulder joint, shaking and manipulation techniques should be gradually increased to expand the range of motion. Pay special attention to long-standing adhesions in late-stage patients, as osteoporosis may occur due to disuse. Gentle force should be applied during shaking and manipulation.
3. In addition to treatment, instruct patients to strengthen functional exercises to enhance the therapeutic effect and pay attention to local warmth.
Functional Exercises for Shoulder Periarthritis
Functional exercises for shoulder periarthritis should be persistent and gradually progressive. The following exercise methods are commonly used:
1. The patient stands with their back against the wall, flexes the affected arm at a 90° angle with the palm facing up, and gradually externally rotates the upper arm, trying to bring the fist closer to the wall. Repeat the exercise, suitable for patients with external rotation dysfunction.
2. The patient crosses their fingers over the top of their head and touches the opposite ear. Repeat the exercise, suitable for patients with difficulty combing their hair.
3. The patient stands facing the wall, and the affected side arm moves up the wall, trying to bring the chest as close to the wall as possible. Repeat the exercise, suitable for patients with difficulty lifting their arms.
4. Place both hands behind the back, use the unaffected hand to grip the wrist of the affected arm, gradually pull and lift towards the unaffected side. Repeat the exercise, suitable for patients with internal rotation and backward bending dysfunction when touching the back.
