Head of the humerusShoulder joint flexion 90° and rotation inside, rotation outside, can feel humeral head rotation, rotation inside can touchThe greater tuberosity and the lesser tuberosity of the humerus and the intertubercular sulcus. (FIG. 2-38)Shoulder peakAt the lateral end of the clavicle. (figure 2-39) the outer end of the scapula and the acromion of the clavicleThe acromioclavicular joints. The lower and posterior margins of the acromion areThe attachment point of the deltoid muscle. (FIG. 2-41)
The shoulder blade surfaceIt is palpable on the outside of the acromioclavicular joint. (FIG. 2-42)
coracoid: in the medial side of the head of the humerus and below the clavicle, the tip of the coracoid process and the medial margin can be felt. It is the attachment point of biceps brevis tendon, coracoid brachial muscle and pectoralis minor muscle. 43) (FIG. 2 –Biceps grooveInternal rotation of the upper arm, proximal to the middle of the humerus, the groove containing the long head of the biceps and its tendons. 44) (FIG. 2 –
The anterior deltoid and coracoid brachial muscles are the major flexors of the shoulder joint. Pectoralis major is the interstitial fibers, biceps brachii, serratus anterior and trapezius minor flexors. (FIG. 2-45)
Deltoid muscleThe starting point is 1/3 of the outer clavicle, acromion and scapular ridge. The insertion point is the deltoid tuberosity of the humerus. Posterior muscle band (spine) : abductor shoulder joint 90° flexion elbow, accessible at the back of shoulder joint. (figs. 2-46, 2-47) the middle band (acromion) : the middle part of the shoulder abducts between the anterior and posterior bands. (figure 2-48) the anterior band of the deltoid (clavicle) : push the shoulder forward horizontally to touch the band. (FIG. 2-49)
Beak brachial muscleAnterior flexion abduction of the arm and flexion of the elbow, a taut cord muscle is felt on the medial side of the arm and behind the biceps. (figure 2-50) starting point: coracoid process. Insertion: middle medial humerus. (FIG. 2-51)
Biceps abdominisIn front of the elbow, in front of the arm down to the deltoid, flex and extend the elbow joint to better show the belly of the muscle. (FIG. 2-52)
Biceps abdominisProximal one third in front of the upper arm, near the pectoralis major. 53) (FIG. 2 –
The biceps tendon: after the forearm is rotated, the resistance flexes the elbow joint, which can be touched at the elbow socket. (FIG. 2-54)
Biceps originThe long head rises from the tubercle on the scapular pelvis and the short head from the coracoid process. The terminal point is the radial tuberosity. (FIG. 2-55)
Before saw muscleRepeat the short inhalation with visible fingerlike projections attached to the ribs between the latissimus dorsi muscle at the back and the pectoralis major muscle at the front. (figure 2-56) starting point: 1st to 8th rib. Dead point: medial margin of scapula and lower Angle. (FIG. 57) 2 –
Trapezius muscleThe upper fibers extend from the occipital protuberance to the outer third of the clavicle. The lower fibers are attached to the medial side of the scapular ridge and run down the medial side of the spinous process of the lower thoracic vertebra. Press down shoulder blade obviously. The middle fibers are palpable from the acromion to the spine of the 7th cervical vertebra and the upper thoracic vertebra, with the scapula clearly receding. The trapezius muscle is flat, with no tension or tenderness due to the rotation of the fibers touching the cord-like structure. (figure 58) 2 –
The posterior fibers of the latissimus dorsi, teres major, and deltoid musclesIt is the major extensor of the shoulder joint. The teres minor and triceps brachii long head qualify as extensors. Shoulder extension pain suggests tendonitis of the constrictor muscle. (figure 2 to 59)
3, stretched out straight
The latissimus dorsiThe muscle can be felt on the medial side of the upper arm, posterolateral to the thoracic cage. (figure 2-60) starting from the lower 6 thoracic spinous processes and all lumbar spinous processes and iliac crest. Insertion: minor tuberous crest of humerus. (picture 2-62, 2-63)
The great circle muscleOn the inner side of the upper arm, the rib cage is pushed up on the back side, and there is a distinct muscular protuberance. (FIG. 2-61)
Small circular muscleShoulder abduction, elbow flexion 90° each, forearm pronation, between deltoid and teres major at the lateral margin of the scapula. (FIG. 2-64)
Brachial triceps longhead proximal end tendon: shoulder joint abduction, elbow joint flexion 90°, forearm distal end resistance abduction elbow joint, the back of the shoulder deltoid muscle fiber and the lateral side of the teres minor muscle can touch the tendon. (FIG. 2-65)
The triceps: origin: long head from subglenoid tubercle; The medial head arises from the bony surface below the groove of the radial nerve; The lateral head arises from the bony surface outside and above the groove of the radial nerve. Dead point: olecranon. (picture 2-66, 2-67)
The middle fibers of deltoid and supraspinatus are abductor muscles of shoulder joint.
The anterior and posterior fibers of the deltoid and serratus anterior assist.
The middle (acromion) band of the deltoid: the middle part of the shoulder lies between the anterior and posterior tracts.
Supraspinatus muscle: abductor of the arm and palpable in the supraspinatus fossa. (FIG. 2-70)
Pectoralis major: starting point: medial half of the clavicle, sternum, 1st to 6th costal cartilage. Insertion: greater tuberous crest of the humerus. (picture 2-71, 2-72, 2-73, 2-74)
6, and internal rotation
Subscapularis, latissimus dorsi, teres major, pectoralis majorIt is the major internal rotator muscle of the shoulder joint. (FIG. 2-75)
Shoulder joint internal rotation pain is caused by tendonitis.
subscapularisTo touch this muscle, there must be a space between the scapula and the thoracic cage. The lateral part of the finger is the latissimus dorsi, the medial front is the pectoralis major, and the lower part of the finger is the subscapularis. (figure 2-76) starting point: subscapular fossa. Insertion: nodule of humerus. (FIG. 2-77)
The infraspinatus and the teres minorThe major muscles of the shoulder. The posterior fibers of the deltoid assist in external rotation. (FIG. 2-78)
The infraspinatus:Starting point: subscapular fossa. Insertion: the greater tuberosity of the humerus in the middle, palpable in the subspinous fossa. (FIG. 2-79)
Small circular muscle:Starting point: back of lateral margin of scapula. The insertion point below the greater tuberosity of the humerus is palpable between the deltoid and teres major at the lateral margin of the scapula. (picture 2-80, 2-81)
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On the right side of the shoulder and back pain, in fact, there are many reasons related, can be due to different diseases caused by, and the shoulder and the shoulder is not the same, today said several, we often meet you may correspond to look at their performance, hope you can help to you, first by priority from top to bottom.
Subganglial muscle strain: this is often seen in occupational diseases, such as: teachers, barbers and laboratory staff, often work with the upper limbs, it is likely to lead to this area of muscle fascia strain, stimulate their own nerves.
This can cause local pain, which radiates to the shoulder of the body, and by dealing with the pain spot in this area, the symptoms may be eliminated.
Thoracic outlet syndrome: scalene muscle of the beam, beam before hypertrophy and spasm, might lead to it through from the body of brachial plexus appeared certain conformity, this might lead to the body's shoulder, back and arms of radioactive pain and numbness, the processing of local body muscle pain points is not enough, must want to remove the body of the brachial plexus conformity.
Local muscle strain, back pain is likely to be due to body lozenge muscle strain, shoulder pain is likely to be due to the deltoid muscle strain, can touch the body of local tissue tenderness, press the symptoms of pain will peace is consistent, this is relatively simple, can be self through massage ball handling, eliminate pain symptoms can eliminate.
Cervical spondylosis: part of the patients with cervical spondylosis, or due to the body of cervical intervertebral disc herniation is the conformity of cervical plexus nerve, the dominant shoulder area and the area back neurons, which can lead to local pain caused by radiation, the problem of processing need to treat cervical spondylopathy, if muscle pain also need to be synchronized.
If such a situation is often encountered, when the patient with right shoulder and back pain goes to the relevant hospital, the first department of treatment should be the department of orthopedics and the department of traditional Chinese medicine acupuncture and moxibustion.
Doctors can examine the body's neck, shoulders and chest with ct and mri scans, and may not be able to find clear evidence. Then you can try acupuncture and moxibustion massage, all kinds of Chinese medicine physiotherapy effect may be poor.
But finally in the ultrasound found that the patient had gallbladder stones, and 95% of cholecystitis is actually caused by gallbladder stones.
So why can cholecystitis cause the ache of the back of right shoulder of the body?
Because gallbladder inflammation can stimulate right phrenic nerve endings, and phrenic nerve is mainly composed of the 3rd, 4th, 5th cervical nerve, the 4th cervical nerve gives off cutaneous branch, ending walks in the skin of the body shoulder.
If the right phrenic nerve endings are stimulated to a certain extent, this signal will pass through the phrenic nerve to the 4th cervical ganglion, and at the same time affect the sensory nerve fibers distributed in the skin of the right shoulder, resulting in a certain illusion in the cerebral cortex of our body, which is mistaken for the incoming pain sensation from the right shoulder.
So the patient may feel pain in the right shoulder of the body. Because acute cholecystitis digestive tract symptoms are very obvious, generally not easy to be misdiagnosed.
And chronic cholecystitis can appear the dull pain of right upper abdomen very likely at ordinary times, be tired of oily food or be the symptom of abdominal distension, the patient often feels the discomfort of right shoulder back and right rib place, stand for a long time or the aggravation after motion. Since the symptoms are not particularly typical and do not affect our quality of life, many patients may only be detected by ultrasound.
Relevant remind: cholecystitis not only can bring about the ache of right shoulder back part of the body, still have the angina pectoris that causes the body even. Because the heart of the body and gallbladder suffer the innervation of plant nerve together, both can have cross feeling in bosom 4, 5 spinal nerve place.
If biliary tract resistance increases when the gallbladder is infected, it may trigger a contraction of the coronary arteries, leading to ischemia in the body and pain in the heart. Clinically, it is called "bare-heart syndrome".
In short, a handful of periarthritis of shoulder may be the ache of the area can also cause the body back and shoulder pain, but the probability is not particularly high, diagnosis can be face to face is the best pain diagnosis, can from the interrogation, to touch, try to solve the problems that are related to do, must start from the root of the cause of pain to, not the surface.
Shoulder and back have drag in the pain, thought it was periarthritis of shoulder, waiting for self-healing, but half a year passed, the pain is worsening, further examination found that the pancreas was "bad". Yao was surprised when she received the diagnosis two days ago, saying she had no symptoms other than shoulder and back pain and a bad stomach. In response, the doctor warned, the weather turned cold, shoulder and back pain more people, many people think shoulder and back pain is periarthritis of shoulder or cervical spondylosis, but it is not the case, it may indicate other diseases.
Half a year ago, Ms. Yao began to feel a dull ache in her shoulder. Since she was over 50 years old, she judged that she had "fifty shoulders".
After listening to the advice, Ms. Yao began to stretch her arms, pull rings, arm swing exercise, hoping to alleviate the symptoms of periarthritis of shoulder. Over time, however, she began to feel more severe shoulder pain and a dragging pain in her back. Especially at night, lying in bed, the pain doubled, tortured Ms. Yao hard to sleep.
Later, Ms. Yao frequently sought medical care, changed two hospitals, did a number of tests, finally found the "cause" of her shoulder and back pain – pancreatic cancer.
"How possible, I usually good health, in addition to shoulder and back pain, recently urine a little yellow, there are no other big problems ah." When Ms. Yao heard the diagnosis, she couldn't understand.
"I had reflux gastritis in the last two years, and I lost a lot of weight. At the beginning of the year, my stomach was not very good. Sometimes I had vomiting and diarrhea. Doctors say these symptoms are already a sign that Ms. Yao's pancreas is "bad."
According to wang cheng, chief surgeon of general surgery department of anhui provincial hospital, pancreatic diseases are not easy to find. If we can notice the onset of symptoms early, it will be very helpful for treatment. He said that the diet of modern people, meat, eggs, milk and fine food increased, vegetables, coarse grains decreased, coupled with smoking, drinking, barbecue and other bad habits, leading to the incidence of pancreatic diseases increased, and gradually younger. Previously, pancreatic cancer patients were mostly in their 50s and 60s. Now, patients in their 30s can be seen from time to time.
Reporter wang jing
Correspondent sun chengwei
Some discomfort or warning of pancreatic problems.
Because the pancreas is "hidden" in the back corner of the right upper abdomen, "hidden" by the stomach, duodenum, kidney and other organs, once the disease is not easy to find, so most patients have been diagnosed as fatal disease. However, although pancreatic disease is "tricky", it is not completely invisible, warns wang.
1, shoulder back has a heavy pull feeling, the pain intensified at night, long unhealed and worsening symptoms — when this kind of pain, can not be simply considered as periarthritis of shoulder, we should be aware that there may be something wrong with the pancreas. You can raise your arms. Joint motion is restricted, arm is lifted cannot rise, it is periarthritis of shoulder possibly. If you have a pancreas, you can move your arm." Wang cheng said.
2. Always have dyspepsia, but the effect is not good when treated as gastric diseases, which may be chronic pancreatitis; Chronic chronic diarrhea, good or bad, may be the endocrine cell tumor of the pancreas.
3. Alway epigastric pain, anorexia, sudden diabetes of unknown cause, may also suggest pancreatic problems.
Shoulder back pain is not necessarily periarthritis of shoulder or cervical spondylosis
Similar to Ms. Yao, because shoulder and back pain to find out other diseases of the patient is not less, wang cheng recently also encountered two cases. He warned that as the weather turns cold, shoulder and back pain has become more common. However, shoulder and back pain is not necessarily periarthritis of shoulder or cervical spondylosis. It may indicate other diseases:
1, if you feel the typical symptoms of periarthritis of shoulder: shoulder pain, joint movement is limited, but at the same time there are low fever, night sweat, fatigue, pale face, wasting symptoms, to beware of shoulder joint tuberculosis.
2. Shoulder tumor can also cause shoulder pain and dysfunction of shoulder arm movement. If you feel shoulder pain gradually aggravating and the pain area expanding, don't "worry" about periarthritis of shoulder and make further examination.
3, most of the first symptoms of cholecystitis is back pain, or right shoulder, right subscapular dull pain. Want to still have disgusting, abdominal distension, regurgitation, the indigestion symptom such as gastric burn feeling, do not forget to go to a hospital to do colour to exceed check gallbladder.
4. Middle-aged and elderly people with high blood pressure suddenly feel back pain, or unbearable pain in the chest and abdomen, as if the body has been cut or torn by a knife. It may be aortic dissection, so please seek medical advice as soon as possible. If the rescue is not timely, about 40% of patients may die within 24 hours.
5. Angina pectoris and myocardial infarction can also radiate to the back, left shoulder and other parts. Patients with coronary heart disease should be careful if they suddenly feel shoulder and back pain.
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According to the American spine therapy association (aca), lower back pain is the second most common cause of physician visits. Lower back pain can be caused by arthritis, being overweight, poor posture, or even physical stress. In fact, aca points out that the most common lower back pain is mechanical, which means it's not due to infections, broken bones or other serious causes, and that it's not common to see back pain caused by kidney stones or blood clots.
This means that in many cases, preventing or treating back pain at home is a viable option. More importantly, one of the most effective ways to avoid back pain, especially as we get older, is to maintain our posture, keep our spine soft, and continue to be physically active in a well-supported manner. All of this can be done with simple stretching, which requires a doctor or physical therapist to check if you have any back pain before performing the exercise.
All of the following exercises should be performed on a solid chair, such as a dining chair, preferably without an armchair. If you are sitting on a relatively hard surface, it is easy to form a good posture, no other equipment is needed. Keep your feet firmly on the floor, knees bent at 90°, and hips in the middle of the chair, not on the edge.
Stretch your neck and chest
Even before the advent of electronic gadgets, people often kept their jaws forward or down, reading, eating (when we look at our plates), driving, and so on. Over time it can lead to neck pain and can cause pain in our spine and other areas of our back (usually the upper and middle spine). The following movements help reduce pain and stretch the chest. When our body posture is poor, we feel tight and need to stretch the thoracic vertebrae back.
Muscular activity:This exercise will stretch the shoulder blades and trapezius muscles in the neck, as well as the pectoral and erector spine muscles.
Sit in a chair with your feet flat on the ground and your body upright. Place your hands at the bottom of your head, fingers crossed, and move your thumbs along your ears and neck. This is a typical "relaxed" position, with your hands on your head.
Place your head in the palm of your hand and face up toward the ceiling.
Take a deep breath in, and as you exhale, relax your left elbow toward the floor and your right elbow toward the ceiling. This will stretch the neck in a supportive manner. Note: this exercise needs to be done gently, with the elbow moving only 1 to 2 inches. You should feel comfortable stretching, not pain.
Take two deep breaths and relax back into a neutral, upright spine position.
5. Repeat on the other side with your right elbow pointing to the floor and your left elbow pointing to the ceiling. Repeat three times on each side, then repeat on the other side.
2. Gently sit, stand and lean back
As we get older, our upper and middle backs (the thoracic and cervical vertebrae) begin to bend forward more, and as our lower jaw descends or protrudes outward, we often do these movements in our daily life, which become habitual. It can also lead to a hunchback, which we often associate with aging, causing tension in the back muscles. This gentle lean back counteracts muscle tension.
Muscular activity:This stretching exercise USES the spinal extensor, anterior cervical and pectoral muscles.
1. While sitting, place your feet on the ground with your hands on your lower back, palms down, and thumbs around your hips toward the front of your body.
Press your hands firmly against your hips and lower back while inhaling.
3. As you exhale, arch your spine slightly and guide the movement with your head. Note: don't tilt your head back too much. If you want to guide the movement with a cervical spine, you need to raise your jaw and face toward the ceiling. The upper and middle parts of the spine should flex.
4. Take five full breaths.
5. Gently return to the neutral starting position and repeat 3-5 times.
Three, back stretch exercise
This stretching exercise helps improve the range of motion of the shoulder joint, as well as stretching the shoulders and chest. When we sit or stand hunched over, it feels like slouching, but it causes tension in the chest muscles by pulling them inward. To avoid the movement of these muscles, it can cause pain in our upper and middle backs. The next exercise is to stretch the chest, exercise the postural muscles, and improve the stretching ability of the shoulder joint.
Muscular activity:This stretching exercise will stretch the anterior deltoid and chest muscles.
Sit up, keeping your spine straight and your feet flat on the floor. Breathe in deeply. As you exhale, bring your hands behind you and cross them. Note: if you can't cross your hands, grab the opposite wrist or elbow.
Take another deep breath and feel your spine elongate as you sit up straighter. Then move your shoulders up and down, with your shoulder blades down.
3. As you exhale, gently straighten your arms if they are clasped (if they are not together, gently pull them in the opposite direction). This helps stretch the upper back.
After taking three deep breaths, relax your clasped hands and return to the neutral position.
5. Repeat three times.
To the next level
If you feel good after the above exercise and don't feel any tension, you can increase your stretch to include the entire spine. This helps relieve pain in other parts of the back and increases the flexibility of the spine.
1. Start in the same stretch position as above, with both hands behind your back and holding tight, or with one hand holding the opposite wrist or elbow.
2. Inhale to feel the ribs lifted and the spine elongated. Maintain this feeling by gently tilting the spine forward at the waist as if the ribs were stretched into the thigh.
3. The range of movement should be within the range that one can bear. If you can keep your ribs down to your thighs, fine, but don't lie on your thighs. You still need to use your postural muscles to hold yourself in this position and stretch your chest, shoulders, and back.
Sit – up cat – cow pose
Many of us suffer from lower back pain, and as we age, degenerative changes in the spine and osteoarthritis become more common. For some of us, when our posture is poor, some of us present a "flat pelvis" when standing, which can cause severe lower back pain. Doing cat-cow exercises helps stretch the muscles in the lower back, and also helps keep the core muscles working and the spine healthy.
Muscular activity:This exercise stretches the erector spine, serratus anterior, iliocostus, external oblique and rectus abdominis.
1. Sit up with knees bent at 90°, feet flat on the ground, hands on the knee, two fingers facing inward, palms on the outside of the thigh.
2. Inhale, pressing your hands down as you exhale, arching your back inward through your spine, and looking toward the ceiling should feel as if you are pushing your hips behind you.
Inhale again, bringing your shoulders forward, then pull your navel toward your spine, lower your jaw toward your chest, and push your hands toward your knees.
On your next exhale, move in the opposite direction, pushing your chest through your arms and arching your spine again, pushing it toward your legs instead of your knees.
5. Slowly control your breathing and repeat 3-5 times.
5. Gentle spine twisting exercises
Gently twisting the spine has many benefits, including improving digestion and circulation, exercising abdominal muscles, and is one of the best ways to stretch for lower back pain. Not only that, doing a few gentle twists a day can improve the flexibility of your spine and prevent future lower back pain.
Muscular activity:The serratus erector and rhomboid muscles, as well as some neck muscles such as the sternocleidomastoid, are active in this stretching exercise.
1. Sit up with feet flat on the floor and knees bent at 90°. Only sit at the front edge of the chair. We may be concerned about the forward tilt of the chair and the instability of the seat, but we need to keep some space in the back for this exercise.
2. Push your weight down when you breathe in, stay upright when you sit, and lengthen your spine when you lift your arms above your head.
3. As you exhale, gently turn to the right. Place your left hand on the outside of your right knee joint. We need to feel that every part of the spine is turning evenly. Using arm force to make the twisting even more damaging, one part of the spine will twist harder than the rest.
4. Hold the twisting position as you breathe in and feel yourself sitting higher. Twist further as you exhale.
Hold 3-5 breaths before you relax, then repeat on the other side, switching and stretching at least 2 times on each side.
These simple stretching exercises not only help reduce back pain at home, but also help prevent future back pain problems. As we age, our muscles get shorter and lose elasticity, and stopping exercise only exacerbates these problems, leaving our muscles weaker and often causing pain. By stretching our back and chest and keeping our shoulder joints and back moving, we can avoid pain, improve our posture and range of motion, and maintain a higher quality of life.
Check with your doctor immediately if you experience any new pain, especially if you have a sharp tingling or difficulty breathing. Most back pain is caused by overuse, poor posture, or excessive weight on your back.
When your left neck hurts, press the houxi point of your right hand with the thumb of your left hand. When your right neck hurts, press the houxi point of your left hand with the thumb of your right hand.
Do motion, move thing when careless waist sprain, press press save bamboo acupoint to be able to have the effect that alleviates lumbago quickly.
Zan bamboo acupuncture points in the face, brow depression is the position of zan bamboo points. Use finger tip vertical point to press two brows, at the same time slowly activity waist, point by a lumbago will be significantly relieved.
Have a headache
Between the eyebrows there is a "Yin tang point", massage this position to help relieve headaches, nasal discomfort and other symptoms.
In addition, two hands tiger mouth intersection, one hand index finger pressure on the other hand on the radial styloid process, in the index finger tip to reach the depression for a series of holes.
Use finger point to press a list of acupoints, the intensity should have the feeling of ache and sour distention to be good, each time continuously dot press about 3 minutes, can alleviate headache likewise.
Have a stomachache
Stomachache, stomach distension does not digest, with the drug treatment effect is not too big, might as well by pressing the acupoint way to relieve stomachache, this acupoint is zusanli.
The foot three li in the knee depression place under 3 inches, the distance four finger long position, is the foot three li acupuncture point.
When you have stomachache, relax the leg muscles and press the acupoint with your index finger. While exhaling, massage. Release the pressure once every 6 seconds.
"Toothache is not a disease. It kills people!" Toothache always lets a person sit restlessly, might as well try the next close acupoint of the body and he gu acupoint right now.
Hegu is located at the highest point of two-handed tiger mouth; Lower it on your face, in front of your ears, and in the depression just below your cheekbones.
Hand yangming meridian veins into the lower row teeth, foot yangming meridian veins into the upper row teeth, hegu, xiaguan are yangming meridian points, massage can pain.
Methods press on the corresponding parts of face with fingers or knuckles, and press on hegu and xiaguan points on the painful side for about 10 minutes, which can not only relieve toothache, but also treat oral ulcer.
When you have back pain, rub your hands around the back of your body.
The waist is what Chinese medicine refers to as "taking the pulse", especially on both sides of the spine, where the kidney is located. Kidney likes warm and cold, regular massage can help alleviate back pain.
Many people often rub their parents' shoulders, but few know what a standard shoulder rub is for pain relief.
In fact, knead the shoulder in addition to can shu live shoulder qi and blood, but also can press the "shoulder well point", that is, nipples on the top and shoulder line hand over, shoulder top, help alleviate shoulder pain, top-heavy, eye fatigue, tinnitus, stiff neck and other symptoms.
Wrist horizontal lines up about three fingers wide, that is, the switch for heartache, here also refers to the point of the inner pass.
If break out angina pectoris, besides containing nitroglycerin to take, still can dot press here 5 minutes, can activate blood to open collateral, have the effect of acerbic pain.
It should be reminded that this method is only used for adjuvant therapy and first aid. In case of chest pain, it is important to call the emergency number and seek medical help.
"The pain switch" is only an adjunctive therapy. If the condition is too severe or the pain is unbearable, you should seek the help of a professional medical institution.
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A type of shoulder pain often misdiagnosed as "periarthritis of shoulder" – rotator cuff injury
Medical guidance: four orthopaedic doctor xiang xiao bing director of traditional Chinese medicine
Fourth orthopedic doctor sun youqiang
With the improvement of the economic living standard of the Chinese people, more and more people participate in some sports, so sports injury diseases are also increasing.
Some middle-aged and elderly friends in daily life, many of them often have shoulder joint pain, pain also accompanied by limited shoulder joint function and other conditions. About this kind of disease, a lot of people take it for granted on the casual out of a disease: periarthritis of shoulder. In fact, sometimes what you think is not necessarily the truth, this situation is likely to be "rotator cuff injury."
Literature reports that the incidence of periarthritis of shoulder is only about 15%-20% in clinical practice, and the number one killer of shoulder pain is "rotator cuff injury". Clinically diagnosed shoulder pain, more than 60% is rotator cuff injury. Rotator cuff injury and scapulohumeral periarthritis the biggest difference is that the rotator cuff injury activity may be normal, especially the passive activity, is likely to be in the normal range, but in the process of activity, can appear pain or activity weakness, and scapulohumeral periarthritis will appear more obvious activity limited.
What is rotator cuff
The rotator cuff is the four muscles that wrap around the joint of the shoulder: the supraspinatus, the subaspinatus, the teres minor, and the subscapularis. This is a group of tendon tissues that are very vulnerable to injury and tear.
Anatomy of rotator cuff: lateral (left) front view, rear (right)
Among all joints, shoulder joint has the highest range of motion, but corresponding bone stability is the worst, so the stability of shoulder joint is mainly provided by soft tissue, and rotator cuff is the most important stable structure. The humeral head is large and the shoulder pelvis small, like a golf ball holder, and the rotator cuff holds the humeral head in the center of the joint like a hand.
Principles of rotator cuff injury
Acute trauma can lead to rotator cuff tears, such as falls. As age increases, the brittleness of the rotator cuff increases, the proliferation of acromial bone spurs, repeatedly hitting the rotator cuff, causing the tear to be frequently "overdone", such as badminton, baseball, tennis and other sports. In life, risk factors for rotator cuff tear are: repeated excessive exercise, such as painting, painting the ceiling, storage shelves; To carry heavy objects, such as luggage; Trauma, such as falling or hitting the shoulder. Even walking a large dog for a long time or squeezing into a bus to pull a sling can cause tendon damage.
Symptoms of rotator cuff injury
The dull pain of shoulder depth, affect morpheus when serious, when suffer from side especially press press it is difficult to finish the action that comb hair or catch back, shoulder force drops.
There is little chance of rotator cuff self-healing once a tear occurs, but 80% of rotator cuff injuries can be treated conservatively to relieve pain, although for severe rotator cuff tears, surgery should be performed.
How is rotator cuff injury treated
1. Conservative treatment: traumatic rotator cuff injury requires adequate rest for rotator cuff injury. If the pain affects sleep at night, oral painkillers can be taken.
The rotator cuff injury caused by degeneration is often mistaken as "periarthritis of shoulder" and required to do "climbing wall" exercise. However, such unreasonable exercise will aggravate the degree of rotator cuff injury, so climbing wall exercise is not recommended for rotator cuff injury.
2. Surgical treatment: most rotator cuff injuries can be repaired with minimally invasive shoulder arthroscopy. Under arthroscopic monitoring, we inserted anchors into the rotator cuff attachment, and then used the tail line of the wire anchor to tighten the torn tendon.
So why do we use "anchors"? Because the tendon is torn where it attaches to the bone, doctors cannot sew the tendon back into the bone, which requires a special tool called an anchor. The tail end of the anchor has a suture line, which is fixed into the bone like an anchor, and the tail line is used to close the torn rotator cuff. The anchor can be removed for life after being put into the body. Generally, the anchor is the size of a grain of rice, which is not harmful to the body and does not affect joint function.
Common anchoring materials include peek, absorbable material, titanium metal, etc.
There are also a number of different ways to sew rotator cuff tears, and the double-row, double-row front bridge technique is thought to be more robust.
For large rotator cuff injuries, or those considered irreparable rotator cuff injuries, there are currently three major surgical approaches: 1. Patch repair; 2. 2. Tendon transposition; 3. Trans shoulder replacement.
Patch repair: patch (from fascia lata) was fixed by wire anchor; Tendon transposition: latissimus dorsi transposition is usually used to replace the function of the supraspinatus. Trans shoulder arthroplasty: shoulder arthroplasty.
Typical case presentation:
Patient was a 69 year old woman, because the right shoulder pain with limited activity for 9 months before admission, the system diagnosed after diagnosis: rotator cuff injury (on the right side of the supraspinatus tendon was totally torn, most of the subscapularis tear, biceps long head tendon dislocation), was hospitalized after "microscopic examination of the right shoulder joint and joint clean + shoulder peak shape + rotator cuff repairs".
Preoperative magnetic resonance imaging (mri) :As shown in the figure above, the supraspinatus tendon was completely broken, most of the subscapularis muscle was torn, and the biceps longiceps tendon was dislocated. The patient had shoulder joint pain with limited mobility.
Intraoperative conditions:Repair of injuries to the supraspinatus, subscapularis, and biceps tendon.
Postoperative treatment: give shoulder joint abduction support brake, anti-inflammatory, detumescence, pain relief, stomach protection, cold treatment and other symptomatic treatment.
Postoperative rehabilitation: after rotator cuff repair, we recommend that patients follow the following rehabilitation plan, which is generally divided into three stages, each lasting 6 weeks.
The first stage: 0-6 weeks, mainly rest and braking
The second stage: 6-12 weeks, mainly passive functional exercise
The third stage: 12-18 weeks, mainly active functional exercise
Xiang xiaobing, md, chief physician of traditional Chinese medicine.
Excel at: shoulder disease and knee movement trauma arthroscope minimally invasive treatment. Such as: rotator cuff tear, frozen shoulder (periarthritis of shoulder), dislocation of shoulder joint, glenoid fracture, calcified tendonitis, etc. Knee cruciate ligament fracture, meniscus injury, cartilage injury, synovitis, etc.
Visiting time: Tuesday morning and Wednesday afternoon (orthopaedic clinic no. 1 on the 6th floor of the outpatient building)
Author's brief introduction
Sun youqiang, md, attending physician.
Good at: the diagnosis and treatment of bone and joint and sports injury. Such as: knee cruciate ligament injury, meniscus injury, femoral head necrosis, hip knee osteoarthritis. I was sent by the state to study in Australia for more than one year from November 2016 to December 2017. Currently, 11 sci papers have been published, and 10 projects have been hosted and participated in.
Please follow the public account of "first affiliated hospital of guangzhou university of Chinese medicine" or "first affiliated hospital of guangzhou university of Chinese medicine" below. Enter the menu bar of "medical assistant" or "outpatient service" and search "doctor's name" to register.
As you all know, almost all upper body exercises are inseparable from the participation of shoulder joints, which are complex and fragile in structure and often injured in training.
It is composed of humerus head and scapula glenoid cavity, belong to the ball and socket joint, the joint is flexibility is bigger, the advantages of wide scope of activities, but with poor stability, although the joint capsule and ligament protection, because the joint capsule is thin and easy to loose, this part of the ligament and there is no power, less frequently, excessive exercise fatigue, shoulder ache to do parallel bars arm flexion and extension.
Do this is because in the parallel bars, arm flexion and our kin friend imbalances happen often makes the stress of the shoulder joint, humerus offset the physical location of acetabulum, humerus in uncontrolled free sliding joint socket, cause the acetabulum in cartilage tissue is a lot of wear and extrusion, so the shoulder will have the feeling of pain, if shoulder joint in training have the feeling of pain, then please stop training, treatment, and have a rest.
How to avoid shoulder joint stress imbalance?
In doing this exercise, the exercisers often neglect to master the correct movements. In the selection of parallel bars, the distance between the parallel bars should be as wide as the shoulder, so that the humerus into the joint socket part increase, shoulder joint force will achieve stability, in the perfect coordination of the elbow, the stability of both sides of the body has been improved.
Second is to guarantee the normal activities of the shoulder blade, the body to maintain integrity, avoid chest round shoulder posture, on this basis, to ensure the shoulder blade shrink back a bit and subsidence, reduce the power of the shoulder are squeezed, but the size of shoulder sinking, should be grasped when keep the same height and elbow elbow flexion, but also pay attention to keep the wrist and forearm in a straight line.
In addition to what should be paid attention to above, we should warm up the shoulders before exercising, increase the lubrication of shoulder joints, protect the cartilage tissue of joints, and carry out the parallel bars arm flexion and extension exercise safely and effectively on the premise of gradual weight loading.
The first warm-up action: stretch the stretch rope body forward
Body standing naturally, from the foot and shoulder are the same as wide, his arms unbend before body, hands holding the ends of the elastic rope, exercise to maintain the stability of the body, arms stretched in both sides at the same time, so the most distant way in the reach, and then return to the starting point, this movement we work 3 to 4 groups, each group of 15 to 20 times of stretching, exercise time control in 3 minutes.
The second warm-up action: single arm stretch rope
Fix the bungee cords in the first place, the body for fixation, holding pull rope left arm straight forward, knees slightly bent, spine in a neutral position, tighten abdominal and back muscles when motion, left hand pull the bungee cord stretch the left shoulder, left arm elbow flexion, when to do big limit, stay for a few seconds, then unbend arm back to the starting point, in his right arm began to repeat the exercise, exercise intensity for 3-4 groups, each group to remain in 15 to 20 times, exercise time control in 3 minutes.
Third warm up: stretch the stretch rope around
Body standing straight, tall, back, arms holding bungee cord natural hanging on both sides of the body, the distance between the feet and shoulder are the same as wide, movement, tighten the core muscles, arms surrounded by a whole to the body after tensile elastic rope, increased the activities of the shoulder joint and get a good effect of warm-up, training intensity between 3-4 group, then each group of 15 to 20 times of practice, time is controlled in 3 minutes.
Above 3 warm-up exercises, as long as the effect does not hurt, 3 comprehensive warm-up shoulder, away from sports injury! The recommended interval between each group should be about 20 seconds.
With the spread of health knowledge, more and more people begin to pay attention to stretching.
Especially after a day's desk work, when neck and shoulder fatigue and soreness appear, people like to do some stretching and relaxing exercises of cervical vertebra or shoulder to relieve the fatigue of neck and shoulder.
But have you noticed these problems?
Although we feel comfortable and relaxed during or after stretching, it seems that after a while these neck and shoulder aches and pains begin to appear again.Even if you stretch every day, the benefits of stretching seem to decrease, and sometimes it's just a few minutes of comfort.Ever wonder why you don't stretch enough and need more stretching?
Today we look at the following:
Why can stretching relieve neck and shoulder fatigue in the office?Why is stretching less effective in relieving office neck and shoulder fatigue? Attached to deal with office neck and shoulder pain method.Why can stretching relieve neck and shoulder fatigue in the office?
This needs to be explained from two perspectives.
First, let's talk about the causes of neck and shoulder fatigue and soreness in the office.
This is usually related to the bone, muscle, ligament and other tissues in the neck and shoulder that are under constant pressure.
When persistent stress builds up and slowly exceeds the tissue's capacity, it is likely to cause some minor damage to the tissue.
If these small injuries start to outpace the body's ability to repair itself, the damage can build up and we can easily get sore. This kind of injury and soreness can make muscles weaker and less powerful.
In addition, due to the continuous pressure on the neck and shoulder muscles, some muscles will be contracted for a long time in order to reduce the impact of pressure.
For example, we often hit the keyboard with the mouse, cervical vertebra and shoulder will unconsciously move forward. At this point, the muscles that control the forward movement of the neck and shoulders will often contract.
To reduce stress and increase the efficiency of contraction,The muscles that control the forward movement of the neck and shoulders become tense.
Next, let's find out why stretching can quickly relieve sore neck and shoulder muscles.
Stretching can be understood as stretching the muscles to the sides.
In this process, it will change the continuous stress state of the muscles and reduce muscle tightness, so as to ease the pain of neck and shoulder muscles and make yourself feel relaxed.
For example, we spend too much time typing in front of a computer, causing neck and shoulder muscle pain due to constant stress. But by changing your posture, or simply lifting your head/side up/shoulders shrug, you will always feel more relaxed after releasing stress.
In addition, as muscle tension decreases and activity increases, the nerve threshold (critical value) for pain is reset, which increases one's tolerance for pain.
As a result, after stretching, our tolerance for pain increases and we experience pain relief more quickly.
Why is stretching less effective in relieving neck and shoulder fatigue and soreness? Attached to deal with office neck and shoulder pain method.
As mentioned above, the occurrence of neck and shoulder muscle soreness is usually associated with persistent stress. Constant stress not only tightens muscles, it also damages them and reduces their strength.
Stretching, on the other hand, temporarily changes the stress state and resets the pain threshold. Although it relieves tension in neck and shoulder muscles, it does not directly restore the strength and stress tolerance of neck and shoulder muscles.
So it's easy to see that even though the muscles aren't as tight after stretching, the fatigue and soreness don't seem to go away completely.
So what should we do about office neck and shoulder muscle soreness?
First, change the state of persistent stress
Changing the constant stress state, in other words, is to avoid holding a position for too long.
Accordingly, suggest a small alarm clock might as well be set in office process, every interval 30-60 minutes or so, simple activity neck shoulder is loosened, specific motion also can refer to below agitate stretch action.
Second, add muscle strengthening exercises
Muscle-strengthening exercises increase muscle strength, improve the ability of muscles to withstand stress, and help relieve muscle soreness.
Common neck muscle strengthening exercises:
Stand with your upper body upright and try to keep your ears and shoulders in line.Put your hand on your forehead, the back of your head, or the left and right sides of your brain, and apply pressure.Finally charge the cervical vertebra, against these pressures, hold 5~10 seconds.Note: the muscles in the cervical spine are small in size, unlike those in our lower back.If dizziness or other discomfort occurs, the action can be reduced or temporarily stopped.Common shoulder back strengthening exercises
For the relief of shoulder pain, it is usually recommended to strengthen the muscles in the inner shoulder blades of the back.
Back strengthening not only reduces the pressure on the shoulders, but also prevents shoulder blades from moving up due to long periods of forward movement, such as keyboarding. (the shoulder blades move up, which increases the friction between bones and muscles/ligaments, aggravating pain.)
Stretch out your hands in a "w" shape.Grip your shoulder blades inwards while swinging your hands back.Be careful not to hunch over the whole time.If uncomfortable, reduce the number of movements or pause the movement.Third, stretch your muscles properly
While stretching doesn't seem to relieve pain in the long term, it helps relieve tension in the muscles and relieve pain and discomfort more quickly. We can do it properly. Such as:
In a standing or sitting position, place your hands behind your back to let your shoulders sink and hold them in place.Turn your head to one side and gently stretch one side of your neck to the shoulder.If not, the head can be pulled by hand to one side more; Hold for 10 seconds.If dizziness or other discomfort occurs, the action can be reduced or temporarily stopped.
In a standing or sitting position, place your hands behind your back to let your shoulders sink and hold them in place.Turn your head to one side at a 45-degree Angle, then lower your head to slightly stretch one ear to the shoulder.If not, the head can be pulled by hand to one side more; Hold for 10 seconds.If dizziness or other discomfort occurs, the action can be reduced or temporarily stopped.conclusion
With that said, let's wrap up today's talk:
Admittedly, office neck and shoulder soreness can be alleviated by stretching.In the long term, however, relieving office neck and shoulder muscle soreness also requires attention to changing the continuous stress state (simple activities with 30-60 minute intervals), and attention to adding muscle strengthening exercises to improve the ability of muscles to withstand stress.Note: if neck and shoulder muscle pain is accompanied by hand numbness, dizziness and other symptoms, it is recommended to seek professional doctors or rehabilitation therapists to provide sports rehabilitation program.Previous articles:
Is bone hyperplasia of cervical vertebra long bone spur very serious? Does the bone spur break the skin?
How long have you been fooled by the idea that exercise is better than bed rest? Rehabilitation process of retroankle sprain
How should office worker protect cervical vertebra? Doctor: learn these four tips well, and keep cervical spondylosis away from you
Neck and shoulder ache when paroxyse, dress, carry content, comb hair to wait for simple action to have difficulty, affect daily life and work badly, how to alleviate neck and shoulder to ache effectively?
1. Lateral lateral rotation method
Lie sideways on the bed, next leg unbend, bend upper leg, upper part hand akimbo, upper body tries hard to do before and after turn body motion, amplitude can make limit to oneself so far, turn 3-6 hind, turn over to repeat afore-mentioned action.
2. Hold the back of the neck
Lie on your back or side, with one hand supporting the back of your head and the other palm on the back of your neck. Use your fingers to hold the back of your neck.
3, shake the head straight
Lie on your back on the bed, with one hand supporting the back of your head, turn your head to one side for 30 degrees, and with the other hand supporting your jaw to push up in the direction of rotation, so that your head is tilted back and the upper part of the oblique is restored, still 2-3 times changing sides.
4, guide body ridge method
Pull your hands up and inhale. Slowly lower your hand and exhale. Repeat 10-20 times each time.
5. Sit back and lift your chest
Lie supine on the bed, the neck after both hands holds him, double leg unbend, with head and coxal for fulcrum, carry the body to leave bed face hard, repeat 30-100 rest again, can repeat to do a few times more, see individual physical strength does according to one's ability.
The method that a few kinds of above alleviate neck shoulder pain is more common good operation, can do at home, the friend that has neck shoulder pain trouble can try.
Warm reminder: in daily life, we must pay attention to maintain the correct body posture, take care of the neck and shoulder health. Relieve neck and shoulder pain, but also can assist the use of neck pain moxibustion.