massage for treatment of upper limb disorders Ministry
Section frozen shoulder
frozen shoulder, shoulder the full name of the surrounding Yan, also known as "Fifty" shoulder, "frozen shoulder", "air leakage shoulder" and so on, is a traditional Chinese medicine "shoulder Bi", "shoulder condensate" and range. Department of shoulder soft tissue and joint capsule occurred in a broader aseptic inflammation. and shoulder soft tissue degeneration, strain, trauma and feel the wind cold dampness evil and other factors. The disease occurs most often in unilateral shoulder after 50-year-old, female, see more, there is self-healing tendency. Most of the patients
onset is slow, often due to a single (double) side of the shoulder pain outreach or on the move is not to be noticed.
one diagnostic points
1, shoulder pain : pain was aching, dull pain or if the knife-like pain. sometimes involve the forearm, neck, back, pain was radioactive string. generally more significant night pain, not Woyu affected side, even by painful wake up.
2, shoulder joint disorders: limb on the move, outreach and internal rotation when the pain intensified, joint stiffness, limited mobility, especially Outreach can be a "bar shoulder" phenomenon. hair, dressing, put pants , face and other activities are difficult. inspection, was joint abduction, decreased range of extension activities. late severe adhesion, the shoulder can be was "frozen".
3, tenderness: tenderness broad shoulders before, outside rear, the size of rhomboid muscle attachment points, margin of scapula spine, etc. there may be tenderness.
4, muscle atrophy: risk of shoulder disease for a long time, local muscle disuse may occur atrophy, especially as the deltoid.
5, X-ray examination: no specific indication, but can rule out the bone and joint diseases.
6, the differential diagnosis:
1) cervical disease: there may be back pain, upper extremity activities are not restricted, the cervical shoulder pain. Sometimes the two diseases may exist.
2) should shoulder the disease peak of bursitis, biceps tendinitis, supraspinatus tendinitis, shoulder dislocation, humeral surgical neck fracture, rheumatoid arthritis, shoulder, shoulder joint tuberculosis, cancer and other differentiated.
Second, massage therapy
(a) of the rule is: Shujin, smooth the joints.
(b) of the way: rubbing, plucking, rubbing, shaking, shaking.
(c) of the acupoints and location: Hegu, Qu Chi, Chen-shoulder, shoulder, shoulder, shoulder well, day cases, Ashi points, and upper arms, neck back.
( d) the steps:
1, rubbing the points, soreness, pain, the degree of patient tolerance.
2, Kneading performer in the shoulder, upper arm, after muscles of the back and relax muscles.
3, plucked the muscles around the shoulder.
4, twist the upper arm, upper limb shaking, shaking the shoulder, shaking rate increased gradually, the way the power from small to large.
5, take the shoulder well, by day cases, the Ministry of palm rubbing shoulder.
(e) Differentiation Modified:
1, shoulder severe pain, difficulty sleep soundly the night may or shoulder pain point with the local chamber closed.
2, the shoulder re-adhesion, could add rubbing moist heat method and should be strengthened Zhu Huanzhe functional exercise.
3, with muscular atrophy, could add local herbal fumigation.
4, combined treatment of cervical spondylosis is required at the same time.
5, by the trauma Erzhi frozen shoulder syndrome should be alert to whether the brachial plexus injury, and thus a reasonable differentiation.
6, after a stroke caused by frozen shoulder or shoulder subluxation, gentle way operation is appropriate.
Third, pay attention
1, warm: to prevent the cold wind.
2, functional exercise: bent over shaking shoulders, climbing wall activities, after the handle body , external rotation, shakes and other exercise.
II subacromial bursitis
subacromial subacromial bursa, also known structure. for it in the deltoid muscle below it is also known as the deltoid bursa and structure. is a Chinese medicine "shoulder Bi" category. subacromial bursa is the largest body synoviae, profits slip shoulder with brachial joint, greater tuberosity of humerus and the acromion to reduce surface friction effect , since the bursa folder in a large range of motion activities between the shoulder joint between the acromion and the humeral head, often caused by fatigue due to chronic wear and tear, resulting in synovial edema, or smooth wall thickening of the tissue adhesion to each other, resulting in sterile inflammation. In addition, when the shoulder when subjected to external impact, can cause acute subacromial bursitis, impeding the normal function of joints.
one diagnostic points
1, pain : Deep lateral shoulder pain, and often only point of radiation to the deltoid muscle, may also apply to shoulder, neck Bleeding, upper arm abduction, external rotation, adduction activities, pain intensified. also was pain during the outreach, while on the move but not painful. mostly progressive pain, night pain, but also its characteristics, can often wake up sore.
2, shoulder activity limitation: the upper arm abduction, external rotation, adduction, especially with the time.
3, tender point: obviously subacromial tenderness.
4, swelling: acute swelling due to synovial rounded front deltoid swelling.
5, muscle atrophy: Early shows a supraspinatus muscle atrophy and infraspinatus, deltoid muscle atrophy can occur later.
6, the differential diagnosis: The disease should go far with the supraspinatus tendon differentiated.
Second, massage therapy
(a) of the rule is:
1, the acute phase: Xiaoyu pain.
2, chronic of: blood circulation, smooth the joints.
(b) methods:
1, the acute phase: rubbing, rubbing.
2, chronic : press, kneading, holding, wiping.
(c) of the acupoints and location: shoulder, shoulder, shoulder deltoid muscle.
(d) the steps:
1, the acute phase: The patient was sitting, suffering from shoulder drooping naturally, doctors in the affected side, rubbing these points, kneading, rubbing the deltoid muscle.
2, chronic phase:
1) rubbing the points.
2) were riding, doctor Satisfy limbs and slightly outside the booth, hand-rolling method applied in the deltoid muscle at the shoulder.
3 ) facilities in the shoulder lightly rubbing method and get method.
4) in the affected area with the rubbing method, to the degree of heat penetration.
5, dialectical addition and subtraction: 1) There is limited joint function adhesion Erzhi those to strengthen the shoulder joint in the treatment of passive movement in all directions, gradually improving joint range of activities.
2) no local swelling, could with the heat.
Third, pay attention
acute phase: After treatment, it is desirable to position the brake outreach arm rest.
chronic phase: joint function limitation, should be Well The active functional exercises for the shoulder, exercise should be moderate.
III biceps tendinitis and tenosynovitis
biceps tendinitis and tenosynovitis is adhesion within the inflamed biceps tendon sheath, tendon sliding disorder in the disease. is a traditional Chinese medicine "muscle paralysis," "hurt Bi" range. is or servant sprain, chronic fatigue, energy and blood deficiency Erzhi.
First, the diagnostic criteria
1, pain: the long head of biceps tendon at the pain, and may delegate to the deltoid muscle pain may be scattered fatigue, exposure to cold or biceps contraction increased, especially in the night.
2, activity limitation: the performance of biceps contraction in the shoulder resulting limitation of activity.
3, tenderness: biceps tenderness at a sharp tendon, biceps contraction and relaxation, often palpable sense of slight friction.
4, swelling: swelling and pain may be associated with.
5, special examination : Anti-resistance test positive (biceps elbow flexion against resistance), shoulder internal rotation test was positive.
6, X-ray examination: No signs of visible bone spurs and other.
7, the differential diagnosis: The disease should biceps tendon disease such as differentiated from the shoulder.
Second, massage therapy
(a) of the Therapeutic: 1 early swelling and pain should be; 2, after the acute phase should Shujin network, promoting blood circulation.
(b) methods:
1, the acute phase: rub
2, acute post: click, rub, set aside, rubbing, shaking.
(c) of the acupoints and location: Qu Chi, Ze-foot, shoulder, shoulder. biceps tendon attachment.
(d) the steps:
1, the acute phase: patient was sitting, then stand outside the doctor, hold the affected side of the upper arm and a hand under it rotation, the hand with the palm rubbing method on the swelling, the warm feeling better and have deep penetration.
2, acute post:
1) so that when the affected arm in abduction , rubbing the points and positions.
2) with the thumb pulp and should be struck at the tenderness the direction perpendicular to the tendon, so that the tendon is struck strings as normal.
3) rubbing, shaking arm, jitter is better to spread to the shoulder.
(e) Differentiation Modified:
acute Tong Shen who can brake off position so that elbow flexion 90 °, and to sling suspension limb, so that tendon relaxation, promote healing.
Third, pay attention
1, reduced upper limb strength in a sudden move to avoid lift movement, so as not to damage.
2, note that the shoulder warm, to prevent cold stimulation.
3, exercise therapy: until the symptoms disappear, do the shoulders move, shaking shoulders, shaking shoulder and swing the shoulder and other shoulder in all directions.
supraspinatus tendinitis IV
supraspinatus tendinitis, also known as "outreach syndrome" refers to the strain or minor trauma caused by the gradual degeneration of the tendon. supraspinatus muscle in the shoulder, is focused on the intersection of shoulder strength, force in the Quartet, it is easier to strain the muscles, especially shoulder abduction 60 ° -120 ° when the supraspinatus muscle to be below the acromion and the humeral head through the narrow gap above, suffering from shoulder coracoacromial ligament and the friction, easy to damage caused by friction and tendon squeeze sterile inflammation. The disease occurs in about 40 years old manual laborer. in the clinically acute, sub acute and chronic onset of three cases. of which the most common sub-acute attack.
a diagnosis of points
1, pain: shoulder pain and lateral attachment points spread to the vicinity of the deltoid muscle. Sometimes the pain can radiate into the neck upward and downward radiation to the elbow, forearm and fingers.
2, arc of pain: shoulder abduction 60 ° -120 ° range, severe pain. even affect the activities of limited mobility to the shoulder.
3, tenderness: arrived in the supraspinatus tendon only humeral greater tuberosity at the point of significant tenderness.
4, muscle atrophy: the course of time can lead to shoulder muscle atrophy.
5, X-ray examination: no special signs.
6, the differential diagnosis:
1) supraspinatus tendon calcification: clinical manifestations of the two similar. supraspinatus tendon calcification in the X-ray can be seen on the calcification.
2) the disease should shoulder subacromial bursitis and other diseases be differentiated.
Second, massage therapy
(a) of the rule is: blood circulation, Shujin meridians.
(b) means: press, kneading, and pinch to take, plucked, shake, shake, rub.
(c) of the acupoints and location: Qu pool, lack of pots, day cases, shoulder, arm. supraspinatus tendon only point.
(d) the steps:
1, rubbing the points and the supraspinatus tendon only points for the degree of soreness.
2, rub, pinch the shoulder, upper arm muscles, plucked supraspinatus tendon.
3, Central, turn shaking the shoulder, led by the shaking ipsilateral upper extremity.
4, rub the affected part, to the degree of heat penetration.
(e) Differentiation Modified:
of acute pain, should be gentle approach ease, such as the onset of severe cases of cervical wrist strap can be used, with the rest.
Third, pay attention
Zhu Huanzhe active treatment should be the function of the shoulder joint exercises, and with the heat . V humerus, the internal epicondylitis,
humeral epicondylitis, also known as external humeral syndrome, tennis elbow, bursitis brachioradialis, extensor carpi radialis tendon injury starting point. is Chinese "muscle paralysis," "hurt Bi" category. The disease mostly occurs in middle-aged, and long-term strain is closely related.
humeral epicondylitis, also known as golf elbow. Department of General of flexor tendons of the forearm attachment of chronic fatigue, and the corresponding external humeral condyle, located in the ulnar, but the incidence than "tennis elbow" less, the ratio is about 1:7.
olecranon bursitis, and said the miners elbow. Department of traumatic disorders of the disease. olecranon bursa has two, are not interlinked with the joint cavity. One is located between the skin and the olecranon on the back, the other located in the triceps tendon with olecranon bone surface between bursitis, mainly in the shallower the former.
one diagnostic points
(a) of the humeral epicondylitis:
1, pain : Posterolateral elbow pain, especially in the rotation dorsiflexion, mention, pull side, push the pain is more severe when such action. Meanwhile Yanshen radiation down the wrist muscles.
2, inability to: forearm rotation and inability to grip things.
3, tenderness: epicondyle of the humerus and the brachioradialis at the joints was tenderness, and Yan Shen broad direction of travel of wrist muscle tenderness. locally was slightly swollen.
4, a special examination: extensor tension test positive, mil Mill
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