Quyuan (SI13): The Inner Corner of the Shoulder Blade, for a Knotted Upper Back

Where Quyuan Sits

This point sits on the upper back, on the shoulder blade, close to the spine. Across the back of each shoulder blade runs a hard ridge of bone. It starts at the shoulder tip and slants down and inward toward the spine, ending a few finger-widths from it. The point lies in the small hollow just above that inner end of the ridge.

It belongs to the line that Vietnamese and Chinese texts call the Small Intestine channel. That line begins at the outer corner of the little fingernail, runs up the back of the forearm and arm, and then zigzags across the shoulder blade before climbing the side of the neck to the ear. This is the thirteenth stop, the innermost point of that zigzag, the place where the line comes closest to the spine.

The modern standard from the World Health Organization places it in the scapular region, in the depression just above the medial end of the spine of the scapula. In plain words: above the inner end of the shoulder blade ridge. The standard adds a check: the point lies halfway along a line from the second bump of the upper back out to the hollow at the back of the shoulder, below the outer end of the ridge.

Under the skin lies the broad trapezius, the muscle that shrugs the shoulders and holds them back. Beneath it, the small muscle that lifts the arm, the supraspinatus, begins in the hollow above the ridge. Close by, the muscle that runs up to the neck, the levator scapulae, fixes onto the upper inner corner of the shoulder blade. The skin is served by back branches of the upper chest nerves. The muscles beneath are served by the nerve of the trapezius and the nerve that runs over the top of the shoulder blade.

Why This Spot

On the anatomical side, this is a crowded corner. Three muscles that steady the shoulder blade meet or pass here. When you sit forward over a table, a book or a phone, the shoulder blades slide out and these muscles hold the strain. After fifty, many people round the upper back a little more each year. The neck pushes forward and the muscles at the inner top corner of the shoulder blade work harder to hold the head up. They tighten into a knot that many people describe as a stone under the shoulder blade. This spot sits right on that knot.

In this tradition, the Small Intestine channel governs the back of the shoulder and the shoulder blade. Its points on the shoulder blade are used when the shoulder aches at the back, the neck will not turn, and the arm feels heavy. This one, the closest to the spine, is the point for the ache that sits deep between the shoulder and the backbone.

The name paints the bone. Qu means crooked or curved; yuan is a wall around a garden. The curved wall is the ridge of the shoulder blade, and the point sits inside its curve. Its Vietnamese name, Khúc Viên, carries the same picture.

What the Old Texts Say About Quyuan

The Systematic Classic of Acupuncture and Moxibustion, the Jiayi Jing, compiled by Huangfu Mi in the third century, places this point in the middle of the shoulder, in the hollow of the curved shoulder blade.

Classical acupuncture texts list it for pain and numbness wrapping around the shoulder blade. Later Chinese manuals add stiffness and cramping of the shoulder and back.

The Vietnamese handbook of points and channels by Ngô Trung Triều, published by Hồng Đức, places it near the hollow above the ridge of the shoulder blade, and lists it plainly for pain of the shoulder joint. Its method for finding it uses a line down from the top of the shoulder, then searches the hollow above the ridge.

Notice how small the list is. Many points carry long lists of complaints. This one has one job in the old books: the shoulder and the shoulder blade. That narrow focus tells you how it was used: as a local point, pressed where it hurts, for people whose shoulders had grown stiff from years of work. That reputation rests on long use rather than proof.

Points That Work With Quyuan

The first partner sits further out on the shoulder blade, in the centre of the hollow above the bony ridge, about level with the middle of the ridge. It works the same muscle that lifts the arm. In this tradition the two are pressed one after the other, inner point first, then outer, when the whole top of the shoulder blade aches.

The second sits below the ridge, in the middle of the flat part of the shoulder blade, about a third of the way down. It is often very tender. Pair it with this one when the ache spreads across the shoulder blade and down the back of the arm.

The third sits on the top of the shoulder, halfway between the base of the neck and the shoulder tip, on the highest part of the thick muscle there. Pair it with this one when the shoulders creep up toward the ears and the neck feels tight.

How to Find and Press Quyuan

Getting Into Position

Be honest about reach. Most people cannot press their own shoulder blade well with their hands, and a stiff shoulder makes it harder still. That is normal. Stand with your back to a wall, feet about a foot out from it, knees soft, and use a tennis ball between your upper back and the wall. A stick with a rounded end, hooked over the opposite shoulder, also reaches the point. If your shoulders are free, you can try the middle fingertip of the other hand, reaching over the front of the shoulder, but the arm tires quickly.

How to Find It

Reach over your shoulder, or ask someone to help the first time, and find the hard ridge across the back of the shoulder blade. Follow it inward, toward the spine. It ends about three finger-widths from the bumps of the spine, at about the level of the second bump of the upper back. Just above that inner end, the finger drops into a small hollow. That is the area.

Place the ball there and lean back into it slowly. Crossing the arm of that side over your chest slides the shoulder blade out and opens the area. Shift in small steps, a little up, down, in and out. Much of it will feel like ordinary pressure on muscle. One spot will sting: a small, sharp, pinpoint tenderness deep under the ball. That spot is the point. Hunt for the spot that stings, because that's the one.

How to Press It

Once you are on the stinging spot, stay on it. Bend and straighten your knees a little so the ball rubs in small circles about the size of a coin, roughly one each second, without rolling away. With a stick, hold the handle steady with both hands, place the rounded tip on the spot and pull gently to make the same small circles. Do not press on the bony ridge itself or on the bumps of the spine.

How Much Pressure

A sharp sting under the ball is right. When you step away, it should fade within moments. If the pain stays after you lift off, spreads, or the area turns swollen, hot or red, stop and leave it for several days. Stop at once for tingling or numbness down the arm. If you are holding your breath, or your shoulders have crept up toward your ears, you are pressing too hard. Step your feet a little closer to the wall so less of your weight goes into the ball, and breathe slowly through the sting.

How Long

One to three minutes on each side. Keep the first sessions to about a minute, because the muscles here can feel bruised the next day. Add a little time over the following days, up to three minutes. Work both sides, even when only one complains. Once or twice a day is plenty.

When to Do It

Mid-morning or late afternoon suits the ache that builds after time at a table, a sewing machine, a screen or the steering wheel. A short session in the middle of a long sitting task can break the build-up. Before bed is a good time too, if the shoulder blade makes it hard to settle. Do not press in the middle of the night. If the ache wakes you, change position and save the pressing for the day.

What This Won't Do

It will not change the shape of your spine or the wear in your neck joints. A rounded upper back and a forward head build up over decades, and no point reverses them. Pressing here can ease tight, tender muscle and give you a few easier hours, which is real and worth having. Results vary from person to person. What changes a stiff upper back over months is plainer: getting up from the chair every half hour, squeezing the shoulder blades gently back and down a few times, a screen or book raised to eye level, and a pillow that keeps the neck level at night.

It is also no substitute for a diagnosis. Pain between the shoulder blades can come from inside the chest, not only from muscle. Call for emergency help for upper back pain that comes on suddenly with chest pain, breathlessness, sweating, sickness, or pain in the jaw or arm. See a doctor promptly for upper back pain with fever, weight loss you cannot explain, pain that is worse lying still at night, or numbness or weakness in the arms.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy, or over a mole or skin lump. Leave the area alone after a recent fall onto the back or shoulder, a known fracture of the shoulder blade or ribs, or recent shoulder or spine surgery. If you take blood thinners, bruise easily, or have thin bones, use a softer ball, lean in less, keep sessions short, and ask your doctor first.

Stop at once if pain stays after you lift off, spreads, or brings tingling or numbness. Nothing here requires you to push through pain. For the full list of cautions and the situations where pressing on yourself is not appropriate, read the full safety guide before you begin.

Questions People Ask

Where is the Quyuan (SI13) pressure point? Quyuan (SI13) lies on the upper back, in the hollow just above the inner end of the bony ridge that crosses the shoulder blade. It sits a few finger-widths out from the spine, at about the level of the second bump of the upper back. In Vietnamese it is called Khúc Viên.

How do I press a point on my shoulder blade I cannot reach? Most people cannot press their own shoulder blade well with their hands, especially with a stiff shoulder, and that is normal. Stand with your back to a wall and lean on a tennis ball placed over the spot. A stick with a rounded end, hooked over the opposite shoulder, also reaches it. Some people can reach it with the middle fingertip of the other hand, over the front of the shoulder.

Can Quyuan (SI13) help a knot under my shoulder blade? In this tradition it is commonly used for a stiff, aching shoulder blade and the tight band between the shoulder and the spine. Pressing can ease tight, tender muscle for a while. It will not change posture or worn joints on its own, and results vary.

Why does the spot sting so much? Muscles that hold the shoulder blade in place work all day and often carry small tight, tender spots. A sharp, pinpoint sting under the ball is the sign you have found the point. When you step away, it should fade within moments. If pain stays after you lift off or spreads, stop.

How long should I press Quyuan? One to three minutes on each side. Keep the first sessions to about a minute, then add a little as the days go on, up to three. Once or twice a day is enough. Work both sides, even if only one side aches.

Other Points in This Library

Each of these sits within reach of the same hand. They are often worked in the same sitting.

This page shares general information about a traditional practice. It is not medical advice and does not replace what your doctor has given you. If you are pregnant, managing a health condition, or unsure whether this applies to you, check with your doctor first.

The whole inner edge of the foot, laid out on one page with photographs, is in The Foot Map — the free book. For every point in this library, see the full pressure point index.

(Point shown: SI13 · Quyuan · Crooked Wall · Khúc Viên.)