Tianliao (TE15): The Upper Back Point for Neck and Shoulder Tension

Where Tianliao Sits

This point sits on the upper back, on both sides, in the dip right above the top inner corner of the shoulder blade, about a thumb's width down the back from the high ridge of muscle on top of the shoulder.

The line it belongs to begins at the outer corner of the fourth fingernail, the ring finger. It runs over the back of the hand, up the middle of the back of the forearm between the two bones, over the point of the elbow and up the back of the upper arm to the shoulder. From here it crosses the top of the shoulder, runs up the side of the neck and circles the back of the ear to end at the outer end of the eyebrow. Vietnamese and Chinese texts call it the Triple Energizer channel. This is its fifteenth stop, the last one on the back before the line turns up the neck.

The shoulder blade has three corners. The top inner one, closest to the neck, is the landmark. The World Health Organization standard of 2008 places this point in the depression right above that corner. The Vietnamese handbook by Ngo Trung Trieu gives a second way: it sits in the hollow above the ridge of the shoulder blade, halfway between the point on top of the shoulder and the point at the inner end of the ridge. In plain terms, find the middle of the high ridge of muscle on top of the shoulder, then move about a thumb's width down the back and very slightly in toward the spine. The corner of the blade is under your fingertip there.

Three muscles layer here. On top is the broad, flat muscle of the upper back and neck (the trapezius). Beneath it, the muscle that fills the hollow above the ridge of the shoulder blade and helps lift the arm (the supraspinatus) begins. And right below the point, the muscle that lifts the shoulder blade toward the ear (the levator scapulae) attaches to the top inner corner. That attachment is one of the most common sore spots in the whole upper back. Different nerves serve the three muscles, including the accessory nerve from the skull and the dorsal scapular nerve from the neck.

Why This Spot

On the anatomical side, this is the place where shoulder tension collects. When the shoulders creep up toward the ears with worry, cold or concentration, the muscle that lifts the shoulder blade does the lifting, and its lower end, at the corner of the blade, takes the strain. When the head drifts forward, the same muscle holds it back. Many people in their fifties, sixties and seventies have a knot here that they can feel through a shirt.

In this tradition the point is described as a meeting place. The line of the side of the body and a second line of the outer arm cross here, together with a deeper vessel said to link the yang channels. That is why teachers use it for complaints that seem to sit between the neck and the shoulder: a neck that aches when you look up, a shoulder that feels heavy, an upper back that will not relax. The name describes the spot: a crevice, a gap in the bone, high on the body, close to the sky. Its Vietnamese name, Thiên Liêu, carries the same picture.

What the Old Texts Say About Tianliao

The Systematic Classic of Acupuncture and Moxibustion, the Jiayi Jing, compiled by Huangfu Mi in the third century, records this point as a meeting point: of the arm and leg channels of the side of the body, and of a deep linking vessel. That status is part of why later teachers gave it more attention than its small size might suggest. A point where several lines cross was thought to influence all of them.

The Vietnamese handbook of points and channels by Ngo Trung Trieu, published by Hong Duc, lists it for pain of the shoulder and the shoulder joint, and for an aching, tired neck. The list is short and stays close to the point. That is a useful reminder. The old writers did not use every point for everything; they used this one for the neck and shoulder, and so do we.

The WHO standard of 2008 kept its place above the top inner corner of the shoulder blade. Because the corner is a firm bony landmark, the point is easy to find on yourself or on a partner, even through some padding. If you have someone to help, ask them to feel for the corner of the blade while you shrug your shoulder slowly; the corner moves up and down under their fingers.

In the wider tradition, teachers often work the top of the shoulder as one band: the point beside the base of the neck, this point at the corner of the blade, and the point on top of the shoulder. Pressing them in turn is a way of unwinding the whole band. That habit comes from long practice rather than proof, but it matches what most people feel: the tightness runs along that band, not in one spot.

Points That Work With Tianliao

The first partner sits on top of the shoulder, halfway between the base of the neck and the bony tip of the shoulder, on the thick ridge of muscle you squeeze when someone rubs your shoulders. It is about a thumb's width above and in front of this point. In this tradition the two are commonly pressed one after the other for tight shoulders.

The second sits closer to the spine, at the base of the neck. Bow your head, find the bony bump that sticks out most where the neck meets the back, then move about three finger-widths out to the side. It is used with this one when the stiffness reaches into the neck.

The third is on the forearm. Turn your palm down and find the wrist crease on the back of the wrist. Measure about three finger-widths up the forearm, in the groove between the two bones. It belongs to the same line as this one, and teachers often press it first, at the wrist, before working the shoulder.

How to Find and Press Tianliao

Getting Into Position

You can reach the top of the shoulder with your own hand, but the corner of the shoulder blade is further down, and stretching for it can strain a stiff shoulder. Use a tool or a ball instead. For a tool, sit upright on a firm chair and hold a long-handled pressing tool, the hooked or S-shaped kind, in the hand opposite the side you are working, with the hook over that shoulder. For a ball, stand with your back to a wall and place a firm ball, such as a tennis ball, between the wall and your upper back, on the corner of the shoulder blade. Let your arms hang loose.

How to Find It

Start with the landmark you can reach. With the opposite hand, squeeze the thick ridge of muscle on top of the shoulder, halfway between the neck and the shoulder tip. From there, slide about a thumb's width down the back and slightly toward the spine. Shrug the shoulder slowly: you may feel the corner of the shoulder blade lift under your fingers. The point is in the dip right above that corner. That is the area.

Now probe the area with the tool's rounded tip, or with the ball by bending your knees slightly and shifting your weight in small steps. Most of it will feel like firm muscle. One spot will sting: a small, sharp, pinpoint tenderness. That spot is the point. It often feels like a hard knot or a grain under the skin. Start gently; this one is usually tender.

How to Press It

Keep the tip or the ball on the stinging spot and rub in small circles, about the size of a fingernail, roughly one each second. Aim the pressure straight down into the upper back, toward the front of the body. With a tool, make the pressure by pulling the handle with your front hand, not by tensing the shoulder you are working. With a ball, make the circles by shifting your weight. Keep the tip on the same spot; do not let it slide across the muscle.

How Much Pressure

A sharp sting under the tip is right. That small sting tells you that you are on the point. The test is what happens when you lift off: the sting should fade within moments. If the pain stays after you lift off, if it spreads, or if the area turns swollen, hot or red, stop and leave it for several days. If you are holding your breath or your shoulder creeps up toward your ear, you are pressing too hard. That shrug is the very habit that made the knot, so let the shoulder drop and lighten the pressure.

How Long

Work each side for one to three minutes. Keep the first sessions to about one minute, because this knot is often very tender at the start. As the days go on, add a little time, up to three minutes. Do both sides, even when only one complains. Once or twice a day is plenty. Pressing longer adds soreness, not benefit.

When to Do It

Mid-morning suits shoulders that are stiff on waking, once you have moved around a little. Late afternoon suits the tension that builds through a day of reading, screen work, cooking or driving. Before bed is a good time too, as part of winding down, so the shoulders drop before you lie down. Do not press in the middle of the night. If a tight neck or shoulder wakes you, pressing then tends to wake you further. Keep the pressing for daytime and the evening.

What This Won't Do

It will not take away the reason your shoulders are tight. Tension at the top of the back often comes from holding the shoulders up, from the head drifting forward, from carrying bags on one side, from wear in the neck, or from worry that settles in the body. A point at the corner of the shoulder blade cannot argue with any of that. Pressing works best alongside the plain things: noticing when your shoulders creep up and letting them drop, raising your screen to eye level, gentle shoulder rolls, and moving every half hour.

It will not replace a diagnosis either. Neck or shoulder pain after a fall or an accident needs to be checked first. Numbness, tingling or weakness in the arm or hand needs to be seen, because it can come from a pinched nerve in the neck. Pain across the shoulders that comes with pain in the chest, jaw or arm, with sweating or with breathlessness, needs emergency care, not pressing. A shoulder ache that keeps you awake every night, worsens week on week, or comes with weight loss you cannot explain belongs with a doctor.

Safety First

Do not press over skin that is broken, burned, infected, badly bruised or rashy. Leave the area alone after a recent neck or shoulder injury or surgery, and with any lump or swelling there. If you have osteoporosis, ask your doctor before using a ball against the wall, and keep the pressure light. If you take blood thinners or bruise easily, use lighter pressure and keep sessions short.

Stop at once if the pain stays after you lift off, spreads, or if the area becomes swollen, hot or red. Stop too for any dizziness, tingling or numbness down the arm. Nothing here requires you to push through pain. For the full list of cautions, read the full safety guide before you begin.

Questions People Ask

Where is the Tianliao (TE15) pressure point? Tianliao (TE15) sits on your upper back, on both sides, in the dip right above the top inner corner of the shoulder blade. Find the thick ridge of muscle on top of the shoulder, halfway out, then move about a thumb's width down the back. In English it is called the Heavenly Crevice; in Vietnamese, Thiên Liêu.

How do I reach Tianliao on my own back? A long-handled pressing tool, the hooked or S-shaped kind, is the easiest. Hold it in the opposite hand and hook the rounded tip over your shoulder onto the spot. A firm ball, such as a tennis ball, between your upper back and a wall also works. If your shoulders are flexible, you can reach it with the thumb tip of the opposite hand over the shoulder, but do not strain to get there.

How long should I press Tianliao? One to three minutes on each side. Start with about a minute, because this knot is often very tender, then add a little time over the days, up to three. Once or twice a day is enough. Work both sides.

Is this the knot I feel at the top of my shoulder blade? Very often, yes. A muscle that lifts the shoulder blade toward the ear attaches to the top inner corner of the blade, right below this point. When the shoulders are held up with tension or the head drifts forward, that attachment gets sore and knotted.

How is it different from the point on top of the shoulder? The point on top of the shoulder sits on the high ridge of muscle, halfway between the neck and the shoulder tip. This one is about a thumb's width further down the back, on the corner of the shoulder blade. The two are close partners and are often pressed one after the other.

Can I press it if my arm goes numb at night? Mention numbness in the arm to your doctor first, because it often comes from the neck and should be checked. Once it has been looked at, gentle pressing here in the daytime is fine. Do not press in the middle of the night; wait until morning.

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: TE15 · Tianliao · Heavenly Crevice · Thiên Liêu.)