Small Intestine Meridian
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SI-11
Safety Warnings
- Dangerous point - requires extra caution
- Deep needling contraindicated - shallow insertion only
Needle Depth
0.5–1.5 cun
Needle Angle
90° (Perpendicular), 45° (Oblique)
Body Area
Shoulder, Back — Upper (Thoracic)
Location
In the intrascapular fossa, at the junction of the upper and middle third of the distance between the lower border of the scapular spine and the inferior angle of the scapula.
Main Actions
- Opens the Channel
- Opens the chest
- Benefits the breasts
Indications
Elbow pain
Breast pain
Scapula pain
Breast lumps
Shoulder pain
Chest fullness
Low milk supply
Breast hardness
Lateral costal region pain
Commentary
Like its neighboring point Jianzhen SI-9 and Naoshu SI-10, Tianzong SI-11 is also effective in opening the Channel, so as to treat stiffness and pain of the shoulder as well as scapula. It should always be checked for sensitivity when selecting local points for Painful Obstruction Syndrome.
A Reducing Needling Technique should be used for needling, followed by moxa.
Another function of this point is to open the chest, so as to relieve pain and fullness in the chest and lateral costal regions. For postpartum women, it also benefits the breasts by relieving breast abscess and engorgement. Therefore, it increase breast milk supplies.
Classical Sources
《針灸甲乙經》(Zhēnjiǔ Jiǎyǐ Jīng - The Systematic Classic of Acupuncture): "肩重，肘臂痛不可舉，天宗主之" (Heaviness of the shoulder, pain in the elbow and arm with inability to lift - Tianzong governs this).
《銅人腧穴針灸圖經》(Tóngrén Shūxué Zhēnjiǔ Tújīng - Bronze Man Acupuncture Classic): "主肩胛痛，臂肘外後廉痛，頰頷腫" (Governs scapular pain, pain on the outer posterior aspect of the arm and elbow, and swelling of the cheek and jaw).
Name etymology: The name Tianzong (天宗) means "Celestial Gathering" or "Heavenly Ancestor." Tian (天) refers to heaven or the upper part of the body. Zong (宗) means ancestral temple, gathering place, or something revered. The point is named because it sits centrally among surrounding points like Quyuan SI-13 and Bingfeng SI-12 "like stars in the heavens," acting as a central gathering point where Qi ascends toward heaven.
How to Locate
The patient is better to be seated in a relaxed way with arms hanging down. Draw an imaginary line from the midpoint of the scapular spine to the inferior angle of the scapula. Tianzong SI-11 is located at the junction of the upper and middle third of this line, in a depression on the infraspinatus muscle, which is often sensitive to pressure. Also, Tianzong SI-11 is generally at the same level as the gap between the 4th and the 5th spinous process (T4 and T5).
Caution
The scapula may have a natural foramen (opening) that could allow the needle to pass through toward the thoracic cavity. Do not needle deeper than recommended depths. If the needle does not contact bone at normal depth, do not insert further. Best needled with patient sitting upright. Use oblique insertion for thin patients to avoid penetrating too deeply. Always ensure proper angle to prevent pneumothorax risk.
Needle Angle
90° (Perpendicular) / 45° (Oblique)
Depth Category
Medium
Standard Depth
0.5–1.5 cun
Needling Directions
0.5–1.5 cun vertically or obliquely into the muscle tissue.
Expected Deqi Sensation
Local distending and aching sensation that typically radiates toward the shoulder joint. When needled obliquely toward the axilla, sensation may extend down the arm. Some patients experience a characteristic warmth spreading across the scapular region known as "穿胛熱" (chuān jiǎ rè - warmth penetrating the scapula). The point is often tender on palpation, especially in patients with shoulder problems.
Moxibustion
Recommended
Duration: 10–15 minutes
Cupping
Recommended
Bloodletting
N/A
Gua Sha
Recommended
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