Was it not for a acupuncture course in sri-lanka many years ago with the late prof. Anton Jayasuriya , then I would probably still not know what to do with the various shoulder-conditions described extensively in your paper and so commom in general practice. Really one just needs only one's thumb!! Far better still, one single needle. In at least half of the patients with a "shoulder-condition" [ with purpose I don't define frozen shoulder, rotator cuff etc] , even longstanding cases, one can see a miraculous improvement within a minute or so of pressure [even better by needling] on the acupuncture point : stomach 38. This is improvement may be