XXX, male, 47 years old, was admitted to the hospital with the main reason of “unfavorable left limb movement for 5 months”. Diagnosis: recovering from cerebral infarction hypertension grade 3 (very high risk) hyperlipidemia Major impairment: post-stroke shoulder pain. NRS score: 8/10, knife-like pain, episodes of about 3-4h/d, nighttime, unable to lie down, poor sleep, need to take oral painkillers to relieve 2, left shoulder in internal rotation position, internal rotation muscle group is obviously tense, hard to palpation 3, left upper limb can not complete functional movement; left elbow can be flexed, forearm weak rotation, left wrist dorsiflexion difficulties, with The left upper extremity had increased muscle tone, grade 2 internal shoulder rotators; grade 1+ elbow flexors; grade 2 forearm rotators, grade 2 wrist palmar flexors and finger flexors. Key problem: Relieve shoulder pain: The patient refused injection therapy and conventional OT training due to pain. Treatment idea: Correct the abnormal left periapical tension, restore the shoulder-humeral rhythm and relieve shoulder pain. Treatment method: (1) adjust scapular position to improve scapular mobility; (2) left shoulder internal rotator relaxation maneuver; (3) joint loosening: left shoulder sliding back and forth with abduction and rotation, sliding up and down with flexion and extension, keeping the joint mildly separated during treatment and loosening within the pain-free range. Discharge status: left shoulder pain significantly relieved, NRS score 3/10, soreness and swelling, can lie flat at night, sleep improved, no need for oral pain medication; episodes significantly shortened, about 0.5h/d; left upper limb muscle tone grade 1+; left thumb, index and little finger appeared partially extended; left shoulder can be forward flexed to 90°-100°, abducted 90°, externally rotated 45°.