How to Assess Shoulder Pain and Instability with The TAOFit Method

Assess Shoulder Pain and Instability

The 5 Primary Kinetic Chains
“The 5 Primary Kinetic Chains” by Dynamic Neuromuscular Assessment. On my list of “must-have” poster sets (link below). https://dna-assessment.com/product/applied-anatomy-set/

This class is an example of how the TAOFit Method can be used to assess shoulder pain and instability.

As an assessment, I am looking at gait mechanics through a neuro-muscular-fascial-structural lens. Assessing the relationships between the anterior and posterior core spirals of the wrist, arm, shoulder, and spine through the thoracolumbar fascia to the contralateral hip, knee, and foot. 

Below is a case study (I am the subject). The class is 64 minutes followed by a brief Q&A. In the Q&A, I dive a bit more into the movement anatomy and theory of The TAOFit Method.

Case Study:

Two weeks ago, I participated in a men’s gathering in the rugged mountains of southern Oregon. It was a phenomenal weekend with an amazingly diverse group of masters. Over two days, we did a navigation challenge (maps and compasses). I hiked up and down steep gorges 10+ miles the first day and 15+ miles the second day. This was a significant increase in movement volume and intensity compared to my general conditioning program.

Afterward, I experienced minimal pain and noticeable swelling in the right knee joint (loss of about 10-20 degrees of deep knee flexion). Totally normal for me considering the circumstances and nothing unexpected. Overall, my body held up better than expected. 

A brief and incomplete injury history:

Going back to 1998, I’ve had six total knee surgeries. Both knees experience true instability with the tendency for pain, inflammation and/or swelling after intense physical challenge.

The right knee has a full PCL rupture. Due to true PCL instability, there is a significant shifting of the femoral head on the tibial plateau with every step, lunge, and/or squat.

  • Two PCL reconstructions with partial meniscectomy (1998 & 1999) – PCL reconstruction failure both surgeries 
  • Two surgeries to clear staph infection (1999 & @ 2002)
  • One ACL reconstruction with partial meniscectomy (2006)
  • Signs of degenerative arthritis via X-Ray over the years

The left knee has some medial meniscus removed (affecting tibiofemoral stability). The head of the femur has a tendency to slide off the tibial plateau when in a deep knee bend with tibial rotation

  • A partial meniscectomy (2016 or 2017) 

As well as multiple concussions, whiplash incidents, and other joint traumas from years as a competitive athlete (college basketball) and a self destructive lifestyle (not taking care of my body).

Returning Home

I drove back home from southern Oregon to Austin, Texas with my son. The drive was 32 hours. We completed it in 41 hours. Two days of hard-driving – i.e. sitting, and next to zero restorative movements (I’m a bit of a masochist 😊).

The first day back, a neighbor gave away a 4×8 foot piece of solid plywood (weighs between 60-85 lbs). I loaded it by myself into the truck, As I lifted the board, my nervous system spoke loudly. I felt my left shoulder become neurological unstable and mildly painful (3 to 4 on the pain scale of 10). Not terrible, but definitely “off”. As the day progressed, left shoulder stability continued to deteriorate, especially with stabilizing away from the midline of the body through the elbow and hand (example – getting up from the ground). Stability remained solid and non-painful with carrying and hanging. But active pull-ups felt unsafe.

As I took some quality time to self-assess movement, using the above template, I noticed significant core imbalances in the core relationships between the posterior left shoulder to the contralateral right hip, knee, and foot.

Hypothesis

The current hypothesis that I’m working with is that the active inflammation and swelling caused neurological instability within the knee. This had a cascading affect to the complex relationships between the right foot, hip and spine (and from the spine it can spill out into anything and everything).  As a secondary stability strategy, my left shoulder compensated by neurologically increasing the bracing patterns around the shoulder complex. (examples of bracing patterns – humeral compression within the glenoid fossa and humeral internal rotation to wind up the fascial spiral). 

As a protective mechanism, this bracing strategy (i.e. compensation) generates greater structural stability within the contralateral hip and shoulder during the loading phase of gait mechanics (walking, running, crawling, climbing, swimming). This is a fantastic strategy for a wild human. It allows us to keep moving while preventing a more devastating injury. 

Basically, with each step, my left shoulder was neurologically tasked to provide greater stability and tension to support an unstable right knee related to gait. When I lifted the bulky plywood, it blew out the neurological stability of the shoulder complex (analogous to blowing a circuit breaker). 

Assess Shoulder Pain and Instability and Resetting the Circuit

Through the movement assessment, I am comparing the quality of movement at the edges of range of motion that are pain-free vs. pain-“yes”. I am using pain as a guide to building a highly sensitive movement map (i.e. where can I move safely, non-painfully, and with solid motor control).

At the same time, I am slowly exploring the edges of the map. The goal is to restore joint-by-joint neurological connection, integration, and stability. Slowly challenging each segment to connect into larger and larger multi-segment chains.

This doesn’t always happen in a single session. Depending upon the injury history, it can take days, weeks, or months to fully integrate. However, the results tend to be powerful. My shoulder isn’t 100%. But within the first 2-3 days, I’ve had 70-80% improvement in pain level, stability, strength, and function. Between 4-7 days, the shoulder is at 80-90% with the addition of light push-ups, pull-ups and climbing. 

Findings of Interest from Assessment:

  • Imbalance of core integration related to gait
    • Anterior Spiral – right hip to left shoulder 
    • Posterior Spiral – left hip to right shoulder
  • Lumbar spine
    • Neurologically “stuck” in right lumber lateral flexion T12-L5 & Sacrum 
  • Thoracic spine
    • Neurologically “stuck” in left lateral flexion
    • Possible disc degeneration and/or spinal nerve impingement on the left between T6-T10 
  • Spinal compression C3-T1
    • Neurologically “stuck” in left rotation and lateral flexion
    • Possible vagal nerve impingement causing occasional heart arrhythmia (atrial fibrillation with tachycardia)
    • Movement restriction in left rotation and left lateral flexion
  • Left shoulder
    • The humerus is “stuck” in compression (posterior capsule) and internal rotation
    • Movement restriction and Pain with external rotation
  • Right hip
    • Neurologically “stuck” in compression
    • Movement restriction with external rotation 
  • Left hip
    • Neurologically “stuck” in anterior compression

Gift Economy

My movement practice is something deeply Spiritual. This movement philosophy is a part of a daily practice. A method of movement that I have cultivated over decades of study with many amazing teachers. It requires consistency, something I occasionally fall short. But considering my long and well-earned injury history, the more consistent I am in this practice, the more I able to participate in cool adventures like hiking 10-15 miles through the mountains. Something, after the first knee surgery, the doctors told me I’d never be able to do again. 

Structurally, at the age of almost 48, my body has the physical wear and tear of an 80-year-old, yet I experience less physical pain and greater overall freedom of movement, skill, and capacity than many 30-year-olds. Considering I’ve had six knee surgeries with true joint instability in both knees, I maintain a pretty solid level as a highly functional, Dysfunctional mover.  My hope is to be able to play in the rugged mountains well into my 90’s. If successful, this video holds a few of the secrets that I’ve learned.

I hope you find value in this class. If so, I would love to hear your feedback.  What did you discover? Please post a comment below. If it was a “super awesome” discovery, it would be super awesome if you liked, subscribed, and shared this video with your tribe. Tell us about your discovery and tag The Art of Fitness on the post. It helps us to grow The TAOFit tribe.

If you are

  • Experiencing chronic physical pain
  • Experience pain with any of these movements
  • Find these movements to be extraordinarily challenging
  • Are a Movement Coach/Teacher who wants to learn about movement assessment
  • Or are simply interested and ready to change your life by developing a daily natural movement practice

Read the Rules of Pain

 

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You can start the journey at $10/month. Your support helps us create more amazing content and promote The Movement Movement. 

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Continue reading “How to Assess Shoulder Pain and Instability with The TAOFit Method”

Knee Surgery Rehab – 12-Weeks post op – Movement Restoration Class

This class was written for a client who is 12 weeks out from knee surgery and has been cleared from PT. She can do full range squats and split squats without pain, although, there is a noticeable imbalance (potential instability) between the surgery and non-surgery knees.

This video is a resource for Patreon subscribers who are working directly with TAOFit to help them recover from knee pain and/or injury. The class is recommended for anyone who can perform squats and split squats without instability or pain. Give it a go and let us know how you feel.

Please consult a physician or contact Jesse James directly prior to following this video.

If you are dealing with rehab for knee surgery, or any other injury or pain (read the Rules of Pain here), please schedule a free consultation with Jesse James prior to following any of these videos.

The focus of the class is on building the functional relationships between the foot, knee, hip, and spine through get-up variations. Not only are these movements fantastic for maintaining foot, hip, and spinal mobility, they are also incredibly practical. The ability to get up and down from the floor, in a variety of ways, improves long-term quality of life outcomes.

Rhetorical Thought Experiment:
How important will the ability to get up and down from the floor in a variety of ways feel when you are 90?

One of the benefits of receiving an online consultation with TAOFit is that you get a Movement Restoration class programmed specifically for you, and potentially anyone who may be working out similar movement problems. The bonus is that it will be posted on Youtube for future reference.

Click here to schedule a free online consultation

The Rules of Pain

The “Rules of Pain” is the most important lesson that I teach.

Know the Rules of Pain

How do you move when pain is present? Follow the rules of pain 

Pain is a form of communication from within our bodies. Generally, when it comes to our movement, it means that something is not moving well.

Ignoring pain is kind of like sticking one’s fingers into their ears and yelling loudly. Except, the longer one ignores it, the louder it becomes–until it eventually gets their attention.

A big lesson in the Mobility Restoration program that I teach is to simply slow down, become a little more sensitive to the conversations within your body, listen to your physical pain, allow it to become a guide or a coach to help you move better. Below are the simple “rules of pain” that I follow to move better, even when I am feeling pain.

Moving when pain is present

Begin by acknowledging that pain is truly present. This surprisingly is one of the hardest things to learn for clients (as well as myself). My ego likes to go hard, and sometimes going hard is not what my body needs. When it comes to moving with physical pain, I don’t want to move my body from my ego’s point of view.

The Rules of Pain

Rule 1:  Is it Painful?
The pain scale

  • This is a very important question to answer.
  • The answer is either Yes or No.
  • If you get anything other than Yes! or No!, then keep asking the question until you get either a “YES” or a “NO”.
    • If the answer is No, then great. I suggest you keep reading and save this email for the next time you are in pain.
    • If your answer is “Yes!” Stop moving! Read the Rules of Pain (read it over again each time you’re in pain).

Rule 2: Do not move into pain, but do keep moving.

How to move when pain is present
Rate your pain on The Pain Scale of 1 – nonpainful to 10 – excruciating. (I consider slight discomfort to be between 1-3 on the pain scale).

A more accurate pain scale

  • If the pain is less than 3, Slow Down!
    • Enter your movement slowly, cautiously, safely, and non-forcefully.
    • Don’t take movement beyond a level 3 on the pain scale.
  • If the pain is greater than 3, Slow down, even more.
    • No matter how slow you go, you can always go slower).
    • Make your movement smaller and less painful.
    • Keep it below a level 3, and move slowly, cautiously, safely, and non-forcefully.
  • Super Important: Don’t move beyond level 3 on the pain scale!

Going slow and exploring the edges of your painful range of movement is a wonderful space to explore the depths of your breath and heart. Be spacious, playful, open, and generous with yourself.

Jesse James Retherford

Tips for surviving Thanksgiving well

Happy Thanksgiving!

tips for surviving Thanksgiving wellI have a love/hate relationship with Thanksgiving. I love spending time with beautiful amazing people amid the gluttony of rich decadent food. I hate the way my body feels (and often looks) for the next several days, up to weeks, after being hit by the tryptophan truck.

Over the years, I have compiled a few tips to help myself, as well as clients, to not only survive Thanksgiving but to also enjoy the holiday to its fullest without some of the negative physical hangover. Some holidays have been more successful than others 🙂

Tips for surviving Thanksgiving well

Prioritize Movement

I like to strategize about how I will move my body through the holidays the same way I would run through a mud pit. Get a running head start, knowing that halfway through my legs would feel like they’re churning through thick molasses, with the hope that all that momentum will carry me through to the end. Every little bit counts.

Momentum

  • Make time for some solid movement sessions prior to all the feasts and festivities.
  • Start today.
  • Start right now.
  • On Thanksgiving Day
  • Get 30-90 second movement restoration snacks between each food serving.
  • Practice Chair Yoga wherever you sit down (it’s a great conversation starter – Seriously!)
  • Take a short walk/hike outdoors before and/or after each meal.
  • Play games
  • Post-Thanksgiving
  • Wake up early Friday morning for a coffee/tea movement flow.
  • Keep moving throughout the weekend.
  • Just. Keep. Moving.

As for the Eats

As a lover of food, I am not a good self-regulator when fat and sugary foods are in abundance. I find that the best way to prevent too much overeating is through the physiological state of being satiated with a full belly.

My strategy for satiation is:

For starters

  • make a large first plate of salad and raw veggies.
  • Use a small plate for all other servings.
  • Take my time between servings.
  • Drink water
  • Don’t beat myself up for having small servings of all of the desserts.

Share an Extra Meal – including dessert

If you have a ton of leftovers, please consider making a meal/s for someone in need. There are fewer gifts greater than that of filling an empty belly.

I hope you find these tips helpful. Do you have any tips that help you survive Thanksgiving that you’d like to share? We’d love to hear them on the TAOFit Tribe.

Thank you for living such an inspiring life. Have a wonderful Thanksgiving.
Jesse James

Vagus Nerve Entrapment Causing Atrial Fibrillation with Tachycardia – Case Study

My theory: I have a Vagus Nerve Entrapment Causing Atrial Fibrillation with Tachycardia due to the reverse curve of my neck.

History:

I occasionally get A-fib with tachycardia – an irregular heartbeat with an increased heart rate. I believe these episodes are caused by a Vagus nerve entrapment. I started having episodes in my mid to late twenties. The medical diagnosis was that it was caused by a hyperactive thyroid. At the time, my entire metabolism was haywire. I was burning over 5000 calories a day at rest, not including exercise (measured through resting and active VO2 testing) and had lost over 20 pounds in less than two months. I would experience A-fib episodes that lasted 5-8 days (day and night).

Over the years, my thyroid has returned to normal function, but I continue to have A-fib episodes, although much briefer in duration (a few to less than 24 hours). I’ve seen endocrinologists and cardiologists. They don’t know the root cause and the only solutions they have been able to offer are either pharmaceutical drugs or surgery (ie pacemaker). I tried drugs. The side effects were untenable and I’m not willing to have invasive heart surgery when the doctors really don’t understand the cause of the condition. I’ve witnessed way too many people have these types of surgeries which either didn’t solve the “problem” and often made things worse.

These episodes are not comfortable. My nervous and cardiovascular systems are in a state of overload and stress. My heart is working 25-35% harder at everything I do. It basically feels like I’m running… when I’m sitting, lying down, and sleeping. Physiologically it feels like I’m having an anxiety or panic attack. Any kind of physical activity, such as climbing stairs or working out, immediately leaves me breathless and occasionally dizzy.

Reverse curve compared to posterior curveI also have a posterior or reverse curve to my cervical spine (as seen on x-rays). The cervical spine should have an anterior curve. This is a significant structural adaptation that has more than likely developed from my extensive injury history – concussions, whiplash injuries from multiple car and motorcycle accidents, knee surgeries, and many other injuries.

Vagus Nerve (a very rough overview)

The Vagus nerve (CN X) is a cranial nerve that is directly linked to the parasympathetic nervous system, playing a role in heart rate, respiration, and digestion. The Vagus nerve helps to down-regulate or slow down heart rate after the body goes through a sympathetic “fight or flight” response – ie the massive adrenaline rush after a scary situation. In our modern world, most of us are in a constant state of stress creating a low-level “fight or flight” response. The sympathetic and parasympathetic nervous systems are constantly interacting with one another to maintain some semblance of homeostasis or balance.Vagus nerve

The Vagus nerve originates in the brainstem, traveling down through the neck (external to the spinal cord and spine). Since it travels outside the spinal cord, it is exposed to potential muscular, fascial, or structural entrapment.

My Theory

Due to the reverse curve in my neck, any kind of excess tension or restrictions in the muscle/fascia or vertebral position of the cervical region can occasionally entrap the Vagus nerve. If the Vagus nerve becomes entrapped, the electrical signals between the brain and heart (or respiratory and digestive systems) can become inhibited – ie experience some loss of signal. This loss of signal affects the balance between the conversation of sympathetic and parasympathetic related to heart rate and can cause heart rhythm irregularities. In my case, less signal to downregulate the heart rate which leads to an increased heart rate and arrhythmia.

Movement Session

Today, I am experiencing an episode of A-fib with tachycardia. There is also tension/restriction in my neck related to specific movement patterns. My focus of this session is to improve neck and spinal mobility through the combination of self-massage (using a Thera-cane and lacrosse ball) and Movement Therapy to free the Vagus nerve from entrapment. The past few times I’ve had an episode, this combination seemed to help resolve the arrhythmia pretty quickly.

When searching for the underlying root cause of a “problem”, it is easy to get into a game of the chicken or the egg. The “problem” is rarely ever found with just one simple solution. The human body is a complex system of complex systems. Each system is intricately connected to one another in a constant feedback loop. When one system isn’t working properly, it affects change and can cause other systems to stop working properly, which then feeds back into the larger system, wreaking havoc. This is just one theory that I am playing around with in my movement practice.

**UPDATE to this Case Study with Follow Along Movement Class**

Neck Mobility Vagus Nerve Flossing – Movement Therapy – Feb 04, 2021

Are you Seeking a Natural Movement Lifestyle Upgrade?

Check out the TAOFit Method Movement Mentorship. For as little as $3/month, you will gain access to a library of classes, workshops, movement snacks, and personalized TAOFit Method coaching to help change your relationship with pain and your body.
Move better. Feel Better. Life change. 
Jesse James

big feels – a pome by Jesse James Retherford

My heart stirs.
The deeper I dive…
the older the wounds I find buried within.
My heart has been locked up tight…
Prison for a lifetime…
I don’t want to hold onto this any longer.

Movement is healing…
Movement is relief…
Movement pushes me deeper,
exposing older wounds. 

To move exposes pain,
I am forced to feel and left with the choice…
bury it, lock it up tighter, and stop movement…
or surrender…
dive deeper…
and free my Self.
I will always choose freedom over confinement.

Degenerative Joint Disease of the Knee

According to scientific research studies, just the mere fact that I’ve had one reconstructive knee surgery (I’ve had three on the right knee alone), I am automatically placed in the “at risk” category for degenerative joint diseases of the knee such as arthritis (x-rays already show arthritis in my right knee), chondromalacia patellae, arthrochondritis, and a future knee or hip replacement. Having surgery alone is a risk factor, just as being over the age of 65 is also a risk factor. What is not considered a risk factor is the lack of a deep resting squat.

Many doctors (as well as quite a few physical therapists) have told me over the years that “once you’ve had just one knee surgery, you should never squat again.” Their fear and concern is that the shear forces which take place within the deep knee bend of the squat, damage the articular cartilage that protects the soft delicate structures within the joint space. This could exacerbate and speed up the process of degeneration.

I agree that this is a potential risk. And a very real risk. I take this risk very seriously considering that I will have to live with these joints for the rest of my life functional or not.

So why do I move the way I move?
More Epic with sound 😃

I disagree that squatting, or the types of movements I perform, will speed up the degenerative process. In fact, I believe the opposite. I believe these movements are vital to not only maintaining the precious joint surfaces I currently have, but they also repair and heal the joints slowing down the degenerative process.

In the 20+ years that I’ve been learning and teaching movement, I’ve seen a fair amount of degenerative knees and hips. In my estimation, not a single one of those hip joints degenerated because of a squat. A squat couldn’t cause degeneration, they hadn’t squatted in years. By my assessment, it is because they hadn’t squatted that caused the degeneration. Regular, adequate, challenging and pain-free movement is necessary for the long term health and function of your joints.

What equates to regular or adequate or challenging varies from person to person. If you are experiencing knee or hip pain and don’t know where to start, please feel free to schedule an in person or online consultation. I offer a free one-hour consultation (limited by availability) to anyone seeking guidance towards a natural movement practice and lifestyle.

The Art of Embodiment: listening through your feet

What Do We Mean By Embodiment?

Embodiment is the experience you are having… right now! Our modern lives require us to experience life from our minds, which can create the feeling of disconnection from the very embodied experience that is taking place within us at all times.

The art of embodiment is an opportunity to consciously reconnect deeply with ourselves and to share, as well as receive, this rich experience with a partner.

EmbodimentListening through your feet

This workshop will discuss the basic anatomy of the foot – its fascial, meridian, and core awakening relationships to the whole body.

We will guide you and your partner through:

  • Primal postures – the gateway to lifelong mobility
  • Foot massage, reflexology, and joint mobility (how to give a damn good foot massage!)
  • The ancient practice of Thai Yoga Bodywork
  • And much, much more.

Time & Location:

Sol Healing and Wellness Center

http://solhealing.com/

13805 Ann Pl, Austin, TX 78728

February 14, 2019 6-9pm

Cost:

$250 per couple

A gift for partners, lovers, family, or friends.

The Art of Balance to Prevent Falling Injuries

This Move Minute is all about improving your vestibular balance skills. Considering that one in three adults over 65 falls each year, and falling is one of the leading causes of death or disability for older populations, balancing is a hugely important movement and life skill to work on.

The Art of Balance to Prevent Falling Injuries
The Balance Challenge

The goal is 10 minutes per day for 30 days balancing on a 2×4, balance bar, slackline, or other balance tools (variety is your friend). If you’re up for it, film it, and share it. I’d love to see and hear about your progress.

The Art of Balance to Prevent Falling Injuries

You will need:
A seven-foot 2×4 (or other balance tool)

To begin:
In order to cultivate this skill adequately, balancing needs to be practiced every day. Because of this, it is important to keep a 2×4, or another balance tool, in a main room or hallway. If it is placed behind a couch or out of sight, the chances are high it will collect dust and not get used. Keeping it out in the open increases the opportunity to engage and play.

Go slow. You want to find where balance is most challenged. Speed and momentum can cover this up. You want to go so slowly that you feel unbalanced… this may feel frustrating, but it is a good place to be. This is where your nervous system is learning. The slower the better. Keep at it and it will improve.

Drop your arms and focus on your breath. When you feel unstable, soften your knees, breathe fully, and allow your arms to fall to your side.

Take off your shoes. Another added benefit of balance work, it is a great way to strengthen the intrinsic musculature of the feet.

One thing I love about the balancing on a 2×4 is that it mimics our natural environment. As you get better at balancing, you can start seeking balance play in your everyday life. I love balancing on tree roots, curbs, sidewalk cracks, railings, fallen trees, and so much more. Give it a go and let me know how it feels.

About Move Minute:

Move Minute is our way of helping the world get up and moving. Each video will teach you at least one technique to help preserve mobility in just one minute. In many cases, these movements can be done anywhere and performed in seconds. With Move Minute, you can learn how to maintain your ability to move for the rest of your life in just a minute or two a day.