shoulder pain

In 2014, at age sixty-four, I began to experience pain in my left hip that eventually became quite debilitating. For the first time in my life, I went to a chiropractor, which resulted in relief that lasted a couple of years. By 2015 I had consulted first one, then a second orthopedic surgeon, who recommended a hip replacement due to osteoarthritis. 

The first clinic I went to, I felt like I was visiting a bone and joint factory…I decided to wait. The second place, they were reading another patient’s notes! That doesn’t give you a lot of confidence!! Not feeling completely comfortable with either of the surgeons, I began doing my own research. 

I longed to get back to hiking and walking pain-free.

I’m not one of those people who jump into things, especially surgery. So I went to a clinic where they did a lot of rehabilitative physical therapy and I asked one of the PT’s: of the people you work with who have success with their surgery, which surgeons do they use? And that’s how I found my hip surgeon. After a successful surgery in January 2016, as well as physical therapy sessions with the excellent physical therapist who recommended the surgeon to me, I recovered quickly and was thrilled to resume walking without pain.  

During the summer of 2018, while out shopping, I experienced both of my knees feeling as if they were on fire. My knees continued to bother me, but, afraid an orthopedic surgeon would tell me I needed surgery, I consulted a sports medicine doctor. He performed X-rays and confirmed that I had osteoarthritis in both knees. He suggested physical therapy and braces, as well as steroid shots (which I declined). Physical therapy helped to provide some relief as the muscles around my knees strengthened.

The following year, I read an article by Christiane Northrup, M.D., in which she shared information about the Gokhale Method®. I researched the method and learned that a one-day Pop Up course, one of the in-person ways to learn the Gokhale Method, would soon be offered in a nearby town, Boulder, Colorado. After the course, I did my best to focus on glidewalking, which did reduce the bone-on-bone knee pain.               

    
Everyday activities, such as bending, are taught in Gokhale Method group courses. Bending can be done in ways that align the bones well, use muscles appropriately, and spare the joints. Learning to hip-hinge benefits the knees, hips, shoulders and neck, and more besides.

I made it until June 2021, when I had successful bilateral knee replacements with the same surgeon.  I opted to do them both at the same time to get it over with, but recovery was challenging. After weeks of physical therapy, I was told to just do normal everyday activities. However, I did not feel I was making the progress I wanted.

My husband took these photos of my knee replacement X-rays at my 6-week post-operative follow-up appointment. Our joints are precious things to take care of!

Because COVID was still raging, I joined the new Gokhale daily online program. This enabled me to extend my recovery in a more enjoyable and focused way, and my knees became ever stronger. Even now, if I am unable to participate in the day’s live session, just receiving the email about the topic of the day is a great reminder and encourages me to focus on practice. And I regularly watch the replays if I miss a session.

Gokhale Exercise members receive a daily email outlining the day’s program, complete with an inspirational posture reminder image. This was May 7, 2024.

In February 2023 I began experiencing pain in my hands and my left shoulder. I was diagnosed with Carpal Tunnel Syndrome (CTS) and given exercises and braces for my wrists/hands to wear at night. While the shoulder responded and had some improvement, my hands were still an issue.

At a follow-up appointment six weeks later, it was suggested I could have “a little surgery” on both hands to fix the issue. I looked up information about CTS and the surgery, and learned the pros and cons of having that done. I lived with the pain off and on until this year, when in early 2024 a diagnostic nerve test was performed by a neurologist to check the severity and cause of my particular CTS. Even though C7 (the seventh neck vertebra where nerves to the back of the arm, wrist, hand, and middle finger exit the spinal cord) was mentioned to me during the nerve assessment, the hand specialist who ordered the test did not mention it at a follow-up visit. He suggested surgery on both hands. A day after this appointment, I called the doctor’s office to find out more about possible C7 involvement and to ask if that might be the cause of my CTS. If so, how would surgery to snip the ligaments in my hands fix the problem? Since I never received a response, I did not schedule surgery.  

Pain-free wrists and a mobile neck are important to enjoy my hobbies. Here I am on a painting course that my daughter and I took together.

An X-ray of my cervical spine in March did indicate osteoarthritis in my neck, which in our society would be regarded as “normal” for my age. I discussed this finding with my chiropractor, who uses the Gonstead Technique. She felt confident that regular, gentle adjustments of affected areas, found by palpation and the use of a heat sensor that indicates inflammation, could be successful in eliminating the CTS symptoms. She checked my grip strength and adjusted my hands and wrists. Because I had difficulty using my hands for so long due to pain and numbness, they had become stiff and weak. I was also given suggestions about what I might do to help with my neck after my appointment. This made me once again think about what more I could do to contribute to my own healing.

My neck X-rays showed several areas of degeneration and misalignment that would potentially cause radicular pain. 

It had been almost five years since I first attended the one-day Pop Up course. I would say that up until recently, I had been somewhat “dabbling” in the Gokhale Method, without a full understanding or commitment to change my posture. Although chiropractic treatments helped to relieve my symptoms, I recognized that a healthy baseline posture was lacking, resulting in repeated misalignments. Understanding that an issue with my cervical spine might actually be the cause of my CTS, I finally came to the realization that I had been overly relying on others to fix me, and that I also needed to do everything I could to help myself. Just the thought of yet another surgery became extremely motivating!

That’s when I decided to circle back to the Gokhale Method. During an Online Follow-up with Esther in January this year, I explained that I wanted more confidence about what I should be doing for my posture and wanted coaching. Shortly after, I began the one-on-one online Elements course with Esther, which ended in April. In the early sessions, it was difficult for me to even get into positions that required me to use my hands and shoulders. By about halfway through the course, my pain from CTS had subsided, as well as the stiffness and pain in my shoulders which had not been in the healthy place they should be. I used to change up my mattresses and pillows a lot, but now I realize it’s not all about these external things—good mattresses and pillows can help, but how you position your body makes a big difference. 

On a regular basis, non-genetic scolioses/asymmetries tend to diminish with standard Gokhale Method training—that is, without any special focus. In my case, it reduced the strain on my neck. This surprised and delighted me.

Now for the really great news! I have not experienced CTS at all since completing the Elements course. While I practice healthy posture with my whole body, as everything interrelates, my main focus has been on my neck, head, and shoulder placement. Chiropractic appointments have gone from bi-weekly, to weekly, and now, only occasionally. For weeks now, C7 has not needed an adjustment and it makes my heart so happy when my chiro tells me the instrument that measures heat and inflammation in that area is clear! She has seen how my improved posture is making a difference and has been extremely supportive of the Gokhale Method.  

My exercise and walking had greatly diminished over the years after the onset of osteoarthritis, pain, and then surgeries. My upper body has been my main concern recently, but other techniques, such as glidewalking, have greatly improved my mobility and stamina. I would like to take the Advanced Glidewalking course in the future. I am working my way back to a healthy weight and an active life—thanks to the Gokhale Method.    

In this video I share how glidewalking has enabled me to travel and walk longer distances in comfort.

Best next action steps 

If you would like to improve your joint health, get started by booking a consultation, online or in person, with one of our teachers. 

You can sign up below to join any one of our upcoming FREE Online Workshops…

This is Part 2 of a 3-post series on cycling with healthy posture by Gokhale Method teacher and longtime cyclist Tiffany Mann. Read Part 1 here!

Little Tiffany (circa 5 yrs old), a new bike rider, having such fun!

Neck and/or shoulder pain is a common ailment even experienced cyclists regularly encounter. It takes awareness and muscular engagement while cycling to not allow gravity to further pull the head forward and down and round or hunch the shoulders, a posture problem that is already prevalent in our modern culture.

This cyclist in Berlin is on a bike that is too small for him, leading to the pronounced rounding visible in his upper spine. A supportive fit helps prevent rounding. Original image courtesy Raquel García on Unsplash.

While it does take some effort, via muscular engagement and kinesthetic awareness, to maintain a healthy shoulder and head placement while bicycling, the payoff is worth it. You will be able to ride pain-free for longer, and you will also be patterning a healthy upper body position regardless of your activities and movements. You will also strengthen and develop baseline tone in stabilizing muscles, and they will become more accustomed to doing the job of maintaining shoulders back, back of the neck tall and straight, and head lined up over the body, as we teach for all posture stances — sitting, standing, hip-hinging (all of which cycling incorporates!).

Opening the shoulders and chest
Rolling open the shoulders and drawing the scapulae down and back onto your back where they belong allows your chest to stay open. This gives you a better breathing pattern and better circulation to and from your arms, both of which are especially important as you are using your arms to support yourself and guide the bicycle, and using your lungs to provide oxygen to your muscles and cells that are working hard during this exercise.

This cyclist in Lisbon, Portugal rides a well-fitting, front-suspension mountain bike. Her leg is externally rotated, with a slight bend in the knee. She demonstrates a J-spine with her torso and head stacked, and hinges at the hips. Finally, her shoulders are back and her grip on the handlebars is relaxed. Original image courtesy Justine Camacho on Unsplash.

Activating the inner corset as a shock absorber
Using the set of muscles deep in your abdomen and back that we call the “inner corset” helps protect the neck along with the lower back (that other pesky trouble spot for cyclists!). Inner corset engagement gives length to the whole spine, including the cervical discs, and creates more space between the vertebrae. You will better withstand any jarring sensation from uneven road surfaces, potholes, or gravel, with this brace of deep muscles engaged. This brace of muscles includes the longus colli — deep muscles in the neck, which, when engaged, keep the neck tall and straight, and as a bonus, allow your trapezius muscles, those “hunchy” shoulder muscles, to relax.

This cyclist in Manhattan uses his well-fitting bike skillfully. His pelvis is anteverted, his shoulders remain back, and he uses his eyes to lead his gaze, rather than compensating with an arched neck — even with a baseball hat on underneath his helmet. Original image courtesy Javier de la Maza on Unsplash.

Hands, arms, and handlebars
With your inner corset in place and holding your torso steady, your arms can be relaxed when they need to be and not doing more of the work than they need to. Your hands and arms want to be relaxed and not be squeezing or holding on too tightly to the grips and handlebars — that creates unnecessary tension and fatigue.

My family on a banana seat custom tandem: Skip, Willa (4 years old), and Coco (7 years old). Original image courtesy Ken Richardson.

Lengthening the neck and employing the gaze
Craning your neck is another unhealthy posture pattern that can both fatigue the superficial muscles in the neck and damage the delicate cervical discs. Instead of craning your neck to look around you, keep the back of your neck long and tilt the head on its axis, and use your eyes — they can see plenty well and will actually benefit from the exercise of looking out into the horizon and to the periphery. 

This cyclist in Vietnam demonstrates an open chest, relaxed shoulders, and healthy leg rotation while riding. Original image courtesy Minh Pham on Unsplash.

Putting it all together
All of these pieces work together to help keep your ride sustainable and pain-free. Our founder Esther Gokhale, in her two-part series on cycling posture and choosing the right bike seat for good posture, goes into great detail about ways to prevent more types of cycling-related pain through the application of Gokhale Method techniques. As Esther explains, stacksitting and hip-hinging are both crucial for sustainable cycling posture. If you need an introduction to these or other Gokhale Method techniques, keep in mind that you can get familiar with them in Esther’s book, or even work online with several of our teachers, one-on-one! Some teachers are even available for one-on-one teaching in person, where permitted. Don’t hesitate to reach out!

For more information on Tiffany’s teaching in the Boston area, contact her here.