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Table of Contents

About TFSWhy A Solution Is Needed 1The Story 4The Theory 6The Results 10

The TFS TechniqueLimitations 14Why It Works 15How To Do It 16The Advanced Technique 18

Conclusion 20References 21

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Why a Solution Is Needed

Nearly 61% of shoulders have some form of tear in the rotator cuff area (2). While many of these tears go unrecognized and untreated, for those of us who discover the hard way that we have a tear, it can be a constant source of pain, frustration and limitation.

Unfortunately, one of the most common suggestions to alleviate the pain and lack of motion associated with injuries from injured shoulders and rotator cuffs is an expensive (around $12,000 avg.) and sometimes painful surgery…

And worst of all…the surgery, usually followed up by a longer (4 month) physical therapy plan as well…has no guarantee of success (1).

So if you’re faced with the unfortunate situation of dealing with a rotator cuff injury, surgery can be a daunting option.

However, there is hope for non-surgical treatment.

And according to one man who the New York Times has labelled a “renegade” Doctor and yoga instructor…there may be a solution that “can seem almost a miracle” (1) to the thousands who have tried it, many of whom have found…

“Immediately after completing the exercise, the average improvement…was 150 percent. In other words, these patients more than doubled their range of motion and could lift their arms

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normally. Much of their pain disappeared. Patients reported their pain reduction on a questionnaire.” (2)

And not only has the yoga-inspired method achieved fast, effective pain-free results…

In followups of over 30 months, the method has been shown to be effective when combined with a light physical therapy regimen…to sustain the results of pain-free motion (2).

How does the method stack up against the results of surgery? According to the inventor of the method, it “had results equal to or exceeding outcomes for participants in published international surgical, arthroscopic and conservative treatment studies” (2). (Those are the surgery options traditionally recommended).

The maneuver has been shown to work on about 90% of those who try it…and most show relief and drastically improved flexibility and motion…within 30 seconds of performing the maneuver!

And best of all? It takes no equipment but a wall to stand up against. And the instructions are so simple, a child could do it easily.

You’re about to learn this secret technique that was so radically effective that at first it wasn’t believed by medical or therapy circles…

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Until it was proven.

Now, before we get to the technique, a brief history of how it came to be discovered…

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The Story

The “renegade” doctor mentioned earlier is none other than Dr. Loren Fishman.

Dr Fishman is also a teacher and practitioner of yoga as part of his physiotherapy practice to help heal patients of injuries.

Seeing thousands of patients with rotator cuff and shoulder injuries over the years, according to the doc, he “never thought” he would “come upon a non-surgical solution” (2).

That is, until he suffered a painful rotator cuff tear himself nearly fifteen years ago.

The resulting pain and lack of mobility that he encountered frustrated him to the point of being willing to try nearly anything. One of the leading frustrations was that his own doctor suggested that he avoid the yoga that he practiced every day that helped him maintain maximum health, flexibility and strength.

Being the “renegade” that he is…this answer just wasn’t satisfying to him, so he went forward and attempted some of the yoga poses that he thought might actually HELP his shoulder issues, despite the fact that they were forbidden by his doctor.

And that’s when he discovered something amazing…

According to a new york times article devoted to his incredible discovery, the story went like this…

“One day” says the article… “he attempted a yoga headstand. After righting himself, he discovered he could raise his left arm

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over his head without pain, even though an M.R.I. showed that the supraspinatus muscle was still torn.” (1).

This discovery was incredible, and has since shaken up both the yoga therapy world and the world of physical therapy when it comes to rotator cuff tears and shoulder injuries.

His discovery that day has lead thousands of people to avoid painful, expensive surgery to correct their mobility and pain issues when it comes to their torn rotator cuff injuries.

The immediate and surprising success of performing this one ancient yoga pose and almost immediately alleviating pain and restoring a significantly greater range of motion inspired the doc to write his now (in)famous peer-reviewed paper,

“Yoga Based Maneuver Effectively Treats Rotator Cuff Syndrome”

for which he won a prize at the 1st International Conference on Yoga for Health and Social Transformation (2).

So how does this near-miraculous technique work?

As you’re about to see, the “magic” is in its simplicity…

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The Theory

The technique is founded on a very simple, somewhat strange but highly effective principle:

Adaptation.

See, in order to survive the human body has developed an incredible capacity for adaptation. Specifically, as human beings we are masters of physically changing our body (and according to recent discoveries, even our own brain!) to ADAPT to the current situation for optimal survival.

This concept is at the core of every single thing we do.

Doctor fishman found an incredible “loophole” in the traditional way we treat rotator cuff injuries by exploiting his own body’s constant desire to “adapt” to whatever situation it’s presented with.

Think of it this way:

When you life weights, you know that you’re doing it to get in shape…to look better…to feel better…to have nice muscles.

But NONE of that makes sense to your body!

What does your body think is happening? Think about it:

While you’re having a nice fun day at the gym, your body is sounding its internal ALARM BELLS. Lifting weights triggers a system that says “THREATS ARE PRESENT”

Why?

By lifting dumb bells over and over, you’re telling your body…

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“Ok, now I know it seemed like we were safe, sitting down on a comfy couch…watching television…eating delicious fatty and sugary foods that are packed with nice easy energy that will fuel us for months…”

“But actually…”

“We’re in trouble! Things are HARSH out here! We’re going to have to keep LIFTING THESE HEAVY ROCKS over and over! We’re going to have to BURN that precious energy we have stored up (fat) and we’re going to have WORK HARD!”

This is exactly the OPPOSITE of what we’re programmed to do for SURVIVAL.

We are programmed to look for the easiest, safest path to survival. Not the hard one.

But, our bodies don’t get to determine our actions. They can only REACT to what is there in the present moment.

And how does the body respond to the message that apparently (by going the gym every day and lifting weights) we’re going to have to keep lifting heavy rocks again and again, day after day?

IT PHYSICALLY MORPHS to step up to the task.

That’s right. “Building muscle” is actually just your body “adapting” to your new “situation” of having to “lift heavy rocks” every day.

What do you need to be able to survive in that environment?

Thicker, denser muscle tissue…

A stronger heart…

More flexibility…

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And how does it happen? These things physically…chemically CHANGE inside your body. Your cells grow thicker, denser…blood flow changes…your body literally changes to a NEW body.

If you take a second to think about it…that’s absolutely miraculous!

But to get those changes…

First, you have to send your body the “message”.

Now, what does all this have to do with healing your shoulder with a yoga exercise?

See…the exercise uses the exact same principle to “send a message” to your rotator cuff muscles…

And that message is…

“Hey, one of our muscles is down (torn rotator cuff)”…but here’s the problem:

Apparently (because we’re doing this exercise) we still NEED to be able to accomplish what we used to do with our entire rotator cuff functioning perfectly…

Is there any way we can do this?

Turns out…there is.

When the rotator cuff muscle that is torn can no longer do it’s job…

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This simple yoga exercise (and the maneuver that follows immediately)….

Gets another muscle to do the job of the first one!

That’s right. Just like a coworker stepping in for you while you take a sick day, the other rotator cuff tendons “learn” how to “take over” the job of the one that’s been torn.

Now, what are the results of this incredible process?

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The Results

In a word, the results were astonishing.

In his own words, in an article on Huffingtonpost.com, Dr. Fishman says that immediately after completing the exercise the first time…

The average improvement for the 46 patients in his initial study was 150 percent!

“In other words…” he said, “these patients more than doubled their range of motions” and even more miraculously… “could lift their arms normally”.

After the first time trying the exercise!

And what about their pain? Much of it “disappeared” according to Fishman. (2)

46 of the patients were satisfied with their results. The average improvement was 82%, and “many said they were pain-free”. (2)

Results within 30 Seconds?

According to Fishman and his partners who conducted the peer-reviewed study,

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“our patients had no “down time” whatever, and most were able to pursue all normal activities 30 seconds after treatment onset.” (4)

It’s also important to note:

“Most patients also received just enough physical therapy to solidify their gains -- an average of five sessions over a period of one week to 10 days.” (2)

Here are some of the results from his published peer-reviewed article (If you’re into the technical jargon):

Peer-Reviewed Study Results• Mean painless and maximal abduction and flexion

improved significantly immediately after the initial 30-second TFS.

• Painless range of motion improved 100% or more in 37 of 49 patients (75.5%) directly following TFS. Mean improvement was 150% (SD 1.3; median improvement 120%).

• Gains were sustained in mean 2.5 year follow-up• Three patients did not improve.

(Source: (4) : “Yoga-Based Maneuver Effectively Treats Rotator Cuff Syndrome”)

And how long did these results last?

According to the New York Times article about the success of this method, “the benefits matched, and in some cases exceeded, those following physical therapy alone or surgery and rehabilitation.”

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In fact, “All the yoga-treated patients maintained their initial relief for as long as they were studied, up to eight years, and none experienced new tears.” (1).

On his popular blog “The Doctor Weights In” doctor Dov Michaeli MD, PhD admitted that he showed a bit of hesitation to believe the claims of the report and the press that praised the effectiveness of this technique.

However, listen to what he found when he used the technique to treat his own torn rotator cuff injury:

“Not wasting any time I tried it for the recommended 30 seconds. And guess what—it worked! I could immediately

raise my arms over my head without much pain (just a twitch).” (3). - Dr. Dov Michaeli MD, PhD

How do these results compare to surgery?

According to Fishman, of the 46 people who improved using the TFS technique had “results equal to or exceeding outcomes for participants in published international surgical, arthroscopic and conservative treatment studies.” (2).

A Quick And Permanent Solution?:

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In concluding the peer-reviewed study, Dr. Fishman says that the TFS technique “appears to reduce the pain and disability of RCS…(Rotator Cuff Syndrome)…”quickly and permanently for some patients.”

And it just might prove to be a “nonsurgical, low-cost, painless, and virtually immediate means of treating some cases of RCS.” (4).

Could it be the quick and permanent solution for you?

At this point you’re probably very curious to know more about this wondrous technique, and learn how to try it for yourself.

Fear not, because in the next section you will learn exactly how to try this technique for yourself!

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Limitations

Before attempting this technique, keep these limitations in mind:

While Dr. Fishman has seen this technique work for over a thousand patients over the years, most with immediate and drastic results, there are some limitations.

1) If your muscle are overtrained

Some participants such as string musicians did not see a result, because over the years of practicing their profession, their shoulder muscles had been overdeveloped. (1)

2) Frozen Shoulder

There is a possibility that frozen shoulder may “inhibit the effectiveness of the maneuver” (4)

And of course, before attempting this or any other physical treatment, make sure to consult your doctor or physical therapist to see if it’s a viable option for you.

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Why It Works

This technique works because of the adaptation principle we talked about earlier. In this case, one of the rotator cuff muscles (the subscapularis) adapts to take over the job of the injured muscle (the suprispinatus) that is rally in charge of raising the arm from below the chest to above the shoulder (1).

There is one very important step that is crucial to activating this, so you can tell your body that it needs to switch muscles…and it requires a bit of courage and boldness, especially if you’ve suffered from pain from this injury for years.

The instructions for activating the new muscle to take over are as follows (taken directly from the peer-reviewed study):

“One post-TFS instruction was given to all patients for both abduction and flexion:

“Boldly lift your arms up to vertical. Do not stop at 90 (degrees) and wait for it to hurt”. (4)

This instruction is crucial to starting the re-programming process. It should immediately follow doing the TFS technique for 30 seconds.

Next, you’ll see exactly how to do the TFS technique.

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How To Do The TFS Technique

The Modified “TFS” Technique Credit: Jason Lee, NYtimes.com

1. Interlock your fingers, making an equilateral triangle with your forearms as you place them against a wall.

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2. Place the fontanelles (the “soft spot” area of your scalp) in the center of that triangle.3. Walk away from the wall, so that your torso now slants toward the wall. Some weight is now on your head.4. Lower your chest and press your elbows and forearms into the wall, using the pressure to pull your shoulders far away from the wall.5. Draw your shoulder blades back, down and apart, still pressing against the wall with your elbows and forearms. Press yourshoulders, but not your head, away from the wall.6. Stay like this for 30 seconds.7. Now come away from the wall and stand up straight.8. Boldly lift your arms up to vertical. Do not stop at 90 and wait for it to hurt.9. Do the same with flexion (bringing your arms directly up in front of you).Source: “Yoga-Based Maneuver Effectively Treats Rotator Cuff Syndrome” (4)

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The Advanced “Chair Assisted”

VersionWARNING: EXERCISE EXTREME CAUTION WHEN ATTEMPTING

THIS VERSION.

Verbal Directions for Inverted Triangular Forearm Support,

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Chair-Assisted

1. Stand with your back to a chair.2. Place your right shin on the seat of the chair.3. Bend forward, placing your palms on the (blanketed or carpeted) floor, fairly close to the chair.4. Raise the left shin to the chair seat, so that you are now kneeling on the chair with your hands on the floor.5. Bend your elbows as you lower your head to the floor. After your head is securely planted on the floor, center it between yourhands. Be careful not to place your weight either on the forehead or the back of your head, but rather at the fontanelles, thespot that is soft in babies.6. Make an equilateral triangle on the floor with the little finger side of your forearms by clasping your hands. Place the heels ofyour hands, not the palms, in contact with the back of your head.7. At this point, with your weight chiefly on your head, press down with your forearms to lift your shoulders away from your ears.Widen and raise your shoulders further from the floor.8. Stay in this position for 30 seconds.9. Now bring first one knee, then the other to the floor, using your hands and arms for support as necessary.10. After 5 to 10 seconds, quit the position and stand up normally.11. Boldly raise your arms up to vertical. Do not stop at 90 and wait for it to hurt. Continue the motion as far as possible.12. Do the same with flexion.

Source: “Yoga-Based Maneuver Effectively Treats Rotator Cuff Syndrome” (4)

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So there you have it.

Go ahead and give the TFS technique a try for yourself, and see if you get the same results!

(Of course, asking your proper doctors and physical therapists for permission first, and making sure to take any other necessary precautions).

And if you want to learn more of Dr. Fishman’s incredible yoga based body-healing techniques, check out his fantastic book “Healing Yoga” Available at amazon.com

Buy Dr. Fishman’s book here: http://www.amazon.com/Healing-Yoga-Postures-Ailments%252014from-Backache/dp/0393078000/ref=asap_bc?ie=UTF8

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References

1. "Ancient Moves for Orthopedic Problems" - NYtimes.com - http://www.nytimes.com/2011/08/02/health/02brody.html - Jane E. Brody

3. Fishman - “A New Yoga-Inspired Technique To Help Your Shoulder Injury” - Huffingtonpost.com - http://www.huffingtonpost.com/loren-fishman-md/yoga-for-rotator-cuff-injury_b_916728.html

4. Dov Michaeli MD, PhD - August 3, 2011“For Rotator Cuff Injuries – Try Yoga” - The Doctor Weighs In - http://thedoctorweighsin.com/for-rotator-cuff-injuries-%E2%80%93try-yoga/

5. “Yoga-Based Maneuver Effectively Treats Rotator Cuff Syndrome” - Fishman, Loren M. MD; Wilkins, Allen N. MD; Ovadia, Tova PT; Konnoth, Caroline PT; Rosner, Bernard PhD; Schmidhofer, Sarah BA, RYT - Topics in Geriatric Rehabilitation: April/June 2011 - Volume 27 - Issue 2 - p 151–161 doi: 10.1097/TGR.0b013e31821bfe68 Yoga as Therapy

6. “Self-Healing Shoulder Pain with Yoga” - Norman Popvsky - http://slyoga.com/2011/08/self-healing-shoulder-pain-with-yoga/

7. “How Joan Healed Her Shoulder Pain with Yoga” - Norman Popvsky - http://slyoga.com/2013/01/how-joan-healed-her-shoulder-pain-with-yoga/

8. “How to Heal (and Prevent) Shoulder Injuries” - DOUG KELLER - Asana yoga shoulder treatment - YOGA + JOYFUL LIVING NOVEMBER' DECEMBER 2007 YOGAPLUS.ORG

9. Healing Yoga: Proven Postures to Treat Twenty Common Ailments—from Backache to Bone Loss, Shoulder Pain to Bunions, and More - Loren Fishman January 5, 2015 W. W. Norton & Company