So I thought I’d write an update today on how my visit with the OSU PT went last week and what’s been going on since then. I went last Monday with my dad down to Columbus to check in with one of my surgeon’s hip team PT’s. I’ll be 3 months post op this week from the most recent hip surgery (right hip scope to fix the torn labrum and shave CAM bump, small pincer, and ASIS impingement-basically shaved off a bunch of excess bone on the hip and socket and stitched the hip that was falling out of the socket back up into it). Obviously if you’ve ready any of my posts I am not the “typical” hip surgery patient. I’m chronic and my issues started small 3 years ago but due to many factors that I’m not in the mood to lull over tonight, grew into such a large problems that practically have left me housebound with 24/7 pain despite 3 hip surgeries that have fixed the structural problems (the first step that needed to be taken on this chronic pain journey).
The OSU PT and I talked for 50 minutes, she answered what questions she could (which were most of my questions) and was honest about not knowing the specifics of some of my pain symptoms. We agreed that my body recruits the wrong muscles to do the work and instead of working together everything works against itself. I’ve adopted “maladaptive strategies” of movement even with basic things like walking, reaching down to pick something off the floor, reach up to get something out of a cabinet, etc… I even sit wrong (if you didn’t know that’s possible, yet it is!). It’s so frustrating because I started realizing this over the past several weeks, so my strategy had become to move less because then I would hurt less. I knew this was wrong, but became so overwhelmed by the pain and the enormity of the problem that I just continued to make my world smaller and smaller to decrease the amount of burning pain throughout my body. My body felt like it was fighting itself and was being pulled apart in every direction. I was contemplating going to a pain management doctor, but deep inside know that the drugs they would throw at me won’t fix me, they will only mask the symptoms of what’s happening, leading me to continue to reinforce faulty movement patterns and making me worse over time. The PT reinforced that I need to go slow with strengthening, but incorporate correct movement patterns into my local PT to start correcting the way I move in functional, everyday movements. She said also that I need to stop focusing on all of the specific pains I feel in different muscle groups and look at the big picture, that as I work to normalize my movement patterns to recruit the correct muscles then the pains will slowly start to lessen and eventually disappear. She also said that I shouldn’t “push through” the pain, but that I needed to force myself to be more active daily, even if it’s just trying to carry a laundry basket or unloading the dishwasher. Basically if a movement involved bending or carrying something more than a pot of water when cooking or a gallon of milk, I’ve avoided it because something would get stressed in my upper back which would lead to a lower back spasm which would lead to my pelvis going out of whack which would lead to nerve or fasical pain down the leg(s) and so on and so on, or the pain would start in pelvis and move down through legs up then up to back, etc… She said I need to think about posture, recruitment of the larger muscle groups in my core, and do the movement slowly and cognitively. I’ve tried this with several things and it hasn’t been too bad, as long as I don’t repetitively make the movement over and over many times because my muscles fatigue quickly, as I have some muscles strength but no muscle endurance. She also said to minimize the amount of releasing of the muscles I was doing because in the long term that wasn’t what was going to make me better. I agreed to stop myofasical therapy for a few weeks (as it wasn’t giving me relief the last several sessions anyway) but said I was keeping my chiro for ART weekly, but would try to minimize the things he released (based on my pain at the end of the week when I see him each week).
So I started back with my local PT last Wednesday (the two PT’s had talked before then about the plan and agreed on everything) and we started incorporating some basic movement patterns into PT. We didn’t know how hard or light to push since we were doing several new things. I felt pretty good when I left; however within 24 hours all the muscles in and around my pelvis tightened up and shut down and the horrible burning pain came and I was miserable. I was limping by late Thursday afternoon and doubting the plan and completely miserable. When I physically get like that mentally I am tore up inside. Friday morning I saw my chiro and said to just release the really bad things because I was trying to stick to the OSU PT’s plan, so we released a little back, hip flexors (which were nightmarishly painful) and right hip rotators/glutes. I had some relief so was grateful for that. Later that day I realized my adductors were so painfully tight all the way from their attachment down all the way into the medial calf into the foot. Burning pain, inflammatory pain, a little nerve pain all mixed together. I was angry at myself for not just getting them released in ART, but it was too late, so just had to deal with the misery. I do have a scraping tool I bought similar to Graston (but way cheaper) and had my husband basically do myofasical release over my whole back, legs, and pecs with a big focus on the adductors of the legs. It helped a little. Sunday we went at it with the tool again on the adductors and he also did some deep tissue massage to them which helped with the pain some too. When I went back to PT today I told her about the awful 5 days and crippling pain (because I should mention when something is as tight on me as my adductors have been, my whole body compensates for that, so pain is much wider spread then just that muscle group-low back, SI joint, both legs, calves, feet) and how I got limited ART, and she said if it gives me relief through this process, then get it done to whatever muscles I think I need it to, and she has no problem with that. She said she was happy I flared because it gave her good information on what I can/cannot do, so we scaled back several things today and are hoping this will be a good baseline for me. We’ll know tomorrow I guess. Once we get my baseline then we will know how to progress me.
My husband had the day off and accompanied me to the PT appointment today to talk to my PT and see if there was anything he could help me with at home. She showed him how to do some trigger point releases on my adductors and talked to us how to do them on several other problem muscle groups of mine as well. He also got to see how basic the stuff I am doing is and how much I struggle with it. It was very humbling to me and especially to my husband to see one of my exercises tonight and how much I struggled with it. Basically I stood close to a wall and had to stabilize one hip while lifting the other leg just a few inches to touch my toe to the wall. I had to close my eyes to think first finding a pelvic neutral position (I was wearing a biofeed back iPod device that would let me know if I broke out of pelvic neutral by beeping at me), then once I got that down I had to think about the sequence of recruiting the deep abdominal muscles and firing them, then think about recruiting the stabilizing hip/glute muscles and then get them to fire while holding the ab ones, then I had to think about lifting the opposite leg a few inches and engaging the hip flexor in that leg to lift it up and tap the wall and hold it all for 1-2 seconds. I only did 5 on each leg, but each time it took so long just to get myself stabilized, and my whole body would shake because it was so hard to hold and coordinate everything. My husband was shocked, saying to the PT that basically that’s very simple what I did, like basically breaking walking down into slow motion and I could barely do it, and she said yes, that’s how weak I am with poor endurance and very poor motor planning. What comes natural to most people takes like 10-15 seconds at least for me to try and think about and coordinate in my brain, then to actually perform it in the correct sequence even longer. That shows me how much compensation must be going on each day in my body with just very BASIC things like moving around my house. Ohhhhhhhhhhhh it’s going to be a long road. I’m hoping I don’t flare too bad tomorrow, but PT said I may flare up some for the next 6-8 weeks until I build that core endurance and learn to coordinate my muscles better in everyday movement…………so basically to expect that there will be possibly many more bad days to come, but hopefully they will be less intensive and less frequent as time passes. I want to believe her and hope this is true, it’s so hard after living in this body like this for so long now. I watch people move naturally everyday without pain like it’s no big deal to walk, sit, stand, do anything really and I’m fascinated by it. I constantly think how much people take for granted the little things they do everyday, how much I took it for granted for so many years. If I ever am pain free again in this lifetime I will not take it for granted. It would never have crossed my mind to just get up and run out to the store to pick up a few things, to go outside and play ball or a game with my kids, to walk to the garage fridge from the kitchen to grab the extra milk when we run out, but these simple things have become so overwhelming and stressful when I try to do them because I know what I will feel like from putting the extra steps/effort into my days. I’m not complaining because I’ve come to accept (most days anyways) that this is my life right now, but hopefully not forever. I know others are suffering similar and want them to know that someone out there can relate, because being in chronic pain for years is a lonely, lonely place. that you feel like nobody can understand. I don’t expect anymore most people to understand. I am happy that my husband has come to understand it from watching me over the past 3 years, and he is so awesome and helpful and supporting, I am so lucky to have him. I also feel very blessed besides my husband to have my kids (who just today after I told my daughter someday I hope to be better so we can go out and do fun things together says to me “mom you are fun now,”—tore at my heart hearing that, just what I needed today)and to have my parents close by. They just love me and support me unconditionally no matter what and are the people who keep me getting up and going forward on a regular basis. I continue to try to keep my heart lifted up to God, I know he’s with me even when my brain try to tell me He’s not. It’s not always easy to keep going, but then again He never promised life would be easy, only that He would be with us. I’ll update in a few weeks, thanks for reading, until next time….