Eval by back specialist/dry needling PT

Well yesterday my parents took me to Columbus (so I could lay in the back and not flare up my hip flexors which is what usually happens when I sit too long, especially in the car) to have an evaluation by another PT from my surgeon’s office, this one specializes not just in hips, but also the whole lumbar/pelvic/low back as well, plus he does dry needling. We chatted a few minutes, then he thoroughly assessed my hips, SI joint, pelvis, and low back. His assessment was that my SI joint itself was fine, and he thinks my ongoing issues with the right hip are not a result of the mild dysplasia, but from chronic tightness/weakness in those muscles surrounding the hip, and said that when the muscles have been dysfunctional for so long it’s hard to get them to break out of their spasming/guarding mode in order to effectively strengthen them. He gave me a few suggestions (I’ll come back to this later) about this. He said the nerve and back and hip pain comes from the fact that the right hip muscles aren’t functioning properly to support my pelvis on that side, so the pelvis drops when I walk and that creates all of the low back, SI, and nerve pain. It’s hard to wrap my brain around the fact that muscles can wreak this much havoc on the body and cause this much pain to the point where I cannot be standing still longer then 10 minutes (with pain the whole time) or walking more then 20 minutes (with pain the whole time) or I flare those muscles up BAD which then wreaks more havoc and pain through the pelvic/back and whole body. As for getting those muscles to relax and “let go” in order to strengthen them effectively he said I need to not just get them released (like with the ART I’m getting), but also get them to stretch out. Now I hesitate to stretch because stretching a hypermobile person like myself generally stretches the ligaments vs muscles and creates more pain and issues. Everytime I have stretched in the past 3 years it has made me worse. I tried to tell him, but he didn’t really listen (and he really doesn’t know my body) so when I talked to my chiro today about this he said that I know my body better then anyone and if stretching makes me worse, listen to my body, and I agree.

Anyways we also did dry needling to 2 areas. Area 1 is to the piriformis and hip rotator attachments on the right hip, because those muscles have always been a problem area on me, and are still tight/weak from pre-surgery guarding and post surgery trauma. The other area is to my left TFL (the muscle that is at the top of the IT band). This is where I had my first scope surgery (which I’m coming up on a year anniversary of it, it was April 9th, 2013), with the reason I’m having trouble and pain there is because after I had that surgery I only had a few PT visits, didn’t get too active, then had the major pelvic breaking PAO surgery 5 weeks later where I was non-weight bearing and didn’t use those muscles for another almost 7 weeks. At that point I had tightness/pain around the scope portals and felt like the scar tissue was deep and adhering to the IT band and not allowing it to move at all. It’s been that way ever since. Touching it is painful, using my scraping tool on it brings tears to my eyes. I’ve had countless ART and graston sessions on it, but still it remains the same. Yesterday he put needles into it, and said it was very dense and hard to get them in. He then hooked up a machine to the needles and it contracted the muscle trying to stimulate blood flow for healing. It was uncomfortable, painful when the needles went in (because that area I think has a bunch of nerves trapped in the scar tissue). He said I would probably benefit from several more sessions, so I am looking for a place closer to home where I can get that done.

As I mentioned today I saw my chiropractor for ART and what I’ve noticed through the past couple of weeks is that my pelvic falls forward more and more and I feel like my femurs are turning into internal rotation putting more stress on the already overstretched muscles of the posterior chain (glutes, low back, piriformis) and that’s what causing me to have more pain back there. The muscles in my groin have been really tight. Today I asked my chiro to get deep into the groin muscles and as I suspected pectineus was screaming tight on the right, as well as pretty bad on the left. My psoas tendons were trapped in that mess of tightness (but the muscle bellies themselves were not too bad this time which was a nice surprise), as well as tightness in several of my hip adductor tendons. Once he released those things I could immediately feel my hip rotators and glute on the right begin to fire and function. I think they were begin inhibited by those tight groin muscles. We went through the usual muscle groups on me with ART as well (QL, hip rotators, glutes, neck muscles, and rectus femoris) and besides a little tightness in my rectus and neck (which has slowly been gaining a little more stability as well) things were not bad. I went straight back to do my rehab with the trainer and I was able to activate and coordinate all of the deep stabilizing muscles much easier today with few cues from the trainer. He was shocked and said it seemed like my body was finally coordinating things (usually he has to cue me verbally and with his hands non-stop the whole session about using my core muscles at the pelvis and shoulders when doing any exercise). I think releasing those tight groin muscles (vs. just psoas and glute/rotators) made a huge difference in that.

So moving forward I am 1.) not going to see a back specialist now since 2 OSU PT’s, my surgeon, plus my chiro and trainer all think my back pain and resulting issues are just due to muscle imbalances and weakness (I hope they are right!!) and 2.) seeking out a dry needling professional in my area to see if we can break up some of this scar tissue that nothing else seems to be able to touch. Oh, this whole journey is so frustrating and although I’m happy that several people all have the same thoughts on my body, I am also frustrated and flabbergasted that muscles can play so much on the body causing debilitating pain. I long to have normalcy in life soon, but this is still a long journey that hopefully will get better overtime, but it doesn’t seem like that will be anytime in the near future. So once again I am trying to adjust my expectations that the fun filled summer I planned with my kids will most likely not be happening, and try to keep my hopes up that I will get there in 1-2 years. In the meantime I have many down days, I know I don’t smile and laugh even close as much as I used to. I have days I cry and get depressed. I have days too though where I feel mentally strong and patient, although I probably have the least number of these. I guess after 3 years in chronic pain, 3 surgeries, and continued daily limitation where I try not to leave my house unless it’s short periods of time or I have to (then of course pay the consequences of it with pain) I’m just mentally and physically exhausted sometimes. But I have 2 little people that need me so I push on forward with the help of my hubby and God, trying to work on patience, thankfulness for the things I do have, and trying not to let the “what ifs” take over my thoughts. Thanks for reading:)

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One thought on “Eval by back specialist/dry needling PT

  1. I just have to ask but have you had your lower back imaged? Spasms of the spine are very common if you have degenerative disc disease. I’ve had a few in my neck, and they were horrible. My neck pain started about 2 months after my hip surgery. They really had nothing to do with each other. I mean it sounds like this is all due to your hips, but I just ask because if you do have EDS, degenerative disc disease is pretty common. My spine started degenerating at 25. Lower back went out on me at 28. I had a lot of nerve pain associated with the neck, but after a cortisone shot it’s gone. My lower back doesn’t have nerve pain, but it feels just like my neck does, so I’m 95% certain it also has bulging discs and bone spurs.

    But if you do have EDS, having extensive soft tissue problems is not uncommon either. My left side still has the high hamstring tendonitis, and I hurt something in the front 3 weeks ago. It’s not a labral tear. I’ve had 3 and I can tell. My capsule was not plicated though, and now I’m wondering if my muscles are spasming trying to hold that joint together. Don’t know. But I need the right hip fixed because it’s doing so badly. Did your hip surgeon plicate the hip capsule? Most PAO surgeons just close it, but there’s a lot of debate going on as to whether it makes a difference.

    And even if you do have spine degeneration, it can be hard to tell if that is actually causing the problems. For my neck it was very straight forward. For someone like you it might just make the situation even more muddy :/

    Also, soft tissue problems can hurt about as much as a labral tear. They never reach quite that same intensity that a labral tear can, but they can come pretty close when they flare or spasm. I had rotator cuff tendinitis (yes, just tendinitis) going on 16 months now, and it’s 70% of normal. It was so bad a few months back that I had to ice it and take norco for it. I thought this was ridiculous because I’m having surgery on my right hip and my right shoulder hurts more. It’s a lot better now. Still not 100% That’s the beauty of EDS, it just keeps giving >_> My dad had rotator cuff tendinitis and it lasted for 3 months. I have it, and it will probably last for 2 years. Lovely. They say that people with EDS feel pain stronger too, and I’ve heard varying responses on why that is. Regardless, I feel pain much stronger than normal. I had a bout of Achilles tendinitis that lasted 4 years, which is not normal at all. It sucked, a lot. My spine surgeon told me that wasn’t normal, and I said, “I know.” We didn’t know about the EDS then, but it makes sense now. It might have healed faster if I did PT, but PT made it flare something horrible. And ART probably would have helped, but I didn’t know about it back then. It’s fine now, but I won’t ever put on a pair of pointe shoes again!

    Stay strong! Glad your family is being supportive. Like I said, I grew up with a mom that was somewhat disabled, and it made me a more understanding person. I’m praying that you will turn the corner soon 🙂

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