Welcome to My Blog!

I've been diagnosed with a small labral tear and mixed Femoroacetabular Impingement (FAI) in my right hip. This blog follows my efforts to do something about it.

Friday, August 27, 2010

Tempting Fate?

I have been very concerned with jinxing my progress by explaining how much better I'm doing, but I've decided to tempt fate and share it. 98% of my day I have no hip pain. That is HUGE!!!!! The other 2% of the time is when I stand up from a sitting position. And it doesn't happen all of the time. I'm still trying to figure out how to avoid the pain when I stand, because I assume it has something to do with the angle of my leg, hip, etc. But I feel like a completely different person than I felt when I started keeping this blog a couple of months ago.

Physical therapy is a gift from God. It has to be. I've been able to exercise pain-free, and I'm able to see just how strong I'm becoming. I have been increasing the intensity of the exercises (larger fins for resistance, increased number of squats, faster walking/running). And the water exercises have the added benefit of working my abs and arms also. That sense of accomplishment I got from running -- the pushing beyond my own mental and physical limits -- I'm getting that again, but in the water. And I'm even starting to enjoy the water. It's been hot here -- over 100 degrees each day this week. The water is a wonderful way to workout.

I'm still following Noell's 6-week eating plan (http://pickorstab.blogspot.com/) and I'm not really sure how many inches I've lost or how many pounds, but my clothes are getting very loose. I'm wearing a shirt today that I haven't worn in years (literally). Same with my pants. I even bought a new pencil skirt 3 weeks ago that was quite form-fitting, and I wore it yesterday and it was baggy in places. So, I assume that the reduced weight is helping relieve the pressure I'm putting on my hips also. 

I still haven't really resumed much activity beyond the pool-based, so that's my next challenge. Can I maintain this level of comfort and reincorporate some of the other activities I so dearly want to do -- bike, pilates, walk, yoga? I won't tempt the fates with running. I'm sad about that. There's a Keith Urban song, Till Summer Comes Around, and he's basically frozen in this place where he had a perfect summer love and hopes she'll return each year...she doesn't. He can't leave. I kind of feel like that's me and running. I fell in love, head-over-heals, and (due to my hip), running has said goodbye. I'm still wishing for it turn return to me, to give me the clarity of mind, the release of my over-busy head, the sense of accomplishment, etc. But I think I need to come to terms with the lost love and learn to love again. I'm seeing some shimmer of hope for a long-term relationship with the water.

I still don't know whether or not I'm going to end up requiring surgery. I know that the exercises I'm doing are not actually fixing my labral tear or FAI. They are just allowing me to function with minimal pain. I have a real concern that by not fixing the real underlying cause, I'm just postponing the inevitable, and when I do ultimately get the surgery, I'll have frayed more of my labrum, and caused much more damage to the joint. That is what is driving me to still meet with Dr. P and hopefully gain some more perspective. But at a minimum, I know that losing weight and strengthening my body is the best thing I can do pre-op anyway.

The rest is out of my hands. There isn't anything that this world can throw at me that I can't find a way to endure and of all of the possible things, this truly isn't that bad. Am I tempting fate? Maybe.

Thursday, August 19, 2010

Doing well (for now)

I haven't updated my blog recently because I'm not sure what to say except that, for the most part, I've been feeling pretty good. I am definitely getting stronger, and have been increasing the resistance of my ankle fins during the pool PT sessions. When I do the exercises on my own, because I don't have the fins, I've increased the number of reps I do. I have added in-water squats to the mix and some stepping exercises also. I've been having a really hard time with the straight-legged walking motion in that my legs kind of wiggle through the water. Jenn (my physical therapist) says that it's because I have extremely weak gluteus medius muscles. That is the butt muscle on the side, so it makes a whole lot of sense that its weakness has been making me compensate with other muscles, etc., and that's why my IT band is so darn tight.

I've been doing my pool PT 3x/week, and my land-based PT exercises the other 4 days. Additionally, I've thrown in some swimming and some walking, both of which are mostly comfortable. Last night, for the first time in over a month, I tried my easy 20 minutes Pilates mat video. I definitely am tighter in my legs than I used to be, but with some modifications (bending my legs slightly), I was able to get through the DVD without any pain. No pain a few hours later, but I did stiffen. This morning, I had no pain, but was tight. So, next time, I'll make sure to stretch but....yay!!!!

I admit though that I'm still concerned. My hip is constantly clicking, and I still get the occasional blinding pain when I stand up. I'm getting a little more careful in how I stand, so that I evenly distribute the weight, and I'm wearing better shoes, etc., so that pain seems to be less frequent. But it's frustrating to know that any step could be the one that hurts.

I don't know if the reduced pain is the result of my PT or my weight loss, or both. I haven't lost a ton of weight, but I definitely have lost some and my clothes are getting much looser! I have a strong but highly unrealistic dream of losing all of this excess weight and finding that my hip stops clicking and I can run without a problem. It's silly, I know. It's not like the bone will reshape itself.

I'm feeling a weird mental challenge at the moment. The stronger I get, the more excited I feel and the more I want to try doing the things I was doing before I was injured. Of course, I know I can't, and that makes me very sad. And I'll have random moments throughout the week where, for no apparent reason, I just burst into tears at the utter uncertainty and the pain and the frustration, the why me's, etc. The waterworks don't last for long, and they sometimes are empathetic tears when I read someone else's blog posting. But one surprising thing has helped me over the past few days --  I discovered the story of Job this week. That story definitely struck a chord with me...I'm clearly not the only person who has ever wondered why rotten things happen to good people.  And it helped me come to terms with the fact that I don't understand why or how I ended up with a mis-shaped hip, and that I don't know what will happen (in terms of whether I'll need surgery or whether I can postpone it indefinitely with the pool PT).

But I'm seriously lucky. Things could be so much worse than they are, and I have so many good things going on in my life right now. In a few weeks, I'll be celebrating my five-year anniversary with my husband. I've got some of the greatest friends in the world. I enjoy the work that I do, and especially the cases where we get to help employees who have been victims of harassment, discrimination and/or retaliation. I may not be saving the world, but I'm trying hard to make it a little more decent of a place to live in.

Thursday, August 12, 2010

Payoff

I'm still impressed with myself for returning to the pool to complete my PT on my own yesterday, and finally, I feel like maybe it's working. I woke up this morning feeling stronger, more stable, and sans pain! Don't know how long it will last (or if I'm jinxing myself by writing this), but I'm pretty excited.

But alas, this morning did not go exactly as I had planned because I awoke to an unfortunate surprise that one of my dogs left for me in the kitchen (ewwwwwwwww). BUT, since I'm in the mood to see the silver lining, in order to clean it, I had to do a lot of bending and scrubbing, and that did not seem to aggravate the hip!

Wednesday, August 11, 2010

Commitment

I realized today just how strong my commitment is to trying to heal my hip (or rather, strengthen the area and hopefully avoid surgery) by the pool physical therapy program. I got a late start on the morning and can't even put into words how much I didn't feel like going to the pool. I wanted another 10 minutes of sleep. A large coffee. Anything but having to actually go through the exercises... much as I love being able to do some exercise, I still don't particularly enjoy pools because the process to exercise at our public pool takes forever.

But I did it anyway. I went to the pool, later than I had planned, but I got there and started my routine. I was doing pretty well 17 minutes into the exercises when a lifeguard came over to me and said that the pool was closed. Closed? Yes, I know I was running a bit late, but it's 9am on a summer day. "When do you reopen?" I asked. He said at 11. So I had to stop my exercises and leave.

I decided that I really needed to finish my exercises, so I went back to the pool during my lunch hour. It was swamped with children of all sizes. It never ceased to amaze me how people so little can make such enormous waves, kick the water so hard, and displace so much water. But I found a "safe" little corner in the deep end and finished my entire set of exercises. I didn't start over from the beginning because I didn't want to overwork the muscles, but I did my first set again to warm up my body. I think that was a good idea. I started to have some pain while I did the exercises, so I backed off of the intensity and I focused hard on my form and squeezing the correct muscles.

I got a lot of curious stares but nobody pestered me. Of course, people don't tend to approach people who are wearing headphones. The music in the water is a good thing and a bad thing. I have a tendency to want to push harder when certain power songs come on. I have to fight that urge. BUT, it keeps the pool exercises a little more enjoyable, and that helps me actually get going. Yay for fun!

I'm proud of my commitment. At the end of all of this, if I ultimately have to undergo surgery, I want to look back at my effort and know that I did everything I could do to the best of my ability to help get better. Beyond that, it's out of my hands.

Monday, August 9, 2010

I tore my labrum AND my jeans

Before you start with the fat jokes, please realize that my jeans were actually quite baggy. But sadly, the universe decided that I dress too sloppily and ripped my jeans. The damage is irreversible :(  Why do I think it's a message from the universe? Well, I don't really. BUT, I had been shopping most of the day to replace my horribly tattered and size-inappropriate (for once, too baggy) wardrobe.  I found some very sharp ensembles and felt quite sophisticated when trying on what became my new purchases. But the contrast of what I purchased with the way I was dressed was actually somewhat funny (and sad). So, I just happen to have an unwearable pair of jeans and a whole shopping bag of fashion. I guess I'll just have to wear the classy looking stuff! :-)

I had a great weekend and somewhat of a semi-local, semi-vacation. I did my pool PT exercises on my own at the pool at the hotel in which my hubby and I were staying. I had purchased my very own floatation belt for the occasion (and future ones) so that I could do my exercises without having to sacrifice form while trying to stay afloat. It mostly worked. The deepest portion of the pool was only 5 feet. I'm approx 5'3" so I did scrape the bottom once or twice. But I got through all of the exercises. And if I thought I got stares during my electric cart ride through the airport a few weeks ago, ha! Everyone stared at me with looks that said, "hmmm....should I keep my kid away from this nutcase or not?" Whatever. I had fun and felt pretty good.  I had some pain later in the day when I was sitting in my car for a while, but the pain was primarily in my left hip. Weird.

I had PT again this morning. This was the first time that I've done the exercises in the pool that I've felt real pain when I did them. But the pain was a little unusual for me. It felt like it was in my right groin and front of the leg, but it also felt like it traveled down toward the knee. It wasn't the sharp awful pain I'm used to, but rather, was like that horrible feeling you get just before you get an horrid muscle cramp. Pervasive and all I could think about. We stopped the exercises and Jenn helped me stretch my quads and that helped the pain dissipate, though not dissapear completely. She also spent some time on my extremely tight IT band. Thankfully. The pressure on it hurt so badly but in that good sort of way that tells me it's effective. And I reduced the intensity of all of the exercises I did. But then I really felt like I wasn't doing a whole lot of anything. She assured me that I am, but I shouldn't feel any pain from these exercises.

I did get a couple more exercises to add to my list, including a quad stretch, and the best glutes exercise. For that one, you grab the wall and extend your body, front down so you're floating on the water. Then you do a sissors motion with your legs, straight, moving slowly and strongly and squeezing your butt. The legs press down through the water, so you work through all of that resistance. We do a bunch of sissor motions -- but this one is the only one I've done face down rather than "standing" and I think it's much harder to do. But that's probably because I have not developed these muscles as well as others. That's the coolest thing about doing exercises in the water. It really shows you where you're weak. It's obvious because you'll literally spin toward the side that is stronger. It feels like I'm canoeing with one paddle sometimes. And when I'm trying to move my leg straight and forward, sometimes I'll bend, or swing it outside of the frame of the body before I can get it realigned. It's weird because I do that when I walk also, but because the motion is so much faster out of the water, it's hard for me to really notice it or correct it. I wish I had learned these water-based exercises before I had even started to learn how to run. I would have been so much stronger. It's the best cross-training I've found yet.

I heard back from Vail.  Dr. P wants to meet with me and have me do another MRI before he decides whether or not to operate. I suspect that he'll also do that injection thing to isolate the problem and see whether it's just the hip or if the back side pain is coming from something else altogether. But he can't get me in before December. AND, that's only tentative until October when they finalize his December calendar. So my date might get moved (so no purchasing airplane tix quite yet). BUT, I have 14 pages of forms to fill out and return in the meantime, and I will definitely have an opportunity by then to see what kind of progress I can make with the pool PT.  Fingers crossed!!!!

Friday, August 6, 2010

Feels like someting else

Well, I'm experiencing firsthand proof that the "recovery" process (if that's what you can call what I'm doing....it's more like "precovery") is a lot of stepping forward and moving backwards.  I went to stand up after sitting for a few hours, and that blinding pain from the groin to the side of the hip prevented me from completing the motion. Worse even, the pain was in both hips and was most severe in my "good" hip. It is coming on in the same way as might right hip pain did. I assume that if, ultimately, the water PT helps the right hip, it will also help with the left hip pain. But if not, I'm not looking forward to the prospect of going through this whole cruddy process for two surgeries. 

Sigh. I guess one step (literally) at a time. Maybe this pain is reasonable to expect after the horribly sedentary month that preceeded it. I'll see how I feel tomorrow. Looking forward to "swimming" with the pull buoy and giving the hips a rest since I know they worked really hard this morning.

Feels like dessert

Physical Therapy this morning was mostly familiar this morning, with a few key distinctions. 1) I got to work out in the middle of the deep end, tethered to the wall so I wouldn't float all over the pool, 2) I got to work with ankle fins for additional resistence, and 3) I got to experience dessert! No, they didn't feed me. No, I didn't burn enough calories to actually justify dessert. BUT, when I was finished with all of the PT exercises, Jenn strapped some weights around my ankles, gave me additional floatation devices, and send me to relax in the deep end. She said I had earned some dessert. Now, back in the day when I actually used ankle weights for working out, probably the last word I'd use to describe them was dessert. BUT, in the water where my top half is kept afloat and my bottom half is pulling down, it gave me the most marvelous stretch and opened the hip joints. I got to hang out like that for 10 minutes! Initially my muscles in my butt and thigh were trying to hold on tight and were tense figuring out what was going on. But I finally relaxed into the stretch and it felt soooo good. I just wanted to stay like that all day. Sadly, I couldn't. The transition to gravity was dramatic, just like it was on Wednesday, but a little less jarring because I was expecting it. Since PT, my hip has been a little twingy, but no severe pain. Fingers crossed!

Thursday, August 5, 2010

Not the end of the world

I won't lie...the blinding pain I had last night scared me and sent me through the whole spiralling thought-process about the futility of PT and the ultimate result of surgery, and concern that I haven't heard back from Vail, etc. etc. So I was really scared to wake up this morning and see what sort of pain awaited me. I felt a little twinge when I rolled over in bed, which I promptly ignored and snoozed through. But eventually I couldn't put it off any longer and I scooted myself to the edge of the bed and stood up. A quick systems check, and voila, no hip pain. (A little muscle tightness though, and I think my IT band is still pulling on my right knee). But I took a large sigh of relief, and went through my morning routine. Fingers crossed that I get through the entire day pain-free!

Wednesday, August 4, 2010

And a set-back

My enthusiasm may have been a bit too early....

This evening, I bent over to get something out of a bag that was on the floor, and when I went to stand upright again, I got the sudden sharp, excruciating pain in my hips. It was actually much worse in my "good" hip (the left one), but it was definitely present in both and I had to hold onto a chair for support. It went away within a few seconds.

This is the first of that degree of pain I've had now in about a week and a half. I'm so disappointed. But it may have been the angle that I was using, or maybe it was the fact that I stiffened when I was sitting for a while before that. Maybe it was the angle I was sitting on the couch. Maybe it was the fact that I worked out harder than I have in a few months. Maybe it's the fact that I have a torn labrum and FAI.

It's now been 2 weeks and I still haven't heard from the scheduler at Dr. Philippon's office. I fear that although the PT may help, I'll ultimately need the surgery and I certainly want to move ahead so I'm able to pursue that option. I guess I'll call the office tomorrow if I don't hear from them by mid-day.

Why can't things be easy and straight forward?

Pool Therapy First Session

Today I experienced my very first pool physical therapy session. Let me preface this post with the fact that 1) I've never seen, let alone been in, a therapy pool before, and 2) I had previously looked at some exercises in a book for water workouts and after completing these exercises, ended up in quite a lot of pain for the following week.

I had to shower before getting into the pool, which I think is pretty typical, except that I was early, so once I was wet and freezing, I had to go sit in the waiting area by the side of the pool for 5 minutes. Next time I'll try to time it better. But then I was invited into the water to do a quick warmup. There was a waterproof wheelchair that I didn't need to use, but that I was impressed was even made, and a ramp with a handlebar that gradually let you enter the pool. I used the ramp and was very pleased to find 92 degree water. Fabulous.

Along the perimeter of the pool were two handlebars which reminded me of the bar on the wall of a ballet studio. My physical therapist, Jenn, had me "warm-up" by walking forward, backward, and side-to-side across (and back) the shallow end of the pool. Then, she secured a floatation belt around me, and taught me a whole bunch of exercises to be done at the side of the pool in the deep end. I started out with a "deep run" for 2 minutes, followed by a "power walk" for 2 minutes, followed by "flies" (hello adductors and abductors!) for another 2 minutes. I did three rounds of these exercises, followed by a minute each of "quick scissors," "abdominals" (i.e., keeping my body steady with the bar and bringing my knees into my chest), "bicycle" "straight-leg deep" (i.e., similar to the challenging exercise I've been doing on land), and "scissors" which is like "flies" but I'm at a 90 degree angle and can't let my butt fly away from the side of the pool. Then I do some stretching, (hamstring and thighs). Then I moved into the shallow end to do some leg raises (lateral), leg swings (forward), leg circles (lateral), knee swivels, quad extensions and hamstring curls. That was a lot to remember, so I got a laminated card (so it can get wet and I can bring it with me to the pool) with pictures of the exercises and instructions on how many of each to do.


Basically, it took me 45 minutes, but without the instruction in the future, I think it's about 30 minutes of actual work. There were a few exercises that I felt immediately, and a few more that were somewhat challenging, but I asked Jenn a few times if I was doing something wrong because I didn't really feel it. She checked my form, chuckled and said I am doing it right. She told me that we'll eventually add resistance, but she wanted to make sure I learned the exercise and had the right form during this session, and see how I do.  But I didn't fully comprehend her chuckle until I got out of the pool.

YOWSERS!!! Gravity hit me and I felt like I had just finished boot camp. I got a phenomenal workout. And apparently, when I had previously tried to do exercises on my own, I did them completely wrong. And, given that I have difficulty gauging my effort level in the pool, I had completely overdone it too. So working with Jenn was VERY helpful and in order for me to not do anything stupid on my own, I made sure to check and double check what I'm "allowed" to do on my own, and how often. Here's what I get:


  • I can swim!!! (No breast stroke, that'll hurt my hip). BUT, I don't HAVE to use the pull buoy as long as I don't have any pain (though I can use it if I want). No pushing off of the side of the pool though. No swimming on days that I do my pool PT exercises. 
  • I should try the pool PT program on my own 1x this week. (That'll be Sunday or Saturday probably). I shouldn't do it every day, and since I've got PT again on Friday, that means tomorrow is a swim day or rest.
So, I'm pretty excited. She told me to take it easy on the duration, but pay attention to how I feel. I think that given how hard I worked my legs today (and my abs, wow), I will probably go ahead and focus on my upper body tomorrow and use the pull buoy tomorrow so I can be at top form for PT on Friday. 

YAY!

Monday, August 2, 2010

Prescription PT

I decided to try Dr. Klapper's suggestion and do a water-based physical therapy program. I met with the physical therapist last week for the initial evaluation where she put my legs through a variety of strength and range of motion tests. Not quite surprising was the fact that my right leg was weaker and had less range than my left in nearly every aspect. I was given 5 land-based stretch/strength exercises to do on a daily basis. I am finding that, if I do the exercises correctly, they're challenging. If I cheat and use other muscles than the intended ones to accomplish the result, they become very easy. That tells me that I've really been compensating for some muscle deficiencies (but they're still there).

I've been watching what I've been eating with particular care this past week. I had been seeing a nutritionist who gave me guidelines to a healthy diet (which I had been getting increasingly less careful following), until last week, where I coupled my nutritionist's advice with a 6-week challenge, courtesy of Noell (http://pickorstab.blogspot.com/), whose challenge essentially mirrors the advice I've been given from my nutritionist! With the combined burst of motivation from the challenge, and some helpful accountability from my nutritionist, my sister and my hubby, I lost 4 pounds last week! And (maybe coincidentally), I haven't had much true hip pain this week. Only a few twinges. The discomfort I have felt this week has been entirely muscular -- things are so tight, especially my IT band.  But the muscle pain is actually much preferable to the joint pain because that means there is something I can do to make it better! I believe that PT will help me strengthen and lengthen the muscles around my hip (and hopefully all over). 

I'm so ready to start my pool-based therapy, but my first in-pool session isn't until Wednesday. Grr. But, in the meantime, in addition to my land-based exercises, I went swimming on Saturday for 20 minutes. The public pool was packed for a swim meet, so I ended up driving to the gym and using the pool there. But that pool didn't have any pull buoys, so I had to constantly remind myself to take it easy with the excessive kicking. But I didn't remember not to squat and kick off of the sides of the pool, so about 18 minutes in, I realized that I probably did more damage from that repetitive motion than I did from any kicking of water. Darn. But I got an incredible massage that evening to help loosen the muscles in my butt and hip and outer thigh and I think it helped a lot.

I feel really good today. Not just because my hip is not hurting (though it doesn't feel quite normal), but I have a lot of energy and I'm just excited. I don't know why I'm excited, but I think it's the first time in a while I truly feel hope. I also feel fear of feeling hope, but that's not really productive, now, is it!?!

I think that my biggest challenge this month will be sticking to what I'm instructed to do, and not overdoing it and pushing it. I walked my dogs yesterday, and it was a relatively short walk (though the first I've done in a while). I felt good and I wanted to keep going and thankfully, Noah reminded me that I should stop when I feel good, not when my hip is throbbing. So I did. And today, I feel like I can do it again. Maybe I'll add on another minute or two. But I don't seem to be good at self-moderation. Hence, my injury in the first place.

But I have a new healthy admiration of the human body. And I want to treat it with the respect it deserves and not treat it like a trash can I can throw whatever junk I want into and expect it to run properly. I have this amazing vessel I've been given in which I can explore and experience this life. And, in a weird way, I'm grateful for the hip injury. It is the only thing in my life that has really given me pause to truly think about the body I've been given, not as simply a superficial how-do-I-look kind of thing, but as a gift. Had I not injured my hip, I may still be running right now. But I'd otherwise be continuing down the same unhealthy lifestyle. I have a feeling that, for the long run, my hip pain may have been the wake-up call that saved my life.