Whatever I can do

I saw Dr. Klapper for a follow-up on Tuesday and the long and short of it is that there is some moderate improvement in the right hip and the left hip is more problematic. I'm going to keep up with the physical therapy and see whether I still have pain in another 6-8 weeks. If I still do, he recommends surgery and if not, then no worries. He said there's a possibility that some tears form something of a callus and so it would be possible to have something of an irregularity without pain. He doesn't think that you need to necessarily operate simply because there's an irregularity on an MRI or X-ray.

I don't know what to make of that.

I described to him the pain I had following Pilates last time, and he explained that it's not the hip that is causing the pain, but the surrounding musculature and weakness. So I asked him if I could do Pilates and/or Yoga, and he gave me the answer that I can do it as long as it doesn't hurt. Okaaaaaaaaaaaay.

So I went back to Mind2Body today and worked with the owner, Lani. She identified a bunch of ways in which I was unintentionally compensating for weak muscles by overworking the stronger ones, and was so good at explaining ways to isolate the ones that I need to strengthen. As a runner (or should I say former runner -- booo), I was particularly fascinated by the weakness in the inner foot and big toe area. I'm so used to putting the pressure on the outside of my feet from the way I pronate, and it's amazing how that has made my inner feet weak. I managed to get through the entire hour without pain, and I am hoping to get through the rest of the day in such a way. But the thing I found most interesting is that I think, despite my best efforts, that I'm compensating improperly in some of my water exercises. It's hard to tell because nobody is there watching me contract each muscle specifically. Some of the Pilates exercises seemed like the pool therapy exercises (but on land, of course). I would love to do both because I think they compliment each other and that by getting better at one, I'll necessarily get stronger and improve my form in the other.

I had a massage last night, which was really helpful to loosen the areas also. My massage therapist suggested that I get regular deep tissue massages (I'd love to if they lowered their prices, lol), and to try rubbing certain essential oils into the hip/thigh area. She also suggested that I try acupuncture. Her other suggestion was to sit on a tennis ball where the butt and leg meet to send blood to the area and to loosen up that area.

In light of all of this, I got very excited and a renewed sense of optimism that I may be able to forego surgery. After all, it seems like even if they fix the joint, I'm still going to have to deal with all this residual weakness and imbalances. But my husband brought me back down to reality with the simple, "it's all necessary, but it may just be postponing the inevitable...you may still ultimately need to have the surgery to correct the joint." Maybe, but either way, I want to do EVERYTHING I can do to strengthen and heal on my own first. No regrets.

I saw one of those inspirational questions the other day that asked if you could change one thing about your life, what would it be. I would normally answer that question "lose weight" but I realized something was different when that no longer felt like the honest answer. I AM losing weight (approx 13 pounds so far). I still have a way to go. But my new answer to that question is "heal my hips." I want this done and far behind me. Is that too much to ask?

Experiment - Part 2

So it's been 24 hours since my Pilates experiment. Drumroll please.....the result is that I am not sure if I can do it or not. I know, pretty anticlimactic. Basically, my sciatica (I think that's the muscle in my butt that was spasm-ing but I'm not sure) bothered me off and on for the remainder of the day. I rolled it out with a foam roller in the evening, and that helped somewhat, and I iced it twice, which also may have helped. This morning I woke without that pain (though the other side hurt a bit). So I don't know.

Could it have been triggered by the Pilates? Absolutely. Could it have been something else? Sure. Am I scared and did I go into the typical worry-cycle assuming the worst? Of course. Will I give Pilates another chance? Yes, but I'll ease into it...I'll keep up with my physical therapy and take one day at a time. And I'll wait a week before attempting Pilates again.

I wish this were easier and that there were some guarantees. I guess there are some guarantees, though just not the kind I want. I'm guaranteed that if I go out and run, I'll be in pain. I'm guaranteed that if I don't move, my muscles will weaken. That seems to be the extent of my guarantees at the moment. That, taxes and eventually death. You know what? Maybe I'm not so keep on guarantees after all :-)

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.

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.

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!

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.

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!!!!

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!

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!

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!

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.

Too Good To Be True?

Ok, this is going to be a long post. This morning I met with another local orthopedic surgeon, Dr. Klapper, who is the Director of the Joint Replacement Division at Cedars-Sinai here in Los Angeles. I had an idea of what to expect from him because I read the book that he wrote entitled Heal Your Hips, in which he advocates non-surgical approaches to hip recovery and hip well-being. He only advocates surgery when the conservative approach fails. But what I like is that his conservative approach seems to be a joint pool and land therapy program. In his book, he discusses the downward cycle of hip pain, how it causes people to move less, and that lack of using the hip joint (and replacing the fluids in the hip) actually causes the hip to stiffen and results in more pain, when thus, makes you even less active, etc.

He looked at my films and the MRI and arthrogram reports, performed a physical examination of both of my hips to see at what point in the range of motion I have pain, and then he showed me on my x-ray where the extra bone portion is located and explained to me how that is bumping into the labrum. He said that it is FAI. BUT, unlike the other surgeons who have looked at my films, Dr. Klapper did not believe that I have mixed-FAI. He saw the evidence of it only on the ball, not the socket. If he's correct, and the portion of the socket were shaved down, there's no question it would make my hip unstable. So who is correct? YIKES! And ultimately, I'm not sure anyone can be 100% sure what's going on simply by looking at these films. I assume once I'm cut open, it's a whole other world and they'll actually see what is what.

But Dr. Klapper said words that I didn't dare to hope to hear:  "I don't advocate surgery for you, and definitely not yet."  Given the fact that this past week I've been nearly pain free and given that I have almost full range of motion, he suggested that I learn the pool therapy exercises and see if we can keep the pain from returning while slowly reintegrating activity into my life. He said that my labral tear was small and that although some surgeons will scare the crap out of me, tell me they need to cut sooner than later or I'll end up with early on-set of arthritis, they simply don't have the conclusive studies on that. Will I get arthritis? Maybe. But can I make some modifications to my lifestyle now to postpone it for many years? Possibly.

But Dr. Klapper said the words I dreaded -- that running is the best activity for mood, stress regulation and weight loss, etc., but the absolutely worst activity for your joints. He wants me to give it up completely. No running ever, unless I'm being chased.

At first, I immediately rejected that suggestion. And then I really thought about it. I'm not a professional athlete. Until last year, I wouldn't have even called myself an amateur athlete. A little over a year ago, I'd have never even considered running to be enjoyable. Now I adore it. Maybe I could feel that way about a different sport that is less taxing on my joints. I love to exercise outside. Okay. But I can swim, walk, and bike outside.  (Once I'm feeling better). I absolutely LOVE pilates. The mat work, at least, is not high impact. (Actually, I don't think it's impact at all, it's just the bending motion that was irritating my hip). If I want to do marathons or half-marathons, many of them allow you to walk. And I know first-hand, walking 26.2 miles or 13.1 miles is no easy task. What is it that I want long term? To be a fast runner? To complete Boston? Or to have a lifetime of mobility, activity and good health?

I keep hearing horror stories of complications from surgery. If you dislocate a joint, it's my understanding that that joint will always be a little less stable than it was before the dislocation. But that's what they'd do (to some extent) to get into the labrum to repair it. There are simply no guarantees with surgery, no matter who is doing the cutting.

Is it realistic for me truly to live a life with FAI and a small labral tear with minimal pain and moderate activity? Who knows. It certainly seems like I've got nothing to lose by trying. The pool therapy sounds like a really good idea to try because it's non-impact and I'll have someone trained to explain the exercises and watch me to make sure I've got the right form.

He wants to see if I've got any improvement in the next 6 weeks. Either way, I wasn't planning on having surgery then, so I don't see why I shouldn't give it a try. And if I ultimately need surgery, I'm still waiting around for a call from Vail to set a surgery date. And if I don't end up needing it, I don't end up needing it. Still, I don't want to get my hopes up. But if I could have a week like this week every week for the rest of my life (and I mean that level of comfort while doing activity, not while sitting around), I would definitely forego surgery.

But two conflicting ideas are swimming through my head, both trying to answer the question of why was this week so much better than the last bunch? 1) I did very little activity of any sort this week. That makes me concerned that once I kick up the activity level, I'll go right back to the pain. 2) I ate better this week than I have in months. No added sugar, no alcohol, no processed foods, regular healthy snacks and small healthy meals. Lots of water. I'm sure I've lost a few pounds. Maybe my excess weight is really a huge factor that the surgeons are awkward about calling my attention to. I know that FAI and the labral tear won't go away. BUT, maybe without the extra body weight, the pain would go away. There's only one way to know for sure, and it's about time I shed this fat!