Updates and Progress: November 2, 2018 – January 5, 2018

Much progress has been made. While I’m still on a cane, I can foresee a time in the (hopefully) near future where I can get rid of this thing. A few milestones over the last few months:

  • End of September 2018, on Pennsylvania trip: last time I regularly used the crutches (one crutch, to be exact). Used the cane a bit on that trip. Struggled when using the cane outside of the condo.
  • End of September 2018: Upon returning from that trip, I noticed I had more space in my left hip. Meaning, I could stand and lean to left, and my body let me. This was HUGE. It really changed my attitude about my recovery. I began to tentatively hope that maybe I could get better.
  • Started walking with exclusively the cane in October 2018
  • December 5, 2018: Had a booster PRP shot from my stem cell doctor. He did an ultrasound before the procedure and got giddy at the amount of cartilage that had regrown in my hip thus far. He said, “It almost looks like a normal hip.” Woot! In my mind, this confirms much of my current pain and disfunction comes from my muscles.
  • Sometime end of December 2018: I stopped holding onto walls, counters as I moved around the house (hadn’t realized I’d been doing this. When I did, I decided it was time to stop). This resulted in an increase in strength within a couple days. Wow.
  • Stopped going to gym for most of December 2018. Things got busy, and I also found myself in a weird “in-between” stage where I was doing a bunch of muscle activation movements at home, outside of the pool and hot tub, re-acclimating my body to gravity.

As of December 31, 2018, I’ve started walking on the treadmill at the gym for 15-20 minutes, using speeds ranging from 1-1.8 for far, at various levels of incline. (This is serious progress. In March 2018 at the height of my pain, I could only do 0.6? 0.7? for 10-15 minutes, holding onto both side of the treadmill for dear life, and it was excruciating).  Currently, I hold onto both side sometimes, but much of the time one side, and vary my steps in length, and also where my feet fall in relation to my midline. Sometimes I’ll pretend I’m walking a tightrope (while holding onto both sides), and other times I’ll strive to carefully have my feet fall across the midline. This is the range of motion that’s the toughest for my body and muscles, so it stands to reason that I should (again, carefully) practice it.

Also, I’m working on activating and strengthening my muscles with my legs closer together in the standing position. Super tough. I wish I wouldn’t have let that range of motion go, but alas. You live and you learn. Currently, with my feet as close to each other as possible, I’ll hinge at the waist, often using our kitchen peninsula for support.

The concept of standing “in” my left hip, and evening out my legs

Also, I’ve noticed like 2-3 days ago that I don’t stand “inside my left hip” as much as my right. I still tend to stand with more weight on my right hip, with my hip protruding out to the right. I’m working on carefully shifting my weight into my left hip and letting my muscles (and ligaments, tendons, etc) learn how that feels. What’s interesting is that if I move into my left hip enough, my legs even out/almost even out before my very eyes.

The first night I did this, something in my inside hip (upper groin area) wanted to lock up on me with what I’ve come to call “blue lightning” pain. I remember encountering this back in February/March 2018, when I had a hint of feeling better, but let that pain scare me away. I remember after that spending weeks/months on the couch, and quickly went downhill. Fast forward to today, and I’m determined NOT to let that happen. This pain is trying to tell me something. Maybe I pushed things to far, although my movements were slow and careful. Or maybe it’s a temporary, inevitable pain that comes from soft tissue that’s complaining but not accustomed to moving that way. I’ve encountered different kinds of pain over the last few months that proved to be inevitable and temporary, but would go away over time as long as I gently encouraged my body to learn the movement. Funny, I don’t so easily get frightened anymore by different kinds of pain. Same with the popping and cracking I’ll get with specific movements, which I’ve come to learn means the muscle is weak and doesn’t know how to lengthen and/or shorten. With time and careful, slow activation movements, the popping, cracking, and pain usually goes away.

Yep, daily life hurts m@therf@cker, but I’m still here.

Currently, I’m working on sorting out this blue lightening pain. I’ll do gentle hip Hanna Somatic movements while sitting and laying throughout the day to encourage my hip to NOT lock up. I’ll also gently, slowly repeat the movements that caused the pain, while working on activating the muscles involved in the movement so my body learns how to handle it

Current regimen:

  • I’m eating more protein than I ever have before. Trying to get close to my body weight since I’ve got muscle to build, especially in my left leg, with its semi-withered hamstrings, quads, and who knows what else.
  • Trying to walk for 20 minutes on treadmill 6 days a week. Surprisingly, I’ve done 5 days in a row so far, and I feel improvement. My body’s ability to recover is improving. Beautiful.
  • Considering incorporating 5-10 minutes of backwards walking and evaluating how my body responds. Planning on trying the first session at home.
  • Core work: Hanging from pullup bar and lifting legs (super tough), laying and lifting leg to activate and strengthen psoas (tough, but I’m able to get through almost 3 sets of 7. I’ve noticed just about the day after I started doing this, it was easier to get to lift my left leg to get into the car, and in and out of bed. Interesting). I’m not doing these every day yet, though I know I should be. More like every other day as of a week or so ago. Also doing sit ups laying down with legs straight out.
  • Quad work: kneeling hip hinges (hip thrusts), which really, really tire out my quads
  • External hamstring work: Standing in forward lunge position on wood block
  • Calf stretch work: utilizing wood block in kitchen
  • Generally learning to stand with my legs closer together.
  • Also learning to put weight on each tip toe of each foot. Tough. But the more I do it, the less general pain I have.
  • Considering adding back in glute bridges, hip thrusts…
  • Light rebounding work in various positions: Me likey. Hoping it helps me recover some of my lost “spring” in my step. Currently I walk like a lopsided, drunken elephant.
  • Tissue work: electric massager, PEMF mat just about every day (these two work pretty well together), working on incorporating the hot tub more again
  • Consider an evening floor routine: push ups, shoulder pushups, plank, quadruped rocking, downward dog, upward dog, kneeling hip hinges (I like this guy’s form with your feet together: https://mikereinold.com/kneeling-hip-thrust/). Finish with sitting cross-legged.
  • Considering: Assisted squats? (as in, holding onto something and going down into as deep a squat as I comfortably can).

Note to self: I think I have supination with external rotation of the knee, based on this article: https://www.monikavolkmar.com/2017/04/25/the-week-of-externally-rotated-knees/

As part of the solution, try this Aim (Anatomy in Motion) stuff for walking:

http://:https://www.youtube.com/watch?v=0QHHs9Ye9AA&index=9&list=PLPYYXiSTPdCKOcF11BcM7k73Jd4ry2PLQ

: https://www.youtube.com/watch?v=J_hA28ovDRw

Consider: https://www.findingcentre.co.uk/wakeyourbodyup/

 

November 2018 (and into the Winter!) Initial Forecast

Still seeing improvement. Limping a bit less. Pain is a bit less, thank God. Still a ways to go. Can now stand on left (weak) side for a few seconds. Have also discovered I can just barely walk upright and tall, using my cane, and can pull the left side of my pelvis into posterior tilt with my butt and hamstring muscles…if feels like it anyway. There’s definitely more extension going on back there.

I’ve had to work hard for this progress. The progression of healing is not linear in this case. Sometimes I push it so hard I’m sore the next day, and I actually don’t like that. Some of it is unavoidable yes, but it temporarily makes me feel like I’m moving backwards. The soreness isn’t like regular DOMS. It feels like back when I got the original injury sometimes. Ugh.

Alas. Overall, progress is definitely being made. Now that it’s November, I’d like to build in a habit of movement over the winter. The last thing I want is to be sedentary and depressed like last winter.

Here’s what I’m considering:

To introduce currently (November 2018):

  • Continue to work at the computer standing up, as you have been the last month or two. This involves constantly moving and shifting my weight, and doing small exercises. Don’t forget to throw in a session of “belt work” around the knees as well.
  • Work on concept of resting squats (with much assistance)
  • Lying on stomach leg raises (extension)
  • Glute Bridges
  • Hip hinging and squatting in everyday life
  • Resting squat in hot tub at gym
  • Balancing hip muscles in sitting position, partial 90/90
  • Mobility work on ankles with board, wall exercises
  • PEMF therapy 1-2 times a day
  • JUST DISCOVERED I can lay on back and do a straight leg lift. This has felt next to impossible in the past. I can knock out 4-5 medium height leg lifts now. PRAISE GOD!). Now I’ll have to grease the groove with these daily, while I lay on couch at night.)
  • Not able to do side lying leg lifts yet, so let’s try the standing version with band attached to a table

Working up to:

  • Perfect form squats
  • Perfect form Romanian Deadlifts
  • Perfect form rotational lunges

Even further down the line:

  • Perfect form squats with barbells
  • Perfect form Romanian Deadlifts with barbells
  • Perfect form rotational lunges with barbells
  • Push ups (full body health)
  • Pull ups? (Way down the line, lol. Full body health!)

Hamstrings, oh hamstrings…I think you’re more important than I realized

As I briefly mentioned in my previous post about my frustration co-existing with my obvious progress, I think strengthening my left hamstrings will help pull that side of my pelvis back into a more normal position.

This morning my little medial hamstrings on my left side are notably, slightly sore, and in a good way. That is so cool. It means they are activating, and can now be strengthened. Seeing as they’ve visibly atrophied (they look and feel so floppy compared to the other side), it’s super exciting to know they are turned on and I can strengthen them. What did I do yesterday to make them sore? I did three sets of 8-10 glute bridges twice total, and the PRI 90-90 exercise sitting in a chair, with the EMS unit on my medial hamstrings.

Evidence for this line of thinking:

The Postural Restoration Institute (PRI) mentions one of the first things generally done is using the hamstrings to pull the left pelvis back.

I even had a knowledgable physical therapist I highly respect tell me single leg romanian deadlifts would help calm down my painful adductors.

And looking back over this year and a half of hell, the weaker that hamstring got, the worse my pain became. At my most painful point in March 2018, if I was laying on my stomach and tried to use my hamstring to lift my foot off the ground, I could barely do it. At the time, I didn’t give it a ton of thought because, frankly, I was overwhelmed and in one of the deepest depressions of my life. Alas.

The more I used walking aids, particularly both forearm crutches, the weaker my hamstrings seemed to get. And the more my pain increased.

This interesting article from Swiss Physio has some interesting points that hit home for me:

“Throughout the stance phase the hamstrings act to stabilise the pelvic girdle and propel the body, and therefore the centre of mass, forward. The faster the walking pace the more muscular activity is needed to maintain stability…

Any weakness may result in an anterior pelvic tilt and thereby an excessive lumbar lordosis, especially if the gluteus maximus is weak as well.”

Yep, that’s me, including the anterior pelvic tilt I go into when placing weight on my left side. So it stands to reason that strengthening my hamstrings (and glutes) will help naturally correct that.

And this interesting statement is from https://fulltorquefitness.com/?p=262, and highlights the importance of the Biceps Femoris (one on of the hamstring muscles) in hip stabilization and the SI joint:

“Together these muscles [the deep longitudinal muscle slings] work as stabilizers of the hips and core. This is mainly seen as we walk, these muscles absorb energy from the ground and transfer it up the body. Where the energy being set up will dissipate before reaching the head if the core is acting properly.

The Biceps Femoris has a special value in the stabilization of the hips. As the Biceps Femoris is contracted the sacrotuberous ligament is pulled down with it. This forces closure of the Sacroiliac Joint (SI Joint).”

Now, as I take steps to strengthen my hamstring, I notice I’m in less pain and feel sturdier on my feet. I’m mentally kicking myself a bit. I really, really wish I hadn’t let the muscle wither away to this point. Oh well…

Interesting observation: after doing two sets of 3 glute bridges last night, I was to the point of exhaustion. When I got up off the floor, I could literally, barely walk. In that moment, it provided me the opportunity to momentarily observe my gait when my glute and hamstring muscles were exhausted. In a way, it was really interesting, because it provided immediate evidence that my hamstrings and glutes are very, very important. It allowed me to hypothesize that therefore strengthening these same muscles should allow me to walk better. That’s encouraging.

It’s a gateway to accessing other areas of dysfunction

Of course I understand that activating and strengthening my hamstrings won’t fix everything, because my situation is complex. However, I strongly feel it is very, very, important because it will (1) directly influence how I walk and reduce my pain levels and (2) allow me access to other areas of my body that need straightening out and progress to more complex exercises that straighten me out as a whole, especially as the left side of my pelvis moves back into a more normal position. It’ll be neat when I can stand on one leg, hip hinge better, do single leg Romanian Deadlifts, single leg glute bridges, squats, and even walking with a more normal gait. These complex movement address other muscles in my body that need balancing.

Training thoughts moving forward 

  • I think I’ll try switching focus to fast twitch fibers for a bit with my EMS unit.  Apparently, hamstrings are primarily composed of fast twitch fibers. I didn’t realize that. Doggonit.
  • Eccentric training where I can.
  • Try different foot positions to target different hamstring muscles (neutral, outward, or inward)
  • Try dorsiflexing and plantar flexing to target different hamstring muscles.
  • Eat more protein.

 

*Did some research from Strength Sensei)

Impatient, Frustrated, Discouraged…And Yet Improving

Life seems to be all about paradoxes and contradictions. I’m no exception, apparently. I’m impatient and frustrated, and yet improving. It’s more important now more than ever that I record my improvements, or else they’ll slip by me unnoticed as I compare myself to other people.

Here are my latest improvements:

  • I have increased internal rotation. Notably. Got down on my knees today, and was able to rotate my left foot out/left knee in farther than I have in a long time (a year?). I can actually get my foot in line with me knee, whereas before my foot was inside the knee when looking down, as in stuck in external rotation. Dare I say it, but now I think I can even get a little actual internal rotation. This is huge. Every bit of internal rotation I get, the more access I have to my glute muscles and medial hamstrings. And how have I achieved this improvement? Several things. Reverse clams. Sitting, moving my legs as close to internal rotation as possible, and activating the muscles (adductors, hamstrings, glutes) in that position by pressing my foot in different directions.

 

  • Glute bridges actually produce a burn in my glutes and hamstrings. It’s been ages since this exercise produced a burn anywhere other than my right lower back (yes, you read that correctly…my lower back). Seems like now the correct muscles are being activated. And while some may say only my glutes should be activating…oh well. My left hamstrings have visibly withered away, so they need MASSIVE work. I hypothesize that strengthening my hamstrings will help pull the left side of my pelvis back into position (I think it’s rotated forward at the moment.) I’ll take activation of both muscle groups for now, thank you very much. This is HUGE. Now I can do this exercise every day, or as much as I my body can take.

 

  • I’m increasingly using no aid walking around the house. This presents a huge paradox for me. Out in the world, I alternate between one crutch and a cane mostly. Once and a while (rarely), no aid. While this is overall an improvement, it making me work harder than ever. This makes life feel twice as hard as it used to be when I was on two crutches, because then I could simply lean on the crutches. Walking with fewer aids is hard work, and when life gets hard, I get discouraged. Nevertheless, me using less aids is an improvement. I need to remember this, even as I struggle to get accustomed to fewer walking aids. Sometimes I miss using two crutches, even though I think it made my lower body weaker overall.

 

  • My right, less symptomatic hip is less achy than it used to be overall. I’ve noticed the improvement since making it a point to be on my feet around the house more (working on the computer, etc)

 

  • My standing stamina is improving. While walking 10 feet with no aids is still a struggle, standing on my feet and carefully shifting my weight is getting easier. I’m able to last around a couple hours (max) on my feet. This much, much better than the 20-30 minutes I used to last when I was at my worst months ago. At my worst months ago, I was terrified that I was one step away from a wheelchair. Not anymore, woot!

Thoughts

Has using walking aids hindered my progress? I wonder. Now that I’m doing corrective exercises, walking without any aid may have its benefits. My muscles may grow stronger. My muscle slings may learn to work together.

Everything is hard. Everything. Turning while standing. Maneuvering. 10x the effort. However, my theory is that my muscles will adjust to the increased load and will also respond quicker when I need them. If less movement this winter increased my pain and feebleness, it stands to reason that mindful, careful increased movement will help me get better.

My working theory at the moment:

Psoas firing and strengthened –> pectineus firing (and strengthened?) –> adductors release as a result, and maybe heal from the repetitive strain they’ve been under –> glute medius becomes uninhibited by adductors –> while I also do muscle sling work to get everything to work together (use walking poles?) –> gait restored

Observations

Working the anterior sling in the seated chair exercise seems to be helpful. Especially as I twist towards the painful side, I’m able to slightly lift my left leg off the floor. Still difficult, but a little easier. I also try to focus on kind of sucking the leg into the hip, in hopes that I’m activating my psoas and pectineus.

Future Plans – Sling Work

This is what I’m doing right now, and it’s working so far:

  • Continue with rotational lunges in jacuzzi and out (lateral sling.)
  • Stand on one foot more (lateral sling)
  • Reverse Clam Shells
  • Bridging (I want to get to single leg eventually)
  • *Practice laying leg extensions with arm movement (posterior sling) – Not doing this regularly. Need to.

Things I need to add:

  • My left adductors are really weak. So weak, it gets painful when I bring them towards the midline of my body. I’ve been avoiding this movement, but I think I need to face it. There may be the possibility that these weak adductors are what’s causing my abductors to be tight. It’s worth exploring. As it is, these weak adductors are also a weak part of that anterior oblique slings. I think that’s a large part of why my leg stays away from my body when I walk.
  • Be on feet more during day, but be strategic with it.
  • WATCH THE ORDER in which I do things. I should try activating the left adductors first (pressing leg into cane while standing does this), then activate abductors in that position by pressing into cane. Then practice putting weight on left leg.

List of slings from https://breakingmuscle.com/fitness/re-thinking-functional-movement-the-sling-systems-of-the-body:

“Anterior Oblique System: External and internal oblique with the opposing leg’s adductors and intervening anterior abdominal fascia.

Posterior Oblique System: The lat and opposing glute maximus.

Deep Longitudinal System: Erectors, the innervating fascia and biceps femoris.

Lateral System: Glute medius and minimus and the opposing adductors of the thigh”

Also, great article here: https://experiencelife.com/article/why-you-should-activate-your-sling-system/

 

 

Deeper Findings: The Role of My Internal and External Rotators

The more I explore different movements, the more I am convinced that my internal rotator group of muscles in my hip are weak on the left side. In some ways, it seems obvious, especially given the fact that I have very little internal rotation on that side.

Interesting, however, is that the more I do gentle rotational lunge movements with that side, the more internal rotation I gain. Sometimes, I’ll notice an immediate improvement in my internal rotation.

And there seems to be a direct correlation between how much my pain adductors learn to lengthen (which reduces pain) and how activated my internal rotators are.

The rotational lunges I’ve been doing have been very, very helpful. The reverse clam movement seems to activate my internal rotators as well, so I need to do more of those. I’m hoping the two movement complement each other. However, with me compliance becomes an issue with any movement that requires me to lay down, simply because it takes alot of work for me to get down on the ground. Therefore, I’ve been practicing with standing movements that focus on activating my internal rotators, such as focusing on rotating my left heel out (but keep it planted to the ground) while I rotate to the left. Also, focusing on driving the left knee inward is a helpful cue. If I can find a good corner to place o the outside of heel, then that helps too. And placing my hands on my hips and feeling those muscles move is very helpful.

Speaking of placing  my hands on my hips, I can feel a clear difference when my internal rotators are active versus the external rotators, especially on my right (stronger) side. It’s extremely helpful having a stronger side to compare the weaker side to.

Upping My Game

Considering trying some/all of these for a week, in addition to what I’m already doing, to see if it helps me move even more in the right direction:

  • SUPER IMPORTANT: Rotating lunge on weak leg. Twist to left. Sarah Duvall recommends this exercise too, here. This should help your pelvic floor as well. I notice an immediate positive difference in my strength and pain level when I do these. Also, the same day I started doing these, I noticed my leg length discrepancy (while sitting on couch and leaning back with knees drawn partially up) was noticeably less. To start off, I’m doing a bunch of isometric holds first and adding in a little bit of twisting where I can. This is quite the challenge. Considering taking this movement to the pool to see if I get greater range of motion)
  • Standing leg extension for hamstrings and glutes. Progress to band when you can. Use with EMS Unit.
  • Practice putting as much weight as you can on weak leg while in internal rotation. I seem to stand better on one leg when in internal rotation, as opposed to external.
  • Glute bridge
  • Laying on stomach leg extension with EMS Unit
  • Fire hydrant tissue work
  • Walking in park or on treadmill (have done this just a couple times in the last week, so let’s do more)
  • Reverse clam
  • Normal clam (when you can do it without popping and clicking and excessive TFL activation)

Undeniable – Positive Changes, Slowly but Surely

Since Thursday August 23, I’ve been “Greasing the Groove”, often with my EMS unit, and generally being on my feet more. When I’m on my feet, I try to move correctly and use neuromuscular-minded movement, although I still have a way to go. I also do repetitive drills throughout the day. I also take more time to make dinner (as opposed to rushing through it in order to get off my feet, or not making it at all). On Monday, I was on my feet for an hour to make dinner, and I could barely do it. On Tuesday (yesterday), I was on my feet for nearly two hours at dinnertime. While it wasn’t as much moving around (maybe?), it was much easier than the day before.

For the last 3 days, I’ve also been doing mini “triathlons” as I like to call them: I’ll hop on my stationary bike for about 10 minutes, then the elliptical/adaptive strider at the gym for 5-7 minutes, and then I do my aqua routine, which includes mobility work in the jacuzzi. I’m still trying to figure out when I should work in active rest days, as it’s not a ton of activity, but I don’t want to overdo it.

The results so far? By night time, I’m usually feet-aching did-I-rub-down-my-cartilage tired. It’s alot of work, physically and mentally. But when I got up this morning, I noticed I have slightly more power in my posterior chain, and as I maneuver around the kitchen, I can use my stabilizing muscles to help me stand ever so straighter.

Interesting struggle: It’s so hard for me to get a good left glute squeeze. Instead, I tend to clench my jaw and pelvic floor automatically. This needs to stop. I’m working on it.

Interesting realization: it’s been weeks since I’ve had hamstring pain on my left (weak) side.

I’m definitely a little better, and definitely not worse. Despite my constant fears of grinding down the joint (it’s so hard to get the bone-on-bone MRI and Xray images out of my head), there is an increase in strength, and a decrease in pain.

Greasing the Groove

While it’s all the rage to go hard and fast with a chosen workout routine these days, perhaps I’d be served best by “greasing the groove” – as in, doing a little bit each day.

Months ago, it hurt to even point my toes while lying down – and on both feet. It felt like a thin bolt of lightning down the back of my leg, just under the calf and extending to my achilles tendon. The movement was also accompanied by weakness, as if I didn’t have full control. Alarming, to say the least. I don’t know what caused this, but I think perhaps the muscles were getting weak/imbalanced since I was walking so oddly, and without crutches at the time. Once I started using crutches, I also made it a point to flex and point my toes while lying on the couch and watching TV. How often, I don’t know, but it became a semi-habit. I was unconsciously “greasing the wheel”.

And I can’t remember exactly when, but over time the pain lessened, and then went away. For months now, it’s been a non-issue, but I haven’t dwelled much on it. But perhaps I should. Perhaps because the muscles were slowly strengthened / re-educated on how to move?

What if I need to “grease the groove” for my hip/leg muscles?

And what if this is the case for my hip? What if my much of my pain is coming from freaked out/imbalanced muscles? Even if this is only partially the case, I should pursue this. Totally worth it if I were able to reduce my pain by 50% for example. If I could cut my pain in half, I think I’d lose my mind with joy.

So I think I need to try this with my left hip. I’ve experimented with simple strengthening movements this morning, and feel the difference already. For example, every time I get up, I do some micro lunges withe the weak leg forward in order to target the hamstring and glutes. This movement creates that shooting sensation of pain that leads to the audible sound of things cracking in my leg (I still can’t put my finger on where. The knee? The hip joint?), so I move SUPER slow and gentle. Every time I do it I hope I’m not doing damage/wearing away cartilage, and yet it’s such a basic movement I’m tired of avoiding it. If I want to walk again, I need to be able to do things like this. And I keep the lunge angle to a minimum. Seriously. This is a regression of a mini lunge. It’s a freakin’ micro lunge, y’all.

Then, with my leg still out in front of me, I’ll lower myself into a gentle Romanian Deadlift-esque bow/hip hinge with my weak heel pressing into the ground in order to gently strengthen my glutes and hamstrings.

Then I’ll lean against a nearby counter and extend my weak leg behind me in a slow, mini extension move. I try to do 5-10, although sometimes I’ll quit early because, again, the crackling and shooting pains.

Then I’ll stand up straight and tall, and gently shift my weight from side to side., then front and back. Being able to shift my weight over to the weak side is new, and I like it. Still can’t get all my weight over there, and I can’t stand on one leg yet, but I’d like to think I’ll get there eventually. Interesting that putting my weak leg in front of me and shifting my weight slowly onto the heal is the most difficult and painful.

It seems like I’m thinking up new movements every day. Some of them don’t have names, ha.

Then, I did something I don’t usually do: I slowly took the flight of stairs up to the second floor. On average, I go up and down the stairs ONCE per day. But what if I made it 3-5 times per day? It’s a short flight, and I understand that I need to be careful because it’s such a weight-bearing movement. But it didn’t kill me. Wasn’t too bad, actually. For some reason, going up the stairs is easier than walking forward on level ground. Beat’s me.

This afternoon, I think I’ll do 5-7 minutes of the elliptical. What if I kept it short like that and just did a little every day? As opposed to killing myself doing 14 minutes (like last time), and then avoiding the thing for 4 days because I dread doing it again. Then I question my whole reason for even doing the elliptical, and then I question why I even bother with any of this, and then I question why I even both with life.

Best to avoid and prevent that train of thought.

This all adds up to a slightly higher activity level than I’m accustomed to. My hope is that my body adjusts over time, and I get over dreading being on my feet. An added benefit is higher moral. If I’m not killing my muscles all the time (which can be painful), I won’t dread doing the exercises / movements as much.

So in a nutshell, this is how I may “grease the groove” moving forward:

  • micro lunges
  • gentle deadlift/hip hinge bow
  • gentle leg extensions
  • shifting weight side-to-side, then front and back
  • placing left leg slightly in front of me, as if I were going to take a step. And then slowly shifting my weight onto that left. Only go as far as you can with minimal pain (I can’t get far yet). This one seemed to reduce my pain when walking with crutches and moving around in general.
  • take the stairs on occasion
  • 5-7 minutes on the elliptical
  • usual aqua exercises/jacuzzi routine

I’ve been ignoring my glutes – by accident!

The a couple days ago I laid on the floor on my stomach, and attempted to lift my left (weak) leg.

Couldn’t do it.

All the improvements I’ve seen over the last few months, and yet no improvement on using my glutes to lift my leg.

So yesterday I decided to focus on glute activation OUTSIDE of the pool. I kept it simple. Really, it was a series of glute squeezes in various positions. Lo and behold, today I notice some improvement in my pain levels.

Therefore, in doing research, here are glute exercises I’m considering:

  • starting every warm up I do with glute activation squeezes to make sure they’re turned on and ready to go (neuromuscular re-education
  • lay on stomach, squeeze glutes
  • hip thrusts
  • glute bridges
  • resistance band exercises

Eventually, I want to work up to doing glute bridges and hip thrusts because I can’t do them right now on the weak side.

Had a Great Workout Today – I Want to Remember It

Day by day, I’m feeling stronger. There’s less pain, and I feel my glutes and hamstrings getting stronger on the weak (left) side. Standing straight is getting easier, as well as moving around my kitchen. I’ve even found myself dong more tasks in the kitchen lately!

Today – August 15, 2018 – had a solid workout, and wanted to write it down so I don’t forget it. Here’s how it looked.

  • 13 minutes on the elliptical/adaptive strider (took occasional breaks): took long strides, did some slow squat holds, and lifted my knees up near my chest by balancing with my arms. Also did stair stepping motions.
  • Jumped in the jacuzzi and put my leg in traction. Also did the couch stretch.
  • In the regular pool, I walked forwards and backwards.
  • Also put the band around my knees and walked side to side.
  • With the band around my knees, went down into a squat and held it.
  • Took band off. Did weird long side-to-side strides, pushing off with my posterior muscles and stretching out my adductors. It looked like I was dancing/doing some type of Tai Chi in the water, but if felt right. 🙂
  • Using the noodle, I did my kicking drills: forward, backward, and each side
  • Hopped back in jacuzzi and put my leg in traction again.
  • Did some gentle range of motion movements in the jacuzzi.

This workout left me tired, but feeling stronger. Of course, I grounded with my grounding blanket and used the electric massager when I got home.

Woot!

Interesting. Discovered trigger points? Something up with my glute muscles?

Trigger points in my right glutes causing groin crease pain?

Today, I hobbled out to the back deck and plopped down on the top wood step. After shifting around a bit, trying to get comfortable, I realized when I leaned to the right (good) side, just to the outside and under my “sit bone”, it reproduced the pain on that same side groin crease. There was also a lump there, and it reminded me of a knot. Or trigger point?

Very interesting.

Trigger points in my left glutes causing adductor pain?

I did this a few times, and it confirmed it. Later in the day, I performed the test on the left (bad) side, and discovered the pain in my adductor area was reproduced when I shifted my weight just to the inside/under the “sit bone”.

Also interesting.

Do my hip/pelvis muscles need these specific, subtle movements?

And later on, when leaning over the bed and balancing myself with one arm while changing clothes, I decided to do some light movements to activate the glutes/hamstrings in that position. I braced both hands on the bed while bent at the waist, and lightly rocked from side to side. The left side was more painful, so I took it slowly. I also leaned to the left and tapped my foot. Did this for a few minutes.

After straightening up and moving around the house, I noticed it was notably easier to shift my weight from my right to the painful left side.

These movements are subtle. I’m also working on the subtle weight shift that happens when going from one leg to the other while moving around the kitchen, or even from sitting to standing. For the past couple days, I’ve been trying to be mindful of these movements, rather than simply putting most of my weight on my right (good side). The hope is that over time my body will get used to these movements, and the involved muscles will become stronger.

So many questions.

Is this something I should look into? Is much of my dysfunction coming from possible trigger points in my low glute area? Could these trigger points be causing the pain I feel in my adductor area on the left side, and groin crease area on the right side?

So many questions!

I’m Becoming “That Creeper” at the Pool

So the more I exercise and do range of motion work at the pool, the more I realize how much my body likes it. The more I realize my body likes it, the more thought I put into how I can maximize my efforts. The more I work to maximize my efforts, the more I begin to incorporate somewhat weird tools into my aqua routine.

Example: I’ve started utilizing an exercise band around my legs for side to side movements in the pool to work my lateral muscles. In fact, I’ll wear the band around my waist before I even get into the pool. Sometimes I get weird looks, like I’m trying to start a fashion trend. No, my dears. Perhaps in official aqua rehabilitation pools these bands are normal, but apparently at the local fitness pool, not so much.

Another example: Today, when I go into the jacuzzi, I’m going to bring my small lacrosse ball in with me in order to work on my glute/piriformis/possibly hamstring muscles. Whatever I can get it. I may look like a perve while doing this.

Another example: I’m probably going to experiment with “trigger point taping” my adductors. This tape will show while I wear my swimsuit, even with the  shorts I wear. I will look weird.

Alas.

July 21, 2018 – Unmistakeable Improvement

Good gracious me. It’s been almost a month since I’ve been going to the pool, and the improvement I’m seeing is unmistakable. I almost don’t want to say anything, because I’m afraid I’ll start overthinking things and sabotage myself. I think the improvements are due to a number of factors, including the pool exercises, jacuzzi mobility work, stem cell therapy, and the nutrition/supplementation protocol I’ve been following.

A realization – I need to get at those trigger points

For the past few days, I grudgingly started learning more about trigger points, and that’s been a revelation. Here are a few facts that stood out to me:

  • trigger points can shorten and weaken a muscle
  • trigger points in the adductors can make it neurologically difficult for you to engage your glutes and hamstrings
  • often, trigger point pain can be debilitating, and is often confused with the pain of arthritis.

If that ain’t me, then I don’t know what is. Looking back over a year, there’s a very good chance trigger points were involved in alot of my pain. They could even be a large part of why my left hip joint closed up (possibly. Although it’s also possible my left hip joint was closing up over time. I did have some impingement, after all for years before that, after all).

So for the past few days I’ve been working periodically throughout the day to get at my adductor trigger points on both legs, since my right side is beginning to display symptoms similar to my left. ugh. I’ve been using my hands and my electronic massager to get at painful spots. Sometimes I focus on relaxing the muscle. Other times I bring the muscle through a range of movement. I try not to overdo it with the electric massager because the jury’s still out on if over-using it could damage nerves/bones, etc. The thing is powerful.

Exercising while working

I spend a fair amount of time at my computer in the mornings while working at home, so I’ve been playing with keeping my body healthy, moving, and hydrated while getting work done. How do I do this? I think I mentioned it in another post, but here’s a run down:

  • I drink my green powder + MSM + vitamin C mix
  • I drink my coffee + bone broth powder + grass-fed butter + stevia or honey
  • Immediately after, I drink a cup or two of water.
  • Start working on computer. With feet on floor, lean forward to engage glutes and hamstrings in a kind of hip hinging move.  Lean back into couch to practice pelvis stabilization and core engagement, similar to a gentle sit up. Sometimes, while leaning back with my core engaged, I’ll lift one or both legs. It’s incredibly difficult, but getting easier.
  • After 20-25 minutes, I have to pee, so I get up to pee
  • Drink more water
  • Work on computer. Do more mindful movements. Sometimes I’ll hook up my EMS to my left (weak) hamstring for 20 minutes to help it recover from the previous day’s workout, or I’ll put it on a stronger setting to actually work the muscle a bit.
  • After 20-25 minutes, I have to pee, so I get up to pee
  • Work on computer.
  • And so the cycle goes

I find that this keeps me from sitting at my computer for hours without moving, like I used to do. I also get some healthy movement in. 🙂

I’m still so impatient.

My pain is steadily decreasing. My strength is steady increasing. And yet I’m still really, really impatient. At the pool a couple days ago, I walked in grumpy because man, this process is grueling. It takes up my whole day. It’s literally on my mind all the time. It seems like the entire world can walk but me. Getting stared at with these crutches gets old. Quick.

And yet, all I can do is persevere.

 

July 15, 2018 – Am I pushing myself hard enough?

Let’s see. Today’s Sunday. Here’s a quick recap of what the last few days looked like:

Thursday

Before heading to the pool, I did the couch stretch on my right side, and then did some posterior muscle activation to hopefully teach my right psoas to freakin’ relax. Performed glute bridges, side lying leg lefts, and then some assisted single and double leg Romanian deadlifts.

Tried the sitting leg curl machine for the first time (in years, anyway). Could only curl 10 lbs on my LEFT (weak) side. Good grief. I would have tried less than that, but it was the lowest the machine would let you go. I mean, the 10 lb weight was literally welded to the bar. So. Did about 3 sets of 5 and left it at that. Kept it slow and gentle, because the last thing I want to do is pull or tear that hamstring. As I slowly performed the movement, I could feel pain as the muscle shortened and lengthened. It wasn’t horrible pain, and seemed unavoidable considering the lack of use that muscle’s had lately. Hamstrings are one of the most common things to injure. Amazing that hasn’t happened already in the craziness of this past year. It’s gotten visibly smaller and floppy.

On my RIGHT stronger side, I did 30 lbs. Is that normal? Seems low. That side seems chronically tight and tired every day these days though, due to it overcompensating for my other side. Decided not to do any complete sets on my right side, because I’m not sure if stressing that side is the way to go. Again, I don’t want to pull the doggone muscle. The thing feels rock hard most of the time anyway. And as I mentioned, tired, like its full of lactic acid.

Went to the pool and did my usual exercises.

Friday

Note: Right side glute med definitely sore. Did I overdo it?

Since I wasn’t sore from Thursday’s hamstring curling, I decided to try the machine again. At first, I set the machine on 10 lbs for my LEFT hamstring, cringed in preparation for the pain, and curled my leg down.

I nearly flew off the seat.

No pain. Huh. After a moment of looking bewildered, I increased the weight to 20 lb. Performed a curl. Only a fraction of the pain from the day before, along with the normal sensation of my hamstring struggling with the increased resistance For kicks (no pun intended), I then increased the weight to 30 lbs and performed one for two curls. Was tough, with a little more pain, although still not as much as the day before.

In the end, I set it at 20 lbs, delighted that I was able to double the resistance in one day. Performed about 3 sets of 10 lbs. Definitely tough, but only a little painful.

Just as a test, I set the resistance to 30 lbs for my right (stronger) side. Definitely felt easier than the day before. What the deal? I increased it to 40 lbs, it felt appropriately difficult. However, I again decided not to perform even a full set on that side because it feels chronically overworked.

After that, I did some bicep curls for fun in front of the mirror because they’re fun. Also, with my forearm crutches and crawling-like exercises I do throughout the day for my muscle slings, it feels like I’m constantly working out the back of my arms and back. I don’t want to ignore my biceps. Also, I’m just a bit vain about my biceps. Always have been. They look nice, and it feels darn good to feel a little bit positive about one part of my body.

After that I hobbled to the pool and did my usual exercises. Jacuzzi afterwards.

That night, I used the EMS (electronic muscle stimulation) unit on my left bicep to hopefully help it recover fast. In fact, I used one of the “muscle recovery” programs.

Saturday

Right side glute medius still a bit sore.

Left hamstring definitely sore from the day before. Feeling it.

Spent a fun day with the in-laws, so I never made it to the gym/pool. However, they have a jacuzzi, so I used that and did some light range-of-motion exercises. Felt awesome not to lose a day of physical therapy. Am I getting obsessed with my rehab? Yes. Has it taken over my life? Perhaps. But you know what else takes over your life? Being in constant pain and limping everywhere. So the way I see it, I might as well attempt to take some control over the situation.

Even though I didn’t officially “exercise” per se, I found myself physically exhausted by the end of the day. We took the boat out, and apparently, walking from their back deck down the sloped yard, down the down to the boat, and then back was alot on my body. I did a total of 3 laps, with 2 of them being on one crutch. The last lap I had to use two crutches because my legs were just plain tired. And then after eating on the back deck, I attempted to help clear some of the dishes, and seriously struggled after a few trips from the back deck to the inside kitchen.

That night back at home, my hubby was amused at the sight of me sprawled on the couch, barely able to keep my eyes open (it was like 9:30pm). I was literally in and out of consciousness, mouth open and occasionally babbling. Seriously. I was also sleep deprived from the previous two nights, so yes, I was a mess.

Sunday

Glute medius still a bit sore. Dagnabbit. Seriously wondering if I overdid it. Did I put more stress on a muscle that’s already over-compensating and overstressed?

This is all such a mind-game.

Slept like a newborn-baby, so feeling good in that respect. My left hamstring is sore, but that’s not a bad thing. After a year of bizarre, severe pain on my left side, it’s nice to experience some normal DOMS. This may be a good thing. Perhaps I should incorporate seated leg curls into my routine 2-3 times a week. I wonder if I can try the movement with the foot turned in and out to target different areas of my hamstrings? Dunno yet. Don’t want to hurt myself.

Another thought: I don’t have extra pain from being on my feet so much yesterday at the in-law’s, so I wonder if I should push myself to get used to using just one crutch when I’m outside the house? One of my goals is to get down to one crutch all the time (as opposed to just inside the house), feel no pain while doing it, and not have to hold back while putting weight on my left side. At present, I can go short distances on one crutch, and most of the time I experience muscle pain in the groin/adductor area.

But it makes sense I’d need to go down to one crutch if I want to go down to one crutch. Ha. However, I don’t want to do it too soon or grind down the joint. Or disturb the stem cells that were placed there a mere month ago. I was trying to wait until I was in less pain, but maybe in order to get in less pain I’ll need to increase my activity level…which would mean more pain until my body adjusts.

However, I also want to appropriately push myself. Hmm. I’ll give it some thought.

Some symptoms coming from “good side”. Who would have thought.

Doggonit. My right side needs work.

So apparently my (mostly) non-symptomatic side RIGHT glute medius may be weak, lazy, and lengthened. Great. And here I thought that was the “strong” side. Well, it’s at least stronger than my left side.

So in addition to “couch stretches” for my tight psoas on the right side, I’ll need to add side-lying leg lifts. I should probably do some other other glute activation in that area, a la Upright Health’s recommendation.

The sequence would look something like this, twice a day:

  • 5min: Couch stretch on right side, using electric massager on the quads/psoas-ish area
  • Right side glute bridge
  • Right side side-lying leg lifts
  • Right side assisted Romanian deadlift

In a way, I should be happy part of my solution lies in strengthening my right side, since it’s far, far easier to do these exercises on my right side anyway. It’s just…who would have thought the side that doesn’t hurt as much could be such a key component to the other side’s dysfunction?

Perhaps I should cherry-pick exercises from The FAI FIX for my RIGHT side. Eh? Eh? They already mentioned the side lying leg lifts and glute bridge, for example.

Time to tackle the leg lefts for my LEFT side

Additionally, I should start working on the dreaded lying leg lifts (while I’m laying on my back) to strengthen the LEFT side psoas. I think it’s gained quite a bit of strength compared to how it used to be (could barely lift my left leg an two inches while standing), but I still struggle with lying leg lift, so there’s that. Granted, it gotten easier (I can get just barely an inch or two up off the ground when laying, and that’s HUGE progress), but still. It’s a struggle.

An overview:

Here’s an important part of the dysfunction we’re looking at:

Right psoas/iliacus OVERACTIVE/TIGHT
Right gluteus medius WEAK/LAZY/LENGTHENED

Left psoas/illicaucs WEAK/LAZY/LENGTHENED
Left gluteus medius TIGHT/SHORT (but probably also weak and atrophied).