Oh, I'm psoas sore.

So, I thought it would be a neat thing to post about all things Physical Therapy today. I’ve been spending so much time going to it that I figured it might be nice to keep track of what I’ve been doing. It might be helpful for my hip ladies to see what I’m doing at PT and give them ideas of new exercises to do.

First I thought I’d start with some astounding facts and figures.

Last night marked the 41^st time since RPAO that I have attended a physical therapy session. 41 times! Every physical therapy session bills out at $320 a pop. This is NOT what I pay, I am covered significantly by my medical plan…however I think it’s amazing what these numbers come to for health care in general. So, if every session is $320, and I’ve been to 41 sessions…that means that my little hippy has needed $13,120 in physical therapy! Holy guacamole! That brings the grand total for my bionic hip to nearly $70,000 to date. And that’s not even counting surgeon office visits, all of the medical imaging it took to get to this point (many many x-rays, MRI’s, CT Scans, etc), the equipment, the corticosteroid injection, or prescriptions, etc. That is one EXPENSIVE hip. YIKES. No wonder Dr. S is insisting I be so careful with it!

I guess I should explain what the heck it is that I do there when I go…seeing as it’s costing an arm and (HAHA) a leg!

My suite of exercises that I do at each session has evolved significantly since surgery. Now, I’m doing more advanced exercises, but it’s mixed in with some pretty rudimentary things. In some ways, my leg is far along in the healing process…and in others it’s not. There are some exercises that I can complete that are pretty challenging…even for a normal, healthy person. And then, there are things that I really struggle with that seem like they should be so easy. Going to physical therapy is like being in a glass box of emotion (to quote Anchorman…I’m sorry if no one gets the reference). There are times where I’m so happy and proud of myself…like last night when I completed 3 sets of 10 pike planks. Pike planks are by far one of my hardest exercises and to get that many was a personal success. However, there are also times where I’m really bummed out and discouraged…like when I still can’t increase my weights on something as simple as a side leg lift. Those are so difficult, and so painful…and they just don’t seem to be getting much easier.

Anyway, I’ll list all of the exercises with reps and include photos so you can get a visual on what I’m talking about. They are as follows:

I start with leg lifts. I do them four ways, 3 sets of 15 each:

I'm never this happy when I do these, FYI!

Side leg lifts with 6 lbs. These are pretty hard for me still. They hurt and it’s hard to keep correct form. My hip and muscles, etc. pop and crinkle while I do these. I haven’t gone up in weight in a while on these because I can’t seem to get my act together. This is one of the ones that discouraging.

Leg lifts backward while I’m on my stomach with 7.5 lbs:

This looks awkward and uncomfortable...because it is!

Inside leg lifts with 6 lbs:

Straight leg raises with 4 pounds. These are the hardest and most frustrating thing that I do at PT, by far. They hurt, and I feel crinkling, clicking and popping in my psoas and in the ligaments and tendons in the front of the joint. When I do these, some of my muscles rub over the top of my ilium which has excess bone growth from the bone cuts…so I feel it moving and pulling. My iliopsoas is still so weak…and I’m really worried it may never come back. I hate to think like this. Dr. S says it’s probably going to take until March 2014 until I can get this back to normal. Another example of how SLOW this recovery is.

Then I do my physioball and bosu ball exercises.

Hamstring curls on the physio ball. 3 sets of 15.

  

Planks on the physio ball. 2-3, hold for 1 minute each.

Pike Planks on the physio ball. 3 sets of 10

 

I hate these and love these all at the same time!

Marching planks (on bosu ball). 3 sets of 10. I currently do these without the bosu, but had progressed enough post-RPAO to do these on a bosu ball for a couple weeks before my second surgery in March. Since then, I haven’t been able to do these yet…but I’m thinking about adding them within the next couple weeks (depending on what Tom says).

I do this and then lift one foot at a time off the ground.

The three above, I do one of those each session, sometimes two. I don't do them all at one session.

Side planks on the bosu ball. 2-3 each side, hold for 1 minute each.

Then I do my moving exercises.

Side Steps with resistance. I go about 15 steps one way, then go the opposite way 15 steps, that’s one rep. I do 6 reps.

Sumo lunges. Same rep description as the Side Steps. 6 reps

OR

Weighted, walking, rotational lunges. I just added these back in. Last night was the first time I’ve done lunges since February. These hurt pretty bad for the first few reps, but I did 8 reps with a 2-3 lb medicine ball. By the end I was okay, but these exercises showcased my weakness and instability for sure. These specifically bothered my psoas. The turning in both directions really stretched and pulled at it.

Lastly, I do step-downs. 3 sets of 15. These are difficult for me as well…but these are getting easier as the time passes.

I rotate the step downs and marching planks (on or off bosu) in and out of the regiment depending on what else I’ve done and how I’m feeling.

So, when you’ve been going to PT once or twice a week for 30-ish weeks, you sometimes have days where you’re just plain tired of it. I was driving to PT last night and I just kept telling myself “I am SO SICK of this!” It’s time consuming, and exhausting, and quite frankly when it’s dragged on for this long it’s freakin’ inconvenient. I was frustrated and I just wanted it to be over. When I have these nights, I tend to react in a rather negative manner by doing WAY MORE than I should. Like, magically, if I do 4-5 sets of leg lifts instead of just 3 it’s going to cross some kind of invisible threshold and be instantly better. I just don’t have the patience anymore and my answer for it is to over-exert myself sometimes. I need to just chillax…but it’s HARD to do that when you’ve been working at something for this long.

I worked really hard last night and it was probably one of my most difficult sessions. At the end the hip and especially the psoas was pretty painful, and my bum was painful too (too much info?). It was this deep, aching and spasm feeling…every time I’d move a little bit this way or a little bit that way and WHAMMY (second Anchorman reference…yessa). I pointed out the trouble area to Tom (my physical therapist) and learned a brand-y new word: Piriformis. 

It’s my piriformis that’s now behaving badly, as well as the psoas. I stretched out quite a bit last night trying to avoid any long term aggravation from this new little trouble maker…but left there feeling a bit uneasy.

I limped my way home and around the house the rest of the night, sort of because of the pain and sort of because of the stiffness. When I woke up this morning I was (and still am) very stiff, it’s almost comical. EVERYTHING is sore and stiff. What’s worse is, that little pesky piriformis is not feeling any better…and either is the psoas. The piriformis isn’t so bad because it doesn’t hurt me that much. It’s constantly just a little achy. Only every once in a while do I move wrong and make it spasm badly. However…the psoas…yowzer does that bother me today. I can’t take a full step, and if I do I cringe from the pain. It’s like a stabbing, pulling pain. I have been trying to stretch it out when I’m standing…but gosh…it’s really sore today. I don’t know if I’m helping or hurting it by stretching it out.

Well…to close I’ll just say this. This hip preservation recovery is still emotionally as well as physically challenging. Besides all of the physical challenges like those listed above, I spend most days reading through messages from other hip ladies talking about their dancing and their running and all the normal exercising they’ve had the opportunity to return to. It’s hard for me to see these things. While I’ll more than likely be able to dance here and there, I’ve been told many times over by Dr. S that I will surely never run again. I haven’t run in years because of the pain, but when I first started on this hip preservation journey I thought I might be able to get back into it. It’s hard to give up something that you love. The worst is the loss of volleyball, though. The feelings of sadness have been worse lately, as I see lots of posts from my friends about all the volleyball they are playing. I really miss it. I think it’s also harder now because I’m so much more capable than I was before. I’m moving around almost completely normally. It’s hard to think of what could have been had I not had the deformity. When I think about volleyball, it’s one of the few times I really feel like I have a disability. It’s not a great feeling.

Anyways, enough with the pity party. I’ll keep you posted on anything new.

Sorry for the long post,

We’ll chat soon,

D