Thursday, October 18, 2012

Physical Therapy: Week 1

I had my first physical therapy appointment today - it's going to be once a week for awhile, and then I believe more often once I'm actually able to work on strength (as I understand it, that is 2+ months down the road.  This recovery process is no joke.).

I got to the office and filled out a bunch of paperwork.  When asked what my goal for therapy was, I wrote "To run a half marathon? Too much?  How about to walk without a limp?  Better?"  Later, there was the question of what I had previously done for this problem and whether it had worked.  I wrote "Physical therapy.  It worked, but not completely so I had surgery."  And I put "maybe?" next to whether surgery worked.

My therapist came to get me and was laughing and saying "your intake paperwork is killing me!"  I immediately knew I liked him!

His first comment was that we had to fix the way I was using my crutches.  Then he asked for the whole sordid tale of the last 8-ish months (which really starts with 10 years ago when I first noticed my snapping psoas, but I started to really fall apart in February).  He winced over a few things - especially about the physical therapist a decade ago who said the snapping psoas was benign and was just due to my having low body fat.  "Never go back to that therapist," he said.

Then he did some evaluating and pretty quickly said that I have a single therapy goal for this week:  straighten my right leg and lay flat.  Literally, that's it.  A very simple-sounding goal, which I'm fine with because yesterday's goal was to put on my pants by myself (which took upwards of 5 minutes, and I probably fell asleep twice, but was accomplished!).

He kept straightening my leg, little by little, and asking if it hurt.  "'s more like uncomfortable with a side of creepy crawly ickiness."  I can't even describe it.  It's not exactly painful.  More like nails-on-a-chalkboard cringe-worthy.  I wanted to make it stop, but it didn't exactly hurt. 

As far as I understand, there are two things making it feel like this and I have to work on both this week.  The first is that there's a lot of swelling going on there (not surprisingly, right?). The second is that my psoas was cut, so now it would like to curl up into a ball and keep my leg slightly contracted forever and always; not too contracted (I actually can't really pick up my leg), but definitely not straight.

So, for the inflammation: 1) I have to keep icing (but not as often as I have been) and 2) do some light squeezing sorts of exercises to move the fluid toward my heart/kidneys/abdomen/basically parts that will get it the hell out of my body.  The exercises aren't really too bad - he said if I'm getting sore or feeling more stiffness I need to back off because the whole point is to get rid of all that right now.  (There's plenty of time for soreness, right?)  Also, these same exercises will help keep blood flowing while I am mostly off my feet so I don't get a blood clot (because dying would be a bummer!).

For the contracted psoas, I have to lay down and relax and have The Beast help me by starting with a pillow supporting the leg a lot but then lessening the support each time I'm able to relax.  This is the difficult thing for the week - just laying there and relaxing and breathing and not making The Beast pick my leg back up.

I have to breathe through that nails-on-a-chalkboard feeling and let the nails keep scratching until they fade away.  ::shudder::

At the end of my appointment, as I put my shoe on (yes, I can put my own right shoe on!  Another small accomplishment post-surgery!), I said, "I know I might regret asking this, but do you have any sense that you wish you'd seen me before I had surgery?"  Yeah, I know, it's probably dumb for me to ask these questions when I've already had the surgery and can't exactly undo it,  but I partly ask to make decisions going forward about whether to keep running or find another sport/endeavor/sanity-saver. 

His answer actually put my mind at ease to some extent.  He said, if anything, he wishes he'd seen me in February before the half marathon.  He says it sounds to him like I was breaking something down at that point, and he suspects the labral tear actually happened after the race when I was running low mileage but suddenly could not run even 4 miles without limping home.  He also said that once there's a tear, that's surgical. 

So, essentially, once I realized that simple rest and stretching was not going to improve things, it was too late.  I'm ok with that - though I will probably not, in the future, train through even a minor injury without being evaluated.  Live and learn, right?  This time I learned the hard, stressful, painful, and expensive way!

Before I left, the therapist moved the grip on my crutches up higher. The crutches say they are for someone 5'10" or taller, and I am barely maybe 5'7" but he said they're actually only about 1/2 inch too tall for me, so I should be able to make them work for a couple of weeks (we think I'll be on crutches for 2-3 weeks.).  Anyway, just moving the grips allowed me to stand and walk much more erect, which will help with straightening that leg, too.

Onward and upward.  Or, I guess, downward with that right leg to the bed...

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