Since my last post I had another appointment with Dan. I had gotten back to “normal” with the tightness with my right side and the pain from the bursitis in my left had mostly gone away. The appointment started with a discussion about what I was able to do and how it made me feel. I still wasn’t back to where I was before messing with the scar tissue, but I’d found a new baseline.
Next Dan did another assessment. He thinks I have one muscle, the iliopsoas or inner hip muscle, that is still weak. That’s the muscle you use to raise your leg straight in front of you. It makes sense that it would still be weak because per Dr. Mayo’s directions, for the first several weeks of PT I wasn’t allowed to use that muscle. One good thing about the weakness being in this muscle is that it is strengthened by walking and cycling. I don’t need to do any specific PT exercises for it. All the muscles not strengthened with every day activities have returned to normal. That’s great!
After the assessment we talked again about long-term goals and concerns. Dan asked what I was most worried about for the future. I have no doubts that the weakness in my left side will be resolved. I had this same weakness last time and I think all of the strength has returned. By far, my concern is the tightness in my right side and fear that it will develop on the left side.
As always, Dan knew exactly what he wanted me to try next. The previous stretches and strengthening exercises were obviously too much because they inflamed the area. The goal is to very gently stretch the front of the hips and strengthen the back. We started by finding a baseline for the tightness by walking down the hall, first at a normal walking pace and then at a fast walk. Then I tried the first stretch, variable 1 (lie on the floor on your stomach, straighten arms to lift upper body off the floor while keeping your legs on the floor, hold 5 seconds, repeat 5 times), and did my walk test after. I didn’t notice a change when I walked. Next I tried the first strengthening exercise, variable 2 (lie on the floor on your stomach, lift one leg a couple inches off the floor, hold 5 seconds, repeat 5 times on each leg). Again I didn’t notice a change when I walked.
After the second stretch, variable 3 (stand with front leg bent and in front and back leg straight, it’s a calf stretch but also stretches the hip, hold 5 seconds, repeat 5 times on each leg), I felt more tightness in my hip. Next we tried strengthening #2, variable 4 (with stretchy band in the door, loop band around your calf and pull backwards 10-20 times, repeat 2 times on each leg). Again this one produced more tightness in my hip.
So the plan was to do variables 1 & 2 for 2 weeks. If things were going well, add variable 3 for a week, then a week later add variable 4. I was allowed to keep walking and cycling. I was even allowed to add hills to both as long as I didn’t do it at the same time I added a new variable. If I have any problems, he wants to know for sure what caused the troubles. That makes sense to me. I also asked him about adding massage. He was fine with that, as long as I didn’t do it at the same time as adding something else to the regimen.
I went home encouraged about the new plan, but sore from the experimentation. I felt like I should allow myself to return to my normal amount of discomfort on the right side before starting the new plan. The next day I had a sore throat which turned into a full cold within a few days. I decided to start with just the first stretch, and because of the cold I didn’t feel up to cycling. After a few days the cold got a little better and I added the first strengthening exercise. It didn’t go well. I was more sore on the 2 days I did it. After 2 failed attempts to add that exercise, I knew I needed to stop it but I wasn’t sure if I should add something else.
I decided to call Dan again. This time he was with a patient when I called so I got his voicemail. He called back at the end of the day and told me to try variables 1 & 3. If that goes well try variable 4 for a week then try variable 2 again. It’s been a week. I’m doing 1 & 3 every day and 4 every other day. After a recurrence of my cold, I’ve finally kicked that and I’m riding on the bike trainer most days. It has started raining so I’m less motivated to walk or ride outdoors. So far this attempt at the new exercises has gone well. I’ll try variable 2 again sometime next week. I might also look into massage.
Things are going well, but I’m used to seeing obvious results from my efforts. I asked Dan when I should notice a difference with this plan. He said within a month or two. Yikes. That’s kind of ungratifying. And what if I do this for 2 months and see no changes? I am not good at being patient, but what choice to I have? None. I do trust Dan. Now it’s time to work on that patience.