Wednesday, August 22, 2012

Some Proof of Improvement.

Sometimes I wonder if the improvement from prolo is all in my head.  I mean, there is much I can point to and say “see, my hip is getting better!”  I haven’t had any MRI’s lately, nor X-rays.  Sure I can say that my hip is feeling better, and the muscles around it are noticeable more relaxed (not just my own opinion, my massage therapists as well).  But it’s nothing quantifiable, and my hip still clicks on occasion. So being the person that I am of course I am going to look at myself in the mirror and ask, “Are you getting caught up in this prolo hype?  Are you just convincing yourself that it’s working? Do you want to believe it will work so badly you’ll lose all common sense?”

Well today I actually have something I can point to, something that I couldn’t do before prolo that I can do now.  Today I tried something that would always make my hip clunk.  Like it was a solid clunk, guaranteed, every time.  I crossed my right leg over my left, and then uncrossed them, and nothing happened.  It was funny how intense it was for me, how I was kind of wigging out while sitting there with my legs crossed the “wrong” way.  I was so nervous anticipating that clunk, that tell-tale sign I had something wrong going on in my hip and nothing seemed to be helping.  But it didn’t happen this time.  Nope, nothing, didn’t even feel like pressure, although it did feel very strange.  I haven’t tried it again, I’m that afraid of that clunk.  But that clunk was something that would happen EVERY DAMN TIME I uncrossed my legs, and it didn’t happen this time!

It may seem like a small thing, but whenever my hip catches it’s a reminder that I’m not well, that I haven’t beaten this thing despite the years I’ve put into trying to figure out what is wrong and how to handle it.  Now I know that I’m getting better, that I’m heading in the direction I want to go.

I remember when I was thiiiiiis close to having surgery.  You can deal with the pain for so long before it starts to really mess with you, and when surgery seems like the solution for all your problems it can sound oh so sweet.  Thankfully, I managed to take a different path, one that, I pray, will take me to a completely healed labrum.

4 comments:

Anonymous said...

hey adam, enjoyed reading your blog. i myself have always been stiff in the hips with a clunker in one hip when raising and lowering my leg while laying on my back. after picking up surfing late in life i started to experience some left hip pain. recently, i went to an ortho and was almost immediately diagnosed with bi-lateral fai from xrays and rom tests. i had a non-contrast mri done, which came back negative for a labral tear, so i've been sent to physical therapy and put on anti-inflammatory drugs, which i don't take. my hip feels like it's going downhill everyday, and the groin pain is now starting to set in along with the lower back pain, burning in butt, and severe tightness in the IT. so, as you see i'm at the beginning of this wonderful journey. i hate the idea of surgery, but the pain and lack being able to what i love is getting to me now. by any chance can your DO and PRP doctors refer anyone in the Los Angeles or San Diego area? feeling a bit lost at this point.

Adam said...

A couple of things immediately comes to mind hearing your story. 1)MRIs really aren't that good at diagnosing laberal tears. I had two MRIs, one with and one without contrast, and neither really indicated a laberal tear, yet clearly I have one. So MRIs can give false negatives. Did your doctor have an explanation for the clunking if it wasn't a tear? Did he do a manual test, feel what was going on? If not you might want to find a Dr that specializes in FAI.

2)You might want to try doing some mobility work. Do you sit a lot? you probably have tight hip capsules, and that is loosened up with massage/mobility work. After doing that for a while (about 8 months) my FAI went away, this was confirmed with an MRI so it's not just me talking out of my ass. Try checking out Kelly Starrett's blog, he has lots of good stuff. Try following these stretches: http://www.mobilitywod.com/2011/02/episode-161-hip-impingement-ais.html He also provides a great explanation of what's going on in the hip. The more the stretches hurt (the kind of pain that just feels like pain not injury pain, if that makes sense, I'm not a doctor) the more you need to do them. Starrett works in San Fransisco, if I lived as close as you to him I'd see him in a heartbeat.

3)Do you ever see a massage therapist? A great Massage therapist can be hard to find, but ask people at gyms or your PT for opinions, that should help some.

4) You mention IT pain, but I've learned that IT pain is usually referral pain. I'm willing to bet $10 the IT pain stems from your tensor fasciae latae being too tight and pulling on your IT. The fix for that is mobility/massage. Try taking a tennis ball and lie on top of it sideways, mashing it against your hip. Again if it's tight it will be painful, but once you get it to release it will feel amazing.

5) I'm willing to bet the burning in the butt is another tight muscle. If you sit a lot or used to sit a lot I bet it's the piriformis, again foam roll that/massage/stretch that.

6) Here's the contact info for Dr. Hauser and Dr. Craddock, I'm sure they would be happy to refer you to someone in LA if they know of anyone:

Hauser: drhauser@caringmedical.com
Craddock: info@fallschurchdoc.com

7) I strongly suggest making surgery a last resort, once you go there there's no turning back. If you do get surgery don't let some random Orthopod do it. Only let some one who had done hundreds of FAI scopes operate on your hip.

8) Something you might want to try instead of a DO is a chiropractor that practices non-force directional technique. I have found them to be just as effective and not as nearly as expensive. I've been told the majority of them are in socal so it shouldn't be too hard to find.

Does that help? Let me know if you have any questions, I'm happy to help.

Adam

Anonymous said...

Adam thank you. I couldn't have imagined a more helpful answer.
I'll look into all the resources you've posted.

I don't necessarily trust the MRI, they also did find a focal subcortical cyst on the femoral head, whatever that is.
I'm in IT and have spent most of my last 12 years sitting. I wouldn't hesitate to believe this is the root. My pincer spurs are quite large and visible in xray, not sure what type of FAI you have but I'm mixed. Having my hips stretched and rotated is very painful past a certain point, and it feels like a hard stop. Beyond that point can only be explained as a this joint is about to separate and break feeling.

I believe that surfing positions and the types of stretching I was doing to gain flexibility in those positions exposed my issues or caused the injury. Think taking a reasonably wide kneeling position, with your feet apart and parallel, as opposed to touching, and then just sitting down on the backs of your calves. This would force my hips to open and rotate inwards. Pretty sure this did me in as I couldn't kneel down very far in this position and kept pushing it.

I went for a long walk on the beach yesterday in deep uneven sand, and was feeling good by the end. I always seem to feel good when my muscles are pumped so I did a sprint over a dune, no issues. On my walk back, every step was accompanied with a sharp pain that felt pretty deep. The harder I stepped on my heel the more it hurt.

PT now is consisting of hip flexor stretches, side steps, and lunges to try and strengthen my weak hip and glut. I need to be doing more massage and mobility work.

Forgive the rant, I know you're not my doctor :) But you do seem to have more helpful suggestions than he.

Thanks again!




Adam said...

From what I understand, that cyst is like a blister in your bone. I might be wrong on that (“but you can trust everything on the internet!!!”), but it would make sense with the FAI and tight hip capsules. I’m not sure what part of my blog you have read so forgive me if this is stuff you already know about my experience, but from what you have told me so far you’re on a similar if not the exact same boat.

For me, my muscles were so tight (and painful) they were jamming my femur into my hip socket, thus causing the FAI (both cam and pincer), which in turn wore down the labrum. When I worked on mobility the muscles loosened up, I stayed active (tons of squatting and such) and the body seemed to take care of the excess bone. However, some muscles were still tightening up no matter what because they were protecting the damaged joint. That’s where the prolotherapy comes in, and so far I have had a significant improvement in the joint. The pain is now to the point where it’s so subtle I don’t even notice, like I have to sit back and focus on how it’s feeling to realize it’s not 100% yet. It’s pretty amazing considering how much pain I was in day in and day out this time last year. I feel like if you do the same you can avoid surgery as well. Of course every one of us is different, but this is working for me and I know of so many people who have had surgery without success or are worse off.

Are your hips out of alignment? If so I would highly recommend seeing a chiro that does non-force directional technique (nfdt) or a DO that does manipulation. If you don’t like chiro’s because of the crack of a joint you should now that the nfdt is different, much closer to what I’ve experienced with a DO.

Concerning what to look for in a prolotherapist, my next post will be about the different techniques used and my non-medical opinion on them. But I encourage you to contact Dr. Hauser and see if he can refer you to someone in LA. …You could also try contacting kelley starlett asking if he recommends any la therapists.