The hip mystery continues.

So with all this physical therapy some things are becoming clear while others are not.  It seems that my right groin muscles are always “on”, one reason why I’ve pulled them more than once now. So I’ve been doing exercises that work the glutes as well as trying to shut off the adductors on the right side.  Conversely, my left side is almost always “off”, it’s hard for me to activate them. This imbalance is at least one of the reasons why I tend to shift my hips sideways (to the right, I think) when I squat heavy, especially if I use a wider stance. It is also a reason why I pulled my groin in the first place, as well as why I am still having hip pain.

So that all makes sense, but some other things, namely sources of pain, are still a bit of a mystery.  Sometimes when walking when I push off of my right foot I get a pain in the front of my hip. It feels like it’s in the femur rectis area, but perhaps it’s the psoas, I’m not sure.  However, when the PT tested the muscles he found both to be supple (and neither were in pain).  Of course, after he did that I walked around and have no longer felt that particular pain, so that’s a good thing.  Perhaps it was the pectineus, I’m not sure if we checked that out. Regardless, it was nice to hear that both of those muscles, which previously had given me trouble, were behaving nicely. But still, it begs the question of what the hell is going on and which muscles are acting up? Perhaps it’s all entirely my groin right now, and after working on the groin some the other muscles, that were acting up, have settled down. Who knows, all I know is that I need to keep working on my exercises and not do anything to cause a setback.

Speaking of setbacks, it has been hard to shut down working out the lower body completely.  There are temptations to do leg extensions or curls, calf raises, etc., but I have to avoid doing any of these in order to stop aggravating my groin.  I see these guys in the gym doing reverse grip bicep curls in an attempt to do a power clean, and my ego begs to do some real power cleans to show them who’s boss. But for the past couple of days I have stayed true. I have decided to even avoid farmer’s walks for now, it’s so annoying but I fear the stress on the groin of walking with weight will set it off. The only leg exercise I’m am allowed to do so far is riding the bike for a bit, provided I don’t aggravate the impingement in my hip and the resistance is low enough. Now I’ve been doing 10-15 min of mild bike as a warm up for lifting and so far I’m able to walk away without feeling like I might have tweaked something.  It has taken me years to get to this point, hopefully it will only take like six weeks to reverse it all.

Getting "yoked"

So I’m progressing nicely with all these strange exercises the PT guy is having me do.  Soon, perhaps next week, we will be going from these funky isolation exercises that have no real-life value, to doing exercises that will translate to the real world. In other words, I will be going from doing exercises lying down on the ground to exercises performed while standing up.

Also, I met up with some of the wife’s classmates the other day. They haven’t seen me since before winter break and as I walked in wearing a jacket they were amazed at how “jacked” and “yoked” I was.  Guess despite the fact that I can’t do any real work (aka, squats and deadlifts) in the gym I can still see some small progress with the upper body.

Neck/shoulder Update

My shoulder/neck have been really bothering me. Well, that’s not entirely true. There are days where I feel very little discomfort, if any at all. Yet there are days that are really uncomfortable.  I have thought about seeing a local massage therapist to help me out, because after Bobby released my medial scalene, tricep, and them rhomboid I felt amazingly normal.  However, after the prolotherapy treatment the rhomboid tightened back up.

I’ve tried to work on my rhomboid since then, using a tennis or lacrosse ball.  I’m able to get it to release a little bit, but there is a section of muscle that will just not budge.  It feels like I’m just rolling over a tendon or something solid like that, but when Bobby encountered the same area  he told me that it indeed is the rhomboid, it’s just insanely tight. After the PT takes care of the hip I’m going to have him check out this shoulder/neck issue, but in the meantime I’m tempted to try a local massage therapist and see if he will have any luck releasing these muscles.

I have talked to the PT guy about this issue, and he told me that although it is possible that the rhomboid/tricep/etc. is tightening up in response to some type of joint damage, it is also possible that it could be a neurological issue.  That doesn’t mean that there’s something wrong with my brain, just that maybe for some reason (he named a few but they were long names that I didn’t catch) my rhomboid is getting some signal that it needs be as tight as possible.

It’s funny, as the pain/discomfort with my hip diminishes, the pain with my shoulder/neck seems to increase.  Well, that’s not entirely true, I am feeling much better than when I was stricken with tendonitis, but it’s more like I notice what’s wrong with my neck now more because my hip is no longer yelling for attention. It’s like my brain can only take so much pain info, and my hip took precedent.  Now that the hip pain is going away, I’m now able to pay attention to what is wrong with my shoulder.

I have no idea how long it will take for my PT guy to take a look at my shoulder, but hopefully shortly after that happens I’ll be done with this issue once and for all.

First week of PT: working on mechanics

So I’ve met with the PT twice so far, and it appears that something is off/painful with my groin (more like my adductor magnus, not necessarily my pectineus, perhaps bobby helped fix that), my rectus femoris, and my good ol’ psoas. Mike did some graston on my groin, felt strange because it made me feel the layer of facia under the skin and how bumpy it was.  Now I have some pretty bruises where he worked it, but that area of my leg is feeling better. He said I could try the leg press, but if it bothered my groin I should abstain.  I tried it with like 50#, but I experienced pain in my rectus femoris area. Technically, since that wasn’t my groin I could keep going and not go against the letter of what he said, but I decided to shut it down anyway because I’m sure he meant if it caused pain don’t do it.

The PT is having me do postural restoration, at least that’s what  I think it’s called.  It consists of various, albeit strange, exercises that force me to use the muscles that I tend to ignore (like the glutes) and shut off the muscles that I tend to use (like the groin).  Through the various stretches and exercises it seems that I needed to keep doing my favorite Kstar Mwod, because when I try to put my femur into the back of the acetabular socket I feel all kinds of stretching on my right side. The PT thinks that if we can fix this, everything else will fall in to place.  I makes sense, the tight hip capsules, FAI, torn labrum, pulled groin, they all stem from something, and I think my mechanics are a big factor.

I should also mention that I have not felt my hip catch at all since December. I haven’t really pushed it but I’m not trying to flex the hip more when I do things like tie my shoes, and so far nothing out of the ordinary has happened. I think it’s good enough for me.

So in summation since the Graston my groin has been pretty much pain free, I think (it’s hard to locate hip pain sometimes), but I am still feeling pain in my hip from the psoas and the rectus femoris. Perhaps a Graston session will help with that as well.  Also, I am starting to notice engaging my abs more in everyday life, hopefully from the exercises I am doing from physical therapy.

Physical therapy for hip.

So I've decided to use the Orthopod’s prescription for physical therapy. I get the unique opportunity to go to Duke’s Sports medicine center, so I figure it is worth a shot.  I met with a PT name Lori who did a lot of diagnostic stuff and tried to figure out which of the PT’s would be a good fit for me. I tried telling her the whole story with the hip for the sake of full disclosure, I was fearful of leaving something out but I think I got it all in there.  She asked about the possibility about a sports hernia, and I told her what the doctor said, that the way to figure out if it’s a sports hernia is to try everything else first. So first let’s look at the pulled groin.  She also noticed that my psoas was tight, which was a little saddening because when I hear tight psoas I equate it with torn labrum. Perhaps there is still some laberal issues, I sure hope not though.  She noticed some imbalance in strength, like I have really weak glute mediuses, and my right side is even weaker than my left.

After doing her examination, she thought some postural work, massage, and something else I can’t remember would help.  Can’t say I disagree. 

Looks like I’ll be meeting up with a guy named Mike, and so we’ll be working on strengthening any weak stabilizers I have as well as use the Graston Technique as a method of massage.  At first my research on this technique came up with some questionable results. Basically, that article in the link says that there is absolutely no scientific evidence that the technique helps with anything.  However, after looking at these youtube clips of the technique being applied to some strong dude it looks to me like it’s just a type of massage that uses steel tools instead of fingers to release the muscle and break up scar tissue.  Personally, it seems like the tools (they’re like $3k) and price to be a licensed Graston person is a complete rip off for the therapist.  But I do see it being effective, although probably not as effective as a good, patient massage therapist. Regardless, I’m not paying (very much) for it, so I figure what the heck and let them do as they will.

…I have a feeling they will not be used to someone like me.  When the therapist was setting up to do a stretch and explained what she was doing, I said “Oh yeah, I do this one all the time, learned it on the internet.” To which she responded with “You can’t do this one on your own.”  After she started working on my hip I then explained how I do it, and she said, “Oh yeah, yeah that would do the same thing.” So of course I couldn't let that go and pointed out that I was right, to which she conceded that she was wrong.  I know that going into these things I’m a “layman” in the fact that I don’t have a degree, and I know that there is a lot that I don’t know, but all these doctors and therapists seem to treat me like I don’t know anything, and that is completely wrong.  It should be interesting to see what happens with Mike, and I will try not to rub him the wrong way. I mean, I don’t want to tell him how to do his job, but I do want to be respected as someone who has taken a lot of time and effort learning about the human body.

A second career?

So I was working out yesterday, and was thinking about my recent promotion.  I work for the United States Patent & Trademark Office, an agency in the Department of Commerce.  I get a special badge and everything.  Anyways, I just got promoted to a Primary Examiner.  This iskind of a big deal, it’s the most senior position an examiner is allowed (GS-14), and so I’m given full signatory authority. What I say, goes. I don’t need any oversight, I’ve proven I know this stuff.  So now, if I want to go to a GS-15 or SES, I will need to go into management or something like that. To be honest, I don’t know if I ever want to do that. For one, it might require returning to Alexandria where the office is located, and if my wife has a job elsewhere after she graduates from Duke I’m not going to make her quit her job so I can continue progressing.

The point of all of this, is that now I’ve basically climbed to the top of my career ladder, I find myself asking, “Now what?” I don’t know if I want to spend the rest of my 35+ working years being a patent examiner (although I would have a sweet pension by then).  The unfortunate  thing about patent examining is that the skillset you learn doesn’t really transfer to anything else.  Basically, you have to start over with a completely different career. I know a lot of senior examiners are able to startup businesses on the side, while keeping their main job, but I don’t know how I feel about starting up my own company, I wouldn’t know where to start.

But if given the opportunity to start over, what would I do as a second career? I’ve been asking myself this question for a couple of days now, and one possibility came as I was working out in the gym: a strength and conditioning coach.  I have no idea if I would like it, but at least it’s something I’d like to research further. I’ve found some excellent resources here, here, and especially here.

So perhaps someday I would be able to form Adam’s gym, of some sort.  Who knows, this is all just conjecture because I am in waaay too good of a place right now with my current job. (To my boss, I know you read this so please don't worry about me leaving the PTO for like the next 10+ years.) For one, it has sweet benefits, allowing me to try all kinds of things in an effort to get better, which is what my next blog post will be about.

Labrum seems fine, pulled groin

Well, I can say with quite a bit of certainty that I have a pulled groin.  I saw Bobby again this Friday and when he worked on my pectineus and adductor magnus it was pretty painful, for the second time.  However, my psoas and everything else was pain free.  Also, the pain just feels… different, it feels like an injury to the muscle rather than the muscle is tight to protect the hip joint.  So I think I can now say that I’m done with PRP for my hip, and am glad I can close that chapter of my life. It has been a long time coming, let me tell you!

I guess I’ve just been making the pulled groin worse and worse over the months with Starting Strength, and now I feel pretty darn foolish.  I mean, I just figured the hip pain was related to my labrum as was something I could just ignore.  Instead, I was just making an injury worse and worse.  At least this groin pull should be a lot easier to handle than any issue with the labrum.  However, groin issues can linger.  I mean, I basically didn’t squat for a year, did rehab on the hip and then slowly introduced squatting again, and even then when I started adding weight it reared its ugly head again.  So it seems this injury will have to be dealt with patience. A lot of patience.

I saw an Orthopod and he prescribed physical therapy, so I have that if I want.  I also plan to see if he can write up a letter of medical necessity so I can have massages covered by my FSA account, that would be awesome.

From what I can tell, one reason why you pull a groin injury is weak abs.  That sounds about right, given my abs have always been weak and I still have a hard time getting  them tight while I squat. Weak abs, actually, are pretty much the culprit for all of my hip problems. Weak abs led me to anterior pelvic tilt, weak abs led to tight hip capsules, weak abs led to the tear in my labrum. And now they have led to a pulled groin.   I finally got the knack of engaging my abs while squatting near the end of SS, but I worry that by the time I return to squatting I will have forgotten everything. I think I’ll do some Pilates in addition to everything else when my groin is no longer an issue.

This is really annoying though.  I mean, I take my squat from 125 to 270, gain 20 pounds in 14  weeks, and all for what, just to have it all go away due to injury? I’m tempted to now just take this as an opportunity to go into a cutting phase, but I really don’t want to just yo-yo between 200 and 180. I will have to come up with a plan, a goal, and then figure out a way to get there.

Good news on the shoulder front.

Well, after the last prolo session my shoulder has gotten way, way better.  I saw Bobby and asked him to check out my rhomboid or lavater, and it was my rhomboid that was super, super tight.  He worked on it for a bit but after going nowhere fast he decided to release my tricep first, then did the rhomboid.  The rhomboid released almost too easily. So it seems like my tricep and rhomboid were playing tug of war, with perhaps mymedius scalene joining in on the fun too.  But wow after that almost everything felt normal.

Saw the Chiropractor as well, and for the first time ever, in the 1.5 years I’ve been going to her, my C6-C7 joints were not out of alignment.  This is pretty awesome, I think we made huge strides in the last prolo treatment.

Although everything feels much better, it’s not yet 100% and I have another appointment with Dr. Hauser tomorrow.  I will only have him work on my shoulder, and this, I think, will also be my last visit concerning this matter.  Feels really, really, good to be done with this.

First it all started with tendonitis in the shoulder, then it progressed to working on the scalenes because it was causing referral pain in my back, I retaught myself how to sleep, switching from ALWAYS sleeping on my side to sleeping on my back, and then I learned that I'm tricep dominant, and that was messing up my neck, and then after that I learned that just hanging from a bar would help me out, but every time I peeled back one layer of pain/discomfort it would only reveal a new, different one.  As I look back on various posts on my shoulder pain, I found this particular passage:

I really, really hope that I can find a cure for all of this pain I experience. Not a day goes by that my hip and shoulder ache or throb, and imagining living without pain just sounds like an idea that is so tempting I don't trust it. I catch myself getting excited at the idea that PRP could be the cure for all my ills, but I have to remind myself that there is a chance that it might not work, that I might have to deal with this pain a little while longer.

That was writtenOVER THREE YEARS AGO!!!! Wow I am one stubborn SOB, you think I would've thrown in the towel after all this, after all this pain and discomfort.  But for some reason I am determined to fix these issues, I don't feel like I should have to live in pain for the rest of my life, that I'm too young to start limiting my activities. Even though it seems like beneath every issue/injury is another one just waiting to reveal its ugly self, I figure it has to come to an end some time, right?

I've tried not to let these issues define me, I don't talk about them to anyone except for my wife, and even then I try to limit it.  But these issues have been what has been motivating me to keep updating my blog, there always seems to be a new breakthrough, a new angle I haven't thought about before.  Hell, I haven't even done a WOD in like 16 months, yet I still consider this a "crossfit" blog.  Blog-wise, injuries seem to be all I have, really.

Eventually, hopefully, I will run out of injuries to talk about.  And when that time comes, I'm afraid I'll stop updating this blog. But at least I will be happy and pain-free.  That's a really, really nice goal.