Tag Archives: body mechanics

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Transitions

Today is officially the longest day of the year, the start of summer…and it’s 60 degrees, grey and scattered rain showers. Last Friday was nearly 80 and sunny and glorious – go figure.

At the beginning of next month, my new boss officially starts in the office. My boss of the last 15 years is retiring, but not officially until the beginning of August. So it’s a new season starting in our office as well.

It’s been 10 months since my back surgery, and I’m in the midst of my beginning of summer annual medical checkups. Made all the appointments, showed up for my mammogram last week. Next week is fasting blood work, and then my physical the following week. I feel good and have no great concerns to discuss with my primary care doctor, so hopefully this will be a smooth slide into the summer without more tests and appointments to think about.

How’s my back? Well, “good” or “better” are the easy answers. It’s different than before surgery obviously, since I have hardware holding me together, but it’s also been a long recovery process (well documented here on the blog). Today I don’t have chronic low back pain. I don’t have constant sciatic and muscle cramping in my back, hip, butt, or thigh. I don’t have the constant ache, and grabbing my low back when I twist or move funny. I don’t have to take over the counter or prescription medications to allow me to get through a day or night. I don’t have to have my heating pad waiting on the couch for me to come and sit for a few minutes and ease my muscles out of a cramp. But I’ve worked my butt off in physical therapy to both recover from the trauma of the surgery I had, but also to strengthen the muscles I haven’t used for years to support my spine. It’s an ongoing process of listening to my body while also pushing myself to improve.

I still have some lingering nerve issues, and recognize that I probably always will to some extent. Some of it is damage done before the surgery from my spine being unstable and pinching the nerves (sciatic)- some surface numbness on my right leg in several places that was present before the surgery….is still there. But the cramping that was an everyday thing before surgery is gone on the right side. Some of it is also from the surgery itself – I had a lot of sciatic cramping on the left side after surgery (I whined about it for weeks), and while the cramping has resolved – I still have some residual nerve pain in the top of my left foot. I whined about that quite a bit and worked on it during physical therapy – and while it’s vastly improved – it’s still there. But I’ll take a little bit of surface numbness and a touchy left foot over debilitating daily pain and muscle cramps any day!

I no longer have to get up 20 minutes early just to go through a series of stretches to wake up my muscles. I still do a series of range of motion stretches each morning just to get the blood flowing a little before my shower – and work off the sleep haze – but it’s not 3 sets of 10 repetitions of this one exercise, and then 3×10 of the next one, etc. During the week, I do yoga on my lunch break – specifically targeting my core strength, my hips, glutes, and hamstrings, and actually working on my upper body strength too. I have several dynamic flows that I work through to strengthen my body overall – not just focus on spine surgery rehab. Throughout the week I still end up doing all the same kinds of exercises that my PT taught me to do, and I’m seeing great progress in my strength.

I have tried and tried to like the exercise bike I bought (used) last year for cardio – but I just don’t. It caused me more body mechanic issues throughout my recovery because it’s basically just one movement in the same position over and over again – primarily focused on my hips and IT band. So I stopped using it at the suggestion of my PT when my IT band kept flaring. Instead I walk as much as I can. On the weekends I walk in the morning before a shower. During the week, I make it a point to get up and walk at work as often as I can…and then walk in the evening when I get home. Walking was the thing my surgeon had me doing immediately after surgery – like the same day….with a walker and a catheter in…I was walking the hallways every couple of hours. On day 2 they took the catheter out and I had to get up to use the bathroom….and walk the hallways every couple of hours. I have continued that pattern throughout my recovery. During my PT, I would start out on the treadmill for 10 minutes before seeing my PT for the rest of my appointment. As my rehab continued, I came to love my time on the treadmill, and as weather permitted I walked my driveway at home too. When I was allowed back on my exercise bike, and started having trouble with my IT band, I started thinking about selling the exercise bike and getting a treadmill. That’s still a discussion at our house – but I haven’t been on the bike for months now….and my IT band hasn’t flared in the least.

In January I made a concerted effort to start eating better, and tracking my food each day. I haven’t been perfect, but I’ve been much more aware. I’m down about 14 pounds, and the yoga has helped me trim off over 6 inches overall. I’ve been able to recognize what foods I can eat and continue to lose weight slowly – and I know what foods stall me out completely. My goal isn’t a number on a scale or a clothing tag – my goal is a healthy mind and body combined. My current routine is getting me closer and closer to that point.

The final transition I’ll talk about today is menopause. Last year about this time, my doctor confirmed/agreed with me that I was likely peri-menopausal based on what I had been noticing in the preceding year. Menopause is a tricky thing to nail down in women like me with MRKH. Most women experience a change in their monthly menstrual cycle – and they notice the change because their pattern of bleeding (their period) changes. But I don’t have the benefit of being able to track differences in menstrual flow. Over the years I came to recognize subtle changes in my body during certain times of the month…and asking very pointed questions of my close girlfriends. I learned to notice not just pre-menstrual symptoms of emotional changes, bloating, tender breasts, and acne breakouts, but also the more subtle changes that came with ovulation. I actually had a pretty regular cycle that once I understood what I was experiencing, I could work to manage a little more effectively. But without the “period” to mark the date on the calendar, and obviously no worries of an unplanned pregnancy ever – it was just interesting to note what my body was doing. In the last 2 years I began being more aware of the fact that my “pms” symptoms were happening less frequently, and not near the end of the month as they used to be. Add in a whole lot of tossing off covers in the middle of the night, and some changes with vaginal moisture and elasticity – and my doctor marked my chart as peri-menopausal. We had a brief discussion last year about hormone replacement and options available – but I declined any formal treatment. I had a baseline bone density test last year which was totally normal, and I read a couple of hand-me-down books on menopause. Knowing this is a natural progression, and understanding that everyone’s experience varies greatly, I’ve opted to be preventative, but minimalist in my journey. I’ve added a women’s multi vitamin, vitamin E, and collagen for joint health, and made sure that I am eating a balanced diet that includes lots of variety in both vegetables and proteins, and a moderate amount of (mostly) whole grains. Thus far I have not been overly bothered by crazy mood swings, hot flashes, excess fatigue, thinning hair (it gets grayer each year, but it’s still thick and crazy curls), and I’m still able to effectively manage my weight. All in all…I think I’m doing just fine on this journey.

As I think about all the transitions going on with and around me lately, I try and remember to just put my trust in God. He has a plan, and my part in this plan requires me to act with compassion and humility, to trust Him completely, and to practice patience with His timing.

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5 Months post Lumbar Fusion

6 screws. 3 rods. 2 inter-vertebral cages. That’s what’s been holding my spine together for the past 5 months. I’m well on my way to a good solid fusion, my bone growth is good. My muscles have reattached, and I’ve worked to strengthen muscles I’ve ignored for years – probably decades. I’m feeling pretty good overall, and I’m working on the areas that sneak up and bother me. I’ve been in physical therapy for 12 weeks now, and am looking at another 6. Rehab and Recovery is WORK – but it’s also working.

My physical therapist Danielle has left now – to be a momma to a 2 year old boy they are adopting from another country. I’m thrilled for her, and we talked a few times about bringing him home and how excited (and nervous) she is about it. I never did ask her why she went the adoption route, but I know she doesn’t have any other children. Whatever her reason, I’m just thrilled that this dream is becoming a reality for her!

So Danielle left to be a mom, and I got referred to another PT in the clinic, Brenda. I worked with her one of my first visits, but I felt it was a good opportunity for fresh eyes and to talk about my current symptoms and see what adjustments we might need to make. She reviewed my chart notes and did some assessment and moved me around and watched me move. She is comfortable with how my spine is healing and how I’m moving around the fusion. My deep core work is keeping the fusion and my spine in general supported and aligned. My pelvis and the pesky SI joint was a little out of alignment, so she worked to line me up better, and doing so, she found that my Iliotibial Band (IT Band) is inflamed. It runs from the hip to the tibia along the outside of the leg, and helps to support the knee. What I had been attributing to sciatic inflammation on the right side (and had me quite concerned actually) is actually a muscle pain memory – and caused by the inflamed IT band – not the nerve.

So, our focus is now to change the muscle and pain memory. We are working to heal the inflammation in my IT band and then work on my body mechanics to prevent it from flaring again. Remember me talking about bossy muscles before? Well, that’s what’s going on again. My hamstring is trying to compensate for what my hip and glutes should be doing. My pelvis is out of whack making the SI joint inflamed, and so then I move wrong and cause new problems – like an inflamed IT band. IT band injuries are often attributed to running injuries – overuse when there is a bio-mechanical misalignment. I’ve done that in spades…so time to work on releasing the IT band and hope that allows me to work on continued strengthening in my hips and glutes.

So…how to release the IT band – well trigger point massage is the best way, but let me tell you…it’s NOT fun. Brenda used a torture device and really massaged where the IT band connects to the tibia (outside top of the calf), and along the edge above my knee where the hamstring connects. I don’t remember what she called it – but that’s probably because I was gritting my teeth and trying not to hyperventilate. She also did some work on my hip, with the trigger points as well. We talked about home care and how to continue working on the IT band. I have a tennis ball and a wall – and I lean into the hot-spots in my hip and glute and through direct pressure and tiny micro movements, I am working to get the tension (aka nearly cramping they are so tight) out of my muscles in my hip and glute. I also have a “massage stick” that I use to roll massage along the outside of my thigh and search for and find all the tender hot spots along the IT band and hamstring. When I find a hot spot, I stop and put direct HARD pressure on it, and slowly roll off of it. It’s not fun…I suck a lot of air through clenched teeth…but hopefully it’s doing the trick. Kind of like a begging toddler – you just irritate it, nag it, and keep after it constantly until the muscle gives up and relaxes. It’s still very, very sore – but the memory pain of the sciatic nerve that I thought was going on, is diminishing. So that suggests that what I’m doing is helping.

I’ve also been doing massage on my left foot – the one with the nerve pain, trying the same theory – lets see if I can irritate it into healing through persistent massage. I’m also working on ankle stretches, because as Brenda put it, “On the spectrum of flexibility – you are quite stiff. Your joints don’t move enough to be able to stretch the muscles that are tight.” Um…thanks, I think. So ankle stretches a couple times a day has been added to my PT rehab plan.

Since my last post I’ve been doing well with eating clean and with tracking my calories. I’ve reigned in most of my bad food habits. I’ve set up a routine of riding my exercise bike each day and have worked hard to move more in general. The scale has appreciated my efforts. I’ve also gotten much better about taking my supplements each day. I think all these things together are working to help me feel better not only physically, but emotionally. The whole adage of garbage in= garbage out is so true. When I fuel my body well, both nutritionally and with exercise and movement – the results are always better. So that’s my words of advice for all of you – treat your body like a temple. Be respectful and humble, know your limits – but push them a little too!