A Graceful Rehabilitation

I’ve been thinking I need to give an update, let you all know how the rehab is progressing. The change of physical therapist has been good. I’ve been able to switch things up and make some real progress. I’ve seen Brenda 3 times now, and have been doing my home exercises and when I see her each week she works on something else.

The first week was that darn IT band and trigger point massage in my hip and glute, and using my roller massage stick on my hamstring and the IT band itself. The incredible tenderness has diminished, and the tension has released significantly. I continue with stretches and work to build balanced strength. It’s clear it’s all working, as my SI joint is much more stable, my pelvis aligned, and the IT band isn’t holding so much tension.

The second week, she worked the soft tissue in my hip and then put me through the paces on the Pilates Reformer – doing a lot of core work and leg work. More stretching and a reminder to keep the rest of my spine above the fusion mobile. While we want good stability around the fusion, we want strength and mobility in the rest of my spine.

This week when I saw her, I asked her to help me trouble shoot the left foot nerve pain. We went through what I have been doing at home, the stretching and “neural flossing” and she did a body mechanics assessment. She had me make some small changes to the way I had been doing the neural flossing, and focus on a couple different ways to stretch and work my ankle and foot. With some soft tissue work – more trigger point massage- in my calf and ankle area she helped release some tension, which should help that nerve to glide more freely. I’ve had to do some home massage and really work at the hot spots – so as it heals from the massage work, the hope is that the nerve will glide smoothly and that annoying nerve pain will diminish. Again I’m in a work it hard for a couple days, and let it rest and heal a day or two and then go back after it for a couple days. Hopefully soon I’ll see some progress.

I feel like I’m at a point finally where I’m really ready to go at this rehab and recovery thing on my own. I’m glad I’ve pushed to continue with the physical therapy past the initial 6 week protocol. I’ve needed to work through problems that have developed as I’ve healed – the SI joint, the IT band, the nerve in my left foot – all the while continuing to retrain muscles to support my spine. I’ve been careful, but I’ve also pushed myself in rehab. I didn’t want to just heal the incision and let the bone heal – I wanted to really rehab my body to get back to a place of strength and stability that I haven’t had in several years. I wanted a new lease on life, so working on healing and rebuilding strength has been important to me – a full recovery. I’m so thankful that I have good insurance and the ability to take the time to recover that I’ve needed.

I see my surgeon again in February – almost exactly 6 months from my surgery. That’s about when my physical therapy “prescription” runs out again. I feel like I can see the light at the end of the tunnel, like my recovery and rehabilitation has been a success, and that I will back to myself and my “pre-fusion” activities soon.

I’m looking at spring and summer craft fair dates, and feeling like I am physically able to do the work of setting up and tearing down shows. I need to spend some time making soap in preparation for that – and I feel like I’m physically able to do that too. I have to admit, there was a time when I was wondering if I would be able to get back to the soap biz – so it’s a very good thing that I’m feeling like all my hard work in rehab has been worth it!

I’ve been consistent for over 3 weeks with clean eating and exercise. I’ve been taking my vitamins and supplements every day and doing everything I can to fuel my body well. And I’ve been giving myself grace to just live a little too. I have found the balance that has been lacking for a while in my life.

Oh yeah…and it was recently my baptiversary – so I treated myself to a new bible and bible cover. With my focus on women’s ministry I have been doing a lot of bible study on women in general, and leading our local Ladies Night In ministry – so I wanted a bible that would help me do that. One of my favorite blogs put out a devotional bible recently, and so I treated myself to one. It’s visually a beautiful bible, but it’s also chocked full of reading plans, devotionals, and highlights over 50 women of courage. I’ve really enjoyed skimming through it and prayerfully considering which reading plan I wanted to start with. As usual, God had a plan and led me right where He wanted me to be.

Stability

As any healing journey progresses, you have highs and lows, hills and valleys, starts and stops – but the goal is stability.

Tomorrow marks 4 months of healing from Spinal Fusion surgery.  Overall I feel pretty good.  I’m off all the muscle relaxers and pain pills, and I rarely use ice packs now.  I do physical therapy exercises every morning, and add in gentle yoga routines most days.  I do as much walking as possible, but now that the weather has changed, it’s not safe to be walking outside – nor is it warm, for the record!  I need to establish a routine to get some time in on the spin bike a few times a week, but finding a consistent time is always a challenge.  

I saw my surgeon two weeks ago.  He says I’m doing great.  He will see me again in February, and then probably, I won’t need to see him again – it will just be my regular primary care doctor.  I did talk to him a little bit about the nerve pain in my foot – but nerves are slow to heal, and what I’m doing with physical therapy does seem to be having an impact.  I also talked to him about the movement and shifting in my pelvis and specifically the SI (sacroiliac joint).  He poked and prodded, and offered to do a cortisone injection into the joint.  We talked about extending my physical therapy, and about my recovery and rehabilitation in general.  I opted to not have the injection yet, and to see if more physical therapy will help stabilize it.  He agreed to the conservative approach, and approved another 6 weeks of physical therapy.  

In the past few weeks as I’ve increased my activity level, and done more and more muscle work for both flexibility and strength – essentially loosening up the crazy tension I was holding for so long…we’ve created a bit of a stability issue.  My body is learning how to move with and around the spinal fusion.  As I move and rotate my upper spine – my back pops a bit as things realign and adjust.  This isn’t causing any problems, but it is an indication that my muscles aren’t as tight (from chronic pain), and as they loosen, those joints can actually shift around and go back into alignment on their own.  I’m not concerned about the upper spine pops, nor is my physical therapist and surgeon.  But as I am moving, stretching, healing more an more – I am getting some popping and shifting happening along side my sacrum(that is now fused to the vertebrae L5 above it), through that SI joint which leads to a misalignment in my pelvis and hips.  Also the pops and shifts are the tissues themselves making noise – and creating a bit of inflammation. 

So…we are focusing almost all our attention during PT now on stabilizing the sacrum and pelvis through deep core stabilization.  We are backing off on some of the strengthening and flexibility in the big muscles (hips, glutes, thighs, etc) to focus on the inner most deep core stabilizing muscles – transverse abdominal and the multifidus.  Hopefully this step back to work on the less obvious muscles will give me the stability that we are after.  I also have to pay very close attention to body alignment.  No side bending; no twisting while reaching; feet, knees, and hips always squared up; no rotation unless hips are square and core is engaged. I need to really reign in my movements until we have the stability back on track.  

I’m finding myself in a valley, but with a clear path lined up to get me out of it. Three steps forward, and 2 steps back.  But no one said that recovery from spinal fusion would be easy!

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Thankful for Healing

On this Thanksgiving Day, I’m thankful for the healing in my body this year.  The year isn’t over, nor is the healing, but it’s still something to be thankful for!

I’m at a touch over 3 months post spinal fusion.  My spine is held together by 6 screws and 3 rods, plus cages in the disk space between vertebrae L4-L5, and L5-S1.  Oh, and bone matter.  The goal is that everything will be held together by solid bone, and the titanium of course.  I will see my surgeon again next week, and expect a good report from him.

I’ve been in physical therapy for 6 weeks now.  Danielle is finally back, and she has been working me hard!  We have a couple areas of focus:  my hips and pelvis, and my upper back.  She wants increased movement and flexibility in my upper spine so I’m doing a lot of stretching and rotation work in my shoulders and upper rib cage, rotating from the bottom of my rib cage to look over my shoulders, and reach across my chest.   My hips and glutes are working as well to give me stability in my pelvis to support my sacrum and low back.  During my PT sessions, Danielle has me working on the Pilates reformer – doing a lot of squats in various positions to work specific muscles both in my hips and glutes, but also in my lower abs.  We are working on the flexibility of my low back (those muscles got VERY tight after surgery) while keeping my spine itself in a neutral position, but also stretching my hamstrings and hips.  Everything has been very tight because of years of chronic pain and moving in “defensive and protective” mode.  So I’m doing lots of stretches each day, as well as muscle building activities.  Danielle has also been working on helping the nerves to heal by loosening their paths as well as stretching them.  I have a series of “neural flossing” stretches and movements that are working like a charm.  Nerves heal so slowly, but I am noticing changes in my symptoms, so I know what I’m doing is helping!  Also, Danielle has been great about helping me modify and get comfortable in different yoga poses to help me get back into regular routines.  Best of all, she’s given me confidence to start really pushing my healing forward.

I’ve kind of turned the corner from being in a very protective healing mode and being extremely careful, almost fearful, about doing something to put my surgery in jeopardy – to pushing hard and moving much more.  My stamina is increasing, both muscular and cardio.  I can walk comfortably for a lot longer – it’s not just one slow gentle walk to the driveway, but 3 trips back and forth at a quick pace.  I’m noticing more muscle strength in the muscle groups we’ve been working on, but still need to focus on really engaging the RIGHT muscles to do the exercises, not what my body has been compensating with for years.  I laughed when Danielle said I have some really bossy muscles that need to take a back seat to the ones who are supposed to be working.  I won’t see her next week, but I will continue with my home exercises and yoga practices for hip and sacrum stability.  I have scheduled once a week check ins with her through the end of the year.  I’m doing much better – but I’m not “back to normal” yet, so therapy with guided exercises will help me get there.  Re-training muscles is hard work, in case you were wondering!

I’ve got a lot to be thankful for this year, but I really am thankful for the body God gave me and how resilient it is.  I pray you each have blessings abounding that you are also giving thanks for.

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