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!

Image result for thy word is a lamp unto my feet

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.

Image result for Thanksgiving scriptures

 

Physical Therapy – the next step in healing

I had my first physical therapy appointment this week.  I got a phone call the day before my appointment that Danielle would not be available due to an illness – but they could move me to the afternoon to meet with Brenda.  I asked if my follow ups would stay as scheduled with Danielle, and was assured that they would.  Knowing this, I accepted the change and planned to meet with her the next day.

She assessed my movement and range of motion, checked my reflexes and strength, and asked about what I have been doing so far and how I am feeling at this point.  While I have been doing quite a bit of stretching, she wants me to focus more on some micro movements.  Building stability and supporting the fusion as it heals.  I was given a sheet of stretches and exercises that take about 20 minutes to do each day.

I start laying on the edge of my bed and letting the outer leg dangle down – stretching the front quadriceps and hip flexor.  Hold for 30 seconds, bring it up and rest, then repeat.  Then switch sides.  Next, on my back knees bent, feet flat – lift and tighten my pelvic floor, belly button to spine, keeping my knees together, slowly rock knees side to side – holding stability and gently stretching hips – but not rotating the spine and it’s a steady motion – for a count of 20.  Next comes a hamstring stretch with a strap – knee bent slightly, foot flexed, pushing up through the heal, and keeping the pelvic floor and belly button engaged – 30 seconds, switch sides, twice each side.  Next is knees bent, feet flat, pillow between the knees.  Inhale and on the exhale, squeeze the pillow, lift the pelvic floor, and belly button to spine.  10 repetitions keeping steady with my breath.  Keeping with this same them, of lifting pelvic floor, belly button to spine, I then do slow and deliberate marching – micro movements of lifting my heel no more than 2 inches – focus on engaging those muscles in my pelvis and lower transverse abdominals.  Count of 20, and then we continue on the marching theme with lifting foot, straighten leg, lower and lift (small micro movements of less than 6 inches total) and back to knee bent, foot on the floor, then the other side. Up, straight, lower, lift, bend, down…count of 20 total.  When I’m done with all those, I roll to my side, feet stacked, knees stacked, hips stacked…and it’s clamshells – 20 working up to 30 each side.

When I’m done with the series of exercises, then I stand up between the bed and the wall and bend at the hips…hands on the wall to stretch the long muscles in my back – it’s kind of a modified downward facing dog – to stretch the long muscles in my mid and upper back.  I hold it for 30 seconds, and then switch to bring my hips forward and a slight backbend, allowing my hip flexors to stretch for about 20 seconds, then another set of stretch for 30, and flex back for 20.

So far this is feeling good, without too much difficulty.  I had to set my mind to just doing it first thing in the morning.  So I get up, let the dog out, start the coffee, and then into the spare room to lay on the bed in there and do the stretching and exercises.  Then let the dogs in, feed them, and off to the shower to start my day.  My intention is to then be able to continue to walk throughout the day and especially at lunch, and at least 3 days a week, spend 20-30 minutes doing a gentle yoga routine.

For the next 6 weeks I’ll be seeing Danielle for more physical therapy appointments on Tuesdays and Thursdays – so we’ll see how the routine changes, but it is my hope that getting up and doing the physical therapy first thing will be a routine I can keep long term – and that hopefully Danielle will help me to incorporate more yoga into the therapy routine.  I also wouldn’t mind using the morning to do a little ride on the exercise bike too – before I’m really awake and full of excuses as to why it won’t fit in today’s schedule.  I’m working to establish healthy habits and I know it will take a bit of time to establish the habit – but that’s where a little help from God will be useful!

Image result for god helping scripture