Showing posts with label physical therapy. Show all posts
Showing posts with label physical therapy. Show all posts

Tuesday, April 26, 2022

Fixing my Hip

Let's try this again. I wrote this whole post out last week, accidentally posted it early, thought I hadn't, tried to update it, and ended up deleting it somehow. The idea of rewriting it (especially because I'd kind of forgotten everything I'd written) was a no go, so I figured I'd write it again later. This injury isn't going anywhere. 

One of the things I enjoy about my job is that it has good health insurance. I have not had good health insurance since I was on my parents' plan, but even the copays back then were tricky, so it's honestly been a while. Now though, it's great! And I'm finally able to get consistent care. 

I've done a physical, seen the doctor for my esophageal spasms that sometimes feel like a heart issue (they are not but it's nice to hear from a doctor that my chest pain isn't anything to worry about), and am going to finally get my contacts paid for after years of paying out of pocket, but the weekly/biweekly visits working on my body have been my favorite part. I started working with the chiropractor every other week for a while, which has been great. My upper back and neck are always really bad and I've always found that regular chiro helps with that. Sure enough, I didn't realize how much pain I was in until I started going regularly! 

I just started physical therapy as well! It took a while to get on his schedule and it was something I kept putting off until my hip actually freaked out. Then I went in (and have an appointment for my wrist coming up too). 

This

He did a full examination where he looked at my balance, having me stand on one leg and do certain movements. He came to the conclusion that my piriformis is incredibly tight and that is causing my pelvis to be tilted and THAT is causing some interesting problems. Long time blog readers who have very good memories for weird biomechanical things may recognize some of these symptoms...

1.) my right leg wants to be more bent than my right
2.) my left oblique is weak
3.) I might find it hard to drop my right seat bone
4.) my right side is stronger than my left
5.) I can't turn off my right hamstring

Hmmmm I told him that all of those things sounded like my long time riding problems. 


Me, about my SI injury


He thinks that this is a very old injury, where something happened where my pelvis was twisted hard. Then my body basically tightened up around that twist and it stayed. Namely, my right piriformis tightened around my right hip and locked it into place. Then a decade later, I was squatting and my piriformis yelled I CAN'T TAKE IT ANYMORE and freaked out. 

Back in early 2011, I was riding a horse who my boss had assured me had been out all week (I was gone). He had not. He had this nasty root-buck-twist move and he did it to me early in our ride. Rooted me out of my secure position, leapt into the air, then twisted. I was out for a couple of weeks but all I did for it was take anti inflammatories and gave myself a stomach ulcer. Then that caused me to drop weight and therefore feel super weak, so I got flung head first into a fence. Being a horse trainer crash dummy is rough. I went back to school after that. 

That is very likely when this injury occurred and my body has been compensating for it for years. 


My SI and my hip to me, I'm sure lol

I'm bummed that I didn't take it seriously back then (and honestly, I couldn't, I had to keep working and had almost no money since it was winter) but I'm glad I can take it seriously right now. I am doing my physical therapy exercises each day, which mostly include me pummeling my right piriformis and right hamstring with a lacrosse ball. 

Hopefully it starts to get better! I can already feel it complaining. My back has been hurting, which I think was due to the balance on the saddle being off but could absolutely be part of what my tight piriformis was protecting me from. 

I go back today for a check in, I'm hoping to get some exercises for my wrist too! We'll see how far we get. 

Wednesday, February 5, 2020

Mary Wanless Workshop: Connecting the Dots with My SI Injury

Nine years ago, right around this time, I had an accident. It wasn't even a real accident, I didn't come off. I don't come off nearly enough, so many of my injuries have occurred when I wish I'd come off but I didn't.

This injury in particular occurred when I was working at the event barn I worked at. Winter is tough and I went to get on a particularly rude horse (looking back, he probably was in pain) and thought he'd been longed the day before. Turned out he hadn't been out in a week. He went to buck me off and twisted while pulling downward.

I was a tiny person, about 15-20lbs lighter than I am now, and weak. He yanked my back and I was in instant pain.

At the time, I had no health insurance and was quickly skating around debt, desperately riding horses for people for as little as $15 just to pay my bills and survive the winter. So the last thing I wanted to do was go to the doctor.

You can see me falling left here
Fast forward nine years and I am out of pain, been out of pain for a while now. Occasionally I'll piss off the joint by doing something weird, get some crazy sciatica or just have a lot of pressure on the right side of my SI joint, but it goes away with a lot of walking and rest. For the most part though, it's been fine!

I've long thought that my right side weakness in riding has something to do with this injury. I've been told by instructors that I pop off that seat bone, have had every horse I ride go through the right side of their body. But I can manage it, I got through the Grand Prix with it, and when I sit in front of the mirror, my body is even, I can feel both seat bones and everything.

So I figured it's fine, I'll just keep strengthening the right side and that'll help both my riding and to support this weakness that's been there for so long.

Definitely love the left side
At the Mary workshop, we had a lab session where we sat on saddles and got realigned. I didn't necessarily want to take up a bunch of time being realigned, because I'm fairly happy with where I'm at and I've also found that sitting on a fake horse makes me sit weird, so it's not the most helpful. But Agi was playing with bands with Nicole, finding out where her weaknesses were in her stability, and I wanted to play too.

We briefly chatted about my desire to twist left, so I wanted her to try to twist me each way and see where my weakness was. When she went to do that, she saw something weird. Just sitting still on the saddle, both seat bones were weighted the same, I always thought it was interesting that trainers said I popped off of the right one because I honestly feel that one on the saddle all the time. BUT when Agi went to shift me, apply forces to my body, my right glute immediately popped my right seat bone up and forward, away from the saddle... protecting my injury. She put bands on and the same thing. When I go to resist being jostled, my body goes into protection mode.

She talked me through keeping my right seat bone on the saddle while I was resisting her push/pull/twist and I was in immediate pain. INTERESTING. Sounds like whenever I'm having to absorb/transmit forces from/onto TC, my first priority is to protect the injury. But then when I stop and work on my position, I sit just fine.

Me as a child, I could not lean right like this now!
Anne, who puts on these clinics, is a physical therapist and dressage trainer extraordinaire. She worked on Nicole the day before, just briefly, and I saw the difference she made. I wanted to talk to her about this injury because she specifically understands dressage. A regular doctor or physical therapist would probably think that because I'm not in pain, whatever. I figured Anne would understand why I wanted to address it and how to help me both on and off the horse.

Luckily, she had time to set up an appointment for Tuesday, yesterday! So I audited some of Mary's riding clinic (my work from home days are excellent, I got some good work in AND learned a ton) and then headed into Anne's office.

The first thing we did was put me through some of Anne's tests. She pushed lightly downward on my shoulders while I was standing and was able to feel a lack of mobility in my... left SI. Turns out that the frozen part is the problem, not the painful part! More tests revealed that my SI as a whole has almost no flexibility in it. She asked me several questions that were really on point, things I've just kind of minorly struggled with for the last ten years or so. Nothing enough to even think about but when she mentioned it, I was like "huh, yah that describes me" and such.

Hyper-mobile right SI causing my seat bone to come off the
saddle and shoving my right leg back
The PT itself didn't feel like very much. She first pushed on my pelvis (lightly in comparison to a chiro) in all different directions, finding that my left SI was stuck frozen upward, she said I essentially dislocated the joint at one point and now it was stuck. It had a lot of mobility going up but no ability to be pushed downward. Meanwhile, my right SI was all over the place, making up for the frozen left side. The way I understood it, and I'm sure my interpretation is off, is that the pain in my right SI is a strain caused by my left SI having no ability to move.

She basically just loosened up my left SI and then worked on my vascular system to calm the area down again. During this work, the hurting part of my injury felt like garbage at times and wonderful at others. I had everything from intense pressure in the original place to sciatica all the way down my leg, to a tingling feeling, to a totally relaxed feeling.

At the end, she had me stand again and felt my shoulders. I could feel the pressure down to my feet (so essentially, I was able to be in neutral spine for once), which was a huge change from earlier in the day. She then told me that I would feel weird, that I should take it easy physically (no climbing, no lifting, no sitting trot, minimal riding) for 48 hours as my body relearns how to operate after nine years of being totally frozen.

How cute is baby TC? Also look at my right side unable to get
into flexion pattern
As time went on over the few hours afterward, I felt WEIRD AS SHIT. I couldn't balance on uneven ground, I felt like I couldn't stabilize my pelvis, I could actually activate my glutes in an insanely different way - it felt like I had way more ability to turn them on (maybe that's been my issue in my squat over the last few years!), and I could stand on my right leg really easily, but couldn't stand on my left leg anymore.

Anne gave me permission to ride lightly, so I did. TC was foot perfect and so many weird things happened. When I first got on, I felt completely off balance. I sat more on the right side than I ever have before and low key felt like I might fall off to the right, but also felt safe there? That doesn't make sense, oh well. I struggled with my stability in posting trot, unable to put my butt back in the same print that it left seconds earlier. I could feel my right stirrup for the first time, possibly ever, I don't know if I've ever actually felt it before. TC felt amazing, super soft over his back and very willing to stay into the bridle, more so than usual. That could easily be the training plan we've shifted to, but at least I wasn't messing him up. He was such a good boy, Anne warned me about how horses sometimes respond to PT and I told her that TC was wonderful and he absolutely was, god I love this horse.

I'm still too early on to know how well it worked, but I do feel different and way more able to move around! I still have a bit of pain on the right side (as of Tuesday night), so I'm treating it like an injury (like I should have in the first place) and resting it a bit. I ride with Tanya on Thursday and Saturday, so we'll see how much I can do. Then I hope to get another PT session soon and also ride with Anne to work through some of this weird stuff on TC! Nine long years, I cannot wait to have this worked out so I can continue down the pathway toward my intimidating goals.