And so it goes on… another injury for the list!

Since arriving in the UK my right ankle and my right knee have been playing up. I’ve been walking 1-2 hours a day and navigating London’s tube stations which involves a lot of steps. I’ve been spraining the ankle regularly for a long time now but don’t recall actually injuring the knee. Something has happened in the last few weeks and now the knee bothers me when I walk, go up steps and when I get up from sitting. I have a sneaky suspicion it might have been the yoga classes I went to (sigh) and the increased activity levels from having a fixed hip (hooray). As usual I gave it a couple of weeks to settle by itself and as things were getting worse I went back to the physiotherapist I saw when I first arrived in London.

The physiotherapist did a lot of tests on the knee and ankle and has determined that I am lacking in strength in my hamstrings, calves and hips. This combined with the loose ligaments means that my knee joint is getting irritated and she suspects I may have torn my meniscus. She said if it doesn’t get better I may need to go see a surgeon. I told her very firmly that it WILL get better. Hopefully by strengthening around the knee and addressing alignment issues, the injury will heal on its on.

I got a bit tearful during the appointment due to the disappointment of my body letting me down once again, the thought of more surgery and adding another problematic joint to the list of joints that need managing. The cost of private physiotherapy in London is very high, it’s worth every penny but it is an expense that I was hoping to avoid. For some reason I thought if I spent enough time in India doing yoga therapy and got enough distance from New Zealand, then my body would settle and I’d no longer have to deal with these sorts of problems. Apparently not. But I must not forget how far I’ve come and the progress I’ve made since my hip operation. I’m on zero medication, my activity levels have increased significantly, the CRPS symptoms have gone and my hip has almost fully recovered.

How things pan out in London is going to be fully dependent on my attitude. If I choose to make a big deal of this, focus on the negative and get frustrated with the pain – then it will be a problem. If I accept what is happening, listen to my body and follow the advice of the physiotherapist – then in a 6 months or so I should be in a much better place.

The physiotherapist stressed the importance of doing my physio exercises consistently FOR LIFE. I’ve got a pattern of going to physio, doing the exercises and then stopping when I feel better. Then I loose strength and injure myself again. It’s a boom-bust pattern that is painful and expensive. The idea of doing physiotherapy exercises for life is very depressing as I find them incredibly boring. To break the cycle of boom/bust I think I need to do my physiotherapy exercises as told for 6 months (suck it up) and find a way to integrate appropriate exercise into my lifestyle. Then once I have the strength built up and the pain is settled, I should be able to take away the training wheels (of physio) and maintain my condition without help. I was hoping that yoga could do this, but I don’t think yoga is going to be enough. The physiotherapist said I don’t need yoga as I have enough flexibility, she suggested pilates instead. I don’t think she realises that yoga can be strengthening, but I get her point. I think in the short term I’ll do swimming and cycling, then when I’m working I’ll transition to a gym. There is a great gym near my work that has lots of classes (including yoga), a swimming pool, lockers..etc. its expensive but its money well spent in my opinion. I’m not giving up on the yoga as its too important to me, but I appreciate now that yoga alone is not going to help me and is potentially harmful for me right now. So I’ve decided to stop going to classes until I’ve got more strength to protect the joints.

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A change of pace

I’ve been in London a week now and things have been pretty good. I think the cooler climate has been good for my joints and trading sandals for proper shoes (with orthotics) has made a huge difference to my ankles, knees and hips. I’m in generally in a lot less pain and have been able to stop taking paracetamol (teylenol) regularly. My liver will be pleased! My neck has also improved but that might be due to the better ergonomics of my laptop setup. 

I’ve increased my walking considerably, and while I’ve been sore the hip has coped really well. I’m living in a household with a dog so have been walking at least 60min a day. Yesterday I walked 7km (approx 2hrs) and it’s amazing how different the hip is now that I’m almost 9 months after the surgery. It really does feel like I’m a new person! Before I was in pain all the time, took a lot of medication and was unable to walk for more than 10min without the pain getting unpleasant. 

My fitness is still terrible though and my legs are very weak, but I’m sure that will improve with time. I can feel the muscles in my feet are getting stronger and my inner thighs are doing some work. I’m not 100% sure my biomechanics are quite right so I’ll see a physio this week to fine tune my rehab and help me get back to yoga classes. I’m quite keen to give barre classes a go too , and when I’m feeling more confident in my recovery I’d like to return to the gym. 

Things aren’t perfect though and I’m often reminded of “what was”. I get tired easily and need to sit down to rest fatigued muscles. I was in the supermarket on Friday and the hip got stuck and clicked very painfully for the first time in months. I’m pretty good about not panicking when this happens, but it does make me a little uneasy. But as things continue to improve week by week, I’ll stay positive. I believe having a positive mindset is a key ingredient to a successful recovery.

  

Will I ever be ok? 

As I near the end of my 4 months of yoga therapy, I’m starting to wonder… Will I ever be ok? It’s been a long 4 months of 90min yoga therapy sessions 5-6x a week that has been specifically designed to meet my needs. While everyone else is doing advanced yoga, I’m very much back to basics. It’s so frustrating and a little dull. I’m not even allowed to join the class to do the sun salutations. It’s very humbling to go from having a strong practice to this. While I have significantly improved, I’m still having pain in multiple joints and am struggling somewhat to progress. I’m at the stage where I’m wondering “Will I ever be OK?”.  This hip injury has been such a long, painful and tedious journey.

These days hip itself is actually ok (mostly), it’s my ankle, shoulder, neck and wrists that are causing grief and stopping me from progressing with the yoga. I am seriously questioning if yoga is for me but I’m not quite ready to give up. Before surgery I tried a few yoga classes and it always destabilised my pelvis and significantly increased the hip pain. The problem with the classes was that it was hatha style, and I never knew what I was getting until I was in the class. Some classes were better than others. Theoretically now my hip has been fixed and I’ve got a lot more strength, I should be ok but my other joints are playing up. I’m a little fearful of making things worse because of the hypermobility. Some people say yoga is ok and helpful, others say it’s a terrible idea. My instinct is that the right kind of yoga will support my health and joints moving forward, it’s just a case of taking it slowly and not pushing myself. I need to find the right teacher to help me find my way.  I am having doubts that my teacher in India is the best person to help me find my way. This is disappointing as I’ve considered myself a student of his since 2008, he was my first ever yoga teacher and to some degree has had a big impact on my life. My yoga practice changed me in so many ways.

Because of these doubts I’ve been reading up on hyper-mobility and I learnt that it takes 6-12 months of exercise 5x a week to build up the necessasary muscle tone to support hyper-mobile joints.  Muscle tone is different to muscle strength, muscle tone is how your muscles feel when at rest… a few months ago mine were soft and pudgy. I’m starting to get some muscle tone but I’m really only 3-4months in, so really need to keep up with the exercise despite the pain. Hopefully once I have muscle tone back the joints will be less painful. When I was active (before the hip problems) I had minimal joint pain, and I’ve had a physio tell me it’s very very important to exercise regularly for the rest of my life.  I know exercise is very important and while the next 6 months might hurt a little, I need to keep working on it. It’s just a case of working out the best approach.

Soon I’ll no longer be under the guidance of my yoga teacher, the training wheels are coming off and I really do need to trust that “it WILL be ok”.  I can do this, I’ve already come so far. I think I’ll probably continue with my yoga sequence, modify it a little to make it more enjoyable and hopefully less painful. My instinct and experience is that my joints like to move, I think starting with basic sun salutations is best for me. I’ll seek my teachers opinion first, then experiment with it. I think I’ll also do less yoga and more swimming/cycling. I’ll be going to Bangkok where I’ll have access to a pool and exercycle so I’ll make the most of that.  Hopefully after a few more months I’ll be ready to try a beginners yoga course and can take it from there.  When I go back to yoga classes in the west I think it’s very important to start with a beginners mind and make sure my technique is sound. I believe that a strong foundation of strength and knowledge will set the scene for an enjoyable, balancing and safe asana practice. I really hope so.

It will be ok. 

I am ok. 

It is ok. 

I will continue to be ok. 

It’s going to be ok. 

I will be ok.