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.

A celebration breakfast

I’ve just been to the shoulder physio and am having a celebratory breakfast as I’ve said my goodbyes. My shoulder has been niggly and there’s still some joint instability, but it is as good as it’s going to get. I’m cleared for swimming but was told to pace myself, not to swim every day and to make sure my stroke is deep. She’s given me the name of a swimming coach so I’ll probably get a couple of lessons to correct my stroke. I’ve been told pain in the 2-3 range is ok, pain during/after swimming is ok but if the joint is sore the next day I’m to do less.

Because of my hypermobility it’s very important I exercise and maintain strength in my muscles to protect my joints. Swimming is a very safe exercise and given my track record of injury that is where I’m starting! I also asked the physio about the yoga because many people are telling me that yoga is not good for hypermobile people. She told me it’s fine as long as I never melt into a position, I must be ready to jump out of a posture in 1second. It’s become very clear to me that when I return to yoga I’ll need to do it with a beginners mind. That will be a journey in itself.

So I’m sitting in a cafe (on a cushion for my hip), enjoying the sunshine and feeling a sense of optimism about the future. The hip recovery is going well and I’ve got two more weeks off work to focus 100% on my rehabilitation. I’m so pleased I’m able to use some of that time swimming and am able to put my shoulder issues behind me.

Two injuries down (ankle and shoulder)… just my hip to go! Life is good.

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Ligamentous Laxity

The other day when finding out that I’d torn a ligament in my shoulder I asked my physiotherapist “What is with my joints?” “Why do I keep getting hurt so easily?”.  She said its because my ligaments are too lax.  I’ve had a few treatment providers tell me over the years that my ligaments are lax and/or my joints are very loose and I’ve never really understood what that meant until recently.

The biggest and most important piece of information I’ve learnt from talking to my physiotherapist is that to avoid injury I MUST exercise and stay strong.  Usually the ligaments hold the bones together and create stability in the joint.  Because my ligaments are lax, my muscles have to do the work for them. The reason why I’ve had so many issues this year is because I’ve been unable to exercise due to the hip pain, my rehabilitation programme ended and I wasn’t able to keep pushing through the pain by myself.  So I’ve lost a lot of strength and now my body is starting to fall apart!

I didn’t realise I had this problem until this year and it has been a big “ah ha” moment for me.  I understand now that yoga came too easily to me, I was doing things in my first month of yoga that take some people years of practice to achieve (I didn’t know this until speaking to my teacher earlier this year).  I understand that why the list of injuries from childhood to adulthood so very long; I’ve injured ankles, knees, hips, shoulders and wrists.  I also understand that my feet aren’t flat, the ligaments just don’t hold them up when I’m standing up.

But having lax ligaments has got to have some advantages:

  • I’ve got great range of movement (ROM) in my hip where most people with FAI and associated joint deterioration struggle with loosing ROM and get very stiff.  Not me.  I’ve lost some ROM, but I’d say its probably still better than the average.
  • I’ve not had to do any stretching as part of my physiotherapy and rehabilitation programme.
  • When I sprain my ankles the bone can hit the ground and my ligaments won’t tear.
  • Yoga can be easy.  This is a double edged advantage though as stretching is not good for people with lax ligaments (with the exception of hamstrings apparently).  When I return to the mat I will have to be very careful to practice strength over flexibility.  I’ll also have to learn how to use muscles better and to stop before my end range.
  • I was very good at the limbo when I was a kid.  And I can win that drinking game where you pick up a coin with your mouth without putting your hands/knees on the floor.
  • Sitting on the floor is very comfortable. And I can lie on my tummy (on the floor) and watch TV easily.

OK… I know I’m clutching at straws, it is not really an ideal situation but it is very manageable.  My plan is to get through this hip surgery and then focus on the return to exercise.  I’ll go back to yoga however it will be a practice that focuses on strength over flexibility.  I’ll also return to the gym, hopefully get back into boxing and spin classes.

Here are some photos of things I don’t think I’ll be doing again in any hurry:

 

Some answers on my shoulder and a plan forward

Yes I know this is a blog about my hip, but my shoulder obviously wants some time in the spotlight too.  I can’t remember when I did it, but a few months ago I sprained my shoulder getting out of the bath and it has been causing a fair bit of grief ever since.  I’ve been working with the physio on the issue and after a period of rest (and some cool taping) the shoulder got better for a period of time, then it got worse again.  Its been crunching/clicking painfully and is obviously a little unstable.   I had one round of  x-rays and ultrasound images taken early on which didn’t show much.  So after several weeks of treatment, some serious taping (like a rugby player she said), my physio was just about to write off my ongoing pain as “central sensitisation” and chuck it in the chronic pain bucket. This caused me some concern and to my surprise, she decided to order repeat images.

To my joy I found out today that I tore a ligament in my shoulder and this is why there are issues with the AC joint.  I’ve got evidence of subluxion (joint instability) and bursitis in my shoulder. For some reason it was missed in the first lot of images.  Why am I happy about this?  Well, its good to have a reason for my pain as my hip surgery is so soon.  Had it been central sensitisation causing unexplained pain in my shoulder, I’d be very concerned about having the hip surgery because the biggest risk (for me) is around having a bad pain reaction.  This risk is caused by my history of suspected CRPS and is being very well managed by the hospital, but it is still something I’m a little worried about. This is why I’m very relieved to have good reason for having ongoing pain in my shoulder.

The bad news…  I really need my shoulder to work properly for the upcoming hip surgery as I’ll be non-weightbearing and on crutches for a period of time. So the plan forward is ice x4 per day, continuation of strengthening and I’m still banned from swimming.  If there isn’t much improvement in the next week or two we will do a cortisone shot to get the pain and inflammation down before I have my hip surgery.  Usually a course of NSAIDs would be prescribed before cortisone is considered, however I’m allergic to them.

Photo: Very cool shoulder strapping by my physio, several people thought I’d actually got a tattoo!