Wednesday, March 10, 2010

Recovery is time consuming

I've been too busy recently to blog about what's going on, specifically with my hips problems, so it's time for a recap.

Last week I had my first Alexander Technique appointment. For those of you who have absolutely no idea what this is and are perhaps wondering if I'm heading for a bionic hip or something, here is a brief synopsis of what the AT is and why I'm trying it.

Using the description from the official website: "an Alexander Technique teacher helps you to identify and lose the harmful habits you have built up over a lifetime of stress and learn to move more freely." So, basically, someone takes a look at your body mechanics, the way you move, the way you sit, your posture, and helps you to be in a more natural alignment, thus helping you to mitigate muskuloskeletal pain caused by your misalignment. This, of course, is a gross oversimplification of what this process is all about but, unless you're really into it, I think that description suffices for the purpose of this post. If you want to know more, you can visit the Alexander Technique website at

The Alexander Technique has been around since the 1800s, when it was created by it's namesake, Frederick Matthias Alexander but I learned about it from my friend, E, of The Gurly Life, who has been suffering from the same hip and SI Joint issues as I have. It's not new news to me that my posture leaves a lot to be desired and, after hearing consistently from my physical therapist that I have the body mechanics of a rag doll, I felt the time was right to add Alexander to my treatment strategy.

As I live in the Sacraghetto area, I am not blessed with an awful lot of options when it comes to these alternative treatment options. So, I had the grand choice of one AT teacher within 100 miles. For the purposes of this blog, we'll call him Jim, although that's not his real name.

Jim works out of a granny annex at the back of his home and it did occur to me briefly, as I walked down the residential driveway, that I could be heading into the lair of a sex offender or something. Fortunately, although Jim is indeed 'weird' (at least by my definition of the word), he appears to be safe. Jim's 'weirdness' comes from his posture, general demeanor and the way he speaks. The first thing that bothered me is that he holds himself like a caveman, with long arms that seem to hang limply from his shoulders and large hands that almost brush his knees when he walks. This wasn't very encouraging, since I was there to learn 'better' posture from this guy - developing the gait of a prehistoric cavewoman wasn't on my list of goals for the year. (I know, right?) Secondly, Jim has this presence about him that is very... superior and supercilious, let's call it, but in that quiet and self-contained way that makes you think that he spends all day meditating, eating willow bark, and avoiding any and all stress in life.

I may be over-reaching in my first impressions, but it seems like Jim lives his life in a bubble of calm, peace, and ease, and feels a level of disdain and pity for the rest of us who run around in our complicated lives, stressing ourselves out with roller-coaster emotions, and poor habits. He obviously sees his work as an AT teacher, as a way to preach a better way and I guess that's where I had a problem connecting with him. His teaching felt borderline creepy-religious-cult. I know I'm over-reacting here, because I don't think at all that this guy is dangerous, but I'm just trying to convey the reasons why he irritated me.

Now, I'd like to be clear in this - I don't aspire to live a life of calm, peace, and ease. Really. I mean it. The very thought makes me want to puke with panic. I like roller-coasters, both literally and figuratively. I never feel more alive than when I'm zooming through the air on some crazy theme-park contraption, the wind whipping at my face and adrenaline rushing through my body. I don't want to live my life on a flat-line - I'm ok with ups and downs because the downs make the ups so much sweeter, and the ups make the downs bearable. I recognize that's not for everyone - some people prefer to live life on a calmer sea - but that's me. And for some reason, people like Jim just freak me out. I have a phobia of those quiet, self-contained, calm people. I think part of me fears that they're really just bottling it all up and that, at some point, it's all going to come bubbling over in some major, psychotic breakdown. Emotions - both high and low - are natural and it seems unnatural (and dangerous) to me, that someone can regulate their emotional self to such an extent that they never really display or experience extreme joy or sadness. Ok, psychoanalyze this all you want, it is kind of an oddity I'll admit but not something I plan on stewing over. So let's move on...

The point is that it was hard to settle into the advice I was getting from Jim because of how I felt about him. However, I did get some good nuggets that make sense and that I have been trying to deploy into my regular day.

Our spine (neck to tailbone) is connected, not just in a literal sense, but in a behavioral sense also. Meaning, what you do at the top of your spine affects everything below it, and visa versa. This may sound simple and obvious but it's more than that. For instance, if you let your chin jut and/or down out when you're stressed or thinking, it not only affects your neck and upper back (which is a no-brainer) but it throws off your entire balance because now your whole spine has to readjust to balance your head (which, let's face it, is a big-ole thing on your shoulders) resulting in unnatural load bearing in different areas of your back and the connecting muscles. It's these types of readjustments that result in chronic pain. Your body, over time, unlearns the way to be in balance, the way our skeleton was designed. Our muscles start taking over from our skeleton, to do the job of holding us upright, and - hey presto! - all sorts of odd (painful) things happen.

Personally, my poor habits include hyperextending and locking out my legs when I stand, over-arching my back, curving my shoulders, and (at the same time) driving my heel into the ground ahead of me when I walk. This last one is important because, what this means in relation to all my other body mechanics, is that I am literally driving the head of my femur into my hip socket with force, every time I take a step. OUCH! All the other stuff amounts to me placing too much load on my lower back. What feels like a "natural" or "upright" posture for me, is actually leaning back. When readjusted for 'neutral', I feel like I am leaning forward. It's the craziest thing! So, I have to re-learn standing, sitting, and walking (amongst other things.)

Jim actually told me to watch Daisy walk because, obviously, her body mechanics have not been contaminated by modern life... yet. She walks with her head leading and her body following, almost as if she is about to fall forward at any time. Although this may be an extreme example of what I need to do, the basis for my new posture is right there: lead with my head, not my feet. There's a lot more involved in it than that, of course, stuff about pausing, giving my body directions, "letting my neck be freeeeee!", looking down from my ears (!), and pulling back my ribs to name a few, but essentially that's the primary guiding factor. (And yes, I did feel and look a bit like a prehistoric cavewoman in the "ideal" posture. I think I'm going to have to modify it a bit to suit me, for vanity purposes!)

After all the walking and sitting instruction, I got to lay down with my head balancing on a paperback book, knees up. Again, my instruction was to let my neck be "freeeee" and to lengthen my spine through relaxation. My homework was to do this for 15 minutes a day every day. Something which I just haven't found the time to do. I guess I could be doing it now instead of blogging, so maybe I don't really have an excuse. Drats!

Add this to my physical therapy exercises and appointment, doctor appointments, and other miscellaneous advice about how to move, bend-down, stand, roll-over, sit-up etc... and it's all a little overwhelming.

I've calculated that, if I did everything the physical therapist and Jim tells me to do, I'd spend approximately 4 hours each day just working on my recovery. Who has that kind of time when you have a full time job and are the mother of an 11 month old??? It's like having a second, part-time job!

That four hours breaks down into:

  • 20 minutes of physical therapy exercises 3x per day
  • 20 minutes of laying down, icing my back, 3x day
  • 15 minutes of AT head-on-book balancing 1x per day
  • PLUS, at least one hour per day, most days, at appointments for either my doctor (who I see for osteopathic manipulation once per week), my physical therapist (who I see 3x per week), and now Jim (one time per week + 30 minutes drive-time each way.)

All that time comes out of somewhere and none of these folks take appointments outside of business hours, so, I have to take early or late lunches, resulting in things like me eating pre-packed salads in the bathroom while trying to shower.

As I said, this is not to mention the almost-impossibility of trying to remember all the other advice about my general, everyday movements. Trying to go through a 3-step, back-friendly process just to bend down and pick something up off the floor, kind of just flies out the window when it's your daughter reaching for a choking hazard. It's ok when you have the time to remember it but, for the most part, I'm too busy to spend time thinking for ten minutes every time I move a body part. I try but it's an imperfect science right now. I guess I would say that I'm learning to be more aware of what I'm doing, when I'm doing it, which is a start.

Adding to this, I am trying to re-incorporate some yoga back into my routine every day. I know my physical therapist said no yoga but she isn't a yoga practitioner and I think (from what she has said to me) she has a shallow understanding of the discipline, reducing it to all those power-hot-yoga classes, taught by a svelte 20-something, who understands little-to-nothing about proper body mechanics. Good yogis spend years and years refining their technique and understanding of the human body and there are certain sectors of yoga that place strict emphasis on proper posture and alignment, most specifically Iyengar yoga, which is what my friend, E, practices. So, I found a book on yoga and back pain using Iyengar principles and which has a section on SI Joint Dysfunction. On Monday I started (slowly and gently and cautiously) adding some of the positions into my evening workout routine. My other goal is to find a weekend or evening class locally that I can attend, where I can get some one-on-one instruction (which has really helped E) but finding that in the Sacraghetto area is proving to be hard and, anyway, when on earth would I fit it in????

Then there's the cost.

Each doctor's visit is $25, each physical therapy visit is $45 and each Alexander Technique appointment is $70. Add that up and I'm already spending a wopping $230 a week on these treatments! I could literally go broke just trying to get healthy.

It would all be easier to bear if I were feeling any significant difference in my pain but I'm not. The only improvement that I have noticed is a reduction in the shooting, nerve-related pain that was occasionally going down my thigh and into my ankle. I'm still left with a sore low back, a sore right butt cheek, a very, very sore outer thigh (from a tight IT band) and soreness and twinges in my inner thigh/groin, as well as around my hip flexors/psoas.

I keep telling myself that I have been experiencing this chronic pain for years and so it's going to take more than weeks to undo all the damage and compensation and bad habits but, as much as that makes sense rationally, emotionally (and financially!) you need to see results to keep plugging forward on the same path. I've been with this new diagnosis and treatment plan for 5 weeks now and I would have thought I would be feeling more of an improvement than I have.

My doctor seems to bear this out because, every Monday when I see him, he asks me how much better I am doing (as a percentage). Each week he sayes something like: "So, are you 70% better? 80%?" and each week I reply with "No, more like 30%." I get the feeling he thinks that I am being obstinate or difficult but really what's the point in lying? 30% may even be overstating it, quite frankly.

I veer from despondent to hopeful on any day in any given week. My hope comes from my friend, E, who has battled this and come out the other side. My despondency comes from my lack of time to really do everything I need to do, the cost, the slow (if at all existent) progress, and the repeated pattern of pain. It's not an excrutiating pain but, at any time of day, whether sitting, standing, laying down, or walking, I'm experiencing low grade pain (3-4 out of 10) somewhere in my body. After a while it wears you down.

So, after all of this, I'm not sure where it leaves me. Except, it seems, with a broken "J" key on my keyboard. It literally just flipped off, up into the air, and landed on my lap. Not that I use the J key much but every time I tap a key near it, which is I, H, K, M, and N, it flies away again. So, off to order a new keyboard from the IT department...

1 comment:

e said...

I can relate to the frustration. As I've mentioned to you before, my improvements were negligible and seemed to not really be happening. But then eventually instead of 1 day every 2 weeks with less pain, it was 2 days. Then 3. And so on. But the progress was very very very slow. I could tell the difference in increments of months, not days. It's not to say you should stick to something that doesn't work, but I'd say hang tough. This whole hip/SI joint area is really stubborn. Big joints, big muscles, stubborn. You're doing everything possible to heal. And you will.

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