Hip Pain is Currently Hip!

Hip Pain- Part 1bones

I’m not sure if I would go so far as to say that hip pain is the new black, but over the past decade its popularity has been on the rise due to innovative arthroscopic surgeries.  These techniques are similar to those used for years to help knee and shoulder problems.  The major exception is that the hip is a much deeper joint, and by nature built for stability.   It has taken a little bit longer to figure out how to do a less invasive procedure which includes an exterior camera and weighted traction.  The huge plus is that many things that weren’t treated by the open procedure surgeries are now able to be corrected.

Why would a bodyworker be so excited about the advancement of hip surgery?  It is quite simple -research must support the things we do in medicine.  Twenty years ago, as a new physical therapist, the only hip problems referred for rehabilitation were bursitis, and post-operative care following hip fracture and hip replacement.  Today we have a much better understanding of what is happening if you have hip pain. This improved system of differentiation, offers more treatment options and the ability to screen those that may be at higher risk for more severe hip problems later in life.

Let’s consider hip anatomyhip-150x150

Here’s what you want in terms of having a good hip.  Nice congruent and well aligned surfaces between the thigh bone (femur) and the pelvis (acetabulum), and normal cartilage spacing between these two bones that make up your hip socket.

What if you don’t have these things?  Here is where the biggest questions live.  Are you more prone to develop hip arthritis?  Will performing arthroscopic surgery to help improve the contour and alignment of your hip joint today, prevent a hip replacement later on in your life?  Since this is all pretty new, the jury is still out on the final answer, but I believe things are looking pretty hopeful for the future of our hips.

So you have hip pain what do you do?

I recommend getting a consult with an orthopedist that specializes in arthroscopic hip procedures.  You will have to do your homework as this training is still relatively new.  For instance, in Austin, at the time of this blog, we have only two physicians with this expertise.  They will rule out if you have a true joint problem, a muscular problem, or a combination of both.  Once you know this, the options are pretty well laid out, and include medication, corticosteroid injection, soft tissue mobilization, rehabilitation and/or surgery.

Rehab Perspective- A good assessment is imperative!

An individual program should be designed to support your hip alignment and correct movement dysfunction.  Common findings are functional pelvis asymmetry, decrease in hip range of motion and muscular flexibility, and neuromuscular imbalances which include both weak and overactive muscles in the hip, abdomen and pelvic floor.  It is important to pick someone skilled in these areas of assessment to assist you in figuring out a corrective program you.

          hip-muscles

Your biggest job is to figure out and stop the irritating factor(s).   A good rule of thumb is any pain brought on during or after an activity or exercise should be discontinued or modified for the time being.  With this effort and putting a knowledgeable team in place, you should have the best opportunity to return to doing all the things you liked to do before your hip started to hurt.

“The obstacle is the path.”- Zen proverb

Hip pain: Part II will examine hip injuries and treatment in more detail.

 

 

Life’s Little Surprises

Since my last post that I would get back to you about hip pain, I have been completely sidetracked.  Symptoms are divert, alter, and change. Digress, switch, and veer.   Deviate, shift, and redirect.  And yes, since I last wrote all these things happened.

The first Saturday in May started out innocently enough, like any other, but unfolded into the unexpected.  Mid-afternoon, my neighbor called to see if I could entice a kitten out from beneath her Toyota Tundra.   “Sure,” I said.  After all, how hard could it be to coax a tiny creature out of its hiding place?  An hour and a half later, I finally had the smallest, gray fur-ball, I have ever seen, extracted from its perfect spot on top of the snug fitting spare tire.

2013-lil-lion-009-smaller-150x150It was hard for me to believe that the pair of lungs that brought her to our attention came from this teeny creature.  All fur and protruding ribs, she clearly didn’t weigh a single pound.  And plenty scared, as she tried to adjust to her new surroundings.  But who wouldn’t be- the high pitched cries for help had been for her mother and clearly not for the nine pairs of human eyes that had shown up instead to lure her out of her safe haven.

024-email-sizeAwaken your capacity to be delighted.Everything is new and exciting to this kitten.   Every inch of her environment must be explored.  New noises stop her in her tracks.  Big brother’s tail is a complete preoccupation.  Just watching her find delight in nearly everything she does reminds me to view my everyday tasks a little differently.  In these crazy, busy days that encompass most of our time, remember to do something you truly enjoy doing each and every day.

Since life has a way of constantly bringing on the unexpected, here is what this itty-bitty thing made me ponder this month.

Active Release Techniques

I’m off for a 4 day workshop and will be back to write more about what this means to me as a body worker and to you as a client.

It’s been quite a journey just to get to this place and I know in the next few days I will have plenty of aha moments, and plenty of times when I’m not really sure what point they are trying to make. It’s all part of being back at the beginning.

Let’s Start with a Clean Slate

clean-slate-3 “How you do anything is how you do everything.” I, for one, can’t believe it is the end of January- already. Everywhere I go people are talking about their New Year’s resolutions. I have long stopped this practice, but still find it fascinating to listen to others participation. Personally, I like to look at each year as a clean slate. It is both frightening and liberating to me; a time with nothing specific planned and no big goals to master. It won’t last long as life has a way of giving me plenty of tasks to handle. However, during this time, I like to notice if any of my own bad habits have shifted over the past year.

As a body worker, I see many different personalities on my table, but the most trying is the driven client who, despite all the body’s careful warning signals, continues to disregard them and to push through any type of pain. He/she only knows the quest of pushing further and further. Not until their body completely fails or their nervous system literally freaks out, will they maybe see the harm of this cycle. I hope that the time spent on the table will bring awareness to this destructive path before they take their body over the edge. If I am not careful, this can be me.

This brings me to the yogic concept of samskara. It is defined as a pattern deeply ingrained in our subconscious that causes us to act out variations on the same theme again and again. Samskaras are our individual actions, ideas, or thoughts. Lumped together, they become all of our many patterns. These can be physical patterns of holding tension or postures that keep things in a constantly stretched position, as well as mental patterns harboring our fears, needs, and beliefs.

“How you do anything is how you do everything.” I have tried to find the source of this quote to no avail. But the gist of it is that your true nature will handle everything in your life in a pattern that you are not even aware of. It’s important to realize that our patterns are conscious choices to make. It’s up to us to choose them. If we aren’t aware of this, we are strengthening the old default muscle. Yes, we are creatures of habit, but it is important to see that we have a choice in our habits.

So how do we create healthier patterns? It doesn’t happen by accident, we have to call attention to it. The massage table is the perfect place to notice our habits. To start, I ask my clients to try using breathe instead of gripping, and a mental scan of the sensations they perceive as they receive the work. With only these two intentions, change is started just by their heightened awareness. These tools are then taken off the table, back to everyday life, where conscious choices can be made.

I know when my clients retain this awareness by the way that they communicate with me about their body. If they just want to hand it over to me for me to figure out, we won’t achieve the same results. If they can tell me a little bit about their pain’s behavior, together we are more successful. If they can give me insight about their body, I know they have taken the time to slow down and listen. This input they are learning to access is more valuable for their overall health than anything I can offer. This will serve to create healthier patterns.

Awareness is what helps us see our thoughts, behaviors and movements as patterns. It allows us to ask if these habits are working for us. Instead of wondering, ‘Why is this happening to me?’ Ask yourself, ‘What does this pattern have to tell me?’ And then you can act on it. On the table, I ask my clients to envision the change they are looking for. When we step out of our patterns, we can restore our bodies to more optimal health.

Are you open to the idea of a clean slate, to get out of the deep groove of a pattern made by year’s of endless repetitions? Remember it is your choice.

“These pains you feel are messengers. Listen to them.”― Rumi

So What are YOU Grateful For?

bittersweet-150x150It seemed appropriate, as we wrap up the month that houses Thanksgiving, to explore the idea of gratitude. My own holiday had the grace of easy airline travels and many bittersweet moments connecting with family.

‘Count your blessings’. This phrase is used as an invitation for each of us to contemplate all that we have going well, and all of the areas in which we are blessed, instead of focusing on the not so sunny things in our life today. It’s interesting to me because it is used in either the context when things are going really well or when things aren’t going well at all. The idea is to take note of things as they are right now. As things, both the good and the bad will shift again so make the most of any situation. counting-150x150

Keeping track of gratitude. Dr. Robert Emmons, UC Davis, and others in the field of psychology have found that gratitude lists and journals are actually good for our health. They reported that by writing a three-item gratitude list just once a week for three months, subjects reported feeling up to 35% healthier in mind and body. Folks in this study reported that they were more optimistic, more energetic and had fewer illnesses. These are things that I personally have great interest in. It seems like an almost too good to be true scenario, but really what do we have to lose here? So I’ve got my notebook and pen on the ready.

Here goes. For today, I am grateful for……………………

  • My wonderful story-telling friends that keep me writing and creating and connected to what is truly universal.
  • My clients who make me search deep within to bring out the best work that I can do.
  • My peeps who offer me unwavering support as I ebb and flow along my unique path.heart-hands-150x150

Gratitude, it is said, is the memory of the heart. Related studies have found other benefits as well, and the one that I wish for all of us, is better resilience during tough times. I know that during these times, if I remember how I saw things as a child, with wonder and awe, not fear and dread, I didn’t really notice the bumps in the road. They were just life. So during our most difficult times and darkest hours, it is essential that we look at things that make us smile. It’s not to say don’t feel the bitter, but remember to always find the sweet.

So what are YOU grateful for?

 

“We often take for granted the very things that most deserve our gratitude.” – Cynthia Ozickhow

Resilience: Try Letting Go Instead of Holding On

fall-leaves-150x150Autumn has arrived, even if the changes here in the south are more subtle. The sun hits the earth at a different angle, the shadows are more noticeable and we have more time in darkness. Nature’s cycle is for the leaves to eventually find their vibrant attire and then fall from the tree. It is a period of change; a gentle reminder of the transience of things. Which for anyone suffering from an injury, it is great to ponder impermanence and know that “this too shall pass.”

Each of us brings our habits, physical patterning, and emotional baggage with us on our day to day journey. So every injury has all of these components associated with it, in addition to the actual story of the injury. I watch my clients rack their brains for the exact moment and action that created the pain in their body. As if, by figuring this out, things would get right back on track. If you have to look that hard, it’s just life happening around our own beautiful, but real imbalances in our bodies. I often say, “It truly is the straw that broke the camel’s back.”

“People think that muscles move our bones around, but really the bones and muscles exist in one big fascial net,” explains Tom Myers, the author of Anatomy Trains. “Very often what’s going on with the hip is connected to what’s going on with the neck.” In other words, our bones are supported by our muscles but our muscles are also supported by our bones. The Dry Bones song, which many of us may remember from childhood, reminds us that ‘the thigh bone is connected to the back bone’ and this makes perfectly good sense. But the more essential meaning to take from this is that truly all our bones are interconnected from our head to our feet. Our alignment is important in our body’s efficiency, so our support systems don’t have to ‘hold on’ all the time. skeleton1-150x150

How does bodywork help with these holding patterns? Exploring our old patterns is what creates freedom in the body. Bodywork requires you to breathe and receive, and be witness to where you are in your own body. Knowledgeable hands can find the overactive, busy muscles and sense where you could use more support. It can help open up space in those stuck spots, so that you can soften. The experience may offer you tools for you to shift from your habitual pattern. It can allow more freedom in your system so that you find more resilience to meet the demands of everyday life.

Nature is in a cycle of letting go. It’s a great time to check in with your body to see if there is any habit that you would like to let go of. In my own body, I can sense a very old pattern in my hip. Every time I try to let it go, I get a strong sense that I still need its protection. I hope that I can give it an experience that allows it to find the freedom that it needs to leave this old pattern behind. Maybe you too can let go of something, and find both more resilience and more softness in your body.Opening-to-Stillness-150x150(1)

“To be a warrior in this world, this kind of opening is necessary.” – Susan Piver