PT

I'm going to a new physical therapist, one recommended by a friend who's been doing PT his whole life due to cerebral palsy. I really like this guy, because he's professional, no-nonsense, he seems to know what he's doing, and he pushes me. The last therapist I had just talked the whole time.

He currently has me doing a dozen or so different stretches or exercises, a couple of sets of each, a couple of times per day, which takes a while--in fact, I haven't been able to find the time to do them as much as he would like me too. But it's helping nonetheless. I'm finally able to (start to) cross my leg, and I can walk almost normally. I sometimes limp, but more out of habit, and when I realize that I can even out my gait. I need to gain a bit more extension because my heel's coming up a little bit sooner than the other heel.

My hip got a good workout a week or so ago when we took the kids to a logging competition (like the kind you'd see on ESPN). I ended up standing for standing outside for three or four hours. My muscles were tired, but I didn't have that deep ache in my joint that I would have felt before surgery, which is a very hopeful sign.

I still have some significant limitations in flexion and rotation. I'm getting 90˚ flexion, but I'd like more, as it's still a bit awkward putting on shoes and socks. My rotation is improving, but it's uncomfortable crossing my leg. But every week my hip feels looser and more normal.

I think my hip's better now than it has since the surgeries began.

Physical therapy

(Yes, I've been delinquent in posting updates. Terri's excellent posts on her PT reminded me that I needed to post about it too.)

Since I've been given the go-ahead to bear full weight, I've been doing physical therapy to loosen and strengthen my hip muscles. For the first few weeks I went into the PT office twice a week, but now I'm just doing the exercises he gave me at home.

At first it was all I could do to bear enough weight on the operated side to quickly drag my good leg forward a little bit in time to take my weight before the other leg gave out. And was my hip ever tight! I tried to be super careful not to violate any of Dr Mayo's straight-leg lifting and abduction limitations, since it would be a Bad Thing™to tear one of those muscles free. That, together with the ectopic bone mass in front of my hip socket made for a very tight joint, with virtually no internal or external rotation. But I could get around reasonably well with one crutch.

So I began PT. My physical therapist gave me several exercises to do: abduction (a sort of standing one-legged snow angel), extension (holding the leg extended backwards), and rotation (while lying flat wearing an ankle weight with the knee bent 90˚, lower the foot to either side).

He recommends holding the muscle in the stretched position for a minute or so because after about 45 seconds or so the stretched muscle "melts" and begins to relax, thus helping the muscle to stretch.

After a couple of visits he gave me a length of Theraband (a piece of colored surgical tubing) to add resistance for building up strength. I tie a loop in one end, stick it around my ankle, and anchor the other end by closing the other knotted end in a door. Then I do three sets of 10 reps of abduction, adduction, and extension exercises.

For a while a muscle deep on the inside of my leg felt very tight, so I worked on isolating that muscle and stretching it frequently. I think it's stretched out (as much as its neighbors anyway) since I'm not able to "find" it anymore.

Sometimes it feels like one of the muscles that attaches to the outside of my leg bone (to the trochanter) is more of an inflexible strap rather than a pliable muscle. It's a weird sensation. I'm not sure if it needs stretching, or whether that's a side effect of the ectopic bone tissue, or what.

After a week or so of PT I was able to waddle around with a severe limp when not using my crutch. My operated side would dip down so much when I shifted my weight to that side that I wondered if my leg were now shorter than before, but my physical therapist said it's all due to muscle weakness. (Besides, physiologically it was impossible that the surgeries I had would have that effect.) I was surprised to learn how much our muscles support us; before I assumed that muscles just move our bones, but evidently they do a lot more than that.

Now I walk with a mild limp with no crutches. What seems to have helped the most (but it could just be coincidence) is climbing stairs the two weeks we spent at my sister and brother-in-law's house over Christmas. At first it was almost impossible to step up using my operated leg, but by the end of the two weeks I was able to walk up normally without using the handrails, except for the wobbling and grunting. It feels strangely good to go uphill now, healthy, as if the exertion is getting everything all properly tightened up and aligned. I need to make sure I'm not violating Dr Mayo's limitations; I hope not because it feels good.

The rotation stretch seems to have helped a lot, and is the stretch that's the most uncomfortable.

My major limitation is still hip flexion (i.e. bending the hip into a sitting position). The ectopic bone tissue in front of my joint severely restricts how far it will bend. Every few weeks I try to sit in the front seat of our van but it just won't bend enough, which means I sit in the middle row with my daughter Eden (thankfully I don't need a car seat). I can sit in the driver's seat for a few minutes, but it's such a cramped position I can't easily move my foot from the accelerator to the brake pedal, requiring me to use my left foot for the brake. Also after a few minutes it becomes very uncomfortable. So until we can hack out that ectopic bone, I'm just a passenger.

More on that in a bit.