Range Update

Measurements were taken at physio on Monday and for the passive ranges of hip flexion I'm at 100 degrees on the left and 91 on the right.  Active ranges are a couple of degrees less. They weren't that good pre-op and I'm still getting weekly improvement.  That has to slow at some point and I won't be disappointed when that happens.  I think that side of my progress is more of a bonus now with my focus on improving my gait.  Ranges are all in functional ranges now and though there will still be exercises to improve them further, I will be ok with slower progress.

I still get a little confused about the logic of how the left side got so far ahead of the right.  The left started off well behind with the drop foot and a splint that I really didn't really wear for that long.  When I started walking, the left was the side that was most difficult to lift.

The best guess to the logic as to how it took over was that while the right side was taking most of my weight and compensating for a lack of strength on the other side, the left could spend its days actually working on range.  The muscles on the left aren't as tight and the movement on that side feels a lot more fluid in the higher range.

More than 90 Degrees!

Today my right hip flexion got to a passive range of 93 degrees.  This is a large jump up from where I was last week and over the magic 90 degree mark that I have been aiming for.  The left is still below, at 80-something degrees (I was so focused on the 90 number, I can't remember the other one) but thats ok.  There was still improvement on the right side and it would have still been an improvement that I would have been happy with, especially with the plateau of last weeks measurements.

I was so excited that I wanted to jump...  I didn't!  I'll save it for the pool on Friday.

Today was a good day for the elliptical as well.  I've stepped up to 15 minutes from my previous 12.  I completed this in two sessions and I think that I could probably even go a third session but I want to wake up in the morning first and see how I feel.  I am using level 2 on the ramp and resistance for most of the time.  I figure that I can get to 30 minutes and then I can increase the resistance and ramp throughout the period and maybe even use some of the proper programmes rather than manual settings.

Hip Flexion Ranges

I realised something on Friday at hydro that I forgot to mention.  I have been a bit hard on myself about my hip flexion ranges and how slowly they are moving now.  On Friday, I tried to get out of the pool using the step ladder, which I knew I couldn't but I wanted to try anyway.  I was about an inch off.  I remembered that a few weeks before I went into surgery, we had to use the outside pool and it doesn't have a ramp.  Reese had to help me get out of the pool because I couldn't do it then.   This is good news to me.

It will be interesting to see if I'm still on that plateau or whether the ranges have increased again.  I'll try again each week to see if I'm any closer to that bottom step.  I'll have to figure out the range next time so I have a pretty good idea of what I'm aiming towards.

Guarding my thoughts

Today I didn't make it into the office.

I made it as far as Physio and to one of the venues to pick up invoices and then I went home to start work on them.  I wasn't up to going in today.  I'm not sure if it was the thought of the chair and table that I am using until the person using my desk full time moves into their new office or whether it was inevitable questions explaining how the work I was doing actually fits into the grand scheme of the businesses' future plans that kept me away.  Perhaps it was a combination of both.  

I started off the day with a headache and it didn't really ease until later this afternoon.  My range measurements didn't improve this week either, so not only was there pain there was also general grumpiness and a little despair at the plateau that I've reached.

I've been thinking a lot about that plateau today and have started wondering whether I ever had greater hip flexion than that.  I'm currently at a passive range of eighty degrees but I'm not sure when it was ever better than that.  Maybe it hasn't been since I was a child.  In that case, it's going to take a hell of a lot more than three months worth of stretching to bring it back.  I guess because the abduction range came back immediately, I expected the rest to follow suit pretty quickly.  Under the guise of pain, there were a few tears at Physio today.  You can kind of get away with it when you have your head in the hole and it you are involuntarily jumping each time the pain is sharp.  It probably helps that I'm a girl too.  A little more socially acceptable.   Not that anyone would say anything negative, I'm sure that they would be a great support, it's more that I don't really want to share some of these thoughts.  Not until they've been processed and I can decide how I want to deal with them.  The crazy thing is that is probably the place where how I'm feeling would be understood the best.  

I think the abundance of people who ask but don't want to really know have made me a little more guarded about discussing it especially when I am having a bit of a tough day.  I read a blog a while ago about a girl that had a total hip and wrote a blog.  She stopped blogging when someone made a comment about how that was all she ever spoke about.  It feels like that is where people are at now with me but they just haven't said it yet.  The thing is that this thing is still the central point in my life at the moment.  My whole world revolves around my rehabilitation and the distance there is still to go.  I don't have the energy for too much more than that.  It might seem like I'm projecting that all is good but this doesn't mean that I'm ready to take on anything more than I am right now.  As it stands, I think that I might have too much and I'm not making enough time for all my exercises, that somehow I should be doing more of them.  I worry that this could be part of the reason that I've hit the plateau.  These are just more things that people don't want to know.

I don't know why I thought that this would be any different than talking about the arthritis.  I didn't talk about that too often because those who haven't dealt with it before don't understand living with a chronic condition.  This is an extension of that.  Just because I want to talk about this massive change in my life, doesn't mean that others aren't sick of hearing about it.  I'm thankful for those that have been through this process and those spoonies that can understand.  Even when I have finished rehab and life is better than it has ever been, I'll probably still want to talk about them.  I guess I'm going to have to find some new people to talk to.  Ones that are interested in resurfacing, replacements and MOM joints.  I guess there will always be a place for me at Surface Hippy.  I'll also be able to blog.  People can choose to read or not.  If they don't, well they don't need to hear my hip talk and the important changes that are going on in my life. 

In an attempt to feel like I have achieved something today, I've increased the time on the elliptical today to nine and a half minutes and 500 metres.  I'm not sure how that will treat me tomorrow but I really needed to increase and improve something today.  I feel ok so far so hopefully it will be ok.  If I'm doing well tomorrow, I might try to add another minute and a half.  

Aside from exercise and Physio, I had a little bit of work to do today, though nothing was time critical.  It was more getting a bit of a start on the work that needs to be done this week.  Tomorrow is the time critical day which I already have a good start on.  As for the rest of the week, I guess I will work out as it progresses.  

Improvements and Progress

I had physio this morning and we measured my ranges, as we normally do once a week.  It has been a little over a week this time since we did two hydro sessions last week instead of the usual program.  Today was all about trigger pointing to release some muscles, measurements, review of the land program (as opposed to the water) and practice walking with the cane.

There have been improvements on both sides, with the biggest ones on my right side.  My passive range of hip flexion on the right side has increased 9 degrees to 80 which I am really happy with.  This measurement is made with the left leg straight and assistance to bring the right leg up as to isolate the joint.  If both legs are at table top, the range is greater but it isn't an accurate measurement as it isn't just hip flexion.  The passive range is less as I don't quite have the strength to bring my legs to a tabletop position on both sides which would improve the 'active' measurements.   This is the only way to improve them as my knees are close to becoming the limiting factor measuring from a heel slide.   On one of the measuring days, my knees and muscles surrounding them were really tight and before we used trigger pointing to release the IT band, my active flexion range was about 5 degrees less.

It's the muscles that are limiting the range now, not the actual joints.  My physio program aims to improve strength and flexibility over time.  The ranges that I have in all directions are better than I had pre-op, so the muscles that I am working to grain these ranges haven't been used for quite some time.  The only range we aren't measuring is adduction as I'm not particularly comfortable with that range.  I think this has a lot to do with 6 week restrictions not to cross the mid-line.  I'm not entirely convinced that it is completely muscle discomfort either, I think that my brain learnt during that six weeks that it didn't like that movement as my hip could pop out and it's taking a little while to get over that.  I didn't just learn this because I was told, for at least the first few weeks, if I accidentally moved my leg too close to the mid-line, it hurt and the hurt was a bad pain that was quite clear that it wanted to be avoided.   It still feels like it wants to be avoided though not with the same level of pain feedback so I am taking it slowly with exercises in this range.  I'm ok with that range taking a little bit longer than the rest.

Surprisingly, the muscles on my right side are starting to loosen up a little bit and it's the left side that's playing at being tighter now.  Maybe this has to do with the different muscles used while driving, since that's one big change since the last time we released everything using trigger pointing.  The clutch movement is very different from moving between the accelerator and brake.  It's not really a big deal, it's just interesting to try to figure out what is making differences.  The main reason that I know what side is tighter, is that is the side that hurts the most to release and so by contrast feels more amazing after the muscles are released.

Walking with the cane is a lot more difficult than crutches.  I practiced for quite a while today.  The movement is not natural at all yet and will take a little bit of time before I move to using outside of the house.  The cane shows just how much weight I am still putting through the crutch and at what point the pressure is being put through it.  Even though I can feel where I'm going wrong, I can't quite figure out what muscles aren't firing the way that they should.  To help correct, we are practicing with exaggerated movements and have filmed me walking so I can see what it is that I can feel so that I can try to link the two together and get things working properly.

It feels like I have had another big burst of improvement over the past week and it's spurred me on again.  Things felt like they were plateauing and I was having difficult staying positive and on task with everything that needs to be done.  From what I've read, it seems this is a normal part of the recovery process.  Some days are just harder than others and you need to just push through as some day soon there will be a massive boost which will restore your faith and move you a lot closer to your goals.

This is the first week that I'm going to pick up some more work.  Depending on how worn out I end up for the next few days will influence how many updates there are between now and the weekend.