warming up

Massachusetts is currently digging itself out of an enormous amount of snow which makes me want spring. It also makes icing my hip not too appealing when it's 10 degrees outside. Thankfully at PT recently I've been getting heat instead of ice. It's pretty wonderful to be wrapped up in two enormous heat packs and four towels in January. Getting good, deep heat on a hip can be difficult but my physical therapist has come up with a method that I am a very big fan of. I think this could be pretty easily done at home with two hot water bottles or two microwaveable heat packs. It doesn't fall off, it gets heat around the entire hip AND it's great for bilateral hippies like me.

1. Take a flat sheet and fold it into a rope and place it across the bed
2. Place two heat packs of the sheet with their ends touching so they make a big rectangle
3. Take bath or hand towels, depending on how big your heat packs are and layer them on top of the packs. (The number of towels depends on hot your heat packs are and how much heat you can tolerate)
4. Do your best princess and the pea impersonation and lie down on the towels
5. Tie the sheet around your waist (you can put a wedge or some pillows under your knees if you like) 

ice is nice

Maybe it's the weather outside or maybe it's because I've been having more pain lately...who knows, but ice seemed like a good topic for today.

In my opinion ice is great for hip pain and really great for post-op hip pain. Lots of people swear by the  Game Ready ice machine. It plugs into the wall and requires no pumping and allows you to adjust the temperature. pretty nifty. After my arthroscopy I was sent home with a low tech version of the game ready. You fill the cooler with water and ice cubes and squeeze the bulb to get ice water to flow into the the pad which is strapped to your hip. Pretty good relief for being very low tech! I also have a big therapeutic gel ice pack that I bought from a physical therapy place. It's very helpful but not as good as a machine for post op when you need around the clock ice. ( they can be a bit pricey and a bag of frozen peas does the job too!)

post-op ideas

My family and I went into my first open surgery not knowing what to expect. We had gone to a long pre-op clinic beforehand and learned that it would be rough and  got the basic concept of surgery and recovery. Beyond that we weren't too sure what little problems we might encounter and other little details. Having to experience the same exact surgery three months later was sacry (we knew what would be hard) but it was also reassuring not having there be any unknowns. I try to keep track of the things that made my recovery easier knowing. Some of them apply only to open surgery but most of them are for hip surgery in general.

• If you are the kind of person who wears nail polish (like me!) remove it before you go to the hospital. Most hospitals require this because the OR team needs to check circulation during surgery. They do this by looking at your toenails. who knew.
• If you'll be spending a few nights at the hospital bring a lightweight blanket (fleece is good). It can keep your legs warm in  the wheelchair, prop up an air mask so you don't have to hold it and if you roll it up it can keep your "good" leg from roatating inward when your "bad" leg is in CPM
• Have your CPM and any other rented supplies delivered before you go to the hospital
• arrange for sleeping arrangements on the first floor for at least a few days. pain meds+crutches+stairs=very bad
• If you've had open surgery please have someone shift your position slightly every couple of hours while you're not able to get out of bed. Prevention IS the best medicine. I am assigning absolutly no blame, my hospital is fantastic, but I did it a pressure ulcer/bedsore on my heel after my first surgery. Healing was a huge process that I wouldn't want anyone else to go through.
• If you live more than 1/2 hour away from your hospital, stock your getaway vehicle with at least three pillows to prop your leg up with when you're going home after surgery.
• If you know you'll be on more than a few medications after surgery have someone make you a med chart while you're in the hospital. It's helpful to have a chart with times and dosing on it so you don't forget anything.

Got any other suggestions? Let me know please!

IT band rolling

The iliotibial band or ITB runs from past your greater trochanter (the bump you feel on the side of your hip) all the way down to the side of your knee. Foam rolling is a great way "massage" the IT band if it's tight, snapping or painful. Though it's quite painful at first foam rolling is a great way to get some relief ( if your doctor and physical therapist give you the ok first!) I've attempted foam rolling many times and each time I end up in a twisted heap on the floor because my arms couldn't support my weight on the roller. Because I have been having IT band problems lately my surgeon suggested a rolling pin. brilliant. Even though I might an IT band release surgery in the future this provides some relief! It's much easier to have someone else do it for you, just tell them how much pressure to use.
P.S. tell me if you like these videos, I can do more physical therapy videos if you like!

muscles ligaments and tendons oh my

I do not have a good relationship with my IT band. In fact I think it may borderline on an abusive relationship. Oh  well. Since I've had hip surgery I've learned quite a bit about hip anatomy. More than sometimes I'd like to know. The biggest thing I've learned is that there are a lot of muscles, tendons etc. in your hip that you might not even know exist until they decide to go on strike. About 1/2 of my hip problems caused by FAI have bee joint (bone or cartilage) related. The other 1/2 have been muscle and tendon problems related to FAI. In fact I spent 6 months on crutches due to muscle atrophy and tendinitis. Pretty crazy to think that even though now my joints are now normally shaped (yay!) the various problems related to being on crutches, having surgery, suddenly changing the shape of my bones and simply growing are tremendous and that I still deal with them today. The iliotibial band runs from your low back to the outside of your knee. It's pretty darn big. Because of many causes mine (left only) is much too tight to the point of needing surgery to release it. The moral if this little story is that you should never take your muscles and tendons for granted. I would only think about my bone and cartilage and labrum but it is equally important to take care of all of your hips. Ice and physical therapy are great but sometimes rest is the best. Happy New Year!