NotSoZen YogaJen

Posts Tagged ‘hip bursitis

Keep calm and do Pilates

Source: Parsley & Dill

In June, after having been diagnosed with hip bursitis earlier in the year, I had completed two months of physical therapy and gotten a cortisone shot, but my pain persisted and I still couldn’t do yoga.

What happened after that was, I got the second cortisone shot my doctored recommended, which was really the last one I could get, for awhile at least. And my pain got worse. I started having muscle spasms in both legs and pain in my right calf. Also, aside from bursitis, my physical therapist thought that there might be something wrong with my actual hip joint.

I called my doctor to tell him about my worsening symptoms. He was very friendly and upbeat, assuring me that nothing was wrong.

“Youshouldhaveafinehip,” he said.

“What?” I asked. I was taking notes, and didn’t want to miss anything important.

“You. Should. Have. A. Fine. Hip,” he said, overly enunciating every syllable.

I felt like I’d been punched in the stomach. The way he’d switched on a dime from warm and cheerful to cold and condescending made me feel like a little kid who was getting reprimanded. So I responded how I always do when someone speaks to me harshly and I feel immense discomfort: with excessive cheerfulness.

“Great, thanks!” I squeaked. “Have a great weekend!”

The next step was to get an MRI but in the meantime my doctor prescribed pain medication for me — at the highest possible dose. I’m very sensitive to medication and also have depression and anxiety, so I quickly experienced disturbing side effects. I felt spacey, disconnected, and checked-out, in addition to really sad and extremely anxious to the point of panic.

After a few days on the medication and feeling like I was jumping out of my skin, I had a meltdown at the pharmacy counter late one night asking through tears if I could stop taking it immediately or had to do it gradually.

“Stop!” the pharmacist said, handing me a tissue.

My gut, which felt like it had been punched after my last conversation with my doctor, was telling me to go to a different doctor. But I felt scared and people-please-y.

Maybe I should at least go back for one more visit and get the MRI through him, I thought.

The primary reason I didn’t want to go back to him was the way he’d talked to me that one time, which didn’t even seem logical. Maybe I was too sensitive or just overreacting.

But then I started to think about how he’d prescribed a pain medication at the highest dose allowed when I’m a fairly petite person who’s highly sensitive to medication. And then I started to think about how after four months of treatment including two cortisone shots, my injury wasn’t getting any better at all. I still felt nervous about not going to him anymore, though.

If I wasn’t trying to please someone else, what would I do? I asked myself.

The answer came loud and clear: Go to a different doctor.

So that’s what I did.

My new doctor didn’t think I had hip bursitis, the condition I’d been diagnosed and treated for over the past four months. She thought I had a labral tear in my hip, and prescribed an MRI.

Early on in my injury, I thought I had a lip labrum tear based on a conversation with my neighbor who had the same thing — her symptoms sounded exactly like my symptoms. At the beginning of this year, when I was experiencing these symptoms, Lady Gaga had a labrum tear in her hip and had to get surgery. My fear, going into my first doctor’s visit in April, had been that I would have a hip labrum tear and would have to get an MRI and surgery, and I was so relieved when I was diagnosed with hip bursitis and did not have to get an MRI.

I’d heard scary stories about MRIs — the enclosed space! The loud noise! — so by the time I got to the hospital for my appointment, I was terrified.

“Are you claustrophobic?” the pre-MRI questionnaire asked. I panicked. I didn’t know if I was claustrophobic. I had anxiety that could be pretty severe at times and didn’t want to discover I was claustrophobic while I was in there.

My MRI technician put me at ease though, talking to me through headphones throughout the session to let me know what was going on. Pretending I was in Savasana pose, I put one hand on my heart and the other on my belly and breathed. The noise was loud but repetitive and oddly soothing, and I fell into a calm, meditative state. By the time it was over I was almost asleep and totally relaxed.

The results of my MRI confirmed what my new doctor had suspected — I had a labral tear in my hip, and no bursitis at all.

A labral tear never heals, but there are things that can be done to manage or hopefully cease the pain, like stretching and strengthening.

After a very extended yoga hiatus and barely being able to do any physical activity all year, at my appointment where I got my MRI results, my doctor cleared me for Pilates right away (!).

Excited to get back to a class of any kind, I found a small Pilates studio a few blocks from where I live that offers a super-beginner level class. That Sunday, I put on yoga pants and a tank top, and sat down on a mat — similar to my familiar yoga mat — at the studio.

There were only four people in class, and before it started I talked to the instructor about my injury.

“I knew about Jen,” the teacher said, standing at the front of the room, “but are there any other injuries I should know about?”

Everyone raised their hands. There was a shoulder injury, a painful lower back, a knee thing.

So this is what it’s come to? I thought, laughing to myself. I used to do advanced yoga and now I’m in Pilates for injured people.

Although I stopped going to physical therapy a few months ago when my injury wasn’t improving, I’ll go back soon and incorporate that into my rehabilitation routine along with Pilates. Hopefully physical therapy will have more of an impact once it’s treating the correct condition.

For now, I feel happiness from my new Sunday afternoon Pilates ritual with a wonderful teacher who remembers what my injury is from week to week, tells me when I shouldn’t do a pose, and offers adjustments and modifications. And with my new — correct — diagnosis, I’m starting all over from the beginning, taking gentle, mindful baby steps on the slow road to recovery.

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Me not doing yoga

Two months of PT and one cortisone shot and I still can’t do yoga!

When we last left off, I’d just been diagnosed with hip bursitis. Finally knowing what was wrong with me after having been in pain for six months, I felt relieved, hopeful, and optimistic.

This was two months ago. I’d gone to the doctor, he told me I had hip bursitis, and said I had some choices:

1) I could get a cortisone shot right away
2) I could go to physical therapy
3) I could go to physical therapy for a month and if my hip didn’t feel better after that, then I could get a cortisone shot

He inserted the caveat that most people aren’t responsive to physical therapy for this condition, but it was up to me what I wanted to do. Also, he said that sometimes one cortisone shot completely relieves the pain, but sometimes a second one is necessary. However, two is really the max you can get and if that doesn’t work then you’re just barking up the wrong tree (pose) and need to start looking into if something else is wrong.

Regardless, it seemed totally possible that through some course of treatment, I would be able to be pain-free, regain my full range of motion which had been severely limited by the bursitis, and go back to yoga, resuming my normal practice.

Not wanting to jump right to the cortisone shot without trying other alternatives, I opted for physical therapy for a month, after which I would evaluate how I felt and decide if I wanted to get a shot.

After not being able to practice yoga consistently for months, the moving and stretching in PT felt great. It started out as very gentle strengthening and stretching exercises. Also, being stretched out by the physical therapist, I discovered that having someone else stretch you is like the greatest thing ever — you get to enjoy the juicy stretching sensation without having to exert any effort whatsoever to hold it there.

I thought it would go on like this forever — a gentle stretch here, an easy bridge pose there — but soon, things got harder. Through PT is was revealed that although I’ve been doing yoga for 15 years, I have a very weak core. Having a weak core means I can’t properly hold myself up, so things compress and put undo pressure on my hip. PT then went from gentle stretching to hardcore core workouts, with long holds in forearm plank becoming a staple of my routine.

But after one month of stretching, strengthening, and core work, my hip was not showing big signs of improvement — some days it felt better, some days it felt worse, but it always felt painful. At my follow-up doctor appointment, I decided to hold off on the cortisone shot for one more month. I figured that it had taken my body a long time to develop this injury, and I wasn’t going to fix all my misalignment and build up all that strength in just one month.

After the second month though, I still felt daily pain and decided to give the shot a shot. My doctor cautioned that it might feel worse for one or two days, but then would feel better.

Humph, that was it? I thought when I got home after getting my shot, thinking I was in the clear. It really didn’t hurt much at all.

The next morning, I woke up in excruciating pain, worse than any I had ever experienced throughout the entire duration of this injury. Grateful that the doctor had warned me, I knew not to freak out and that I was having a totally normal reaction to it and that this too shall pass.

On Day One, every step I took was painful. Not only was I limping, but I had to hold onto desks, tables, and chairs in order to sit down or stand up, take stairs one at a time, and ask someone to let me sit in a seat on the crowded rush hour subway because it hurt too much to stand.

Day Two was noticeably better but still noticeably painful.

But on Day Three, I felt NO PAIN. For the first time in almost nine months, I was pain-free! Having this injury, I’ve come to automatically limit my range of motion to avoid painful positions, so I was cautious and didn’t try to do anything that I thought might hurt, like sitting cross-legged or bending my right knee in too much. Even with my limited range of motion, I still got the sense that all the pain was gone, which was amazing after having become accustomed to daily pain for so long.

At my final physical therapy session, I reported the exciting news — no pain! — and they gave me program of exercises to continue on my own at home, and a t-shirt as my PT graduation gift.

A week later I started to feel some soreness — not the sharp pain I’d had before, just a little tenderness. It wasn’t bad though, and I’d been given the OK to go back to yoga, so I picked a gentle-looking class that was partially restorative that I wanted to take, and eagerly anticipated my return to yoga.

That day I ran into my neighbor who’s a massage therapist at a physical therapy facility. I’ve been giving him updates about my bursitis, and told him about my plan to go back to yoga.

He suggested that I try Pilates instead, and told me about the studio he went to that he loved. A former yogi, after having done Pilates at the studio for a while he said he took a yoga class there that a classmate recommended.

“You know what I thought of it?” he asked. “Barbaric!”

Unrolling my mat for the first time in months at the restorative class that night, I thought that yoga and I would have a joyful reunion, skipping towards each other with open arms. I thought I’d take things slow, pay attention to how I felt, and back off and modify a few poses if they hurt. I thought I’d be able to do almost everything, and possibly even be able to sit in a cross-legged seat at the beginning and end of class.

This was not what happened.

Almost everything hurt. I had to modify a ton, back off a lot, flat-out not even do some poses at all. And this was a restorative class.

Trying to make it through class, feeling sharp, shooting pain if I moved too much this way or bent too much that way, I wanted to cry. I’d hoped that I’d be able to — maybe slowly but eventually — go back to my beloved yoga practice as I knew it. I thought that the cortisone shot would be the solution, would bring the healing that would allow me to return to my pre-pain ways.

Sitting cross-legged with my knees bent up to my chest instead of resting comfortably on the ground, my eyes welled up. Poses that were easy for the rest of the students were impossible for me, and every position was a reminder of things I used to be able to do but couldn’t do anymore.

Jen Garam coffee yoga

Look how comfortable I look! I can’t sit like this anymore. But I can still drink iced coffee…

When I got home that night I texted my neighbor, “Took a restorative yoga class tonight: Barbaric.”

After two months of physical therapy exercises which were simple, precise, and alignment-focused, yoga, even a restorative class, seemed too fast-paced and full of coarse, all-over-the-place movements. It hurt during class, and left me afterwards with pain I still feel a few days later.

Despite what I’d hoped for, I hadn’t found the solution, experienced the fix. I had to go back to the drawing board.

I feel so disappointed that my pain isn’t gone, that I can’t yet return to life — and yoga — as usual. But I still feel hopeful that one day I will be able to be pain-free; it just might take longer and look different than I’d initially thought.

Even though I graduated from physical therapy last week, I’m going to call to make another appointment this week. I’m going to get the second cortisone shot that I hoped I wouldn’t need. I’m going to be as diligent as I can with doing my ongoing physical therapy exercises at home. I’m going to take yoga off the table for the foreseeable future to prioritize healing my hip bursitis. And once this post-yoga class pain in my hip calms down, I’m going to check out that Pilates studio that my neighbor recommended.

It makes me sad to think of giving up yoga, for now at least, as it’s brought me so much healing, serenity, and happiness for the past 15 years, and been such a big part of my identity. But being in so much pain, I didn’t even enjoy the class I took the other day, and I know that right now, my body needs something else. So for the time being, I just might become NotSoZen PilatesJen.

leg injury

(source)

I’ve had injuries before where I couldn’t do yoga. There was my back pain, my tweaked out arms and neck, and my broken toe. But none of these things seemed that serious, and the most I’ve ever had to stay away from yoga was a little over a month.

This is worse.

In September, my right hip and leg started hurting after a restorative yoga class. This class consisted of lounging around for long periods of time, propped up on various bolsters and blocks, so it was baffling how I got hurt during it. I meditate daily, and after this class I noticed that it started to hurt to sit cross-legged in meditation, so I took a short break from yoga and mediating, and then went back to both after about a week.

Over the next few months, several things happened to make my injury worse:

  • One Saturday night in November, I double booked myself and made two plans. I was tired and cranky and couldn’t decide which plan I wanted to do, so I canceled one, and then I changed my mind and canceled the other one, and then I tried to get my first plan back but it was too late. So I wound up home alone with no plans, and in frustration I plunked down hard on my wooden kitchen chair. I felt something snap in my right hip, and it hurt. Then I had canned soup for dinner. That night sucked. The next day the pain was still bad, and I was limping. I was so mad at myself! If only I’d gone out for one of my plans! If only I hadn’t been so cranky! If only I hadn’t plunked so hard! And I took a break from yoga and meditating again.
  • In December, I was showing off — not warmed up at all — how I could touch my toes. I made it half-way there when I felt pain in my right leg, and again, took another yoga/meditation break.
  • On New Year’s Eve Day I went to yoga. I took precautions. I talked to the teacher before class and told him about my injury. I didn’t sit cross-legged at the beginning of class. I sat in Virasana. On a block. But, not wanting to be limited, not wanting to be injured, I tried to do Compass pose. And hobbled out of class.

At this point, I could have gone to a doctor. Except I didn’t have health insurance then and having no idea how serious my injury was, I was afraid that walking in a doctor’s office would bankrupt me. So I decided to manage it myself by taking a longer break from yoga — six weeks off — and hoping it was just a pulled muscle or something and that that would take care of it.

After six weeks off yoga, a number of things happened to make my injury worse:

  • The day before I went back to yoga, I went sledding. Sitting cross-legged on the sled brought back the pain in my leg and hip. And it turned out that I didn’t even like sledding, although I did like the hot chocolate afterwards.
  • In pigeon pose in yoga class, the teacher adjusted me. Doing hip opening poses like pigeon is excruciating with this injury, but I’d figured out a way to make it not hurt that much by not opening my knee that wide. But on this day, the teacher came over and adjusted me, moving my knee wide and opening my hip way up. I told him I had a hip injury and didn’t want to go deep into the pose, but he moved my leg anyway saying that the way I was doing it would injure my knee, and then I’d have an injured knee and hip. This is where I got mad at the teacher, and even madder at myself. Because the teacher was a hot guy and one of those too-cool-for-school yoga teachers, and even though I know better, in the moment when he adjusted me I abandoned myself and let him, whereas if he had been a woman, or a not-so-hot guy, I would have stood my ground.

By this time I had health insurance again, and friends who were encouraging me to stop blowing this off and go to the doctor. So I made a doctor’s appointment but the earliest I could get in was in three weeks.

I suspected that my days of yoga were numbered and once I went to the doctor he was going to tell me that I couldn’t go anymore, so I just wanted to get in a few more classes. That weekend I went to yoga. I felt sort-of-OK-not-terrible afterwards.

But the next day I was in agonizing pain, and it was constant. I felt it with every step I took. When I stood up. When I sat down. While I was sitting. Walking up stairs. Going down stairs. And even though I’d been all this-is-no-big-deal about my injury for six months, all of a sudden I started to FREAK OUT.

This was my LEG. I need it to STAND ON. And it hurt ALL THE TIME. I was afraid I’d be in pain forever, that I’d never be able to do to yoga again, or to take a step without feeling a sharp pang in my leg.

I worried that I had a torn hip labrum like Lady Gaga (she does yoga, too!), and that I’d need an MRI and surgery, only I wouldn’t be able to afford a blinged-out wheelchair like Gaga’s.

I was freaking out, and I couldn’t do the thing which makes me not freak out, which was go to yoga. I panicked that I’d have to go on anti-anxiety meds, only I’m super-sensitive to medication and the one time I took it for a week I wound up not only not anxious, but sedated.

And then my doctor appointment arrived. I told him my symptoms, and he diagnosed me, which seemed kind of miraculous. That I didn’t have to worry and wonder and assume the worst anymore. That I could say, “This is what is wrong,” and he could say, “This is what you have.”

Which is hip bursitis. Something that does not require an MRI, or surgery, or a secondhand wheelchair. Something that can get better. Something where I can be free of pain, get my full range of motion back, and return to yoga.

I start a month of physical therapy next week and I’m so excited. I like/need to practice yoga about three times a week, and I haven’t be able to practice consistently since last fall. I’ve only gone to yoga a handful of times so far this year, between taking long, long breaks. As a result I often feel tired, achy, listless, foggy — and anxious!

I’m not meditating because sitting in my favorite meditation position is painful. Technically, I could still meditate and sit in any number of other positions, but meditating is kind of Pavlovian for me and I associate sitting cross-legged on a rolled-up blanket with the peace I then feel, so I’m being stubborn and not meditating at all.

Sitting cross-legged is also my favorite lounging around my apartment position, and my favorite watching TV position. Pulling my right leg in and crossing it is my writing position, and my talking on the phone position. I haven’t been able to do any of these things in months either.

After having been relatively inactive — and in pain — for so long, I’m excited to move and stretch in physical therapy. I’m excited for gentle exercise, being forced to take it easy and not push myself, which feels like it’s going to be really nurturing. I’m excited for healing my body and getting my writing and lounging and meditation positions back. And one day hopefully soon, getting my yoga back.