first pt appointment for my back - an adventure

So here is what I learned: my back is probably fine, in itself.

The problem is my hips and related muscles.

The following were performed for her totally professional amusement after she did resistance checking of my legs, feet, and toes:

1.) get on the ball of my foot, lift the other leg, and kind of bounce my heel up and down
2.) repeat with other leg
3.) bend over from standing position
4.) bend backward from standing position
5.) lay down and pull my bent knee to my opposite shoulder
6.) repeat with other leg
other numbers.) I don't remember exactly but variations

From what she said after evaluating me, checking my flexibility, and asking me a series of questions and me volunteering more related to my answers: my back is uninjured, no vertebrae are being sketchy, nothing unaligned, etc. Good. The problem is my hips are stiff as fuck and my back has been pressed into compensatory service for way too long in ways that are not in the original design. There could (maybe?) be other problems but she's pretty sure its asshole hips.

Basically, my hips are hurting my back and need some correction to be brought to stop their freeloading ways.

Example (used several times in different variations):
Her: Your hips are immobile doing [this thing]
Me: What are they supposed to do?
Her: *look of very professional 'oh boy'*

Having a very very tight hamstring (all my life) has been a problem and did not help, which combined with stiff hips is why I was also having periods of intense left leg (rarely but sometimes, right leg) pain that felt like a nerve was being sawed along its length from hip to knee (or sometimes, mid-calf) for weeks or months at a time over the last few years.

So my orders: get a three foot long foam roller and while supporting myself full-length, roll my body, hips to knees, on top of it for thirty seconds on all four sides (face up, face down, and on my sides with only the necessary upper body parts touching the floor to keep myself aloft upon the roller (when on my sides, the opposite foot gets to help!). Then a series of simple exercises ('sit on bed with feet on floor, straighten so your pelvis is over your hips, and flex your foot for thirty seconds' for each foot; 'using your bed, place folded leg on bed and other foot on floor, lean over folded leg and slide folded leg forward without moving foot on floor' and others helpfully sent with my after-visit summary and report. Pelvis over the hips is super important to more than one).

When she took out the foam roll and demonstrated how to use it on all four sides:
Me: What's this for again?
Her: It will help loosen your muscles before the exercises.

After rolling myself over foam roller on all four sides mostly successfully from a certain point of view:
Me: Wait. Am I being tenderized like a steak?
Her: Yes.

So in short, 'tenderize, then exercise' is the solution to the pressing 'hips like idek'. And PT once a week for a while. Sometimes with dry needles: I am honestly looking forward to it. It just sounds cool.

I have to admit, this does help give context to all the times people say 'bend from the hips not the back' like that was something bodies did. Apparently, that's a real thing you can do and not some kind of weird way to annoy me with nonsense; the more you know.

And that explains something: after Child was born I took jazz dance for one of my college credits and also to help fix my balance and endurance. I told the teacher I had a bad back sometimes--that started coincidentally after I quit athletics when I was sixteen--and so she'd come to assist or watch me with some of the positions and moves and see if I needed to skip any. I never did, actually, and I forgot all about my back.

Part of this was because I was fucking exhausted; to keep up, I'd go an hour before class to do the stretches she taught us and then the entire warm-up routine, so in class I'd be less obviously really bad at using my body on beat. But the actual reason is now kind of horribly obvious.

By the time that class ended--it was an nine week summer course--I could not only touch my toes, but flatten my hands on the floor, and I could do a split on a turn from the barre to the floor with either leg forward, things I had never in my life been able to come close to doing or even thought possible without literally cutting those muscles. I was eighty percent getting to the front split, maybe closer. That's just the dramatic stuff; there were a ton of things my body apparently could actually do and boy was I surprised every time.

And she taught us the single most useful exercise I learned, that I've been trying and trying to work out why I can't manage since I strained my back; no matter what I do, I can't get the position to start it. I used to do it often years ago and it was only when my PT therapist was talking about hips near the end of the visit that I realized what the problem was.

For the exercise you stand away from the barre and bend over, grab the barre, then do a slow motion arch and release by muscle group up and down your back from hips to neck. She watched me doing that one, and to teach me, she'd put a hand on my back to indicate where to tighten or release in sequence.

(When it comes to movement, I'm a very physical learner. As in, for a lot of things, after demonstrating it for us all, she'd take me aside and physically move my body herself until my body clicked. Reinforce that shit with a beat, and I could easily keep up with the class when performing no matter the speed, whereas without music, I was always too slow. When I played basketball and was a cheerleader, same thing for anything very new. I got better at translating it, but if pressed for time, more than once, a teammate took me aside and physically moved my body through something that I just wasn't able to get no matter how many times I watched.)

I loved those back exercises; it took a lot of control, but it relaxed the fuck out of my back after (and felt like my whole body), and by the time class ended, I could do it going from flat footed to the ball of my foot and back both in sequence and during the exercise without thinking about it. I could do the entire exercise mid-floor without the barre before class was done. It was part of my pre-class routine, in fact, as soon as I learned it well enough to use it. Afterward, all my stretches were much easier and I could more easily perform a lot of the positions and steps.

Today, I realized:
To get to that initial position--back straight, arms stretched full length to hold the barre, upper body perpendicular to the floor--I need to bend at the hips, which very obviously I could do then pretty goddamn well and completely forgot was humanly possible since. It was, in fact, a necessary component for most of the stretches I used to do and haven't been able to while wondering why why why.

For the life of me, I can't figure out why the hell I didn't realize that until now. Seriously, what the fuck.

Comments

[ruric]

Enjoy foam rolling!

As a fellow tight hamstring sufferer my PT has me down the following (as well as the more general foam roling). Get either a tennis ball, one of the small spiky massage balls or a cricket ball and when you're sitting down pop it under one hamstring and start form the base of your butt gradully rolling it down to your knee and back up again. The smaller ball gets deeper into the mucles than a foam roller does. It it's supertight/tender start on the tennis ball and them work up to the spiky instrument of torture.

My hips are pretty flexible - alas it's my hamstrings, IT band (muscle than runs the length of the outsie of the thigh) as well as the sneaky psoas muscle (which comes from the base of the spine, around the pelvis and connects to the femur). I;ve learned all sorts of fun (and often very painful!) foam rolling exericses to get them to loosen up a bit.

And tenderise is a great way of explaining how I feel after a long stretch/foam rolling session with my PT!

Good luck with it all. I still maintain bodies are weird. *G*

[seperis]

I'm noting this down for when I'm a little farther along; the foam didnt hurt, per se, but I also couldn't get the thirty seconds fully either in a single go. But I just bookmarked everything you said, because right now I can only work from bed (foam mattress for the win) and those smaller balls would be great for when I'm working but waiting for a meeting to start or an email and get in a quick exercise while watching teh screen.

(Also honestly, might use during meetings; help keep me awake.)

Thank you!

[princessofgeeks]

So glad you got some answers! Take care.

[seperis]

Thank you!

[ivyfic]

When I was in grad school, I had a personal trainer who was a physical therapy student. Best goddamn trainer I've ever had. I, like you, have also always been stiff, though sounds like for different reasons. This guy was the first one to identify that the sensation I described while trying to touch my toes was not the feeling of tight muscles, but was the feeling of stretching the nerve. And I should stop that immediately--nerves don't get more flexible with use. I am just not built such that I will ever be able to touch my toes straight kneed. He instead had me bend my knees a little, and then I could do the lower back stretch I was supposed to be doing.

I so wish he'd come along sometime in the middle school presidential fitness challenge torture years, where I was repeatedly accused of being lazy for "not even trying" to touch my toes.

(He has a very unique name, so I googled him recently, and he is now working as a sports physical therapist, which was his dream job, so good for him.)

[seperis]

He sounds awesome. One that listens, even.

My PT therapist is already on my happy list by listening to my concerns (lots of calf cramping if I'm not careful, that I'd always had problems keeping my heels down when I exercise) and telling me what the exercises were addressing and making them all extremely simple to do at home (I explained apartment, not much space, which I think is why she gave me the one that uses my bed to stretch. I can literally start it by half sliding out of bed). And she was very clear: each should not be more than thirty seconds right now and once a day, just make sure and do them every day, and should take only five minutes.

[kore]

YAY for your back being okay! Back problems are THE WORST.

It's always really fascinating to me how the body will try to compensate for the ways we physically misuse it, with the result that -- and this has happened to me so many times -- we think X is the problem, when really Y is the problem and X is just getting fucked up by the body trying to compensate. There's probably a moral there but I need more coffee for it.

[seperis]

I never even considered my hips were in any way involved with this nonsense, but apparently, I am super ignorant about hips altogether (I literally forgot 'bend at the hips' was literally something both real and I used to do!!!!!!!). I was really worried i'd slipped a disk or misaligned something falling asleep on the Demon Couch from Hell, and to be fair, makign myself sleep in my bed every night has meant my left leg doesn't hurt in the morning.

The hip thing though: I sleep on my side, and I realized my sleep on right side preference is because rolling on my left side, I can feel the muscles pull uncomfortably I know now those muscles that were hurting were in fact teh muscle groups she said were a problem aka my hips. Seriously, its a whole new world.

Welcome to Tenderize Town!

[jesse_the_k]

There's a ridiculously expensive range of PT-adjacent therapy balls called Yamuna which provide a much gentler experience than foam rollers (or racket or porcupine balls). That's what I started with. It feels much more like a hand than an iron meat hammer

I use my foam roller from waist down -- also manages to loosen up the calves. I'm glad to tell you it gets much less painful after the first week.

Re: Welcome to Tenderize Town!

[seperis]

Okay, I may add calves into my routine then. I am very very tired of risking cramps when I tense them or stretch in the morning (or at night) without thinking. Last time, I had to sit up (and try not to scream), drag my knee up, and force my right foot flat on the bed with my hands because it hurt too much to concentrate to tell the foot to stop that.

Thanks for the tip!

[timespirt]

"HUGS"

Hope you feel better now hon and will be on the mend.

[seperis]

Thank you! I am honestly looking forward to this; being taught safe, useful stretches by a professional who knows what they're doing is almost worth throwing my back out this bad.

Half the reason I can't keep a routine is I start hurting myself because a.) I'm doing the exercise wrong or b.) I can't do the exercise but don't know if its 'lack of willpower' (I fucking ran cross country in high school and hated it like nothing else in heaven and earth just so i could ply basketball; willpower shouldn't be a problem here) or 'physically incapable of'. Powering through tends to lead to (a) and misery and stopping that shit.

Someone else setting the limits who knows what they're talking about helps so much and honestly is giving me confidence. No, there will be progress and you are not going to be supine on the floor waiting until it stops hurting to move to get it.

[timespirt]

You've got this hon.

"HUGS"

[virtual_particle]

I also have asshole hips! That description made me laugh for the first time today.

My hips have issues for entirely different reasons than yours, but the result is the same (an unhappy back). Good to hear that your spine itself seems to be fine.