First, let me say that I am deeply touched by the responses to my last post. Thank you all for your concern and your comments about your enjoyment of my writing.
It’s easy to make the decision to write about today’s medical events since they directly bear on my cruising. The PT who assessed me today is a way ahead of any of the several that I’ve had in Maine. He listened to the history carefully and went at the problem just the way Gary at Drum Point Marine did my oil leak. He came up with equally positive news and we are now both confident that he can get me back to where I was a month ago.
I’ve moved into my friend’s house for a while to get away from the motion of the boat and the need to climb over the lifelines to the dock (one of those very short fingers with piling slips where you have to go over the bow.) I’m going to go to PT three times a week until I’m ready to resume my cruising.
The medical scoop for those of you who are interested: (Here’s a good link for orientation:
http://www.mullumbimbychiropractic.com.au/common-problems/the-sacroiliac-joint)
The PT is positive that my problem is not due to worsening of the arthritis. It doesn’t happen that fast and the fact that I have been through a few rapid cycles of getting worse, better, and worse tells him that this is being caused by muscles. If it were the arthritis in the joint, it would have been a slow and inexorable progression.
He then did a lot of checking and examination and concluded that my Ilium (the big hip bone) is rotated forward, twisted around the sacroiliac joint. The ball and socket is slightly too far aft and the big knob of bone under where most people put their cell phone on their belt is too far forward.
As Stephen the chiropractor said in the last thread, this kind of misalignment is common and a cause of SJ inflammation and pain in many people. When it’s happening to a joint already compromised with arthritis, the result is very severe pain. Going in this morning, it was so crippling I could barely walk.
The arthritis was diagnosed by X-ray 10-12 years ago when I became nearly this crippled after hand digging several cubic feet of dirt mixed with rocks that the shovel kept hitting, putting shock loads on my whole spine. That was back when I thought I was still young and was certainly still stupid. I just kept digging through the pain thinking how strong I must be getting.
My doctor at that time, a D.O. who specialized in manipulation, put me in a sort of fetal position and put nearly her full weight on me (that was exciting). There was a pop and immediate relief of 80% of the problem. PT took care of another 10% and I’ve been dealing with the remainder pretty well ever since.
I mentioned that to the PT today and he said, “Yes, and I could do that. So could a chiropractor However, your hip is being pulled out of position by muscle tension which means that some of those muscles are strained close to capacity. Stretching them further and moving everything around forcefully may work . We have some time here. I’d prefer to first try getting everything relaxed and retraining your muscles to position the hip properly.”
He also pointed out that I have a lot of muscle development from my healthy cruising life. I mimicked some of the anchor hauling and other things I do and, wow, did it hurt. All of the muscles that do these tasks are pulling in the same direction the hip is rotated. Direct manipulation is therefore working against stronger forces than in many people who have this problem simply because the muscles have gotten weak are not supporting the bones properly.
My original diagnosis was Piriformis Syndrome, my doctor’s theory being that the inflammation from the arthritis was stimulating the nerves nearby causing the big muscle in the hip to clamp down on the Sciatic nerve. I’m not sure now that she was right. The symptoms and treatment are similar and, after having all this explained to me with the full size skeletal models, I think I may have had this hip rotation to a lesser degree for years. She undid most of it but I was in some pain for weeks after and walking and moving so as to protect the SI joint also promote shortening of the muscles and rotation of the hip. No one before ever did the careful measurements of exactly how the Illium was positioned.
I might also have just pulled the Illium out of position with all the recent excess activity combined with additional muscle tension produced my mental stress and worry. It doesn’t really matter, the objective now is to get the hip back in position and teaching my body how to keep it there. At some point, it might need the additional help of direct manipulation of the bones but doing that after the muscles are more with the program makes good sense to me.
So, once again I’m wrong. Good thing I’m used to it. My second “Titanic” show ends with me saying in the last scene “Gee, I was completely wrong.” Great TV. I was wrong about the oil seal and, boy, am I ever glad. Now, I find that I had it backwards on this hip thing. Instead of arthritis hurting muscles, it’s muscles hurting arthritis and you can teach muscles how to do almost anything. I tell you, being right isn’t all it’s cracked up to be.
It’s easy to make the decision to write about today’s medical events since they directly bear on my cruising. The PT who assessed me today is a way ahead of any of the several that I’ve had in Maine. He listened to the history carefully and went at the problem just the way Gary at Drum Point Marine did my oil leak. He came up with equally positive news and we are now both confident that he can get me back to where I was a month ago.
I’ve moved into my friend’s house for a while to get away from the motion of the boat and the need to climb over the lifelines to the dock (one of those very short fingers with piling slips where you have to go over the bow.) I’m going to go to PT three times a week until I’m ready to resume my cruising.
The medical scoop for those of you who are interested: (Here’s a good link for orientation:
http://www.mullumbimbychiropractic.com.au/common-problems/the-sacroiliac-joint)
The PT is positive that my problem is not due to worsening of the arthritis. It doesn’t happen that fast and the fact that I have been through a few rapid cycles of getting worse, better, and worse tells him that this is being caused by muscles. If it were the arthritis in the joint, it would have been a slow and inexorable progression.
He then did a lot of checking and examination and concluded that my Ilium (the big hip bone) is rotated forward, twisted around the sacroiliac joint. The ball and socket is slightly too far aft and the big knob of bone under where most people put their cell phone on their belt is too far forward.
As Stephen the chiropractor said in the last thread, this kind of misalignment is common and a cause of SJ inflammation and pain in many people. When it’s happening to a joint already compromised with arthritis, the result is very severe pain. Going in this morning, it was so crippling I could barely walk.
The arthritis was diagnosed by X-ray 10-12 years ago when I became nearly this crippled after hand digging several cubic feet of dirt mixed with rocks that the shovel kept hitting, putting shock loads on my whole spine. That was back when I thought I was still young and was certainly still stupid. I just kept digging through the pain thinking how strong I must be getting.
My doctor at that time, a D.O. who specialized in manipulation, put me in a sort of fetal position and put nearly her full weight on me (that was exciting). There was a pop and immediate relief of 80% of the problem. PT took care of another 10% and I’ve been dealing with the remainder pretty well ever since.
I mentioned that to the PT today and he said, “Yes, and I could do that. So could a chiropractor However, your hip is being pulled out of position by muscle tension which means that some of those muscles are strained close to capacity. Stretching them further and moving everything around forcefully may work . We have some time here. I’d prefer to first try getting everything relaxed and retraining your muscles to position the hip properly.”
He also pointed out that I have a lot of muscle development from my healthy cruising life. I mimicked some of the anchor hauling and other things I do and, wow, did it hurt. All of the muscles that do these tasks are pulling in the same direction the hip is rotated. Direct manipulation is therefore working against stronger forces than in many people who have this problem simply because the muscles have gotten weak are not supporting the bones properly.
My original diagnosis was Piriformis Syndrome, my doctor’s theory being that the inflammation from the arthritis was stimulating the nerves nearby causing the big muscle in the hip to clamp down on the Sciatic nerve. I’m not sure now that she was right. The symptoms and treatment are similar and, after having all this explained to me with the full size skeletal models, I think I may have had this hip rotation to a lesser degree for years. She undid most of it but I was in some pain for weeks after and walking and moving so as to protect the SI joint also promote shortening of the muscles and rotation of the hip. No one before ever did the careful measurements of exactly how the Illium was positioned.
I might also have just pulled the Illium out of position with all the recent excess activity combined with additional muscle tension produced my mental stress and worry. It doesn’t really matter, the objective now is to get the hip back in position and teaching my body how to keep it there. At some point, it might need the additional help of direct manipulation of the bones but doing that after the muscles are more with the program makes good sense to me.
So, once again I’m wrong. Good thing I’m used to it. My second “Titanic” show ends with me saying in the last scene “Gee, I was completely wrong.” Great TV. I was wrong about the oil seal and, boy, am I ever glad. Now, I find that I had it backwards on this hip thing. Instead of arthritis hurting muscles, it’s muscles hurting arthritis and you can teach muscles how to do almost anything. I tell you, being right isn’t all it’s cracked up to be.
