Making peace with pain

Anyone who’s lifted weights or been remotely active in their lifetime would have experienced pain in the form of DOMS (delayed onset muscle syndrome). Anyone who is female would have experienced period pain – oh the joys of being a woman.

I’m going to put it out there and say that active females are overall better at coping with pain than active males. Because we have ovaries.


It gets to that time of the month and for many women, ibuprofen is our best friend for at least 24 hours. The pain is temporary and acute.

Similarly, if you’re a bro ‘never skips leg day’ you would be familiar with the slight agony caused by lowering one’s bottom to the toilet seat to relieve oneself, with day-two-DOMS. Painful but also acute.

Now imagine you’re an active female, perhaps even an athlete. You do weights to muscle failure 2-3 times a week, or other similar muscle-fatiguing training. You know DOMS, in fact you experience it for approximately 50% of the week. Oh AND you get period pain once a month. So all up, you’re in some degree of physical pain for at least 60% of the year. And you get used to it.

But wait a minute… that’s an awfully big generalisation to make Emma. Hmmm, yes it is. Google time. And, result!

‘Do men have a higher threshold for pain, or are they just a bit emotionally repressed?’ 

Well now this is interesting…

Pain is subjective – and diagnosis requires you to say how much pain you are in, where it is located and so on. So the gender differences reported in some studies, like the ones above, could therefore be down to a reporting bias – in that men simply don’t like to admit to being in pain and only turn to their physician when it gets really bad. Men are still often expected to suppress certain emotions and action, such as crying for example, and these beliefs may also affect how pain is expressed, viewed and responded to.

Regardless of who experiences pain more frequently or to a higher degree, pain sucks. And chronic pain sucks even more.

I’m unsure really of when my hip pain started. You could say that it started back in my mid-20’s when my hip muscles used to get really tight, a bit of sciatica here and there, all low-level stuff. I was always active, exercising 6-7 days per week, but also mostly desk-bound at work. All pain was fixed from a visit to the physio who would stick a few needles in my bum, the muscles would go PING, then relax and the pain gone. I always thought this pain was just because I wasn’t using my gluteus medius muscles (used to abduct the hip, i.e. open the legs) and wrongly overusing my piriformis muscles.

Maybe that chronic misuse was just the body’s instinctive (yet still incorrect) way of protecting the joint? A method that actually doesn’t help because the tight muscles crush the bones together – a mortar and pestle comes to mind – instead of being supple enough to move the head of the thigh bone in the hip socket.

THIS IS WHY EVERYONE SHOULD DO YOGA (joking, not joking). Any muscle is only truly strong if it can tense firmly and also release fully.

Since September, my pain comes and goes. Sometimes a dull ache at the front of my hip, sometimes searing jolts down my shin, sometimes absent altogether. It’s definitely a lot better than how it was when got up from the couch paralysed mid-September, but it’s not as ignore-able as it was 5 years ago. Over the last six months I’ve learned what aggravates it:

  • Stress, mental or physical
  • Activity – with incorrect muscle activation
  • Excessive activity – with correct muscle activation
  • Prolonged sitting
  • Fear or anxiety
  • Everyday activity where I’m not conscious of proper muscle activation (let’s be honest, I’m not thinking about proper glute mede activation when I’m having sex)

What do you do when you experience pain? Well, advertising would have us believe that the answer is DRUGS.

Most hilarious product name ever.

And sure, drugs help in acute circumstances but they’re not everything. I find myself taking anti-inflammatories (NSAIDs) a few times per week and more often than not, in a preventative way. For example, usually my hips are feeling a little tight on a Friday night – it’s the end of the working week, I’ve been sitting for at least 30 hours – so I’ll do some stretching before bed and pop some pills. This is so that I’m not woken at 1am by the pain.

What helps me the most when the pain is about an 7-8 out of 10, is physical and mental activity.

  1. MOVE: some gentle yoga, stretching or swimming to alleviate the pain.
  2. THINK: tell myself that “I’m ok, I’m ok” as I walk around our apartment at 2am because the pain has woken me up.

To me this treatment makes sense, as my pain triggers are both mental and physical.

The research around pain continues to evolve rapidly and there’s growing mass realisation that only pumping someone full of drugs is not the answer. An attitude of helplessness and passive behavioural pain-coping strategies have been shown to increase disability and depression.

There’s various pain management strategies, both active (“I can do this to fix my pain”) and passive (“This thing will fix my pain”). Some people may use more passive strategies, some people may use more active strategies. The thing is, many people (including me!) don’t know of all the strategies and health professionals (surgeons, physios, yoga teachers, PTs, chiropractors) generally have a preferred type, i.e. the type they specialise in. [The PainHEALTH website is a great resource for anyone experiencing pain]

The only person who can decide the best treatment of my pain is me. And if you’re reading this and you’re in chronic pain, it’s you. No one else knows what your pain feels like.

There’s a good Insta-inspo quote that’s relevant here (it’s also currently graffitied on a Stirling Hwy billboard). Something one of my yoga teachers bangs on about often, something that is otherwise known as compassion.

I reckon yoga’s been the second most helpful thing to date with treating my pain. I like to think that my own pain management aligns to the components of Kriya yoga:

  • tapas (discipline) – discipline to keep moving, to go to the gym/pool/yoga mat when I can’t be bothered because I know movement makes me feel better
  • svadhyaya (self-study) – noticing what triggers my pain, noticing my reaction to those triggers and my instinctual, emotional response to pain
  • ishvara pranidhana (devotion) – letting go, allowing myself to fully feel the pain rather than avoiding it because eventually, that I’ll have to deal with all that shit.

But in my mind meditation wins as ‘most helpful pain management strategy’. All other techniques to alleviate pain and find physical/mental peace require something else – an able body, a health professional, a pool, hell even a bottle of wine! Meditation requires nothing.

And speaking of which, I’m signing off… to eat dinner, drink wine and meditate. Something I can definitely get better at.

P.S. For anyone reading this and thinking, “If all these active pain management strategies are so great, why are you still getting a hip replacement then Emma?” well, that’s the next topic of this blog… 



The baby cage

Child-bearing hips. What nonsense! The majority of women can bear children whether their bone structure is XS or XL. ‘Bearing’ children involves way more anatomy than bones, and a shitload of patience. I prefer the name ‘baby cage’ for the whole pelvic structure… which is very entertaining to Google because baby cages were an acceptable thing in the 1930’s (see above). Bob Irwin would have been right at home. bob irwin

Anyway, this post is about having babies and hips (baby cages)…

My old housemate Wade bet that I’d be pregnant within two years shortly after I met Ken in January 2016. I vehemently deny this will happen – and by the way Wade, I WILL WIN. But having babies was the factor that tipped me into deciding to have a hip replacement.

Y’see, I’m 80% certain I could manage the pain for another 12 months if I chose to. I’ve made a lot of adjustments to get this far, physical and mental. Pain is a complex thing but I strongly believe in the power of the mind to minimise it. I can sit cross-legged for 20-30 minutes whilst meditating and get up with minimal stiffness – but I can’t sit watching TV for that long, or at my work desk. Go figure.

A discussion with my GP made me consider things from a more pragmatic perspective. I explained my hesitation about becoming a parent and continuing to manage the pain…

Many of my friends have had babies in the last year – we’re that age. My social media feeds are full of cute babies next to “I’m x months today” signs and the ever-creative pregnancy announcement pics. I worked at Ngala (a parenting organisation) for two years and that was a bloody good contraceptive! I know of the immense sleep deprivation, the social isolation, the discomfort of feeling the size of a house, the frustration of wanting to ‘get your body back’ – and frankly, I don’t want to go through that being in pain when I could choose to not be in pain.

As you can imagine, this whole baby thing launched a few heavy conversations between Ken and I. We had already talked about kids in a vague sometime-in-the-next-few-years ways prior to my diagnosis – now it’s a much clearer reality. We can’t really afford to be vague anymore.

For example, to gain the average 11-16kg would put a huge strain on my hip. Add in the relaxin released during pregnancy, resulting in increased joint elasticity and wear, and my hip would be SHOT.

People say it takes a year for a new replacement joint to feel like your own. Imagine giving birth to a baby out of a baby cage that didn’t really feel like your own?! Weird. So fast forward 12 months and I’ll be 33 before we’d even start trying for a baby, and creeping ever closer to the fertility-falls-off-the-cliff age of 35 (ONLY JOKING, but seriously, I’m thinking risk-reduction here).

It’s ironic to think that something most people get in their 60’s and 70’s could postpone me from having children at 32. It also sucks because my private health insurance doesn’t cover joint replacement (again, not something most 32 year olds need) but I was given the option to include pregnancy when I switched to Medibank in August last year… which I chose not to, given we have a fantastic public health system here in WA.

So it’s another phone call to the surgeon’s office tomorrow to find out what the options are; public admission, forking out $$$$ for private admission (without PHI cover) or perhaps some way around the obligatory 12-month waiting period.

Let’s see how we go.

I’ll have a Royal Doulton, please.

Sometimes despite you doing all the ‘right’ things, shit happens. When I was 16 or so, I coined my own platitude; “Shit happens so turn it into manure and grow.” Totally daggy and wildly optimistic, yep.

I am having a hip replacement in April. Despite doing all the ‘right’ things to take care of my health for most of my life. But this isn’t intended to be a poor me, poor me post because self-pity isn’t my style (whereas self-aggrandisement, guilty as charged).

A visit to the ‘second opinion’ surgeon occurred on Friday afternoon. This surgeon had been recommended by Ken’s sister, a physiotherapist, who had seen him present on hip preservation techniques. A bit of background research – LinkedIn is my new favourite stalkerbook social media – uncovered that he was a dual Australian Olympian whose patients included many athletes and young people. No more gardening and golf for me!

I completed an online questionnaire prior to the appointment, scoring my pain and how much the arthritis inhibits daily activity (housework, commuting, work and even sex – yes, a fair bit). We walked in and went through the pleasantries before the cracker; “Your hips are terrible! I’m really surprised you’re not in more pain than you are.”

IMG_3334 (1)
There should be some space in between those bones, aka joint cartilage.

Mate. Maaaaate. Thanks. I reckon it’s partially because I’ve made many life modifications  (and kept up the good habits) to manage the pain…

  • Yoga regularly #yogaeverydamnday
  • Reformer pilates weekly
  • Physio visits monthly
  • Remedial massage monthly
  • Buying a new mattress
  • Foam rolling and self myofascial release every gym session
  • Giving up running C25K and taking up swimming instead, plus abstaining from my much-loved (high impact) BodyJam dance classes
  • Glucosamine, fish oil and magnesium supplements daily
  • Weight training at least 3 x per week, for better glute activation
  • Getting a new office chair
  • Sleeping 7.5-8 hours every night
  • Not sitting for more than 30 minutes at a time at work
  • Buying a new bike with less hip flexion and cycling shorter distances
  • Eating a healthy diet (hell, I used to teach this stuff to parents for a living!)
  • Journalling every night before bed
  • Returning to meditating regularly

The list goes on. I was doing all the right things – apart from maybe the glass of wine or G&T consumed most nights, but never to excess.

A colleague recently described me as, “a walking, talking Wholefoods store”. That description will possibly be more apt in mid-April, given I will soon have a portion of the cookware section (ceramic) inside my body.

You can plan your life away to finite detail but sometimes, shit happens. You get made redundant, your girlfriend breaks up with you, your mother gets cancer. That’s life. Shit happens no matter how hard we try to control all the variables.

I am turning this into manure as best I can. Sure, there’s bad days where I’m grumpy/sad/angry/frustrated but on the plus side, think of the longterm PERSONAL GROWTH Emma! Or that’s what I tell myself when the pain gets a bit much.

Slow, methodical and committed has never really been my style yet come rehab and recovery time, it will have to be. Then again, that’s what personal growth is I guess – challenging long-held patterns. In a way, it’s growing up.




Thank you Google (or not)

"When your legs don't work like they used to before,
And I can't sweep you off of your feet."

I was folding washing when our Google Home played this song. I asked the Google to “play some music like this song”. The Google replied, “Here’s a Spotify playlist called ‘ Sad Songs’.”  Hmmm, I didn’t know my music taste was that depressing. Thanks Google…

It’s been 7 years since I started writing insteadofanemail as a lonely, intellectually-starved teacher in Dongara. Apparently seven-year cycles are a thing, so it makes sense to start something new in 2018. Inspired by Ed Sheeran. Not meant to be sad. Ok, it’s likely that some of it will be sad (writing is cathartic) – but also hopeful, nostalgic, ambitious, funny, informative and more.

The legs. My legs. They definitely don’t work like they used to. On 13 September 2017, I was diagnosed with osteoarthritis in both hips. That’s the thing that your grandma has, or maybe your mum. Definitely not your now-32-year-old friend. That friend who used to teach fitness classes in her 20’s and dance until dawn at nightclubs, the one who still does a lot of yoga, weight-training and cycling. She’s strong and flexible, isn’t she?

Sometimes your ego gets smacked about with a dose of reality. 

One Friday evening I was snuggled up on the couch with my boyfriend, watching some kind of highly emotional TV show. It may or may not have been The Bachelorette finale. I got up off the couch once Stu had officially won Sophie Monk’s heart and OUCH!!! I couldn’t put any weight on my left leg without searing pain radiating through my hip and leg. With Ken’s help, I made it into bed after taking some anti-inflammatories and barely slept. In the morning the leg was still not going to hold any weight. After an emergency trip to the miracle-worker and a few needles in my bum, I could walk again without hobbling.

It wasn’t until a routine GP appointment that Friday – the pain had subsided slightly during the week thanks to another physio visit – that I wondered if the acute pain may have been indicative of something else. I mean, it had been a pretty stressful few weeks at work and Ken had only moved in with me five weeks beforehand but… I was sent for some x-rays by the GP.

The call you never want to receive occurred just as I started work; “Dr Weir would like to make an urgent appointment with you. Can you come in this afternoon?” Sure, ummm ok. I spent the afternoon Googling ‘abnormal hip x-ray’ (note to self: never do this again). Ken and I fronted up at 4pm to the doctors surgery. We were ushered in, the doctor sat down, turned to us and said, “You have osteoarthritis.” Cue tears. Lots of tears. Thank goodness Kenny was there because someone had to remember what the GP said… though to me the most shocking thing was when I asked if it would affect pregnancy (LONG TERM THINKING). She replied, “Well, you’re so small that they’d probably do a c-section on you anyway.” WHAT?!

And that’s the kicker. That something could affect not only the Emma I’d outgrown, but also the Emma I’m slowly growing into. My hips are central to my idea of self.

My hips were an asset when I was nannying as a 17 year-old in Boston, carrying a child on each side around the house as the snow poured down outside. My hips swayed just enough to make the boys glance in first year university, I always did like walking away. And in the evenings, my wing-woman and I danced our little bottoms off at clubs (Clubba, Red Sea and Clubba) until dawn broke. Or we left early and our hips got a different kind of workout that evening. My hips held me strong when I completed my BodyBalance training at 20, equally keen and nervous to teach a group of gym-goers yoga. When in Auckland and doing 5+ dance classes a week, the movement of my hips set me free from the mental chaos of my job. My job where I wore pencil skirts that hugged the curve of my hips, with sky-high heels that contorted my posture something wicked.

Well, I don’t bother with pencil skirts anymore, nor sky-high heels because frankly both  inhibit freedom of movement and also, there’s no one want I want to sleep with at work. I’m very happy in my relationship and my job. Things have changed.

The one thing that is the same however, is this comment made to me back in 2010; “Gee, you really don’t let the grass grow under you!” Right now that’s not by choice, I literally can’t sit down for long periods without discomfort. Ha ha ha.

The grass grows whichever side of the fence you water regularly, tend lovingly and respond appropriately to the environmental conditions. My environment in 2018 is vastly different to what it was 10, 5 or even 3 years ago – aside from the old lady hips, the biggest difference is that I’m in love (more on that later).

Within the next month we will determine, with the help of the orthopaedic surgeon, when I will get a hip replacement. Major elective surgery, I guess? In my mind, what’s more major is the mental transition from the Emma described above to the Emma who… I’m not sure yet. That’s what this blog is for: finding out.

I can’t wait to get into gardening and golf!!!