Sitting cross-legged on the floor to watch TV. Doing child’s pose and feeling my bum gently touch my heels, without effort. Being able to comfortably fall asleep lying on either side of my body.
These are tiny, simple things that six months ago, even 18 months ago, were not possible for me.
My new hip is now just over six months old. Pre hip replacement, I’d had pain in my hip for much longer than six months. Years, possibly since 2013 or earlier. I’m fairly certain that the back injury that saw me stop teaching group fitness in 2014 was because I’d been overloading my lower back to compensate for my diminishing hip flexibility. It’s pretty easy to do a backbend with poor technique; it’s far more challenging to backbend with equal fluidity in all 33 vertebrae.
So how is life six months on from a hip replacement? It’s pretty damn good.
I can complete day-to-day tasks with ease, like squatting to plug a power cord into a floor-level socket. I’m not scared that I might, on my 900m morning walk to the train station, feel a sharp shooting pain in my hip crease that causes me to limp and lock my jaw in determination. I can sit and watch a movie on TV without fidgeting every 5 minutes to relieve the discomfort.
I can go about life without fear. It was fear, the fear of pain, that was so debilitating before my operation. Was the pain all in my head? No, but my perception of my experience of pain it definitely influenced my actual experience of it.
And there’s still niggles, discomfort and aches occasionally… which I put down to the side effects of being active (uhhh, DOMS anyone??). About four months in, a visit to the physio determined that I was probably “overloading” my right side while my left side was still regaining strength. The physio said that I may be subconsciously “looking for pain” – an interesting thing to consider for anyone who’s experienced chronic pain. Anyway, about a month later that pain seemed to resolve itself and balance returned.
In terms of exercise, I’m slowly getting my cardiovascular fitness back. Cycling to and from work a few times during the week and doing an outdoor ‘Pikachu workout’ (because Pikachus are small and powerful apparently) with my partner once a week.
The rest of it – strength and flexibility – is also a work in progress. But already my glutes are stronger than they’ve been in years! This is not without work though; weights 3-4 days a week, pilates weekly and yoga (mostly at home) 2 days a week.
It’s not cheap but it’s not extortionate – mostly it’s just time (hello gmail calendar!). I guess it’s all about priorities too; I could spend $199 on a set of eyelash extensions or I could spend it on 3 x physio-led pilates classes (and claim them on health insurance). The way I see it is that my body is my home, so I may as well try to make it a comfortable place to live.
Most people will rent or buy more than one house in their lifetime – we’ve each got our own meat sack for life, so we may as well make the most of it!
A 20 km bike ride on Saturday. A 60 minute yoga class that afternoon. A 9km hike on Sunday… A year ago a weekend like the one just gone would have meant a very sore Monday for me. But today, almost four months on from my hip replacement, I feel great!!
AWESOME actually. It’s not just the 22 degree day and sunshine (although how amazing is anything-but-winter?!!). It’s that I don’t hurt. I don’t have any muscle soreness. No joint stiffness. None of that underlying antagonising sensation in my hips.
To be fair, my cardiovascular fitness is possibly the worst it’s been since I was 12.
My rehab has focused on strength and flexibility, rather than cardio… also cardio is kinda, well, boring. Unless it’s purposeful (cycling to commute) or expressive (dancing).
Rehab? Well, it’s kinda boring too. But I can see more purpose in being able to retrain my muscles to work correctly for my lifetime, than training to run 10km. The train station is only 800m from home and airport concourses are definitely shorter than a kilometre. #purposefulrunning
On a serious note, years of moving incorrectly due to activating the wrong muscles because I subconsciously wanted to avoid the joint pain associated with activating the correct muscles, takes time to undo.
Time in the gym, time spent doing specific exercises to re-establish the mind-to-muscle connection. Exercises to isolate those muscles that have switched off segments of themselves over time. Hello adductor, hello glute med.
The functional movement diehards would say, “Why do isolation work if your muscles never move in isolation outside the gym?” Yeah sure buddy, that’s cool if your muscles are moving properly in the first place. ALL THE TIME. And you never get or have been injured. Hmmm, that sounds like… oh wait, no one I know.
Rehab is important. Now I’ve never been the most patient or committed person when it comes to rehab – my left shoulder for example, is incredibly weak likely due to being born with a cystic hygroma. Have I ever put enough commitment into training it properly to balance it out with the other, much stronger, shoulder? Nope. But now, now I see the benefits of rehab! It only took a hip replacement to get there. Haha ha ha… ha… ha.
As an aside, how often is that the case in life though? Things have to hit rock bottom for people to do something to change their pattern of behaviour. Usually that change is quite drastic.
Fortunately, I’ve always loved the gym and doing weight training. In winter, the gym is like a cosy little playground. As such, doing rehab has been mostly enjoyable, despite not being able to “smash out the reps ’til failure”. Sometimes, you don’t actually need to go hard or go home. Amazing huh?
So life has pretty much returned to normal – better than normal! I’m weight training in the gym 4 days a week, doing yoga most days, clinical Pilates once a week and yes, the occasional cardio. I’m moving, specifically squatting, better than I have in 6-7 YEARS. Also (sorry mum), I can open my legs wider than I have been able to since my early 20’s!
What can’t I do? I haven’t tried hardcore dancing again yet. Or a full backbend in yoga. Otherwise, the splits (well supported by a bolster and blocks!!) felt good in Saturday’s yoga class. Hiking 9km was fine, I’m no mountain goat yet but I am learning to trust my feet, my legs and my hips to support and balance my bodyweight again.
Here we are, almost five weeks post-hip replacement and I’m walking – albeit no more than 2km at a time and quite slowly. I’m careful, but not cautious. There’s a subtle difference…
I am in awe of how little pain I am in, how quickly I am ‘back on my feet’. It’s a different way of being back on my feet though. It’s moving without fear.
Pre-operation there were certain movements that caused me excruciating pain. Even small, basic ones. In a yoga class that I attended weekly we would often start on hands and knees, moving our hips around in the smallest of circles to “lubricate the joints”. Unfortunately you need an agent to lubricate a joint, that agent being cartilage. There would be a point in my circle where a shooting, sharp pain would radiate down my left inner thigh.
Only now do I know that that pain was not muscular, that was arthritic pain, that was bone rubbing against bone.
I wanted to believe it was muscular. And sure some of it was, not all of it though. I wanted to believe for a long time that I could change that pain, completely eradicate it all. That I could control it and fix it – yet still continue my normal activities. Activities such as dancing and yoga; movement has long been a creative outlet for me.
Then I stopped. Because it hurt. I stopped dancing. I stopped certain yoga movements. And in a way, my creativity started to fade. I replaced the joy of creative expression with the joy of GETTING SHIT DONE. Something I’m very good at but maybe became too good at it. Perhaps to counteract the loss of creativity, I pushed even harder. Kicked more goals. Achieved more. A dopamine fix in itself.
But now, I can do that movement (and many others) without pain. Oh how happy I was when I first realised this! My downward dog isn’t lopsided anymore and quite frankly, I can open my legs wider than I’ve been able to do so in recent memory.
There is still pain when I overdo things – like yesterday, because I walked a bit too far for my recovering body. But that’s ok, I understand it’s temporary. It’s not chronic, it won’t be there tomorrow. As long as I’m careful.
Careful. Care-full. Full of care. Different to moving cautiously. Caution is motivated by fear, by a need to avoid a negative consequence. Moving carefully is motivated by care, by kindness to self and others.
So my approach to movement is changing. Instead of push-push-push it’s slowed down, it’s more responsive to my body. You can’t avoid listening to your body when you’re trying to settle a new hip – overdo it and suffer lower back or knee pain. You have to do it with care. Care for the new joint, care for your mental health – as chronic, physical pain has a detrimental effect on mental health (and vice versa, poor mental health often shows up physically). Physical activity is not and must not be the only coping mechanism when faced with difficulty. Our bodies aren’t made to last forever.
Can you be careful yet still push your limits? Sure. Can you be careful yet still dance, ravished by the music? Sure. Just not all the time. And I know I’ve still got to do the work – the rehab exercises, the swimming, the weight training to get specific muscles to fire again after years of dormancy.
Recovery continues. Patience. Care. And of course, a generous serve of fun (or perhaps creativity) along the way too.
It’s been almost three weeks since my hip replacement and there has been one surprisingly unexpected outcome.
“Less is more in the first six weeks,” said my surgeon. Hmmm, that might be a challenge I thought… the adjustment period was a challenge indeed. I’m a pretty on-the-go person, I’m efficient and I get shit done. I have trouble binge-watching TV, in fact I don’t think I’ve ever watched more than two episodes of something in a row. Why would I? There’s so many more exciting things in life to do rather than watch life go by. This ad came out the year I was born…
Instead of TV, I became a lover of exercise. It was productive, healthy and could distract my mind – much the same as binge-watching Netflix can for some people. Problem was, I probably did a bit too much of it between 2007-2009. Don’t want to feel something? EXERCISE!!! Don’t want to think about something? EXERCISE!!!
But something happened when I had a hip replacement. The pain that would occur from sitting down for long periods (even 20 minutes) disappeared. The stiffness, the irritation. Gone.
About a month before the THR, Ken and I went to see Star Wars: The Last Jedi at the cinema. It ran for 2hrs 32 minutes and I was fidgeting around in my seat like crazy; not only was the sitting causing inflammation but the IMAX sound heightened my pain (pretty common with chronic pain). It was not an enjoyable experience, the movie was quite ok though (but not amazing).
Fast forward to 11 days post-THR and we’re in a cinema again, watching latest The Avengers movie. All 2hr 40 minutes of it. I’d hobbled into the cinema on crutches, more through precaution rather than necessity, and sat through the whole movie without pain. No fidgeting, no discomfort. I just sat still. Quite happily. Again, the movie was quite ok (but not amazing).
Being still has never been my thing, despite cultivating a meditation practice – the regularity of which waxes and wanes with life events. Moving always felt better than being still – though perhaps I now know why. Inflammation.
I had always used movement to alleviate pain, even when the joint pain worsened over recent years I turned to yoga and gentle exercise over pills. As a result, I was rarely still even if the movement was very gentle.
Perhaps now I’ll slow down but not because I have any less energy. If anything, I have more disposable energy because my energy stores aren’t contaminated by pain. No, perhaps I’ll slow down because it feels good to be still. And that’s probably a very good thing.
As my surgery date snuck closer and closer, Ken and I did what we now tend to do in periods of life upheaval – whiteboard.
A list of things to consider prior to surgery, and another for after surgery. The hospital had provided an ancient paper booklet on hip surgery, covering the process and some broad suggested precautions – the details were for us to work out.
It struck me that preparing for hip surgery was a lot like preparing for a new baby.
preparing bulk meals for freezing, eaten as dinners in the first few weeks,
re-arranging the furniture – it’s safer to get into the same side of bed as your operated hip,
going on a pre-surgery holiday – just like a baby-moon, but for us it was 4 nights in Bali in between my old and new jobs,
going out for one last pre-surgery celebrating – a fancy dinner at Balthazar, I even wore heels (quite a feat with the pre-surgery hip pain),
attending education classes at the hospital – the nurse who greeted us goes, “Oh you’re clearly not here for the Joint Education class” and was a little taken aback when we corrected her,
changing your exercise routine to support the changes to your body – I exercised up until surgery but it was less focused on ‘results’ and more focused on maintaining ease in the muscles, fascia and joint itself,
before the big day, relaxing to the max – the week prior consisted of two physio appointments, one massage, one restorative yoga class and two floats (heaven!!) and there goes my private health insurance Extras limit.
Things that we didn’t do that we should have done: buy more baggy tracksuit pants, as yoga pants are not compatible with a swollen hip surgery wound.
The day of surgery we had to be at Osborne Park Hospital at 6.30am, I was second on the list for the day and the nurses had told me that that was prime position “because if you’re first the surgeon is just warming up and he’s a little tired by number three”.
I find hospitals strangely comforting, perhaps it’s because I spent a lot of my early childhood in them with multiple operations for a cystic hygroma (6 by age 3).
As such, I was quite relaxed going into surgery. Kenny waited with me until it was my time to be wheeled off to theatre, about 10am… though on second thought, maybe the pre-anaesthesia drugs they gave me helped a bit too!
Many people had asked was I nervous about the surgery – well, a bit but not the surgery per se. I have complete faith in the procedure and skill of the medical team; my surgeon had explained the procedure thoroughly pre-op. It was after the surgery that made me nervous. Exercise is a bit of a drug for me, it makes me feel good, it’s my me-time. How was I going to handle six weeks of sitting on my (sure-to-be-growing-larger) ass?
I was wheeled into theatre after a few failed attempts at getting the cannula in, then a successful cannula insertion was made and then I was instructed to sit on the edge of the bed for a spinal. A sharp ‘punch’ and then… out.
Next thing I remember was waking up in the ward, a nurse watching on. The next 24 hours were a bit of a blur; an attempt to walk that afternoon ended at standing before I started to go faint again. My parents came in to see me mid-afternoon. Kenny returned later in the afternoon, he was there for less than a minute then I promptly threw up the egg sandwiches I’d ravenously consumed after fasting since the evening before. Such a vibrant proclamation of love! Food was not going to happen until Day 1 (operation day is Day 0).
Recovery was relatively swift once my blood pressure finally stabilised. My first physio session on Day 1 was both surprisingly easy and surprisingly challenging. I was amazed at how much weight I could bear on the operated hip yet lifting the knee on the operated side to ‘march’ required a ridiculous amount of energy and concentration.
My surgeon – who I’d highly recommend just in case you’re reading this and considering a hip replacement too, fun times! – performed the hip replacement via anterior approach, the incision being made in the crease between the leg and hip. This meant that I could be more mobile, more quickly. Woohoo!
[As I write this, Ken is practicing yoga next me – our two bedroom apartment means we have a bedroom and a dressing-yoga-study room – and I am slightly envious of his ability to move his body, not even to handstand, just do a simple uttanasana.]
Discharge on Day 3 came soon enough, hospitals aren’t bad but home is nicer. I showered independently for the first time that morning and carried my PJs, toiletries and towel back to my bed… and then remembered I’d left my crutches in the bathroom. Whoops, bad patient.
Freedom felt good. Upon getting home a few further minor adjustments were made – although he didn’t say it, I think Kenny quite enjoyed creating ‘life hacks’ for his invalid girlfriend. Examples as below:
adding a rope handle to my ‘grabber’ (an ingenious surprise gift from my OT friend in Sydney) so I could sling it over my shoulder as my hands were occupied with the crutches,
putting the ‘Emma-stool’ (I’m short and we have high kitchen cupboards) next to our also-high bed so I could get in and out more easily,
locating my backpack so I could carry my laptop/water bottle/phone/book/magazine when moving from room to room,
borrowing a chair from our friend Pierre, who lives one storey below, to put on our balcony so I could get enough Vitamin D without leaving the apartment,
buying a power board so that phone/lamp/laptop could all be plugged in next to my bed.
All this made the daily routine of wake-breakfast-medication-rehab-activity/outing-nap-lunch-medication-rehab-reading/Netflix/activity-nap-reading/Netflix/activity-dinner-medication-TV-rehab-medication-bed much easier. WE WERE ONTO IT.
What we weren’t prepared for was how vulnerable I would feel. Usually strong and independent – to the point that in our first year together, I sometimes insisted I’d meet Ken at dates rather than be picked up – I was incredibly dependent on him for even small things. Like carrying a glass of water for me.
It was an adjustment for both of us. Me feeling totally vulnerable and, at times, confused and forgetful due to the painkiller side effects. Ken learning that his usually strong and independent girlfriend (who loves her regular Monday nights alone while he has man-cave-time with Pierre) actually needed him more than ever. Hindsight is a wonderful thing: we had a huge row on the first evening back as Ken had a work lunch that afternoon and then went out for cocktails much to my ‘displeasure’ (read: Emma cracked the shits). A friend of Ken’s hit the nail on the head the next day when he said, “Emma was probably feeling very vulnerable”.
What is this vulnerability thing?! I thought I’d done that… I cry at the drop of a hat as much as I laugh and I don’t consider myself to be a cold, career-minded Capricorn (much). I’d watched Brene Brown’s TEDTalks, I’d done yoga teacher training and collapsed into tears in front of strangers, I’d fallen in love.
Being emotionally expressive is different to being vulnerable – being vulnerable is being rocked out of your comfort zone. Being emotionally expressive is well, easy. For me anyway, thanks genetics (hi Mum) and cultural norms for females.
I now understand a little more, the part that I found most beautiful about working at Ngala (a parenting organisation). It wasn’t the miracle of birth, it wasn’t watching children take their first steps. It was the parents, specifically the mums. It was watching mums who’d previously been strong, independent and driven career-women become mothers. You can control, plan and evaluate many things in a job but when you have a baby? No one can control those little fuckers, plus no one really knows what the fuck they’re doing when they first become a parent. There’s no rule book, no deadlines to hit, no Gantt chart – each little human is different. And it can be really confronting. As my mum said to Ken and I, “You guys are getting a good warm-up to parenthood”.
As far as my recovery goes, the desire to DO MORE is still pretty strong. I’m slowly learning to be a slob though – it doesn’t come naturally at all. I’m trying to view it as an opportunity for personal development; to become better at being and worse at doing (by default, obviously). Also, to nurture my creative side as ‘be creative’ isn’t something you can just cross of your To Do list – it requires time.
Or perhaps I should do as Ken just said to me: “Just be a slob for two weeks. That’s your job. If you can’t do that then you’re shit at your job.”
Even just for a day, I may not have chosen to have hipppp, re-place-ment surg-ery until laterrr.
This post is not about Beyonce – although her music does mark some pretty key memories in my life – it’s about gender and the choices we make in life based on it. Not just gender as a cultural concept, but also sex because until there’s a medical miracle males can’t give birth to humans without significant intervention.
Let’s start with sex. I was born a female, still am a female. Last year I was diagnosed with ‘moderately severe’ osteoarthritis in my left hip, to which a contributing factor was undiagnosed developmental dysplasia of the hip (DDH).
First born: yes, it’s me and (not so) lil’ bro
Family history of hip dysplasia: my father had a hip replacement at 52, does this count?
More likely in left hip than right hip: yep
If I were a boy, my chances of developing hip dysplasia would be statistically lower.
But I’m not, I’m a female so let’s crack on…
If I were a boy, I may not have taken such a liking to BodyStep, BodyJam and BodyBalance. Let’s not make too many generalisations but, in the absence of solid, statistical data for group fitness participants, how many classes of the above-mentioned Les Mills programs have you seen where there’s been more males than females? Yeah, I haven’t seen many either (though everyone should do yoga, regardless of gender).
[To be clear, we’re now moving into gender rather than sex, because who’s to say that it’s ‘natural’ for females to dance more than males? There’s an element of cultural attribution to this]
Sure, I might have played cricket or soccer and done equal damage to my joints by doing so… but wait, I did play these sports! Then I stopped because we weren’t taken seriously (cricket) and vanity got the better of me at 16, I hated having bruises on my shins from soccer tackles. There’s something in there about how we raise women to value their looks and men to value their sporting ability (including battle scars)…
I chose the gym when I returned to Perth in late 2003, at almost 18, over sport because fuck it, you can study whilst using the stationary bike. That’s so very effective (it’s not) and efficient! Funny how we’re hard-wired for efficiency even when it’s not very effective. Also, there were hot guys there and when I started working there as a receptionist, the gym was paying me to workout. I grew to love the BodyStep – the ultimate in camp aerobics – and the yoga-based BodyBalance classes. Later, when I moved to New Zealand and was clearly using exercise as a coping mechanism (oh the unsustainable endorphin high!), I got hooked on BodyJam (dance) classes. I’d do 4-5 per week and ride the wave of adrenalin, dopamine and endorphins. I got used to muscle fatigue during this time. I got used to pain… between 2003 and 2009, I probably did a fair bit of damage to my joint cartilage as well. Very. High. Impact. Exercise.
I don’t know if this actually happens but… I have a theory that I overused my joints because my muscles were so fatigued (and under-nourished, MUST EAT FOOD) most of the time that it was painful to use them to facilitate proper lower body movement. Hence I dumped into the joints. I didn’t allow my body time to recover because if I did, I’d get sad. True story. You should always have a toolbox of coping mechanisms.
So my gender had something to do with the exercise I chose in my early 20’s and likely, the resulting joint decay. Though who’s to say it wouldn’t have been worse had I become a bro in the gym? Who knows… it would have been different in some way.
But in my mid-to-late 20’s I was doing yoga more regularly than any other form of movement (still weight-training and cardio but #yogaeverydamnday at some points). I did yoga because it felt good – which was the same reason I did BodyJam (look up ‘dopamine addiction’) – and made me move better. Stiff muscles, usually from weight-training or cycling, were eased and lesser-used ones tested.
My physio and surgeon have both said that it’s likely that the yoga (plus other weight-bearing exercise) that I did, helped me manage the arthritis pain. This doesn’t mean there wasn’t pain when I was exercising – oh jeez there bloody was! I have vivid memories of the first day of yoga retreat in Bali, oozing into a hot mess of tears and sweat in long-held yin poses that stretched the muscles of my hips. Crying because ‘yoga tears’ (emotions being stored in the body) but also because my hips were so, SO tight.
Now, how many men do you see in yoga classes? These days up to 50% of the class might be male, but there’s still more females than males doing yoga.
If I were a boy, I probably would have continued with competitive team sport and over time, moved over to gym-based workouts and maybe running (HAHAHAHA, running). If I’d felt my legs and hips getting tighter, I probably would have a) seen a physio, b) done a lot of foam rolling, c) got a sports massage, or maybe, just maybe d) done yoga.
I highly doubt that, as a boy, I would have collapsed into the same oozing puddle of sweat and tears doing a yoga pose that I did whilst on retreat in 2015.
Men handle pain differently to woman; aside from the biological differences, culture and psychology play a role too. Pain can leave you vulnerable. Men handle vulnerability differently to women. Few men are taught that it’s ok to be vulnerable. I won’t go into toxic masculinity too much – Tim Winton writes beautifully on it here – but will assert that pain, and our collective experience of it, can often be perceived through a gendered lens.
If I were a boy and felt pain in my hips, I might have reacted differently. Would I have pushed harder through the pain? Ignoring it until it severely incapacitated me?
Maybe. I’m pretty good, a bit too good actually, at pushing through pain and not listening to my body (always a work in progress). If I were a 30 year-old male who went to the gym and used social media, I would have definitely come across these messages…
And sure, pushing through pain achieves results but at what cost? Can you push through pain still maintain full body awareness (i.e. ‘listen to your body’)? I’ve seen very few people who can and they are highly skilled at navigating between both ends of this spectrum…
Lastly, my decision to have hip replacement surgery would have been different if I were a boy because boys can’t have babies. It’s that simple. And that was the final kicker, let’s be honest.
Pregnant Emma without hip replacement surgery: carrying an additional minimum 11kg on a joint that had almost no cartilage around it to protect it, plus added joint laxity due to the hormones released in pregnancy. NO THANK YOU VERY MUCH. Ouch, ouch, ouch.
Having a hip replacement is something I never thought I’d have to think about, in relation to starting a family. But hey, life happens and it’s all about choices.
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!
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.
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
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.
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.
MOVE: some gentle yoga, stretching or swimming to alleviate the pain.
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 increasedisability 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…
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.
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.
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.”
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.
"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.