Status Report, January 2018

Long time, no update.

I'm very slowly gaining strength.  I can now balance on one leg for 30 seconds without holding onto the wall.

I tried an online yoga class that runs for this month, but the sessions were too long for my current fitness level, and trying too many new exercises in one day was bound to frequently find exercises that tweak my hip.  I am trying to use this class showing up in my feed as a trigger to do other exercises.

I did find this "pelvic reset" exercise that seems useful.  The first time I did it there was a significant klunk and improvement.  It's not a reliable fix, but it is strength building and doesn't tweak anything, so I'm including it regularly.



If I rotate that soccer ball a little bit so that my bad leg is lower than the good leg, I can find a weak muscle that doesn't tweak anything to work on.  The push/pull part can hurt pretty badly when pushing down on the bad leg, but it doesn't seem to have negative lingering after effects, so we can categorize it as the kind of pain that is chasing out weakness.

The same trainer had some good insights on exercise for the hypermobile:


(TL;DW: motor control and massage is good, range of motion and stretching is bad.)

An important discovery is that I can work on adduction as long as I don't move internal of the neutral position.  The isometric work with the soccer ball between the knees is one example.  I can also fasten a stretch band to the leg of the bed, side step away, and work on moving the leg from external to neutral position.  When I've had a bit of consistent sucess with my current routine, I may try something similar with internal rotation, rotating from an external to neutral position.

My daily checklist which I've been sloppy about following for awhile now, includes ankle rotations, one leg balancing, and calf raises.  Working hard on my ankles gives more general stability to my system, so the hip doesn't have to work as hard.  The hip does do some work in balancing during these exercises, but isn't the main focus.  Working primarily on the ankles means I'm not likely to tweak the hip with PT.  The newer stuff referenced above addresses the hip more directly.

On the ergonomics front, I'm about to start a new job.  I'm a little nervous about going back to full time, but I think I'll be fine if I get my desk and my bench in on day one.  I have done plenty of long days on part time work, and even the occasional 40 hour week.

Hip Improvements

Been awhile since I updated on the hip.

I finally got the red tape cleared and saw a specialist.  I had x-rays and an MRI, and no real diagnosis.  My x-rays look perfect, except a blur at the top of my hip socket where it hurt which "is probably a bad x-ray".  There was a tendinosis finding on the MRI, but I believe that was secondary to the bad PT I was getting while waiting to see the doc.  There was a secondary observation of an anomaly with the cartilage in the top of the hip socket (where my pain was), but that the imaging was of the wrong type to make any conclusions.  The doc said tendinosis is kinda like bursitis (uh, no reference I can find agrees) and wrote tendinitis on my PT referral (also not the same thing).  He completely ignored the observation that wasn't in the "findings" summary.

I took my PT referral to a new PT, and boy did I get lucky.  If you're in my area, I highly recomend Kelly Monsma, DPT of Gananda-Walworth Physical Therapy.  She did a very careful evaluation of my issues, she thinks independently, she is willing to keep learning, she seems to have a grasp of why my hyper flexibility is a problem and what to do about it.  She is willing to re-evaluate and change direction when things are not working for me.

During my evaluation, the PT pulled on my leg.  It felt pretty good, so when I got home I had my husband pull on my leg.  He pulled a little harder.  There was a pop, and the next day I was walking almost normally.  I'm still in PT to rebuild strength and address the secondary issues of my loose joints.  I have to have my leg re-pulled about once a week, or every couple days if I'm wearing barn boots.  When it needs pulling, I feel kinda compressed, like the feeling of putting on a frame pack laden near your max carry weight...

The best news is that I'm back to working as much as I want to, and sitting at my desk at home as much as I want to.  No more moping on the couch watching TV.  (Ok, at least not as a habit.)

So I'm making progress on hip stability, but it's pretty clear now that my ankles are the most limiting factor in balance right now.  My right side ankle control muscles got all cramped up and caused problems with my plantar fascia.  I'm currently weaning myself off of crutches in the morning and sports tape backing up my plantar fascia during the day.  I do mostly ok once I'm warmed up and moving.

There are lots of different methods of taping feet for PF support, this one works for me:

I tried an ankle brace that just didn't fit me well.  I can't find a night brace sized for my 18" calf.  (although some are sized by shoe size and others by calf size?)  If this goes on longer I may apply my corset making and shoe making skills to custom fit ankle bracing...

Barn boots provide some ankle stability but prevent stretching further, so they're a sometimes shoe.

I've also *gasp* bought another pair of Asic Gels, my old friends that turned on me...  I was in so much pain the day I bought them, and the sales guy too busy to help, I only tried 3 pairs and didn't give other brands a fair chance to win my love.  I also stuck over the counter PF inserts inside them.  They provide a lot of support and the heel rise means I can function before being fully stretched out, but again, this is a sometimes shoe when I need rest more than stretching.  I'm still barefooting and wearing moccasins at least half time to keep things as limber as possible.

Another thing that's been useful is a big fat foam roller.  Before putting my full weight on my feet when I get up in the morning, I sit on the edge of the bed and work the foam roller under my feet, stretching the calves by elevating the toes.  I still sometimes am in too much of a hurry to get up and just grab crutches, but it's a major improvement in my crutches-free days rate.  At work I have a lacrosse ball under my desk.  I don't work my feet intensely with it, but I do prop up the ball/pad of my foot to keep things stretched out as much as possible.  I'm considering getting rollers for my desks as well...

Two steps forward, one step back, hopefully I'll at least keep on making net progress...

Aidells Teriyaki & Pineapple Chicken Meatballs

Usually chicken sausages are lower fat versions of their pork cousins, but these guys pass the all but the strictest high-fat macronutrient tests:

 (per 5 serving package)

Total Calories	665
% carb calories	9%
% protein calories	30%
% fat Calories	61%
Ketogenic ratio	131%

 And quite tasty to boot!

There are a couple soy products within, but just traditional sauces (soy sauce and miso flavorings). Soy sauce does contain wheat, so this isn't a good food for celiacs, but should be low enough gluten for most gluten sensitive individuals. It is ketogenic, but not strongly enough for the treatment of epilepsy. The meatballs are browned in vegetable oil rather than an animal fat, it's unclear how much of the fat content is vegetable oil, and how much is the fattier parts of the chicken.

So, not a perfect food, but close to my 600 calories per meal target, tasty, not likely to trigger my carb overload symptoms.

Autonomous SmartDesk 2

So, when you're uncomfortable sitting, but tire easily standing, and you have a desk job, what are you to do?  Well, I'm going to give a motorized sit-to-stand desk a try.  There's a one month lead time on my order, so a review will be a bit in coming.