clevermanka (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
clevermanka) wrote2015-06-27 09:22 am
clevermanka) wrote2015-06-27 09:22 am
Email conversation with my PT guy
Me:
Tim,
Doing my exercises this evening, I remembered something about the timing of my left hip pain over the last five years. It was terrible right before I started doing CrossFit--the worst it had ever been. Sometimes the pain kept me from sleeping. I had diagnoses of bursitis, piriformis syndrome, and sciatica. None of the treatments for any of them helped. When I joined CrossFit, the first thing the coaches did was teach me how to squat correctly and after just a few weeks of regular bodyweight squats, my hip felt better. It continued to feel better as long as I continued to do squats. Then I hurt my back and can't do squats comfortably without losing form less than halfway down, and now my hip hurts again.
So I don't know if that's coincidental. Until now I just thought it was a steady regression of my general physical health, but now I wonder if there's a stronger connection, there.
Anyway. Just thought that might help with treatment and I was pretty sure I wouldn't remember this next week.
Tim:
Thanks for the e-mail. History like that helps us put the pieces together in terms of what will be the best approach to treating you going forward.
My initial thought after reading your e-mail about squatting at your CrossFit gym was that you were probably on the right track until your back injury derailed your training. Good squat form requires huge contribution from your glute max. One of the other primary roles of your glute max is keeping the femoral head (the ball of your upper leg bone) centered in the acetabulum (otherwise known as the hip socket) when you flex and extend your hip. Without good glute strength, you have less control of the femoral head in the hip socket. The most common result is what you're experiencing now, pain in the front of the hip.
The road back, in terms of healing your hip and your back, is re-establishing good firing and control through full hip range with the glute max. We're on the right track as far as that is concerned. Remember that good muscle strength in any area of the body, takes a lot longer than the typical doctor or trainer would lead you to believe. If we look at muscle adaptation at the cellular level, we know that it takes about 90 days to replace all of those muscle cells. The stimulus you provide during this time (whether it's exercise or inactivity) dictates how these cells adapt and either get stronger or weaker. Another consideration is that strength is in large part dictated by the strength of your tendons (the tissue that connects muscle to bone). The cellular replacement timeline for tendon is even longer than muscle, with turnover happening at a rate of once every 200 days or so (this timeline also applies for ligament and fascial layer turnover, as well).
Hope this provides you some insight and encouragement. I believe we can get you stronger and decrease your pain. You're already helping yourself tremendously from day to day by varying your body position regularly.
Have a great weekend and as always, give me a shout with any other questions or concerns.
Tim,
Doing my exercises this evening, I remembered something about the timing of my left hip pain over the last five years. It was terrible right before I started doing CrossFit--the worst it had ever been. Sometimes the pain kept me from sleeping. I had diagnoses of bursitis, piriformis syndrome, and sciatica. None of the treatments for any of them helped. When I joined CrossFit, the first thing the coaches did was teach me how to squat correctly and after just a few weeks of regular bodyweight squats, my hip felt better. It continued to feel better as long as I continued to do squats. Then I hurt my back and can't do squats comfortably without losing form less than halfway down, and now my hip hurts again.
So I don't know if that's coincidental. Until now I just thought it was a steady regression of my general physical health, but now I wonder if there's a stronger connection, there.
Anyway. Just thought that might help with treatment and I was pretty sure I wouldn't remember this next week.
Tim:
Thanks for the e-mail. History like that helps us put the pieces together in terms of what will be the best approach to treating you going forward.
My initial thought after reading your e-mail about squatting at your CrossFit gym was that you were probably on the right track until your back injury derailed your training. Good squat form requires huge contribution from your glute max. One of the other primary roles of your glute max is keeping the femoral head (the ball of your upper leg bone) centered in the acetabulum (otherwise known as the hip socket) when you flex and extend your hip. Without good glute strength, you have less control of the femoral head in the hip socket. The most common result is what you're experiencing now, pain in the front of the hip.
The road back, in terms of healing your hip and your back, is re-establishing good firing and control through full hip range with the glute max. We're on the right track as far as that is concerned. Remember that good muscle strength in any area of the body, takes a lot longer than the typical doctor or trainer would lead you to believe. If we look at muscle adaptation at the cellular level, we know that it takes about 90 days to replace all of those muscle cells. The stimulus you provide during this time (whether it's exercise or inactivity) dictates how these cells adapt and either get stronger or weaker. Another consideration is that strength is in large part dictated by the strength of your tendons (the tissue that connects muscle to bone). The cellular replacement timeline for tendon is even longer than muscle, with turnover happening at a rate of once every 200 days or so (this timeline also applies for ligament and fascial layer turnover, as well).
Hope this provides you some insight and encouragement. I believe we can get you stronger and decrease your pain. You're already helping yourself tremendously from day to day by varying your body position regularly.
Have a great weekend and as always, give me a shout with any other questions or concerns.