New Lower Back Pain

After last Thursday/Friday, I thought that I'd just mildly strained my lower back from the daily physio and gym session. However, it turned out to be a chronic thing, most probably nerve related (as the muscles are fine but the pain remains). So, I've been taking painkillers all week to sleep (and occasionally during the day) for lower back pain and right butt/hip pain. Stopped all physio and went to the pool on Friday rather than the gym. Swimming helped but the back pain returned Saturday morning after standing just a short time.

I have worked out that one of the right hip problems may be pudendal nerve irritation. The symptoms fit perfectly. Will let the physio or GP know if/when it helps.

Physical/mental recovery has definitely been better since coming off the Trazodone.

That's it. Fed up with being in pain really after hoping for the reduction in hip pain and ending up with chronic back pain and even worse hip pain!!!

Back to a daily physio routine

Northern Wheatear (passage migrant), Buckinghamshire, 11/08/2012

It's been a week of mixed feelings. On the one hand, I'm glad to have a way forward with my right hip. On the other hand, getting back to a daily physio routine has been quite hard to come to terms with. I thought I'd done all the ground work. I remember the first 6 months of 2 hours of daily physio routines (1hr am and pm) and the constant pain, injuries and exhaustion. I didn't have any room for anything else in my life! It does feel like a step backwards to now be doing an hour of physio a day (1/2hr am and pm). My right hip has hurt constantly since the physio appointment and I'm now taking painkillers every night to be able to sleep with it. I'm also icing my right butt at least once a day. Overall, it's worse and I'm hoping that's it's a case of it getting worse before it gets better.

I tried to stick to the exercise bike last week rather than going for walks - it's kinder to the hip joint.

I did my usual gym session yesterday but followed the physio's advice to revert back to 2km run/walk (2mins run/1min walk) rather than a full run on the treadmill. Unfortunately, my hip was really a lot worse and I reckon that I need to stop the treadmill work completely until the hip is pain free. It seems silly to do the high-impact work knowing that it's not really strong enough to cope.

Of course, that's disappointing. When I started to run, it felt like I was finally getting somewhere. I guess I have to recognise that my body still isn't strong enough to manage running (especially when walking even aggravates the hip!). Once again, I've had to recalibrate my assessment of a) where I was when I started this (i.e. I must have been a lot weaker than anyone realised) and b) how much further there is to go.

On a more positive note, I have been day-dreaming about the prospect of having a healthy right hip. The thought of it being pain-free is wonderful. I can only imagine what it would be like to walk and run and swim and not have to worry about how much my hip will hurt as a result etc. Bliss. Oh to be pain-free!!

The other positive is that I was able to get out for a walk today (the day after the gym) and enjoy the sunshine and birds. It's early days, but I'd say that coming off the Trazodone has improved my post-exercise recovery by about 50%. My brain feels less drained/fogged up and I feel less like I've been hit by a bus. The limiting issue today was the hip and my lower back (which is slightly strained from the efforts of the daily physio, I think). It's all about the muscle weakness and fatigue right now....grrr.....

I'll get back to the daily physio tomorrow and probably go for a swim next Friday (it's easier on my body, esp hip). The following week, I'm off on holiday so that should give my hip the best chance to heal up and strengthen up.

Re: the Trazodone withdrawal: I think my emotions have stabilised a bit now and I am sleeping a little more normally (albeit fitfully -waking a lot during the night). It's still taking a while to get off but the hypnic jerks have all but stopped (unless startled by my noisy neighbours!). I do feel more refreshed during the day, even if it's taken me a long time to get off to sleep.

Physio Assessment - Right Hip

I should really start this post with a word about Andy Murray and his Gold (and Silver!) medals. However, my mood, the last couple of days, has plummeted somewhat and it's hard to write with the inspiration the achievement deserves.

Woke up yesterday and today feeling tearful and depressed. I can only put it down to a further stage in the Trazadone withdrawal. I had a few days of feeling really good, alert, energised and positive and now I seem to have swung to the opposite. I shall just hang on in there and hope it'll pass.

Finally visited a local physiotherapist this afternoon about my right hip. The upshot of the hour-long appointment is that the pain/problems are still down to muscles imbalances and weakness. Even after 4 years of rehab directed at these main muscle groups, my glutes (esp the outer glutes) on my right side are still too weak to allow my hip to function properly. The upside is that it doesn't seem to be a structural problem and that a few daily, targeted strengthening and stretching exercises should sort things out. The downside is that I just cannot believe that, after 4 years, my hips still aren't strong enough to function properly. I should be pleased there's nothing seriously wrong, but I actually just feel gutted. For 4 years, I have done countless reps, with increasing difficulty, targeting the glute complex of muscles....and still they're too weak. At this point, I'd like to swear and curse etc etc but I won't. I suspect I'm not really in the right emotional head-space to deal with much at the moment.

So, the daily exercises are a couple of stretches targeting short/tight hip flexors and a couple of exercises aimed at strengthening the outer glutes on the right side (single leg glute bridges and an exercise where I stand on my right leg on the stairs and then drop/lift my left leg down/up from the hip (hard to explain, see below)).

Quad Stretch: 1 min, 4 x each leg

Hip Flexor Stretch: 1 min, 4 x each leg

Single-leg Glute Bridge: as illustrated but once in position B, lift left foot off the floor

and hold for 3-5 seconds, 5 reps, 2 x per day

5 reps, 2 x per day

More Murray Magic

A great day for sitting in front of the telly! Thoroughly enjoyed the Murray and Robson matches today. Full of skill, drama and smiles. I wonder if Murray can manage double Gold?! Either way, it's uplifting and exciting to have GB in the final of two Olympic tennis events. Great effort Andy - well done!

I should perhaps make some excuse as to why I post about Andy Murray on my rehab blog. It's not just because he's the best and most talented tennis player to come out of Britian in the last 70+ years. It's also because I am very aware of the hard physical work he's put in over the years. I have watched him transform his physique from good to excellent. He's put hours and hours of work into gaining muscle and condition. I don't think it came as naturally to him as to perhaps someone like Nadal. He has really had to work hard at it. And, that's where I feel some degree of affinity with him. It's taken him years. And, it'll take me years. We're world's apart but both with a goal to improve physical fitness for the lives we lead.

I really do take comfort from the fact that it has taken him years. It wasn't something he achieved in one season or even two. And, he's gaining all the time. I also take comfort from the fact that what he's achieved has been done with immense support, expertise and guidance. None of which I have. I don't have a physio to treat the sore muscles; I don't have access to an MRI scanner to assess with tendon I strained; I don't have a personal trainer or adviser or any kind of expert input. I am doing it alone. Therefore, I reckon I can be proud of what I've achieved so far and recognise that even with all the support/expertise etc in the world, it still takes years to transform one's physique if you're a 'hard gainer'.

Swim-Gym-Swim & DWP

I tried something new this week. After last Friday's swim, I felt I recovered pretty well and was surprised to be able to manage a good 3 mile walk on the Sunday morning, followed by another late afternoon. I was basically trying to wear myself out so I'd sleep but the fact that I could manage it felt fantastic. Of course, the glorious weather helped (and it could well have been some kind of temporary 'high' related to the Trazadone withdrawal). So, my plan was swim-Friday, gym-Tuesday, swim-Friday.

Tuesday, I hit the gym with the main intention to focus on my upper body (I'd done enough walking for my lower body). I did my usual weights routine but upped the number of sets by 1 or 2. I also did do a couple of sets of leg-press and leg-extensions. At the end, I went on the treadmill but quickly realised my legs had turned to lead - the nerves were fatigued and there was no way the muscles, esp below the knee, were going to work properly. At that point, I called it a day.

I had the usual right hip/butt/groin pain following the gym. It felt worse than normal, which was disappointing. I was hoping for improvements but it seems that using the leg-press and leg-extension machines aggravates the problem in just the same way as it used to. I also felt pretty worn out on Wednesday and Thursday.

Finally, I hit the pool again on Friday and swam 32 lengths (0.5 miles). It actually felt easier than last week although from length 20 onwards I was getting cramp in both feet (fatigued nerves again). I came out of the pool, showered, changed and actually felt good. It was a positive experience. It was also the last time I'll be able to use that pool. It's a members only, 'posh' fitness club, which at one point offered non-members the opportunity to buy 4 visits for £30. I used my last one yesterday and they've stopped doing the offer. There's no way I can justify, let alone afford, membership.

This morning, I feel tired but ok. I suspect it'll be a telly day, recovering.

Other stuff this week.....I have arranged a physio appointment for Monday 6th at a local physio centre, for my right hip. I need some help with it.

...and....the letter I have been dreading for months and months finally arrived from the DWP on Thursday. They are reassessing everyone on disability benefits to transfer them onto this new employment and support allowance (ESA) benefit. Everyone goes through the "work capability assessment" (WCA) process, starting with a questionnaire, followed up with a medical assessment. The horror stories for those with mental health issues or conditions such as ME/CFS are numerous. In essence, the WCA doesn't sufficiently assess conditions which fluctuate or have a mental health element. People who have been struggling to recover find themselves having benefits withdrawn and their fragile mental health shattered once again. This post on the MIND website sums it up well: Link

Finally, a word on the Trazadone withdrawal. I have now done 9 nights without it. The first 4-5 nights weren't pleasant at all due to the hypnic jerks and my brain having no capacity to seemingly switch off. I wasn't getting to sleep until about 2am and then sleeping very badly for perhaps 4 hours at most. The last 4-5 nights have been better although still not great. After 12 years of having sleep-inducing medication, it seems like my brain is going to have to relearn the sleeping process. It is taking hours to get off to sleep and then I'm waking fairly regularly through the night. I seem to be getting the best sleep as we head into the morning. Today, I allowed myself to sleep until 10am. I can't work out yet whether I feel better during the day for having come off the meds.....we shall see. If there's no real day-time improvement and my brain fails to learn to sleep again, then I may end up just going back on the meds. I'll maybe give it a good 6 months and then re-assess. 

Andy for Gold

I'm loving the Olympics and especially seeing Andy Murray beat Novak Djokovic this evening to get through to the Silver/Gold Medal final on Sunday. What a superb effort. He played tight, aggressive tennis. Can he go one better than he did at Wimbledon....!?! I'll definitely be cheering him on.

I'll save the weekly rehab update for tomorrow sometime....