Things are beginning to slowly improve in some areas and at the same time new problems crop up.
My left hip is roughly at about 80% prior PVNS normal function. Three surgeries in two years create a lot of healing to be done, so I am generally happy with the 80% function. I still struggle with Illiopsoas flare ups when I do too much. One thing I have found that helps when this happens is Dry-needling treatments. These are similar to acupuncture but instead of working on the Chi in the body, dry-needling works on pain points. The needles are inserted in areas where the patient is feeling the most pain and then wiggled about to relieve the pain. It seems backward to inflict pain to relieve pain but it works. It has also been very helpful in reducing the scar tissue and relieving the tightness that develops in the tendons of the groin.
My right shoulder (non PVNS) is at about 80% as well. I have regained full mobility since my surgery 08/2013, and I am working on strengthening exercises. However, I still have a lot of shoulder pain and feel a catching in the bicep when picking things up and there is a grinding in the ball and a popping as I move. Both sensations are very disconcerting.
My right shoulder has been confirmed via an MRI to have a tear the surgeon recommended that I return to see him when I could no longer take the pain. For now I am putting up with the pain and trying to keep the muscles strong by doing isometric exercises at home. On a positive note no PVNS is seen in this joint.
My right hip is beginning to have the same symptoms that my left developed before the diagnosis of PVNS. The surgeon suggested that I return when I could not longer take the pain and we would do a THR at that point.
I developed pain in my left elbow in late October and have been visiting the hand specialist at my orthopedic surgeon's office. Initially the diagnosis was an ulnar nerve impingement. However after OT and sleeping with a splint for six months I have had no change. I saw a couple of weeks ago and had Xrays which show nothing. He ordered an MRI of the elbow with and without contrast to figure out what is happening. I saw him yesterday for my follow up and the MRI results show tendinopathy of the elbow. So now I have a tennis elbow brace and I got an injection of the tendon sheath.
I also have been dealing with intense foot pain during the last year. I saw another OS who specializes in problems in the feet and found out I am dealing with two new issues.
Left foot pain appears to be caused by plantar faciaiitis and will hopefully clear up with exercise and rest. I already owned a McDavid splint from when I broke this ankle in 2012 . The doc felt would be good to use to immobilize the ankle when not doing the exercise. If this is not helpful the options are casting or a boot and if that is not helpful the final resort would be surgery to open the fascia.
plantar faciaiitis
Intermittent right foot pain is caused by a pinched nerve. I mentioned to the doc that I have a spot on the lateral side of the leg that bubbles up. After looking at it and discussing how I walk and watching how I stand he concluded that it is the result of a Facial hernia, this occurs when the facia (a thin sheath of fibrous tissue enclosing a muscle or other organ) has a hole that is too big and the muscle pops through.
transfacial muscle hernia
The only treatment for this is a
Fasciotomy or patch grafting are treatment options.
Dictionary.com lists the definition of a Fasciotomy as
Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome.
So now I have answers to most of my pain but no real solutions short of exercising and surgery.
I began walking again in the spring and have gotten back up to the 2 mile loop that I used to do. Weather had made it difficult to walk lately. I started back to the gym three weeks ago and have been walking laps in the water (one lap is up and back). I walk forward lifting my legs high on half a lap and the backward on the return. I walk sideways lifting my lead leg (Working flexor muscles) high as I take a step and drag the trailing leg (working adductor muscles) on the first half of the lap and then reverse legs on the return half lap. Then I swim freestyle (crawl stroke) one full lap.
I started with 20 min the first day which worked out to five sets or 15 full laps. I did ok but I waited a full week before going back to see how my illioposas responded to the exercise. The second week I also did 20 min (15 full laps) once again waiting a week between sessions. The third week I did 25 minutes or six sets or 18 full laps. My illiopsoas is very inflammed this week following this exercise session. I have made an appointment with my dry-needling PT to have a session on Friday. She is very helpful for these flare up's but in the meantime I am miserable. I try to keep moving and not just sitting around feeling miserable but I just can't find a happy medium!
My left hip is roughly at about 80% prior PVNS normal function. Three surgeries in two years create a lot of healing to be done, so I am generally happy with the 80% function. I still struggle with Illiopsoas flare ups when I do too much. One thing I have found that helps when this happens is Dry-needling treatments. These are similar to acupuncture but instead of working on the Chi in the body, dry-needling works on pain points. The needles are inserted in areas where the patient is feeling the most pain and then wiggled about to relieve the pain. It seems backward to inflict pain to relieve pain but it works. It has also been very helpful in reducing the scar tissue and relieving the tightness that develops in the tendons of the groin.
My right shoulder (non PVNS) is at about 80% as well. I have regained full mobility since my surgery 08/2013, and I am working on strengthening exercises. However, I still have a lot of shoulder pain and feel a catching in the bicep when picking things up and there is a grinding in the ball and a popping as I move. Both sensations are very disconcerting.
My right shoulder has been confirmed via an MRI to have a tear the surgeon recommended that I return to see him when I could no longer take the pain. For now I am putting up with the pain and trying to keep the muscles strong by doing isometric exercises at home. On a positive note no PVNS is seen in this joint.
My right hip is beginning to have the same symptoms that my left developed before the diagnosis of PVNS. The surgeon suggested that I return when I could not longer take the pain and we would do a THR at that point.
I developed pain in my left elbow in late October and have been visiting the hand specialist at my orthopedic surgeon's office. Initially the diagnosis was an ulnar nerve impingement. However after OT and sleeping with a splint for six months I have had no change. I saw a couple of weeks ago and had Xrays which show nothing. He ordered an MRI of the elbow with and without contrast to figure out what is happening. I saw him yesterday for my follow up and the MRI results show tendinopathy of the elbow. So now I have a tennis elbow brace and I got an injection of the tendon sheath.
I also have been dealing with intense foot pain during the last year. I saw another OS who specializes in problems in the feet and found out I am dealing with two new issues.
Left foot pain appears to be caused by plantar faciaiitis and will hopefully clear up with exercise and rest. I already owned a McDavid splint from when I broke this ankle in 2012 . The doc felt would be good to use to immobilize the ankle when not doing the exercise. If this is not helpful the options are casting or a boot and if that is not helpful the final resort would be surgery to open the fascia.
plantar faciaiitis
Intermittent right foot pain is caused by a pinched nerve. I mentioned to the doc that I have a spot on the lateral side of the leg that bubbles up. After looking at it and discussing how I walk and watching how I stand he concluded that it is the result of a Facial hernia, this occurs when the facia (a thin sheath of fibrous tissue enclosing a muscle or other organ) has a hole that is too big and the muscle pops through.
transfacial muscle hernia
The only treatment for this is a
Fasciotomy or patch grafting are treatment options.
Dictionary.com lists the definition of a Fasciotomy as
Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle. Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome.
So now I have answers to most of my pain but no real solutions short of exercising and surgery.
I began walking again in the spring and have gotten back up to the 2 mile loop that I used to do. Weather had made it difficult to walk lately. I started back to the gym three weeks ago and have been walking laps in the water (one lap is up and back). I walk forward lifting my legs high on half a lap and the backward on the return. I walk sideways lifting my lead leg (Working flexor muscles) high as I take a step and drag the trailing leg (working adductor muscles) on the first half of the lap and then reverse legs on the return half lap. Then I swim freestyle (crawl stroke) one full lap.
I started with 20 min the first day which worked out to five sets or 15 full laps. I did ok but I waited a full week before going back to see how my illioposas responded to the exercise. The second week I also did 20 min (15 full laps) once again waiting a week between sessions. The third week I did 25 minutes or six sets or 18 full laps. My illiopsoas is very inflammed this week following this exercise session. I have made an appointment with my dry-needling PT to have a session on Friday. She is very helpful for these flare up's but in the meantime I am miserable. I try to keep moving and not just sitting around feeling miserable but I just can't find a happy medium!
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