When the Doctor Becomes the Patient

Great article on hip dysplasia from the perspective of an orthopedic surgeon who is also a bilateral PAO patient:

http://www.bmj.com/content/342/bmj.d2152.full

New Boots

Orthotics are great, but they make boots smaller. So my feet have been killing me because they are squished into my 10-year-old custom boots, which were fit exactly to my feet.

So I felt the time was right to break in my new boots. I have a pair of Klingbeil dance boots which have been mounted on my picc frames. I've worn them a couple of times with the piccs but since they were slightly too big I didn't think I would switch them out. With the orthotics inside they fit perfectly. I have regained enough balance and stability that I feel OK about breaking in a new pair of boots.

Today was day 1 with new boots + orthotics. My feet don't hurt like they did in the old boots, but I have some different pain because the boots are new and stiff. They still felt a bit big in the heel, but I am going to wear thicker socks tomorrow. I like the higher heel and lower cut of these boots - I feel like my toe point is better. I did the MIF group class tonight and was able to do everything in the class, so I think the boots are going to be fine with some break-in time.

Tomorrow I have my second lesson with Coach I. to work on my Cha Cha Congelado. I would like to test it this summer. We started working on it again last week. We'll see how much I can do tomorrow with the new boots.

I didn't blog about my lesson with John D in San Francisco last Monday. Look for that in a future post.

See No Evil

Not what Dr. Mayo had in mind when he said, "return to normal activities"!



But at least I got the t-shirt!




My husband Perry came to the rink to videotape me yesterday. Part of me wanted to look, and another part of me was horrified at the thought of seeing myself on tape. (Our video recorder is ancient, so "tape" is actually the correct term.)

Perry's remark was, "you are skating so slowly." This is very true; everyone else is whizzing by me on the session and I am plodding along as if skating through sand.

I also took a pretty sick fall by catching an edge. The video never lies - it was just a dumbass "for no good reason" fall - but you can see one of the other ice dancers in the background clapping when I fell. I'm sure he had no idea my husband was directly across the rink from him filming.

It was a hard fall on my backside but I was able to get up and keep going for the rest of the session, and I feel OK today, so no harm done.

So after reviewing the film, I noticed the following:
~On the good side, I have some very nice deep edges (however, see the final two points below)
~I am skating very, very slowly and tentatively
~I have very little free leg extension
~I overuse my arms and hands and they look awkward
~I carry my arms and hands too high
~I take very short choppy strokes
~I kick up my feet behind me when I stroke instead of extending (this is because my feet hurt from the orthotics but I didn't realize it was so obvious and constant)
~I am bent over with poor posture most of the time
~I hook my edges at the end of lobes
~I tend to take edges that are TOO DEEP for my speed

Some of this I can do something about, some I can't. I find the last two things very, very interesting. I think they are causing some of the problems I have. I never thought I'd be telling myself to "try for flatter edges," but that's definitely something I need to work on. My take on this is that my body still remembers how to hold a good solid edge, but I no longer have the leg strength or velocity to use it to advantage, so it's hindering me from flowing from lobe to lobe and doing turns like I used to.

It's a theory which I'll test out in the near future.

The Great Orthotic Experiment

Day 2:

The progress continues. Today I was able to pad my foot enough to avoid some of the existing blister pain. I also removed the original insole to make more room for the orthotic (since my boots are custom and very tight fitting).

I was able to do some things that I hadn't even dared try since surgery (Quickstep choctaw, for example) since the outside edge had been too unsteady and it just seemed impossible.

I think I may have always had this problem but was able to muscle through in the past. Now that my muscles are not nearly as strong as they were pre-surgery, I must use good technique to do things and can't just get through them by pushing harder. My balance is also different now and my new hip alignment has exacerbated the problem.

This isn't going to fix everything, but it certainly makes it easier not to fight my own body all the time. I didn't realize how much I was doing that until today.

The Great Orthotic Experiment

Day One:

Brief history - I have always had very flat feet but no pain and no pronation
problems with walking. I have always had the tendency of rocking over easily
to the inside edge of my skate when I don't want to, so have to really force
outside edges. I managed to do OK for many years skating freestyle and figures,
but in ice dancing always struggled and just thought it was caused by other
factors (laziness, bad hips, weak muscles, tuning out my coach).

Fast forward, two hip re-creations later, I'm still re-learning how to skate. I moved my blade over and considered shimming it several months ago, which helped slightly. But I still didn't feel secure and stable on outside edges. It occurred to me that perhaps I'm pronating in my skate even though I don't do so in shoes. On a whim I just thought I'd try orthotics in my skates even though I don't pronate.

And, Voila, today I held real outside edges with no struggle. They felt right.
They sounded right (without that scrapey, "it's about to change to an inside
edge so I have to force it" sound). Some of the things I had to muscle through
in the past just to stay vertical seemed suddenly easier. It made a HUGE
difference.

I didn't have time to try very much and the new orientation of my foot meant a
blister formed so I'll have to fix that, but ... but ... but ... well, this is
all very exciting. Wish someone had told me (or I had figured out) to do this
years and years ago. What a difference it would have made! I had heard about
orthotics but since I didn't pronate off the ice it never occurred to me I might
need to fix what was happening to my feet inside my skates.

Happy birthday to me!

Flirting with Mediocrity

Yesterday was my first time on the ice since the week before the Costa Rican travel accident. Skating was mediocre as expected, but considering the time off and the fact that I'm still sore, I am OK with mediocrity.

I have an appointment with Dr. Mayo April 12th (soonest available) but I think I may end up canceling it since I am improving and there is clearly no boney damage to my hip joints. In my (haha) medical opinion it's just soft tissue damage which will resolve over time. Sara, Dr. Mayo's PA, confirmed this was her suspicion as well but said if I'm not better by April 12th I should come in, so that's the plan.

Based on yesterday's mediocrity I now have a goal to strive for on the ice. I plan to compete in the All Figures competition in the Novice Twizzle event.

Novice Twizzle Demo:


Even on days when I can barely walk I can usually do a decent twizzle, so might as well showcase that strange rotational ability somehow. I did several patterns yesterday and realized later I had done them slightly wrong, but no matter. I have several months to perfect the pattern. I am referee for the competition but see no reason why I can't make a fool of myself as well!

Post Vacay Decay

Back from my Costa Rica vacation, where I did not skate but did swim, zipline, body surf, hike and drink beer without hip pain. An unfortunate accident having to do with a car seat on the last day jammed both legs into my hip sockets, leaving me sore and unable to skate or exercise at all since my return.

I've left a message with Dr. Mayo to find out if I should come in for an examination. I am finding it difficult to limp since both hips (and my back) are sore. Which leg do you favor when they both hurt? I've got the cane out but I always hate to use it ... so many questions from people who have recently seen me doing just fine without it. Crap.

Will post more later but I'm hoping it's just a matter of rest and time and ice and NSAIDS, and that it's soft tissue injury and not a fracture.