Breakthroughs at 1.5 years post LPAO

I haven't given a hip status in a long time, so it's probably time to do so and tie that status with some breakthroughs I'm having on the ice.

I am at about a year and a half from my second PAO, which puts me at 1 year and 10 months for my first PAO. I was told at the beginning of this journey that I will continue to see improvement up to (and sometimes beyond) the two year post-surgery mark, and I'm hoping to see the progress continue.

I had a bit of a setback at the end of February when a car seat slammed into my knees, pushing my femurs back into their sockets abruptly. Before that happened I had been experiencing very little muscle pain. Now I am having more muscle pain with exertion, but Dr. Mayo thinks it could take up to 6 months to heal from that trauma. He saw me 6 weeks after the accident and noted that my abductors were very weak, and I'm working on getting that strength back - I think it was due to lack of activity right after the accident.

Hip status:
~My scars have faded into oblivion and can barely be seen.
~Certain muscles are still weak (hip flexors, abductors). When I say "weak," I mean "weak compared to what they once were." They are probably normal or better for someone my age. Skaters have strong hip flexors and mine were cut and atrophied to nothing, so building them back up so that I can do nice forward flare extensions on the ice is probably going to be impossible.
~I no longer have low back pain.
~I walk without a limp unless I'm really, really, really tired.
~I don't like to walk long distances although I can. It's not the best exercise for me as it puts the most pressure on my hip joints and can cause fatigue and soreness. For the same reason, I don't run, but I never did.
~I can sleep in any position.

Skating breakthroughs have been notable this past week. I am able to bend better and extend better. I have finally taken the training wheels (two-footing) off my FI mohawks and can push and extend on the FI edge before the turn. This is partly balance and partly strength. FI mohawks are considered an "easy" skill and it has taken me about a year to be able to stroke into them with confidence, but before this week I felt very unstable in that position solo.

I still can't do many turns that start with a FO edge (other than rockers and twizzles). The abductor weakness is probably to blame, as my legs aren't stable enough. I can't do FO counters (although I can do BO counters). I can't do the Argentine twizzle, but that's because it's really a counter. I can do the QS choctaw slowly with a touchdown but I think if I spent some time on it, it might improve. Can't do FO closed mohawks except slowly with a big touchdown but that should be no surprise! That will probably be the last thing to come back, if it comes back at all.

I can do full patterns of the Intermediate and Novice twizzle sequences and they are better than some of the kids' tests I've judged, if I do say so myself. Very happy about how those are coming along.

Cha Cha Congelado

This is Thursday's rendition of the Cha Cha Congelado, skating with K. This was a crowded freestyle session on 2/3 ice so no way to skate it out or do full patterns, and we didn't have music. You can't really tell this is a Cha Cha, and for an international dance this isn't done very well, but considering my week-old boots I'm pretty happy with this. I suppose considering that a year ago my friends were holding me up to do the Dutch Waltz, I should be ecstatic:



My finest hour:

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!