Maximizing your Progress After your Hip Scope – Month 2/Post 2

If you missed the last blog, read that here

by Dr. Caroline Withall

This month I want to highlight the importance of appreciating your progress, even when it feels like there are raging storms at sea blowing you right off course – yes, I’m continuing with the nautical analogies as I find them rather apt!  I have seen significant progress with my hip scope rehab, which becomes more obvious as I reflect. Last time I described how upon my return I started my program a little over enthusiastically, and consequently my snarky psoas decided to make a reappearance, setting off some nerve pain to boot. 

As you can imagine, I’ve been incredibly frustrated with myself, but also acutely aware from past experience that it doesn’t always pay to try and push through and carry on; it’s okay to take a step back if you need to, and be gentle on yourself.  As anyone who has dealt with psoas issues knows, it is a difficult beast to settle.  The good news is I have quelled its rage for now! It has taken four weeks to get back to where I was when I left the US, yet in that time I have still managed to carry out more parts of the program than I initially realized, and even better, as I reflect on my progress, I am not only aware of the learning points, but to my surprise, there is still success to celebrate.

How to Calm a Flare-Up

So how did I manage to steer back on course? Critical to this was knowing which parts of the program were appropriate for the situation, so I set aside sections which seemed to aggravate the flare up, principally core and glute work, but still adhered religiously to release and breath work to help me through; as mentioned previously, the home program is so much more than just a set of exercises. 

Complete rest is never the answer, and in periods such as these, the daily release sequences are essential not only to ease pain but also continue to make progress after your hip scope.  It not only soothes the body but also the mind – and the mind is something you really have to watch out for, because when you start to feel deep psoas pain again, very often it mimics the types of pains you’ve had before surgery and you have to work really hard to stop yourself from going down the path of worry.

My tip is to check in with Dr Ginger. When you leave her office, you are not abandoned at sea.  She is still very much on the voyage with you. A few temporary modifications to the program and some reassuring wise words go a long way to steadying the ship. However, only I could get a grip of the cycle of rumination; no good comes of chastising yourself and over analyzing the mistakes made to cause a set back.  

Progress after a Hip Scope? – The Truth is Irritating

To break this burden I relied heavily on trusted methods to encourage relaxation – I’m a particular fan of the thousands of free meditations and soundscapes on the Insight Timer App. Breathing exercises, cupping, gua sha, combined with a stern reminder to myself that it is only a temporary setback. I know, there’s nothing more annoying than people telling you to relax, but the irritating truth is that it really is key during a flare up as muscular problems are just intensified if you become more stiff and scared.

It’s incredibly difficult to manage, and hard for someone who hasn’t been through this injury to understand that it is not at all like muscle pain you might experience from over exercise, and you feel no benefit from taking a couple of NSAIDs and fully resting for 24-48 hours.  This is the sort of injury that needs a little bit of everything, equal parts gentle movement and rest, and it’s a delicate balance to find, but you can get back on course, and I’m pleased to report I have.

Over the last week or so I have been slowly adding back in my various exercises on top of maintaining release work and this steady approach is working well. Each day I focus on adding in another exercise, or increasing repetitions in a precise and methodical way learning from my previous mistake – and now I can comfortably hold a screw home position for the entirety of brushing my teeth, or feeding my cat.  

Being Reasonable with your Progress after your Hip Scope

This leads me to another very important tip I have for those starting out on their own program – managing your lead up time.  As discussed in my last blog, you will leave Dr. Ginger’s office feeling very confident across all aspects of your program. Yet when you come to start it yourself, even with videos and notes, it is not as simple as jumping straight into it, and learning the details is time consuming at first.  You will want to skip to the part where you know the exercises inside out, so it takes much less of your thinking time, and is second nature. 

It is quite hard to get to that stage when there are other commitments in your everyday life competing for your time, such as family life and work.  When I landed back in the UK, it was the school holidays – so not a great time for self care to come to the top of the agenda! I wanted to be present and active with my daughter, and also with wider members of the family coming to stay.  

Part of the reason my psoas flared up was not only due to jumping in too hard with my program, but also because I was doing more things than I would ordinarily comfortably do in my condition.

Caroline Withall

My advice to anyone contemplating some intensive treatment is to actively factor in some time after your visit to really get to grips with your program.  You will never pick up an exercise perfectly straight off, but it is surprising how quickly you can assimilate things if you don’t rush.

You will never pick up an exercise perfectly straight off, but it is surprising how quickly you can assimilate things if you don’t rush.

-Caroline Withall, PhD and Patient of Dr. Ginger Garner

Something you will also have come to terms with is acceptance that it is going to take more time.  When you have been injured for a while, and life has been on hold, you are desperate to get stuck in and see results. If you can, remove any self imposed deadlines such as “I must be better” for holiday, an event etc.  This is undoubtedly very hard to reconcile with life because the fact is we do have commitments and things that we want to do, but where you can, clear space in your mind AND your schedule to just focus on the present, taking it day by day and concentrating on the quality of your commitment.  

The Progress after My Hip Scope Continue to Grow!

By scaling back on other things for a short while the movements become second nature, such that they then incorporate very easily into a busier everyday life.  I have already seen clear examples of this working – I have taken the time to really perfect the technique of psoas flossing and now while out and about I can very effectively do this if I feel tightness of the muscle creeping in.  After just one week of doing warrior wall twists every day there are noticeable signs of increased movement in my thoracic spine. 

There’s a big win and progress with my hip scope rehab that I couldn’t see at first when I was scared. I have been able to do elements of the program at ALL times, even when in pain. Even better, I am seeing results from that. During this flare, I have not had ANY orofacial pain, or more importantly a decline in the progress of correcting that.  That is huge! In the past I have really suffered with my neck when my hip is raging.  

Consistent use of the wand has been a game changer with virtually no symptoms at all now with my left obturator internus.  Thoracic rotation is improving and I can feel a bit more strength in my right leg when doing some of the exercises; at first it was really wobbly, but now it is starting to become a more steady anchor. I’ve made progress with the functional medicine side too, the adjustments to my diet and recommended supplements have led to improved sleep. 

So you see, I am not all at sea! Sometimes we just have to adapt our course according to the weather, then pause and reflect in order to realize we are actually making gains all the time, even during choppy waters.