Big Wins with Hip Scope Rehab Post 4/Month 4

Testimonial from Dr. Caroline Withall

November started positively in my hip scope rehab journey, having climbed my way out of the hole I was slipping into, both mentally and physically.  Concentrating on glut work only has begun to pay some dividends, in particular the ball bridge exercise. This is a good one for people like me who don’t want to activate the overworked hip flexor/tensor fascia lata area, traditional bridging has always been very difficult for me and resulted in flares.  

With Dr Ginger’s adapted version, it really is the tiniest of actions, “micro movement” as Dr. Ginger advises, which is hard to get your brain around at first because you feel like you should be doing more, as it is so subtle.  However, once you crack this, it is surprising how easily you can feel both the gluteus medius and gluteus maximus working.  This feels like a real achievement, as back in July, I remember being in Dr. Ginger’s office in Greensboro, NC trying out some electrical stimulation therapy because we could not get the right glutes to fire very well at all.

So I am really proud of my determination and resolve to stick with coaxing them back to life.  That is not to say they are working optimally at this time, there is still more work to be done. But when I think of where I was a few months ago this really feels like significant progress. 

Getting Grounded in Body and Mind

Another encouraging development is noticing signs of my body sometimes automatically going into the screw home position.

Caroline Withall, PhD

I have glanced down on occasion and noticed I’m in that better position, and I am getting so much more body aware about making sure that the outer edge of my right foot is really planted down. I look at my knees less to correct myself into the position, because I can now feel the action required with my body, I can engage my brain and visualise the gluteus medius activating, pulling my hip back into alignment. Good support comes from the ground up!

I have consciously tried to increase relaxation by translating it into practical activities as well as doing the more mindful aspects such as breathing practices – I have talked before of the need to find the balance between focusing on rehab but also taking a mental break from it. So, I started a paint by numbers, an achievable and creative task to complete, and an excellent distraction from thinking about pain and issues, as it is quite absorbing!  Similarly I enjoyed doing some traditional festive baking, making our Christmas cake and some Christmas puddings!

Digestion and Abdominal Pain through Hip Scope Rehab

Unfortunately, I continued to struggle with pains in my abdomen and this month I concluded the gastric investigations to try and determine whether we are dealing with that sort of additional issue, or if it is all muscular in origin.  After several tests and an abdominal ultrasound I was pleased nothing sinister was found, the only possible issue being a positive result from a SIBO breath test.  After discussing this both with my gastroenterologist and Dr. Ginger, I felt that given my ultrasound was completely clear, taking antibiotics to treat potential SIBO might be somewhat heavy handed, so I resolved to keep working on my diet, and try taking a digestive enzyme supplement.  I am now a fortnight [2 weeks] into taking them with every meal and it has been quite transformational, almost eradicating digestive symptoms such as bloating, constipation and IBS like episodes.  

So, if gastric issues are not the cause of my abdominal pains, what are? The answer appears to be two-fold.  First, I revisited the issue of scar tissue. Back in July when I worked with Dr Ginger in person she did a lot of dry needling on my scope scars. There are six scars total. This really helped the scar tissue that was tethering from the top of my thigh to the TFL and iliopsoas.

Scar Tissue Issues

I’ve carried on the work myself consistently cupping, but I felt that there was one left that seemed to still have some stubborn restrictions.  Not having access to a dry needling practitioner of Dr. Ginger’s expertise, although a slightly different modality, I went to a trusted acupuncturist that I have visited on several occasions over the years for various ailments.  

She checked all my scars and agreed there was just one outstanding problem. I was delighted to get the validation that the extensive cupping I had been doing had paid off. The exact scar I had identified as being an issue still, which she felt was attaching to my TFL and restricting hip flexion a little.  After just 3 sessions there was a very big difference. I have barely had TFL pain since having this treatment, and I also had quite a big release around the external oblique area.  This has been a really liberating development and increased my continuous walking time considerably.  

Maximizing My Self Management in Hip Scope Rehab

Despite this breakthrough, I still struggle with deep front line pain, particularly in my rectus abdominus and diaphragm.   It is not constant, but when it flares up, it is really uncomfortable.  Here’s an example of what can set it alight…afterall, it wouldn’t be my blog without a mishap tale!  This month, I was walking down a broken escalator in a shopping centre.  Miscalculating how much deeper than ordinary stairs a step down is, and although I could do it pain free at the time, only a few steps after getting off I started to feel pain all through my deep front line and the obturator internus went into overload…

In addition, when the right side is badly flared, my left hip starts to over compensate again resulting in pain on that side too.  Fortunately the tips and tricks Dr Ginger taught me get it in check pretty quickly. I can usually have everything back under control on the left side within 24-48 hours.  This really is all self management in action. I’ve got pretty good at knowing when to use which exercises and tools! However, I felt that something continues to not be correct with the right hip.

Reviewing My Hip Scope Rehab Progress to Date

Dr. Ginger has been encouraging the whole way, and December marked three months into the program.  I tend to be my harshest critic (sound familiar?) and she really lifted my spirits, telling me I was doing well at this point considering how much of a mess (I was in before I started the program (my words not hers ;). I am so happy to say now that the left hip is pretty much sorted, and if it does flare, Dr. Ginger taught me how to control it very quickly.

The right side referral pain are also well under control and hardly bothering me anymore. Back during my visit stateside in July, I had pains from the orofacial area right all the way down into the foot. It really feels like I have reduced the right side issues just down to just the torso/pelvic area. Dr. Ginger has a related video on the orofacial/voice and pelvic floor connection that may be helpful.

Dr. Ginger also pointed out how body aware and literate I have become as part of this process, which allows people to be able to assist me as I can accurately describe the issues I’m experiencing.

As Dr. Ginger says, with complex cases like mine, it is very much like peeling the layers of an onion – and I genuinely feel I have shed a few of those layers over these last few months.  

Carolina Withall, PhD

Lingering Worries in my Hip Scope Rehab

And yet it is still hard not to feel worried as to why I continue to struggle with the abdominal and pelvic areas. We concluded that given the program has worked so well for the left hip, there must be something else going on with the right. So it is time to change tactics – peeling off the layers of the “onion” that just concern the muscles has gotten us this far, so now it is time to hone in on the neural/fascial components of the problem on this side of my body.  

We have identified so far that the main problem continues to be a continually flaring obturator internus, tight rectus abdominis, obliques and diaphragm. My new tools include self myofascial release techniques, “stacking the layers”, treating these trigger point areas through indirect methods, rather than directly as before.  

Support, Guidance, and Gratitude

After a first practice of this, I felt my obturator internus pain melt away, I believe it freed up the area that tends to trap the nerve when tight, and I enjoyed my longest run of minimal pain…THREE WHOLE DAYS! This feels like a really good technique to have in my toolbox as I enter into the festive season with all its extra commitments.  There is one more possibility that could be lurking on this right side – endometriosis.  

Many of you will be following Dr Ginger’s own brave journey, and in the nicest possible way I hope that I don’t have to emulate her – but what better role model could there be if I do.  For now, I remain hopeful that our new approach is going to pay dividends.  I have a huge test of progress coming up, a trip to Venice to see my daughter sing on her choir tour.  Although potentially more than I should be doing at this stage in my rehab, it is simply an experience I am not willing to miss out on. Although I don’t know how well I will fare, I do know I am not fearful of trying. 

Thanks to Dr. Ginger for her solid support and constant desire to not give up on me. With her help, we’ll figure out what is going on with my body!