I got to see a physical therapist today. Finally.
Joe checked me out, asked a ton of questions, and gave me four stretching exercises to do twice a day. He had me do the first set of the day while I was at the clinic so he could show me how to do them correctly.
I like Joe.
And once again, I have to say that I like my VA health care. Joe the PT has to be one of the most empathetic people I’ve ever met. (Either that, or he’s a fabulous faker!) When I told him how long I’ve had rheumatoid arthritis (23 years) he winced. When I explained that my hip bursitis has not only worsened over the last several weeks, but that it’s attacking both hips, his eyes widened and he gasped. There was nothing histrionic about his reactions; he simply, truly, cared.
I said that this bursitis has really been a pain in the butt. Joe grinned. “Literally,” he said.
Did I say I like Joe?
My right hip is stiffer and has less range of motion than the left. I figure that this is because of the RA, which used to attack that hip joint with great intensity. My rheumatologist has tested the range of motion in that hip, had x-rays taken and subsequently discounted any problem with it, but today, as I was attempting one of the exercises, it was clear that I couldn’t easily move that hip in the required way. I could move it, but it was far more difficult than it was on the other side. And, to my dismay, I discovered that using my left hand to help pull my right hip toward my left shoulder (while laying on my back) was a problem, too. My left hand immediately yelled with pain over the stress.
And so, Joe got a towel and we looped it around my knee, and grasping the two ends, I was able to use my left hand to pull my hip into position. Why it was easier and less painful to grasp that towel in my hand rather that my knee is a mystery to me. But it was. Amazing.
After the session with Joe, my hips became much more sore. He said to expect that for a while, since the idea here is to stretch the tendon that slides over the greater trochanteric bursae (hip bursae) so that it doesn’t get so irritated and inflamed. In hip bursitis, it seems that not only are the bursae themselves inflamed (in my case, because of RA); that tendon is, too. It gets sore and tight, and stretching it out will, in time, relieve the pain.
The exercises will also help to strengthen several of the muscles that move the hip.
I did them all again tonight, one set of repetitions of each exercise on each side. OMG. Ow, ow, OW! It’s funny, because the exercises themselves weren’t painful, nor was stretching the tendons. What hurt was laying on my side on the carpeted floor—which meant laying directly on my badly inflamed, really aggravated hip bursae. And now, as I sit up in bed, laptop computer on my lap, my hips and butt are killing me. I’ve iced both hips, as instructed, and took some tramadol a little while ago. With luck, they’ll calm down enough for me to sleep soon.
I’ll be seeing Joe again on the 30th of this month. He’ll check my progress, and said he’d probably give me a cylindrical-shaped foam roller that I can use to massage that tendon and bursae. We tried it today; it was painful, but I could manage it. Joe said we’ll wait until that tendon stretches a bit and, hopefully, I’m having less bursitis pain.
I’ll be seeing the pain doc again on the 28th. If this current pain isn’t better by then, I’m going to request another round of steroid injections, a different kind of pain medication, and something to help me sleep at night. I’m convinced that I’ll be able to handle the pain of this bursitis better if I can get more sleep. Four or five interrupted sleep hours a night just isn’t doing the job.
I’m hurting like hell tonight, but I’m still hopeful. And I like Joe.
RheumaBlog 
Oh dear – so sorry it’s Sooooooooo painful … but delighted you like Joe! It’s amazing what a difference that makes. For the next two weeks my usual physio is doing training and I’m seeing someone else who while I don’t dislike, I don’t have any ‘connection’ with … and she’s not chatty. The thought of sitting there for twenty mins, almost nose to nose while having ultrasound on my shoulder from someone who doesn’t talk is not appealing. But then again, the one treatment I’ve had has helped HUGELY. I hope yours very soon gets through the hurting worse stage and starts moving into the feeling better stage!
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Sounds very familiar Wren. It’s wonderful when you can like your Physical Terrorist (my mom’s name for them-lol) because what they have you do does hurt before it helps. The best thing about my last PT was the end of the appointment when they would have me lay down on a giant heating pad with a TENS machine hooked up. I would work my butt off to get to that 20-30 minutes.
I really hope the PT helps. Like my Rheumy said on Thursday when she was shooting me full of cortisone- having OA, Fibro, bursitis and other painful ailments on top of RA is just adding insult to injury.
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Oh man. I feel for you. That IT band is a killer, and you’re right, one of the worst parts is trying to lay on your side and get any sleep (or turning over in the night and having the pain wake you up). Sounds like you’ve got a caring, skilled physical terrorist (at least that’s what it feels like when they’re working on you). I have faith this will help, and I hope it helps soon.
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oh, wren, i am hopeful that this session of recovery helps. honestly, the best part of all of this is joe (yes, he outweighs the exercises, even). to have someone really listen and give you some internal confidence in your abilities is the best medicine there is.
i am sending you good energy, friend.
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Glad to hear things may be looking up. It is always a plus to have a therapist you like and who listens to you. I use the foam roller that you may get. It hurts while using it but in the end it really helps to stretch the muscle and get all of the knots out. I use it even when I’m not having problems to try and prevent future issues.
Hang in there. It sounds like things are looking up!
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Wishing the best for you, Wren. Hoping the PT kicks some butt for you soon! I want to know what the white part in the picture above is that runs along the back of the gluteus maximus. This is where my bursitis is worst and that muscle or what not feels really tight when I bend over or try to raise my leg from a laying down position, right at the base of the butt where it becomes the back of the thigh.
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When I started physical therapy, I had a lot of pain also. But in the end, it did help. I hope the same is true for you. My pain lately has been in my hip also. It is amazing how the pain is different in each joint. The hip pain definitely does keep you awake at night! I think my pain is almost gone and I slept 11 hours last night. The sleep was definitely needed. Keep doing those stretches and know good thoughts will be coming from here and all over which means the pain will surely be gone soon, right?
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I love my foam roller and just ordered a new one because I have worn it out (if you get one for home, invest a bit more in one that has a hard PVC core, the pure foam ones break down quickly with regular use.) My biggest problem with using the foam roller is the need to support my upper body on my hands. My wrists are shot and so limited in range of motion that I can’t flex them enough to put weight on my palms so I have to be really creative.
Don’t you just love when rheumys take x-rays and say a joint is fine when you can hardly use it, sheesh.
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i love foam rollers too!
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Ow indeed! That sounds awfully painful – but Joe does sound great. True empathy makes a huge difference. I hope that as you continue the physio sessions you start to notice a change. Good luck, Wren!
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