I’ll explain the title in a bit, but just to clarify, “PPS” (“The Patient, Physician, and Society”) is a class we take during the first two years of medical school.
Anyways, I’m feeling a bit more resilient about my hip/back/IT band/whatever else today. Well, except for the fact that I am horrified that I’m probably going to get fat not running and eating Christmas candy.
I went to physical therapy at Hospital for Special Surgery today. I know – chiropractor + PT?!? I thought I was over-doing it, too, with my “multidiscplinary approach” to my injury management. I wavered on not going (maybe I could look stuff up myself?), but, in the end, thought of my “plan” as follows.
I need the chiropractor for the “now.” Dr. Levine helps keep my pain at bay (by inducing more pain with Graston/ART?) and re-adjusts my ever moving SI joint, which, after adjustment, leads to almost immediate relief of all of my symptoms. Plus, he works me in last minute and such.
However, seeing as I can’t get my SI joint adjusted and IT band manually dissected ever day, I need a physical therapist to help me develop the proper strength to keep everything from falling apart. The physical therapist is for the “later.” Although I can look up stuff myself, I do need expertise to make sure I’m not missing something plus authority to make me do the actual exercises.
As suspected, I have horribly weak hip a-B-ductors, as evidenced by me not being able to keep my pelvis in a even plane when walking up and down stairs. In turn, during the stance phase of running, my hips don’t have the strength to counter balance internal rotation of the femur, causing excess strain on the IT band. Plus, my glutes don’t work well, or something like that. Sorry for the horrible explanations, this is all from memory.Further, she was able to explain to me why my medial most hamstring would be feeling as if it was pulled. Basically, when my SI joint gets all dysfunctional (moves inappropriately), my left hemi-pelvis tilts backward, causing excess pull on many muscles, including the one in which I feel pain.
Walking around the physical therapist’s office, I felt sort of, well, lame. There was a girl next to me with her ankle externally fixed and another working on neck control. I felt sort, I don’t know, like a whiner complaining over some pain that was keeping me from running.
I mentioned to the PT that I felt sort of bad being there seeing as “my problems really weren’t that bad nor acute or severe.” She immediately legitimized my problem telling me, “No, this is bad! I’m a runner. I know this sucks horribly and you miss it.” This made me instantly feel better and I went off on my merry way to the pool, happy as a clam.
It was then, after my pool sweat sesh, that I realized I had been PPS-ed. In PPS, they teach us this “PEARLS” mnemonic in an effort to remind us of how to build rapport with patients. You can achieve a good doctor-patient relationship by using your “PEARLS.”
p = partnership
e = empathy
a = apology
r = respect
l = LEGITIMIZING
s = support
We used to make fun of “PEARLS” a bit. But, homeslice PT totally made me feel better by using “L,” legitimizing my physical pain and emotional pain of not running. Snaps to her.
I can’t believe I fell for the PEARLS. I guess they do work, after all.
Of course, I asked the PT when she thought I could run again. Instead of giving me a promised time frame, she told me that I have to be able to do 3 specific exercises with good form and control. The three exercises are specific to my problem and, if I’m able to do them correctly, I should have relearned the correct neuromuscular control in order to run.
For some reason, that made me satisfied. The whole “go by pain” thing hasn’t been working too well for me, as I think pain is too subjective. I have a hard time knowing if the pain I’m experiencing is legitimate or not enough to warrant a problem. I’m ok tolerating some pain, which isn’t going to help my injury.
I did ask her if she thought I’d be able to run by the New Year. She said I should be, but come to think of it, I didn’t specifically state 1/1/2012.
I also asked her if she though I had a torn labrum, stress fracture, or impingement syndrome. She said probably not, but if things are better in a month, we’d go to imaging.
Lord, I hope I can at least social run in a month!
Finally, before I go, if you think you’re tough, go watch this video. Here I was complaining about walking 3 miles, and Beth persevered through 20 miles of walking during her 100 mile race.
CHIME IN: What do you think of Beth’s video? (I ran in her pace group in my first marathon) Recognize yourself ever being PEARLS-ed by your doctor? Been to physical therapy and/or chiropractor an had success (you better say yes)?
Until next time…