The Case of the Tilted Pelvis (a.k.a The Leg Length Mystery)

Pretty much since I got off crutches I have had a tilted pelvis or a leg length difference.  Or a titled pelvis caused by a leg length difference.  Or a leg length difference that causes a tilted pelvis. Or something. The leg length difference, it should be noted, can be structural or functional.  And even if it is structural, many people have leg length differences and walk normally.

This seems to be the last hurdle to (at least) appearing to be back to 100%.  It is not completely noticeable to everyone but it bothers me and somewhat makes me walk with a strut.  Struts are cool if you are the strutting type but I am cool enough to strut.  I know I will have some ongoing aches and pains from this injury for a while but for some reason it is important to me to look healed and move around like a healthy person.  I want to feel solid.  Strutting makes me feel wobbly.

If I were in a black exploitation film, I would be cool - those guys had cool struts.  If I were in a music video for the KISS song "Strutter", I would be cool.  If I were Sherlock Holmes, I would be cool with a strut.  But Sherlock Holmes would be cool in wheelchair.  He is just plain cool.  Alas, I am not a revered detective.  I am not a doctor.  I am not a nurse.  Or a PT or a trainer.   I am not even a musician or an actor.

I am just me.  With a tilted pelvis.  And I would like to fix it.  And it appears this is easier said than done.  And not just for me, the approach to resolve it varies - so I am confused.  Internet research and the like reveals multitudes of resolutions, all of which are not definitive, to say the least.  Perhaps because of this my recovery is at an impasse.  Perhaps I am unsure of how to proceed.  Perhaps I am wondering if I will be like this all my life.  Perhaps I am worried.  Perhaps. Perhaps.

I think the best way to figure out what to do will be to take a Holmesian approach and use some deductive reasoning.  Maybe I, you might wonder, should have done this before.  Maybe a more astute person would have acted in this manner a long while ago.  As I said, I am not Holmes.  Just me.  With a titled pelvis. 

Well at least it will be healthy to lay it all out and stick with the facts.  Even then I am not sure we can solve it.  But some mysteries do go unsolved.  Some take time.  Some go away and come back.  Maybe the tilted pelvis is my Moriarty.  It is my nemesis.  Maybe it will help me get into acting.  Maybe it will be a source of fodder for years to come.  Maybe I start wearing makeup and singing songs like "Beth".  Well let's see.

As many may know, deductive reasoning has 3 steps:

• Premise
• Evidence
• Conclusion

I will try and focus on the facts and as much acute observation as I can.

Here is what I know.

Premise:

1. I don't have x-rays of my hip position prior to the accident.
2. It was caused by broken left hip, caused my a fall off a road bike onto some railroad tracks.
3. It hurt like hell.
4. There were 3 screws drilled into my left femur to reattach the hip socket.  The surgery was deemed a success.
5. The bones fused back together in about 8 weeks.
6. I was on crutches for 9 weeks, forced to put all my weight on my right leg
7. I walked with a cane for 2 more weeks where I still wobbled around with more weight on my right leg than my left.

Evidence:

1. I walk with a limp.  The limp is not as bad as before but nonetheless a limp.  Also known as the aforementioned strut.
2. My low back hurts sometimes.
3. The surgeon confirmed in the x-ray that my pelvis is slightly titled.  He noticed that one leg is longer than the other. 
4. A chiropractor did their version of the leg length test and confirmed one leg is shorter than the other - according to her test.
5. I can stand straight up with legs together and align the pelvis but it isn't a natural position as it once was.
6. Stretches, yoga, and mobility exercises help.  I think.  I think little by little there has been improvement.  I think.  Some positions are better.  Some are not.
7. Strength training helps.  There are brief moments after a session strengthening my legs that I feel normal.
8. Swimming helps.
9. Biking sometimes feels good.  Sometimes it doesn't.

Conclusion:

The results, I think, are inconclusive.  None of the tests are definitive, except the x-rays and the way I have received x-rays thus far are of a limited view.  The chiropractor test, by their own admission is also inconclusive.  I could get another set of x-rays to do a measurement of the femur.  But that may not even solve the problem.  Because what I don't know is when it got longer.  The accident could have caused it OR I have always had it.  In the case of the latter, my body should eventually know how to straighten itself out.  And I can, with some difficulty, even it out.

Well there you have it. 

A trained logician would probably cringe at the above analysis but that's it.  I was partially hoping that this exercise would reveal something new.  The process of writing these blog posts is an introspective task that often tells me something about myself.  Maybe this didn't reveal anything new.  Maybe it told me what I want it to tell me.  Maybe I need to get into acting.

So what do I do?

I suppose I keep doing what I am doing and give it time.  There is a theory among some body work practitioners that the body will go into certain states to protect itself.  My body leans onto the right leg because the left leg hurt and to some degree still hurts.  So the tilted pelvis has caused a leg length difference because my body is doing its best to avoid pain.  That is what it has known.  I can do as much as I can to change that but until the body feels it, I am going to have some tilting.

I could also try some PT.  After not ever getting PT, the surgeon finally recommended it at my last appointment a few weeks back.  He said the PT could, "Stretch you out."  That's a definitive conclusion, huh?  Aaah, surgeons, you have to love them.  Yes, I love them like I love a car mechanic.  Or the dentist.  I am beginning to view doctors like I view death and taxes.

I could also try some other body work like Rolfing or Feldenkais or Sourcepoint.  I for sure will do some of this because I have a friend who is a Sourcepoint practitioner.  But this goes to the above premise that when the body is ready, it will allow it to be reset to its original patterns.  I don't know when that will be.

In all likelihood, I am going keep doing what I am doing until the pain is gone.  If the titled pelvis is still there, then I need to try a new approach.  I may dabble with PT just to see what they say but I am pretty confident what I am doing is better than what any PT could give me.  My apologies to my PT friends out there but their hands are tied and many of their methods are dated.

So where do I go?  I guess I trust myself.  I know many readers have heard it before.  To that, I had a dream recently where I was in a boat with my personal trainer and we almost tipped over several times.  And then he righted the boat and we sailed along smoothly.  Does that mean he has the answers?  Is the boat my body and he can help me balance it out?  Is he my Dr. Watson?  Is my intuition talking to me?  God only knows.

So I guess the mystery continues until new facts surface.  Moriarty The Tilted Pelvis and I will play a ongoing game of cat and mouse.  The mystery will be solved in one way or another.  It is just a matter of when.  Until next time...

Check back soon for more of The Case of the Tilted Pelvis...

Thanks for reading...

Women

I have been thinking a lot about my favorite author Charles Bukowski.  That might say something about me, if you know Bukowski.  For those of you that don't know Bukowski, he was a poet and author whose prose centers mostly around himself using an alter ego named Henry Chinanski.  The stories extoll Chinanskis’s ups and (mostly) downs in the underbelly of Los Angeles.  

Bukowski has a ton of poetry, and is perhaps more well-known and respected for his poetry than his prose but his novels are essentially memoirs of his life - which make them interesting and provide the reader with a sense of realism.  This is not life in suburbia with a few kids and a minivan and private schools.  This is world where the next few bucks to buy the next drink is the most important objective of the day.  It is a rough and tumble world where death or serious bodily harm is possible every day.  It is survival of the drunkest.

Chinanski, like Bukowski, lived in the bars, horse tracks, liquor stores, and shithole apartments of society as a boozer with little ability to hold down a job or have any meaningful relationships. When he does find stability of sorts, he works for 10 years in a soul sucking job with the US Postal Service, which provides the content for one of his novels, Post Office.  This period, coincidently, corresponds with a 10 year absence from writing.

Bukowski's novels take their way through his life, from his youth in Ham on Rye with an abusive father and various self-esteem killing ailments - including a nasty bout with boils, to the latter part of his life when one of his books is being made into a movie in Hollywood.  If you are wondering, the movie is called Bar Fly with Mickey Rourke.  A few years ago, one of his other books, Factotum, was also made into a movie with Matt Dillion. His last novel, Pulp, was written shortly before he died.  Amazingly he made it to age 72, original liver still intact.

For me, one of his most revealing novels is called Women.  This takes place after Chinanski (Bukowski) has achieved some literary success and is getting more and more interest from women, including ones quite a bit younger than him.  What you come to learn about the author and his exploits, is that even with all his flaws and poor choices, he is strangely a romantic.  He has a deep love for women, with all their complexity, quirks, emotions, problems, and flaws as well as their tenderness and beauty and empathy and sexuality and love and care.  He is after all a poet at heart.

It is probably hard to believe - given that articles have been written about how to never date a Bukowski fan or that he is a misogynist - that he really wants and needs a woman in his life.  He wants to be cared for.  He wants routine.  He wants more than a hangover and another juicehead sprawled across his floor with little recollection on how she got there.  He just doesn’t know how to help himself.  Bukowski is certainly not perfect and never claims to be – and that is why he is so refreshing.  He doesn't treat women as well as he should and never fully shows remorse.  In reality, nor do most men.  I, as a man, certainly should feel worse for my misgivings with the women in my life.  It is not that I don't have them, I just don't show them.  I don’t know how to help myself.

Eventually Bukowski stayed married for the latter part his life and finds some peace but it was a broken, wet, and downright dirty road to get there.  But even that relationship had its rocky moments.  Surprisingly, he also had a daughter from a previous marriage.  The thing I like about Bukowski is that he is able to admit that he, the woman, and his relationships with them are imperfect.  They are real.  And real is messy.  But you just survive another day, hung-over or not.  He was once quoted as saying, “You have to die a few times to learn how to live.”

I think one of the reasons Bukowski has been on the forefront of my mind is that I believe my accident has changed me.  It is not that I want to see where a bottle a day can take me, it is that my interaction with people is different.  Perhaps it has to do with how I see myself.  Maybe it is what I see valuable in friendships, in conversation, in interpersonal contact.  And a big part of that has to do with women.

If it weren’t for women, I never would have recovered, physically or mentally.  The paramedics were women.  The nurses at the hospital were women.  The PTs and dieticians and Pilates instructors were all woman.  The physician assistant is a woman.  My sister.  My mom.  My aunts.  My wife.  My daughter.  My mother-in-law.  My nieces.  My boss.  My sisters-in-law - in particular my wife's twin sister. 

Did I mention my wife?  No one has carried and live through recovery like my wife.  She has had to endure more conversation about hips and pelvic tilts and avascular necrosis and limps and crutches and pain and canes and screws than she ever would have dreamed.  And she has never once not supported me.  She has attended every appointment and has lived it as if it were her own injury.

The only male directly involved has been the surgeon.  And side from the surgery, he hasn't done much.  There are only a couple of other males and those are the personal trainer and a coworker.  The personal trainer has helped greatly and if he lived nearby, I am sure I would spend a lot time speaking with him.  The coworker is also far away and in North Carolina.  But even by phone he has been great counsel and great support to me.  There are others but the interaction is far less frequent.

My realization of this internal change came as a part of conversations I have had with other writers and bloggers, all of whom are female.  I sat and had coffee with one friend and writer and had great, in-depth conversation.  I also attended a gathering with a group of about 6 other women and talked about everything from kids and parents to funny household stories. 

Before my accident I don’t think I would have ever even thought of doing such a thing.  Nor been in position where I would have even been invited.  Nor would I have enjoyed it as much as I did.  I enjoyed their depth of thought.  I enjoyed their humor.  I enjoyed their lack of airs.  I enjoyed their stories.  I saw what I had been missing.  I saw myself.

What I mean is that I enjoyed is their ability to convey a sense of reality.  These are moms with 2, 3, 4 kids, all under the age of 10.  Some have jobs outside the house.  Some don’t.  They are all, however, very busy people who are surviving in their own way.  No one has enough sleep.  The kids have a million activities.  Spouses travel.  Parents are getting old.  Budgets are tight.  Jobs are lost.  Kids have problems.  The furnace breaks.  In laws are pains in the ass.  Relationships ebb and flow.  On and on. 

But that is the beauty and color of life.  And one shows that better than women.  They feel okay with admitting that they, like Bukowski, have died a few times and found a way to live.  And that is comforting and inspiring.  And it is hopeful.  I feel that writing again and talking about life with women has helped me evolve into a better, more well-rounded person.  Unfortunately, I have about a million years of evolution to go before I catch up with the females of the world.

Just as you can tell from Bukowski’s work, the women in my life sometimes irk me.  Sometimes I think they are nuts.  Sometimes I want to go to garage.  Sometimes I wish I was alone in the woods.  But women have helped me recover physically and mentally better than any legion of men ever could.  And I now stand to have more friends who want to explore the depths of surviving life and children and love.  And if that happens in the cozy homes and coffee shops of St Paul, Minnesota instead of the mean streets of L.A., that’s okay.  Survival is survival, bottle in hand or not.

Bukowski never really achieved mainstream success until later in life and perhaps that is why his work always has a subtle undercurrent of hope.  And if I have learned anything from the women in my life is that hope is never lost.

So in honor of the women, I raise my glass.  Charles Bukowski would have it no other way.

Thanks for reading…

Recovery Intuition

Intuition is a funny thing.  We all have it.  Some believe it, some don't.  Some trust it, some don't.  Some have been brought to greatness by it, some have tumbled to disgrace.  Some see it as factual, some see it as subjective.

But really what is it and what does it have to do with recovery, injury, or illness?

In my opinion, quite a lot.  The Sherlock Holmes in me may disagree but Holmes never had to solve the case of his own body, did he?

Our good friends at Merriam Webster define it as "the power or faculty of attaining to direct knowledge or cognition without evident rational thought and inference."  Interesting.  Intuition is the "power" to get "knowledge" but it does not include "rational thought".  So intuition is not rational?  Perhaps.  But it does give you knowledge, right?  I am in agreement that it has nothing to do with thought.  If I could think my way to recovery, I would have been healed months ago.

Given all that, I think people should put stock in their intuition, and the intuition of those around you.  As I have said before if I had trusted my wife's intuition, I wouldn't be in this mess.  I probably never would have broken my hip.  She didn't want me to go on that ride.  She offered to pick me up half way through.  She said she had a "bad feeling".  I ignored her pleadings and didn't listen to her.  Now I can walk thanks to some metal screws holding me together.  Shows what I know.  Her intuition told her something was going to happen to me and I ignored it.  Well let's just say now when she says she has a bad feeling, I listen.

That's why I think intuition and recovery go hand in hand.  Intuition is a feeling.  Pain is a feeling.  Hunger is a feeling.  The only way our bodies can talk to us is through feeling.  And in some strange hokey way, it knows things before they actually happen.  I know that sounds a little far-fetched but there is something there.  So as we recovery we need to listen to the little messages our intuition tells us.  It is the only way to know if we are going in the right direction.

I recently debated about adding or replacing some kettlebell or body-weight exercises with some barbell exercises.  There was exercise in particular that is considered one of the best - the deadlift - and I thought it would be beneficial.  But the more I thought about it, the more I realized it it wouldn't be appropriate for me. I had this feeling I would get hurt.  And I wanted the feeling of throwing around some weight.  What I would get, though, would be another injury.  Barbells are forgiving.  Either you are in form to use them or you are not.  I certainly am not.  This time I listened.

Another time right before my wife and I got married, my wife was heading back to her apartment.  She was on the phone with her sister who begged her not to go because she had a bad feeling.  She listened to her sister and didn't go.  I went to her place a few hours later and found it had been broken into.  And this was 5 days before our wedding.  My sister in law - like my wife - has some crazy sixth sense intuition.  When they feel something, you listen.

And with recovery all we have to go on is feeling.  The doctors and therapists can make recommendations but if it doesn't feel right, then we need to question it.  There is a lot less science in recovery.  Yes scientifically they put screws in my hip to put the bones back together and then scientifically it did fuse back together.  But after that it has been all feeling.  By everyone.  The doctor has his feeling - probably influenced by experience as does the therapist.  The massage therapist.  the chiropractor.  The personal trainer.  Then we have our own.  Which is the most important.

Perhaps the only scientific fact left in my recovery is X-rays.  And even those are are interpreted through subjective lenses.  Sometimes the doctors see what they want to see and their intuition tells them to make a diagnosis or recommendation.  There is not a sure fire way to fix whatever is appearing on the screen.  We can get information but the information does not make the decision, a feeling does.  And if anyone says differently they are lying.

In the kindest of ways, people always think they know they way to heal us bruised and battered.   And sometimes they do.  Sometimes they don't.  And the amount of suggestions can be dizzying at times.  Everyone has an idea on how to help.  And I think people should explore as many options as they should but ultimately settle into the ones that feel right.  For me I could be doing other things but my intuition tells me to focus on some mobility and light yoga, strength work, and riding my bike.  That is pretty much all I do aside from a massage every couple of weeks and the occasional chiropractic adjustment.

I have thought about doing other things.  I have even ignored advice to perhaps not do as much strength work until after my pelvis is better aligned.  But that doesn't feel right to me.  I like the weight room.  I like doing pull-ups and dips in the garage.  I feel at home in these places.  And as much as I feel like I have changed, that hasn't changed.  I know where I belong.  Either walking perfectly or with limping with a cane.  I don't dislike the yoga studio but I like the weight room better. I like Pilates but I need something different now.  I like how I feel after doing what I have chosen to do.  I feel like I am going in the right direction.  I think.

So whatever your body is telling you, you need to listen.  And listen over time - because it changes.  If you are tired, listen.  If you are hurt, listen.  Your body can't speak so you need to listen to those little messages.  And though the dictionary says it isn't factual, I think it more useful.  Recovery facts are few and far between.  There is no law of gravity to abide by.  There is only the law of what we feel to be right at that very time.

All we have is what we feel.  It is what us makes us human.  So use the intuition to your advantage and to the advantage of those around you.  You get better and you'll get better happier.  As we manage our own care, we can't rely on tests as if we were testing the air temperature.  We have these finicky bodies that talk to us how they want to, not how our minds suggest.  Go with your intuition - trust your gut as they say, you'll heal faster.

Thanks for reading...