American Academy of Orthopaedic Surgeons, Bride of Frankenstein, Health, Heidi Klum, lower back pain, Orthopedic, Pelvic floor, Physical therapy, Transversus abdominis muscle
Well, what do you know about that? Herewith, the cause of all my back trouble:
One of my legs, the right one, is shorter than the other by about, oh, one centimeter, according to Dr. Amanda Miller, my physical therapist. That’s almost a half-inch, isn’t it?
No wonder my back had me in the throes of agony.
A reader commented on Part I of “There Was a Crooked Woman …” that she’s in the same predicament, and has heard the situation is not unusual.
That got me thinking …
According to the American Academy of Orthopaedic Surgeons, limb length discrepancies, as they are called, are not at all uncommon in the general population. The AAOS website references a study of 600 military recruits. Thirty-two percent of them had a one-fifth to three-fifths-inch difference between the lengths of their legs, a “normal” variation.
Isn’t this, like having flat feet, the sort of thing that disqualifies one from service? You can find a list of medical eliminators on the Military.com website. Apparently, crookedness can indeed keep you home. There it is, in the section on Lower Extremities:
(2) Shortening of a lower extremity resulting in a noticeable limp or scoliosis.
I remember being checked for scoliosis when I was a child; fortunately, I was spared that malady. But I never thought I had a limp until a clerk at our dry cleaners chastised me for dragging myself into the shop one afternoon.
“You’ll have to step livelier than that!”
“Well, I can’t step any livelier,” I said. “My back is killing me. And you know what? I’ve just come from seeing my physical therapist. She says that one of my legs is shorter than the other.”
“Honey, I could have told you that. You limp.”
Interesting. Someone I see twice a month, at best, had noticed what neither I nor my husband could see. I have a limp.
So much for my dreams of slinking down the runway during Fashion Week.
I have a theory about why one leg is shorter than the other. (Notice how I have yet to say, “One leg is longer than the other?” Typical. I must learn to accentuate the positive.)
Anyway, the theory: My left leg is taller now because I broke it several years ago. Slipped on the ice on my driveway. When I was single. On Valentine’s Day. Should have had a blog back then.
The break was at the knee, a “tibial plateau fracture,” the orthopedic surgeon called it. I was in the hospital for 18 days.
At the time, no one told me that because of all the hardware in my knee, I would be gifted with an extra half-inch in addition to the thrill of TSA pat-downs whenever I trigger the alarm at airport security.
The thing is, the dimensions seem off to me. I have actually lost height over the years. Where I was once a leonine five feet seven and one-half inches, I am now, on a good day, five feet six. Where did these inches go? Oh yes. Never mind. I remember. Next subject.
We’ll explore the wonderful world of osteoporosis and osteopenia in a future post. And maybe, if I’m feeling brave, the weight gain that comes with being an incredible shrinking woman of 55.
For now, I want to tell you that after several sessions with Dr. Miller, I was feeling much better. The first thing I learned from her—and perhaps the most valuable—was the importance of “engaging my core.”
I’m something of a sloucher. It’s true. And what with all the transitions of this whopping big year, I allowed the modest exercise regimen I enjoyed in Ohio to fall by the wayside. One year of no exercise—save walking the dog, trudging up and down the stairs, running the vacuum, and, ah, getting to know my new husband better—will wreak havoc on the body’s vital systems. In my case, the skeletal and muscular ones were in pretty shabby shape.
Being in such pain, I couldn’t just jump on the nearest treadmill. I had to begin gently, and from within. The first set of exercises Dr. Miller assigned me were a dream for a phys-ed slacker such as myself. She taught me how to “set” my TA, or my
For those of you playing along at home, here’s what you do to “set” your TA:
- TAKE A NORMAL BREATH IN, AND A NORMAL BREATH OUT.
- AT THE END OF YOUR EXHALE, SLOWLY AND GENTLY CONTRACT YOUR PELVIC FLOOR MUSCLES.
- HOLD THE CONTRACTION FOR 2-4 BREATH CYCLES.
- RELAX AND REPEAT 10 TIMES IN A ROW, 3 TIMES PER DAY.
The best positions in which to practice this, progressing from the easiest to the hardest, are:
Hooklying (on your back with knees bent)
Sidelying (practice lateral rib expansion with inhale in this position)
Prone (practice belly very gently rising away from the mat, NOT pushing into it)
There are several “muscle cues” one uses in order to engage the pelvic floor:
Imagine slowing the flow of urine
Imagine yourself drawing in a tampon
Pull the anus toward the pubic bone
You definitely should not hold your breath. And you should not see your tummy bulging, your belly button moving dramatically, or your ribs popping up. Dr. Miller’s image, which I like very much because it involves food, is to think of a bowl of cereal on my abdomen. Under no circumstances am I to tip that bowl of cereal. After several days of setting my TA, applying ice to my back, and taking the anti-inflammatory pills Dr. Miller asked my other doctor to prescribe, I was beginning to feel better. I was walking, if not like Heidi Klum, than less like the Bride of Frankenstein.
Next Monday, Dr. Amanda Miller of Progress Physical Therapy will be the inaugural guest on “The Midlife Second Wife’s” newest feature: MONDAY MORNING Q & A. Stay tuned!