Hello! My story and a question about getting back to exercise

Hello! I’m new and am really open to the idea that, although I had structural issues, my secondary, lasting pain has been caused by TMS. My background-- in my late thirties, I was in really good shape, but had scoliosis that was worsening I decided to undergo a 7-level fusion 3 years ago.

After the surgery I had an acute nerve pain on my right side, but knew that nerves sometimes took a long time to heal after big surgeries so I just tried to be patient. My nerve pain was near my spine and caused me great difficulty sitting. It prevented me from doing much of the exercises I had really found to be helpful and enjoyable before my surgery. I slowly improved a bit each year, but a few weeks ago, I decided to had a second surgery to remove some of the hardware from my back. My hope was that if I could get rid of that nerve pain, I could finally return to exercise and treat the secondary hip issues. The surgery went well and the recovery has been going well.

So for my secondary issues –these include a painful snapping hip on the right side and psoas problems-a lot of glute/hip pain made worse by sitting on soft chairs or doing certain exercises. No matter what I tried (after first surgery) I could not return to my level of activity before the surgery.

For the past three years, although I kept the ideas of TMS and MBS in the back of my head, and read a lot on mind-body connections, I felt compelled to explore all possible structural problems that were going on as I knew that it wasn’t uncommon to go through pain in recovery. Some of my issues didn’t fit with TMS necessarily, but others definitely do. I had a painful childhood, my mom had MS and died when I was an adolescent and I’m a sensitive person in general. But I’ve been in therapy for years and the past month I’ve gotten back to journaling. As my therapist and I joked in terms of repressed emotions, there’s not too much more lurking in the attic. I think it’s more a “fear of pain” issue at this point.

After my first surgery I think I returned to physical activity too soon and it caused major pain which in turn made me fearful and more stressed, etc. I attempted to go back to activity in different ways—at first in a work through the pain and “pretend nothing is wrong” way and I felt like I kept reinjuring myself and it kept setting me back. Then I tried baby steps which were more successful. But ultimately I just kept plateauing.

So my question -- I feel that removing some of my hardware was a good idea and am eager to rebuild my body and life, but what can I expect as I try? I’ve read that snapping hip and psoas problems can be MBS because they are essentially tension issues. Im working on reducing stress, but I know it will always be around in some form or another as it’s just how I’m wired. I guess I just don’t want to be in the same situation I’ve been for three years where I’m going in circles and flaring my self up each time I kick it up a notch. Part of that could have been the hardware in my back, but I believe, too, MBS has played a role. And I guess I just want to become active again without a big setback. Hope that makes sense! And if you made it this far, thanks for reading this, I know it was long.

 

Hi Livlive!

Welcome to the forums! It definitely sounds like some of the issues you're experiencing now are TMS, this is common after a surgery or accident. Since your surgery was 3 years ago you're certainly healed by now, though I could imagine that some of your motion is restricted a bit due to having a 7 level fusion. "snapping" hip (i assume you mean the sound of popping?) and psoas tension are almost definitely TMS at this point. As for activity, work on ramping up slowly and steadily- don't push through severe pain, at the same time try not to be overly cautious or "baby" the sore muscles, if that makes sense. Hardware at this distance will mostly restrict motion, shouldn't be painful. Let me know if you have questions!

 

Thank you so much, MindBodyPT for your thoughtful response and for wading through a long post.

Yes, the snapping hip does come with a popping sound--it's around the illiopsoas/ hip flexor area. For me it's like a nerve gets painfully trapped in the hip/glute muscle and then the hip "snaps or pops" and releases it. I have read it can be the tendon getting caught over and over again and it's different than just a hip joint popping I get those normal pops but they aren't painful.

I saw a sports med guy who thinks it was tied up with the back issues. He said I could also have a labral tear, but he didn't want to do exploratory surgery (nor did I want one) because he said either way his advice would be rehab and ice, etc. But I've not been able to fix the issue and it gets worse with exercises and with sitting on squishy couches without back support. I connect it now with not being able to relax my psoas.

I did see a post for newbies that really resonated with me. Alan Gordon's video that described the difficulty in accepting the diagnosis. That's definitely something I'm trying to wrap my head around as I'm in pain when I do certain activities so I connect it with them! My hip/glute swells and it starts snapping more frequently (I once just tried to go for a run a year ago and I was in debilitating pain for days). So I think I kept thinking "there's something going on here".

Do you think in some cases you can get an acute injury (in my case, I might have initially messed up my hip going to the gym too soon after my surgery) but then instead of healing on a normal course you develop TMS as you are predisposed to it (and the pain itself is traumatic)?

 

Yes i definitely think this is the case. Many people develop TMS pain after a "real" injury to an area. Remember the physical tissues have likely healed after this long of at time but the pain and swelling could still persist as TMS symptoms.

Also recall the idea of conditioning, that the swelling or popping could be happening as a conditioned response to certain movements. Popping and snapping aren't problematic and its impossible to say exactly where they come from. All of us have joints and areas that pop, crack and snap without pain, I know I do in many areas.

 

Thanks, that makes a lot of sense to me. It's very easy to get trapped in a fear/distraction cycle after a physical trauma I think. Still trying to work on letting myself know I'm safe now and I can move forward! Thanks again for your thoughts, MindBody.