Broken pelvis update

[CHT]

I am about 4 months out from having broken/compressed(?) my pelvis. I am surprised by the pain/discomfort I am still in. I sleep like a rotisserie chicken - constantly changing sides.

The horse that bucked me off is leaving today - we aren’t offering year round indoor board any more and she wants a stall even in the summer. It is a good thing - she is (and has been for years) afraid of her horse, and I was feeling I had to cater too much to keeping her safe. I have started doing obstacle stuff (in hand, because that is all I can do), and I always had to hide the things so her horse wouldn’t be too spooky for her. Now I can leave them up or in the corner.

New beginnings. Changing the barn focus - schooling shows, cross country schooling, obstacle days, working equitation, trail rides. If/when I can run again, I am going to show my pony in showmanship. New things to re-energize me.

Started a few new students. Took on a beginner. I haven’t taught a beginner for years. I used to run beside them for the first trot…now I have to lunge.

Standing or sitting for more than a few hours is uncomfortable. Almost couldn’t make it out of Walmart the other day. I am not sure if this is normal. My physiotherapist can’t answer that either: how can you have a normal when there is no precedence for a torn pubic synthesis not needing surgery? Maybe I need to ask what pain levels are normal for someone who had surgery? It’s hard - if I take it easy, lay down or spend time in the recliner through the day, I feel ok physically, but not mentally.

It’s a process. I need patience. I just wish I had more answers, but the answers aren’t there. SO on the one hand glad I avoided surgery. Glad I avoided a three month hospital stay. But not knowing if what I am feeling is “normal” or ok is harder than I thought.

And I still can’t wear regular pants.

[jaj]

CHT,

Ihave been following since you first started writing about your accident. It seems to me that you have made great progress both physically and mentally. Your posts in the beginning were, quite rightfully, filled with the difficulties in the present and fear for the future. I am guessing your pain was horrendous, but also I think you had lost your concept of self in relation to horses. (I am not even an armchair psychologist, more like a footstool psychologist, so take my observations for what they’re worth.)

What you post now seems so optimistic in comparison. It’s like transitioning from winter to spring. Your plans sound great, and were I closer, I would sign up for some lessons. Congratulations on all the sunshine that has returned to your life. I am rooting for you.

Jeanne

[iberianfan]

I am with @jaj. I’ve been following and think you have done remarkably well. I don’t think I have your strength. I also like your new directions. Sounds fun.

But I want to sympathize with your physical limitations. I have very similar issues but mine come from arthritis virtually everywhere. Just recovered from a second hip replacement, but standing kills my back,walking hurts my back and knees. A day of rest helps, but depressing. I don’t know if what you are experiencing is normal. But be patient. Keep up PT and do what you can. Allow yourself to have a day of rest here and there. You had a life changing injury. You’ve come so far in just 4 months!! You are astounding!!

Look back again in a month or so and see how far you have come!!! Listen to your body. If it hurts too bad, rest. Use the handicap carts in the big stores. Wearing yourself out in Wal-Mart means no energy for what you love. Or use a cane if it helps.

I just admire the heck out of you. I think you are doing super.

[Christa_P]

Not my pelvis but I blew something in my knee when I jumped off a horse/ did an emergency dismount. Landed on my feet, went to take a step and something snapped, to me it sounded like a gunshot went off.

I didn’t go to the doctor, but I hobbled around on it, used knee braces or wraps and it took over a year for it to really feel better. The injury was in 2013 and the knee is pretty much normal now, but it took TIME.

Think about how long a horse can be on stall rest with a soft tissue injury.

[Simkie]

I had my pelvis broken on purpose, in a controlled, surgical manner, where every goal was to preserve function.

While I was off crutches at ten weeks out and cleared to have the screws removed at 6 months, it still took a lot of time to feel “normal.”

Four months is so little time to heal. Especially after something like a traumatic fracture. There’s still so much improvement yet to come. Be kind to yourself, and give yourself some grace

Are you still in PT? If you’re not feeling like PT is moving you in a generally forward direction, don’t be afraid to try someone new. Manual therapy in particular can be SO useful but it really takes someone good at it.

[CHT]

Ouch. Yes, I think I am glad to have avoided surgery! Thank you for sharing your experience. I am still in PT. Every three weeks. I think it is helping, but I also realize I need to take better notes on what causes pain/discomfort. I think I will remember, but I don’t.

Standing and sitting, for example, don’t hurt themselves, but I think they still make my pelvic floor work to hold up my organs, so I need to recline/lay down to give them a break, otherwise I hurt later on. My seat bones, for example, hurt right now - I just finished teaching a lesson and lunging two horses. I felt ok doing it, but now it hurts. I need a recliner in the barn!

I am going to try using a yoga ball to sit on as needed when teaching to see if that might help.

[Simkie]

So at four months, I was still in PT twice a week. And needed it. Is insurance driving your appointment schedule, or can you be seen more often?

Is your PT really well versed in hip instability? I’d think someone who specializes in EDS patients would be a good fit. Or, someone who really gets into traumatic childbirth rehab. It just wasn’t that long ago that cutting the symphysis was an alternative to c section.

Are you tossing and turning because lying on your side is painful? Greater troch bursitis? Manual therapy at PT can make a world of difference there, but so can aggressive icing and aggressive use of Voltaren gel. Supporting the upper leg when lying on your side is also so important–not just a pillow between your knees, but all the way to the ankle. A nice thick body pillow (or one of those u shaped pregnancy pillow, if you have room in bed!) can be so helpful.

In a lot of ways, what you’re facing is so much harder than my big surgery–my trauma was all controlled, and my pelvis went from unstable to stable. You had an uncontrolled trauma that took you from stable to unstable. There’s healing, and then there’s all that muscle re-education on how to stabilize when the bony structure isn’t. That A LOT. A really big deal. And it’s brutally unfair how connected the pelvis is to everything else

[CHT]

The PT is a pelvic floor specialist, so we are doing internal massage/stretches.

We don’t have insurance to cover PT, and as I didn’t get surgery, I don’t qualify for hospital PT. The every three weeks was suggested by the PT. We would pay for the extra, but not sure if it would help? They do keep suggesting icing, but so hard to ice when it is cold in the house!

I get uncomfortable on the right side, but can’t sleep long on the left. On my stomach feels better, but can’t stay that way long. Things just crunch. I have a knee pillow, but I will try using more. I have to put Diclofenac on my shins because somehow I keep pulling the tendon that runs along the front.

[Simkie]

Does your PT work on strengthening the big hip stabilizer muscles? Glute med, glute max? Does she do any manual therapy on those muscles?

Alison Grimaldi has some great info on greater troch bursitis (which is really so much more than just inflammation of the bursa) that might help:

Blog

Pelvic floor PT is a great thing to do, but a PT focused on building overall stability could also be really helpful. Maybe worth a consultation at least?

[CHT]

Keep in mind I wasn’t on bed rest for long, so I don’t need as much therapy on the external muscles. it is the Pelvic cradle muscles that are giving me grief. They get tired of holding up my organs it seems. Really hard to assess, as we have limited access to them, but they are less contracted now.

She has given me exercises to do to work on other muscles, but they are weak, not in pain or tight…I just miss my core muscles.

[Simkie]

Unfortunately, weakness in the bigger muscles mean the smaller muscles are recruited to attempt stability. And while they’ll try to do that, it’s not their job, and then they complain. I hear you–it seriously sucks how connected the pelvis is–but you cannot separate out the core muscles vs everything else when you’re unstable. It’s all involved.

An issue with greater troch bursitis does point to an issue with the glutes.

[CHT]

yes, I agree. Trying to work on them. Need to inflate my Yoga ball - I am going to try teaching from it. I need to find more time for the exercises she gave me.

I need to prioritize myself for a bit longer - I think I got ahead of myself taking on new clients (although the new people are fantastic!). We aren’t going to take new boarders other than a friend that is bringing her horse Feb 1. She helps ride one of my lesson horses in training, so having her here will be a help. It’s both hard, and kind of nice to be down two high maintenance boarders, and a third leaves end of the month.

[skydy]

Thinking of you. Take it easy on yourself, OK?

[CHT]

I went snowshoeing today! Just in our back field. It is hilly, and the snow is deep, but it was good! A little sore now, but I think it will be a good outdoor activity for when weather is nice.

[CHT]

Minor update.

Overall going well, but I still can’t run. Even just a few test runs (20 meters) leaves me incredibly sore by the time I go to bed. Need to discuss in physio next visit. Also sitting on a yoga ball causes pain later that day.

Anyway, it looks like my gelding sold. Got the deposit today, waiting on a cheque and hauling to be arranged. It sounds like a fantastic home, but I am still mourning the loss that his future endeavors won’t be with me. I will miss him.

Bucky horse owner left on Jan 15th, but she wants to come back for a visit to watch a barn friend ride. How do I say it is too soon (or more so the timing is bad with my horse selling, which I know sound stupid)? Or do I suck it up? Stupid or not, I do resent her for the fact I have to sell my horse in this manner…but I don’t want her to know that.

[jaj]

I think that from a purely business standpoint, you let her come back to watch her friend. I know your business model is evolving, but I think that you shouldn’t burn bridges. Do you have to be present?

[candyappy]

@CHT

Bucky horse owner left on Jan 15th, but she wants to come back for a visit to watch a barn friend ride. How do I say it is too soon (or more so the timing is bad with my horse selling, which I know sound stupid)? Or do I suck it up? Stupid or not, I do resent her for the fact I have to sell my horse in this manner…but I don’t want her to know that.

You let her come and watch her friend. While it is awful that you have to sell your gelding, you willingly hopped on the horse and it is not her fault that your life has been turned up side down. It is just what happens with an accident-- especially when horses are involved.

Nothing will change what you are dealing with but harboring ill will won’t be beneficial to you at all. Move forward and keep improving as you have been doing and hopefully one day you will be physically able to have another special one to bring along.

[Simkie]

@CHT

Overall going well, but I still can’t run. Even just a few test runs (20 meters) leaves me incredibly sore by the time I go to bed. Need to discuss in physio next visit. Also sitting on a yoga ball causes pain later that day.

Have you gotten a few additional surgical opinions? Is surgery something you would consider? Have you been reassessed for overall pelvic stability by an orthopedist since getting through the initial healing period?

You’ve had such a major trauma to your pelvis, I’m honestly surprised anyone would clear you to run. It would be worth going to see a couple of the best docs in this field you can find to get an opinion on how you’ve healed and if you’ve regained enough overall pelvic stability to do the things you want in life. I’m really sorry things still don’t feel great

[CHT]

These are all great questions. The orthopedic surgeon just said “If it still hurts in a year, come back”, and “don’t do things that hurt”. The problem is that things don’t hurt in the moment, it is just well after, and not always in the same place. They do feel it is very stable bone wise. I don’t honestly know if there is a way to check the cartilage. I see physio on Tuesday so will ask her, and what she can’t answer, I will ask the surgeon via email.

I assume it is connective tissue that is still an issue. Maybe things didn’t re-attach? The consensus among people I have since met with similar breaks (but had surgery) is that I am expecting too much. Surgery could still be an option if needed I suppose, but it’s three months in the rehab hospital…yikes.

Looks like my horse might be leaving tomorrow. The kid getting him is very excited. I hope he is as good a boy for her as he was for me. I am sad to see him go, angry that this is how our story ends, but glad it is ending with him going to a great home.

I still need to find a home for my mare, but have a great rider for her in the interim.

The next part of my journey is addressing my neurological issues. I have a feeling it is going to take a lot of my energy and focus.

[CHT]

She wants to come watch a lesson. I think now that my guy is sold and will be gone, it will be ok. It was just in the middle of his trial/PPE/offer, I was getting a little stressed/emotional. It also seems super soon - although we left on good terms and have been messaging each other a bit.