The medical saga continues...
At the beginning of the year, my orthopedic decided to send me to physical therapy; not so much for my benefit, but for his. He had done every x-ray and test he could think of and/or looked at all my past results, and was at the end of his rope. He hoped a physical therapist would be able to see something through regular visits that he couldn't in my brief appointments.
I finally started at the end of May and my last appointment was on Friday. And I don't want to get too hopeful, but.... well, I'm hopeful that this has at least pointed us in a certain direction.
Early on in therapy and after a bad week of flare ups, I told my PT my own theory, and it turns out I may have been a bit right: I told her my knee is a tired, cranky old man yelling at kids to get off his lawn, my ankle/foot is a middle child just throwing up flares, happy for any kind of attention, and my hip is a spoiled 5 year old, just throwing random tantrums with seemingly no pattern.
We worked through quite a few victories (the kind where I can move my leg that extra quarter inch or something didn't hurt quite as much as the week before) and let downs in battling flare ups, new or moving pains, not improving in a way that was very noticeable, or even going backwards in progress. It truly takes a special person to help patients like me celebrate something so small and not get discouraged by the rest of it. To constantly reassure me that even trying each exercise was a good thing, wether I was able to do it or not, and remind me that I may be able to do it next time. We distracted each other with stories or my teasing her awesome use of technical terms like "stuff" and "things" or reminding her of the one exercise that I got to use some weights.
A few weeks ago, we stumbled on a bit of a discovery. She manually "turned off" a muscle in the front of my hip and showed me how to do it myself, then showed me one for the pain in back. When I came in the next week, I told her that I was able to calm some flares in the front, but the back one was only good in the moment... then I told her that if I can keep the front fairly calm, it helps the back. She said that points to the iliopsoas, which was a theory of another doctor as well; my adventure in injections, but because of my reaction to the injections, the results were inconclusive.
At my last appointment, after she did her final assessment, I asked about her conclusions. This isn't something she usually does; her job is to treat, not diagnose. I asked because that's specifically why I was there. She started off by splitting the joints rather than trying to put them all in one box; my ankle is mostly just weak because it never had a chance and my recent injury (which I will be asking about, she got me out of the brace, but I still have a sharp pain where the bone chip is), my knee is old and rusty and can't compensate for the others, my hip is the problem.
Conclusion: The iliopsoas seems to be the problem, it's stuck in the ON position and can't turn itself off. It could be tendonitis, it could be the muscles or tendons (she threw some actual technical terms at me and I forgot them a minute later) around it are irritating it somehow, my weak glutes may be making it overcompensate, something deep in the joint could be causing a problem. So the problem area has possibly been narrowed down, but the cause and the why for the cause are still a mystery.
It's a small step (one of those quarter inch ones), but it's a step. If she's right, it's a definitive one that puts us on a more certain path. And that makes me hopeful.
