Last weekend I got sucked into climbing halfway up the Peak to play soccer with my son and his friend. I didn't realize the ascent would be so lengthy or so steep and it killed my knees. I was out of action for a week. It was just too painful to lie down or get up from floor exercises, never mind walking downhill to the gym.

I went to physio yesterday and got another double session. It was mostly massage on my lower back and right buttock to free up the spasm there. While that was effective, more interesting was our investigation and discussion of what makes my right hip click. It turns out that it's my "thick but weak" gluteus medius which is the source. It attaches to the iliac crest at the top and the (strangely named) greater trochanter at the bottom.

The first part of the massage freed up the clicking at the top of the buttock but then I ended up with two clicks (depending on the angle my leg was at) lower down! There just wasn't enough time for the physio to massage everything into oblivion but it turns out that there are some pretty good low-impact exercises I can try to help alleviate the problem. See eg:

http://www.bodyresults.com/E2gluteusMedius.asp
http://www.sportsinjurybulletin.com/archive/gluteus-medius.htm
http://www.aafp.org/afp/20050415/1545.html

The main thing is to "stretch, strengthen and massage", to break down the "thick" connective tissue in the muscle.

The physio also taped my knees but did it in a hurry and I felt no benefit and the tapes fell off after 12 minutes of cross-trainer in the gym afterwards. So now I have just shaven, painful, crunchy knees. Still, I learned 3 things:

(1) The gluteus medius is the one to work on.

(2) Don't walk up and down too many steps, as my knees and back work against each other still.

(3) Some knees tapers are better than others.

It's been a while since I've blogged but quite a bit of progress has been made.

Last weekend I went to physio and almost got a double session since my therapist was late and her next patient didn't show up. In that time, she was able to massage my right buttock to free up the clicking that had been bothering me for the last 2 years. I was really happy, because it confirmed the opnions I had been given that the clicking was not bone-on-bone but just due to a thickening in the ligament in my hip joint. This thickening doesn't go away but mobilising the joint should apparently give me back my normal motion. While the clicking returned by the end of the session >:, apparently lying / rolling on a tennis ball at home - my suggestion - will help achieve the same result.

The rest of that day I felt quite mobile, and it is amazing to see how connected my mood is to my physical comfort. I was inspired to run a few errands (laptop & camera) until my discomfort returned. With the humid weather - or maybe I'm just less worried about my hip - I find that the worst pain is now in my knees again. In addition, I am not sleeping any worse than before but my left shoulder pain and right hip pain means I need to roll over several times every night.

Another good hip exercise I was taught is to stand on one leg wth the other leg bent. You then compensate for the one leg my leaning against a wall using a beachball or similar as a cushion. You have to stand straight (face a mirror and watch your hip line stay horizontal) and basically you're using both hip muscles to keep yourself in that position. Stand there for a while, relax, and do it a few times. Switch to the other leg. The first few times I did this, I felt a good burn in the hips. Now I am used to the exercise, I don't feel it as much. One of the nice things about this exercise is that you can watch TV or talk to people while you're doing it, and you don't need to lie on the fllor or change into gym clothes.