Welcome Groupon Folks!

CONGRATULATIONS.  And Welcome to Rebalance Pilates Studio!

TO ALL NEW CLIENTS. GETTING STARTED:

-Call or email me your 2 best times and days that you would like to start a class or a private session.
-Reformer Class schedule is currently available below on my blog.
-Let me know if you have any orthopedic issues or concerns or if you have any movement limitations.
-Let me know your level of experience in Pilates; never tried it?, mat?, privates? group classes?
-All sessions are 55 minutes. Wear comfortable yoga type clothes, either bare feet or socks are fine.
-All ages and abilities are welcome.
-24 hour cancellation policy applies to all sessions.
-Precise directions to the studio entrance are on my website at www.rebalancepilatesstudio.com/location

Looking forward to working with you.

All the best,
Katrina Charmatz- Director/Certified Master Pilates Trainer
rebalance Pilates
#1 Alta Drive
Petaluma, ca 94954
707-694-8813- studio
Katrina@rebalancepilatesstudio.com

NEW !!! Pilates Reformer Classes

Mon.   Beg./7a, 8a, 10a,
Tues.  Level 1/5;30p, Level 2/6:30pm
Wed.  Beg/7:30am, 8:30a 10:30 , Level 1/5:30pm
Thurs  Level 1-2/ 6:30p
Fri.     Level 1-2/ 7:00am, 8a, 10a,

               $30/class for a 10 pack = $300
               $35/class for a 5 pack = $175
               $40/class drop-in rate

Beginner: Brand new to Pilates, work on foundation and essential concepts of reformer work. Learn to stabilize spine, shoulders, hips, legs and correctly engage abdominals during exercises.

Level 1-2*: Build on foundation work, adding more balance, coordination and challenge movements.         *Instructor approval req.

6 months Post Op.- November

Sean and I went to the South rim of the Grand Canyon and did a sunset hike down and back up. AMAZING. The weather was in the high 60's, but as soon as the sun went down, it dropped to about 30's-40's.  We hiked down about 2 hours (loose, dusty dirt, really need to look where you are going!!)

And about 1 hour back up. The way back up felt much better on my hip because I was really working it,

using all my hip and leg muscles. I was even running for the shuttle bus after the climb cause it was the last one of the evening. I was very happy and pain free.

4 months/October Post Op

I hiked Bolinas Ridge Trail in Olema, Ca in West Marin today with Sean and Uma. It was 4.6 miles and it took us about 2 hours. It is a wide fire road with lots of cow herds. We saw a coyote that Uma was very interested in, however, she wasn't so keen about the cows, preferred to hide behind her dad.

I've been working with Jack Burns,  a Sonoma County horse trainer, rehabilitating  rescue thoroughbred horses at a facility named GEVA in Glen Ellen, Ca.

http://www.jbequine.com/
http://www.glenellenfarms.com/geva/index.htm

Riding feels very good to work the muscles that are needed to ride with skill and sensativity. The gelding I'm riding is "Chunky" a chestnut thoroughbred 15.1 hands who has had some mistreatment or rough handling. He gets scared when going to the right on the lunge line, and while he like to be groomed, you have to approach him softly and gently as you start to brush him. Ive just started working with him so we are just getting to know each other. We are working on very basic Dressage techniques as well as getting Chunky comfortable out on the trail.

My riding feels much more balanced and I can give the horse a correct leg aids, cause I can move in my hip much easier. Feels really great to be back in the saddle!!

I've also, been trying to increase more cardio...life long challenge. So its swimming laps at the outdoor pool for 1 hour with flippers, the stationary bike for 20 minutes and the "Gauntlet", which is a  continuous stair climbing machine for 10 minutes (taking to breaks to catch my breath--it's hard!!) I am also starting to teach Mat Pilates class at Club One 1 x a week. Trust me... lots of abs and LOTS of hip work... :)

Hiking is sill part of the program... I hiked around Ross Lake for 3 hours. That was A LOT... need to stretch the hips, back and quads or else I get super stiff. I  have been shoveling mulch, weeding, so if i overdo it (which I tend to do) I will take an Aleve ( 1x a month) and get in the hot tub more.

12 Weeks/September- Post Op from Hip Surgery

I'm walking, hiking with Uma the Border Collie WITHOUT the cane. I still am a bit weak on standing. The sitting to standing movement has been a bit slower to recover than i expected, but it is getting better. I've been working on using my adductors (upper inner thigh muscles) more, since I know they were weak to start with from the OA. I also, to continue to stretch my psoas muscle. I also started to stretch the back of the hip in a figure 4 stretch for the piraformis muscle. I am trying to go slow, so i don't feel it in my knee, but rather to feel it in the posterior of the hip socket.  In a very gentle and kind way, i am working on the exercises that are hardest for me.... Straight leg raises, Marching in a neutral spine position.  For release and the flexibility of the hip, low back and the Quadradus Lumborum, I sit in the hot tub and aim the jets around the trochanter and the scar and get a wonderful tingily, itchy, deep massage....feels great! Massage also breaks up scar tissue, so that full mobility and range of motion is restored.

Week 8- August 2 months Post Op.

I've been walking a lot at our hilly regional Park Helen Putnam, mostly without my cane. It feels really great on my hip, it gets a little "itchy" indicative of blood flow into the surgical site replenishing the tissue and healing. I try to keep in mind, to walk with an even stride of my gait.

 I've also been doing Side Leg lifts from my Pilates Mat work. This strengths the Glute Medius and Minimus...all the side hip muscles, which stabilizes the hip and helps with balance and gait.

Week 6-Post Op.

WEEK 6.-Post Op.

I had my 6-week follow-up with Dr. Vail http://orthosurg.ucsf.edu/Thomas.Vail and I saw my 1^st x-ray with both hips resurfaced…crazy! Everything looks good. The stem of the Wright medical Conserve Plus device is a bit longer than the left Johnson & Johnson Depuy XLR  device, but essentially they look very similar.

Dr Vail was happy to know that I’m being active, and getting stronger. He says that the glutes are still weak, so I need to keep working at what I am doing. I see him again in 6 months. He said that the surgical healing period is till about 3 months on average.

I also gave my ok to be a part of the American Joint Replacement Registry. UCSF is creating a research study to establish a California state and nationwide joint replacement registry. In the U.K and in Australia they have joint registries, but not in the U.S. until now. Since I have been researching hip resurfacings, I have been amazed that there was no U.S. registry. It is being created to have a national data bank for safety and quality control over joint replacements. I think it’s long overdue.

This week:

Monday: PT

Tuesday: 1.25 walk with stick

Wednesday: PT

Friday: I swam & water walked in the pool for 1 hr.    Felt Great!

Saturday: I walked for the 1st time up our local hilly regional park- Helen Putnam Park. 1.25 hrs. The park has lots of un-even terrain, hills and paved path. I went with Sean and he took the dog. I used my stick for about 1/3^rd of the time.  I felt really good in my hips! strong, itchy from blood flow to surgery site….and then I did some yard work for about 1.hr TOO MUCH.

Sunday: Friends from New Mexico visited and we had a raw oyster picnic in Tomales Bay (we saw a red fox!) and then walked along Pt Reyes North Beach for 1.hr. I used my stick. I was sore and really feel like I NEED my stick.

Just goes to show….Listen to your body. And don’t do too many things without a rest in between days.

WEEK-5 Post op

With feeling better comes over-doing it. I did some yard work, moving pots of dirt around, without stick. Nothing sudden or a fall, but just increased pain in my hip and low back. This is good, cause I need to know my own boundaries. I need the stick, but it gets in the way and I try t give it a go without it. Everyone keeps telling be “be careful”.

Besides, PT and swimming 2-4 a week. I have been adding Pilates work in as well. Some exercises I have been working on: 

CADILLAC: rollbacks, push thru w/ side bend, articulating/neutral bridges (working up to singles), clams, side leg lifts.

REFORMER: foot and leg work, (working up to single leg) straps, standing butt blaster, kneeling arm work with yoga block, frame pull in neutral!

CHAIR: standing balance, VMO pump, side stretch.

MAT: adductor stretches, supported table top, marching with pelvic differentiation, psoas stretch, prone leg lifts, quadruped- leg lifts, and knee to chest, Childs pose!

WEEK 4- Post Op.

I am driving! 

I have a clutch, but my surgery was on the right. No problems getting foot off gas and on brake. Getting in and out of the car is challenging due to the space between wheel and seat is too short. The flexion in the hip, along with the internal rotation of the hip is a bit uncomfortable. I have to push the seat back and then forward to drive. An easy fix. Freedom feels good. I can get around on my own easier and walk, with and without the dog.

I am continuing to work on aqua therapy in the pool, swimming for 1 hr. Not like used to do it (1 hr with flippers), but working on resistance, balance, stamina, mobility and strength for a full hour. It feels great; I don’t want to get out! I am also increasing my walking. I can walk flat track for 1 hr with (and a little without) my stick. Feel the glide of the hip joint! The freedom of un-impinged hip extension!!

I have started Physical Therapy http://www.postwellnessbydesign.com/ in Petaluma. And I am working with Mitch, the owner 2 times a week.

 I get a great soft tissue massage as part of each session. This helps to break-up scar tissue around hip &  ITB. 

We are working on very functional gait work without the stick, and of course…. lots the glutes. Glutes on hip flexion (squats), glutes in extension (pushing off and weight transfer, as in walking), glutes on abduction (getting into my car), glutes on adduction (getting out of my car & being in hands and knee position). Most of the lateral glute attachments have been super stretched or excised and sewn back together. 

POST has a reformer, chair and a move-able mirror! I would like to get one like that.  It’s been good to have someone spotting me in different foot & legwork exercise. I started some leg strap work this week too. Feel the glide of the hip joint!!

I have weak glutes on the R; rather, the glutes have a hard time firing correctly. I have to REALLY think about working them. It takes a few times of really focusing on using them, then they seem to turn on.  I think is is from having the OA, (or maybe they got weak and this started causing OA??). Anyway,  this patterned evolved. 

I am most focused on not going back into my old movement patterns. This takes work, cause I think if there is a issue before surgery, it will be most likely (or weakness & dysfunction) there after surgery as well, and needs to be addressed before it gets to imprinted into the nervous system.

A short walk in Petaluma's Shollenberger Park at 4 weeks:

Some areas that I need work on are: R-adductor tight and weak, R- Quadradus Lumborum- tight weak, Deep rotators tight and weak. Piraformis- tight, weak. R-Illiacus & psoas tight & weak.

My Hip resurfacing -2-3 weeks Post Op

Day 8-Home PT has been great. We are walking around the yard and gardens with the cane. I have a bit of psoas tenderness as I am using the hip a bit more. We have been gently stretching it and strengthenin it by doing a few knee folds  (precursor to Marching exercise).

Day 14

2 weeks post-op

I got my stitches out today. I am off to wash my hair in the shower and start aqua therapy tomorrow. I remember most of the water movements from my prior PT sessions in 2007.

Home Pt has challenged me to be walking with only the cane by the end of this week. I love a challenge! So today I walked around the house, Pilates studio and gardens with the cane. It really takes all my focus to think about how I am walking and keeping the pelvis neutral and move from my hip, not my back muscles- as I was so used to doing. It feels good, and I can get a sense of the strength, but it is tiring. When I get too tired I am relying on the walker as a back up. I feel the inner hamstring group & adductors as a weak link, mainly because I have avoided the whole inseam of the right leg for a number of years.  I will working on those in next PT session.

Day 20-post op

Went to the Petaluma City pool today and did my aqua therapy in the 90 degree heat. It felt great. I did a total of about 50 minutes including; 10 minutes of water walking in about 4.5ft; working on hip extension, straight leg kicks, adduction/abduction (side stepping), easy crawl swimming with flutter kicks, and bicycling in the deep end. We went to run 2 errands before and after the pool, and I was wiped out! , but I came home took a rest and then watered the veggies in our yard. I rested and iced my hip as I watched TV and rested.

2011-The other hip-PT

Day 4 Post-op

Home PT came today to asses my hip. There was a bunch more lymph swelling than with the left surgery. My P.T.- Maria, was great, she showed my lymphatic drainage massage that helped decrease the swelling. She also addressed the large bruises I developed down my surgery leg. It is a common condition; blood thinners can contribute to post-surgical bruising.  Dr. Vail encouraged me to walk as much as tolerated, the muscle contractions in the leg, circulate blood flow & will massage the bruises away. Maria, the PT did her Pilates training with my mentor, Madeline Black. Maria was also a Feldenkrais teacher and was a great person for me to work on getting out of my previous bad movement patterns. We worked on hip and pelvis differentiation; single leg marching, neutral pelvis stabilization and good ole abduction. I am able to over in bed to sleep on my side or belly. I use a foam pillow and squeeze the inner legs as I roll over. This isometric squeeze also is strengthening my side hip muscles at the same time. Can start to feel stronger in the hip.

Day 5 Post-op

I am working on walking heel to toe with the walker and lifting up off my new femur bone and stretching up tall as I walk. PT-Maria made my walker taller so I wasn’t so hunched over, this helped better my gait &  posture. I started doing more and more lateral hip work in flexion (and attempted extension). The leg becomes more of a lever and is a whole lot heavier in extension. I will be working up to this.

Just laying on my side feels so good on the side hip area, not only cause it was so stiff, tight and sensitive, but also cause the fascia is getting stretched too. I also really feel the posterior aspect of the hip socket. Lying down with my knees bent feels so great on the back of that hip.

The bruising has resulted in Dr. Vail discontinuing the daily blood thinner injections that I had to administer to myself. YEA! I guess the blood thinning was working too well. I am taking about 6 painkillers a day, trying to space them out as much as possible. The pain is more of a dull ache and sitting on the sitzbone area/hip joint is sensitive. I tend to shift to various positions every 2 hrs or so, sitting, laying down, walking/standing, etc.

feeling good, moving well. 

2011-Leaving the Hospital

Day 3- Discharge today!..Yikees

PT came back today and I walked the entire orthopedic floor at UCSF and practiced on the faux staircase. Much better day for movement and regaining all feeling back in my leg. P.T.-Chris guided me through all the in-bed exercises to do. Very similar to foundation moves in Pilates! Heel sides, quad isometrics with glutes, ankle pumps, ankle stirs, adduction and abduction. These last 2 were Believe me I felt them all!! Doing isometrics is great to get those muscles woken up.

I dressed myself in my street clothes and organized my belongings. Lots of instruction on going home and home care. I little nervous about how I will be able to move and feel at home.  My friend Dallas drove me home and was very careful. Everything was a bit harder at home. My bed was lower than hospital bed, sitting on hard edge of toilet bowl is sensitive! Ouch! more moving of leg and lifting onto/off of the bed. I bought a handbag on QVC to make myself feel better. I am planning on returning it. (i did)

June 2011- I decide to have the other hip resurfaced

At about 2.5 years later (2009) and probably because of the increase mobility of the new hip, the right side started to give me similar arthritic symptoms as the left. Joint space decreased, I started to feel my gait compensate, my back muscles got tighter, knee discomfort, tight/weak psoas, gluetal amnesia, significant pelvic rotation, etc. However, only on this side, most of the symptoms were on the lateral/posterior side. That is were the bone spurs were forming. On palpation, you could feel them. I decided to act, instead of waiting, cause I didn’t want to risk my otherwise healthy spine and lower extremities, not to mention my psyche, emotions and attitude. And thank god we have options that we can help ourselves out of a pain spiral of immobility. We have a choice.

Katrina’s right hip resurfacing

Pre-op 5/31/11

Surgery day (kind of graphic for those who may be sqweamish)

My mom and friend Kathy came with me to the hospital. I had a lumbar plexus nerve block that was inserted in the pre-op area. This flexible thread of a needle will stay in my back for about 3 days to keep the post op pain to a minimum. A little stick and it was in, didn’t feel much obvious effect. After adding a bit of "relaxing medicine" I was brought into the OR and then was administered a full nerve block that numbs the whole lower body, from the chest down. This was administered by a trainee (UCSF is a teaching hospital) under the instruction of the anthestiologist. He was having a bit of trouble so it was a bit painful. After 2 or 3 tries and a few “don’t moves” they were in. In a moment or 2 the medicine took effect and the numbing was full and quick. I believe that is the same medicine as an epidural for baby deliveries. I was turned onto my side and was prepped for the surgery. It was weird to feel your lower body numb and have no control of it. I was very cold, shaking deep throughout  my body. There was a lot of clanking around of operating table parts, tools, what have you. Dr. Vail’s eyes had a look of “sorry for all the noise”. They drape your upper body and put you into a heated tent so you are more comfortable. The anethstiologist asked if I felt anything? I said like what? They said, “Did you feel the bladder catheter?” I said no. The lady who put in the catheter smiled thru her mask and her eyes said, “Good I am glad”.  I felt the pressure of Dr.Vail's hands on my hip. That’s the last thing I was aware of. Next I was in post op feeling thirsty.

No discomfort from post-op. I was wheeled into my room. Yea! It was a private room. With a killer view of a mountain of waving Euclucptus trees and sky. (UCSF ortho ward has killer views from all the rooms). Was hooked up to the morphine drip and checked by nurses on a regular schedule.  At 7pm my husband Sean came into the room to visit I was asleep. He said I was kind of out of it. I was on a PCA (patient controlled anthestic) i.e. a morphine drip that helps keep the pain low and I had the nerve block in for a day or so more.

Day One- all the nurses at UCSF were great. The resident ortho Dr. Yamamoto who works under Dr Vail had a great bedside manner, was gentle, listened well, explained the muscular anatomy that was effected in the surgery…because I asked I wanted to understand the process. Physical therapy and occupational therapy came by today to get me to feel what its like sitting up, swinging my legs over the bed a standing up. My blood pressue went way down (91/50) and I felt lightheaded and nauseous.   I was shown how to use the tools to put on/take off socks and clothes, my “grabber”-best device for picking things up out of reach, how to sit on the toilet and what it feels to walk on the new hip! That was enough for the day. I still had the numbness in the leg, and it was a bit worrisome, cause I wanted to move it, but couldn’t. I was told that I would be weaned off of it slowly, as so not to have pain. Because I had the numbness, and no control of my new hip, I wanted to get that nerve block out.  I was still on the drip. My friend Blanche came and visited me in the afternoon, that was nice.

Day 2- Dr Vail came by early in the am and felt I was doing great. I am feeling minimum discomfort still. Nerve block was finished and I had tingling, then full sensation back in my leg. It was still very weak in psoas area and tender posterior /lateral side glutes. I started doing basic PT/Pilates therapy for strengthening…isometrics & Heel slides, quad/glute contractions ankle pumps and circles…all good. I noticed that since the hip joint has been so stiff, tight and dysfunctional that I really feel “loose” in the beginning and the muscles have been stretched during the process, so there is the sensation of instability. You can feel deep in the joint and surrounding muscles a sense of tugging and stretching and dull ache. BUT nothing like the OA.This is quite a remarkable awareness the day after surgery.

Started to gain appetite back (darn) but made sure that I ate, steamed veggies, chicken, yogurts, fruit. Things that were nutritious and fibrous. The pain meds make you constipated, and I was given stool softeners daily, which continue while on painkillers. My friend Rhonda came to visit. The morphine drip ended today. The pain now is managed on Percocet. Dr. Yamamoto changed the dressing and I got a peek at the 8 inch scar. NICE!  Clean, dry, no redness. He said Dr. Vail’s work always looks like this (my 1^st surgery looked perfect too). I told him that Vail should have been a “seamstress”…I must have been pretty out of it.

2007-My 1st hip Resurfacing

 In 2002, I had left hip arthroscopy by Dr. François Antounian at CPMC, S.F. The torn cartilage was removed and the femur was shaved a bit to attempt a better fit. It lasted for about 5 years, but after the cartilage was removed, then basically you are left with bone-on-bone, which advances the OA & the gait compensation patterns and the pain.

I had that same left hip resurfaced by Dr. Thomas Vail who had just joined UCSF to chair the orthopedic department in 2007. He had tremendous experience with hip resurfacings (one of the few docs in the US at the time) and had even developed a couple of the latest FDA approved devices. I did 5 years of research prior to having my 1^st hip resurfaced. I interviewed 4 surgeons prior to selecting the resurfacing surgery and the surgeon. I wanted a surgeon who had done MANY procedures and was well respected in the field…and of course was in my insurance group. I was lucky that Dr Vail came to San Francisco!

The left hip surgery was great. Recovery was easy but focused and I was diligent on my PT and Pilates strengthening regime. I regained full range of motion, strength, functionality, etc. From the beginning, this hip was worse, but in x-rays you could see a little bit of joint space narrowing starting on the right side. But by comparison to the left, it was fine. I continue to do private Pilates, hike, swim, ride horses, bike, walk, stretch, myofacial release work, take occasional yoga and gyrokensis classes…all great, prescribed non-surgical treatments. 

What is Hip Resurfacing?

Hip resurfacing is new type of hip surgery that was FDA approved in 2006. It has been done in Europe, Asia and India since the 1980's. Hip resurfacings are done to younger patients who want to conserve as much bone (socket and femur), while shaving away all the OA bone spurs that have grown in the joint. 

It is the same process of when the dentist whittles down the tooth, and fits it with a "crown". And  they clean out the acetabulum or hip socket as well. The result is a non-impinged, free-moving fluid hip joint! 

They use metal ball over your own femur and they reline the acetabulum with the same metal. Unlike a total hip replacement, you keep more of your bone and there isn't a giant metal stem implanted into your femur shaft, plus your anatomy is the same, less to no precautions, faster recovery. And if you should need to have a total hip replacement in the future (resurfacings last about the same as total hips- 20-30 yrs- ideally) you will have enough bone to have that procedure done later.

Here is a great resource for everything you want to know about hip resurfacings, it is 

http://www.surfacehippy.info/

Baby Boomer's living with Osteoarthritis

From early in my 20's I had issues with my hips. taking years of high-impact aerobics, competitive horse riding and jazz dance classes, might have made them a bit more worse for wear. I remember getting massage sessions and my illiac crest was always very tender. But really around 2000, i felt the need to reach out to the medical profession. I was told that I have Osteoarthritis in the hip joints. i could not believe it. I was only 40!! 

One of the things that made me feel stronger, stable and flexible in the joint and my entire body was Pilates. At that point, I changed my 25 year broadcast TV career  into "plan B" and became a certified Pilates trainer. I change of career was personally inspired, but I also realized that there were probably many other baby-boomers like me who have had the same issues of OA or other impingement syndromes in their joints. And with so much of my own personal work in the area of hip anatomy, biomechanics, gait, posture, strengthening, stretching, stabilization for the joint and the surrounding muscles and tissue, I feel like I can really offer  help to those interested in helping themselves.

Coming up next, is my story of my 2 hip resurfacing surgeries.....