4 Year Update

November 30, 2016

Four years later and my hip still continues to improve. This year was a big improvement for my resurfaced hip toward a more natural function and feel.

But, this did not happen without a renewed effort.

In my first year post op I was able to return to playing soccer. After that I lost focus on continuing to work on my hip range of motion. I just figured with all my activity that it would improve on its own.


It was not until my fourth year that I sought out professional help with PT to see if they could help me improve my performance in sports. They showed my that my body was still compensating for my resurfaced hip due to lack of ROM. As soon as I began to gain more degrees in my hip function (in all directions) I noticed improvement that I couldn't imagine. Even just walking it was much more normal.


I ran the Thanksgiving 5K this year and sliced over 10% off my previous two years - and I could have run much faster but I was very restrained with my pace based on the previous years.


Keep on working on the ROM hippies and it will pay off!


My journey started with unexplained back pain for a couple of years when I was 43. I went to three different surgeons. The third x-rayed my hips and discovered the "painless" severe osteoarthritis in my left hip (the side that the back pain was the worst). He was shocked I had no pain in hips but he predicted that my hip would be in pain within two years. He was correct. But in the meantime I used pillows under my knees to sleep knowing that my stiff hip joint was the source of my back pain. If I got the position right and didn't roll around too much, my back pain would be much less the next day.

February 14, 2013

I had LBHR by Dr. Friedrich Boettner at the Hospital for Special Surgery in New York City on November 30th 2012. Dr. Boettner is one of the two hip resurfacing specialists at HSS. The other is the famous Dr. Edwin Su. But, don’t underestimate Dr. Boettner, he has done hundreds of resurfacings and was trained in the McMinn technique in England. He has an impeccable resume and I sensed he was a perfectionist – a good quality to have when installing the BHR components.

I am a 46 year old male 6’1” 195 lbs and an avid soccer player and coach. I am a former Division 1 college soccer player. My hips began losing their range of motion back in my early thirties although they never hurt at all and were never weak. At the age of about 42 I began seeing doctors about low back pain and it took several years and many different doctors until one took an x-ray of my hips and found they were the source of my back problems. Not until recently did I ever connect the dots that the loss of my ROM was the onset of osteoarthritis. Turns out I had severe OA of the left hip and femoroacetabular impingement too (FAI).

Immediately after my resurfacing, I was convinced that I was the rare case where the device had come loose from the start. It seemed to be the only possible explanation for the surprise "clunks and weight bearing shifts" I was experiencing. Well, at my three week post-op visit, the x-rays proved that the device was still perfectly positioned. What a huge relief. But what questions I had about these sensations. None of it caused any pain so my surgeon said not to worry. Since then I made myself really busy with rehab three times a week and intense stretching and just plain ignoring the stunning sounds and shifts I was feeling.

A month later at week seven I felt so good that I got a little ahead of my rehab program. I discovered I could jog and bounce up the stairs like a normal person. I only tried those activities one day just to see how strong I was and there was no pain whatsoever. It was amazing seeing my leg able to move where it couldn’t before the surgery. Since that day I have gone back to walking and continued stretching like my recovery program requires.

At 10 weeks I feel and know that I could do any sports I want. Sticking to the six month wait time to begin sports will be an interesting time. To be absolutely sure something doesn’t go wrong with the device is worth waiting. My surgeon has already given me the green light to return to soccer and whatever else I want as soon as I hit that six month mark so I am very enthused. By the way, the clunking and shifting isn’t that much different than before but just by ignoring it you realize it really is nothing more than a distraction. It doesn’t impact any activities unless you choose to let it.
 

March 7, 2013

 I'm 3.5 months post op now so I am two weeks into the low impact strengthening and conditioning portion of my rehab that I will continue for at least 2.5 more months. Yesterday I walked three miles at a good clip. I could really feel the fatigue to those deep external rotators when it came to the hills. Like you said, the large muscles feel fine but those small ones felt like jelly. I found that I could massage the area while walking and it helped but people watching me walk by rubbing myself that way must have got a chuckle.

April 7, 2013

At the start of month three I began moderate walks twice per week. Then at month four I stepped it up to three to five aggressive walks per week. I have this cool app on my I phone that tracks all this. Now at 4 1/2 months I am able to walk several miles comfortably at 12:30 per mile which I think is close to a slow joggers pace. I started out six weeks ago only able to maintain 17 minute miles so this hip flexor is probably improving and I just don't notice or I wouldn't be able to walk that fast.

April 22, 2013

Made my return yesterday. Played the last 25 minutes of a 90 minute match. I was strong and quick despite holding back quite a bit. Today I have NO PAIN or soreness in my new hip.

If anyone is wondering if the device is strong enough...the first five minutes I absorbed one of the worst types of contact. While carrying the ball a defender missed his tackle and snaked my operated leg right out making me airborne and landing on the operated hip. I jumped right up. My teammates were silent wondering if I was OK. I just ran back to my position and casually said "I'm fine guys". And I was.

Playing central mid I was one of the fitter players on the pitch. At one point I was able to get up the field fast enough to take a chance on goal from a cross on the ground. I shot with the operated leg. Had I not been so tentative I would have buried it but instead I went for power and blasted it a foot high over the crossbar from top of the box.

My comeback has been faster than expected. At three months post op (per my surgeon) I began non-impact strengthening and conditioning. I kept track of all the walking and exercising and just kept increasing the level incrementally. Not once during this phase did I ever have a day where I thought I did too much too soon. The leg was responding to every increase. After 6 weeks of that I began light soccer playing with friends. My footwork for that was comparable to a person playing doubles tennis so I had no fears. But two weeks into that I realized my leg was back.

So yesterday I jumped back into competitive soccer and was perfectly successful. Thanks Hernanu for all the "soccer specific" advice.
 

May 6, 2013

More over-30 league soccer this past Sunday. I know I like reading this kind of stuff when others post it so here is some stuff about my match this weekend.

Last match two weeks ago was against some bottom feeder team but this week was against a good team with some real players. Some ex national players from Trinidad and Tobago, D1 college etc.

Unlike the last match, I was really nervous going in to this match. The pace was very fast and it was physical. I entered 30 minutes in the first half as the starting central mids were exhausted. First thing that happened when I got in there was one of their central defenders ambitiously began to carry the ball out of the back to try and shoot past our midfield with his fast pace. But, his second touch was a bit heavy and the ball got a bit ahead of him. At full speed I went to ground on my operated side and delivered a two-footed tackle. I had been watching Liverpool vs Everton earlier that morning and I think Steven Gerrard would have been proud of my tackle! Then I got closed down with the ball at midfield with my back to my goal. The ball was on my left foot and I had one quick chance to be successful. The one option I had was to deliver the ball across field to my defender side using the outside of my foot on the operated side! It worked! And it didn't hurt.

But, my legs started getting rubbery shortly after that and I was thinking "Uh Oh, maybe I just over did it?" The pace of the game seemed just too fast. My throat began to burn a bit too from the heavy breathing. Somehow though I made it to the end of the half.

Second half I was watching from bench. Within 15 minutes the manager was calling my number to go in but I refused. I was still feeling a bit weak and unsure. Well, 5 minutes later one of our midfielders went down with an injury. I went in reluctantly.

This time though, my breathing was better. So I pushed the pace a bit. I really got going and made an overlap run around my outside midfielder. At this point I really had forgotten about my hip because the game was getting pretty intense. I found myself with the ball at one point facing up a player in the attack. I feinted right and pushed the ball left (totally forgetting this would require and explosive push from my operated hip). Well, right away it looked and felt like it was going to be a total fail because I just couldn't seem to convince my brain to do the action needed. But as the defender starting to gain position between me and the ball, out of nowhere, competitive juices began to flow and I was able to salvage my move with a powerful lunge that got me to poke the ball to my (now open forward because of that move) teammate for a great chance at goal.

After the game and even today my hip feels great. I have other joints that are sore but not my new hip. I have another match in two weeks so I'll keep you updated.

May 15, 2013

A welcome setback! Playing friendly 8 v 8 with a regular weekly crew. I was really feeling good and starting to see the old step coming back when wham! Hamstring stain on the good leg! You gotta be kidding me! Well, maybe it was because I'm still favoring the op leg more than I realize.

Well, it was so slight that it was more like a tightening up than a strain. So I kept playing for another hour but avoided any sprinting. What a pleasure to know that my new hip is no longer the my weakest part. Having the new hip take over for the other hip was flawless and I actually forgot about it for the most of the time.

June 10, 2013

For all you soccer enthusiasts and hippies, the goal came, and so much sooner than I could ever have imagined. I haven't scored in a competitive soccer match in years. And the way I scored the other team would have just about fainted if they knew I had a metal implant.
My fitness was quite superior to the opponents and at about the 60 minute mark I was able to step in front of their midfielder who was trying to receive a pass out of the back from his own defender. They were totally caught by surprise so I carried the ball with pace approaching the attacking third as their center half stepped up to try to slow down my progress. My faithful central forward made a perfect run toward the right touchline drawing the lone center back part way out with him. I delivered a diagonal pass to that forward and when the defender went to close him down he played the ball first touch back into the center as I had shot right past that center half into the space. The last defender then wheeled around to pressure me but it was too late. I blew right past - that's right folks, the guy with the brand new 6 month-old Birmingham hip blew past the center half and last defender to engage in a one-on-one with the keeper. I easily slotted it to the low left corner for a goal.

Earlier in the game I had faced up a defender, faked and pushed the ball right at the top right side of the penalty area. It wasn't the greatest move but I was able to burst past with three quick steps and blasted the ball off the goal frame right where the crossbar and post meet. Love that sound when the goal post rings the whole park.

I played about 70 minutes and today have nothing more than some welcome muscle soreness. All is right in the world at this moment.

September 10, 2013

I'm 9 months post op and went through lots of new pains (injuries).
Back pain that I had before surgery finally went away once I could really extend the hip. While the flexor was still tight for first few months I would sometimes get back pain.
Both knees were really sore for periods - like 6 week spells. I asked my doctor if maybe I had rheumatoid arthritis because so many joints would hurt. I don't have it.
At 4 months as I became active the knee on my op side swelled up like a grapefruit and I had to chill out for 6 weeks. Surgeon said it is common to have the knee on op side have problems as it adjusted to the knew movements of the hip.
Then my Achilles on op side strained. Upon examination realized how much it had atrophied over years because of hip problems and it takes a long time to build the Achilles up because it has such low blood flow.
For years before hip surgery, the body slowly reclaims range of motion and those muscles simply shut off and atrophy.Then post hip surgery, those same muscles are jolted into action again and they just hurt and twist and stretch until they strengthen and adjust.
I feel really good now and can play soccer full out now but I had 3-4 months of nagging stuff I never had before.
Scar tissue is only a problem if you don't work at regaining your range of motion in the first couple of months.

May 5, 2014

I'm 15 months post op for my left BHR. I too have experienced a strong ache that comes on during intense physical activity. Right now it is directly related to the intensity and duration. I don't think it is related to ions at all.

When I first began a walking regimen at the three month mark, going up hills used to bring on an intense ache. A few minutes of rest would resolve it but if I continued right away the ache would occur even sooner. Over time that ache diminished during my walks as my endurance improved.

As my athletic abilities improve, I am able to increase the time and intensity before that ache creeps in. Right now it happens playing soccer (only when it is a competitive match) after about 70 to 80 minutes. It used to happen sooner.

If I compare the most recent ache to the ache I had at the three month mark, it is not any different. That ache just the same will have me limping and if I continue the limp becomes very marked. One time that ache lasted 2-1/2 hours after I stopped. But once it was gone that was it. The most recent onset(yesterday) it came on after 70 minutes of intense soccer but the ache went away after about 30 minutes of rest - not hours. That is a definite improvement. 

Does the body improve its ability to handle a spike in ion release or is this ache really a muscular endurance issue? I think it is the latter.

If I can work my endurance so the ache never occurs I'll post on that.

July 16, 2016

For what it's worth guys, I went through the whole back issue before my left hip was resurfaced.
I had debilitating back pain and stiffness for several years. Saw many surgeons and pain specialists.
X-rays and MRI's showed problems with my spine. Nothing major but bulging disc, compressed nerves, and slipped discs.

Finally, it was an orthopedic surgeon who teaches at Yale University, Dr. Dawe, who diagnosed me correctly. He focused on my hips and said he predicted that, although my spine had issues, it was my hips that were the main factor and they were keeping my spine constantly inflamed (my hips were not even hurting me at the time so I was confused). He also predicted correctly that my left hip would really start bothering me within the next two years. He was 100% correct. BUT, when I went back to him, this guy didn't do resurfacing and wanted me to wait six years until I was 50 to get a total hip replacement.

I did research and found the Hospital for Special Surgery and had my left hip resurfaced.

Within three months my back issues had completely disappeared. I have never had any problems with my back ever since. I have returned to playing competitive soccer and neither my hip nor my back are ever a problem.   

 

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