Already had bilateral scope-waiting for bilateral resurfacing

[HockeyGuy]

Well I haven't gotten any better regarding my back pain.  I now walk with a cane, and practically bent over to a 45 degree angle, to my left.  Nothing has worked!  Two different physios and my chiropractor couldn't turn my back pain around.  All my previous back pain and hip pain is also magnified now.  I could go on and on.  Actually during the night, nerve impingement in my neck causes both my hands to go completely numb.  I have been battling this for years as well, and was really hoping getting my hips fixed up, would allow me to deal with this issue to.


I officially have gone on to Long Term Disability as well, and sorting this out is a challenge to.  I was faced with very bad news at first for my back on top of everything else.  Dr. Beaule told me I had to deal with my back before he would consider moving forward with my hip surgery-fair enough as I am so crooked and couldn't do the physiotherapy to recover post op.    I was referred to a back surgeon, but initially was told I would have to wait 10 months before even seeing him.  I was devastated!  I had also been forced to go to the Emerg dept. as well one night, as my pain was out of control.  All they did was give me so much morphine I puked.  Meds weren't working, all the treatments weren't working, my hip surgery is on hold, and I am told I have to wait 10 months before seeing a back specialist!  What the!!


I finally caught a break and got a call from the back surgeon on Friday giving me an appointment yesterday.  I saw him, and he immediately recommended that I get back surgery for bulging discs at L4/L5 and L5/S1.  Surgery will be scheduled sometime this November.  It can't come quick enough as I'm getting a lot of weakness in my right leg, and limping a lot, even with a cane.


I am beyond bored and pissed off as I have put on about 25 lbs!  First time I have registered for hockey in 41 years.  I go watch my wife play and my kids!  Keeps me going, and raises my spirits.  It's hard though.


I will be contacting Dr. Beaule's office to plan out how to go about planning for my bilateral hip surgery.  I am hoping to get everything done before returning to work.


It's going to be a very tough year looking ahead.


I really love hearing positive stories here, and spend lots of my "free" time reading here.


Cheers to all those who have overcome their surgeries, and are either completely healed up or working their aces off during recovery!!

[chuckm]

Hey Hockeyguy - I'm going to chime in with the same story I told you before. You sort of dismissed it last time saying that your low back only hurts in a blue moon and it was your neck that bothered you.

But now you are considering surgery on the L4/L5 and L5/S1. That is low back.

Here is a summery of how my MRI report read three years before I had my left hip resurfaced.
I was 42 years old at the time.

L5-S1 Slipped disc and compressed nerves.
L4-5  Bulging disc.
L3-4 Thickening of the ligaments and narrowing of the nerve canal
L2-3  Bulging disc.

I had debilitating back pain. I stopped sports like soccer, running, etc.
After two years of this suffering, my back began to get a little better on its own, but not a whole lot, just manageable.
What was happening was that the ligaments of my spine were adapting to all the motion they had to take up from the lack of motion in my hip. But the back did not take all the motion up from my hip and so my back was always a problem to some degree no matter what I did.

Then I saw Dr. Dawe, an orthopedic back surgeon who was also a professor at Yale University. He is the one who told me that despite these bulging discs and other problems with my spine, it was my bad hips that were causing my back to be in constant pain. It was a constant flare.

Three years after my back pain began, I had my left hip resurfaced. Within a few months the back pain got less and less and within about two to three months there was no back issue any longer. I never experienced any back pain ever again. I have returned to running and competitive soccer. I can jump out of the back of my pickup truck without a thought, carry heavy trash bags, etc and my back is fine.

I think the medical advice you are getting could be all wrong. Just a thought from someone who went through what you are going through.

Chuckm

[HockeyGuy]

Hey chuckm, sorry you thought I dismissed your post about your experiences related to your back pain and how fixing your hips was ultimately the real solution you needed.  I 100%, whole heartedly agree that bad hips often causes back pain!  I firmly believe that my poorly functioning hips, combined with a lifetime of playing hockey, has caused by back to break down.  I honestly was truly hoping my back would last out until I had by bilateral resurfacing, so that I could strengthen my back and get it back to it's proper function.  Unfortunately my back didn't make it.


The advice I am getting is most definitely NOT wrong.  I tried my best o avoid a back surgery at  ALL costs.  I was doing physiotherapy twice a week, doing all kinds of Mackenzie exercises.  This didn't work, so I went to a different therapist who tried many other techniques including IMS needling(hurts like hell), but they didn't work.  During all this time I was going twice weekly to my chiropractor who also did 20 min of A.R.T. during each visit.  Nothing was working.  I has pain meds, and anti-inflammatory meds, as well as Lyrica for nerve pain.  Nothing worked.


During this time I walk, bent over to the left at more than a 45 degree angle.  I need a cane, but the moment I am up for a few minutes I'm done.  I even ended up at the emergency department in excruciating pain.  Just gave me more pain medication.


Trust me, my back pain started when I was 21, and I have had every sort of MRI, CAT scan, bone scan, tested for fibromyalgia, rheumatoid arthritis, and various other disorders.  I saw many neurologists along the way, and over 20 respective physiotherapists, and chiropractors.  I did Rolfing for 2 20 plus sessions, prolotherapy, acupuncture, MAT in another city and joined yoga.  I have a gym in my home and an obsession with trying to return my body to as close to healthy as I can get it.


I have also seen the top back surgeon here in Ottawa 5 times over the course of my 20 + year back pain journey.  He has never said I needed back surgery, but also never thought I had a hip problem either.  Thankfully I found Dr. Beaule on my own, albeit several years later than could have been.


I have seen Dr. Beaule since my back has gone out, and he knows exactly how I am doing, and seen the MRI.  I am so bad that I would not be remotely close enough to be able to do the needed physiotherapy post op.  I am not kidding, I can't stand up more than being bent over 45 degrees.


I do have other back issues all along my spine.  Tight subscaps and scaleens which are the most likely culprit for my numb hands, as well as a horribly tight thoracic section.  I do believe that once my back is fixed and healed, and I get my hips fixed, that I can work on a permanent solution for my back and entire body.


The information I had posted earlier along with DVD's are very useful for maintaining joint function and overall health.

[LMS]

Aww Hockey Guy, I'm so sorry about what you're going through.  I kept checking every day to see if you had posted an update.


Did you call Angela?


I work from home, so my computer is always on if you need to chat, need to vent or are bored out of your skull.  My husband is from a cop family (his father was OPP, he himself was invited to join & my son started the steps into this profession in Police Foundations at Algonquin & so on, I could list friends, clients etc)

[HockeyGuy]

Hey LMS, thanks for the reply.  No I didn't call Angela, just kept up with what I was doing.  I had some real good people working on me, and had lots of suggestions for other options as well.  Unfortunately I didn't respond to any treatments, and have gotten significantly worse.  I am at peace knowing that surgery is the option I need at this point for my back, and just want to get it done, and work on the recovery.  Because I have the bilateral scope to look forward to!!


To be honest, at least I know what is going to happen, and have a better time line for everything.  My goal now is to work with Dr. Beaule's office and get my hip surgery scheduled once I have a firm date for my back.  I hope we make them as close as possible, and get it all done!!


Currently it's pain management that is my biggest hurdle.  I was very reluctant to take the dilaudid I was prescribed, as the night I ended up at the General emerg., they pumped me up with so much of it I puked a ton when I got home.  I took it a few times since, and feel very light headed after.  The past 3-4 days have been so bad though, that I have been forced to take the maximum amount, and think that I have gotten a little used to as I don't feel light headed as I did before.


Boredom and pain are my enemies now!!!

[chuckm]

Hockeyguy I'll give it one more try. I'm just trying to help here.

I did all that stuff too:

Four back surgeons
pain specialist
ART
physical therapy
MRI's and X-rays
prescription pain meds and muscle relaxers

My back was a mess and so was I.
Nothing worked - not in the least. 

I spent a year trying to find a solution to my back problems. When I finally came across a back surgeon who said it was my hips, I was in just as much disbelief as you that my hips could be causing such horrible pain in my back. 

When that surgeon, Dr. Dawe, pointed out that my hips were the cause, my hips weren't even bothering me at the time! I would not even had considered getting my hip resurfaced to solve my back pain.

So I dealt with the back pain for two more years. And that is how long it took for the pain in my left hip to develop and become so unbearable that I gladly schedule the resurfacing.

Post hip resurfacing - back pain gone forever! It was a two-for-one.

I am so happy I didn't go for any back surgery.

There are others on this site who have talked about hip resurfacing solving back problems too. I'm not the only one. If there weren't such similarities to our stories I would just keep my mouth shut.

Good luck with whatever you do Hockeyguy.

Chuckm

[Quig]

Chuck is 100% correct. I too suffered from big time back pain (and knee pain) before having my hips fixed. I'm now nearly 6 months post op and I currently have ZERO back or knee pain.


Before my hip surgeries I spoke with Dr. Gross about my back and knee. Without any doubt or hesitation he explained that it happens all the time and that those problems were very, very likely related to my hips and would probably not be an issue after surgery. He was right.

[HockeyGuy]

Thanks chuckm and Quig, I really appreciate you guys telling me your stories and experiences.  I totally agree with both of you, and believe that my hips are the root cause of my 20 plus years of back pain.  It's funny, the day I was at Dr. Beaule's office where he eventually told me I would be getting a bilateral resurfacing, I started talking with another guy in the waiting room.  He was going in for his 2 year follow up with the doc, and was 55 years old.  He is a hockey player like me, and feels that he has gotten back 30 years of his life.  He said he started getting back and groin pain around 25 years old, but at the time, there wasn't much help.  He did everything like most of us have done, but gradually deteriorated.  Now, post surgery, he feels like he was 25 again, and said that his back pain is all gone!!  I then got called in to see Dr. Beaule, and got the news for my surgery. 


I was so excited, and felt that this was going to be what I needed to get to where I wanted to be health wise.  Of course about three weeks later my back goes out.


Of course I have tried absolutely everything to avoid a back surgery, and nothing is working.  I am quickly getting worse, and now limping substantially.  Pain meds including dilaudid do next to nothing.  Even when the back surgeon saw me, he wasn't sure why I am so bent over to the left.  I'm not kidding, without a cane I have to put my hand on my knee to get around.  The pain is getting worse and worse, there are two substantial bulges, I'm losing strength in my right leg, having bizarre abdominal muscle pain, and lots of mid back pain and extreme tightness.  My physiotherapist, actually the second one I have tried, has recommended I get to a surgeon asap, as nothing he is doing is providing any positive results.  My chiropractor, who only wanted me to see a surgeon as a last resort, has also conceded that I need to see a surgeon asap.  I am not only not progressing, I am getting worse!!


Dr. Beaule told me at my appointment that the bilateral resurfacing is impossible due to my extreme posture being bent over so far to the left.  He stated that it would be impossible for me to do the required physiotherapy to recover from the surgery and therefore can't proceed until my back is fixed.  Non surgical methods have all proven ineffective, and the recommendations of two physios, one chiropractor, my GP, and sports med doctor, my hip surgeon and finally the back surgeon, is that surgery is needed.


I desperately didn't want this, but see that it is the only option available to me at this time. 


Another interesting point is that during my 20 year pain journey, and eventual bilateral hip scope, my biggest complaints were in my back, and specifically in my mid back and neck.  I have constant tingling and numbness in my hands, and it's this that wakes me up at night, not my back pain.  When all the rest is settled and dealt with, I SO HOPE that this specific issue will have cleared up, it drives me nuts, affects my breathing and ability to get a good nights sleep.  I am confident that the surgeons will all do their jobs, and I will have to do mine during recovery.


I am planning my approach pre surgery, which is including how to drop some weight without being able to move much!!!  Maybe if I stare at my gym, or watch my wife and kids workout, I will get some results through osmosis!!  Actually considering writing up a Ketogenic diet, as it is most likely my best bet, and will have the quickest results.  The hard part will be the pain is already dropped my patience level, and this may prove to be to hard.  Worth a try.


Also going to see if I can do non weight bearing exercises such as chin ups, dips etc.  Anything will help.  Turning into mush here!!

[LMS]

Ohhhh by osmosis, I wish!  (Your comment made me laugh)


I so understand your back pain issue & being bent over.  I was like that too but I did have days of reprieve which sounds like you never seem to get now.  Have been dealing with lower back pain since I was 14.


Your situation just plainly sucks!   :(

[chuckm]

Hockeyguy, I said in my last post it was my last try. Well, it seems so obvious I feel I have to keep on.

Your back won't get better so long as your hips are the way they are - at least not right away. You will probably go through what I did. The ligaments in your spine cannot deal with the stresses your hips are putting on them. Over time, however, they will gradually remodel themselves and you will get some relief only because your spine will have retooled itself to deal with the situation.

But as long as your hips continue to worsen, the stresses on your spine will increase.

It doesn't matter whether you are standing, sitting, walking or even sleeping, the muscle contracture surrounding your arthritic hips is stressing your pelvis and spine every minute of every day. 

In the end, you may get enough relief that you can get your hips resurfaced so you can find out what we are talking about.

It doesn't matter what all your surgeons say. I had half a dozen surgeons talk to me the same way they are talking to you. And they were all wrong except one.

So, at least bring this up with one of your surgeons and see what they say about real life stories. If they dismiss it then you need to keep looking for another surgeon besides all the ones who can't figure out what the problem is.

Chuckm

[HockeyGuy]

Chuckm, you are right, poor hip movement is most often the cause of slow onset, long term back pain.  If I never get my hips fixed, my back pain will either never go away, or return quickly.  I fully intend on getting my hip surgery as soon as possible after my back surgery.  In fact as soon as I get my official back surgery date, I will be contacting Dr. Beaule's office to plan out when I can get my bilateral resurfacing.  I am being told a 3 month recovery will be needed for my back, perhaps 4.  In a perfect world I hope I can get my hip surgery at the 5-6 month mark.  This will be the most complete solution to my problems.


Not sure if you are familiar with the work of Gray Cook and Mike Boyle with their Joint by Joint approach to how the body works.  They focus on proper movement patterns of the body and how your joints alternate between two main functions, stability and mobility. 


For example,


-ankles-mobile
-knees-stable
-hips-mobile
-lower back(about the height of two fists)-stable
-thoracic back-mobile
-shoulder blades(the most often forgotten joint)-stable
-shoulders-mobile


Most often joints who's primary function is stability, such as the lower back, are forced to change(adapt) their function to compensate for the dysfunction of another joint.  This dysfunction usually comes in the form of a mobile joint, losing it's mobility and becoming tight.  This is primarily due to some form of arthritis.  Using back problems again as an example, tight hips are caused by dysfunctional hips who cause pain.  The muscles surrounding the hip tighten up to reduce the pain.  The lost movement here, is picked up by the back, which isn't supposed to be so mobile.  The body can adapt and function this way for years, however since it's parts, in this case the lower back, are not doing the job they are designed to do, it breaks down.  Far to often the patient looks at the last incident where their back went out, thinking that this is what caused their problem.  They are wrong, and their poor functioning hips, are the root cause, and their lower back was just waiting to finally break down.


Other factors that arise out of poor functioning hips, are extremely tight psoas and pirformis muscles, and dormant glutes.  I have designed my workout programs specifically around releasing these tight muscles and strengthening my posterior chain, specifically my glutes.  As I said I have a gym in my home, and have the luxury of training daily, and use main training techniques to correct my imbalances.  Combined with doing Bikram yoga whenever I can, specific exercises to stretch my psoas and performs, I also have an Atlantis Glute Ham Developer in my home to further strengthen my glutes.  This is all part of balancing out what is most commonly the issues in our society today.  From sitting to much, our hip flexors, specifically the psoas, shorten and tighten.  Our posterior chain, specifically the glutes, fail to fire correctly and become dormant.  Brent Contreras did his PHD on this issue, specifically glute function and how it affects overall health.


Another person who addresses many imbalance issues, specifically mobility issues is Dean Sommerset.  He has a DVD called Ruthless mobility, which focuses on these various issues.  He actually shows how people with mobility issues may have different problems.  Are you tight because you have an inflexible muscle, due to it physically shortening, or is it tight because it's tired and overworked, as it's doing the function of another muscle that has become weak?


The doctors aren't completely certain as to why our hips have deteriorated.  Are we born with deformed hips, and this was all inevitable?  Do we participate in certain repetitive movements either through work or sport, that put our hips in a vulnerable position, leading to dysfunction?  Did an earlier injury cause us to change our movement patterns and therefore negatively affect hip function and lead to a mechanical problem?  One thing that is certain though, we all sit far to much, which is working against proper hip function.  Tight hip flexors, and dormant glutes, will cause back and hip problems.  So even post surgery, if you don't change how you spend most of your day, do muscle work to restore proper muscle function, you will still have some sort of pain, or other issues.


Bikram yoga is a fantastic way of working your hips, and strengthening your back and hips.  It's tough!!  And I'm a weightlifting hockey guy.  For other non yoga workout people out there, read up on the work of Mike Boyle, Gray Cook, Dan John, Eric Cressey, Mike Robertson, Stuart McGill, to figure out proper ways to get our body to work.  I'm a firm believer in exercise for long term results, and can't wait to get back at it.  I will have to educate myself on having new expectations post surgery, and see how I can work my new hips into an effective program.


To make this longer, I do completely agree with how poor hip function causes back pain.  I also agree that restoring hip function will be ultimately what I need to do.  I can't though discount what my back surgeon is telling me, in that I physically can't do the required physiotherapy protocol to recuperate properly.


Last note, our surgeons have told us we need hip surgery.  Some have the scope, as I had a bilateral scope 5 years ago. Some get the resurfacing, which many here have done, and I will be getting, and some get full THRs.  We still need to figure out why our hips became so bad in the first place.  This can't be ignored.  Without knowing anyone here personally, the safest bet is to blame what most of us to to much of, sitting!  Just getting a surgery, and not addressing the root cause of why the hips deteriorate, and we won't get all the benefits.

[chuckm]

Hockeyguy, you are in a tough predicament for sure.

I just wish you could get the hips done before any back surgery. But if there is no way then I guess it is what it is. I feel for you.

A few years ago I posted about the sensations you start getting in the first month or two after resurfacing.
For me, it was like I had been cramped in the back seat of a car for years and then, when I got the hip resurfaced, it was like I got to step out of the car and stand tall while I stretched for the fist time in a long, long time. It is at that time I could actually see how much affect my arthritic hip was having on my entire body.

I hope it all works out for you.

Chuckm

[HockeyGuy]

Thanks chuckm, oh ya, I worked my butt off to avoid having to do this!


I tell anyone who will listen, that most back pain is a result of poor functioning hips, and that the real solution is to loosen the hips up and strengthen your ass.  Hopefully some people take that information to heart so that they may avoid deteriorating body parts as they get older.


Sitting, sitting, sitting!  It's slowly getting us all!


Honestly, check out anything from Gray Cook, Mike Boyle, Eric Cressey or Dean Sommerset, if you are into using exercise to keep ahead of the pain game.  Lots of great information on how to ensure all your parts move properly, do the job they were intended to do, and achieve balance in your body.  This approach is even being used by elite athletes as they have found that and efficiently working body, is not in pain, works efficiently, and can achieve peak performance.  If your goals are more moderate, and just want pain free efficiency,  you will gain some valuable knowledge from their works.


I intend on putting together my own rehab routine as I had done pre and post surgery for my first bilateral scope.


I may post what I put together and update how it goes.


Another thing to consider is the FMS-Functional Movement Screen.  It's a test to figure out your imbalances and what exercises you should use to correct them.

[chuckm]

Hockeyguy, all is good you really know your stuff but you are a little off when it comes to range of motion.

I agree when you are in early stages of hip OA that you can work your tail off too keep in shape and flexible, etc.
Your body may still be cooperating at that point. Much like my right natural hip is right now. It's getting arthritic but hasn't reached the point where my brain takes over without my control.

But once the arthritis advances, especially to stage four bone-on-bone, there isn't anything you can do. I don't care if you are able to do squats, lunges, whatever. The body is fighting a huge battle to avoid those lesions from getting worse. By the time you are stage four, your brain has ordered hip contractures and you are not in control of them and you can't stop them. You might not even be aware of them. Stretches don't affect them. It's too powerful.

Until you correct the hips and give the brain months to realize that it can begin to release the powerful contractions, you are just doing activities that work around the contractures. And your motions during exercise might look totally normal, but they aren't.

And, if you are stage four and are still trying to make your hips go to the range where the legions are, you might be making things worse.

Chuckm

[HockeyGuy]

Of course, there always comes a point where you are at such a mechanical dysfunction, that no amount of treatment or exercise will be able to change things.  Much like the position I am in regarding my lower back at this point.  My back has gone beyond any changes that may occur due to fixing my hips first.  In fact my back is so mechanically broken that it has made fixing my hips an impossibility until it is fixed first.


The best form of recovery for the body is to avoid injury in the first place.  When dealing with early stages of OA you would be best served my maintaining as much ROM as possible to avoid going straight to surgery or having a resurfacing done.  Your original parts are still the best parts.  As I had said earlier, we need to solve the root cause of the problem, not just address the symptoms.  As you had pointed out, much back pain is merely as "symptom" of poorly functioning hips, and only addressing the back issues will not ultimately solve the problem.  Addressing the hips is required.  But the question is still there, "why did your hips deteriorate in the first place?"  Anything that ends in "itis", be it arthritis, bursitis, tendonitis, in layman's terms means inflammation.  Why did this inflammation occur needs to be asked and addressed.  If you were doing everything right, and only had a genetic defect, then the surgery alone will give amazing results.  If you had suffered an injury years earlier, you are a little better off, but still need to address your muscle imbalances that have occurred and have become "your normal."  If you have engaged in an activity, such as hockey, that overworks certain muscles, and causes other muscles to be shortened, you need to perform workouts to counter balance these actions.  If you are to sedentary, and sit to much, you also need to revive your dormant muscles and strengthen your weakened ones.  Surgery alone fixes the structural issues, but you still have muscles that need to learn, or relearn what their proper function is.


This is the often overlooked and forgotten aspect that patients encounter pre and post surgery.  Ask yourself, better yet your surgeon, how you ended up at this stage in the first place.  Evaluate your life style, activity level, etc.  From my experience most doctors don't address much the why you ended up at this point, but are very good at fixing what is wrong now.


I believe in the total body approach to maintaining and improving health.  I play hockey, but also come from a hardcore workout background that, when I was young was mainly a bodybuilding style workout.  I had my first groin injuries in my late teens in hockey, that I suspect may have contributed to my bad hips.  In the late 80's there wasn't much treatment going on for the average family.  I suspect that my gait, and range of motion changed ever so slightly that I didn't notice.  Diving into hardcore workouts then took it's toll as my body could only handle working inefficiently for so long.  My first sciatica happened when I was 21, and the chronic pain started then.  I reached my peak performance at 24, yet I was shying away from much lower body workouts due to pain, and didn't much in terms of stretching or mobility work then.  Typical two minute warm-up and jump right into lifting weights.  I pretty much stopped regular weightlifting at 27, and started my journey into finding alternative exercise options that caused less pain.  I have been working out and teaching others kettle bell workouts for over 13 years now, did a lot of Bikram yoga when I lived near the yoga studio, do cross fit style workouts-essentially my own circuit training, and discovered the importance of mobility training.  If I only do one thing, it's mobility training and corrective exercise.  I follow a risk reward philosophy regarding my workouts, and do not want to make myself worse.  I really like the DVD's I posted as I can do them at home, on my time, and gives a similar benefit to yoga, but more specific to my needs.


Despite all of this, I could not overcome the "mechanical" changes that had developed in my body, and here I am today.  I am accepting my surgeries, but realize that to regain my health to the level I expect, I will need to be proactive with proper exercise and ongoing treatment for a lifetime.  I am a big believer in muscle treatments and chiropractic as well.  As a matter of fact I never went to a physiotherapist after my first bilateral scope an stayed with my chiropractor.  The ART he did worked wonders for me.


I am motivated by reading the other positive recovery stories here, but realize that everyone's journey is slightly different.  My obstacle, as I have seen is the same for many others, will be not doing to much to soon.  I have a gym in my home, so I have lots of close resources, but need to be wise in their use.


As I haven't seen a story exactly like mine yet, meaning a back surgery for two bulging discs, that will be followed as close as possible by a bilateral resurfacing, I think I may start posting some updates as to how things are progressing.  If can get my butt in gear quick enough I will post my pre surgery prep and give some insight into where I'm starting out, what I'm doing along the way, and what the progress looks like.


For example, before my back went south, I was 212 lbs, at 5'10, fairly muscular, but could have used 10 lbs of weight loss at that time.  Currently, after 4 months of sitting around doing nothing, I'm tipping the scales at 234 lbs, and it's not good weight!!  Ahhh  So, challenge #1, weight loss with no exercise.  As I said before, I am exploring a Ketogenic diet, but, having done it before, know it's difficult to follow. 


I actually feeling motivated knowing that things are finally moving along.  When the official surgery date comes, it will get real very quick.  Have to start doing something now!

[Ljpviper]

Hockey Guy,

  You make a couple of great points. Here is my take on hip issues after going through two failed scopes and a recent successful resurfacing with Dr. Gross.

I injured my right hip first in 09 doing crossfit and the left one went soon after. I went to my local scope surgeon, good guy, trained under Philipon. Had x-rays and MRIs
Etc. Showed a labral tear and FAI, no arthritis. He suggested cortisone shots and I was sent to PT.

My hips went from mild pain to 24/7 pain in a matter of months. Looking back PT was having stretch and do exercises basically pinning my hip in extreme flexion. I did not know better, so I just went with it. Now knowing what I know, we should have been working on strength and joint mobility.

So after 6 months of PT I decided to have the right hip scoped, it was a mess. I had a micro fracture done, the labrum was macerated. I was six weeks on crutches. I was never able to recovered completely I always had psoas issues. I had the left done a year after that was a little less messy inside. But in 2014 I tried to return to running and both hips went south.

After both hips went south I started reading a lot about core/glute/gait and how all muscles need to be firing and in what order. First I noticed my glutes were both basically not working. I started to activate them and my stability got better but the damage was done already in the joint. So that led me to Dr.Gross. He was very hesitant to perform resurfacing as my joint space was normal. He was relieved when he did the surgery and found 4 square centimeters of arthritis on both the anterior portion of the joint and acetablum.

I am at month 6 and recovering nicely.

So basically as you mentioned there is a big disconnect in surgery and PT after. IMO I don’t think these scopes can be successful if the proper PT not administered after surgery. If your glutes do not work properly they cannot hold the hip joint back so its consistently pushing forward in the anterior spot where the repair was, in my case.

Also sitting is probably the worst thing for anyone hip injuries or not. I see it in my office as I have been with the same company for 17 years, started when I was 28 now 45. You basically see everyone developing anterior pelvic tilts and unhealthy postures.

Good luck in your surgeries!!!

Larry

[HockeyGuy]

Well things just got very real this morning!  I am scheduled for my back surgery on October 13th, with Dr. Kingwell at the Civic hospital for those in Ottawa.  I heard from a doctor friend there that he is excellent.


Trying now to scramble a plan together with my wife as to her work schedule, and a plan of action.  I am also fortunate that my in-laws live with us, so they will be very helpful in all this.  My own parents will also move in for a bit to help out.  Any bets on how long it takes for the first fight to happen!!!  LOL, no they are all great.


Other than my actual recovery my biggest concern is getting my kids to their hockey!  They both play competitive, and we live outside the city approx. 35 min. from the rinks!! 


Larry, thanks for your post!  From speaking to the surgeons it appears that they all want to do the least invasive approach first, being the scope that we have both had.  I was hoping for a better outcome from that, but here we are today.  It's great seeing other people out there who take the initiative to look into how they can achieve better health themselves.  Essentially we can only control our daily posture, which usually means how much we sit.  How many of us drive to our jobs, approx. 30-45 min one way, sit for 8 hours, then drive 30-45 min. home.  And let's be honest, we then sit for most of the evening at home.  Even if you exercised hard for an hour 4 times a week, then played your sport of choice once a week, most people would consider that active.  The reality is it's not, and you still sit for about 80% of your waking hours.  People who have jobs where they stand, usually have much less back problems.

My wife and I built a home on her family farm, and specifically used wood as our primary energy source, forcing us to be physically more active at home.  Just taking care of 2 acres of our property, also adds to our activity level, and I take it the next level by building an outdoor rink each winter.  I can't wait to get back doing all this again by next summer or fall!   I hope!!!


We can also control our exercise!  I gave a bunch of names of people that really know their stuff and can give a few more.  Larry, you spoke about glute activation, and this is a huge issue with sitting so much.  Read up on the work of Bret Contreras, who did his PHD on glute function, and you will learn a ton on how when the muscle doesn't work properly, it negatively affects so much else in your body-including your hips!!!


For those motivated to do glute exercises read up on hip thrusts and all it's variations, trap bar deadlifts(a much safer way to do the mighty deadlift), step ups, etc.  Stretch your psoas as often as possible!  Stretch your quads as you are most likely quad dominant from having dormant glutes.  Stretch your calves because as Larry said, you are probably in anterior pelivc tilt due to tight psoas, leaning forward ever so slightly, causing your hamstrings to be elongated and weak, and your calves to be over active.  This is one big chain reaction


Another source that really explains how chain reaction concept is from Peter Egoscue.  He invented the Egoscue Method of treating pain and is based out of San Diego.  Unfortunately I only read his book, but don't have any practitioners near me.  It's a good source of information for yourself, and if you are lucky you may have a practitioner near you.


I find that a lot workouts are getting back by good science these days, and have been pleasantly surprise by some quality workouts from unexpected sources.  An example of this is T25 from Shawn T.  His first workout was called Insanity and it lived up to it's name.  My wife also had hip issues and required a PAO also from Dr. Beaule, which is arguably the hardest surgery to recover from.  She loves T25, and finds that it addresses cores issues, flexibility issues, strengthens her posterior chain(everything that is behind you), kills her cardio, she can do it at home, and most importantly she feels great!


Larry, I think you would really like the work done by Dean Sommerset, another Canadian guy from Edmonton.  He has a website with tons of information, and his video called Ruthless Mobility is my next purchase.


I keep these posts going to long, sorry to anyone reading!  Glad you made it this far.


Cheers

[Ljpviper]

I usually work 4 hours in the office and then 4 at home. All this week I have been sitting in the office 9 hours, I can feel the difference, my psoas are real tight and my lower back hurts.

My focus now is to get my body functional even though one hip needs resurfacing. I don’t think the arthritis is too bad on that one. Its not easy to unwind your body after so many years. I had a bad anterior pelvic tilt, its going away. You really have to put in the time everyday as well. I have been diligent of how I walk and sit.

I also bought the core-x system which seems to really strengthen traverse abdominals, etc. I am committing an hour a day to hip/core work, plus walking the dog for 45 minutes and weights 4 times a week.

I will check out the different plans in your other post.

[HockeyGuy]

Hey Larry, one way to address the overall "restructuring" of your body is some hardcore bodywork.  One of the best is called Rolfing, weird name I know, but look into it.  It also has an offshoot called Structural Integration.  Essentially it's the most hardcore massage you have ever had!  They don't use cream either, and it's a 10 session commitment, where they believe they can work beyond just your muscle, but work on the fascia.


Lots of information on-line about it as well, and lists of practitioners everywhere.  All that being said, I have done 2 10 sessions of this several years ago, and didn't get much relief.  Perhaps the results would be different if I get this done once I'm back on my feet.

[chuckm]

Hockeyguy, good luck with the back surgery.

I have definitely failed to convince you that your damaged back post hip resurfacing would return to feeling healthy.

That's ok because it is your back, not mine.

I failed to convince you that my bulging discs and slipped discs with compressed nerves were as bad as yours. Or that I tried to work my tail off to restore flexibility in my hips like you did.

Yes, it is dismissive.

Again good luck and I hope the back surgery allows you to be able to fix the hips.

Chuckm