I'm splitting my story off from the "almost time!" thread in the hip resurfacing topics area. Below are some ramblings as-of post-op day 2
I'm now post-op day 2 and doing fairly well. I was discharged and came back to the hotel yesterday afternoon (maybe 26 hours post-op) after demonstrating that I could do the PT exercises, walk up and down stairs, and generally get around OK.
In the hotel I found getting in and out of bed to be very difficult initially but it's already getting easier. My operated leg is much heavier than I expected when I try to lift it with the leg lifter! Showers, and a non-raised toilet seat are also pretty challenging at the moment. Things have improved drastically in the past 24 hours, but it's still fairly easy to move my leg in a way which causes some stabbing pain, so I need to be very careful. Sleeping is also difficult as I'm not used to sleeping on my back and ended up with a bunch of lower back pain by early morning.
My walking is going very well. I can now walk with a two-step gait (crutches and operated leg move simultaneously, then I step through with good leg, repeat) although obviously there's still some stiffness in the operated leg.
I went out with my wife this afternoon for some coffee. It felt good to get outside even though it's a little intimidating.
I haven't needed any immediate release Nucynta for the last 24 hours, but still taking the extended release ones. I'll probably need some extra tomorrow afternoon for the flight home. I'm lucky enough to have been able to use points to get first-class tickets back and we have AC sockets in the seats -- has anyone tried to use the ice machine on the plane? I'm pretty tempted to try to get it filled post-security and plug it in on the plane...
Sounds good!
After surgery I tried sleeping in the bed once or twice and didn't like it. I don't sleep well on my back either and I also felt trapped since it's hard to move the leg. I recommend getting yourself comfy in the cushy chair and making that work.
I didn't try to take the ice machine on the plane but I did ask the stewardess if there was any way she could put an ice pack together for me. I think she used trash bags and it worked great. That would have been a MUCH more uncomfortable flight without the ice.
Keep us posted! You're on your way. :)
Back home safe and sound and feeling well, although I strongly recommend against following in my steps on the flights.
It's the morning of post-op day 4 and pain levels are pretty low. I'm working on weaning off the Nucynta now. I haven't had any immediate release since right after discharge from the hospital, and now I'm cutting back the extended release from 100 to 50mg per 12h. Try for zero tomorrow day, maybe 50mg again tomorrow night, then done. Obviously we'll see how that goes though!
Zero pain directly connected to just weight bearing on the leg. The muscles are still all fairly sore so stabilizing while weighting the leg occasionally tweaks a bit but the bone/implant/bone part of it doesn't seem to have any pain which feels great.
Psoas is still the least co-operative and painful of all, and very obvious when getting in and out of bed or a car (where I need to lift the leg and swing it to the side) but it's definitely better. Heel slides on the bed are now pretty easy and no longer painful.
I can sleep maybe 6 hours in bed at home before my back starts to get sore so I did that last night and then moved to the recliner for a couple of hours in the early morning.
I'm definitely less terrified of hurting myself now as things are clearly moving back toward "normal", but I keep reminding myself that it's only a few days and I really do need to be very careful still!
Alright, flights. We'd decided to splurge on first-class tickets back on American from Columbia to Charlotte and then to home in California (It was several hundred dollars cheaper to start in Columbia than Charlotte, but I knew that first hop was economy regardless). It all turned out OK as I wasn't in much pain anyway, but I would recommend against doing that. Frankly, it was almost comical how rude and incompetent the vast majority of airline and airport employees we interacted with, with a couple of notable exceptions. My wife and I both felt this, as did a few other couples we overheard venting to each other. I know this sounds ridiculous, but I've just never seen anything like it. I'd read about how great Delta had been helping post-op patients -- I felt the opposite with American. We were essentially ignored, given wrong information about how to get a ride around Charlotte ("just go and sit in those red chairs" -- 15 minutes later we're still sitting, ask again, "just sit there", another 15 minutes ask again, "well, why haven't you flagged down one of the carts?"). The gate agent in Charlotte was just plain rude when we asked if she thought we'd be able to get some ice on the plane and then lectured me about how stupid I was to fly after surgery. Anyway, there's lots more than this. The flight attendant on the main flight was much nicer and helped us out and everything worked out in the end, but I needed to vent since it was such a hugely frustrating day! Since people have seemed to have great experiences with Delta flying home from that area after surgery, I recommend following their advice!
Glad to hear you are doing so well.
The flights: ugh. I am so sorry. After hearing your story, I think I will bring some big ziplock bags and get ice from restaurants. I won't rely on the flight attendants.
You could write a letter to American and complain, too.
Thanks Blinky.
I'll definitely send a letter to American, it was just ridiculous.
I was just going over my op report now. Leg length increased 6mm, does that sound common or unusual?
Otherwise, everything sounds good. 50mm femoral component, 36 degree AIA, zero anteversion.
I should add that Dr Gross also had very nice things to say about the quality of my previous arthroscopic FAI cam decompression surgery (by Dr Sampson in SF), both after reviewing the x-rays, and also in the op report!
My girlfriend (who is a retired Delta flight attendant) will be happy to hear good things about Delta.
Sounds like you're doing well, keep it up and you'll soon be much more comfortable.
As for sleeping on your back - I was unused to it as well, but one thing that helps is to put a pillow under your legs (I found I needed to do both); that cut down on backaches from it.
Today is 1 week post-op.
Everything is still going well, keeps getting better every couple of days. I dropped to 1 crutch today which is a relief as it's far easier to do things at home and while out walking it also felt more natural. I'll wait a few days and see how I like the cane next. Today was one 0.25 mile walk and another that was just a little longer. General stability is also much improved -- I'm much more comfortable showering now, for example.
I still like using the ice machine. That, combined with Tylenol, is plenty for managing pain now. Particularly if I go for a walk and then do exercises, I'm ready to get on the ice machine afterward although it might just be my own paranoia about doing too much! Anyway, ice machine is great.
I know that I'm far from out of the woods at the 1 week point in my recovery (serious understatement) and who knows what muscular issues I'll have to deal with as I work on coming off the walking aids and re-learning a normal gait. But, I'm cautiously optimistic and very happy overall. First two days weren't the easiest of my life, but I've been cruising the last couple so I thought I'd share my optimism!
How much fatigue do you have a week out? Do you mostly doze or are you reading/watching TV/playing on the internet? Can you concentrate on a task? Have you gone out to eat or for coffee or is that too exhausting? I work a little from home and am trying to gauge how pooped I will be....not promising anybody anything!
Is your appetite good?
Very pleased to hear how well you are doing!
Quote from: blinky on October 22, 2015, 10:22:04 AM
How much fatigue do you have a week out? Do you mostly doze or are you reading/watching TV/playing on the internet? Can you concentrate on a task? Have you gone out to eat or for coffee or is that too exhausting? I work a little from home and am trying to gauge how pooped I will be....not promising anybody anything!
Is your appetite good?
Very pleased to hear how well you are doing!
The fatigue isn't enough to make me want to doze during the day, but I do feel somewhat short of normal (no, really!) and as though there's a bit of mental fog (even after coming off the narcotics). No dozing during the day really at all for me after leaving the hospital. Last night I did have to move to the recliner again so I tend to doze for a bit in the early morning but that's it.
Surprisingly to me, the entire week I've mostly just wanted to play on the internet. Yesterday was the first day I tried reading a book and that went fine but I wasn't really motivated to do so before that. TV is easy too.
I haven't given myself any tasks that are difficult enough for me to gauge my ability to concentrate :) . I'm a little bit fuzzy mentally still for sure. I think it would be very challenging to try to do a full day's work at this point, but I'm pretty sure I could spend an hour a few times a day doing work email and other basic work things.
I actually went out for both coffee and dinner 2 days post-op in Columbia as my wife was convinced I could, and it was fine. Done both again several times with her without issue. Just be careful about seats. Somewhere with booths is great as you can use the booth back and hopefully the table to lower onto the bench. I haven't yet gone out for coffee or to eat by myself as the closest places I'd want to go are still about 0.5 miles away and, importantly, I don't really feel comfortable to drive yet. This weekend, I'll do some very easy practice driving in my neighborhood to feel it all out. I'm confident I can get into and out of a car now without help, and now that my psoas is returning to life it should work out fine, but I'm not a fan of the whole left foot on the brake thing!
Appetite has varied between low and normal. I ate real food the day of surgery and the last couple of days I've been quite hungry and eaten a fair bit. Before that, I was probably eating maybe 30% less than I normally do (that might be more in line with what I should eat though!).
I'd say that it's
plausible that you could do some very light work from home at a week, but you might not be able to either. Initially I was hoping to return on Monday but Dr Gross' office wanted 2 weeks post-op and I'm sure I could have talked then into it, but waiting those two extra days just feels like it'll give me more time for everything to be settled. I think I'll be much more comfortable driving there in a week too.
JD
EDIT: I just reread your thread and remembered that you are having bilateral done. Keep in mind I only had one side done, everything will be a little harder with both (but I'm sure you'll manage!).
I'm still incapable of sleeping on my side unfortunately. Dr Gross said it's perfectly safe to sleep on either side but that it'll probably hurt sleeping on the incision. My issue is that lying on the non-op side, I feel the incision on top acutely, in sortof a stretching pressure type of way that there's no way I could sleep through. I've tried up to 2 thick pillows between my legs with no luck.
Has anyone else had this?
It took six weeks or more for me if I remember rightly. Partly discomfort, partly wanting to be reassured i hadn't messed things up by doing too much or whatever worry was on my mind at that time.
Very inspiring! I hope to be going out to eat, too, if not working.
Today was a good reminder. It was the first day that psychologically I felt I was regressing and it was a little hard to deal with. Rationally, I actually still feel stronger and more stable today than yesterday, but I definitely have more pain. I think I pushed it a little too hard yesterday with both the jump to 1 crutch and adding some extra walking that included a (short/mild) hill and then I didn't sleep well. My psoas feels very fatigued and achy and I have some new pains in random muscles in my thigh away from the hip. Oh well, took it easy today, will have a good sleep, hope to be better tomorrow (or over the weekend).
10 days post-op now. Other than the one down day (post above this), things have gone very well. I switched to one crutch after a week, and then yesterday I switched to the cane which I like far more. I had tried it at 1 week and didn't feel ready, so it's amazing the progress made in just a couple of days.
I occasionally do something which causes a sharp spike of pain (for example, I pulled my skin taught above the incision which clearly pulled on something and was rather painful) but otherwise things feel good 95% of the time.
I definitely put quite a lot of weight through the cane but I don't have much of a limp once I get walking with it which I'm very happy about (I'd still limp without the cane though).
I still get pretty tired by evening, and sometimes a little mopey then, but overall psychologically feeling reasonable also.
Headed back to work on Wednesday which is the 2 week mark. Hopefully things keep improving and I'll be able to handle the mental load of a full work day!
Sleeping is still tricky. I've only once managed to find a position on my side that doesn't cause an incision ache (even lying on the non-op side). I tend to try that first and then unwind it toward my back a bit which let's me lie mostly on my back but in a more flexible, movable position. Lying directly on my back with a pillow under my knees/calves tends to immobilize me and causes my back to ache after a few hours.
Today's my 2 week anniversary and I celebrated by going back to work!
Really smooth day overall. No issues on the commute (25 minutes in, 40 minutes in bad traffic to get home), no issues walking around at work or sitting at my desk. Feeling good, and other than 500mg of Tylenol with breakfast (and the mobic Dr Gross has me on), no other painkillers all day.
Yesterday I also thought I'd check the distance on my new walking route and realized I messed up calculating my old one! What I thought was 0.28miles, was actually 0.56 miles, and my new route which I thought was only a little longer was actually 0.95 miles. So I've basically been walking a mile/day for 4 or 5 days now :).
Congratulations JD! Sounds like you're doing great.
Thanks djganz. Yep, overall it's been going very well.
I should be clear though, not 100% smooth sailing. Today (just one day after my fantastic first day back at work), I managed to do something to really aggravate my psoas after lunch and it's been annoying me since. I'm sure it'll go back down, but I want to make sure others reading this are aware that I'm not super human and do indeed have bad times still! :)
A packing Q.
I am looking for the dimensions of the ice machine. Will it fit in a wheely bag? Does it come in a box that can be checked?
We are putting our stuff together to see what kind of suitcases we need.
Thanks!
Yes, it comes in a box that can be checked (although you probably need some packing tape?). We carried it on with the (failed) hope of using it (see above), but it would be easier to just check. It might fit in a wheelie, but it's pushing it.
Just measured: 10"x13"x12.5" (roughly, for the box it comes in).
I definitely recommend checking as many of your bags as you can on the way back. It's going to be painful otherwise for whoever is accompanying you to carry them all.
Thanks! We travel pretty light, but I will remind my H that he will be carrying the bags.
You'll also have the hip kit (or something like it). I definitely recommend this. We were worried that would break in a bag so ended up carrying it... just lots of things to carry!
3 week post-op update:
Everything seems to be going very well still. I'm now only using the cane for long or difficult walks. I don't need it around the house or around my office (or for other very simple errands). If I focus I'd say that I can walk 95% limp-free unassisted. It's very close now.
Thankfully sleeping has improved quite a bit this week, although it's still not ideal. I can now sleep for a few hours on both sides, with a large body pillow between my legs. The main remaining issue is that I can't get through the whole night in one position, and moving positions with the pillows isn't something I can do while asleep, so I wake multiple times to re-arrange through the night.
There isn't really any pain normally at all now. I would say normally I am at a 0/10, with occasional 1/10. I take one tylenol before bed and one with breakfast, but that's it (oh, and I guess I still have the 1/day Meloxicam Dr Gross has me on).
The only real muscle pain I have is perhaps 5% of the time when I overdo things a bit, my psoas flares up and gets sore (noticeable with each step). But if I take it easy, it settles back down easily.
So, overall, very happy! I have routine brief periods of forgetting about my hip which is a very nice feeling. I'm excited to get to 6 weeks and be allowed to stretch!
I'll be 4 weeks post-op tomorrow and the recovery is still going well.
I've just increased my walking to ~0.9 miles, twice/day, unaided + all the little walking around I do to go to work and to lunch, etc. No real issue with that so I've decided that every couple of days if everything still feels OK I'll just add a block or two to the walk. If things feel overstressed, I'll hold back. Still doing Dr Gross' phase 1 exercises religiously twice/day also (except for the ankle pumps which I figure have become obsolete with all the walking and other activity I do).
Psoas and abductors are still the weakest/angriest muscles, but they're definitely improving. I have a little limp when I stand up after sitting for awhile but it's usually 95% gone after 5-10 steps.
Sometimes I have to remind myself to be careful because I momentarily forget about the hip and pivot on it, but that feels pretty normal now too with no pain which is great.
Last night I finally managed to fall asleep with only a single pillow between my legs (vs 2, or 1 + a huge body pillow) without feeling an ache around the top of the incision. This was fantastic! It simplified shifting positions enough during the night that I could do so while barely waking up vs completely waking myself (and my wife) up each time.
Mostly I'm waiting for a tiny piece of scab to fall off my incision so that I'm allowed to go swimming, and more importantly, waiting for the 6 week point so that I can start doing more!
Sounds great! I can't wait to walk a mile and feel that ankle pumps are obsolete.
JD,
It sounds like you are doing really well. I am having my right hip done by Dr. Gross two weeks from today. After 8 years of dealing with this I am ready to get it done. I want to be able to start rehabbing and then training again. I miss the entire process of training hard and then competing at my highest level. I have always enjoyed mapping out a training plan and then putting the work in. Where you are at now is where I want to be. I would tell you to enjoy each stage of your rehab knowing that you no longer have any barriers to getting back to where you once were. I hope you keep posting your progress and good luck.
Thanks to both of you blinky and Kingrob!
I know blinky that you have it quite a bit harder being bilateral. Early on (and still a little now) I really relied on having one good leg.
Kingrob, I'm sure you'll do really well! Your training background and desire to get back to it is going to help a lot I'm sure, just be careful not to overdo it. If (when) things flare up and get angry, just back off a little and then try again. Best of luck!
I'm at 6 weeks today!
The next phase of my recovery is getting started in earnest now. I'm allowed to bend past 90 degrees, and generally do anything with the following exceptions:
- No "extreme" flexion
- No crossing legs at the knees
- No impact
- No lifting more than 50lbs routinely
I think I can live with that for the next 4.5 months. I think the main thing is to remember to ramp up slowly. My psoas has definitely continued to bother me so I need to pay attention to it. Start stretching it out more, work on strengthening it, etc, but not overstress it too much.
Got my 6-week x-rays and the components look to me like they're in the same place as the ones taken at the hospital (phew).
The PT eval was a little frustrating and afterward I realized he didn't cover everything on the form for Dr Gross (condition of incision, 45 degree internal/external rotation, tenderness, leg length). He was going to copy his notes onto the form after I left, but he talked me into coming back next week for some more guidance, so I'll do that and hopefully fill in the missing details then. He spent more time on general mechanics looking forward and pointed out a few things with my feet and knees. He had a lot of generally interesting things to say but I'm feeling a bit wary and wondering if I'd be better off just starting with the basic leg raises and stretches Dr Gross prescribes and slowly adding in my own activities at the gym, swimming, etc. I figure I could come back to PT in awhile. Sorry for the rambling here, but I was a little frustrated about it all this morning and it's just pouring out!
So, jumping back. I'm at 6 weeks and doing well as far as I can tell. My abductors around the incision are sore when I wake up in the morning, and my psoas bothers me a bit when I walk during the day, but overall I'm still happy with the progress. I don't really have any trouble walking 2 miles at a time.
I just noticed re-reading above that today is your surgery Kingrob! Best of luck and please keep us in the loop about your recovery (maybe post a new thread in hip stories).
Thanks for all your updates JD being a few weeks behind you it has been a great guide into what to expect and I think I'm pretty similar in terms of recovery, nearly two weeks now and pretty much where you were at the same point. Hopefully it will continue in this vain for both of us!
So what will you do first, jd?
What tidbits did the PT have about your hips and feet?
JD,
My experience with PT when I had my BHR was both positive and negative. The positive was I had 7 "in home" sessions which were great. Then I also had the opportunity to have a few "out patient" sessions which were not great. This site is invaluable and provides such good information pre/post surgery, it was this information that I used to cancel the "out patient' due to the PT guy not knowing what hip resurfacing was and the precautions required.
Dr. Gross was not my surgeon, but I found the exercises he recommends on his website and used those with great results. Just my 2 cents... if something is contrary to what you know to be true or if you feel something isn't right, stop it immediately. I figured I'd come too far to have someone unfamiliar with my surgery to cause a setback.
Good Luck!
Deb
Thanks for the feedback all.
Deb -- yep, I'm very wary and agree 100%!
Blinky -- honestly, at the moment I'm mostly happy to be able to stretch! I like that, plus the leg lifts to strengthen my hip flexors and abductors that Dr Gross prescribes. Going to start doing some very light workouts at the gym too. Finally, I'll probably start swimming again soon :) You'll be there soon!
A quick update to say that the 6-week restriction lifting (well, modification as there are still plenty of restrictions) for Dr Gross' patients is fantastic! The combination of being able to stretch (particularly my psoas, although I've also been stretching my abductors) and starting doing the straight leg raises (both on my back for the hip flexors and on my side for the abductors) is working wonders. The tweaks in my hip when I'd start to walk after sitting for awhile or driving are essentially gone now, and if they come back a quick psoas stretch resolve them!
I'm very very happy with this, as it was the main limiting factor. Walked ~2.5 miles today and it was easy. Hilariously, my operated hip is doing better on the abductor straight leg raises than my "good" leg (which to be fair has known weakness/issues in the abductors). The good leg is still functionally better but in this isolated test I'm astounded my operated leg is already doing better.
That's great. What restrictions are holding you back now? When you get in the car are you sitting and then rotating in or putting your legs in one at a time?
The passenger seat in a car is easy (unless it's super low to the ground) and I just lower myself down and then lift the legs (directly, not with arms) and swing them in. The driver's seat is a lot harder. Getting in is mostly easy now but it's one at a time with the legs. Operated (right) leg goes first and needs some care to slide it under the steering wheel. Getting out is the biggest trick. I still have to physically lift my foot (with my leg in external rotation) to get it over the door sill. I can also sortof walk my foot up the door sill but that's also awkward. Basically, I'm not strong enough yet in lots of external rotation with moderate flexion to be able to lift the foot up and over the sill.
Main things on the restrictions are workout related. I'd like to be able to pick up a barbell on a power rack and do overhead presses and other gym activities that are somewhat precluded by the "not carrying 50 lbs" rule. It's a sane rule and I'm absolutely going to follow it, but it's the main thing I notice now as at the gym I don't really like to use the machine, preferring free weights. It's difficult when you're not allowed to pick up the free weights though!
Also related to the weights is that I'd love to get back to scuba diving soon (as I usually dive every week), but the 50lb rule prohibits that too. Frankly, I'm very far from strong/stable enough for most of this yet anyway, but they're the things I'm thinking about.
I actually feel strong enough that I think in a couple of weeks I'll go for a very light "hike" with my wife on some actual dirt (ie., uneven and not flat) trail. That's exciting. I can also walk foot-over-foot on stairs with a little assistance from the handrail fairly easily, and it's quickly becoming easier without a handrail too.
I think the main point is that being allowed to stretch and do some basic strengthening really unlocked the next step in the recovery.
Actual dirt!
Would the kicking with fins also aggregate your hip or are you beyond that?
Weights aren't calling me right now, but yeah, that fifty pounds limit will be a drag.
I don't think I could handle fins right now at all, especially not the very heavy stiff ones I use for scuba diving. Even doing normal breaststroke in the pool I'm dialing back the amount of force I use to kick.
Of course, after writing the note yesterday about how I was doing great I had a pretty rough night sleeping and woke up (relatively) sore. Yesterday with my 2.5 mile walk, 45 minutes of (very slow and sporadic, with lots of rest) attempting to swim, and doing the straight leg raises (front and side) was clearly too much. It's not bad, just noticeable, so I'll take it easy today.
Sounds like you are doing brilliantly, long may it continue!
A quick update from me at 7.5 weeks:
- I've been working on single-leg stability exercises (bilaterally) and finding them very useful. Things like standing on one leg then moving the other leg in front, behind, out to the side, lots of different motion. Also doing (light) bicep curls and other very basic upper body exercises while standing on one leg for balance (with a bent knee). I can really feel my glutes working to stabilize my body and getting a lot better at it
- Very slow step-up and step-down, focusing on trying to remain in control / be able to pause at any point in the step. I can very easily step down and mostly easily step-up now but they're more explosive motions without the stability in the mid-range so I'm working on the slow controlled steps to try to improve that
- Went to our friends' wedding on Saturday night, survived, and even danced a little!
- Downsides are that I've gotten lazy and am walking less. I think I fell into a psychological trap where my walk would take an hour so I definitely don't do it twice a day (and often not once/day) instead of just doing shorter walks if I don't have the time for something as big.
I am taking notes.
Went for a (very easy) "hike" yesterday. Maybe 2.5 miles, a little up and down and rough but nothing too crazy. The very steep portions were really challenging so I avoided those (this area has lots of criss-crossing trails), but overall I felt great!
Another milestone.
Great stuff, you must be really pleased!
How is your recovery going? I am trying to shedule my surgery/s with Dr.Gross this week.
Thanks,
Larry
Still going well. Psoas is still my major problem and I don't do too well standing for more than a couple of hours (and sometimes get some pain ~1 hour of static standing).
Big walks are more sporadic now but longer. I did 3 miles yesterday including some minor hills.
Mostly I'm focusing on trying to get stability throughout range of motion. An example would be that my operated-side quads get super shaky in extension (knee flexion) so I struggle to do a lunch with that leg in front. This doesn't sound super important but it does relate to things like tying shoelaces without somewhere to sit. Gluteus Medius is doing pretty well now. Still some work to do but I'm getting better at going up stairs smoothly without a rail.
Things are *enormously* easier than in the first month and I have to remind myself to be careful. As an example I was walking recently and went to cross the street at a traffic light. I read the light wrong (stupid) and realized the car coming had right of way so sortof half-jogged the rest of the way. I wasn't actually in danger of getting hit as the car had space to slow down but my natural instinct is just to get out of the way and I momentarily forgot not to impact the hip. Thankfully it went OK!
Can you sit with no pain for extended periods? I guess working the muscles back to full strength symmetrically is a challenging, now that the joint is new.
Thanks,
Larry
Yup, sitting is no big deal.
Ha! I hear ya. There are times I forget to be careful, too, I feel so good. And then I overdo it...
Remind me, no PT? I am curious about your particular weaknesses and how you found them out. You decided on your own to focus on one leg stability? And decided after discovering it was a problem?
I did remote follow-up for 6 weeks so I had to see a PT for part of the eval and send it to Dr Gross. I'll say upfront that it was pretty difficult to get the PT to actually fill in Dr Gross' eval form. It took me quite awhile to drag it out of them, which was frustrating.
On the other hand, I did listen to some of the things the PT pointed out, and that's where I got part of this focus on stability. It makes intuitive sense to me and I see the clear connection between day-to-day plus (light) sporting activities and the ability to lower body to stabilize. Since I was past the 6-week "take it easy, really only do these things" cutoff, I incorporated some of the PT's suggestions.
So, I sortof saw PT briefly (a few sessions)? I think I have a lot to work on now, so happy to go back off on my own.
Thanks for all the info Joe, Dr.Gross is calling me tomorrow to discuss. I want to set a date alleady.
Thanks,
Larry
It's been a while since I checked in so I figured I owed a quick update. Things are still going very well as far as I'm concerned, although I've been a little lazy about exercise and definitely gained weight during the recovery. Time to fix that!
I just got back from a week in Mexico City on vacation walking a lot. I did far more walking and standing in museums and the like than I would have been able to tolerate before surgery so that felt fantastic. We also went to Teotihuacan (pre-hispanic pyramid site) and I climbed an awful lot of steps, including many very tall ones. Interestingly, I think I actually improved a ton in that day as I'm now essentially perfect on stairs whereas I felt a little weak still beforehand. I'm going to ramp up my stair activity even further now.
So, all good at the moment and no complaints to report!
Joe,
Glad to hear your recovery is going smooth. Its definitely relieves a little anxiety about my up coming surgery with Dr. Gross, as our cases are so similar.
Regards,
Larry
Hey JD!
So you recommend vacation therapy? Especially in a warm locale?
I hear ya on the weight gain. I was doing so well until just recently. Now I feel good, appetite is back 110%, but ability to exercise long and vigorously is not quite there yet.
Ahh yes the weight gain, comes to us all I think. I'm really fed up with myself and now its time to get back on it. I am ok to go back to my pre-surgery routine in the gym now but for some reason my brain keeps telling me to skip the gym and eat more yummy unhealthy food!
Another update.
I hate "cardio" in the gym. Even listening to an audiobook or music it's utterly boring. I've been walking at a medium speed on a treadmill with max inclination (these go to 15 degrees) which starts to get challenging, but still bores me to death. I enjoy the outdoor walks a lot more but they just don't have the sustained challenge of the incline. I should probably just go hiking more often :)
Basically, I'm salivating at the idea of being allowed to lift weights again in two months (although I will obviously start very slowly!), it just feels so much more rewarding.
I've also been considering working back into kettlebell swings. Dr Gross' 3 rules aren't violated by them (>50lbs, extreme flexion, impact) but I vaguely recalled something else about explosive exercises (which they definitely are) so I contacted the office and got a bit of a confusing response. First off they said it was A-OK as long as I didn't violate the 3 rules so sounded fine to them (with a <50lb kettlebell), even after I'd mentioned it was definitely "a bit explosive". When I responded to their A-OK saying that's what I thought but was just being cautious, they wrote back a second time saying "avoid anything 'too explosive' until the 6-month point" so not sure what the story really is. I should probably follow-up for clarification.
Good news is I've recently gotten my diet back under control and starting to lose some of these excess pounds.
Well darn.
I feel your frustration. Feeling good, wanting to do more.
Yup, to be clear, everything is good! Now I'm just getting impatient :)
But I'll be good. 4 months down, 2 to go.
Hi JD, we all had to go through it. We all had to take it easy and be patient despite feeling really good. Even AFTER the six month mark you have to be focused.
My memory tells me that the greatest number of soft tissue injuries I have read about from posts on this website were from athletes who went too fast too soon in the weight room or with kettlebells once they were cleared for those activities. And many they did not completely realize the injury extent of the injury while exercising.
Most were also set back weeks or months. Luckily, no one I can recall (at least in the last few years) has reported fracturing their femoral neck from the weight room or the kettlebells.
As with any of the "restricted" activities, my advice is to choose a level of exertion (50% or 70% for example) and stick to that for a long period - whether it be running, weights, or kettlebells. That way you will keep clear of the level that could cause an injury. Usually it was those who tried to match their level of exertion with how good they felt during the activity that ended up overdoing it.
Steady calculated incremental increases will provide the fastest injury free recovery in my opinion. That also requires the most discipline as well.
Chuckm
That absolutely makes sense to me Chuck. I'd hate to add an injury and definitely understand that even once our surgeons clear us to do "anything", it's understood that it requires a gradual ramp-up to avoid injury. I know that today I am still not particularly strong on the operated leg -- I can't yet do a lunge with that leg forward and without some additional support (it's OK for maybe 75% of the range down, but the bottom part is really hard) so I have lots to work on with bodyweight anyway in the meantime.
Thanks for your support!
JD, I have another important thing I can advise.
Once you are clear at 6 months to partake in impact activities, also limit the time you perform the activities.
It is important to select a level below full exertion as I mentioned before, but then also limit how long you do the activity.
Certain muscles will reach full exhaustion well before others and if you are swinging kettlebells or lifting weights your large muscles might feel great. But there are many internal muscles that were traumatized by the surgery that will fatigue, go into spasm, and then suddenly you have that mysterious injury that you cannot figure out.
Chuckm
A timely warning.
Some days I feel so good I want to break into a run or at least a skip. But I can't. This not yet six month period is dangerous. And I guess the just passed six month period is going to be tough, too.
I started doing kettlebells but only after the 6 month wait. I would recommend going very slowly, don't do anything earlier than that and start with a lighter weight and even then don't go full out, just ease yourself into it. The slightly leaning forward stance while lifting or swinging weights is about the only one that causes me any discomfort 2 1/2 years post op. It goes away after a minute or two so I don't think there's any injury, not sure exactly what causes it (scar tissue?). Rule of thumb is - if it hurts, don't do it - ask the instructor for an alternate exercise.
If you have to ask, the answer is no.
JD, I am like you, feeling great, wanting to do more, but not wanting to overdo it. So I asked if I could go to spin class. Stationary biking is okay. What is spinning but stationary biking with other people and loud music? I was feeling good about getting a yes, my only worry being that there might be some moves (standing and pedaling) that might not be okay. (This was not okay for me pre op because my femoral head was so cystic.)
Lee said no. I have to wait.
Darn.
So walking, swimming, and waiting.
I'm actually pretty surprised about the spin thing blinky. Did Lee explain? I thought that biking was A-OK, just not on a real bike that could fall over. Is she worried about the "sprints/high power" parts? Actually, I just re-read -- sounds like maybe because of your femoral head bone quality?
I actually got the clarification this morning that I was cleared to start doing kettlebell swings, but just to take it easy/slowly. Don't do too many too fast, and don't go at anywhere near 100%. I'll probably either get a really light kettlebell (10 or 15 lbs) or just do some other exercises with it (like presses). Regardless, I won't start either just yet. Maybe wait until 5 months :) then do a slow ramp (staying well within guidelines and away from 100% exertion until after 6 months, and take it easy even then).
What do you all think about low-impact bodyweight exercise that could be done to a high % exertion? For example, the incline treadmill. If I use a 15-degree incline but keep it slow it's a moderate exercise, if I start walking a bit faster (even 2.5miles/hr on this much incline) I can push my heart rate pretty high and it's challenging to keep up for 30 minutes (which gets to about 1000' elevation gain). Obviously I need to pay attention to fatigue in stabilizing muscles but this seems like more of an aerobic challenge than anything else.
I made it to the 5 month point this week!
Most of my exercise/training has been a combo of walking on the 15-degree incline treadmill and hiking up some 1000' gain nearby peaks. The hiking is obviously much more interesting, and I also think it's much better training since it has rocks, uneven terrain, and I have to go down as well as up. Good stuff for stabilization. I suspect that the treadmill will disappear soon, particularly once I can start doing more strength-related stuff at the gym.
I think this weekend I'll go ahead and start trying out the kettlebells, but will definitely take it easy.
Gluteus Medius still gets sore to sleep on, but it's sore no matter which side I sleep on and it's always been somewhat that way so I'm doing OK.
In a week or two I'll also try doing some of the hikes with a <50lb backpack (start small, ramp it up) in preparation for my return to scuba diving where I need to be stable with ~80lbs on my back. Same thing with doing some squats like that for the sitting/standing/sitting portion. I can probably start working on squat form with just the 45lb barbell soon too.
All exciting!
The one month count down!
I am a couple of weeks behind you both, will be 5 months on the 27th.
But have already started running, on my physio's advise, at 4 months (surgeon suggested 3 months). Its on a treadmill and a walk/run (this week 1.5 min walk/3.5 min run x 6) but hope to be running 30 mins continuously by the 4th April by gradually decreasing the walking bits. Absolutely pain free so far.
Good luck to you both and look forward to reading more about your progress.
6 months this week!
I've spent the last 3 weeks or so doing some more serious bodyweight fitness training which has helped prep me for restrictions lifting.
I celebrated today with a (very conservative and light) date with a barbell at the gym. Did some squats, deadlifts, and presses, but again, very light (not much more than the bar alone). Things generally felt good. The biggest challenge was deep in the squat (parallel, not super deep) making sure I use my legs equally. I can tell that the operated leg is still substantially weaker so I'll need to take it easy for a while as that strengthens. Great stuff though!
Congrats on reaching the end of restrictions! So lifting was the thing you have been pining over? Hope the return to heavy weights goes smoothly.
Scuba diving is the thing I'm most pining to do, but thankfully it has been a *horrible* winter here for diving. Usually winter diving is fantastic but it has been one of the worst years in a long time. I timed the surgery well!
The thing is, scuba diving gear is heavy (at least when cold water and drysuits are involved). My rig at the start of the dive weights ~70lbs and I do a lot of shore diving, so walking on sand or uneven surface to get into the water. I want to prepare for that by confirming I'm stable and strong enough in the gym with a barbell first. I'll likely start diving in another couple of weeks if all goes well in the gym!
For others who are at 6 months post-op, can you do a lunge on the operated leg (or either for bilats)?
It's getting a little easier, but I can't do a stable, unassisted lunge with my operated leg forward yet. It feels like most of the limitation is actually in hip flexors (psoas primarily). If I can push off with my hand with light-medium force it's fine, and I can do it without my hand, just not in a controlled manner.
I've actually noticed a huge improvement since I started squatting with a barbell from before, but it still seems limiting (and I'm careful to minimize any favoring of my good leg while squatting as a result).
Just interested on how this aligns to others' experiences, even though it doesn't really matter. I recall that at least blinky had a lot less trouble than me with the prone front leg raises, although I found the side leg raises easy in comparison, so I'm guessing just different muscle strengths and weaknesses...
Another question for anyone else at 6 months+ without restrictions:
Can you adduct your operated leg at all (cross midline, opposite direction of the side-lying leg raises) when flexed to 90 degrees+?
I cannot. The more the flexion is, the more I have to abduct it, although I can adduct significantly with a straight leg without issues, and somewhere around 90 degrees I can't really cross midline. What happens is that there's a really strong tweak somewhere around my psoas (kindof in the area that is getting compressed) that really makes me backoff. No issues up until the tweak point though.
I've contacted Dr Gross' office about it, but wondering if anyone else has experienced anything similar.
In other news, my weightlifting is progressing well but I'm still weak. I won't complain though, enormous progress already from when I started!
I can't do it either. No pain, just a hard stop. Okay, to clarify, left side can cross the midline when bent 90 degrees. Right side can't. Right side is too inflexible in the butt to do it.
Interesting, thanks blinky.
So for you it feels more like butt muscles limiting it, right? That's pretty different to mine. I'm seeing some slow progress by "flirting" with the pain area -- I wonder if there's something there that I'm protecting and it's causing pain and slowly acclimating the tissue to the range of motion might be helping.
I feel like I could do it from a flexibility perspective (in fact, one reason I want to do it is to stretch those muscles) but I'm being stopped by main on the compression side, not the stretching side.
JD, when I was at Dr. Gross's this week he mentioned to not do that particular motion till after 6 months. I know your past that point but I bet that particular motion must put pressure on the joint capsule. Maybe that's why it feels funny still.
Your talking about the movement basically on how you test for FAI, correct?
Larry
Right, I definitely had to wait until post-6 months to test this, so it's possible the issue is joint capsule as you say. A couple of things are a little different though -- I think the joint capsule concern is in the opposite direction (basically the portion of the capsule closest to the incision). Flexing and adducting stresses the capsule near the incision, but in my case the sharp sensations are on the compressed side, which should still be strong since the surgery doesn't cut there (again, opposite the incision).
It's not quite the same as the typical FAI test, as I'm not internally rotating when I do it, adducting instead. Think flex to 90-110 degrees, then flexed knee moves across the body, pulling on some glute area muscles.
I got the impression from Dr Gross' staff that this wasn't a super common expected thing, and blinky not having it is another data point to confirm that. I'm sure it'll improve over time anyway (around the 3 months point it was *very* easy to trigger this sensation just trying to tie shoelaces and that's improved a lot).
All of you are talking about typical symptoms of hip resurfacing.
The hip capsule that was cut 360 degrees around during surgery to dislocate the hip get sutured on one side (the other side has to heal on its own). This sutured area helps keep your new hip from dislocating early on and is why your surgeon asks you to avoid crossing your leg past the midline. That way you don't pull those sutures while the capsule is healing.
But after healing the capsule can be very tight.
Plus, in order to dislocate the hip, your surgeon must also cut the small external rotator muscles and suture them back onto the bone. This is another site that must be protected by not crossing the midline.
There are some other ligaments that tighten as well so you can see there are quite a few structures that are all resisting the ability to cross over your leg after this surgery.
This crossing over motion is also called internal rotation of the hip. The lack of this range of motion will cause you to have knee problems when running (and even walking once the symptoms start).
After you have been cleared by your surgeon, it really pays off to try to regain this motion but it is a lot of work and you must do a little bit over months and months.
There are two symptoms that you feel from this stiffness. One is tightness near or at the incision site (if you had posterior approach - which Dr. Gross does use). The other is the impingement on the groin side. It can feel like a tennis ball is or something is stuck in there.
If you are patient you can gently try to stretch through that every day little by little and the motion will return but very slowly.
Chuckm
Thanks Chuck!
Just to be clear, I'm really *not* talking about internal rotation. Adduction/abduction and internal/external rotation are different motions. I can significantly externally rotate and still have the same issue here -- it's adduction.
You are correct internal rotation and adduction are different but will affect those same areas. Sit proper in a chair with feet a little wider than shoulder width apart. Then with your operated side hand on the outside of your op side knee, push it toward the other knee keeping feet planted.
That motion is both internal rotation and adduction and will likely be tight and / or uncomfortable for a resurfacing patient.
You can improve adduction but you will need adduction and internal rotation.
External rotation and abduction typically do not have tightness but the muscles to perform those are weak.
So there is hope? I am going to have to search the old discussions by post restrictions folks on what they did to overcome some of these obstacles. [size=78%] [/size]
JD, no pain where the contracted area is, just the hip not able to stretch enough.
JD, Blinky, and Chuck
I am a Dr. Gross hip resurfacing patient, now about 10 weeks post op and I am having the exact same issues you all are describing. Really limited range of motion with internal rotation and adduction when my leg is in the flexed position. The more that I abduct and external rotate, the more flexion I can let my leg fall into. I actually had really good range of motion still prior to the surgery, and this was not something I was anticipating would be a main limitation afterwards. It has been really uncomfortable and makes it more difficult to bend over and grab something than I did before. If I am not being carefully when I swing my leg out of bed or out of the car, my groin will get that sharp pinching sensation. I am curious if you have found that this goes away with time and has been improving, because mine has not in the slightest.
I had to review to see what movement we were were talking about.
It does get better. I can cross my legs on both sides easily now. When did that happen? It took awhile, maybe six months. I'd say give it time. Between three and five months I made a bunch of gains in strength and agility. The most memorable was being able to do a legal breaststroke kick. The right leg could do the motion but was weak and a little behind the left. I had an asymmetrical kick. Then it caught up. At first my toes wouldn't point and flex during breaststroke on the right leg, then that ability came back.
If you still can't do it at six months, come back and tell us.
I will confess that I am still weak/stiff in my external rotators on the right side. I have periods when everything feels great and I can do whatever I want, then go too far and and have a period when they feel weak, the right knee is swollen, and I have to dial it back. The point where I have overdone it and I have that problems gets further and further out, so I am making progress, but that is still my weak link.
All of you are amazing and truly inspiring. Keep up the good work!