JD's story

[blinky]

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.

[oldsoccerplayer]

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.

[blinky]

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.

[jd]

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.

[jd]

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!

[blinky]

The one month count down!

[Tri Hard Alan]

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.

[jd]

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!

[blinky]

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.

[jd]

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!

[jd]

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...

[jd]

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!

[blinky]

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.

[jd]

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.

[Ljpviper]

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

[jd]

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).

[chuckm]

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

[jd]

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.

[chuckm]

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.

[blinky]

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.