Serious Hockey Players Who Have Had Hip Resurfacing

[jcalvert]

I had a right BHR on December 30, 2008 and hope to return to playing hockey by next season (Sept 2009).

I am 47 from the Flint, Michigan area and still play competitive hockey with guys half my age and would like to continue to do so.  Physically, I have no reason to believe I won't be able to, on the other hand, I do not want to risk a hard check or fall that would directly compromise the longevity of my new hip.  Therefore, is their anyone out there that has had a resurfacing or THR that has had a chance to get back into playing?  If so, how long did it take to feel like the surgery was not a constant threat looming over your choice to play?  Did you experience any stride or pivot limitations or adjustments to your previous style of play?

I would also be interested in specific training methods that were found to be more beneficial than others in the recuperation and rehabilitation process.

If there is anyone with this kind of experience or with soccer, or lacrosse, or inline hockey, or anything that might be helpful, I would appreciate beginning a dialogue.  Thanks to all!

[DirkV]

Hi. Your post got me thinking about Tim Taylor, formerly of NHL Lightning, who had resurfacing. I couldn't find anything current, but did find a couple articles from when he was 8-9 mo post surgery.
Here are a couple quotes:
"Taylor is "ecstatic" at the results. He said he is golfing, playing racquetball and running 7 miles "at ease and without any pain."And I can play hockey at any level," the center said. "I'm totally convinced if I was 25, 26 years old, 30 years old, I could come back and play for sure." [source url: http://www.tampabay.com/sports/hockey/lightning/article429780.ece]
"Tim Taylor: "I have more mobility that I've ever had, say in the last six or seven years. I'm very thankful...because I feel great now."" [source URL: http://content.momstampabay.com/news/local/story.aspx?storyid=76418]
But read the articles because he didn't in fact come back to the NHL.
I'm a once (and future?) goalie. I've been focusing rehab on bicycling in months 4-10 post-op. I've just started playing hockey again (skating up) the past couple weeks. As a forward, I'm not a serious hockey player, but I can say at this point, I don't have any concern about the hip. That said, I think I'm still a bit weak in the glutes from the incision, and I'm still making progress on regaining ROM. The good news is that I'm working on those things, and I'm still making progress.
Keep lookin up,
-Dirk
Bilat 02/08, 03/08, Dr. Ball

[jcalvert]

Dirk,

That's fantastic news.  Thanks for the info and the articles.

I started this season in September and only played four games before I couldn't stand the pain from push-offs and pivots (as a defenseman) and I couldn't shake the visions in my head that with one wrong move, I would snap my femoral neck because osteonecrosis was a pre-op differential doagnosis.

Also, since osteonecrosis (from the MRI radiologist's report) was a diifferential, my surgeon, Bruce Lawrence, DO, Flint, Michigan, offered and I accepted to undergo an arthroscope to see exactly what was going on.  He stated that he has had a lot of false negative MRIs and was baseing his decision on his 20 years of cllinical experience.  Due to my age of 47 and because my case was so rare, by using a scope to debride and examine, he was able to determine that osteonecrosis was not an issue and that I was in fact a candidate for resurfacing over THR.

My case is an example where resurfacing was a fairly new procedure in Dr. Lawrence's armamentarium (less than twenty cases), but due to his reputation as a highly skilled orthopedic surgeon in general and the fact that he had been trained on the use of the BHR, and I had also confirmed with him on whether I was a "legitimate" candidate for resurfacing, I new I was in good hands.  11 days post-op and I am recovering wonderfully.

Please do me a favor, would you try to remember and then list what post-op rehab therapies you were performing in progressive time frames.  I would like to take that info to my surgeon when I see him tomorrow, Monday, January 12th, so that I can work with him in developing a rehab routine based on another hockey player's protocol.  Also, if you had known, say 2-3 months ago that your glutes would have been weak in your skating, what exercise(s) might you worked on, if any?  Thanks Dirk!

-John Calvert

[DirkV]

Hi John, Glad to hear your surgery went well. It's pretty incredible that this surgery lets us even have this conversation about returning to activities at a high level - even at all.
For the first month or 2, my rehab was garden variety THR Phys Therapy. I added to this bicycling (on a training stand, starting with no resistance and adding gradually). My surgeon recommended cycling as soon as possible, and so I started at between 1-2 weeks.
I started serious phys therapy at around 2 months, but I'm not enough of an expert to really describe the exercises and the muscles targeted. It's also made more difficult because the therapist and facility had nicknames for the exercises: "butt blaster," "sled," etc.
The butt blaster consisted of bending at the knee, supporting yourself on one leg, and going into kind of a bowling follow-through pose; then returning to upright. For added difficulty, after a month or so, they had me stand on a little stand on one leg and then with the other foot on a little wheelie deal, swing that leg in an arc from forward to around back and crossing behind the supporting leg as far as possible.
They had me throwing a medicine ball to a bounce-back thing and then catch it - on one leg, then sideways (to help with hip capsule ROM), then sideways on while standing on balance balls.
There was only one weight machine, a sled which I pushed one leg at a time.
For ROM, there was "the fencer."
Sorry I can't provide more detail. My rehab experience was good, and I think that most of their patients are reluctant, so when they get somebody who wants to really work, they were happy to pour it on. But I had approx 1 1/2 hrs of exercises, and they were always adding little twists, so I'd probably be giving wrong directions if I tried to describe.
After the exercises, they would work on ROM. I think there were -- and to lesser extent still are -- three areas to work on:
* Hip capsule: just plain tight; restricting sideways ROM. It's getting more and more normal.
* Those little muscles they cut (abductors, adductors, I think) and then re-stitch during the surgery. They are tight and when ready to start stretching them, needed stretching.
* Weak glutes (again from surgery trauma). I haven't done much with weights, but have been riding bicycle a lot (completed 85 mile timed ride in November, training over 100 miles/week).
If I were rehabbing specifically for hockey, more glute specific phys therapy might help, but again I"m not sure. I've also read of other re-surfed hockey players who said that those things filled in naturally (literally, getting the big hockey-player butt rounded out) sometime after over a year.
Good luck. I think that during these early days/weeks, the best advice is to listen to your body and surgeon.
-Dirk

[jcalvert]

Thanks Dirk,

I'll make a copy of this post and take it with me so my surgeon can also see the website in general for his potential interest in the resurfacing topics that he might like to use to further develop his own "resurfacing practice" development.

As of today, I am already doing things that I would not have expected at 12 days, like slowly running up and down a full flight of stairs (under control).  I'll be heading outdoors for walks starting tomorrow in our current Michigan daytime temps of the teens & twentes.  I will also be hitting the bike indoors along with my upper body work and shooting the dryland practice ball to begin ROM testing of my hip in shooting postures.  Of course I will be listening to my body very closely.  All of my work will be in addition to any PT Dr. Lawrence prescribes, if any.   As both a former ortho/neuro consultant and personal trainer to hockey teams, he knows that I'm a stickler for proper fitness regimines.  But I am never too arrogant or proud to ask for suggestions.  And so I truly appreciate your responses.

My hope will be to get into some late summer conditioning skates with our local Junior A team and determine by September if I will be ready to ask Dr. Lawrence's permission to start the new season in the Fall of 2009.  And if he or I don't feel I'm quite ready yet, well then, I'll keep training until I am ready!

Again, thanks for all your help and continued success on you own recovery.

All the best,
John Calvert
Flushing, MI

[Grimbo]

John,

You seem to be flying with your recuperation!!!

I'm now 6 weeks post op and my rehab has been hampered by some unrelated issues (knee, ankle and foot problems have slowed down my recuperation). I still can't walk without two crutches.

What level of hockey did you play at - was it full contact?

I play recreational hockey at a very low level but there is full contact and I'm scared stiff of taking a hit with my new hip. I think the biggest fear is dislocation. I understand that at 12 months, you are just about as likely to dislocate as you were with your natural hip!

Anyway - I'm interested in how you get on and the steps you take to get back on the ice... Please keep us informed.

Graeme

[Pylon 16]

I had a durom cup put in my right hip April 2007 and was playing hockey again the following Sept - It felt a little wierd at first and I was scared to get into too much contact - especially anything that would put me in a position where my legs were "spread" apart or my right leg was turned in - good way to dislocate the hip! I have gotten more comfortable with playing over the last 2 years and haven't had any issues with the right hip . I don't know what level you are playing but I am 50 yrs old and playing"old timers" hockey - no contact and no slap shots. I wear core stability shorts and also do regular physio and see a Kinesiologist to work on stretching and core strengthening. - you might ask how come I have been doing this for 2 years - well my left hip now needs a resurface and I am hoping to get one soon - see my surgeon next month. My surgeon never really told me not to play hockey - he just said do what you feel comfortable doing. The whole idea of getting the resurfacing was to allow me to return to doing things I was doing before the hip(s) started to go south on me.


Good luck

[Grimbo]

Well I'm now at about 3 and a half months and I put my skates on for the first time a few days ago. I managed ok although I was careful not to get into any situation where I might hit anyone or get hit... also, I was careful not to fall over!

My physiotherapist told me it was fine to start skating again but I'm not allowed to play until 6 months (June).

I had a lot of aches and pains the next day (but these were proabably just down to using muscles I haven't used recently) - which is exactly why I wanted to start skating again!

[TG]

I too have played hockey competitively for many years but am now facing hip problems.  In Dec 2007 I had surgery to mitigate the fermoralactabular impingement thinking that was my only option to continue playing hockey.  It was devestating when I first heard the diagnosis, which I was in denial over and got a second opinion on - only to find out the 2nd opinion was worse than the 1st.  The second opinion included along with the impingement diagnosis a much more grim OA diagnosis. 

I was 45 at the time of surgery and just recently returned to playing in a league this year.  Since my hip is still tender and has not returned to full range of motion I decided to start playing in an intermediate league to ease back into it.  On my 4th game of the season I was feeling great, skating strong, had scored 2 goals in the 1st part of the 1st period and then my teammate was knocked down and slid into me.  I landed awkwardly and overextended my hip.  It took me a couple minutes to pick myself up off the ice.  I finished the game but had no power out of my one leg - I should have left the ice.  As the Ibuprofen that I use prior to each game wore off I found that I could walk with a big limp and any slight movement in the wrong direction sent shooting pain in and around my hip. 

My orthopaedic has agree to see me on Monday to see if anything is broken but I am slowly coming to grips with the fact that the only real solution may be a resurfacing or replacement.  I will resist replacement if it ends hockey and skiing. 

Sorry about all the sad story above - but what I want to ask is I've only seen ~6 or 7 people respond to  playing hockey after hip resurfacing and most in the early stages.  Is there a greater pool of people out there who have sucessfully returned to hockey after hip resurfacing?  What have you learned?  What about dislocation - I thought that was the big issue after replaement or resurfacing?  Thanks!!

[Grimbo]

TG...

I'm no expert but I think dislocation is quite unlikely due to the physical size of the actual cup and ball!

I'm pretty sure that I read somewhere that after 12 months, you are no more likely to suffer a dislocation than you were prior to surgery!

If you read my thread entitled "turmoil", you will see that I was in a similar place to you... wondering whether to just squeeze another few months or years out of my hips before hanging up my skates or going for it and having the resurfacing.

I'm now 3.5 months post op and had my second skating session tonight! Ok, I'm being REALLY careful (my surgeon told me not to play hockey for 6 months, but didn't tell me not to skate!). The hip feels great, the muscles are still a little weak and sore but a few more weeks and I'm pretty sure they will be back to normal.

6 months feels like an awful long time, but once done - you'll have many more years playing the great game rather than ending up a frustrated spectator!

[TG]

Grimbo, 

To what extent has your range of motion been restored?

I did read somewhere on this site that 12 months after surgery you are no more likely to have a dislocation than prior to surgery - The dislocation probability information is very encouraging but I guess I'm wondering where that information came from?   

Are there material choices for the hip and femur? and if so what decisions did you make? 

I love the game of hockey and its my goal to be able to continue coaching my sons squirt team and play in a mens league with my son when he turns 18, although if he keeps skating he won't want any part of a scrub league. 

Do you know any others who have been through the operation and and have been skating for several years? 

For now I'm on crutches awaiting my appointment to see what I did to myself last Tuesday night.

Thanks for the encouragement.  Good luck on your recovery.

[Grimbo]

My range of movement (ROM) is a revelation compared to what it was!!!!

I had a particularly bad ROM before the op... standing upright I could only open my legs apart by about 7 or 8 inches. Now I can manage more than two foot! In fact, what is stopping me now is my unoperated hip!

I can't remember where I read about dislocation but it will be in these forums somewhere (everything is!!)

I was given the choice of the Birmingham hip (metal on metal) or a ceramic equivalent. My surgeon actually recommended the ceramic hip - but having read a great deal about it - I decided that the Birmingham hip was better suited to me and my aspirations.

I don't know of anyone else who has had a resurfacing.

Lets not beat about the bush... the operation is traumatic and the first 7-10 days are horrible. At about 10 weeks something amazing happened and I started to see the light at the end of the tunnel. From then, the recovery rate was very rapid.

A week or two after my op, my wife asked me if I would ever get the other one done and I said NO WAY! Now, a few weeks later - there is no doubt that I will get the other one done at some point!

It's a no-brainer really!

Let me know what you decide, it'll be good to hear from you.

Graeme.

[TG]

Graeme,

Thanks again for the encouragement.  We'll see how it goes this coming Monday morning - probably some new X-rays to see if anything is broken or further deteriorated.

[n9gun]

Hi Guys -

I am a 45 year old minor hockey coach for many years as well as referee for many years.  Although not playing competitively anymore, keeping up with the Midgets was a choir and rigorous during practices.  I couldn't turn effectively, lost all my power in any stride left, and picking up the puck was awkward at best.  I was miserable the entire 07-08 fall season and had to sit out the 08 spring and fall season.  I decided to get it fixed once and for all as I could barely walk on some days.

I had my left hip resurfaced in Nov '08.  I'm almost 6 months out from surgery.  My ROM has not come close to returning as of yet and I have not been able to put my sock on the operated leg without the help of the sock gizmo.  I was hoping to be on the ice this Spring but will now aim for a Fall 09 return.

I see my surgeon in a few weeks to decide why my tendons are limiting the ROM.  Suspicion is scar tissue has formed on them and needs to be scraped and removed via arthroscopic surgery but that will not be determined until I see the Doctor.

So, although all of us expect to see the ice quickly, even the most diligent of people will recover differently or have issues.  It doesn't mean that the operation was a failure, but be prepared for the unexpected in case it occurs.

Thanks,
Tom