3 Days post-op/stationary bike

[SFHip]

I'm three days out and things seem to be going ok. For about four months leading up to my procedure, I spent a lot of time on a stationary bike to keep the muscles around my hip in good shape. Now that I'm 3 days out, I want to get back on the bike for an easy test drive. Is this a good idea? I've been told I have no "precautions" and to do as much as I can, pain willing. Dr. Vail did my hip, in San Francisco, by the way, who seems like a great hip resurfacing surgeon.

[Tekka]

Hi,

I wouldn't go on the bike just yet, you are really early into your recovery....I remember reading the recovery of Floyd Landis and I think even he waited ten days before he got on a stationary bike. I know it is tempting but try to be patient.

Best of luck mate.

Terry

[John11]

This is another area where doctor's instructions may vary. I was allowed, and even encouraged, to use an exercise bike as soon as I got home from the hospital (4 days post-op).

[SFHip]

Thanks for the notes! As it turned out, my internet access went down (I love Comcast) so I headed over to the gym and got on the bike (a spinner with the seat set pretty high). To my surprise, it felt great. I just rode slowly for about 10 minutes and got off. I was amazed that I could make the full cycle without any tightness or pain. We'll see what it feels like tomorrow when I wake up.

I'm certainly no star athlete, but I try to stay fit, and the bike just seems like the logical therapy device.

Then I had a set-back when I played my son in ping pong in the game room using one crutch. He smoked me. He could pretty easily sort out what shots I couldn't reach and used it to his full advantage, surgery or no surgery.

[Bionic]

In my opinion, you are seriously over doing it.  I had an excellent, fast recovery, but at 3 days post-op I was content just to walk around the airport a little on my crutches.  I didn't attempt to get on the stationary bike until 6 weeks.

Your body is in serious healing mode.  Doing too much now could set you back and result in more scar tissue and adhesions, which could complicate your recovery later.  Take it easy, use lots of ice, and enjoy some down time.  The bike will be there in a few weeks.

By the way, what surgical approach (anterior, posterior, etc.) did your doctor use?

[obxpelican]

The only thing I would be doing that early on is walking, no biking.

If you should fall coming off of the bike you might be done hip wise.  Most all femoral neck fractures happen in the first 6 months post-op.

Besides your body is doing some intense healing.

All we can do is caution, it's solely up to you.


Chuck

[SFHip]

Thanks for the notes of caution! I guess my problem has been that my doctor has told me that there are no precautions or restrictions, not even the 90-degree rule for any length of time. I pressed the nurses and the PT's on this at the hospital and they basically said do what I could tolerate.

I will definitely take it easy and read any reaction to what I do and adjust. I don't know which approach the surgeon used, but he's known to be the best in the SF Bay Area and I trust him. I also noticed that other surgeons from UCSF had restrictions on their patients, but Dr. Vail didn't. In the end, I suppose common sense needs to rule here. I was pretty surprised at the instructions when I got out of surgery as I expected the usual precautions, but they were all crossed out.

[wayne-0]

My Doc told me to get on the stationary bike as soon as I felt like I could. He said that it would be good for me to get that movement to keep things lossened up. He also stressed absolutely no resistence on the bike for 4 weeks. I got on it 8 days post op and I felt like it really helped.

Wayne

[Tekka]

The main reason for me to follow a set of strict protocols was -:

I put myself into a mindset of being careful, because the opposite to that would be I would do anything...knowing the way I am, this was really important for me to ensure I didn't do anything silly.

Just a thought

Best of luck

[SFHip]

I like the idea of "strict protocols," believe me. I just didn't get any.

Anyway, my hip this morning feels ok. Not more sore, not a lot better after the brief ride. But my groin muscle feels a lot better and lifting my operated leg is a lot easier (but still not easy). This was a main reason I got on a stationary bike six months ago - I had a lot of referred pain to my groin and knee. The bike really did the trick. In the beginning, it made it a little worse, but once I started building some strength, my hip felt a thousand percent better. I even considered putting off the surgery. But I knew it wouldn't get any better, so I went for it and am glad I did.

In the end, if you set a seat high enough on a spinner bike and don't reach for the handlebars at all, I think this is lower impact exercise than walking, and involves more muscles. For me, it might be the ideal complement to walking. I certainly wont' stand up in the pedals nor put any resistance on it short term, but I think the working of the groin muscle is a huge relief for me.

Thanks for all the input! This site has been a tremendous resource.

[Bionic]

My concerns about spinner bikes are that you could easily violate the 90-degree rule and easily lose your balance.

Now I realize your doc gave you no restrictions, but understand that your joint capsule was cut, probably 360 degrees around.  I would try not to put any stress on that in the initial weeks after surgery.  Flexing your hip 90-degrees or more is likely to pull on your sutures--not a good thing while you're healing.

Also, remember that your cup is not yet well fixed.  It's being held in by friction only.  It will take a few weeks before your tissue starts to really grow into it and fix it more permanently.  Meanwhile, a good knock in any direction could break it loose.

I do like the idea of moving your leg through a reasonable range of motion.  So, maybe if the seat is high enough you could manage this.  But then the issue becomes safety.  If you're so high up can you really be well balanced?  And if your leg is still weak (which it certainly is, at this point), can you really rely on it as you might expect to help you maintain your balance?

If you really feel you have to bike, I think it would be much safer to use a recumbent stationary bike, where you're sitting very stably in a chair with something to grab onto.  Keep the seat back far enough or recline enough so you're well within the 90-degree range--at least for the first few weeks, and keep the resistance at zero or nearly zero.

The idea at this point is to keep things moving and start retraining your muscles, but not to stress the joint.

Really, at 3 days post-op I'm surprised you're not too swollen to do much of anything except bed PT and assisted walking.

[obxpelican]

After your incision has healed you might want to try swimming, it's a great rehab method.


Chuck

I like the idea of "strict protocols," believe me. I just didn't get any.

Anyway, my hip this morning feels ok. Not more sore, not a lot better after the brief ride. But my groin muscle feels a lot better and lifting my operated leg is a lot easier (but still not easy). This was a main reason I got on a stationary bike six months ago - I had a lot of referred pain to my groin and knee. The bike really did the trick. In the beginning, it made it a little worse, but once I started building some strength, my hip felt a thousand percent better. I even considered putting off the surgery. But I knew it wouldn't get any better, so I went for it and am glad I did.

In the end, if you set a seat high enough on a spinner bike and don't reach for the handlebars at all, I think this is lower impact exercise than walking, and involves more muscles. For me, it might be the ideal complement to walking. I certainly wont' stand up in the pedals nor put any resistance on it short term, but I think the working of the groin muscle is a huge relief for me.

Thanks for all the input! This site has been a tremendous resource.

[moe]

I am a VERY experienced road and mountain biker and got on my stationary trainer at about 3 weeks post op, being a bilateral it was a bit tricky getting on and off. I set up a small step stool to help. I had to raise the handlebars as high as possible to feel safe. I used no resistance at all, just turning the pedals over. It felt so good to move and was really great pt. My doc said he would have me back on my road bike at 6 weeks, I waited till 7 weeks. Keep moving but be cautious. I feel better than I have in years.

[bothdone]

I used an exercise bike a lot before both my BHRs.  After the second BHR it was 52 days post op before I got on one - for 10 minutes.    I'd go with caution.

Hope your recovery goes well.

Ed

[SFHip]

I'm definitely going to take it more easy than I thought - I laid low yesterday doing just the minimal exercises and the leg feels much better today.

A lot of this seems to be a balance between physical activity vs. leg reaction vs. pain medication. I find that I can progress faster with some pain medication (but I've backed off what they originally had me on in the hospital as it made me kind of loopy). How long did you guys continue with the prescribed pain meds after coming home? Did you transition to Tylenol or something else once you did? I can't seem to find much info on this.

Thanks!

[obxpelican]

I quit the pain meds shortly after I got home, maybe like 4 days post-op, ibuprophen is a good substitute if your doctor allows it.


Chuck

[Bionic]

The first weeks post-op are largely a matter of tissue rebuilding.  It's important to keep moving to prevent scar tissue from forming adhesions between structures that are supposed to be able to move across each other, to prevent blood clots, and to feel well generally.

But I really think a little bit is all you need in the very beginning.  Your tissues need to mend before you get too aggressive.  As I told my kids when I got back from the hospital, "I'm held together with only needle and thread, so please be careful!!"

I also quit the pain meds at about day 4.  There was a time after that when I needed nothing, and then, a few days later, I started getting some pains down my leg during the night.  Tylenol and ibuprofen worked wonders.

I tried to keep my course of narcotic pain meds short.  I took them as long as I needed them, but no longer.  It was a good thing, too.  I kept them in the medicine chest for a few weeks, and could sometimes feel like they were calling out to me.  When I started reminiscing with pleasure about how great those pain meds were, I flushed them down the toilet.  They can be quite addictive.