Best Post-Op Recovery Program For Athletes

[stephen1254]

After being diagnosed with OA in September, I began exploring my options and came across this terrific site. I have read and understand what is involved in resurfacing, but what is particularly valuable is all of the insight and feedback from others who have gone through the same thing.

I am 6 weeks out today from my surgery with Dr. Callander in SF. I am working on putting together a realistic work out program for recovery. While I realize that I will need to feel my way, I am thinking of the particular exercises that have worked for others. I am 58 years old and have been mega active for the last 35 years. I bike, run, lift weights, compete in triathlons, hike, paddle board, and ski downhill and cross country - in fact I scheduled the surgery to coincide with the end of the ski season, and to provide a sufficient recovery period before the start of the next ski season. Up until I was forced to stop running in mid-November I had my BF in the 7% range; it is still in single digits.

I have a complete weightlifting gym at the house, with Olympic barbells, a full set of dumbbells, and every machine exercise you could imagine. I have a treadmill and a spin bike, as well as a road bike, TT bike, and a mountain bike. I also live on the edge of a forest and have access to tens of thousands of acres of open land.

So it appears that walking is the primary initial activity. I haven't seen much mention of the treadmill, perhaps because of the need to stabilize with crutches or a cane. I don't see a lot of reference to an exercise bike, although I have adjusted mine to not go beyond 90 degree of leg lift.

I am curious about what others have done for weight lifting exercises in the lower body to speed recovery and aid ROM and healing. For instance I can do a body weight squat while hanging onto a bar to reduce the amount of weight I am squatting. Has anyone tried that? Does anyone do leg lifts or donkey kicks? I know there is a restriction on lifting your leg past 90 degrees, pointing your toes inward, and crossing your leg. Is there a restriction in lifting your leg straight out to the side?

I am sure a lot of this has been covered in other posts, and I have read many of the posts, but I am trying to distill all of this down into a program.

[ZAP]

i'd like to know as well..  It seems to be all over the place. Some people are recovering in  a month and some it takes a year.

[David]

Get hooked up with a good PT for at least the first several weeks post-op.  Work on ROM and slow strength build up.  Soon you'll be able to do whatever you want.  Respect rest and listen to your body when it needs it.  The trails are excellent for putting good walking hiking mileage in with less impact.  I'd keep off the mountain bike for the first 4-5 months, even an easy fall is not a good one.

[Aerial]

Recovery protocol seems to be very doctor specific.  Check with your surgeon about the recommendations.  While I feel like I could have done a lot more during the first six weeks, and feel like I could run right now at 8 weeks, I did (and am) following protocol.  I was not allowed to use an elliptical or exercise bike for 6 weeks.  I could do upper body weights but nothing above 50 pounds for the first six weeks.  Right now I am limited to no more than 50 pounds of weight upper or lower body for 6 months.  No impact activities for a year (running) and no cycling outdoors for 6 months.  I am currently walking a lot, have started spinning classes again, am nicely getting back into yoga, occasionally lift weights and use my elliptical regularly.  I am not going all out on any activity yet.  Although I have been blessed with an easy recovery there are muscle imbalances and weaknesses I continue to work through from the the compensating I did prior to surgery.  The bone is healing and growing into the implant, too much, too soon can be counterproductive. I am willing to keep things low key for a while because I do not want to go back to hurting or end up with a failed HR.  my surgeon was Dr. Gross and he is more conservative than some but with his experience you have to trust him!

[jon]

Recovery protocol seems to be very doctor specific.  Check with your surgeon about the recommendations.  While I feel like I could have done a lot more during the first six weeks, and feel like I could run right now at 8 weeks, I did (and am) following protocol.  I was not allowed to use an elliptical or exercise bike for 6 weeks.  I could do upper body weights but nothing above 50 pounds for the first six weeks.  Right now I am limited to no more than 50 pounds of weight upper or lower body for 6 months.  No impact activities for a year (running) and no cycling outdoors for 6 months.  I am currently walking a lot, have started spinning classes again, am nicely getting back into yoga, occasionally lift weights and use my elliptical regularly.  I am not going all out on any activity yet.  Although I have been blessed with an easy recovery there are muscle imbalances and weaknesses I continue to work through from the the compensating I did prior to surgery.  The bone is healing and growing into the implant, too much, too soon can be counterproductive. I am willing to keep things low key for a while because I do not want to go back to hurting or end up with a failed HR.  my surgeon was Dr. Gross and he is more conservative than some but with his experience you have to trust him!

Yet again (!), I cannot agree more with Aerial's views on this topic and her own experience thus far.  My doc's (McMinn) guidance for all of year one is very conservative (pretty good info on www.mcminncentre.co.uk/ ).  Much emphasis is on getting the device (acetabular cup in particular) firmly implanted.  Huge disdain for any loading and/or impact the first few months.  No running for a year.  I'm almost eight weeks post-op and swimming is my go-to activity.  Not only is the workout great, but the ROM impact is really good. 

[stephen1254]

It's interesting that the recovery protocol seems to be Doctor specific, and not patient specific. I can understand that some Doctors are more conservative than others. Mine seems to push the envelope - he has patients jogging several miles, 3 times a week at 3-4 months.

I will be working with a PT and will follow my Doctor's recommendations. What I am interested in are the exercises that others have utilized that have worked for them. My Doctor isn't going to detail every little thing I can do, so I'm thinking in terms of what is going to help recovery the most. I'm particularly interested in squats, as those utilize all of the muscles in the recovering area and promote blood flow in the recovering area.

[hernanu]

I had a pretty aggressive doc, and he told me to lay off running until six months went by. Listen to your doctor, but you also need to work with your PT. Have they done resurfs before?

I didn't run until about 8 months went by, but I was doing weight training before that. Everyones different, but at three months or so you have to be careful of neck fracture issues. I'm doing some pretty intense workouts now, but I am on one year + on both hips.

[hipnhop]

I think it is all about being smart. Last year I did an IM AquaVelo 3 months post op and had no problems. I was going to shoot for a full IM Aquavelo but my upop hip was giving me too much pain.  I plan to hit the gym after my 2 weeks appt, 80-85% of my weight load except legs.

I plan to be back in pool at 5 weeks post op and on the bike at 8 weeks post op.  I will listen to my body and stop any activity if I feel any type of twinge or sharp pain.  I talk to my doctor but he doesn't have the last say - I do. It's my life and body. There is another side to the equation. While orthos are concerned about the device and your hip, how concerned are they about your heart?  I never hear people talking about the imp of no cardio-vascular work? Is it ok to have a good hip while developing a bad heart? 

[curt]

   I agree that cardio is a must, with downside being that most of us had a favorite sport or sports, be it running, biking, tri's or whatever, most of which are hip intensive.  We are all certainly looking forward to being fully active or nearly that as soon as possible.  My addiction is running, and it was my cardio of choice.  Walking, swimming, biking all worked, but it either didn't get my heart rate up as easily or I couldn't (or wouldn't) do it long enough to get the same result.
    I'm adjusting.  My doc stated that he didn't like squats in the first six months.  Others have said its ok.  My fear is that a setback by rushing my FULL recovery will foolishly cause problems that I can avoid by being patient and giving myself the full 6 months to a year to start worrying about my performance levels.  To each his own, but for me, one year of reduced performance is worth a lifetime with this device.  Besides, I'm getting a little pumped about the chance to do more swimming and xtraining when my running is back on track.  I'm morphing into a plump little Michael Phelps in the pool.
    Good luck with it.

Curt

[triathlete98]

I think it is all about being smart. Last year I did an IM AquaVelo 3 months post op and had no problems. I was going to shoot for a full IM Aquavelo but my upop hip was giving me too much pain.  I plan to hit the gym after my 2 weeks appt, 80-85% of my weight load except legs.

I plan to be back in pool at 5 weeks post op and on the bike at 8 weeks post op.  I will listen to my body and stop any activity if I feel any type of twinge or sharp pain.  I talk to my doctor but he doesn't have the last say - I do. It's my life and body. There is another side to the equation. While orthos are concerned about the device and your hip, how concerned are they about your heart?  I never hear people talking about the imp of no cardio-vascular work? Is it ok to have a good hip while developing a bad heart?

Do you think your restrictions to get onto the bike will be lifted at 8weeks?  And if you are a triathlete will you be able ride aero that far out?  I would like to be back in the pool and biking asap as well but not sure what my dr will say?  From reading and asking questions it sounds like McMinn wants a very conservative approach during year 1, then its go time.  I plan on doing the conservative.  But at 6'3" i want to get my weight down to 180 and keep it there.  I played college football at 270 so for me its hard to get down that light.  Right now the pain will not let me do much.  I try and swim but begins to hurt about 2000yds into a workout.  I am wondering if body composition and bone integrity has anything to do with life span of the BHR? any thoughts?

[David]

You should not have any bike restrictions at 8 weeks.  Riding aero won't be too comfortable, but you can ease into that as your ROM increases over time.  I've been out since 5w and still riding the road bike, mostly because of winter road conditions.
D.

[hipnhop]

8 weeks is fine for the bike but not for a fall. I am almost at two weeks and will get on the stationary cycle at the gym next week. At 8 weeks I should be hammering a comfortable 16-18 MPH, no hills and I stay off the streets. I am just scared of taking a fall and you do fall when you ride.  At week 12 I should be ready for Six Pillars Century, I'm doing the metric century.  Its a flat, open course with little to no traffic except wildlife. The possibility of a fall is low.

Def get your weight down. Deep Water Run is pain is an issue. Team up with the old ladies with the floral swim caps on and get busy. They say every pound equals 3-5 pounds of impact. A loss of 40 pounds will take off 120 - 200 pounds of impact. Your device will thank you. I do a 3400 yds swim set then water run for an hour. I went up to 194 after first surgery (my race weight is 165). I am down to 185 and plan to settle at 175 for training season. As soon as i can get back in the pool it will come off like melted ice cream.

Good luck.

[Aerial]

I am a fan of road cycling. Dr. Gross says no outdoor cycling until 6 months because of the fall issue.  Spinning will keep your heart happy....but come spring it will be hard to ignore the warm sunshine and lure to be cycling outdoors!  Interestingly, I can get into an aero position but I think that is because I also do yoga!  Again, big difference in protocols.  Unfortunately protocols do seem to be one size fits all for a given doctor.  While I admire those who do a lot early, running outdoor and cycling will have to wait for me.  I mentally could not handle taking that chance.

[Woodstock Hippy]

The one thing I'd like to add is to get to the pool as soon as you can.  Walk, aquajog, pull, swim. Do whatever you can do comfortably.  It will feel so good.  I had bilaterals and walking in the pool at three weeks felt like I never had anything wrong.  This phase won't last too long and you'll probably roll right into your regular swim workouts, but for me it was a great start.

[triathlete98]

I know the very second the Dr. clears me for the pool i'll be in that sucker.  I have a TRX at home so i'll do upper body stuff on that until I am cleared for more dynamic movements.  My thing is if my surgery is March 12, when will I be ok to bike outside (please say june lol).  Last summer I had the labral graft and was inside all fing summer. OMG that was torture.  If you've never been on a CPM consider yourself lucky.

[stephen1254]

The one thing I do not currently have easy access to is a pool. I am impressed with what I am reading in this thread, and the overall consensus seems to be working on range of motion while limiting the weight bearing load. I am fine with that. While my doctor has patients doing light jogging at 3-4 months, my plan is to wait a full year before running. Part of that is a function of where I live, in a ski town, where running isn't practical during the winter (this winter excepted). I think I will concentrate on hiking this summer, at least when the Dr. permits it. I'm still curious about squats though. I can do a body weight squat while holding on to a lowered chin bar, reducing the weight load on my legs dramatically. I wonder when that can be rolled into the mix?

[Woodstock Hippy]

With squats, I'd say it depends on your hip restrictions after surgery.  It' something you have to talk to the doctor about.  I had no restrictions and I was doing body weight squats and weighted leg presses within the first month.

T98, my doctor told me I could ride outside after my three week check up.  I still have to go very easy, waiting for my strength to return.

 Like everyone else, I'm working hard and trying to take it easy!

[hipnhop]

@Woodstock: how did you get in the pooll at 3 weeks? Did your wound heal super quick? My doc says wait  6 weeks. I am trying to push it to 5.

@Tri, you should def be on the bike outside by June but like everyone else said, you can ride but are your hips strong enough to take a fall.  I would avoid clipping in, any technical courses, and ride easy on safe roads in familiar places. I plan to do most of my riding indoors and do one long ride a week on a bike flat bike path. After 1 year I will get grimy again.

[David]

I've fallen off of my bike CT 3 times in the past.  Passed out one time from going too hard and no air/circulation, other two times rear wheel came off from not tightening the skewer enough.  I am safer outside...

[triathlete98]

oh how about it..i've fallen on my bike trainer many times, LOL.  So embarassing.