Competitive Soccer

[chuckm]

Anyone out there return to high level soccer? A few years ago at 43 I was still enjoying playing and then my left hip just fell apart. I went from playing 90 minutes every weekend to just watching and maybe playing 10 minutes until it hurt or I emabarrassed myself. For a couple of years I did prove that as you lose your legs you can adjust your game and still be good. But if you can't run you can't play. I'm 46 years old now and 11 weeks post op. I feel really good. My surgeon has me starting to strenthen the muscles starting at 3 months (next week for me) and then gradual return to playing after 6 months. The way I feel now I definately think it is possible.

Chuckm

[hernanu]

Define high level 

I went back to playing my usual games twice a week at 15 months. The other players range from 20's to 40's and one other player in the 50's.

All played college or semi pro leagues (mostly portuguese, brazilian, colombian) and several were scholarship athletes. Or played in Europe or Latin America.

We lost our field (sold to a development), awaiting a new indoor / outdoor complex to open up soon, apparently will have beautiful fields.

[chuckm]

I guess high level would mean competing on a team in a competitive league that has multiple flights with promotion and relegation between flights. I was playing on an over 30's team. It was in the 1st division and there are three divisions.

[chuckm]

Hern, I just read through your soccer postings from last year. It sounds like you have returned to playing at a high level It's interesting that most of the challenge is trying to defend. That is exactly the problem I was having BEFORE the surgery. As my hip got worse, I found myself having to give lots of space to hide the fact that I couldn't run. But, in the end, I couldn't hide it for very long. It didn't take long for the other midfielders to realize they could overlap and I couldn't track back fast enough. When I tried to turn with them, I would grimace, partly in pain and partly knowing it was time to give it up. Interestingly though, after several years of increasing hip pain and loss of mobility, and wanting to stay on the pitch so badly, other parts of my game actually improved. Mostly being able to keep the ball in very tight spaces and the speed of my game. I never needed that because I was a very athletic player before then. I can't wait to get back out there to see where this goes now. It should be a blast if I can mix this new skill set with my new hip. How is your game now?

ChuckM

[hernanu]

Hern, I just read through your soccer postings from last year. It sounds like you have returned to playing at a high level It's interesting that most of the challenge is trying to defend. That is exactly the problem I was having BEFORE the surgery. As my hip got worse, I found myself having to give lots of space to hide the fact that I couldn't run. But, in the end, I couldn't hide it for very long. It didn't take long for the other midfielders to realize they could overlap and I couldn't track back fast enough. When I tried to turn with them, I would grimace, partly in pain and partly knowing it was time to give it up. Interestingly though, after several years of increasing hip pain and loss of mobility, and wanting to stay on the pitch so badly, other parts of my game actually improved. Mostly being able to keep the ball in very tight spaces and the speed of my game. I never needed that because I was a very athletic player before then. I can't wait to get back out there to see where this goes now. It should be a blast if I can mix this new skill set with my new hip. How is your game now?

ChuckM

It has picked up. I think you really have to strengthen the smaller stabilizers to get that quick turn going again. The bigger muscles are fine, stamina needs work (as always), but that quick turn and go was severely lacking at first. And you know, if you drop that first step, you're done for. My friends would chuckle as they steamed past me where before they couldn't. Nice guys.

One thing that I think has helped is the core exercises that my PT forced on me. In my opinion they provide a core  of stability so the smaller muscles aren't as challenged as they would be if your core is not as strong as it should be. (Did I say core enough times?     )

My ROM has improved immensely, not just forward and back, but in turning your leg out. I also started yoga for stretching, so the combination of that and the core exercises have helped. Kicking the punching bag for me (tae Kwon Do) has also strengthened the balancing and turning movements that I think are crucial in soccer.

The ROM is critical in getting your speed back, I think. I noticed my straight ahead speed getting less and less, not because I was moving less quickly, but because my stride had shortened drastically. Getting your normal stride back (without the excruciating pain when extending) gets you to do that nice recovery on someone trying to blast past.

One of the things I noticed that surprised me was that my headers also needed work. I was good at heading the ball before, and thought that would come back easily, once I was able to elevate. Not so fast, Mr. Hern. Elevation was all well and good (once I was able to, about 14 months in), but the dynamic twisting in the air to guide the ball in is greatly dependent on hip and leg action. At least for me, so that also needed to be brought along.

Much better now, so good luck, it is possible to get it back, sometimes, as you note, along with better skills that you developed in self defense.

[evant]

Chuck / Hernan

I love your enthusiasm to the extent that you're making me think I may have given up soccer far too early.

Long may your high level soccer days continue.

[Kiwi]

Love reading this stuff. Keep it going folks!! 

[chuckm]

Hern, when did you feel like you could play after surgery? I see you are bilateral and returned after a year and a half. I must confess I have been kicking the ball with my fourteen year old daughter. The hip (especially the groin) feels much better and more flexible afterwards. There is something theraputic about kicking the ball that helps with my entire body. I have had many knee operations stemming from an accident when I was young. I would just go kick the ball against the wall and the results were so much better than any PT. I suppose it is like swimming for some people. I'm just passed 3 months post op and hope to get back to playing in another 3.

Chuckm

[hernanu]

Hern, when did you feel like you could play after surgery? I see you are bilateral and returned after a year and a half. I must confess I have been kicking the ball with my fourteen year old daughter. The hip (especially the groin) feels much better and more flexible afterwards. There is something theraputic about kicking the ball that helps with my entire body. I have had many knee operations stemming from an accident when I was young. I would just go kick the ball against the wall and the results were so much better than any PT. I suppose it is like swimming for some people. I'm just passed 3 months post op and hope to get back to playing in another 3.

Chuckm

Hey Chuck, I was told by my doctor to stay away from impact sports until one year. He spelled it out for me - no soccer, basketball, tae kwon do, knowing what I was itching to do. 

It doesn't mean I wasn't doing some things that were part of those earlier. I started doing slow motion martial arts kicks by 6-8 months, just stretching the foot out and using the exercise to strengthen and balance. By the time 8-9 months came along, I was doing loose kicks, just to get the full motion - still very low ROM, but I wanted to at least have the full motion.

The problem with impact sports is that they are just that - impactful. I was talking to a friend of mine, and she said that basketball was not an impact sport. I begged to differ, saying that as a bigger guy, I usually draw much taller opponents, so have to use strength and positioning to play with any chance to do anything. So I looked at my typical game, where I'm dragging a 220+ pound guy around and fighting through picks, etc. and I thought my hip would not survive that.

The same in a soccer game, I think. Most of the people I play with are aggressive, so even something as innocuous 50/50 ball with someone who is willing to barge in needs for everything to be able to survive contact. Lowering your shoulder and driving in can end up with you rolling. So I guess I was careful.

The fourteen months was because I had one done, then the next three months after. That meant that the last was at one year when I went back to soccer. The first few months are a relearning experience, but then things eventually click.

Having said that, everyone is different, but I just wanted to be able to be hit sideways on the hip and just curse out the guy, not have to worry. So I complied with the one year wait. Killed me, but then again - now I don't worry, I just do it.

[chuckm]

Thanks Hern. My surgeon gave me a specific time table to return to impact soccer as follows:
At 0-3 months work on just ROM. 3-6 months gradual strengthening and conditioning with weights, eliptical (i've never been on one), etc. but no running.
At 6 months, begin running on treadmill and train using the ball. Train for 6 weeks before playing impact. Seems pretty aggressive to me but this program comes from Dr. Boettner of the Hospital for Special Surgery in NYC. 
What I would like to know is if there are any instances where someone was cleared to return to impact sports after 6 months and then sustained fractured their femoral neck or damaged the device? 

Chuckm

[hernanu]

Haven't heard of a fracture that late, Chuck. I think the danger time is 0-6 months, hence the restriction.

As to damaging the device, I think what you mean is that the cup or femoral component loosens - that seems to be the largest reason for failure. I don't know what the stats are for that at 6-12 months, but there is a 4-5% overall failure rate in the first year, the bulk of which is loosening or lysis. Much lower with the better surgeons, so take that as a modifier.

One thing you could do is ask Dr. Boettner for a sit down, or by email if needed, then go over your plans and get some statistics from him of survival / success rates for people in his practice for the first year. That would give you a better sense of how well it performs in real life.

One other thing you could ask for is athletes who are also soccer players, or in similar sports (hockey for example) who followed their protocol and how they did.

It sounds a bit aggressive, but if they have had success? It finally comes down to you, what you feel and are comfortable with. At 7.5 months I still would have had problems with it; I felt much more comfortable with it at one year.

[chuckm]

Hern, I,m 3.5 months post op now so I am two weeks into the low impact strengthening and conditioning portion of my rehab that I will continue for at least 2.5 more months. Yesterday I walked three miles at a good clip. I could really feel the fatigue to those deep external rotators when it came to the hills. Like you said, the large muscles feel fine but those small ones felt like jelly. I found that I could massage the area while walking and it helped but people watching me walk by rubbing myself that way must have got a chuckle. In hindsight, how would you target those rotators with exercises since you have been through this?

Chuckm

[hernanu]

Chuck, some of the most useful ones have been the ones that big macho guys chuckle at.

• Leg lifts, around all sides. Both standing and lying down (I did them on the bed). In other words, lie down on the bed facing up, leg lifts to about 30 degrees, hold and bring down. Go on your side, face down, etc. Remember this is not a stretch, but to get the smaller muscles involved. Defeats the purpose if you're pushing those big ones into action.
• Exercise bands. Put one around the base of a chair leg, the other around your ankle. Do the leg movements like the leg lifts, but standing while holding the back of the chair. To all directions. Again, not trying to use the big muscles, get the smaller ones in there.
• Balancing. On the floor barefoot, up on one leg. Try for a minute stable. When that gets easier, take a ball (think you may have a couple around), hold it in front of you and describe figure eights as you balance. Then do the same, but balancing on a pillow or a spongy base of some sort.
• If you know how to juggle, that worked for me. It gets that memory going to maintain a balanced midsection.
• A skating slideboard. This is both fun, scary at first and great for that sideways burst. You do look silly wearing the booties, but see above comment about macho types.
• Get an old aerobics step and step up the step down fully, again at a low rise, since you are not doing it to get the large muscles involved, but to get the starting and stopping / balancing motions in there.

Those helped me.  Have fun - also look into a roller, when you're ready for it, it will help work the scar tissue and keep the IT band behaving.

[chuckm]

Those are great ideas Hern. I didn't even think of the juggling. I've been kicking the ball but I didn't even dawn on me to keep the ball in the air for exercise. Especially moving it up to the thighs, shoulders, and head. And you would know Hern, it's a lot of work to lift those knees up suprisingly high to keep the ball at your thighs or it's going back to your feet. It's snowing outside so I have to try in the house. Can't let the ball hit the floor or my wife will complain of the noise. But I'll just tell her too bad, it's soccer specific rehab 

Chuckm

[hernanu]

Those are great ideas Hern. I didn't even think of the juggling. I've been kicking the ball but I didn't even dawn on me to keep the ball in the air for exercise. Especially moving it up to the thighs, shoulders, and head. And you would know Hern, it's a lot of work to lift those knees up suprisingly high to keep the ball at your thighs or it's going back to your feet. It's snowing outside so I have to try in the house. Can't let the ball hit the floor or my wife will complain of the noise. But I'll just tell her too bad, it's soccer specific rehab 

Chuckm

Love that soccer specific rehab 

"It's a soccer thing, honey, you wouldn't understand"

[chuckm]

And I certainly won't expect the wife to understand the UEFA Champions rehab either. It's very important to have all the games on the big screen. We need it so we can see excellent technique for when we get back with the ball. Don't want any risk of injury from poor technique do we

Chuckm

[hernanu]

Actually, that's startlingly true.

I find that in soccer, tae kwon do and even just in running. Just like my body adjusted for the OA, by twisting limbs and muscles around to function, we can pick up bad habits afterwards by not emphasizing good form, since the muscles that are weaker are going to whine and not keep up.

My first couple of times back to playing soccer, I found myself still running the way that I had before, avoiding some things that caused me pain. I really had to step back and go through the mechanics of planting the foot correctly,etc. to realize where I was making shortcuts.

I did the same with working on tae kwon do, back to breaking down the movements, since I didn't want my mind going through the old bad paths that I learned through pain. I had a personal trainer watch me run on the treadmill from behind at about 13 months, so she could spot any issues. She found that on my right I was slightly stiffening my leg before impact, much more so than my left (my 'better' leg). At least you become aware and can work on making things better.

I do believe in the power of visualization to achieve a goal, so can't lose by watching some of the best. Watch some of them and re-learn how to take a dive too 

[chuckm]

Hern, any experience going back to playing on artificial turf? Not long before I got resurfaced, I had switched clubs mostly because I needed a nice grass field or I would be in too much pain. Even then, half of the away games were played on plastic pitches. Toward the end it didn't matter what the pitch was made of but for at least five years I dreaded playing on the plastic turf. In the northeast you have to play indoors from November through March because of snow and cold. I would try but then have to sit out for weeks or months until pain subsided. The new turf styles are better and softer but they still have that elastic rebound. When you step on grass it moves under foot and stays there. Turf moves too but then rebounds back under your foot resonating through your entire skeleton. I don't know about you but around here many of the high schools have converted their grass fields to turf. I don't think we will know for thirty years if making young kids play on turf will have an adverse effect on their joints. I began playing on turf in the Carrier Dome at Syracuse. That stuff was just green carpet laid over asphalt. I can tell that was not good for me later on.

Chuckm

[hernanu]

Haven't gone back to indoors, since most are turf over concrete. Futsal was out, but will probably go to a turf field sometime soon. A complex is being built near my work, we will probably go there for pickup games.

So can't give you any post HR experiences on turf. Played on plenty before, but usually on the new fake dirt types. They are bouncy and the ball runs on them, so it's a different style of play than regular grass.

[chuckm]

Hern, LMAO  The sun came out and so I got a chance to go out there and juggle the ball in the driveway. You would know that juggling for an experienced player is more or less a question of how long can you keep the ball up before you get tired and not so much how many times. But, in this case I couldn't get past 20  . I felt fine but the ball was going left then right. I couldn't figure it out. After an hour or so it started to settle down and I could stay in one spot. I went back out there later in the day and things weren't back to normal but at least I got myself where I didn't look like one of those yahoo dads at a kids soccer game. I'm still grinning at how bad I looked for the first 20 minutes or so.

Chuckm