What type and how much prehab?

[DD8]

Hi.  First some background.  I am a male in my early 50s.  Short story is that I was very active in many sports until my mid-40s when bilateral hip pain worsened.  Like others on this site, I was diagnosed with FAI/cam, mild dysplasia and OA. I was fortunate to learn about HR and this site (thanks, Pat).  After consulting with a few of the HR doctors, I am looking at having a bilateral procedure in a few months.  A few years ago I pretty much shutdown the impact activities and focused on strength training and mobility.  It has helped with ROM and all key muscles (legs, hips, core, back) but the pain has persisted.

What is the ideal prehab protocol?  What have others found to be helpful if not critical in their preparation?   

Evidence on this site would indicate that maintaining strength and ROM aid in recovery.

Thank you.

[Joe_CA]

Hi DD8,

Welcome to the group. You're going to get various responses from the group, however I feel that it's the general consensus that getting oneself in condition prior to the surgery truly helps in your post-operative recovery. I too was a bilateral patient (surgeries were approximately 2.5 years ago with Dr. Gross). It was recommended by several members here to try and get yourself in the best shape possible (within reason) before my surgery date.

So I never stopped going to the gym and focused on my legs, glutes (squats, lunges) as well as my upper body. It was helpful to have strength in your arms, back, and chest in the weeks following surgery as you'll of course have limited use of your lower extremities. So in addition to the gym, I never completely stopped trying to play the sports I always enjoyed, though this became increasingly harder to do as the arthritis continued to worsen.

So of course my experience and beliefs are subjective and anecdotal, but I really believed I benefited from the time I put in before the hip resurfacing surgeries. If I recall correctly, I was walking unassisted about 10 days post-surgery. Would I have had a similar outcome if I were to have simply coasted, and done nothing? Perhaps. There are so many personal factors involved in each of our recoveries.

Regardless, my advice is to focus on your glutes (those are the muscles that are impacted the most) and try and keep as fit as reasonably possible and it will pay dividends.

Good luck and keep us informed!

Joe

[DD8]

Thanks Joe, that is helpful and much appreciated.  I will be having both done at the same time.  I've been doing a lot of squats, step ups and lunges, so my glutes are in good shape. Also doing upper body work with pushups, pullups, etc.  The impact sports just weren't enjoyable anymore when the aching increased.  I guess the silver lining is that I discovered stand-up paddle boarding and how much of a whole body workout that can be with little impact.

[karlos.bell]

  Hi DD8
Bilateral myself. Let it heal first.
Your body will tell you when you have done too much don't pack  in too much.
It seems to be about 1/4% per day sometimes backwards.
Depends how long you have had your issue.
Good luck.

[Joe_CA]

Good luck DD8. Each of our goals is a little different. Some desire to return to long distance running, biking, or activities which involve sufficient ROM and flexibility. My specific goal was to continue to play high impact sports (basketball, volleyball,...), so I specifically concentrated on strength before and after the surgeries, versus stretching. My flexibility and ROM have improved greatly, but I never had much to begin with before my arthritis kicked in ~15 years ago. For high impact sports, getting your hips back is only one (yet vital) component of your return. You'll have to get those muscles back too, as they've atrophied over the years with the arthritis. In the last year before my HRA procedures, I was becoming slightly bow-legged! :-)

I'm more than 100% satisfied with my results, and I'm sure you will be too. For most of us, this surgery is nothing less than a miracle.

[catfriend]

Many people here are happy that they did lots of prehab. In my case, I have no idea. My condition was so bad I had turned into a couch potato and was doing very little with my lower body. I swam regularly, but had to use a pull buoy to hold up my legs and just use my arms as even a flutter kick was too painful. Since so much is cut through and stretched out anyway I'm not sure how much good lower body work does anyway.

I am glad to see you are working on your upper body strength. IMO opinion upper body strength is paramount in the early recovery phase. Getting up from a chair and using a walker or crutches take a lot more strength than you might be thinking! Keep that up for sure. Good luck.

[Rn2md]

Hey,
I used Gross and had the operation on 3/20.

Your questions are familiar and I had the same ones.

I started a thread called, “Preop conditioning” on the next page of this section that you might find interesting. There’s some good back and forth discussion in it.

Basically I did lots of everything, putting a premium on muscles that people appeared to have difficulty with postoperatively, like abductors.

For the most part, I think it paid off, except for the abductor work, which may have worked against me. My whole recovery is detailed in Dr. Gross section if interested.

Good luck with the surgery!