Rehab period - Amer. Sports Medicine "3mo. return to sports activity w/ BHR"

[Racquetballer]

I'm getting conflicting info regarding rehab time w/ BHR. Variety of articles stating return to sports activities in 3-6mo. None state 1yr. Big discrepancy from what I find on the internet compared to what I read here. Is playing racquetball feasible in 6mo.?

[Pat Walter]

Hello

The reason you see a lot of discrepacy is each person heals at their own rate.  I was on one crtuch at 4 days and no crutches at 4 weeks.  I was 61 years old and went to Dr. De Smet of Beligum. He has done over 2400 hip resurfacings and over 3000 THRs.  The overseas doctors have a much different recovery protocol than the new US doctors just learning to do the BHR.

There have been patients of Dr. Bose of India running marathons at 3 months post op.  These are very athletic people that were in very good shape. You can see a lot of athletes stories here  http://www.surfacehippy.info/athletes.php

But even if you are in excellent physical shape, you could have a slower recovery.  It really depends on your body and there is no way to know ahead of time how quickly you will heal.

If you are using the US doctors they will be much more conservative in your recovery as to how quickly you can do things.  They have to worry about lawsuits in the US and they just don't have the experience like the overseas doctors to have seens how hundreds of their patients heal and react.

So you are going to see recovery periods of all lengths.  If you are interested in recovering quickly, you need to ask your doctor what his/her post op recovery protocol is.  Simply ask your doctor  how quickly they will let you start to play racqueball again.

I personally think if you are use to playing, you should be able to start being active again at 6 months.  I would not want to be in hard, competitve games that quickly just to protect my new hip.  It takes a full year for your hip and muscles to heal.  You can be very active before then, but there is still healing going on.

There is nothing standard in any aspects of hip resurfacing.  Some doctors take 45 minutes to do a BHR and others take 2 - 3 hours.  Some doctors have 10-12" incisions while others use 4-6". Most use the posterior approach although some use the anterior approach.  Some use waterproof bandages so you can shower and swim right away - others don't.  Some use staples, some stiches and some glue.  Some let you be 100% weight bearing right after surgery, although it is almost difficult to do.  Others keep you on a walker for a much longer time.

The experienced doctors and most overseas doctors get you up and running much faster than most of the US doctors.  Some of the more experienced US doctors like Amstutz, Gross, Mont, etc, will be more progressive than the newly trained BHR doctors.

You need to ask your doctors many questions so you know exactly what to expect. Here is a list to get you started  http://www.surfacehippy.info/questionsfordoctor.php

You also have to listen to your own body after surgery.  Your mind will want to do much more than your body is capable of.  You need to listen to your body and not over due in the first few months.  You will pay a price of swelling, pain and possibly a femur neck crack or dislocation if you get tooooo carried away.  That has not happend many times, but it is still possbile.

You are getting your hip fixed so you can have a lifetime of your favorite activities back - so be patient for your body to heal.  Then anything is possible.

Hope that helps out. Please keep in touch and let us know if you have other questions.

Pat
3/15/06 LBHR De Smet

[Racquetballer]

Hello,
Thank you for the insight. I can appreciate that we all will recover at different rates with it largely dependent on our physical condition and any operation complications. What caused concern was a blanket statement right up front that the conditions of surgery are the following (Dr. Brooks):

1) no running or jumping for 1yr.
2) crutches for 6wks.
3) no picking up anything weighing more than 30lbs. for the first year.

I can understand that maybe applicable for some, but I am 48yrs. old and very active. If these are absolute conditions for hip resurfacing, they are factors that have to be considered. You do make a good point that perhaps 1yr. is not too much of a sacrifice considering it will enable a lifetime of activity afterwards.

Thanks,
From a racquetballer, downhill skier, & aerobic exerciser that finds it hard to be idle.

[Pat Walter]

Hi

Dr. Brooks is one of the newer BHR surgeons.  As I said, they are very, very conservative.

If you asked Dr. De Smet, Bose or some of the other experienced doctors, they would not have that type of restriction on your activities. You can read the athletes stories to see how quickly some were back to being very active. Especially Dr. Bose patients.  Many people will travel to India or Belgium like I did to get the experienced doctors. Especially if you have a difficult case. 

As I said, I used 1 elbow crutch at 4 days and NO CRUTCH at 4 weeks.  Dr. De Smet and Bose let your own body determine when to stop using crutches.  My only limitation was to use a crutch or cane until I did not limp any longer.  I could have stopped even sooner, but felt I still needed the crutch until 4 weeks.  I was often walking around the house without any crutch because I would forget it.

Again, not all doctor even in the US will have the same type of restricitons as Dr. Brooks. You might want to look at some of the more experienced doctors before you make your decision.  Some will give free email consultations or phone consultations if you contact them.  Dr. Bose in India, Dr. De Smet in Belgium, Dr. Gross in SC all give free consultations.  There are some other US doctors, but I am not sure who they are.  Many people go to Dr. Gross in South Carolina because he is very, very experienced. You can find all their emails and phone numbers on my doctors list.

I would certainly take time to check out my options since you are very young and want to be very active again - soon.

Good Luck.

Pat

[Silver]

Hello,

This is a topic I'm also interested in learning more about.  I've been a competitive powerlifter and I would like to continue in this sport.  I'm almost 9 months post surgery and I've resumed training.  My Doctor frowned when I told him this at my 6 month check up.  I've Deadlifted close to 80% of my pre surgery best and it feels pretty good.  I'm wondering how much faster I can take my training?

Silver

[Pat Walter]

Hi

I don't know much about training for a powerlifter.  I do know that it does take the body and all the muscles, etc, a good year to heal.  Even though you are returning to your normal activities, you are not completely healed yet.

I would personally be a little cautious so you don't do any damage.  There have been a handful of problems with new hip resurfacings lately and I would be conservative. I would also be honest with my surgeon and really discuss what you want to do and how quickly. I would listen to him if you don't want to end up with a revision to a THR.

No one without medical experience and knowledge should be giving you advice as to how quickly you can begin extreme activities with a new hip resurfacing. The real problem with lifting heavy weights and your new hip is that if you get a lot of weight on the new cap of the femur and it is not quite centered properly in the lift - you certainly could do damage to the femur or even the cup in the acetabulum.  It is really a mechanical problem if you think about it.  The bone holding your new cap on your femur is not completely grown around it yet as well as the new bone growth holding the cup in the acetabulum.

The placement of the hip components is very technical and if the angles are not right - there can be a femur neck fracture.  Also if you think about it - putting weight on the new hip when it isn't completely healed in an unusual way could also make it unbalanced and cause you big time problems.

Personally, I would be a little patient now so you can later do what you want to.  It is no fun going in for a revision. I am following a lady now that had her acetabulum cup slip.  There have been about a half dozen people with slipped cups and about 3 femur neck fractures on the big Yahoo Surface Hippy Discusion Group of over 6000 members.  Revision is a real possiblity and you want to do everything possible to prevent it.

Some doctors say that the hip area takes almost 2 years to completely heal.  Better to be safe now than sorry when you are laying in the hospital with a THR revision of your BHR. 

Pat in Ohio
3/15/06 LBHR De Smet

[kas4399]

Has a BHR 9/26/06 Dr Engh. Am curious what other Drs advice is about running after 1 year. Seems as though a lot of people get right back into it. Aren't they afraid of disruption the BH ? Dr Engh seemed uncharacteristically conservative  at my 1 year mark, given what he had been like  everytime before. Any insight about this would be appreciated. Thanks

[Liz]

Hi

I don't know if my experience will be helpful, but I am now just 3 months post BHR and have just been sailing with the agreement of my consultant. Not something I had ever thought would be possible. I am not 100%  and can't yet duck and move about the small boats as others can, but believe, me I have much more mobility than I ever imagined and no pain.

Having had 2 years of not walking at all I certainly wasn't fit pre op and had put on a lot of weight so flexibility will take a while .... I am however walking about 5 miles a day and can manage stairs well, so if you are a fit person it doesn't seem unreasonable to think you might be up to your usual sports at 6 months. I had my surgery in London and my surgeon said as long as I don't put my leg in the position they did to dislocate my hip in surgery ( knee up and pulled in, in the way you might cut your toe nails) for 6 months, I can't really harm my hip. My body will tell me if I am doing too much!

Whilst on Holiday I met another UK orthopaedic surgeon who asked what I had had done, as he was worried about what I was doing to my hip. Once he knew it was a resurfacing not a replacement he was happy. His comment was "oh that's fine you won't do any harm. Give it another 3 months and you won't even know you have had it done."

Hope that is useful

Liz

[momzer2]

Vicky,

I had my LBHR 4 weeks ago.  I used to run/jog 3 miles a day until May when I could no longer stand the pain.  I am no marathon runner and I don't 'pound' the pavement when I run.  I run for exercise and to clear my head!!  I would be VERY interested in the info. you hear at the conference.  I would like to start what I call 'baby' jogging (slowly, carefully, no real hills) in April.  What do you think?  I am 48 and in good physical condition other than this hip!!  Everyone tells me to take it easy and wait a year, but I don't think it's necessary if I'm careful.....

Karen

[coskater]

I am not even four weeks out but I am a spry 43 and in excellent condition as a competitive athlete.  I do know from talking to my doctor, Mr. Treacy that I need to gradually come back to my sport.  I also do a sport that requires not only strength but incredible coordination, doing the double jumps that I could land before my large arthroscopic surgery and then my resurfacing a year later put 13-17x my body weight on my landing leg.  Of course my landing leg is the one that has had all the work, luckily I don't plan on doing triples which are 33x+ your body weight.  This is why you see very light, very narrow skaters doing the harder jumps.(not to mention quads)

Suffice it to say no jumping for me until a year out of the surgery, but...that said I will do all the other components of skating like spinning, footwork, and dance.  Hopefully, these will help with coordination.

It seems prudent to be careful with our new hips.  Canes for 2 more weeks and then hopefully none..

Leslie
Treacy R BHR
10/2/07

[Pat Walter]

Hi Leslie

Sounds like you are having a good recovery.  I hope you will be able to get back to your skating soon.

I think being a little conservative in the begining is a wise approach.  Dr. De Smet told us we could stop using our crutch or cane when we stopped limping.  I was able to walk unaided at 4 weeks.  I still took a cane with me on long walks in case I got tired and started to limp.

Good Luck.

Pat

[coskater]

It is interesting the differences in doctors, I was told 2 canes all 6 weeks, but I never used forearm crutches. (I thought I would use forearm crutches) after the 6 weeks I can go back to pilates, at 8 weeks ballet and also skating.  My plan is to build my strength and my stamina back slowly, skating especially edgework and dancing requires a lot of repetition and practice.  Of course my right thigh is so much gigglier than my left one so it will take a while to get everything back to normal.

Everything in time...


Leslie
R BHR 10/2/07
Treacy