Yesterday was the 10 week mark. I'm feeling dangerously good :) So good that my body starts doing kicks and other karate motions while working out. My range of motion is getting better and better. It will be interesting to see if this leg will have more ROM than the other. It kind of feels like that now but I can't really push it yet. Once I'm able to throw round kicks and side kicks I'll be able to tell.
Lately I've added the elliptical, lots of balance training including single leg mini bends on the small balance trainer. Also, lateral shuttle, high knees moving fwd with hip tilt, butt kicks, front kick and side kick iso squeezes on the balance trainer, lots of stretching. I even did about 4 katas the other day (slowly) along with some light bag training (punches / strikes only), as well as various striking drills. Furthermore, since being introduced to balance trainers I've been doing a lot of core work (cause it's so darn cool on the balance trainers). I have the Bosu and the small balance trainer that looks kind of like an inflated frisbee In addition, I have been working a lot on upper body with the TRX, and pullup bar as well as core push ups on the Bosu :)
I have been working out about 6 days a week and am starting to lean out. I love this regiment!
Soak in the hot tub - roll all muscles with a pvc pipe and stretch
bike for about 5-10min
elliptical for about 5-7min
all of my PT with upper body and core included
stretching, and massage stick work throughout the workout
finish up w/extended tabata sprints on the airdyne (30 on 10 off for 5min)
Yesterday was the 8 week mark. I had PT and the therapist said my flexibility and range of motion are great. They are are where he wanted them. He said you have approx 14 weeks before scar tissue prevents additional flexibility. He said that the aggressive stretching I have been doing has paid off and that if I did nothing else and waited till I got back into karate in about another 8 wks I would have the same flexibility as before.
The therapist gave me more advanced level exercises. I did many band walks squats, balance exercises, lunges etc... Very sore today though.
Last weekend I had my son and a few kids out for baseball practice and actually ended up playing a game with them.... i was able to rotate my hips aggressively while up to bat and run (w/ a limp) around the bases. I still have somewhat of a limp but the therapist said it will go away with strength and even strength in both legs. The unstable moments and random pains are just about gone :)
Today is exactly 6 weeks from my surgery. I am still icing a few times a day. I can work all day but have to sit down once and a while otherwise I fatigue. I haven't used crutches in a while. I am going in to PT today and am supposed to get a bunch of new phase 2 closed chain exercises...
Overall, I am progressing. I still have unstable moments and pains once in a while. I still have a limp that is better or worse depending on fatigue of the joint.
I have some kind of muscular pain by my groin going to my thigh. The therapist tells me to stretch through it. I think it might be adductor or psoas? The pain has been coming on even while biking. Yesterday it came within 5min. I am far from out of the woods but am up for the challenges ahead...onward and upward!
It is exactly 5 weeks today. I've been walking without crutches for the past 3-4 days. I have a gout flare up on my left toe which makes for an interesting limp... My therapist turned me loose on a couple closed chain exercises and said now we can get more into the advanced stuff :) I notice less pain when massaging the hip flexor area where the incisions are. I got up and down my brother in law's stairs last night for thx-giving dinner just fine. I've been walking a lot. The other day I took my son to the baseball field and carried some light gear and pitched a lot to him. Yesterday I stood around a lot but got kind of sore and experienced some pain when I got home. After a good icing or two I was ok.
I am 4 weeks post op today. I went into work for a full day yesterday and felt great! I brought 1 crutch with me but never really used it. I was a busy-bot and actually had a lot of fun working and dealing with clients. My work is video production / editing / transfer and duplication. Lots of multi-tasking , meeting deadlines, and working with computers and equipment.
Over the past few days, I have been working out once a day and feeling stronger and more mobile. I usually jump in the hot-tub massage all muscles with a pvc pipe then head in to the dojo and do 20 min on the bike followed by 3 sets of all my current PT drills along with a lot of stretching. In regards to new exercises, my therapist said were in a holding pattern - stick with the existing drills and to focus on stretching.
I think I'm about ready to loose the crutch all together but am not in a hurry. I'd rather be safe than sorry... I still get that unstable feeling once and a while but overall I am progressing.
4 weeks - time served :)
I have been very conservative lately and today it seems to be paying off. At my last PT appt. I showed my therapist some of the extra things I've been doing on my own like fire hydrants, planks, flag, etc... and he said that's why I'm experiencing pain and have digressed back to crutches. He said those exercises put weight on the joint and are too advanced for this stage of rehab. He said this makes sense as to why I took a step back in progress.
Since sticking to the PT plan carefully and giving my hip additional rest, I feel great. I worked out today - did about 18min on the bike and all the allowed PT exercises. Afterwards I iced then practiced baseball with my son before taking him to his game. I brought one crutch and spent a lot of time standing.
When I got home I got under some ice. I still feel good - no pain... Hope this keeps up :)
I should also mention I've been cruising around the house without crutches more than half the time.
Tomorrow will be 3 weeks. I am back on crutches (sometimes 1 - sometime 2) depending on how I feel or where I'm going. I can walk without them but it seems to lead to pain later, so I am trying to be conservative. However, I am getting stronger and more flexible when I workout.
The docs assistant, therapist and I think the pain is from inflammation due to the new modalities my hip is encountering such as weight bearing, etc...Therefore, ice is very important right now. after my workouts I hit the ice bath. Otherwise, I'm trying to ice at least once per hr when I'm home. I've only gone into work twice for just a few hrs. I could endure longer but don't need to as my staff is handling the shop just fine :) I am taking the time I need to heal and using the quiet time to focus on updating my business's webpage, blog, etc...
As I walked down the hallway this morning, I felt pain in my hip. It felt like a cramping pain that I would think I could get rid of by heat and stretching. I'm wondering what I did to create this? Yesterday, I only did the new stretching movements the therapist said we should do everyday (my wife did them) and the only exercise I got was 5 min on the bike to warm up beforehand. I planned on doing my PT, but thought it might be a good idea to take off and quite frankly I was a bit sore from all the recent PT work and stretching. As a result, I laid in bed all day. Partly because my therapist said it's a good idea to let this heal and give it time. Furthermore, I slept in many new positions and I heard a big pop in my hip during the night. Moreover, there was a slight earthquake last night that made me kind of jump in the middle of the night and pop out of bed...
Today, after felling the pain I iced then hit the hot tub. Afterwards I went in the dojo and biked for 10, did all my PT work and biked for 10 more before jumping in an ice bath for 10min. I'm feeling better and will see what becomes of it? I did have pain during my PT work in weighted leg-press drill other than that the bike felt really good. Hmmmm... :(
The therapist said that hip rehab has peaks and valleys, maybe this a valley brought on by the new stretching exercises and walking? However, I was stronger today in my exercises overall :)
I'm off crutches and walking. Feels a bit awkward but good! I worked out PT on my own and got very sore today. 20min on the bike and tons of PT work. As a result, my legs were sore all day :)
Today was my post op visit with Dr. Safran. After the stitches were removed, the doctor came in and showed me pictured of the surgery. I was shocked at how much damage there was. I had 8mm of exposed bone on one side; however, after he removed part of the overhang (pincer) I only had approx 5mm which he said did not need micro fracture and would be fine for the rest of my life. He said there was only one side of exposed bone with cartilage on the other and he had created enough room in the joint that they would not even rub in the future regardless how I moved my hip with kicks, stretching, etc..
He reattached the labrum and removed a cyst. The doctor said I was on the upper end in terms of healing time and released me from the hip brace, CPM, bunny boot and crutches (when I'm ready). YES!
Afterwards, I went to PT where they stepped up the drills. Many leg lift, clamshell exercises. Afterwards I had a nice Ice and strarted walking around on my own? Crazy, I didn't think I would be doing this well 12 days out - Dr. Safran is the MAN!
left hip combined type femoral actetabular impingement
left hip labrel tear
Postop Diagnosis:
left hip combined type femoral actetabular impingement
labrel tear
left hip chonromalacia of the stem
synovitus
ligamentum teres hypertrophy
capsular tightness
Surgical Procedures Performed:
left hip athroscopic partial synovectomy
left hip arthroscopic debridement of ligament teres
left hip arthroscopic labrel repair using 3 anchors
left hip arthroscopic cheilectomy
left hip arthroscopic acetabuloplasty
left hip arthroscopic capsulotomy with partial capsulectomy
left hip arthroscopic chondroplasty of the acetabulum
fluroscopy with physician inerpretation greater than 1 hr
Equipment:
crutches 2wks
hip brace 2wks
CPM Machine 2wks
bunny boot (keeps foot inverted allowing hip to heal/ set properly) 2-3 wks while resting
Standing Orders:
20lbs flat foot weight bearing / crutches 2weeks
bunny boot 2-3 weeks
CPM 0-70 degrees 6-8hrs / day for 2 weeks
wear brace at all times
caretaker to rotate leg - mini circles 6x day (1min)
wear stockings for 2-3 days
take naproxin 2xdaily for 6wks
My Recommendations:
strengthen other leg before surgery (hip / knee) as it will take the load while on crutches
strengthen shoulders / triceps before surgery - will prevent injury from crutches
4 bags of frozen peas (2 on rotation) ice 20 on/off unless no brace, then game ready device
shim bunny boot with cloths - mine was way too big preventing proper foot alignment
have really baggy sweats / shorts to wear over brace (much more comfy)
have plenty of veggies n fruits - blend them, make salads, etc... since you will be pretty heavily medicated for the first few days, this will help with constipation and toxicity
drink plenty of water
prepare you environment for life on crutches
figure out what side of the bed you will be on - I went on the opposite side (left hip / right side of bed looking up) so that I wouldn't have to climb over the CPM every time I entered or left the bed even-though the Doc recommended otherwise... However, I think either side would work as my leg was strong enough to carry itself within a few days.
get an exercise bike, selection of resistance bands, swedish ball, smaller compressable balls, foam roller and tennis ball for rolling out muscles / self massage (mp3 player for time on bike)
Off we go to the Stanford Surgical Center in Redwood City. This surgy center is far different than the last one I was at in Menlo Park as this was definitely a hospital setting as I was behind a curtain in pre-op. The nurses were friendly but busy. The rep for the equipment I was going to use came in and walked me through the possible rehab tools I would need depending on the outcome of the surgery. This included, a CPM machine which passively moves your leg through about 70 degrees of flexion as well as a bunny boot which keeps your leg inverted while resting or laying down. Also, there was a game-ready icing device as well as a hip brace to limit mobility allowing the joint to heal properly.
The doctor came in and realized that the pre-op physician didn't have me sign the waiver during my pre-op visit. Therefore, he had to tell me all the risks involved with this surgery :( After approx 3 min of freight I agreed and off we went.
I was placed on a special hip table and sent in to sleepy land...
I awakened to the docs around me saying "everything went well" I remember saying "I'm alive"
Next, I was in recovery where the nurse asked about pain levels and gave me pain killers in my IV. The pain was still there - I think she gave me 3 doses. Furthermore, she gave me a percocet for the road.
The doc came in and told me everything went well and that he would explain it all later when I was off medication. I asked "cruches - two weeks or eight?" He said two - YES!
My surgery was approx 2hrs and started on time at 9:45am. I left the hospital around 3:30pm. l had a hip brace on which is fairly bulky and i was quite immobile. The nurses wheeled me out to the car and off I went. My orders were to place no more than 20lbs on that leg and to wear the brace for 2wks with crutches. First post op visit with Dr. Safran's assistant in 3 days as well as Physical therapy same day.
In the meantime, I have to use the CPM machine 6-8hrs per day and do some light mobility exercises. Medication was 2 vicodin every 4hrs as needed for pain and 2 naproxin per day for 6 weeks.
Pain was minimal throughout the evening and I got good sleep. I needed a lot of help from my wife, mom and the kids :) Everyone chipped in and I was a happy camper!
Preop Diagnosis:
left hip combined type femoral actetabular impingement
left hip labrel tear
Postop Diagnosis:
left hip combined type femoral actetabular impingement
labrel tear
left hip chonromalacia of the stem
synovitus
ligamentum teres hypertrophy
capsular tightness
Surgical Procedures Performed:
left hip athroscopic partial synovectomy
left hip arthroscopic debridement of ligament teres
left hip arthroscopic labrel repair using 3 anchors
left hip arthroscopic cheilectomy
left hip arthroscopic acetabuloplasty
left hip arthroscopic capsulotomy with partial capsulectomy
left hip arthroscopic chondroplasty of the acetabulum
fluroscopy with physician inerpretation greater than 1 hr
Equipment:
crutches
hip brace
CPM Machine
bunny boot (keeps foot inverted allowing hip to heal/ set properly)
Standing Orders:
20lbs flat foot weaight bearing / crutches 2weeks
bunny boot 2-3 weeks
CPM 0-70 degrees 6-8hrs / day for 2 weeks
wear brace at all times
caretaker to rotate leg - mini circles 6x day (1min)
Feeling more mobile. I stepped up the PT a bit yesterday and even more today. I rode the bike for 18min, did all my PT work and started delving into more of the long term phase I PT protocol even though my therapist hasn't officially introduced me to the exercises. Slept pretty good last night - no pain, just a bit of tossing n turning (back, front, 1side). I still have to wear this bunny boot to keep my foot angled properly for my hip to heal.
I'm seeing Dr. Safran tomorrow for my post op where he will talk me through the surgery and show me pics. Also, he will let me know when I can get out of this brace and off crutches. I'm thinking I might be walking by this weekend? It's tuesday...
I was pretty uncomfortable last night. not necessarily in pain, just uncomfortable. I might have done too much, as I did my PT exercises and went to my son's soccer game for over an hr where I stood the whole time leaning on my other leg while bracing myself with the crutches. Also, I only got in about 1-2hr of CPM time. I Ice very often, usually at least 15min of every hr, so not doing that yesterday along with the above could have played a part. Also, being off the pain meds. probably had something to do with it as I felt like I had hyper-tension and irritable.
However, after a vicodin (which I'm glad I still had) and CPM / 2 good icings I was fine and got some very deep sleep especially towards the end. I think I slept till 8:30 (sunday - relatively quiet at home). I've been Icing all morning (20 on/off) and am feeling great today!
I'll bust some CPM, maybe get in a bit of PT and head out to my son's baseball game.
-back from my PT work in the dojo. It went well. I felt extremely good, pain free and in a great mood! 8 min on the bike, all my PT exercises, some additional stuff as always including many seated punches, blocks, etc...
I feel like I can do much more, as my body just starts doing things that it is used to such as fire-hydrants (knee raise to side while on all 4s) but I stop myself and stick to the plan. I'm only really supposed to be activating / firing muscles right now. Soon enough...
I'm back under the ice in the CPM waiting for my breakfast to arrive - thanks wifey :)
Cruised to my Sons soccer practice last night - hung about for over an hr. It was nice to drive again as well as crutch the field. Just got back from my training studio (dojo). I rode on the bike just 5 min today as my skin / stitches were a little uncomfortable and I wanted to take it easy today. I say I wanted to take it easy because everything is going so well and that is usually when I end up doing too much and hurting myself.
So I did 5 min, then all my PT work and some upper body stuff on the TRX, core stuff like the plank and flag. Looking forward to game three of the world series - come on Giants!
I am 40 years old and have been actively training in shotokan karate for about 18years as well as jiu jitsu and some judo. Shotokan Karate is very demanding and requires you to articulate your limbs through their full range of motion, often beyond... As I've always tried to kick faster, further and harder while remaining in a low stance my hip joint has developed a condition called FAI where the hip joint binds leading to osteoarthritis and tearing of the labrum.
I have both abnormal Cam and Pincer
My left hip developed severe pain approx 2 years ago. the pain developed the night after a training session where I had tried a stretching technique called P-N-F stretching. Also, I had just gotten back to training after my shoulder surgery which was approx. two months beforehand. In addition, I had always had clicking, popping,catching, etc... in my left hip which is an indicator of hip abnormality.
The pain was acute and near my groin as well as my glute. The sports med doctor told me to stay off it and recommended NSAIDS. After several months, I decided to get an MRI. The sports med docs and Palo Alto Medical didn't see anything wrong with my hips but said if you continue to have pain I should see a hip specialist. Dr. Marc Safran M.D. of Stanford Sports Medicine and Dr. Thomas Sampson M.D. were recommended. Dr. Safran examined the MRI and said I had Femoroacetabular Impingement (FAI) and that he could fix my hip. For a second opinion, I also saw Dr. Sampson who said the same. Dr. Safran said that if I wanted to be certain that the pain was coming from inside the joint I could get an injection inside the joint that would numb the joint; thus, if the pain goes away after the injection this would confirm the need for surgery.
Approx 1 year after the onset of the hip pain I opted for the injection (which included cortisone). The injection was inconclusive as I didn't have much pain in the joint when I went in and I walked out with a limp? However, in the following weeks and months I had less discomfort and was able to train fairly rigorously. In addition, I had a great training program including heat before every workout as I would soak in my hot tub. Afterwards, I would warm-up with about an hour of physical therapy / functional training type exercises to support my hip imbalance. I modified my karate / jiu jitsu training so that I could listen to my body and do drills / techniques that my body would allow. While I could not participate in traditional dojo class type training structure, I have training partners that would follow my lead. Finally, after each and every workout I would jump in an ice bath which I made out of a horse trough (rubbermaid 100 gallon). The ice bath is great in that it reduces inflammation in the whole body; as a result, I could go about the rest of my day pain-free.
The cortisone shot lasted over 1 year and then I was back in pain again. While the pain was minimal and intermittent it was present and I knew I needed to get this fixed as I could not train the way I wanted and I knew I was just doing more damage than good. I got another shot which did remove the pain, therefore, I knew it was inside the joint. This gave me a green light for the surgery.
I scheduled the surgery with Dr Safran at Stanford Hospital in Redwood City on October 19, 2012.
More of the same
Worked out on mine own. 7 min on stationary bike (no resistance)
Completed all the PT work with some additional ab / core drills like plank, flag. Eventually had to kick myself out of the dojo :)
Off pain meds - feeling good!
Feeling great - heading into my private dojo for some PT and whatever else I can do :)
I got through all my PT stuff and incorporated some ab / trunk work, push ups TRX for back, pecs, shoulders.
Later in the day, feeling amazing. I think I'll be walking soon! I am experiencing some light soreness but I am sure thats from the PT work I did today and must be normal. Overall, much more limber and mobile :)
The post op physician said everything went extremely well. They removed the dressing / bandages and gave me new band-aids. They went over the surgery in detail in a way that I could understand although it would have been nice if they had the pictures of the surgery or at least a diagram of the hip joint.
I will see Dr. Safran in about 9 days in which time, he is supposed to over the pictures of the surgery and possibly release me from the hip brace and crutches.
Physical therapy was pretty basic. I did some quad isometrics, ankle flexors, and core / ab squeezes.
I will see PT in 2 days.
Pain very tolerable - I am amazed at how little pain there is. I am down to 1 vicodin every 6-8 hrs. My shoulder and ankle were both much worse than this :)
Soreness went away and was back to minimal pain. I began weening myself off pain meds the day before and hope to be off within a few days. I continued with the CPM and leg circles (someone moves your leg for you in a small circle both ways). I iced diligently as well as kept hydrated. One huge difference with this surgery compared to the last two, was that I am eating a lot of veggies and drinking a veggie / fruit smoothie every day. I use the vitamix to allow fiber intake. My smoothies typically have kale, broccoli, chard, spinach, carrots, apple lime, frozen berrys, mangos and peaches - all organic. This has helped tremendously with constipation from medication.
In the morning I was okay. I had been trying to abide by all restrictions and spent a lot of time on the CPM. Also, Since I didn't get the game ready icing machine due to the hip brace, I used frozen peas and ice packs throughout the day and night. 20-30 on / off.
Around noon, I went to get up and was extremely soar in my hip. This lasted throughout the day. I slept well that night.
I tried to stay positive and not read about the negative experiences on the web. Since the doctor said I might be on crutches for 8 weeks and would at a minimum be on them for 2 weeks, I prepared my environment. This included preparing my staff and business to run itself while I was gone as well as my room and house.
I had to shower with an anti-septic scrub the night before and the morning of the surgery. As with most surgeries I could not eat or drink anything after midnight.
