Sports after hip pinning

8 months/ 1 week post operative – R  hip pinning

 

I was thinking for a while about it but didn’t feel quite ready for it – trying out for some tennis. Yesterday I went for it!

 

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It was only some light mini tennis, easy groundstrokes from the baseline and a bucket of balls for serving, all in all roughly 20 minutes and  VERY  simplified but hey, I was out there!

Of course it was no US Open material and nowhere close to where I used to be, ahem… three hip surgeries earlier, but still. One has to start somewhere!

 

I had a lot of fun and it was awesome to be back on the court.

Here is what I (hip wise) noticed:

  • footwork to the left forward works well, footwork (small, light steps) to the right & backwards feels like I move with the agility of an elephant.
  • (backhand) rotation with the hips to the L works well, (forehand) rotation with the hips to the R not great.
  • going for low balls – difficult, going down and coming up
  • overall stiff and tight feeling on my R side, mostly muscular
  • explosive and fast moves – nope.
  • Rotation, deep knee bends, weight transfer on the serve? Not really.
  • sudden change of direction? Not the best idea.
  • fast sprints? No.

 

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Lots of important things missing but I am sure it will get better with time. (Honestly, I thought it’d be worse with a lot of payback.)

It was a good try out and certainly a great way to confuse the muscles. My hip was NOT  hurting afterwards, I was a bit tight and tired but that was it. Considering where I am coming from, I was pretty happy.

 

So back to the usual – my op side needs more love and attention. Have to work on strengthening, building up muscle mass and gaining endurance. No rest for the weary.

 

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Plot twist

6 months, 3 weeks PO

 

Since it is  VERY  unusual for somebody in the early 40’s to just “slip & fall” and have a complete hip fracture, it was time to investigate further. A  DEXA  scan was performed to measure my bone density in my spine and left femoral neck (my R, op hip, has too much metal in it. Go figure.).

My spine is great but my hip shows early signs of “Osteopenia”.

 

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Osteopinea is the step “before” osteoporosis. The bone is not quite as dense as a healthy bone but not as bad as one with osteoporosis.

~~~

Last time I had one done was 8 years ago, before my hip saga started five years ago and it came back with very good results, spine and hip.

 

I made research and know now that I got this probably because of being on crutches for so long and being very restricted. (3 hip surgeries/ 4 years = 44 weeks on crutches.)

To maintain good healthy bones you need a good, healthy diet and weight bearing exercises. My diet is indeed very healthy and I am quite active but I have not been able to do “sports” like I used to. I am either in recovery mode or doing physical therapy/ exercises since years.

My first two hip surgeries, combined with two stress fractures in my pelvis, took me three years to recover and now I am in my 3rd recovery and in my 6st month.

 

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In one medical article I read “if one is inactive or bedridden for a long time, it can cause it”. I am sure that’s it. EVERY  other question I answered with no.

  • Are you over 50? No.
  • Are you done with PMS? No.
  • Do you drink alcohol? No.
  • Do you drink soda? No.
  • Do you consume a lot of coffein? No.
  • Are you petit? No.
  • Are you small boned? No.
  • Do you drink a lot of coffee? No.
  • Does it run in your family? No.

 

Some other risks include being white and female. Guilty.

I have to make more research because the  LAST  thing I need are brittle bones. With Osteopinea also the risk for hip fractures increases. No kidding!!!

 

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My doctor prescibed me a diet, rich in calcium, take vitamin D 3 pills and exercise “more” which is a bit easier said than done because all of this aside, I am still recovering from a hip fracture and need to be sensible about it.

~~~

Looking back to December 31. 2017, my accident on the slopes – it really was the perfect storm and the last missing piece of the puzzle was just found.

 

Time to rethink and face another challenge. At least I know now.

 

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Things are going according to plan

6.5 months PO

 

I am doing good. My hips like my new PT/ workout routine much better than physical therapy which turned into bootcamp in the end.

 

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I still get achey with my op hip, on “very special” days it’s both hips, but in general they are much calmer. Compared to two months ago I feel much stronger too. Of course that will be put to the test at some point and I probably still can’t keep up with others over longer distances but I am getting there.

For example, I can walk a bit more than a mile now and I even can pass people, so I am officially not the slowest one in the park anymore. Ha!

~~~

  • My Elliptical is up to 11 minutes on level 1,
  • the stationary bike I can do 16 minutes on level 1 and
  • walking on the treadmill is also okay for 16 minutes, medium fast walking speed. I guess adding a minute every two weeks is safe. Of course it’d be nice to go for more but what’s the result? Two pissed off hips.

 

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At my 6 month follow up with my orthopedic surgeon X-rays were taken and everything is healing nicely. There is continued bone healing and bone remodeling taking place and no complications.

 

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He reminded me again, that this is a recovery that can take up to a year. I believe it but I do feel like I have, for the most part, my life back already.

I can take care of my family again, run the household & errands and except for doing sports, I am the same as before I so geniusly kissed the snow. Now it’s all about fine tuning.

~~~

He examined my hip and it is gliding smoothly and its mechanics work well. It is not completely anatomic anymore since the fracture was impacted and I might have aches here and there from now on, but when do I not? I expect things to get even better with time and I am already very happy with the healing process.

 

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I should “keep doing what I am doing” with my exercises and should be able to go skiing again early next year. Music to my ears!

~~~

My daily steps are also improving. I am now doing 10,000 steps several times a week but I also learnt two lessons the hard way last week.

a) I went too fast on my stationary bike and was limping and hurting the whole next day.

b) I have to watch my walking speed and gait. For one of my walks I walked too fast and my stride was too long, was hurting the whole night. So back to walking a bit slower again and making smaller steps.

 

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Big milestone!!

 

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Today I am 6 months post operative and hopefully things continue to go well for me.

The past half year was very tough, physically and mentally.  First the ski accident and surgery that came out of nowhere, trying to accept the situation and the fact that I had to start from scratch yet once again; deal with brutal pain the first few weeks, to doing my 20 weeks on crutches – learning how to walk again, do stairs and just little things.

Especially “the little things in life” everybody takes for granted are not so little, if you can’t do them on your own or not for a long time.

~~~

I seriously could not have done it without the endless support and care of my husband. He was and is there for me when nobody else was/ is. ❤

 

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This was my third and by far, the most difficult hip surgery recovery and what you learn very quickly is, who is a real friend and who truly cares. Let’s just say the list of people who stood by my side was very, very short. Teaches you a lot about people…

~~~

I started physical theraphy at 6 weeks PO with my PT and did home exercises on a daily basis at home ever since. I am still not done with it but the roughest part is over.

Now it’s all about endurance, strengthening, giving it time and waiting for things to fall into place.

 

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My range of motion is good in my op hip, the pain level is okay on most days but I still get achey quite a bit. On a good day I am on a 1-2/10 pain level, on bad days it can go up to 5/10.

My gait looks good but the more tired I get, the more I will start limping. Also, still lots of compensation going on which my good hip is not too fond of and gets upset too. (Good times when both hips are cranky…)

~~~

Stairs are working fine, if they are reasonable and my op hip is in a good mood. The more tired or achey it is, the slower the stairs will be.

Driving my car is no problem anymore and sitting in general is fine.

I am still putting a huge effort into my recovery and do my exercises. As I know from my previous hip surgeries – “happy hips are a lifetime commitment”.

 

Atrophy (as well as scar tissue & adhesions) is also still a problem I am working on.

At this point I can walk 1 mile/ 1.6 km nicely. Not as fast as other people, but not slow either. I also can do about 8,000 steps/ day and feel fine. A bit more is doable but I will get achey. 8,000 steps is a good day.

This was last weeks summary, according to my Fitbit.

 

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In general I feel good and I am happy again but I know there is still lots of work ahead.

Pretty much the only thing that is totally not happening right now is sports, anything beyond PT exercises. Hopefully this will come with time.

Till then, chin up and keep going.

 

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Trying to figure things out

5 months/ 3 weeks PO

 

Since both my hips were seriously not happy last week, I took about five days off and did no  PT  exercises at all. My hips needed a much deserved break.

 

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My op hip is still recovering and the other one has been majorly working overtime for the last six months and has had it too. If I keep plowing through this with my PT’s  “no pain, no gain” attitude, I am setting myself up for a nice stress fracture in either or both hips and that’s not part of the plan.

I kept following my PT’s instructions to the “T” and did everything he asked of me but at some point it became too much.

 

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I am more of the “slow and steady wins the race” kind of girl and like slow approaches, but my PT just kept on piling on, one exercise after the other.

The days off felt so good, like a breath of fresh air to my hips and muscles. Less is more.

~~~

Now I started again with my exercises at home. I made up a workout plan that involves the Elliptical, walking outdoors, the stationary bike; planks, free weights, stretches and of course my PT exercises. Every day a different mix but less.

 

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My muscles need to be confused, if I do the same old, same old – day in, day out, I will build up muscle memory and won’t improve my situation.

~~~

Last week I tried walking a mile on my treadmile. What I know now is, “a mile in the park is not the same as a mile on the TM”. (Again, a lesson learnt the hard way…)

The  TM  pulls too much on my hip. I have to get used to that again and build it up gradually.

~~~

This week I noticed my glutes are starting to fire again. Finally! I am glad they snapped out of it and start doing their share. The gluteus maximus is a huge muscle and if it hangs out in lala land, others muscle have to compensate and muscle compensation is never a good thing. So – welcome back!!

 

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I still have not found the ideal rhythm of being active, challenging my hips & muscles and “pushing myself” but not overdoing it. That will take a while, years probably, but I am used to it from my previous hip surgery recoveries.

My new plan is a hit or miss with countless adjustments coming up and an even bigger need of patience. I am aching again, op hip/ good hip, seperate or together. They are flexible like that.

 

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And… more PT!

Same week, more of the same.

Had physical therapy twice and my PT is really pushing me. The second I am not looking he sneaks another plate of weight on the leg press and exercises that are tough already are  REAL  tough now. Just when I think “this exercise is monstrous”, he tops it with something.

I have made my peace with “clams” by now but two exercises just got more advanced and are killers.

  1. walking sideways 8x with a super tough elastic band around my ankles. It takes everything out of me and burns my gluteus medius muscles to a point that’s beyond funny.
  2. getting up and sitting down from a chair 20x with a 4 lbs./ 2 kg ball in my outstretched arms  AND  an elastic band around my thighs, while the feet are wider than my shoulders.

They are both tough exercises but I really do hate the first one. That band is so incredibly tight, it hardly gives. I swear it’s the elastic band from hell.

 

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I am doing my exercises but I certainly have an opinion about them.

~~~

Did I mention already I almost fell at PT?? I was done with the elastic band from hell, which by the way is so tight it left my skin bloody as I noticed afterwards (!), and hobbled that one meter over to the bench to take it off, when I tripped and almost fell. That could have been catastrophic!!

~~~

Also, my PT thinks it’s a splendid idea to start doing incline on the treadmill. (I personally  KNOW  it’s not a great idea. Already before I broke my hip and I was “just” dealing with two recoveries from FAI & labral tears, incline was a baaaad idea.)

For the moment it is on the lowest level and only a few minutes at a time but I know my PT by now. Very soon it will get steeper and the minutes longer and then I will put my foot down.

 

Coming home from PT I was completely exhausted. So many exercises in a relatively short time, a few were made even tougher and to top it off – incline. I fell asleep immediately,  with my lower body feeling like dead weight. That’s the best I can describe it.

 

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~~~

Last week I tried walking a tiny bit more than a mile (2 km). I needed about 5 breaks and my op hip was not happy afterwards. So back to my mile. Obviously my hip needs more time.

 

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Why does it take so long?

 

5,5 months PO

Recently I got asked over and over again “why is your recovery taking so long?” Well, here it is….

The hip is not “just” a broken bone. The femoral neck is one of  THE  major weight bearing bones in the entire body and neither the fracture nor the recovery is a joke. It is considered a life threatening injury to have and can have many devastating complications, not just during surgery but also in the recovery.

My recovery is slow yes, but everything is going smooth and according to plan. What more could I wish for??

 

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People who ask “how much longer is this going to take?/ Is this ever going to end?/ Geez, this is going on forever!/ Why are you still in physical therapy?” and other charming questions don’t realize just how serious of an injury this is and how incredibly complex the recovery is.

Recovering from hip pinning is way harder than recovering from a  THR. Only young, healthy and active people will be given this kind of surgery, because it’s too tough for older people and they have a higher risks of complications, such as AVN.

~~~

I started off with “toe touching only” for six weeks, to really give the fractured bone a rest and was full time on crutches for 14 weeks, weaning off for another six weeks. So basically I spent the whole month of January, February, March and April on crutches and did not get far.

The recovery is very very delicate since you can not put “too much weight – too soon” on the hip, otherwise it re-breaks and then “the shit has hit the fan”, to be very blunt.

 

Everything has to be learnt all over again over the course of many months and hundreds of hours of physical therapy.

Simple things like “standing” on two legs for example, with the weight equally spread out, is not easy at the beginning and one has to learn to stand for “longer periods” of time, 5 minutes, 10 minutes ect. again.

Might not seem important but it is. How many times a day does one “just” stand? Brushing your teeth, putting make up on, cooking, prepping meals, ironing, standing in line  somewhere…, leave alone learning how to stand on “one” leg again.

 

Other tasks I can think of that everybody takes for granted but I had to learn again:

  • getting up from a chair/ low seated couch
  • unassisted showering
  • putting on socks & shoes by myself
  • getting in and out of a car
  • eventually drive myself again, whereas my op leg is the right
  • doing stairs
  • shifting weight forward and sideways
  • walking without crutches and walking altogether

 

The hip is a very complex joint and lays super deep within the body. It is surrounded by 17 muscles and being on crutches for such a long time will do a serious number on them.

Atrophy begins after 11 days not using muscles, imagine what the muscles look like after 140 days on crutches! Not much left.

 

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Muscle mass is disappearing very fast and it takes forever to build it up again. My OS told me “per week on crutches the body will need six weeks to rebuild the lost muscle mass”. So in my situation I am looking at 120 weeks. This will keep me occupied for over two years and I am working hard at PT.

~~~

Things one has to work on is getting your range of motion (ROM) back, get rid of the limp when walking and find your proper gait again; one must work on balance, the leg (and knee) is very weak because of missing muscle mass and needs to regain strength. With strength will come endurance as well and of course one has major muscle imbalance to deal with.

Not only the front to the back in the op leg but also from the good leg to the op side leg. While the op hip is still healing, my good hip has to take over and do overtime and being an operated hip itself, there will be the point when even that hip has had it and needs extra love.

 

One must also not forget that some muscles need more attention than others. The glutes for example, so important for basically everything but mine don’t fire properly which throws off everything. The muscles have to be “trained” again to fire  when needed. Another task that takes months.

I am not even getting started about soft tissue issues with scar tissue & adhesion build ups and issues with the pesky hip flexor which by itself can make life miserable already. (Soft tissue issues are very real and can take years to go away).

 

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And since everything is off balance and not working properly, SI dysfunction is never far away either.

 

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The bone will take up to a year to completely heal and till  ALL  of this has settled, calmed down, is strong enough again and balanced, it will be a while. I am not too concerned about the timeline. It will take what it will take.

I could go on and on with this, but my point is, this is a very complex and intense recovery. I am not dragging it on because it’s “oh so much fun”.

I am following instructions from my orthopedic surgeon and my physical therapist and between them and me; time, dedication and  A  LOT  of hard work I am getting it done. Maybe not tomorrow or the day after tomorrow but I know there is a light at the end of the tunnel.

 

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