Putting the hip to the test

 

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7.5 months  PO,  R hip pinning.

 

We just came back from vacation and it was a good test to see where I am at. It was a  pretty active few days, nothing too crazy but still, challenging enough for somebody in my situation.

What I learnt was, “speed walking” is not my friend, nor are many “uneven, high” steps, uneven ground or long distance walking. (All in one day…)

 

The mentioned uneven and challenging ground.

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For example – we did a day trip and first thing – a pretty long walk on uneven ground. I thought I was smart by walking behind some senior citizens (they had the perfect pace for me, as pathetic as that is…) but we were told by the tour guide to speed it up and put “a bit more passion into it”.

I did the walk but on the way back my knees were really shaking.

The day was pretty challenging and in the evening I had  NOTHING  left. Zero. I was limping heavily; walking very, very slowly and was exhausted. Once home, I fell onto my bed and slept for two hours like in a coma, only to wake up in the exact same position, pretty much like this guy…

 

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What I learnt this vacation was, 10.000 steps are not 10.000 steps.

I can do 10.000 steps/ day now again but it is a  h-u-g-e  difference if I accumulate this with many, many short distances (grocery shopping, household chores, doing the Elliptical etc.)  OR  if I have to crank it out in several long distance marches. Definitely not the same thing.

~~~

Was I surprised by it? Not really, since this is hip surgery recovery No. 3 and it was a more severe injury, more invasive surgery and yep, more time on crutches than after the first or second surgery ( FAI & labral tear).

I have lost  A LOT  of muscle mass during my time on crutches (20 weeks) and it takes forever to get it back. Probably around two years for me, but I was happy about what I could do.

 

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We had to take one day off, to recover and give my hip some rest but otherwise I did everything. Walked over lots of gravel and uneven ground, climbed up to see waterfalls and iceberg lagoons, hiked around the crater of a vulcano and did a good amount of sitting in busses too.

 

Hiking around the vulcano crater and taking a well deserved break. 

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I had to do the activities my own speed and choose my walking paths more careful than others but I did it. Most of the times my op hip and surrounding muscles started aching in the evening which was okay. That’s why I brought the icepack along.

~~~

So I know now I can walk in an airport without wheelchair assistance and I can do a whole vacation again. Endurance on vacation was at about 40 % to where I was before I broke my hip.

I still need more overall strength and endurance in my op hip, glutes and quads, strengthen the knees as well and work on muscle imbalance. Unfortunately this will take its sweet time.

Some people can just go ahead and really crank it up in the gym to see faster results. Good for them but it does not work for me. My body heals slowly and what I have going for myself is persistence and consistency with my hip friendly, PT based workouts, patience and time will work for in my favour.

 

But the good news is, even though I am not as strong yet as I want to be,  I see improvement to a few months ago and considering where I am at in my recovery, I did really good.

I am happy. The trend is still going uphill.

 

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One lesson smarter

 

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Well, last week was disappointing.

 

My workouts were going well, I was making slow but steady progress and thought, I can upgrade to the next level on the stationary bike.

Going from my hard earned “17 minutes/ level 1” to “12 minutes/level 1 and trying out 5 minutes/ level 2” – BIG  MISTAKE!!

Both of my hips were absolutely miserable at night, like 5/10 and especially my op hip was angry and deeply  aching for another two days. What a price to pay for 5 minutes…

 

I had to take three days off to rest and give the hips a break. And going back to my workout routine, it was a slow start and working my way up again, which took a whole week.

 

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I was really surprised by this since it felt absolutly fine “while I did it” and I thought for sure, being 7 months PO I can do it. Guess not.

With this I also can forget riding a bike outdoors anytime soon. To ride a real bike is a minimum of level 3 and if “5 minutes on level 2” already do this, I do not want to think about it what level 3 would do to me. Bummer.

~~~

But on the bright side, it’s another month closer to skiing! We are getting all those E-mails about ski resorts for winter 2019 and I really want to go.

People are always shocked when they hear I want to go skiing again after what happened but isn’t this the point of recovery? To go back doing what you love? And in all honesty, it didn’t really happen “during” skiing.

If I would have been going too fast and had a wipe out, then I would have kind of asked for it, but I wasn’t. I was standing still on my skies and sliding over, when I slipped and fell. (So lame…)

 

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Maybe that’s why I am not scared of going back. It was a super stupid accident, something that can happen in my own driveway or pretty much anywhere. Plus I think skiing will not be as tiring and demanding as let’s say playing tennis. Skiing is sliding and using gravity, tennis is more of an impact sport.

I am not seeing biking happening any time soon, but I do see myself skiing again and if it’s just some easy blues.

~~~

Till then – back to the park, walking my daily rounds and doing my hip friendly workouts in the gym. I’ll get there, one way or another.

 

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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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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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On my own

Borderline 6 months PO.

 

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Last week was crappy. Every day my hip had something else in store for me, I just couldn’t do it right.

Either it was aching so bad I could not sleep at night or it was very cranky during the day; the hip flexor absolutely hated me and made me look like I just turned 100 when I tried getting up from a chair; or both hips were miserable and since I am being told to “keep pushing myself”, I tried that too.

It took me almost six months to get to 15 minutes on level 1 on my stationary bike, so I thought “let’s try 10 minutes on level 2” instead and see how that goes.

That fell in the category “felt good while I did it….” – not so good afterwards. The payback set in about six hours afterwards with  BOTH  hips being angry, 5/10. Bummer.

 

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~~~

My PT always wants to know how my week was and after I told him, he said it sounds like I have a burn out from PT. (No kidding.)

I counted the reps (of all exercises together) I do while I am at his place and counted 432 – in 1.5 hours! Anybody would have a burn out doing this for months (AND my daily PT exercises which went on for two hours/ day for months, reduced to one hour/ day only recently), leave alone trying to recover from a hip fracture.

 

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He wants me to take some time off from PT and ice more as I am already. Preferably twice a day.

~~~

My good hip is hanging in there, sometimes better than other times. In general it has calmed down quite a bit but it still gets upset easily. My PT even suggested getting an MRI  for the good hip or at least talking it over with my OS, next time I see him, which is in three weeks for another follow up.

 

So right now the plan is this, I let my hip/s calm down and continue with my exercises on my own for a while and see how that goes. In case I need help again, I can always go back to my PT.

Doing too little makes my hip stiff and achey, doing too much pisses things off. I need to find that golden middle that keeps my hip/s happy and challenges them just enough to keep improving.

Sounds like yet another fun journey ahead.

 

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Reality check at 5 months PO

I am back from vacation.

Had a great time and it was my first “sightseeing” vacation since my ski accident/ hip pinning surgery and I know now where I am at in my recovery (5 months PO).

The good news – I could do more than expected but I also learnt a few tough lessons.

At the airport I could walk to gates which where nearby, longer distances I still used the wheelchair assistance. Carrying my backpack not only slowed my walking down, it made me limp and used up more energy, faster.

~~~

I had my crutches along and would have actually used them but at the time of need I was stuck nowhere near our hotel (where my crutches were) and had to deal with the situation, without them.

One time in particular I completely misjudged the walking distance and not only ran out of energy but went into pure survival mode. Sights which I usually would have enjoyed and taken photographs of did not matter to me anymore; I shuffled away in slow motion, tiny steps and with a big limp, till the next bench. It was brutal. I would have given something to have access to my crutches at this point.

It was not that the hip itself was hurting, it was the missing muscle mass, on my op side. Atrophy is a real bitch.

~~~

Most days I stayed around 8,000 steps which is all I can do right now and not be aching. I overdid it a few times and paid for it, every single time.

 

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  • Pulling a heavy suitcase? Pain level 5/10 in the hip throughout the entire night and the whole hip joint felt bruised on the inside.
  • Walking up and down hills results in an aching hip.
  • Walking over cobblestone and uneven ground – hip is not very forgiving.
  • Hip flexor on my op side joined the party pretty much every day and gave a lot of  additional “joy”.

 

On the bright side, I was able to walk behind a waterfall; sitting in trains, cars & planes was not a problem and my icepack was a lifesaver several times.

~~~

I certainly had my moments in which I thought “this is so lame” – for example, trying to take part in a 90 minute walking tour.  Brilliant idea!

The group took off and I was always the last one and never heard a word of what was being said.

At some point I called it quits and left the tour. I could not keep up and nobody cared or asked if I was okay either. So, another one for the list, “guided city walking tours” – not happening at the moment.

I was slow to begin with but the longer the vacation went on, the more aching my hip became and the slower I walked. My good hip was aching off and on as well.

~~~

Overall I could do many things though and had quality time with the hubby. Things went better than expected but still lots of work ahead.

Endurance and strength I have to continue working on. But I am sure my PT will have some good exercises up his sleeve when I see him next week. No rest for the weary.

 

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20 weeks PO after hip pinning

Wow, 20 weeks already – so theoretically I am almost at half time till I can go skiing again! Yep, you read that right. I have full intentions on going on the slopes again. I loooove winter!

I am actually a really good skier, I do blues and blacks, have good balance and don’t fall. Well, except that one time but that was just an incredibly super freak accident. My surgeon said it will take one year to do sports again, so… something to look forward to.

 

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All together I really must say, if there ever is something like “perfect timing” for a hip fracture, it’s probably in the winter. I was laying low for the last few months but now that spring has finally found its way here and I am learning to walk again, it’s perfect to do it outside when everything is blooming.

 

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~~~

Last week was a little bit of everything, hip wise.

I was really aching in both hips after my first mini walk in the park without crutches, but had big improvements only three days later and no problems at all and eventually I made it around the whole pond without crutches. (Walking really slow and limping towards the end.)

PT was going well, so well in fact I thought I still can go grocery shopping afterwards.     BAD  IDEA! I moved around like a 95 year old afterwards. Aching in both hips quite a bit and a miserable night as a bonus. Ergo – lesson learnt. PT and grocery shopping on the same day is still a big no no at 5 months PO.

~~~

PT itself was fine. We worked on balance, some exercises were okay, others very challenging.

 

Walking on a medium soft beam.

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Two different exercises on a wobbly board. Keeping balance while it tips forth and back and keeping balance while it moves left to right.

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Otherwise the same exercises as last week, which are about 15. The leg press, hip extension machine, leg extension machine, exercises with the big ball, clams, bridges, squats, exercises with a resistance band around my ankles, treadmill and so on.

We are also still trying to make my muscles fire correctly. My glutes are still hanging out in lala – land and refuse to fire when needed.

My PT did said I am doing a great job though but I still need finetuning.

~~~

I also saw my OS for a follow up appointment. Three X-rays with different views were taken and everything looks good.

 

  • No  AVN  but we have to monitor it closely from now on
  • No malunion or nonunion
  • The three screws are still in position
  • Bone healing and remodeling is taking place
  • Bone fragments that were floating around are gone
  • Major atrophy is visible on my op side

 

He was happy with my progress and told me again, it was a major fracture and does take time to heal. I am within the timeline of the recovery and got another script for 6 weeks of PT for range of motion & strengthening.
I asked about my good hip being cranky and was told, it is normal and expected for the circumstances. My R is still not healed yet and my L (which is an operated hip as well) is working overtime since five months. Once everything is balanced, things will calm down again.

In the end I was sent on my merry way with the recommendation “push yourself a little bit but don’t overdo it.”

~~~

Summary of what I “can” do at this stage:

  • I am doing my household at about 80% of my usual self
  • 8,000 steps a day, spread out over the whole day
  • Stairs – still Granny style. (L foot up, R foot on the same step. Left foot up, R on the same step; going down – R foot down, L foot on the same step. Ect.)
  • TM 10 minutes slow walking, Elliptical 6 minutes slow walking, stationary bike 10 minutes, no resistance
  • An hour PT every day
  • 700 yards/ meters in the park, crutch free, several times a week

 

And here is a list of what I can not do yet:

  • walk long distance
  • do stairs properly
  • sports that is anything beyond PT
  • carry something medium heavy or heavy

 

~~~

Things are looking good and I am heading in the right direction.

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