9 weeks post hip surgery (FAI and labral tear)

Friday 16th October, 2015

9 weeks since my hip surgery!

Recap – In 2012, I saw a surgeon for a Femoroacetabular Impingement (FAI) and labral tear of my left hip. After seeing a physio and working on glute strength, I noticed improvements so I delayed surgery and began training for a marathon. In 2014, I ran Canberra (3:30) and Melbourne marathon (3:23). I managed my hip by changing my gait. 

My health (short version):

Hormonal imbalance (depression and pain)

Digestion; reflux, gastritis, leaky gut

Mild hypothyroidism 

Late 2014, health and injuries worsened. I could no longer run intervals/speed and I had no power. (My answer was to run slower for longer) 

Mid 2015, I ran an ultra (56km) in South Africa. I had the time of my life. A few weeks later I entered another event but my hip started locking up early in the race. I booked to see my surgeon but I knew surgery meant six months no running! 

Friday 14^th August – Labral tear repaired, 3 anchors, acetabulum shaved, ligaments tightened and ligamentum teres tear repaired.

Weeks 0-2:

Surgery took about 2 hours, needed strong pain relief and had numbness surrounding my knee.

24-hours later, walked on crutches (5-10% body weight).

Protocol – limited hip flexion, gentle exercises; internal rotation, knee flexion and foot peddling. No external rotation.

4 weeks crutches, 4 weeks, no driving and 6 weeks healing 

Numbness and pain in hip/back/abs and movement was difficult.

Tired and strong pain relief for 1-2 weeks.

Pulling sensation on the lateral side of hip when standing up straight and groin pain on flexion greater than 70 degrees.

Day 10, stitches were removed, saw surgeon (advised to follow protocol) and physio (prescribed gentle exercises). Pain medication decreased significantly.

By 2 weeks, stopped using crutches around the house and began glute activation. Groin pain still present on flexion however tightness slightly decreased.

Generally in good spirits considering the circumstances.

Weeks 2-4:

Walking without crutches but small distance with small stride. 

Glute activation while walking still hurt through hip flexors.

Protocol – exercise bike with no resistance, limited hip flexion, isometric glute activation standing, bridging, hamstring and adductor stretches, internal rotation. No external rotation.

Returned to work after 2.5 weeks; started driving and off crutches by 3 weeks.

Still tired and some pain relief especially when walking too much.

Groin pain on flexion greater than 90 degrees. Still struggling to actively hip flex.

Began seeing physio for guidance; 4 point QF activation, resistance band abduction and extension, rolling and gentle hip flexion stretching. Introduced bridges. Hip hiking was not good.

Strength work for upper body and compliant with rehab exercises for hip. 

Increase bike work to 30 minutes most days with low resistance.

Need to do more work on rolling and gentle stretches. Hip flexors feel locked up and glutes, ITB, adductor are tender.

Good days and bad days.

Possibly overdone it a few times, but trying to be careful.

Weeks 4-6:

* Week 4-5, I had a big set back. I was in pain most of the time. In hindsight, I suspect it was going back to work, and generally doing more (combined with normal high-low recovery process).I struggled emotionally. I'd put on weight and lost tone.

Glute activation while walking still hurt a little through hip flexors.

Protocol – exercise bike with low resistance, hip flexion 90 degrees, glute activation standing and walking, bridging, hamstring and adductor stretches, internal rotation, leg circles.

No external rotation.

Still tired and some pain relief especially when walking too much.

Groin stiffness on flexion greater than 90 degrees. Still struggling to actively hip flex.

Physio exercises; 4 point QF activation, resistance band abduction and extension, rolling and gentle hip flexor stretches.

Strength work for upper body - goal; chin ups!

Increase bike work to 30+ minutes most days with low resistance.

Need to do more work on rolling and gentle stretches.

Good days and bad days; hormonal issues making life difficult.

Possibly overdone it a few times, but trying to be careful.

Deep water exercises, deep water running

Weeks 6-8:

* As my hip was progressing, I began doing more exercise and my lower leg issues - calf, flexor hallucis longus - began to hurt again. I also had medial knee pain. I worked on VMO activation and calf raises. I started to feel overwhelmed by the amount of rehab however the physio helped to prioritise. I went for a some scenic walks with my family :) 

Walking and stationary bike 30-60 minutes

Joined protocol and physio exercises – 

- TRX half squat, 

- hip flexor stretches, 

- bridges (attempted single leg bridges), 

- lunge stance but hurt hip flexor, 

- 4 point QF activation, 

- resistance band abduction and extension, 

- rolling and gentle hip flexor stretches.

- calf raises

- single leg extension (VMO activation)

Gradual external rotation.

Strength work for upper body and core/abs (no rotation).

Swimming (once!)

More movement when slow and controlled but still painful on sudden movements.

Handstands for FUN!

Weeks 8-9:   NOW!

* I began setting 2-weekly goals (because after 2 weeks I start experimenting with other exercises and lose focus). Medial knee pain has stopped however my ankle dorsiflexion is terrible and my foot pain is worse. Seeing physio next week. My hip is slowly progressing. I still get some groin (impingement-like) pain but that is normal (I think). I changed my focus to mobilising my thoraco-lumbar junction. My thoracic spine has always been tight and relates closely to hips (which relates closely to calves). I'm still unhappy with being inactive and putting on weight but I'm coping.

ROLLING! Thoracic spine rotation stretches.
Chiropractic adjustment everyday for thoracic spine and foot!
Walking and stationary bike 30 minutes with medium resistance

Protocol and physio exercises – 
- TRX half squat and get ups,
- hip flexor stretches, 
- bridges (attempted single leg bridges) - I've been slack with this one!
- 4 point QF activation - Slack! 
- resistance band abduction and extension - Slack! 
- calf raises

Strength work for upper body and core/abs (no rotation).

More movement when slow and controlled but still painful on sudden movements.
Handstands for FUN!

My husband (Brad) is a Chiropractor and regular adjustments are making an obvious difference to my mobility now. More importantly, Brad is an amazing support, physically and emotionally. Thank you!

* Goals for the next few weeks:
- thoracic mobility and rotation
- Chiropractic adjustments 
- see physio about foot
- gentle yoga
- Functional Movement System corrective exercises
- handstands
- gymnastics strength and conditioning ideas...
- Single-leg stance exercises


One last note: I've had injuries for the past 3 years. I've shared my frustrations and depression with you. I've had ongoing health issues that finally seem to be improving because I refused to give up! If you don't want to hear about my "issues" then don't read it. Unfollow me. I'm far from perfect and I'm sorry if I have burdened you. I'm doing my best. I don't judge my friends, I support them. And I'm grateful for my family and friends who support me. You know who you are - Thank you!