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In January of 2010, at age 38, I had the
difficult decision of what to do about an ailing right hip that had
been diagnosed as moving toward advanced osteoarthritis. I first
experienced pain in the joint at the age of 26 when my regular
doctor told that I should restrict my physical activity (i.e., stop
running) and that I would likely need a hip replacement within 6-8
years. That just didn’t really seem like an option for me at that
early age. I had been very athletic and active my whole life –
starting with basketball, football and track through college and
then playing competitive ultimate Frisbee since then, up to 3-4 days
a week. Besides, I was still fairly mobile—the rest of my body
worked fine—and I was still able to play all the sports I loved.
So, despite my family doctor’s advice, I continued my regular
activities for the next 12 years, just cutting back when I felt
soreness or the stiffness became too painful. Over time, I realized
I had to cut basketball out of my activities because it would leave
me sore throughout the next day. Then running even a few miles
would leave me sore as well. I noticed myself slowly having to cut
back on activities I loved because of the pain and stiffness in the
hip joint.
I visited a newer family doctor in late 2009 to
inquire about what was possible. He told me I "have the hip of a 70
year old," and that I was probably a good candidate for hip
replacement. He respected the fact that I was still very active,
playing competitive ultimate Frisbee (now at the coed level) and
wanted to see that I could continue that. He told me about new
developments in hip replacement—namely, hip resurfacing—and referred
me to an orthopedic surgeon who he said "wasn’t a surgery nut" and
would give me a fairly objective opinion on my options. After I saw
him and expressed an interest in hip resurfacing, he referred me to
Dr. James Rector in Boulder, CO. I talked with Dr. Rector and he
thought I’d be a very good candidate for hip resurfacing. So, after
doing a couple weeks of research on the procedure (including quite a
bit on the Surface Hippy site, which was a great resource), I
decided to go ahead with it, and I scheduled an appointment for late
January 2010.
My early post-op recovery was, by all measures,
excellent. I was off of all pain meds within 5 days after surgery, I
was walking with one crutch at about 9 days, I was walking without
crutches by two weeks, and I was driving by 16 days after surgery!
In weeks 2 & 3, I would sometimes use a crutch when going on
longer walks, because I really wanted to work on maintaining a
normal gait, since I didn’t want to normalize any kind of limp which
I would still fall into doing sometimes without a crutch. The limp
was not so much out of pain as because of the relative stiffness in
the joint that was operated on.
I was very committed to making a strong and
quick (as possible) recovery. For the first 3 weeks of PT (2 weeks
at-home, 1 week outpatient), I worked on the standard exercises they
typically give you for post-op strengthening and increasing range of
motion. They were great, and I did them religiously every day.
When I got to about 3 ½ weeks, I’d pretty much exhausted what they
could offer in terms of PT and I got the go-ahead to get onto a
stationary bike, and by 5 weeks I was even on the elliptical machine
doing 15-20 minute workouts. By about 6 weeks, I decided to get a
pool membership and begin working on some water aerobics, which were
nice because they allowed me to work on my range of motion without
much impact on the joint.
At about 2 months, I felt relatively mobile – I
could go on long walks and I was in the gym doing light weights. I’d
bike 2 miles to work every day, and I’d go to the pool when I could.
It was about that time that I began doing plyometric exercises – the
kind that runners and other athletes do to stretch and strengthen
muscles—focusing on the ones that did not require any high impact.
It was these exercises that made the biggest difference, I think, in
speeding my recovery (I would be happy to share those that I did). I
focused on ones that strengthened and helped stretch the hip-flexor
and quad area muscles, as those seemed to remain the weakest muscles
for me (particularly when lifting the knee and extending the leg
forward). I continued to do these, along with weights and low impact
cardio work, until about 12 weeks post op, when I added beginners’
yoga classes. I didn’t push myself to do everything in the class;
just what I could without pain or without breaking the restrictions
explained by my surgeon. Between these classes and the plyos, I was
able to figure out what muscles seemed to be coming back strong and
which remained weaker and needed more attention. Since I still had
one fairly strong hip, I was able to use it as a barometer for what
"normal" should feel like in terms of strength and flexibility. I
made it to the gym 4-5 days a week, for about 1 – 1 ½ hours each
time, working on plyos, stretching to increase range of motion, and
weights (increasing to moderate by month 3).
When I saw my surgeon for a 3 month
appointment, I was doing pretty well. My range of motion – bringing
my knee toward my chest—still had a way to go and was limited and
somewhat painful if I tried to stretch it too far. Otherwise, the
joint strength felt good. He said things looked good, and told me I
should keep up with the biking, weights, stretches, and that I could
hike as long as I wanted. He told me I should not be doing any
running until a full year after the surgery (beyond running to cross
the street or something like that). I told him I was doing low
impact plyos, and he seemed fine with that. Strangely, he also told
me that he thought I could return to playing ultimate Frisbee by
about 5-6 months post-op, which made me think: I don’t think he
know what ultimate Frisbee is. For those who aren’t familiar, it’s a
lot like soccer in terms of sprinting, cutting, jumping, changing
direction, etc. So it didn’t make much sense to me, especially when
he told me not to run for a year! I tried to explain to him what the
sport was, but I’m not sure he ever got the idea of Frisbee golf out
of his head – which is a whole different game! He said the fact that
it was on a soft surface (grass) – rather than long-distance
repetitive motion on something like concrete—made it less taxing on
the new joint. He told me ever after the year of no running, I
should refrain from playing much basketball. I’ve resigned to doing
that for the long term health of the hip joint.
Even though I expected to be in rehab, I
committed to be the conditioning coach for the local competitive
co-ed ultimate Frisbee team. At about 3 months and one week
post-op, I started hosting twice a week, early season track
workouts. These included a lot of sprinting exercises, like short
recovery sets of 6 x70 yard sprints (1:1 run/rest ratio), with 2
minute recoveries in between, 3 sets total in each workout. Since it
was spring, the track infield was very soft, lush grass, so I
decided to participate in the workouts on the track infield while
they ran on the surfaced track. While I didn’t have full range of
motion, my strength was good, and I had enough motion to run
relatively normally at the 70-75% speed range. I felt as if the
plyometric exercises I‘d been doing prepared my muscles for these
types of movements, and I only pushed myself to the point where I
felt no real pain at all doing it. I did the "sprints" relatively
painlessly, although I was sucking wind because it was the first
real cardio work I had done beyond the elliptical machine, which I
rarely did at sprinters’ pace because I hated sweating all over the
equipment! I was a little sore after the first couple of workouts,
mostly in the muscles in the front of my hip, rather than in the
joint itself. I’d still be able to bike home, and I was fine by the
end of the next day. I never took any pain meds or
anti-inflammatory drugs during my early recovery process because I
figured if I needed them, I was probably trying to do too much. I
kept up the 2 a week (soft) track workouts – largely sprinting, with
minimal jogging (less than ½ mile to warm up before stretching) for
the next 3 weeks. The reason I did as little jogging as possible
was because I was more worried about what the repetitive motion of
longer distance jogging would do to my joint than with the
sprinting, which was bursts of about 10-15 seconds of running on a
soft surface. I’m not saying my logic is medically confirmed, it
was just the feeling I had. I also continued to do stretching to
increase my range of motion on the days I wasn’t sprinting, as well
as some low-impact plyometric stretching and strengthening. If I
felt any kind of prolonged pain that could cause me to limp, for
example, I would take a day or two off, because while I wanted to
come back as fast as I could, I didn’t want to do it too fast. I let
pain be my guide.
At about 4 months, I began to add a host of
higher impact plyometric exercises to my routine – e.g., high knees,
hoping, jumping, bounding, although I had been mixing them in, to
some degree, for the previous couple of weeks. I also added some
change or direction or "cutting" running drills into the sprinting
track workouts – like ladder sprints, where you run 10 yrs and back,
then 20 and back, and then 30 and back. I continued these on the
soft grass and I changed into cleats so that I wouldn’t slip at all
on the turns. I eased into these because I wasn’t sure how my body
would respond, but it responded well. The worst part is that the
operated hip was still stiffer than the good hip, and I didn’t want
to create an imbalance in my stride or muscles by sprinting/cutting
too hard one way and not the other. So I only did them at the speed
that was within my comfortable flexibility range on both legs, which
at that time was about 75% of what I would consider maximum. As it
turned out, changing direction did not feel hard on the joint, but
changing speed (slow to fast) was a bit difficult because it
requires different muscles to slow down and speed up quickly, and I
realized I needed some time to get those back.
At 4 ½ months post-op, our team had our first
2-day tournament. I didn’t expect to play, as I really hadn’t done
any live-action running and cutting other than very controlled
drills. However, I convinced our captain, who called the field lines
on our team, to put me in for a few points at a position where I was
less likely to have to run or chase people all over the field but
would still have to make relatively quick cuts and changes of
direction (at the "handler" position, for those who know the
sport). I wasn’t super fast or quick, but I was okay! The second
day, I took a lot more points, and even played some of the tough,
final points in a competitive semi-final game. In that game, I found
that having to chase around a quicker opponent was stressing the
inside groin muscle on the operated leg, so I wisely benched myself
for the final game, not wanting to put my progress back.
My groin was sore for a day or two after the
weekend tournament, but I continued to stretch it, and found that
all the running I had done had really begun to loosen up the joint
and extend the range of motion – still not back to normal but closer
to 80-85% - I was finally able to bring my knee to my nose while
having one leg on the ground and the operated leg bent on the seat
of a chair (that had been my goal for about 2 months. To get this
flexibility, I found it helpful to do 5 minute deep stretches, which
my PT had recommended. This meant that without pushing too hard at
once, I could work on elongating the muscles in the joint over time
rather than trying to do anything to force them quickly. It seemed
to me to be a safer way to increase range of motion. After 5 minutes
of the stretch, my leg would sort of get "stuck" in this position,
but after I’d slowly ease my leg back down with my arms and set it
straight, it would take just several seconds to return to its
regular state. I certainly have a new found respect for the
resiliency of human musculature!
At about 5 months post-op, which was the Fourth
of July weekend 2010, I attended a 3 day ultimate Frisbee tournament
in Seattle Washington. It had been my goal from the day I scheduled
the surgery to be able to play in this tournament. It’s much more
of a "fun" than competitive tournament, so I wasn’t worried about
having to impress or play 100% all of the time. We played 3 - 1 ½
hour games each day, over three days, and I played in each game. I
started fairly cautiously on day 1, and I did a lot of standard and
plyometric stretching exercises before and after the games. I
didn’t entirely feel like my old self – I’m usually the person who
doesn’t get tired running and jumping around, but I was definitely
tired, both in terms of muscles and lung capacity, but that is
typical enough given where I was in my rehab. After day 1 and 2, I
was sore, but it was the typical sore – hamstring muscles, a little
in the hip flexors on both sides, but nothing that different than
before the surgery. If anything, my non-operated hip was a bit sorer
than the operated one, and this has generally been the case since I
started doing more of the "cutting" types of sprinting activities.
My assumption about why this is true is because the operated hip
does not have full 100% flexibility—and sometimes I do run at
100%--as a result, the other leg has to compensate a bit. That is
why I continue to make it a top priority to get as full a range of
motion back in the operated hip as I can, and for me it has taken
on-going commitment and work. Anyway, by the end of day 3, I was
pretty much feeling like my old self – I was sprinting well, cutting
well, and jumping well. I was very pleased to hear my teammate say "welcome back" after the final game, when I played as well as anyone
on the field, and played a key role in turning at 6-1 deficit into a
9-6 win for our team!
I just got back from the Seattle tournament
last night, and I decided to take time to write this long story. I
know that in my own process of deciding on the BHR surgery and
undertaking rehab, I depended on, and found strength in, the stories
of others who have posted on this site. The stories gave me the
confidence to go ahead with the surgery and made me believe a strong
recovery was possible.
Even though I was very methodological about my
recovery process, I would not suggest that others go against their
surgeons orders on how to best assure a successful recovery.
Medical doctors know much more about stuff than I do. I only know my
body, and I listened to it as best I could, and although I pushed it
at times, I always pulled back when pain or discomfort told me I
should. And I was very good about heeding the post-op restrictions
for the first few months of recovery. In the end, I’m very pleased
with my recovery to date. My old real worry is about how long the
joint may last, because of course no one knows for sure. But being
where I am, 5 months post-op, I couldn’t be happier, and I wanted to
share my story.
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