My Journey Through Hip Labrum Recovery: Entry 6 - Eight Weeks

The heights by great men reached and kept
Were not obtained by sudden flight;
But they, while their companions slept,
Were toiling upward in the night.
Standing on what too long we bore,
With shoulders bent and downcast eyes,
We may discern-unseen before-
A path to higher destinies!
~Longfellow

Today marks the 8th week (plus 1 day) after I had my hip labrum repaired and my iliopsoas lengthened. People keep asking how I am doing, which I've found to be a tough question to answer. Do I feel sick? No. Can I walk? Yes. Am I back to working out? Sort of. Does it still hurt? Sometimes more than I think it should. Is it healed? Some days I can say yes, and others I confidently say no.

Physical therapy for my particular recovery began the day after surgery. I had the surgery, took a couple hydrocodone and was back in the hospital for a post-op 17 hours later where they plopped me on the table and stretched my leg out. From what I can remember, they were able to get 10% range of motion in the joint during this visit and the scope holes were cleaned. My next PT appointment was more formal and I met my actual trainers at the Ironman Sports Medicine Institute 3 days later. This is when the real fun began.

Let me just get this out there without a sugar coating: physical therapy sucks. Really sucks. On my first visit with my new best friends, they picked me up, put me on a stationary bike and told me to get to work. Up to this point, I had not moved the leg from 180 degrees in three days in fear of doing damage to my doctor's artwork. After a couple of revolutions of the pedals, there was an immediate release of pressure in the joint and I felt relief for the first time. I got in 5min of slow spinning and then laid on a table for a 30 min evaluation of the joint, the iliopsoas and all of the surrounding muscles/tendons in my leg. I was released and told to come back in 2 days. The 48 hours that elapsed between my first and second visit to the IM Institute were excruciating, both physically and mentally. The lack of use of my leg was causing sever muscle spasms, the 2 holes in my leg were constantly throbbing and I felt like someone stuck a knife in my lower abdomen. Not to mention the band-aid glue had given me a rash and  the meds were making me emotional and giving me headaches.

On the second visit to PT, I gave them a briefing of what I was feeling, which immediately led into a 45 min stretching session that bent me like a pretzel. I found out afterwards that the guys had visited my doctor and he had given them direction to "release" the tendons and to break up the "junk" that had built up in my hip after the surgery. Dead tissue + platelet therapy blood + drilling holes through my quad + sawing down the iliopsoas = massive fluid and debris build up that has nowhere to go. Like a guest who stays at the party too long, I was glad to see it leave and the feeling I felt upon release is indescribable with words. I was feeling much better.

Over the next 3 weeks I would graduate to spinning longer, stretching more, walking on my own, using the row machine and begin to do squats. I was also cleared to get back into the pool when my stitches were removed during week 3, so swimming with a pull buoy became a regular activity. For every bad day, there were two good ones and I was finally starting to sleep through the night.

By week 6, I was able to frequent the gym, focusing on weight training, swimming (with buoy) and higher velocity spinning. I was also doing crossfit-esque workouts with kettle bells, dumb bells, medicine balls, etc. etc. I also began jumping rope for 30 second intervals. The pain was still there but centralized on the muscles that stabilized the hip rather then the hip itself. I was sleeping again, albeit more sore from working out, but getting 6 hours a night without pain medication. My 6 week post-op appointment with Dr. Adickes was a success and I was given a PT prescription to prepare for running in 4 weeks. Feeling great and getting stronger.

Week 7 PT activity ramped up to the point of squatting with weight, jumping rope, short-distance jumping, lunges, and all of the above workouts combined. I was also going through "release therapy" whereby my iliopsoas was being released at each visit. Pain level was 3/10 and I was getting stronger on the bike, swimming with kicks and working out harder in the gym. Sleep was good and no more pain meds.

At the beginning of week 8 (this week) I was feeling good about my progress and was gaining confidence in my ability to jog a little (10-20 feet) and keep the pain subsided. As I was putting on my pants on Tuesday morning, I felt a snap as I lifted my leg and there was an immediate soreness in the abdomen, groin and hip area. I made it through the day by taking some pain meds at lunch and took it easy the rest of the day knowing I had PT on Wed morning. My trainers had a full 1:15 workout planned which was derailed when they listened to what happened the day before. It was immediately back to the table for an evaluation and I spent the rest of the session stretching and trying to release the sore tendons. Apparently the iliopsoas had tightened up to the point that it was rubbing on the front of my hip (which is why Dr. Adickes cut and extended it) and it took over 30 min to get it to release by pushing through my abdominal wall and lifting my leg straight up into the air. Needless to say, this is a setback at this point in the process as I am scheduled to resume jogging on the 20th of Dec. We were supposed to be ramping up calisthenics and instead are making sure the muscles get some rest. I have a tough PT workout scheduled for Monday the 9th and am hoping I can maintain the 3/10 pain level until then. So now I would say, 3 good days to 1 bad day.

When I made the decision to have the surgery back in September, I had visualized being up and running by mid-January. As of today, I am still on track, although the pain I feel when I jog across the room is eerily similar to the pain I had pre-surgery. This tells me I am not ready just yet. The non-vascularity of the hip joint makes the healing time doubly longer than normal injuries. And given the way it tightened up on me this week, it's not ready.

I thought a weekly activity summary might be helpful for folks having the same issue, just to know what to expect. I wish I had known prior to my experience....

Week 1: Stretch, stretch, stretch, rest.
Week 2: Stationary bike, rowing, upper body weight training plus above
Week 3: Walking, swimming (pulling) plus above
Week 4: Body weight squats, jogger stretches plus above
Week 5: Tendon release therapy plus above
Week 6: Jump rope, crossfit, high velocity spinning plus above
Week 7: Deadlifts, weighted squats, lunges plus above
Week 8: All of the above

Week 9 - 10 forecast: treadmill, side-to-side motions, stair climber, power cleans *and hopefully* jogging....

If this was a test of my metal, I'd no doubt say that this is just piece of the continual journey that I am on. It's the off-season and I am recovering. I have toiled upwards in the night while others have slept. The inspiration I'd like to impart would be to never quit. Don't just say it casually or read it off of a motivational poster...Never quit. Anything (unless its smoking or doing illicit drugs, etc.). Remember, the finish line doesn't move or change--it's always there and waiting to be attained. It's the person that chooses to move forward or give up.

Big news about 2014 racing to come...For now, keep moving forward.

Kelly