Week 9 – First Outdoor Bike Ride

I dove right into it this weekend by taking my first bike ride since surgery on Saturday. My dog was out of food and the pet store that makes his is just a mile and a half away from my apartment – which seemed like a good distance for a test ride after getting the okay from my surgeon for outdoor biking.

I started out with the idea of just biking up to the top of the nearby hill, and checking in with myself to make sure I was still okay to continue. It was very slow going. I did not push for any power, walked up steeper hills, and took breaks. I took a slightly longer route getting to the pet store in order to avoid a busier road (staying on the sidewalk of course) which ended up also having more hills. Overall, what would have previously been a 20-minute round trip ride before surgery took me about 50 minutes including the time to pick up the food. However, it still felt like a huge accomplishment to be back out there! I am not a speed cyclist to begin with and have always tended to bike in a more upright position – so my normal biking style does not put that much pressure on my joint anyhow (in hindsight, that’s probably because of the chronic tears/impingement in my hips). I still felt good the following day on Sunday when I hung out with the ladies during our Sunday ladies BJJ class – so apparently my pacing was spot on!

My goal is to do short bike rides on the weekends until I work up the stability and stamina to ride my bike to work again. It hopefully won’t be too long – depending on others for rides to work for this long has been very annoying.

New Physical Therapist – Monday

I got to meet my new physical therapist on Monday! She’s taking over just at the interval where I’m switching gears to focusing on strengthening more so she started by adding some more strength/stability training to my program. It was a good balance as I was not sore the next day and didn’t feel inflamed, but still managed to get my heart rate up a little bit. Here is the new stuff:

• Shuttle leg press. Really light weight for first time (I think just 50#) She said we will increase next time if I feel okay the day after this time
• Lateral heel tap downs. (I don’t know the official name for these) I stand with my surgical (right) foot sideways on a step and let the other foot hover off the edge. Keeping hips level I do mini “squat” motions with my right side to tap my left heel to touch the floor. I did a lot of these for my knee rehab.
• Blood flow restriction squats. I lie flat with the blood pressure cuff high around my thigh so it calculates my blood pressure then restricts my blood flow by about 80%. Then I do a sequence of movement reps with 30 second rest (with pressure still on). It’s 30 reps, then 3 sets of 15. The oxygen deprivation to the muscles lets you mimic high impact/intensity muscle load with lower intensity activity – getting a similar HGH hormone release for the muscles. It’s great for muscle building when you aren’t free to actually do the impact/intensity loading due to joint issues. Plus it burns real nice!
• Balance practice: I passed a small kettlebell back and forth from outstretched hand to hand while balancing on my surgical leg. I have a feeling I’ll get more time or a squishy pad to stand on for that one since I started passing it behind my back and around my body to make it harder.

I was really tired by that afternoon and really wanted to take a nap, but instead I got a ride over to the Jiu Jitsu academy to watch the evening training class. I’m glad I was able to make it in because we had yet another belt promotion this evening, this time it was Jackson getting his purple belt! He is one of my favorite training partners and I look forward to getting to roll with him again once I’m allowed! (It seems like all my favorite people are getting promoted lately)

Jiu Jitsu Training

This week we have been working on control and attacks from North/South top position. This works well for me as I’m able to do most of the drills pretty safely with minimal modifications since they don’t involve my hips in very many twisted angles like some of the other positions we work from. I didn’t get much training in during this week because I had some systemic inflammation issues and didn’t want to cause any sort of flare up in my hip joint. The systemic issue is unrelated to anything with my hip recovery, it’s a chronic condition that flares up periodically and I have just learned my best option is to ride it out and rest for a couple of days instead of pushing through it.

Friday the 19th we had our first ladies’ competition training class. It was a joint training class open to our other local affiliate academy ladies. It ended up just being the ladies from our local academy this first time around, but they absolutely killed it and the overall consensus was that it was some of the best training ever. We are going to have it at least once a month and shoot for twice if possible. Hopefully the ladies from our other local academies will get on board but if they don’t that’s fine – we had a great time anyhow and I look forward to joining in myself in a few months.

On a slightly unrelated note: I had a follow up with my neurologist this Friday morning. I have been on a daily medication to prevent migraines that has been working splendidly. It’s an anti-epileptic that was a bit harsh with the side effects initially but now that I’ve adjusted to it I have gone from having several headaches a week to only one or two breakthrough headaches a month. He also gave me a more effective medication for those break through migraines as well that doesn’t make me feel trashed for the rest of the day.

Week 10 Physical Therapy

I recovered from my flare up thankfully in time for my physical therapy session on Monday. We added more weight to my leg press (3×10 at 150#) and then dropped it to add single leg press (3×10 at 75#). I had a new standing variation of a clamshell where I had my foot propped on the wall while balancing on the other while using the resistance band, and we modified the banded bird-dog to accommodate my tactile ick to the touching the band with my hand and we did a bird-dog row on the table – which honestly I found much more difficult a move anyhow (imagine doing a “hands and knees” bench row while holding your opposite leg up parallel to the floor while doing your row). To my “step ups” we added a “tap down” in front – just barely tapping my heel to the floor in front of me off of a 4-inch box.

I let my PT know I have access to a full collection of plyo boxes, physio balls, and trx straps at my Jiu Jitsu academy – so she said she would work on upgrading my home working program to include those for me.

Everything felt pretty good and didn’t make me feel worn out, so I put my gi on and joined the evening Jiu Jitsu class. The position this week is turtle bottom – I wasn’t sure if I would be able to do any drilling this week from the position, but I was able to do the moves Monday evening without any modifications, even the wrestling sit outs. Now granted, I did not do many reps and it wasn’t against heavy resistance – but I am able to do light movement drills with a gentle training partner.

Tuesday morning I drilled again in class. I did a few more reps of various moves from the turtle bottom position. I am once again reminded how blessed I am to have great teammates who are happy to be a part of my recovery process and help me drill movements even when I’m not 100%. This was a pretty special class as well because coach promoted Jeremy and Denaro to their purple belts. They’ve both been training since they were smaller than me, a fact that didn’t really hit home until I took a photo with both of them and realized how much they have grown over the years, it got me a little bit emotional! I did my PT exercises during the evening competition class. My muscles were a bit sore but not to a level that it might cause any compensation movement patterns so it was all good.

Wednesday I had as a bit of a rest day and just did my stretches, although I did teach Jiu Jitsu for the first time since my surgery. It was 1:1 in the corner with one of our brown belt ladies during the evening no gi class and I came up with a lesson plan that I could both demonstrate safely and also have practiced on me safely as well. We did a lasso guard sweep as well as an omoplata – then we strategized an open guard concept to help her with a specific goal she has been working toward in her sparring rounds.

Thursday morning was another drill in morning class day – this time I got to get reps in with coach and several of our other black belts. It was a more hip intensive movement but I can feel myself getting more stability and confidence. I would not have been able to do this particular movement a few weeks ago but have built up the joint stability since then to be able to. Every new movement I’m able to achieve gives me more confidence – it’s not perfect at first of course, but it’s a starting point for growth! PT exercises in the corner that evening again during the competition class of course – I think I smell an updated home program coming this week! I stayed over for the last class of the evening with the intent of getting some more movement reps in – but it ended up being me assisting some brand new white belts in class instead.

The Official 10 Week Mark

Friday is officially 10 weeks post op! I decided to mark it by running myself through a slow careful yoga flow session – which I haven’t done since before surgery. It went pretty well even though I just did the opening movements. It was a work from home day since Fridays are a bit chaotic for coordinating rides to and from the office, and my stamina for bike riding is not road ready (especially for around Nashville traffic). I’m doing short sidewalk bike rides around my neighborhood on the weekends to work on my stamina as the weather permits.

The hardest challenge for me in PT right now is reclined straight leg raises. I stay propped up on my forearms to keep my core engaged but I have to really focus to keep all my muscles engaged so as to not isolate just my hip flexors. If that happens then I will feel a sharp pain in them – which thankfully doesn’t last past the exercise. It just acts as a cattle prod to remind me to use proper form.

I’ve been slowly gaining more and more confidence moving through various movement angles and drills in class since my surgeon told me I could drill techniques. I occasionally get someone asking me to “roll light” after drilling and am strictly declining still. Since my surgeon said he will consider the repair work he did on my labrum to be healed around the 4-month mark, that’s going to be my personal benchmark for return to flow rolling – unless he tells me otherwise when I check back in at my 16-week post-op follow up appointment.

Further clarification on that 4-month mark: that’s strictly just the specific surgical work he did (and also could be specific to my individual surgery and/or his own protocol). I still will need additional time after that to work on strength and stability for return to full impact. He said the usual time frame for that is 6-9 months post-op depending on what the sport requirements are and whether or not you run into any difficulties with recovery.