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Prepping to Travel – bulk update

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I’ve had people asking me this year why I’ve been so injured and seeing the doctor so much. It’s not really that things have suddenly come up; it’s that I went for so long without insurance coverage and just ignored issues related to my hypermobility since my other option was to just curl up and be depressed.

I ended up addressing a reoccurring problem with my shoulder this June by having a shoulder stabilization procedure done by my orthopedic surgeon. My MRI scan was clean, but in my surgeon’s physical exam he could feel my labrum was separating from the bone and the ligaments were just all too loose in general. During the surgery he was able to dislocate it with just light finger pressure. He also did an AC joint decompression and distal claviculectomy (shaving down the end of my collarbone) to reduce the load on my SC joint which keeps subluxating and is also giving me problems. He said we don’t want to do any procedure directly to my SC joint unless absolutely necessary because that’s a monster of a surgery, so I appreciate the conservative route being taken first. I’m continuing rehab for my shoulder at this point as the range of motion is coming slowly and due to the combination of procedures done is a bit more complex than a standard labrum repair/stabilization.

Piggybacking off maxing my insurance coverage for the year, I decided to see an ENT to find out what it would take to be able to breathe properly through my nose again for the first time in over a decade. Apparently it will take a lot and she ended up referring me over to the hospital facial plastic reconstruction department for an assessment. The surgeon said that if it wasn’t for my connective tissue disorder it’s likely I could get away with just a septoplasty, but since all of my nose cartilage is weak, he needs to reinforce a good amount of it in order to support proper airflow and prevent it from collapsing when I breathe. He clearly documented that it will be affecting the shape of my nose but that it is necessary for proper function, so insurance approved full coverage of a functional rhinoplasty. The fact that he has good knowledge of connective tissue disorders (without me prompting the topic) and how they affect the nose makes me very confident in his ability – all the other accolades he has as a leader at this top 10 university hospital help as well. If I can breathe half as good after healing up as I did when he propped my nostrils open to test my supported airflow, I’ll be happy all other factors aside. I can leave my mouth breathing days behind me!

This Week:

I’m flying out tomorrow to meet up with my Dad in Spain. He qualified to do the half Ironman World Championship triathlon (he had to place 1st in his division at another half Ironman to qualify) and that race is actually ON his 65th birthday this weekend. I’m planning to meet up with friends in Spain as well and then the day after his race we are flying to Marrakech for a couple of days just to see a new place. We were originally planning to do a week in Marrakech but since my surgery was scheduled for the week after I had to cut my visit short so I will have time to be rested for that procedure. Historically speaking it takes me about 3 days to recover from a trip like this; so coming back 6 days before my surgery should be adequate and my surgeon didn’t have a problem with it when I mentioned the travel during my consult.

In the New Year:

Starting in the New Year I should be mostly recovered from everything, and finally caught up on all the things that were medically neglected. I’ve spoken with my head Jiu Jitsu professor and have his enthusiastic support to start teaching a Friday evening 90 minute class for our academy. It’s been a weak point in our academy since we opened since our head professor usually travels on weekends and can’t run a Friday evening class, and none of our other black belt instructors are available to teach that time slot on a consistent basis. Hopefully it will do well once people realize it’s available as a class! Most of our evening classes at that same time slot are high intensity heavy hitting classes, so I’m planning to offset that by making this one a more instructional based one to close out the week after everyone has physically and mentally exhausted themselves with training/work/life.

My big target for next year competitively is the Abu Dhabi World Pro in November. Our head professor has agreed to go with me and compete as well which is exciting as I have always made that trip alone. Once some of my other team mates learn that our head professor is going they may end up joining in as well and making a small travel group out of it! I figure by spring I should be able to be back to normal moderate training after my procedures and ready to start slowly increasing load intensity by July for a safe gradual increase. Slowly increasing without overloading is especially important for my joint stability to be able to adapt while mitigating my injury risk.

All Clear and Back At It!

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I just realized that I never wrote an update following my post-op visit with my surgeon last month!

To Recap

In May I had surgery on my hip to repair a torn labrum as well fix an impingement issue and debride a bone cyst (no arthritis! yay!). I also had scar tissue on my joint capsule that was most likely from one of the times my hip was dislocated. It was done arthroscopically and wheels in to wheels out took 90 mins. My surgeon said surgery was “unremarkable” although the scar tissue on my joint capsule was “cool”. I did a lot of research on recovery protocols and made a system for myself that centered on the “slow is smooth, smooth is fast” methodology.

My surgeon is a sports specialist (as is my PT) and I was allowed to start doing highly modified drilling work around 8 weeks post-op mark. That’s may not be typical for someone else so soon after this surgery, but my recovery team determined that with my fitness and sports experience level, it was something I could integrate safely. As I proved that I was able to safely navigate drilling moves wisely without causing myself any pain or inflammation afterwards, I was able to slowly progress.

Post Op Visit:

Getting right to the point, my surgeon gave me the all clear with no follow up appointment! He said that I did a great job graduating and moderating my activity levels properly and had one of the smoothest recoveries possible as a result. From a surgical point of view, I am completely cleared. He had to wait until the 6 month mark as the earliest possible release date to check imaging to make sure there was no calcification forming in my joint post-op (I was good). He left me with a standing PT order that I could do whatever I wanted with, so I consulted with my PT and she agreed that since I do a good job at moderating my activity and have proven good patterns of doing my own adaptations as needed, she is comfortable with cutting me loose as well but gave me her card. If I run into any issues, I can call and schedule for a check in session.

I have spent the last several weeks gradually increasing my Jiu Jitsu training intensity and frequency, while still fitting in hip mobility and strength exercises as well. I have a specific warm up routine that helps me activate and mobilize all the muscles, and then a routine in the evening to check in and address any muscle imbalances or inflammation that might be popping up. As long as I keep up with these things before and after training, I am able to slowly increase training demand.

My range of motion would be considered really good for most people, although rotationally it still is not quite where it was before surgery. Strength-wise I’ve never felt better, and my team mates have told me that they can tell a significant difference from before surgery. It’s amazing how much more efficiently a joint works when the labrum isn’t torn halfway around the socket.

As of now I have about 6 weeks to go until the European Championship tournament in Lisbon, Portugal. I’ve never been one to ease my way into anything – must go full throttle or I might psyche myself out with the small things. I’m currently floating between light weight and feather weight as far as weight classes are concerned so I’m considering dropping a couple kg to make feather for the event. I’ve decided to just wait and see what amping up training over the next few weeks will do to the scale numbers and make my decision based on that.

All told, I’m sparring normally with training partners within 30 lbs of my size. I am looking forward to competing but my main goal is still to continue recovering – the competition is for proving to myself that I am back again after this.

I have a few benchmarks for myself to work toward before I consider myself fully recovered. I’m most definitely significantly better than I was before surgery so it would be very easy to write myself off as “all better” at this point already, but I know there is room for improvement and I’m still at a critical stage for getting those improvements. I won’t settle for good enough when I know there’s better to be had!

All told, I am super happy that I had this surgery and it was worth taking the time this year to have done. I no longer feel like my hip is sliding out of the socket while I’m sitting in a chair, I can train without pain for the first time in a very long time, and actually move in ways that I didn’t even realize that I hadn’t moved in over a decade. I’m looking forward to how this will affect the years to come!

Checking in 5 months post-op – 24 weeks

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It’s been a few weeks since I have posted an update and I passed the 5 months post-op mark! I’ve been pretty busy and a lot of things are coming up, so here is what has been happening!

I’m back with my original physical therapist since she has returned from maternity leave, and she has really been amping up with more impact and dynamic movement exercises, working to emulate things I do in Jiu Jitsu class. My therapist has researched and improvised various exercises in order to make them more specific to Jiu Jitsu movement patterns. We start each session with a check in for any tweaks I’ve felt during the week while training in class, a physical assessment, and she makes any necessary adjustments to my program for the day.

I will be seeing my surgeon for a check in next week and PT agrees that he will be very pleased with my progress overall and thinks it is very possible that he will release me entirely from physical therapy sessions (10 days shy from my official 6-month post-op mark). I am scheduled to see her immediately after my appointment with him, if he says I’m free to go I can just come downstairs and bring the good news and cookies.

This past week I had a great class where I rolled as close to all out as I have since surgery. I still feel some rotational restrictions that I’m going to mention to my surgeon, but I think that will just take some more time to work through carefully. It was a good contrast to the previous week where my hip got twisted pretty abruptly in class and I yelled – that caused some inflammation that made me take a few days away from the mats and some anti-inflammatories along with extra home care. My PT checked it of course and agreed that it was just inflamed from the abrupt movement. This was the first tweak/inflammation issue I’ve had of any kind during my entire recovery process – which is pretty stinking good for this sort of surgical recovery.

The only movements still giving me discomfort are quick external hip rotation and compression across the midline. All other movements are fine with a proper warm up before training. I do need to improve comfort and stability at the end of my range of motion, and if I sit for hours without a stretch break it will start aching as well. These are all things I expect to improve in the coming months.

Here’s how training is looking right now:

  • I’m doing most moves in class, just avoiding high impact takedown drills (judo trips and such are ok)
  • Positional sparring rounds in class after drilling: if my pre-selected partners are not available when we change partners I sit a round. Otherwise I proceed like usual.
  • Sticking with familiar training partners for sparring. Since they are partners whose movements I can trust, I don’t have to guard my own self so intently and can therefore progress my own movement confidence safely.
  • I do my own specific warm ups before class which usually overlaps into the group warm up time as well. I do joint mobilization and muscle activation exercises that I use in my PT sessions before getting into strength training.
  • This past week I have started adding more evening stretching before going to bed – in addition to my red light therapy sessions. As training and impact amps up I need to increase recovery measures to make sure the load stays balanced.

Latest PT Session (mostly self-reference):

  • Started with PT check in and warm up on elliptical
  • Stretches: leg box drills adding lean forward over front leg, then back leg clamshell, heel lift, then leg lift (new); kneeling quad/flexor/psoas stretch, tabletop hip isolated rotation (new)
  • Decompress hip by using heavy band anchored to wall around bent leg while lying face up on floor. Pull knee toward chest to decompress joint
  • Activation: Free standing clamshells with band, leaning wall runs with band around feet, squat with soccer ball between knees (hold until feel burn then hold for 10 more secs), hip airplanes on wall, banded sidesteps one foot anchored to the wall at the time, Sidesteps anchored to wall by torso,
  • Strength: hold bear crawl position and slide small plate with toe forward and back 10x, single leg box bridges, 45# v-bar single leg RDL, 45# v-bar squat, Single leg shuttle squat kickback, 45# sled push/pull
  • Other exercises done in previous sessions: Back lunge with cable row at top, Heel elevated kettlebell squat, medicine ball slams (start on two feet, end on one), step off 20 inch box and catch weight on one foot lightly, hop with feet 2 to 1 off and on 20 inch box.

Coming Up

I see my surgeon next Wednesday and am compiling a list of questions for him. Most pressing is to let him know I booked the flights to compete at the European Championships and Tokyo Grand Slam in January since at our last visit he said it was a “reasonable goal”. I’ve also registered for the Europeans and am waiting for registration to open for the Tokyo event – I’ll be flying from Lisbon to Tokyo and doing both events in one big trip.

I have other planned events lining up as well for the year – at least one major event a month (2 more in Feb). The first 6 months of the year I will be competing in 7-9 countries depending on final tournament schedules. I want to be able to enjoy training and learning Jiu Jitsu for the rest of my life, and don’t want to be the stereotype of the old black belt who is too broken to do anything but sit in the corner of the mat with their broken everything. I however do want to get out there and enjoy competing as much as I can while I’m still physically capable of making the rounds at this high frequency. I know with my chronic joint/connective tissue condition I need to be extra cautious about wear and tear on my joints if I want longevity for training, so it’s always a constant game of push and “check in”.

When and if I am released from physical therapy sessions, I will have to continue a structured rehab protocol on my own in order to maximize my full recovery. It will also keep my other hip stronger and useable as my initial assessment done indicated I have the same issue in my other hip (labrum tear/impingement), it’s just not giving me as much difficulty as my right hip was so my surgeon said we would just leave it alone unless it became a functional problem for me.

Unraveling a Puzzle – 20 weeks post op

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Monday

The cookies were met with great glee and I had all kinds of changes and adjustments made to my PT routine at the clinic today!

  • Side planks were advanced to: top leg elevated on box (bottom leg hangs) while on forearm on ground, activating adductors along with glutes and everything else. I could hang there all day like a monkey.
  • Deadlifts with the V-bar, 45# plate 3x10s.
  • Smith machine squats with heels elevated on the slant board. I lightly subluxed my shoulder since it was a new movement with a narrow range of motion – but it wasn’t a terrible one and I was able to re-align it to finish the last set without any soreness. PT said we can leave out the slant board next time to allow me better range of motion.
  • Increased isolated hamstring curls to 40# (baby weights I know, shush!)
  • Added box jumps and ball slams for impact training.

When I got done with everything I bid my therapist a farewell and much thanks – she helped me a lot! I’ll be switching to Wednesdays for next week with PT as my original therapist will not be working Mondays.

I checked my phone as I finished PT and discovered that my coworkers were in a panic trying to get in touch with me. Since they had not heard from me all morning which was out of the ordinary for me, they assumed I was in trouble and my boss was currently driving over to my house to check on me. I quickly called to assure them I was fine, had just been at my usual therapy appointment and my phone had been stuck on “do not disturb” from the night before which was why I had not responded to messages like usual. It’s nice to know they care enough to worry – and I ended up going into the office since they were on their way to my house anyhow and there was a lot to get done that might require some extra coordination. I went “full autism mode” to finish a sudden time sensitive project in 2 hours that would usually take me at least a day at a sustainable pace. It’s a glass canon attack which is understood in my office as leaving me basically useless for any other tasks for at least a full day – so I don’t do it very often and usually work at a sustainable pace.

Since my brain was basically oatmeal for our 90 minute evening class, I wasn’t sure how well I would be able to focus for drilling techniques. Thankfully once I got moving around I was able to hone in a bit and pick up some details and be useful. We had a good sized group of our ladies in class this evening so I was able to get a lot of rounds in with them plus I ran across the mat to grab one of our other black belts for a roll as well.

Tuesday

Coach asked me to teach class this morning for him, it’s a first since my surgery. It is back attack week so I went over what we call an MMA choke (an alternative to the RNC that is easier to do when wearing gloves) and then an evil one-armed choke that dislocates the trachea while applying the choke – all while looking like you aren’t really doing anything at all. We didn’t spend too much time on that second one because I didn’t want everyone to be too sore in the neck for the rest of the week – so we spent about half of the class with live escapes and rounds.

I was really really exhausted by mid-afternoon – probably as a carry-over from my “burst” of focus the day before. I ended up not sticking around to do my PT exercises doing the evening comp class in favor of just going home to recharge a bit more so that I could be more functional the next day.

Wednesday

I felt a bit a delayed onset muscle soreness in the hamstrings this morning from the PT session on Monday, but it wasn’t as intense as the previous week. I’m taking that as a sign of making more improvements/gains! I did wake up with a fairly intense headache (hurt to breathe) however and had to take my headache meds first thing in the morning which is unusual for me. I was pretty tired and did end up taking a second headache pill later in the afternoon – again very unusual for me to have to take two pills in one day. I’ve been having more headaches than usual even with my preventive medication – if the pattern continues over the next month I may contact my neurologist for a consult.

I taught my evening ladies no gi class tonight but due to the exhaustion and coming down off the headache I opted to go home instead of staying for the evening gi class.

Thursday

Just before morning class I was introduced to the new physical therapist who is going to be renting an office space at my Jiu Jitsu academy a few days a week. I may be checking in with him periodically for some of my more minor boo boos in the future.

During Jiu Jitsu class Coach played a switcharoo and left one of our other black belts in charge. Drilled as usual and then rolled one light round and one high intensity round before sitting the rest of class. The high intensity round was a bit more than I was anticipating and I didn’t have as large a selection of people to roll with as I usually do in this class. Again, if I were not recovering from surgery I would have been good to roll with the majority of people in class, however I have to be extra careful still even though I’m starting to feel really good while moving around.

Friday – 20 weeks post op

I worked from home and was pretty chill all day. I did decide to try an experiment this evening as the past several weeks have been rather rough as far as symptoms of low blood pressure, asthma-like issues (I don’t have diagnosed asthma), GI problems, dizziness, headaches in spite of my preventive medications, and general feelings of “ugh.” I have always been negative on allergy tests but when I have these sort of flare ups it really feels like my body is reacting to something it doesn’t like (never been able to figure out what either), so I decided to try out an antihistamine (different than what I’ve tried in the past) before going to bed to see if it might help.

Saturday

Grand experiment results are that the antihistamine seems to have worked wonders! My blood pressure is finally back up to my normal levels (it had been dipping down in the low 90s/60s) and I was able to sleep through the night and a good amount of my issues seemed to have balanced out along with my blood pressure. I’m gonna make a note to bring this up with my primary care dr when I see him in a few months for my annual exam.

Morning class ended up being a 1:1 session working on some back taking details which then led into open mat. I started a round and then popped up to chat with a family that walked in to check out the gym before running back onto the mat. All told I got about 20ish minutes of rolling time in and then stretched out a little before heading home.

Sunday

All told, I feel much better after taking that antihistamine and feel all the inflammation that was all over my body dying down. I’m looking forward to the new week without fighting through all the yuck!

My hip has been feeling really good through all my training this past week. Every week I feel like I’m getting more normal with my movements and my range of motion is getting closer to my normal (it has been textbook normal since my first post-op visit with my surgeon).

What I’m lacking for range right now is some compound rotation movement. On my left side I can duck my head under my foot to place it behind my head (hypermobility) while on my right (surgical) I can hug it almost to my chest. Additionally, it’s still uncomfortable to bring it across my midline and when I do gently work it at that angle it is a bit painful to bring it back passively – this is most likely some scar tissue from the labrum repair, but I will ask my physical therapist about pushing this range of motion since I’m this far out of surgery now.

The Good Kind of Sore – 19 weeks post-op

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Saturday/Sunday

I taught my usual class on Saturday morning, finishing out the week of half guard top position by working some over/under pass variations and concepts. Then I rolled a couple of rounds at open mat. I could definitely feel the progress I have made over the last nearly two weeks of letting myself rest properly after nearly overdoing it. I was moving quite well and very dynamically without too much hesitation – most of my hesitation comes into play when I am in guard and wary of my partner potentially moving my leg and putting stress on my hip. When I play top or neutral position I feel very confident/secure and much as such. After open mat ended I hung out for a little bit and waited for a private client to arrive for an hour session before heading home to relax for the rest of the evening. Sunday as always is my sloth day – I do the bare essential demands so my brain can recharge for the week. I find that this makes the rest of my week far more productive and efficient.

This update is going to cover a few days extra as I’m going to switch my update day to Sundays moving forward.

Monday

I had a surprise substitute physical therapist today, so he asked me if I wanted to change anything about my program and I told him that I didn’t know what he had planned for me and as such I couldn’t make any comments. He said he was going to do the same thing as what I had listed from last week – so I told him that the kettlebell RDLs were very easy and I could probably use an increase. So he took me to the weight room and checked my form on a landmine deadlift with a 45# plate – that became the replacement. Everything else remained the same as last week except that for my straight leg raises I used a larger cone and for my TRX pistol squat I opted to not use the squishy pad as a target behind me and just watched my depth in the mirror to make sure I was getting to the spot I needed to be.

Monday nights we have a 90 minute Jiu Jitsu class at my academy and it is one of our most popular classes of the week. I work from home on days that I have physical therapy but got a ride in from one of my team mates. We warmed up with partner movement drills, then went into our takedown sequence of the month before working on a Jiu Jitsu technique from side control bottom (position of the week). Then we had a good 30-40 minutes of live drills/rounds. I was able to go through the entire class without any modifications to techniques and felt really good in all my movements. I even was able to implement a new passing concept that I sniped our other black belt instructors studying – it wasn’t exact to the way they were practicing it, but it used the same principles in the moment and it worked.

Tuesday

I felt the deadlifts in my upper hamstrings when I work up this morning. Nothing above and beyond, and I was still able to move around like normal, but I could definitely tell I had done them the day before! My blood pressure was running on the lower side of my normal today continuing the trend from yesterday (mid 90s/60s) – so I decided to really focus on extra hydration to see if I could bring it back up a bit. The nice thing about Jiu Jitsu practice is that if my hypotension issues flare up, I’m already on the ground so I’m less likely to pass out except for in between rounds when I stand back up.

Class this morning was fun! One of our black belt instructors reviewed over the technique from the previous evening class with an additional technique that was really stupidly useful (my favorite kind). We got a good amount of live rounds in and I felt pretty solid moving around.

I did a fair amount of mobility and stretching before going into my home PT exercises during evening class as I was still a bit sore. It was just muscle soreness though and my joint felt good so it was okay to work through – I did go a bit lighter with prescribed weights however and only did one set of the single leg (shoulder elevated) hip bridges.

Wednesday

The hamstrings are a little less sore today although my hip joint started getting a little sore. I realized that I was sitting curled up like a gremlin for the majority of the day and it felt better as soon as I stretched out a bit in my big chair that I have set up in the office. I’m still not ready to be hunched over in a standard office chair all day apparently but I’m thankful to my team for setting me up with a comfortable alternative.

I taught some leg framing principles from knee shield half guard tonight (how to activate the core and not just depend on isolated muscles for stability) and then two sweep options depending on whether people are pressuring the knee shield or have their weight neutral/back: a little push/pull dance so to speak. We sparred a few rounds as well and I got to jump in and it has been a while since I did any no gi sparring rounds!

My energy levels had been pretty low this day but since I had gotten my vitamin shots right before class I had a bit of an energy boost and decided to ride it and stay for the gi class afterwards. I got introduced to a new half guard sweep series that I may have to play with a little bit and then got two more light rounds in afterwards.

Thursday

For morning Jiu Jitsu class I was pretty fuzzy headed and had to work hard to maintain my focus and not be a bumbling buffoon during drilling. It was easier during live rolls because that’s more instinctive for me and doesn’t require as much brain power as does focus repetitive technique drilling.

I did my evening PT exercises during the comp class and made it through the full set for the first time this week since the hamstring soreness had died down appropriately enough by this point. It felt pretty good!

Friday – 19 weeks post op

This was typically my work from home day but I had to go into the office after a morning appointment with my therapist as we were down an office staff member. This meant an extra day of sitting which is still a bit more uncomfortable even in the stretched out chair so I had to take extra time to walk and move around during the day.

Saturday

Our morning ladies class is slowly growing and I taught loop choke variations this morning before heading home to relax and take an afternoon nap. I went to see the opera “Carmen” at the Tennessee Performing Arts Center this evening as a special treat and wanted to be well rested for my night out – I really enjoyed the show!

Sunday

That brings us to my new update day. I spent most of Sunday morning doing a deep clean of my apartment and then made a batch of cookies to bring to my PT clinic the following day. Tomorrow will be my last PT session with my current therapist before my original therapist returns from maternity leave to resume overseeing my care – so I figured I would bring some baked goods to see her off. My chocolate chip toffee walnut cookies are always a crowd pleaser!

All in all, I was pretty sore especially toward the beginning of the week in the hamstrings from those deadlifts, but it wasn’t sore enough to cause me to cause me to not be able to move. The main trick I find is that the more choosy I am who I train with, the less guarded I have to be with my movement. In fact this week was some of my best movement thus far. I’m still doing my best to keep the reins on but I can tell I’m getting very close to being where I need to be to get the all clear soon.

Passing the 4 Month Mark

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This week I passed the 4 month post op mark officially (on Tuesday the 17th)!

For a re-cap: I had an arthroscopic hip surgery to repair an anterior labrum tear (4 suture type anchors) and correct a small cam impingement on my femur that also included a bone cyst that reached into my bone marrow. I also have coxa profunda (deep hip sockets) – which seems debatable as to whether it is considered a pincher impingement or not. My surgeon didn’t classify it as pincer impingement as per the chart notes I have read – he did do a little bit of an acetabuloplasty (bone reshaping on the rim of my hip socket) however to give me some breathing room and assured me I’ll be able to have free full range of movement without any restriction or pinching once I heal up. The acetabuloplasty served a dual purpose as well to clean up the rim of the hip socket for the bone anchors as well as to encourage extra blood flow to the area for speedier healing of the labrum. He also did a little clean up in the inside of my hip socket of one of the fatty cushion pads that was shredded and basically useless. I had no signs of arthritis thankfully and my entire time from wheel back to wheel out was about 90 mins – my surgeon described the entire surgery as “unremarkable”.

He did comment (and showed me the photo!) that I had pre-existing scar tissue on my joint capsule that you don’t usually see unless there has been a previous surgery or severe injury. Based on the location it was most likely from when I fell while striking and dislocated my hip causing the initial tear over a decade ago – I think he was lightly skeptical about my tale of the that dislocation until that point.

My recovery process has gone quite well. I think the combination of having an excellent surgeon/care team, being in really good shape beforehand and doing a lot of research on recovery protocols/expectations really helped me in that regard. Additionally I have hypermobility which worked in my advantage in this case because I was able to attain/maintain pain free range of motion and was at 90 degrees flexion within the first week post op – this probably really helped me with keeping my overall muscle and joint usage up and joint stiffness down. I’ve stalled a little bit now in that regard because while I have attained what would be considered “normal” range of motion, it is not normal for me so I’m working on slowly equalizing with my other side. Now that I have reached that 4 month mark it should be safe to start pushing a little more now too – I will double check with my PT before doing anything aggressive of course though.

My I saw my surgeon a couple of weeks ago and he was very pleased with my progress. I told him of my desire to have a solid comeback to the Jiu Jitsu competition scene in January (at 8 months post-op) by doing the Euros and Tokyo tournaments and he is on board with helping me make that happen. He’s still giving me the same precautions to make sure to not overdo training between now and my next appointment in 6 weeks; but approved of the way I have been moderating my mat training since the clinical results spoke well.

Saturday/Sunday

Continuing on last weeks theme of “taking it a bit easy” I taught my Saturday morning class and then skipped out on any live rolling rounds. Instead I did my full home PT routine including all the strengthening exercises for the first time since the previous week of rest. It got my heart rate up and felt really solid! While I of course prefer to be sparring rounds of Jiu Jitsu, I made the right call to skip it for PT exercises instead. Afterwards I went home to rest. Sunday was a day of absolute chill and continued recovery.

Monday – Physical Therapy

I told her how the past week wasn’t my most shining glorious week and what I did to manage. She assured me that as far as bad weeks go, mine wasn’t too terrible and I handled it perfectly by keeping somewhat mobile without overloading myself. Then we got into all the newness.

We changed things up quite a bit this time around in therapy.

  • Did away with my box squats as well as the single leg press machine.
  • Continued my heel elevated squats with a slant board and my PT said they looked too easy so we will increase the weight next week.
  • Continued hip airplanes/twisting pivot single leg squat reps for hip rotators. (I’m slowing these down and focusing on slow controlled movements)
  • Continued side planks and reclined straight leg raises (added ankle weights)
  • Added a TRX strap assisted pistol squat with tapping my free knee to a squishy pad placed behind me (so I can drop lower into the squat).
  • Added lateral step outs: long band around one ankle attached to the wall and I do side steps away from the wall as far as I can do so while controlling the movement against the band – then step back (targeting the adductors). Pretty easy although I was afraid that the band would snap I pulled it so tight, so we will have to use a heavier band or a lot more reps next time.
  • Added RDL with kettlebell – used 20# since it was first time doing exercise in PT but will probably increase next time around. Target muscle group was hamstrings so I had to tweak my form a bit to make sure hamstrings were firing and not being overtaken by glutes.
  • Finished with hamstring curl machine – still at 35# but it was right after doing the RDL with hamstring focus and did not fail, so that is definitely progress!

Since nothing was painful to do, it appears I did well to the previous week to take it more slowly.

My therapist let me know that my original PT will be returning from maternity leave to resume my care in a few weeks. I will have two more sessions before the switch over – so I think I will have to see her off with a thank you batch of cookies or pound cake!

Tuesday – Officially the 4 Month Post-Op Mark!

Back in the office this morning, I went back to my previous routine of participating in our 10:30 morning Jiu Jitsu class including the live positional rounds and did one full five-minute round. I’m of course sticking to specific partners who I know I can work with safely (only ones who I vetted before my surgery).

During our evening competition class I checked out the new home program that my PT uploaded to my app for me to do. It was just 6 exercises, 2 of which being stretches and I was a little disappointed at the minimalism until I hit the second exercise: which was a variation of the hip bridge off the 20 inch box, this one with one leg elevated off the ground (which I hadn’t done before). I then understood why I only had a few exercises, and I took back my previous feelings and instead began wondering what I had done to make her hate me so much. This was of course after doing the standard hip bridge with shoulders on the 20 inch box. The other two exercises are reps of split quats and kettlebell RDLs. I rounded it out by adding in my side plank holds, my hip airplanes for the rotators, and some balance work as well.

I stayed late for the 6:30 fundamentals class which is unusual for me with my current schedule, but one of our newer ladies was present and the rest of the class was all larger new white belt men. It’s a good crew to be sure, but I’m always down to review fundamental movements and figured it would be easier for her to practice them on someone closer to her own size. It was super refreshing for me!

I went ahead and signed up for the tournament in Europe this day since it was the last day for early registration. Unless I have a horrible setback my surgeon was confident that I’ll be good to go by then so I’m staying on theme with how my recovery track has been so far and going for it!

Wednesday

Wednesday evening I taught my ladies no-gi class and we went over my coach’s classic half guard smash pass and then I taught the basic concepts of how to do a toe hold from half guard top and then threw in a rolling finish at the very end just for fun. I stayed afterwards for our advanced gi class which was fun until a chronic issue my partner had flared up quite badly. I sat the rest of the class since we had a high ratio of people attending that class who were competing in the coming weekend and I did not want to insert myself into live rounds when they were focused on prep work. My time will come!

Thursday

I felt pretty good in our 10:30 morning class and I noticed a new pattern that might be emerging in that coach had this Thursday class warm up using comp class drills like he did last Thursday. I opted to do my own PT hip exercises for warm up and avoid the higher impact drills. I was able to do the half guard technique drills as well as the live positional escapes. Coach warned me to be careful who I went with and I told him I had already scouted out three people in class that I could go live with – and I stuck with those three along with coach himself. I did end up with a sudden onset migraine in the mid/late afternoon and had to go home early from work – it was a pretty bad one nausea inducing one so I’m glad I didn’t stick around and try to tough it out!

Friday

18 weeks/4 months post op – it’s been a relatively smooth course as far as surgery recovery goes. At the 4 month mark my surgeon said that is when he considers the tear in my labrum to be healed after he stitched it together, and he said a total of 6-9 months for return to full athletic impact. Now we can slowly start increasing the impact and load and get my hip joint back up to full useability at all angles so that I don’t have to compensate for deficiencies like I have been doing for the past decade while the labrum has been torn. My surgeon and PT are confident and affirming that I’m doing a great job pacing myself for a successful return to the mats and competition!

I booked my flights for competing in Lisbon and Tokyo in January – I figured I may as well since I have been keeping an eye out and there was a good price dip. I used an ecredit that I had cancelled earlier this year to get this surgery. So things are starting to come together slowly – I just have to keep the pace!

Rougher Week – 17 weeks post op

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Saturday/Sunday

Saturday I taught my usual class in the morning and then rolled lightly with a few of my trusted team mates for about an hour. I declined a couple rounds with people, but I explained that I’m only rolling with people who I rolled with before surgery and whose movement patterns I know well. No new rolling partners right now (regardless of rank) for my own safety. Afterwards I hung out for a couple of hours before seeing a few private clients for the first time since surgery since I have recovered enough now for that – so they were happy about that!

Sunday was going to be a bit more of a rest day but I had been struggling with several tasks that had been needing to get done the past week or so. I find that if I wait until “after work” or such then I don’t have the energy to get anything done so I opted to just get up and get things done Sunday morning. I spent two hours giving my dog a new haircut. He sits very well for it, but he is a very small poodle and it takes me some time to get his hair properly shaped and in between his webbed toes shaved properly. After that we took a 2 1/2 mile round trip walk to pick up food from the pet store for him and then stop for an acai bowl (he gets the bananas from it).

The walk was a bit rough on my joints – my left knee started hurting on the way back and my hip started tightening up after that. When I got home I just had to do laundry and then opted to lie down flat for the rest of the day, take my meloxicam, and use my red/infrafred light panel on my joints.

Monday – Physical Therapy

My physical therapist got frisky this week. She must have gotten updated orders to be meaner from the Dr after my visit the previous week. I did inform her that I was a bit sore from my walk the previous day – but the hip was fine after rest, it was the knee that was being a baby today.

We started off with more stretches, focusing heavily on my quads (which will factor in later!) I did discover finally a useful stretch for the quads on my left leg and hopefully maybe I’ll start being able to work some more range of motion into that knee if I’m consistent with those!

Most of my exercises remained the same although I did give myself a little more rest time in between exercises instead of trying to transition quickly from one to the other. I was feeling a little hypotensive again this session. My guess is that since we have been using more weight/intensity it is forcing my blood volume to my extremities more which is causing minor flare ups with my orthostatic hypotension. I’ve started trying to water/electrolyte load before and during sessions but much more and I’ll be running to the bathroom multiple time mid-session – so I’d rather just take a second to just sit between sets and let things settle before moving on.

Back on track to the main event: Why my PT was so frisky when I walked in the door – and why she focused on getting my quads stretched out. At the very end of my usual routine of single leg press, pistol box squats, side planks, bird dog holds, hip airplanes, etc… I was asked: Have you done bulgarian split squats before?

Let it be said, I did not find the bulgarian split squats to be all that terrible. I used the 20-inch box as a foot prop so I could get decent depth. I was actually mostly inhibited by the range of motion in my knee and not the strength/stability in my hip. My PT said “great form! Let’s add weight and do two more sets and do both sides!” Hopefully the inflammation in my knee from the walk will die down and it will be easier to do them next time!

Other thing to note is that for my hamstring curl (machine) I was able to complete all my reps at 35# this time. The previous week I failed at the end of my 2nd set and had to drop back down to 25# to complete my final set after a rest. It sounds like a pithy amount of weight – but I remind myself that it’s a fairly isolated muscle exercise as opposed to a squat or leg press.

I was feeling pretty exhausted by the time I got back home, I went to Jiu Jitsu class that evening as usual but was feeling pretty run down and my hip was really exhausted/borderline painful just from doing the drills. I worked with one of our ladies who was nursing an injury and having to be cautious herself while drilling and we both opted out of live drills/rounds which was definitely for the best for me.

Tuesday

In class Tuesday morning I joined in with some of the drills – It ended up being a game of musical partners because the first move we did involved framing and pushing directly on the hip and I was feeling a bit sore and couldn’t be drilled on so I jumped into an established group of two to just do fit ins. Someone came in late and just assumed we were a standard group of three and grabbed one of the guys while I was getting my reps in and then left my partner without someone to drill on. So rather than try to get fit ins with what essentially turned into a new group of three (which would basically mean far fewer reps for everyone and a stupid configuration) – I moved on to another group to do fit ins on… and while I was doing drills with one of the guys the other guy changed partners with one of the guys who was sitting out from the first group I had been with. Confused yet? I just looked at coach and shook my head while he was giggling. Yea I could have said something as the black belt on the mat and highest ranked student in the class – but I save my rank pull cards for things that actually matter. Me getting fit in reps while I’m recovering isn’t that big of a deal.

I did one light positional escape round with that drilling partner and then called that it for the rest of class. My hip was sore. It was as bad as it has been so far since I’ve started the strengthening/rebuilding phase of recovery.

I opted to go straight home from work and not stay around to do my home PT exercises during evening class. I needed to take my meloxicam and lie flat/give myself some rest.

Wednesday

Wednesday was a bit of a continuation of more resting. I taught my evening no gi class and then went home afterwards instead of staying to drill for the gi class. I have learned that when recovering from an injury/sickness it is better to just straight up rest instead of trying to draw it out. There is a difference between recovery and laziness.

Thursday

I planned to drill a bit in the morning class but it was a bit of an out of the ordinary routine class that threw things off kilter. Long story short: I’ve had a lot of personal things going on, I got frustrated and made a jerk of myself. I did my best to apologize afterwards and had a full blown overstimulated meltdown in my office afterwards as well. I felt better able to focus after the meltdown but the day was basically a wash after that so I left for home right after work instead of staying for evening class.

Friday – 17 weeks mark

I was extra thankful to have Fridays as a work from home day after the events of the previous day and the entire week. I needed a decompression day away from people to help me re-center. It wasn’t my best week as far as recovery, but I did not take any steps backwards because I took the steps necessary to take care of myself when I noticed that I was needing to rest.

So with me feeling more inflamed this week, what I did overall was cut out doing the strength portion of my home PT exercises, as well as live movement drills in jiu jitsu class. Instead I focused on just the mobility portion of my PT exercises and just drilled comfortable movements in class – skipping allowing myself to be drilled on like I had been in previous weeks. I took my meloxicam a few evenings as well as continued the use of my red/infrared light panel.

When recovering from injury or sickness, it is important to take the time to rest when your body needs it. It is not weakness to do so – and if I had forced myself to try to train this week like I had the previous weeks I would likely be in a good deal of physical pain and setting back my recovery process significantly. It’s the difference between pushing pause vs a painful rewind.

Post-Op Visit – 16 weeks post op

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Holiday Weekend

I was an absolute slug all weekend since it was a holiday on Monday in the states and my office was closed. I taught a great ladies class Saturday morning where we worked on side control escapes and then I stayed around for the open mat. I got a few rounds in with people I knew and trusted who needed a light flow round to get warmed up before they proceeded to maul one another. Then I went back home and watched the first three episodes of the new season of Rings of Power that just was released before settling in to play videogames all weekend.

Tuesday – Physical Therapy

Since Monday was a business holiday, I had PT on a Tuesday this week instead. A good portion of my exercises were scaled up to some degree. My single leg press remained the same at 112# and then I followed that by pistol squats to a 20 inch box, and also side plank with top leg extended. We added a 5 second hold to my bird dog rows, increased weight on my heel elevated squats, increased height on my lateral tap downs, added weight to my hip thrust, added weight to hamstring curl. It was a bad hypotension day for me though for this session so I had to sit a few times between some of the exercises to keep from getting lightheaded and falling over. I’ve learned that once you fall over they tend to cancel the rest of your exercises for the day.

I made it back to the office/gym just a few mins late for our 10:30 jiu jitsu class so I was able to jump in and get some drills in as well as positional escape rounds. It was a lot of activity for one morning so I was pretty beat for the rest of the day and concerned about being horribly sore for my follow up visit with my surgeon the next day – so I opted to skip out on participating in our evening competition class and watched instead. I did take a dose of meloxicam when I got home just to be on the safe side too since I had so much activity and did not want to be super sore for the Dr to be testing my range of motion and such the next day.

Wednesday – Surgeon Follow Up Visit

I had my follow up appointment with my surgeon this afternoon. I got an appointment in right after their office lunch break so everyone was fed, happy, and running on schedule. His nurse brought me back almost as soon as I sat in the waiting room (early for my appointment) and did my quick intake noting PT and training progress. One thing I’ve learned is that I start to go into a bit of weird zone out when alone in patient waiting rooms which makes it hard for me to engage when the Dr walks in – so this time I got up to walk around and pace instead of letting myself disconnect during the 10-minute wait.

The Dr came in and opened up with comments about PT beating me up – I agreed but told him that I do like it that way and it’s all in good fun. He did an assessment of my range of motion at all angles as well as comparative hip flexor testing and declared me to be “very strong”. I told him how PT was telling me to “do more” but I wasn’t sure they knew what “more” meant for me, so I was taking video of my movements in class to show what I was doing – he said he loved that and to keep doing it.

All told he said my approach of “slow is smooth, smooth is fast” is paying off in a big way. I still need to stay on that path however as I’m only officially 3 1/2 months out from surgery and have healing still left to do. Same considerations as before to follow: don’t overdo it, stop if anything hurts.

I will be continuing with physical therapy weekly and rechecking with my surgeon again on November 6th which is 9 weeks away. He said that I’m definitely still on track to be competing at the European Championships and Tokyo Grand Slam in January – nothing any sooner than that. I asked about doing the Nashville Open tournament in November which would fall right at the 6-month post-op mark and he made a face then started responding with a sharp inhale and “wellllll” and I interrupted with “It’s all good – if it’s borderline then it’s off the table.” He then went on to explain that it would be definitely pushing it and he wouldn’t want me to try to accelerate my rehab process to try to make an early sports event.

I did check my after visit summary notes and he wrote that I have “full and painless range of motion”, 5/5 strength on all planes of movement without pain, as well as a negative Stinchfield test (I failed that one miserably pre-op).

That evening I taught a small no gi ladies class and then went home afterwards to take some headache meds and relax a bit after all the excitement of the day and still riding a bit of exhaustion from the hard push of the previous morning (in spite of the vitamin shots that one of my nurse teammate gave me before class)

Thursday

I felt pretty good for class this morning where we were working on armbars from s-mount. I was only drilling to one side, modifying actually for my knee not my hip this time since I’m not able to bend my heel to my butt far enough for a proper s-mount on one side (I had a previous procedure that was purposefully healed stiff for maximum long-term stability – it was the lesser evil).

We did positional escapes from mount again – these two weeks working from mount position (top and bottom) are going to be rough since I don’t really have the proper movement to safely do most escapes. So, I’ll just have to hunker down when it’s my turn on the bottom and practice patience and resilience. We did have a couple of full-length rounds in class today which I ended up joining in for this time – it was a little rough at first but with some communication on my end it worked out just fine in the end.

I’ve been neglecting my home PT exercises lately in favor of bjj training. Very tempting to do of course, but probably pretty stupid at this still early phase of my recovery. So I opted to dial it back down and skip out on doing evening comp class in favor of doing my exercises instead. I will keep doing that going forward so that I’m getting the proper strength and stability gains in that I need to be making every week. I have fewer exercises now to do outside of the clinic, but they are more strength focused and higher intensity than before. I’m adding in more stretching and recovery-based things afterwards however just to keep up with the increased demand.

Friday – The week in summary

After seeing my surgeon again I decided I needed to pull the reins and slow my pace a bit since I was starting to pick up speed a little faster that I probably should be at this stage of the recovery process. I haven’t done anything to hurt myself or my recovery, but I was just starting to move toward a direction of a bit more impact than I should be taking at this point.

This isn’t a step back in any way, just putting the brakes on the snowball that was starting to form with my progression on the mats. Still on track and slightly ahead of schedule with my recovery!

Keep on Rolling – 15 weeks post op

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Saturday/Sunday

Saturday was fairly chill – I just went in to teach a morning class. I ended up with one student, so it turned into a private lesson on lasso guard techniques. Afterwards was open mat and I opted to just do a good hour-long mobility/stretching session since my week had been pretty high impact, and there were no partners at the onset who I would be comfortable rolling with at this stage of my post-op recovery.

I stayed up late that evening tracking my dad’s progress as he raced at the Multisport World Championship in Townsville, Australia. He ended up ranked #9 in his division – achieving his goal of making the top 10 and I’m pretty sure he was the top ranked athlete in his division from the Americas. He did the long course triathlon (half Ironman length) which he had to work hard to earn a qualifying spot for on Team USA – so he was pretty pleased with himself!

Sunday is my sloth day. I slept in, did minimal mobility drills for my hip throughout the course of the day, light therapy, and worked on my 3rd play through of The Witcher 3 on my nintendo switch. I am pleased to report that I did however remember to place water bottles in proximity to my nest and stay mostly hydrated during the course of the day.

Monday – Physical Therapy Day

My physical therapist continues to be happy with all the progress – I showed her the videos of some of my live work and agreed that since I can do things without pain during and after, to keep doing it. The only discomfort I still feel is some achiness when lying on my surgical side for an extended time period, and when lying on my non-surgical side it’s more comfortable to put a small pillow between my knees if my hips are stacked.

For PT this day I didn’t really have any new exercises, but we added weight/progressions to most of my existing ones. My single leg press went from 87# to 112#, my hamstring curls went from 25# to 30#, my elevated heel squats went to a steeper elevation and we added a 15# weight, my modified side planks now have me elevating my top leg during the plank. They keep trying to come up with creative ways to stretch my quadriceps – a difficult task due to my hypermobility. Today they had me lie face up on the table (holding on to the opposite edge with one hand) and let my leg hang off the edge with a strap around my ankle so I could pull it back toward my butt while the other one stayed straight on the table. I didn’t need the strap for my surgical side, only needed it for my non-surgical side because I don’t have the range of motion in that knee (since it had surgery and healed intentionally stiff).

For evening class I was a bit out of it mentally because we had some bad from for our extended bjj family (send prayers/good vibes to them!), but I was able to drill a few moves and then get two full rounds with our blue belt ladies when it came time for sparring. I just go more to close guard as opposed to playing my usual open guard game which leaves me feeling a bit more vulnerable to unpredictable movements right now.

Tuesday

For morning class we worked on a side control escape (side control bottom is our position of the week) involving a bump/reverse shrimp then coming back to an omoplata option. There are of course other options once you shrimp out but we chose to work on an omoplata finish today. I did three positional escape rounds, upping the intensity a bit since my training partners were trustworthy and skilled. At one point I was placed in deep half guard on my surgical side and quickly tapped since that is a position/angle that I have not drilled any movements from in class or in PT.

The last round that I had that class definitely turned it up a notch higher than any matches I have had to this date, so I decided to sit the rest of the class and see how I felt after cooling off a bit. I could definitely feel some tightness forming in my adductors and flexors, but nothing painful in the joint itself. All indicators that I stopped at the right time to keep from overdoing it. I opted against doing our competition class or my PT exercises that evening, just because of that hard push and wanting to make sure everything settled properly. I did feel a pain in my TFL that afternoon with a movement (not my surgical area) which was definitely an indicator that my muscles were at their limit for the day and needed more recovery time. I set myself up in my office for a mid-day treatment with my infrared light box panel (glad I opted for the mobile unit!) which helped the immediate inflammation.

Wednesday

Thanks to the choices made the previous day of resting after that morning push; I woke up feeling pretty good with no achiness in my joint anywhere, and no sharp pains with any movements in the morning with my range of motion exercises. All I had was muscle soreness and tightness from the PT on Monday and the training in class the past two days. That is be expected and easy to deal with through gentle mobilization exercises. This keeps blood flow and lymphatic circulation up in the areas and will reduce my risk of chronic issues in the area as my recovery progresses. I noticed more tightness in the abdominal muscles again on my right side as opposed to my left which was impeding some of my rotational range of motion in my hip. I did a little bit of fascial stretching work in my abdominal area on that side which evened out my range of motion with at that particular angle with my other hip.

For our evening ladies no gi class I taught escaping side control bottom utilizing reverse bump/shrimp movements for two different options. I was feeling recovered enough from Tuesday morning’s training to join in on our evening gi class and, after learning a new lasso guard pass, worked a few live rounds of guard passing. I was super pleased to get to successfully try out a new pass to mount that one of our professors had shown me the previous week, as well as smoothly hit the guard set up and sweep from the seminar that we had a couple of weeks ago! One of my teammates filmed the matches for me so I was able to watch the playback, and my movement looks pretty smooth although you can definitely see on my face how much I am concentrating. All my focus during live rounds is on making sure I’m moving safely and watching for unexpected movements that I may need to react to in order to protect my hip.

Thursday

This morning in class I drilled our side control escapes normally and then did positional escapes and rounds. As always, rolling cautiously and tapped once to my leg getting in a potentially threatening angle before any pressure started to be applied to it. My teammate apologized and I assured him that it wasn’t his fault and I tapped solely to the position and not to any actual pain or pressure. I have a good crew to train with that have my best interests at heart, but my physical safety is still ultimately my own responsibility and I’m not putting it all on them – especially when I significantly outrank them.

I was feeling a bit of wonkiness in my left knee and opted to go home to rest instead of staying for evening class. I’m moving differently than usual in order to compensate for my hip and I don’t want to throw my other joints out of balance by overtaxing them since I already have a hard enough time with that due to my underlying hypermobility.

Friday – 15 week mark

That brings us to today at the 15 week mark. Next Wednesday I have my follow up with my surgeon – and I think it’s close enough to call it my 4 month post-op check in. I am writing out my question lists for him which mainly have to do with solidifying what my timeline is looking like now that I’m further out from surgery, and what my PT plan should be moving forward. He said at the before surgery that typically it’s 3-4 months of structured PT post-op so I may end up getting released from the clinic after next week.

My intent for this post-op visit is to make it known that while I am compliant and following all instructions with a long term good outcome in mind, I am only surface level calm and patient about it. Since my progress seems to be coming along quite well, I intend to ask if any events this year would fall within the realm of reasonable and acceptable. Pointing out the AJP World Pro and IBJJF Nashville Open in November (at the 6 month post-op mark), and then just for the drama to point out the AJP Dallas Grand Slam coming up in just one month.

I’m considering scheduling a consult with the orthopedic specialist who did my first surgery on my knee 3 years ago to have him look at my elbow. They all have their specialties so I feel a bit like a ping pong ball since he doesn’t do hips, and my hip surgeon doesn’t do elbows so I can’t ask him about ordering tests at this upcoming appointment. They are in the same group though so at least all my files stay in the same system! I’ve had some long term instability in my radial/ulnar joint (hypermobility life) which I’m okay living with and have managed just fine until now. After I took a hard fall to on my shoulder about 4 years ago though, it resulted in a chronically unstable SC joint which has put a lot more strain on my elbow due to compensation patterns particularly when trying to do any weight posting with my arm, which has become more and more difficult to manage at the elbow. It’s become a bit of a chicken/egg dilemma for me, and I think I need some outside/professional eyes on it to hopefully help me find a way to get balanced out and more useable again.

Adding In Sparring – 14 weeks post op

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It was another busy week and I just reached 14 weeks post op for my FAI/Labrum repair on my right hip. I have really focused on slow steady progress and the patience is really starting to pay off at this stage of my recovery. The fact that I went into surgery in peak physical condition gave me a leg up, and my underlying hypermobility also meant that I did not have to fight for range of motion at early stages of my recovery and instead focused on stability and managing early inflammation.

Here are the Dailies!

Saturday

I taught our first 8:30 morning ladies’ class and it went quite well! We reviewed the techniques that were taught at the seminar the previous weekend and then the class piggybacked into our 9:30 open mat training session. One of my blue belt teammates asked if I would be willing to do a light warm up round with him and I decided to just go for it since I know he is a good, controlled training partner who would stop and freeze if I told him to. I felt my coach giving me side eye the entire time, but nothing felt off or uncomfortable and I felt like I could move pretty normally – although I did of course avoid any movements of my leg across my midline and my usual guard game and only did the one light round. I felt some stiffness in my hip flexor after cooling off, so I made sure to stretch well and found that the red/infrared light therapy tool that I got the previous week really does seem to help with relaxing the area so it is now part of my evening wind down routine.

Sunday

Total rest day! I had no pain from my flow round the previous day but did do more stretching focused on the hip flexors. Jiu Jitsu moves focus on a lot of core contraction motion which is something that I need to watch to make sure doesn’t end up turning into any chronic inflammation complication after this surgery – not when I’m this close to feeling myself again!

I have been using the red/infrared every evening on my hip at various angles. Additionally I have found it to help give me some immediate relief from inflammation in my elbow. My elbow has been a bit unstable at the radial/ulnar joint – not from any sort of training injury, it’s related to my systemic hypermobility issues. The problem is that when I went through my kinesiology nerd out phase I apparently glossed over elbow and as such don’t seem to really be able to figure out how to stabilize the area myself into working order. I may need to check in with the Dr for some assistance once I get my hip cooled off a bit. All my joints are wonky so I don’t expect perfection ever, but I’m usually able to get balanced out to a form of homeostasis once I figure out some method of adaption.

Monday

Physical therapy clinic day! My routine didn’t change much from the previous week although my single leg press weight was increased again, and hip flexor stretches were added. I also learned that the hip flexor strength exercise I tried to describe last week has a name in their system – they call them “hip airplanes”.

I reported about doing my light round on Saturday, and since I had no pain the day after my PT said she wants me to keep pushing to do more. As long as there is no pain in my hip during activity, and I can get out of bed the next day without wincing from hip pain, she said I’m doing okay. I’m barely sore just in my muscles as of right now and definitely no hip joint pain (we just don’t talk about other joints – hypermobility is super fun)

This was my last physical therapy session covered by my insurance plan. Starting next week, I get to pay out of pocket but thankfully I budgeted ahead for it!

Monday night in class I was able to participate in all the drills including learning a new grip setup for a drop seoi nage, and working chokes from side control top position. I then decided to do a couple of the live positional escape rounds before sitting out the 5-minute full rounds. “Doing more” like my PT said and all.

Tuesday

More drills in class that morning, and I once again did the positional escapes and skipping out on the 5 minute rounds. I requested an updated app PT routine on Monday but that had not gone through yet so I just did my usual adapted session with my pistol squats, elevated heel squats, hip airplanes, etc. during evening comp class. We had a new lady come in to try out the late evening class after that so I stayed late to help out a bit afterwards – I fit in a few extra movement reps as well.

Wednesday

I taught no gi ladies’ class this evening at 5:30 – we went over my favorite side control top style of “kill position” and then one of the ladies really wanted to roll quite badly. I figured “why not?” expecting a chill round and she came at me like a bat out of hell – it was super fun! She would have dialed it back if I had asked her to, but we were having fun and I didn’t feel any discomfort or danger, so we kept at for probably about 10ish minutes.

I was intending to stay for the gi class after the no gi class, but I hadn’t been planning to roll like THAT. Since it was something new, I opted to go home, stretch out, and rest to make sure I didn’t let the adrenaline and friskiness overload my hip.

Thursday – Joining Comp Class

Woke up Thursday morning feeling just fine after rolling the previous evening, no soreness and wasn’t even feeling any flexor tightness. I opted to press my luck a little bit further and in class that morning I drilled and then sparred rounds (with the same person from Wednesday evening class) for about 15 minutes. I avoided playing my usual guard game that would put extra work on my hip flexors, but it was still full live sparring rounds, just avoiding certain movements and positions.

Coach saw me sparring and moving safely and conceded to let me attempt to participate in our Thursday evening competition class. I had proven last Friday that I could safely do all but one of the usual movement drills and could substitute in a different move for that one. I have enough body control and experience to be able to protect myself, and there were enough skilled people in class that were not preparing for events that I could partner with for safe training. Basically, the stars were aligned.

Our competition class has two parts. The first half is usually high intensity partner drills: think of it as Jiu Jitsu circuit training. The second half is live matches, usually starting with 1-minute positional escapes and then progressing to full length rounds from standing. The whole session lasts an hour. No breaks are allowed for water, and if someone is moving too slowly the entire class gets to do pushups. In this class you only sit out if you have an injury or some other medical consideration that coach is aware of. We currently run it twice a week.

That all said, I let my training partners know to avoid forcing my leg across my midline aggressively, but other than that told them I’m game. We just agreed that I would tap if at any point I felt myself in an awkward or uncomfortable position for my hip – then I could reset in a more secure spot and continue. I never ended up in a bad feeling position during the entire class (hip wise that is!)

Friday – The Aftermath/14 week mark

Bringing us to today, I woke up this morning feeling just fine even after the training of the previous day! I’m officially at the 14 week post-op mark now and feeling more and more like myself since I’m getting more involved with my Jiu Jitsu training!

What I am watching for is the day after slight tightness in my hip flexors/deep abdominal muscles on my operative side. This seems to creep up every time I amp up my activity/intensity levels, but as long as I respect it and do proper stretching and recovery exercises, the same level of movement is leading to less tightness the next time I do the activity. With this pattern, I’m slowly building the endurance back up without causing that nasty hip flexor tendonitis complication that I’ve read about.

I doubt I could trust a less experienced version of myself to be able to move around safely enough on the mats to be able to do as much as I am doing right now. Thanks to a combination of super amazing teammates who have my back, and over a decade of training experience (body awareness!) I was able to feel pretty comfortable training this past week at a moderate level. I adapted my movements and avoided positions that could possibly compromise my hip (no real aggressive guard play for me for a bit!), and it is feeling great.

I did take some video of the more aggressive matches in our competition class to show my physical therapist for the next time she tells me to “do more”. The ones where folks look like they are actively trying to fight for that last point with one minute to go – you know, those kinds of rounds. That way she can know how far “do more” can scale up for me.

Fun bonus note to close with: my father is currently in Australia – he will be racing this weekend at the Ironman/World Multisport 70.3 Triathlon representing Team USA. He worked really hard to qualify for this spot and took the trip out along with my mother. I’m looking forward to his race report and will be following his progress on the race tracker app!

After the race they are spending some time visiting around various spots in Australia as they have never been before (neither have I either, it’s on my list!) I’m really excited for them to have this trip together!