Tag: hip fai recovery

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!

Hip Surgery Recovery – 12 Weeks Post Op

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I am now 12 weeks post op from my arthroscopic surgery for hip femoroacetabular impingement (FAI) and torn labrum repair. I had 4 suture type anchors used to repair my labrum, an impingement on my femur corrected as well as a cyst debrided. I have something called “coxa profunda” in both my hips meaning they are deeper set than typical (it’s the Irish in me). Whether this is considered a true pincer type impingement or not seems to be a topic of some debate currently from what I can read in current medical journals, but my surgeon did a small shave down of the bone around the rim of my socket where he was doing my labrum repair to ease the friction as well as increase the blood flow/give them clear access to the area where the labrum repair was taking place and increase my rate of healing.

My particular surgeon never really used the terminology of cam impingement. He described what I have on my femur as “a very small overgrowth on your growth plate, most likely formed during adolescence; and your hips are just a little deeper set than the standard model.” Granted that was at our first meeting and he is probably used to using non-medical words to describe things to people – and that’s a pretty good way to describe it!

Before surgery I would feel like my hip was about to dislocate every time I would try to sit normally. After seeing the images of my labrum, I understand why since it was so loose and floppy from the tears that there’s no way it could have maintained the seal to keep my hip in the socket properly. It was only my muscles and tendons holding my hip in place all this time – I even had pre-existing scar tissue on my joint capsule, most likely built up from overuse! Now it already feels like the most stable joint in my body – granted that bar is abysmally low with my pre-existing connective tissue disorder.

In Physical Therapy

I learned that my physical therapist had the same hip FAI/Labrum repair surgery that I had done, which I think explains the laid back/focused balance she has. I reported in with the videos of the techniques I had done in class the previous weeks, as well as my ability to run through my yoga introductory routine without modifications. At my last session, I was able to taunt my way into getting an increase in weight for my single leg press from 75# to 87# (3×10) and then said goodbye to the TRX straps and hello to pistol box squats (3×5 on each leg, adding weight next time), and a 20# kettlebell instead of 10# for my balance drills. We’ve added leg box drills to warmups along with a hip up drill that I like to do before BJJ class. Progress is continuing steadily; in fact, I’m having to start to do some additional strength training on my left leg because the quads on that side are starting to look smaller than on my surgical side!

For my home exercise program, I’ve been swapping out some of the exercises I have graduated from in PT for more challenging ones. Now instead of dead bugs we are doing side plank holds for core stabilizing work, I’m doing my pistol box squats instead of standard bodyweight squats, and also adding in a few extra exercises that we do in clinic that aren’t listed in my app. I plan to ask at my next session if she can update my app program to reflect my progress.

By week 14 post-op I will have finished out the 20 visits of physical therapy that are covered under my insurance plan and will be paying out of pocket. I will be seeing my surgeon again at the 16-week mark and we will evaluate then if he wants me continuing with one-on-one rehab sessions for sport specific training (and at what frequency), or if he thinks what I’m doing on my own will suffice.

In Jiu Jitsu Class

Movements have been coming much easier now in class as I’m gaining better confidence in my ability to control my movements safely. Remembering my surgeon’s directives that I can “do any movements that don’t cause pain or pinching, being careful to not overdo it and cause inflammation” is the main key that I am focusing on when drilling in class. The thing I am having to be extra aware of is how much of Jiu Jitsu is contracting the abdominal/hip flexors – and hip flexor tendonitis is one of the top post-op complications that people run into after this sort of a surgery. To counter this, I have been adjusting my stretching routing and also working more posterior chain strengthening work to help counter the anterior tightness. More tummy time at home while reading and attempting to sleep less curled up.

I started drilling some simple takedown moves these past two weeks. Nothing too dramatic, and I was only able to drill to one side safely but it’s a work in progress and I was able to film to show my PT the movement that I need to be able to do with my surgical side as well. For week 11 I was able to do some tight inverted north/south re-guard drills without any pain or pinching, and even spinning into a few loose triangles (zero pressure of course.) For week 12 we were working on guard passing and I was comfortable being in single leg x-guard on my surgical side to work on passes, and also basing in de la riva guard for passing drills, and even doing standing guard breaks to double under and over/under passing combos. My hip definitely felt tired after doing that much focused work, so I took it a little easier with the hip flexor portion of my home PT program this week and did a little more focus on glutes and back.

I discovered that I can safely flow roll with the kids right now since they don’t have the body mass to be able to hurt me (physically at least). I may occasionally let one of them jump on me after they are done with kids class from this point on if there is room on the mats. My ability to chain movements together has become a lot more smooth, and I’m not running into too many positional issues where I have to compensate or adjust for inadequacies in my hip. There are a few things I’m hesitant to attempt doing on my surgical side, and that’s where filming on my non-surgical side to show my physical therapist comes into play – that way she can know the movements I need to work toward confidence in and adjust my exercises accordingly.

I was able to teach class this past weekend including a move that involved some impact to my hip that I did not think about before I demonstrated it. Thankfully our mats are slightly elevated on foam blocks like a gymnastics floor and have a little more give to them than if they were just laid straight on concrete – and it felt just fine, I just didn’t demonstrate it as forcefully as I historically would have. This weekend we have a seminar with Sophia McDermott that I am really looking forward to participating in, more on that with my next update!

12 Week Summary

Twelve weeks post op just sounds really good. I’ve reached the point now where I’m moving well enough in most drilling situations that people will ask me to roll afterwards but I have to decline still. I’ve been doing this long enough that I can compensate around areas of inadequacies and the challenge for me will be to not compensate for those once I’m out of the danger zone for re-injury. The 4-month post-op mark is when my surgeon says he will consider my labrum to be healed from the surgery: that’s when I plan to start pushing for more out of myself in class.

I did not do any research on my surgeon before scheduling my surgery because I knew if I went down the rabbit hole of surgeon research, I would probably spend months down it and would end up in decision paralysis. I chose to focus my research on pre- and post-op preparation and instead leaned on the power of trust transference for choice of surgeon. My surgeon who did my knee surgery a few years ago is one of the top names in the professional sports orthopedics field (over a decade as a dedicated NFL team surgeon) and is who my Jiu Jitsu coach sent me to. He runs his own sports orthopedics group now; but doesn’t do hips himself. I figured I could trust that he chose well qualified individuals to be part of his practice – and that his research into the matter would be better than any information I could find online through hearsay. After scheduling my surgery, I had a surgical nurse teammate ask me where I was having my surgery done and with who, and received a response of “Ok, good!” – so the inner circle validation was there as well! Since my surgery, I have had other people connected with health care tell me that he’s a great hip surgeon, so I guess my approach paid off!

I may go back to weekly updates for a little bit longer – I feel like so much has happened since my last post and trying to condense it all into a reasonable word count is challenging to say the least.

Hip Surgery Post Op Visit – 8 weeks post-op

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I had my long anticipated post-op visit with my surgeon this week!

Post-Op Visit

No x-rays this visit, I just reported to the intake nurse how PT was going and that my range of motion was doing well enough that we had already changed gears to focusing mostly on stability and strength already. My surgeon popped into the office shortly after she took down the info. I told him my PT said I was on track and ahead of schedule so far and he said to hop up on the table so he could verify everything.

First, he checked my hip flexion. He flexed my hip to 90 degrees and when I told him it was all good, he took me to full flexion and agreed I was definitely ahead of schedule there. Then we went for external and internal rotation which he was happy with. Straight leg raise and then a hold there against a slight press down. He did tell me he wanted me to sit more often with my right leg in a butterfly position during the day to let my hip stretch more at that particular angle. He said I can even press down on my knee a bit at this point and that I’m not going to hurt anything in my hip at this point to do so. (Appointment notes were: progressing well for 7 weeks postop labral repair…. flexion – 120 degrees, extension – full and painless range of motion, internal rotation – 30 degrees, external rotation – 50 degrees, abduction – 70 degrees). He scheduled me to see him again in another 8 weeks, but I will call his office to get in sooner if I have concerns before then.

At this point he agreed that I am ahead of schedule for healing from the surgery and opened the floor for questions. I tried to rapid fire them since I knew he was running behind schedule already in the clinic (answers are not word for word since I just scribbled shorthand)

The Questions:

  • Where was the tear exactly? I could tell the general idea based on the incision portal locations and residual numbness where most of the action was but was curious the specifics.
    • He detailed that he used the anterolateral portal mostly for viewing, the anterior portal is where he was doing most of his actual work through, and the modified anterolateral/lower portal is where he was mostly passing sutures and such through. The tear was pretty much the entire anterior/front facing portion of my labrum (which explains why I always felt like my hip was going to dislocate forward when I was sitting)
  • Nerd question: Does the labrum stretch like all the rest of my connective tissue (I’m hypermobile)
    • No, labrum tissue does not stretch. The only part of me that he worked on that was “stretchy” was my joint capsule tissue. His primary objective was not associated with my hypermobility.
  • What sort of bone anchors does he use for his labrum repairs?
    • Suture anchors – he named the exact kind but I forgot
  • In my random reading I came across various commentary that said certain vitamin supplements shouldn’t be taken after this kind of surgery because they encouraged rapid bone regrowth after it has been shaved down – so I discontinued all mine just to be safe. What are your thoughts on that?
    • I’m okay with you resuming anything you were previously taking at this stage.
  • I only get 20 PT visits covered by my insurance, am I ok at this point to spread them out to weekly?
    • Definitely since it looks like you’re doing your at home assignments well
  • You told me at my initial assessment that my hip socket was a little deeper set than the standard model. Is that something I should think about modifying future training methods to accommodate for? Less deeper squats for example?
    • No, I took a little off the edge of the hip socket just to give you some leeway there. It also served a dual purpose to give you some extra immediate blood flow to the labrum tissue to speed initial healing. (I don’t think I officially had a pincher impingement, he has given off the impression that the bony issue was rather minor)
  • With my underlying hypermobility, I know I’m in a rather baseline level of fucked and am pretty much a chronic coper. What is the point at which you recommend getting something checked out?
    • When pain or instability reaches a point that you can no longer cope. For prevention, keep doing what you are doing as far as strength and stability training – it’s working well for you so far.

I asked about timeline. He said that at the 4 month mark he considers the labrum itself to be healed and that it’s generally 6-9 months post-op to regain full functionally of the joint itself for return to sport usage – which depends on how everything goes in recovery and what level of usage your sport requires. The main risk for me at this point now is overworking myself and causing something to flare up which could set back my recovery timetable. I asked for some specifics:

  • Is the competing at the European Championships in January a reasonable comeback event (8 months post-op)
    • Based on what I see today, it’s a very reasonable and achievable goal provided you don’t overdo anything in the early stages of rebuilding movement.
  • When can I ride an outdoor bike
    • I’m okay with you doing that now, again just keep in mind you could wear yourself out easily and get sore/inflammation easily
  • Rowing machine?
    • That’s the one most people have more difficulties with because of the range of motion causing more pinching in the hip. (I interpret that as a soft “not right now / proceed with caution”)
  • Teaching Jiu Jitsu classes?
    • I’m okay with careful controlled movements
  • Drilling in Jiu Jitsu class? (this was the biggie)
    • I’m okay with you doing careful controlled movements provided it’s movements that you know you can do safely and without pain or any pinching sensation in the hip.

He summarized everything then to tell me that any movement that I do in PT I can do outside of PT. The key things he said is that the movements I do need to be controlled, pain free (no pinching sensation) and they need to be without impact on my hip.

I baked some cinnamon walnut pound cake the night before to bring to the PT clinic that day since it was my last week with my PT (she was going on maternity leave). I brought one for my surgeon and his PA as well and they must have been running ragged all morning without a break based on the way they snatched it up quickly.

At the PT Clinic

I got to start off on the elliptical machine for the first time this week in PT. I only got 5 minutes on it and the first few mins felt a little awkward in the joint but about halfway in it started feeling really good. I think next time I may sneak in early just to get some extra time on it (or play on it afterwards while I wait for my uber home).

I gave my report to my PT from the surgeon and let her know about needing to drop to one day a week for physical therapy in order to conserve my remaining covered PT visits – which meant that was my last session with her. She sent me off with a bang adding leg box drills with a lean forward, extra height to my step ups (since I reported walking up the hospital steps one at a time that morning), and pistol box squats (TRX assisted, but I didn’t need too much help beyond minor stability). She was also very excited to receive her cinnamon walnut cake and promised to write useful notes in my file for my new PT such as “talks shit but follows instructions well”.

Re-Joining Jiu Jitsu Class

I opted to not try joining class that same day that I had a 90 minute PT session – I figured that could fall under the umbrella of “overdoing it” that my surgeon cautioned against. So for context: My post op visit was Monday morning of this week, and I went straight to PT afterwards. I elected to just watch the evening Jiu Jitsu class with plans to drill in the Tuesday morning class. (position of the week is turtle top/attacks)

Tuesday morning the techniques were back takes that I did not feel confident I could do with the allowable movements I have in my card deck, but coach said I could just walk the room and jump in on people to rep moves of things I could do safely. So, I practiced clock chokes and a few rolling finishes that involved me rolling shoulder first. Everything felt really good, and I did not feel any pressure on my hip at any of the movement angles. I waited until later in the afternoon and put myself through a light version of my PT circuit as well and then watched our evening comp class get smeared into grease spots on the mat. I did take video of the technique being taught in the morning, and then video of what I actually did so that I can show my PT next week how I was modifying in class in order to participate.

Wednesday: I had thought I might try dropping taking my daily meloxicam at this stage and see how I feel, which I did Tuesday but by mid-morning on Wednesday I was starting to feel a bit of an ache in my hip joint that I hadn’t felt at all before. I figured since I am upping my activity levels and getting started on more strength building in PT now may not be the best time to taper off it. So I decided to take my dose again the Thursday morning and stay on a bit longer.

I worked in the office for most of the day and then did my home PT exercises in the afternoon. We had an all female turnout for our 4:30 pm no gi class in the Jiu Jitsu academy next door and I decided on principle that I should jump in to get some technique reps in if possible. It’s a technique drilling class and I was able to do it the drills without any pressure on my hip. I avoided being drilled on however just because I did not want to worry about having someone’s bodyweight on me while I had my hip flexed in turtle position (next week will be difficult for drilling since we are working specifically from that bottom position, I may have to improvise).

We had a guest instructor visiting from San Diego who taught our 5:30 no gi and 6:30 gi classes for us. The drill he taught was using the underhook to escape side control and various methods of back takes to sweeps for no gi, and for Gi class going to deep half guard and working sweep options from there. I was able to do the no gi drills with skilled drilling partners who were able to position themselves to keep all pressure off me (lightly interactive grappling dummies), but I was not stupid enough to attempt any deep half guard positions in the gi class – so I just enjoyed watching!

After doing my PT exercises that day, and drilling slowly about 20 reps of exercises in one class and 10 compound movement reps in the second class (reps all spread across a 2 hr time frame), my hip felt tired in a similar way to the first time I did straight leg lifts for the first time in the clinic at PT. I considered icing when I got home, but after lying down I didn’t feel any actual discomfort, so I opted against it.

Thursday morning I woke up feeling just fine after my evening of “excess”. I had skipped taking my meloxicam for the previous two mornings and didn’t feel horrible for it but remembering the slight ache from the previous morning I opted to resume my morning dose for the time being.

Normal day at work, with a break for me to jump into the 10:30 Jiu Jitsu class. I did just a couple reps of one of the moves demonstrated. It was an armbar attack using your legs to hook the near side arm when you’re in turtle top position. I was able to safely do it on one side (surgical hip down) but I wasn’t gonna try to do it on the other side with my surgical hip doing all the hooking and pressure. The next phase was to do a back take when your partner defends by tucking their arm which I just watched since I didn’t want to pull someone’s weight over top my surgical hip.

I opted to just do the stretching portion of my PT home program this evening and even pulled out my ice machine to give myself a little extra tlc that evening. I didn’t have any pain, but I was feeling a bit tired around the joint and figured since I was considering it for the second night in a row I should go ahead and use the ice.

Friday brings me officially to the 8 week post op mark! I’m working from home today again as it’s a difficult day to get to and from the office due to everyone’s schedules.

The Grand Recap and Thoughts

Mentally and physically I have been feeling great since I have been able to participate a bit in Jiu Jitsu class again. I’m being patient because I am keeping the goal of competing at the European Championship in January on my mind. Overworking my joint will set me back in my recovery, so if my muscles start to feel tired, I stop. I modify the class technique as needed to avoid pressure points on my hip – if I can’t modify then I just observe instead. I will not run the risk that one risk that one instance of over-working or moving incorrectly could mess up my long-term goal.

The formula I used this past week for each class was as follows. For a simple movement drill: 20 reps spread out over the 1-hour long class. For a compound movement: 10 reps spread out over the 1-hour long class. That doesn’t sound like a lot of reps compared to what I was doing before surgery, but it was plenty for slow methodical movement and testing out the safe limits of what I can do.

When my PT updated my home exercise program a few weeks ago at first it was pretty tough and I could only do it every other day. Last week I was able to do it every day without feeling trashed. This week with the extra activity I felt the need to dial it back a little bit so what I did was add more rest and recovery time in between exercises which seemed to do the trick. Thursday however I skipped the exercises entirely and just did the stretches as my joint felt tired and I did not want to overwork it. My muscles feel a little bit of workout soreness as well since I have added resistance bands now to my home exercises (since we have done so in the clinic). Most of my exercises focus on core, glutes, and quads.

I’ve been training Jiu Jitsu for about 13 years and as I’ve mentioned before, I was in peak physical shape before my surgery. This has contributed to my ability to drill in a somewhat safe manner. I additionally have good, experienced teammates who are happy to help me with my recovery by positioning themselves appropriately at right time to keep pressure off my surgical hip. My 14 years of hands-on study of kinesiology and anatomy due to being a structural focused massage therapist, as well as needing the self-learning to manage my hypermobility condition has really helped give me a good baseline for this recovery process.

A big difference between my recovery for this hip surgery and recovery for my knee surgery is that this time I am not feeling isolated and unsupported by my community. Around the time of my knee injury was one of the darker times of my life and that compounded the whole issue. By comparison, this is a much smoother process knowing I’m surrounded by people who have my back – figuratively and literally!

Hip Labrum Surgery – 7 weeks post-op

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I had a bit of a switch over in therapy this past week. My therapist said that due to my pre-existing hypermobility, I’ve really gotten my range of motion back in record time and she doesn’t want me really working on pushing any more range of motion for the time being. Instead we are going to focus on stability and strength and let my joint capsule have a break to recover a bit. “Why put strain on it when we don’t have to at this point?”

Exercises progressions are as follows: increased band resistance for standing hip flexion/extension/abduction, added band resistance with bird dog, increased reps of staggered bridges, increased reps of single legged timed balance on squishy pad, increased reps of reclined straight leg lift. Added new exercises of dead bug, holding shallow squat on balance board for time, and slow step ups on a 4 inch step.

Next week the plan is to start me on the elliptical trainer instead of the bike. That will be after seeing my surgeon earlier that morning as well so I’ve been writing down a bunch of questions to ask him. My PT suggested I ask him what would be a good timeline to start integrating sport specific movements into physical therapy. Jiu Jitsu is a very different type of movement than the typical sport and she wanted to make sure she had everything lined up as well as possible in my notes. Next week will be my last week working with her as she will be going on maternity leave – if she makes it that long!

My therapist said that I am right on track with my recovery – and trending a bit ahead of schedule even. I do only get 20 PT visits covered by insurance and I’m pretty sure that is a hard limit, but I will budget to pay for additional myself as I want to make sure I’m able to recover properly (I did send an email to my insurance rep and he is doing some research for me to see if I have any wiggle room). My PT said since I’m so good at doing my own work at home I’m a good candidate to just be in the clinic once a week and be on my own the rest of the week.

I’ve reached the point where I’m starting to really normalize a lot of my daily movements. If I didn’t have the cane in hand most people wouldn’t know that I had a hip surgery such a short time ago based on how I’m moving around. (I don’t use the cane except for when I’m outdoors or walking a lot like when I went to the farmers market this past weekend.) I’m looking forward to the push to regain strength and power with stability because while from the outside it looks like normal movement, it is with very conscious thought and focus still. I have one speed setting: casual amble – and I need to level up to gain more settings safely. Yes this is 100 percent a video game character build out.

Future Jiu Jitsu Training

I had a thought for my future Jiu Jitsu training that has gotten me quite excited. I have been training now for almost 13 years, and the past 8 or so years has been focused primarily on variations and offshoots from open guard and half guard that started developing when I was a white and blue belt. The one thing I was never able to integrate in was shin or butterfly guard techniques – I just could not for the life of me get the positions or sweeps (in particular butterfly) to work for me. Now I have an inkling of why.

The orthopedic surgeon showed me how the type and position of this injury that I have – which happened right before I really got into Jiu Jitsu training – caused instability in my hip joints and subsequent muscle weakness right at the angle and position I would need to properly execute most butterfly guard maneuvers. I’ve been able to work around it for most other moves and techniques but this was a specifically targeted move that I just could not find a work around for.

I’m excited to revisit trying to work butterfly guard into my game once I get the all clear from my surgeon. Now that the injury has been repaired, I want to test if I can make it work for me now with a functional hip. Even just this short of a time out of surgery it already feels like the most stable joint in my body.