Tag: hip rehab

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.

Hip Labrum Repair Recovery – 6 weeks post-op

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Physical therapy amped up a bit again this week!

Monday started off with warming up on the stationary bike for the first time which made me feel pretty awesome! Then back in the main room my PT told me she was going to push my range of motion, which made me nervous because I had flashbacks to painful months of attempting to push flexion back into my knee post op (it healed stiff by surgeon’s design). Thankfully since this procedure didn’t require ligament immobilization/support for an extended period of time, my range of motion hasn’t suffered too badly.

I was able to comfortably flex my hip to about 120 degrees flexion on my own, which she said was “full range of motion”. I then demonstrated flexing/rotating my non-surgical hip to be able to put my leg behind my shoulder and she amended her declaration to “normal” range of motion. She did some passive range of motion work which included external rotation for the first time since surgery which felt pretty good, as did the abduction stretch she put me in. All around everything is coming along really well and my range of motion on all points is not requiring any aggressive intervention thankfully!

Up until this point I had been sticking to the post-op hip movement restrictions since I hadn’t been told otherwise, other than the end of last week when I was told I could start bending past 90 degrees if comfortable. So, she sat me down at the end of our session and clarified for me that those post op restrictions are pretty much lifted and now I’m at the phase where movements are allowed, provided that they are controlled, not excessively uncomfortable, and no impact. Still no aggressive isolated hip flexor engagement, single foot per stairs on ascent/descent, etc. Thursday we did start adding some shallow straight leg lifts to start strengthening my hip flexors again, and also added a band around my ankles for my standing hip extension/flexion/abduction reps.

My cane has been approved of although I have been 100% okayed to walk around without it. I am going to continue to carry it when out and about for two main purposes; to slow me down so I don’t do something stupid, and also to alert other people that I’m slow and to not run me over.

New Home Program

My therapist gave me an updated home program which I dove into for the first time on Tuesday – she also said I was free to do any additional exercises that we did in clinic as well. I got done with my first run through and it just seemed like it was more exhausting than doing the session in the clinic – probably because I had done PT the day before. It could also have something to do with the new mobility work of work of external rotation, and activating/opening up a bunch of muscles that haven’t really been targeted for a hot minute. After my discussing with my PT on Thursday she agreed it might have just been exhaustion from two days in a row and agreed I should do the stretching and mobility work every day and just do the strength work every other day while I’m rebuilding.

Some of the new exercises this week have been 45-degree wall sits, non-banded clamshells, standing leg extension, and bird dogs. I’m also now adding a butterfly stretch for external hip rotation. Additionally, a “bend knee, grab toe, straighten knee” hamstring stretch has been added to the stretches now that I can comfortably/safely bend far enough for that movement.

Since I was told my post-op movement restrictions are eased up, I decided to test myself and (with the support of my cane at first) discovered I was able to do box drill movements with my legs. I like to use my cane or a strap for support if I am trying a new movement so that I can bail on it easily if it starts feeling awkward. I showed my PT and she approved the movement since it feels smooth in my hips and I’m not leaning forward or putting any weight the joint yet. I’m able to control the full movement including extending my right foot in front of me and holding it off the ground while switching between internal and external rotation. I currently am moving my left leg first and using it to base but eventually will work back up to moving both sides at the same time.

My current weaknesses that I notice are definitely in any “step up” motions with my right leg and the clamshell actions are weak as well since it’s new. The first time I did them on Monday I was not able to comfortably bring my knees together again since I had still been observing “pillow between knees if lying on side” precautions as I hadn’t been told differently so I was stiff at that angle. Doing them on my own Tuesday I was already able to comfortably bring them together, so the stiffness was already worked out.

Week Recap

By the end of the week, I could already tell a huge difference in confidence/strength for my hip flexors. I went from barely moving to able to use the light resistance bands without any soreness afterwards. We are of course keeping an eye out to make sure nothing we are doing is causing any tenderness that might be a signal that we are progressing too quickly.

I’m a bit slow to post this update (I usually post it on a Friday but today is Sunday), but I wanted to wait and add on my Saturday adventure before posting. A friend came to visit and I was able to (slowly) walk all over our local farmers market. I brought my cane of course and it was exhausting, but I did it and had no pain – waking up this morning feeling just fine.

I’ve noticed with my home program that with some of the movements I will feel an occasional small pinch in my hip. If I pause the exercise and internally rotate my hip for a small stretch which relieves the pinch and then I can resume the movement without the sensation. I’m going to bring that up to my PT and also my surgeon when I see him at my follow up. My guess is it probably has something to do with scar tissue and/or my hypermobility – since it resolves easily I’m not too concerned at this point.

This coming week I will only have one session in the clinic of Physical Therapy since Thursday is Independance Day here in the US. So I will be in the office Mon/Wed, and have PT on Tuesday. Thursday the office will be closed and I’ll likely work from home on Friday as well. The following Monday is going to be a big news day – post-op visit with my surgeon. I’m writing out a whole bunch of questions to annoy him with!