The closing of a chapter

Two years ago I wrote a blog about life being like a chapter book.  Each segment of life is a chapter, and when one ends, a new one starts.  I originally wrote about my stepping out of the fitness industry (with full intentions of coming back), closing that chapter while I open a new one.  One filled with a bike racing journey full of highs and lows, a journey where I could focus 100% of my time  on racing, just to see how far I could go.  How far can I push my body?  What are my limits?  With the closing of that chapter I opened up a new one focused solely on bike racing, fully knowing the future of my hip.

Last week I walked into my surgeons office for my 4 month follow up visit, and had a flash of nostalgia as I was walking out of the office, for the last time (we hope).  When I got to my car, I turned around for one last look at the building, I snapped a picture, and I waved good bye.  It's funny what changes in a year.  Last year at this time I walked out crying, so thankful that I made it four months post op, and was so excited, yet so scared to start pushing my hip.  I had flash backs not just from my first trip into the building (more on that later), but flash backs to the start of this chapter.  This hip chapter is interwoven amongst so many other chapters of my life.  

 My first summer of mountain biking.  

My first summer of mountain biking.  

I was 25 when I went for that 30 minute easy run and ended up limping for 25 minutes of it.  I was in my final year of Grad School studying "Human Movement and Performance" and I was convinced I knew everything there was to know about my body.  I was 27 in 2012, that's when my back started hurting.  I thought it was from cyclocross and and traveling.  It hurt a lot.  I was 30 when my hip took a turn for the worse.  I figured I nursed it back to a pretty functional state for 5 years, why couldn't I do it again.  I did what I did before, only this time nothing I could do would make it better.  Rest wasn't helping, taking out the aggravating activities didn't help.  I raced on it, that didn't help.  I started PT.  I was 31 when I walked into my surgeon's office.  It took me 6 years to walk into that office.  6 years.  6 years of denial that anything horrible was wrong.  6 years of sitting with what felt like someone was lighting a torch in my hip.  6 years of basically quitting running (my original love before biking) because it hurt too bad.  6 years of just never quite feeling "normal", but what wasn't normal to some, became my new normal.  

In those 6 years I wrote more than 1 chapter of my life, but what remained a constant, was this damn hip.  In those 6 years before walking into that office I graduated with my Masters, I moved in with Chris, I learned how to mountain bike, my brother came back from rehab, I got engaged, I got married, I became a professional CX racer (whaaaaaaat), my grandma passed away, I raced more bike races than I can count on my fingers and toes, I went through a total of 13 bikes.  That's a lot of bikes!  That's a lot of transitional life that was being lived. 

I can't tell you exactly why I walked into my surgeon's office when the thought of surgery wasn't even in my mind.  I think I wanted answers, even though in my gut I knew what was wrong.  I remember walking into that building, looking around and thinking to myself "I"m way too young to be here".  I remember the anxiety, the nervousness I felt.  I'm pretty sure the only words I mumbled to my surgeon that day was "I don't want surgery".  I walked into that office set on NO surgery.  I walked out crying.  I remember feeling blank as I sat there in his office.  I felt empty inside, scared, worried, concerned, confused on what I ACTUALLY should do.  

 my first MRI with contrast

my first MRI with contrast

I had a lot of internal conversation with myself after that initial appointment, and when I went back in for a follow up after my MRI, I was open to surgery.  It's funny, there are moments in my life I think I'll remember forever, and then there are some I wish I could forget.  It's those I think I'm going to hold onto till the day I die that I forget, and it's things like every single ortho appointment I remember.  I can tell you every month I went to see my surgeon and everything that was discussed in each appointment.  I can tell you which appointments Chris came with me and which ones he didn't.  The past 2 years have been so pivotal in my life it's like every moment happened yesterday and I can see the detail of it all like it's right in front of me.  

 

April 2016, May 2016, October 2016, Feb 2017, April 2017, May 2017, August 2017, September 2017, January 2018, Feb 2018, March 2018, May 2018.  

14 visits (2 of those being surgery).

In retrospect, 14 isn't that big of a number, but this nostalgia I'm feeling from that last visit reminds me of my first.  I feel blank, confused, lost, and almost empty, but yet happier than ever to end this chapter.  I'm struggling to find words that truly express how I feel right now, and how I felt when I walked out of that office.  The only thing I can compare it to is how I felt when I finished reading the Harry Potter series.  Seriously!  I finished reading those books, and I felt like I lost my friends.  I all of the sudden had all this extra time and I didn't know what to do with myself.  

14 times isn't a lot to see someone, but it's enough to make something feel like a routine.  Walking into that building, checking in, waiting, seeing the MA, talking with my surgeon, all became a routine in my life for the past 2 years, and it's very strange for it to end.   Don't get me wrong, I won't miss the drive, the waiting, or the fact that I felt like I've been on a leash for the last 2 years, but it is enough to make it feel like a loss (in an extremely strange way).  My surgeon has been very involved in the whole process from pre-surgery, to post-op, to rooting for me in my racing.  It's strange to think that someone who has entered into your life for an extremely pivotal time is just done.  What's even stranger to me, is I know I'm just another number, another patient.  People come and go, and with enough time those memories fade.  

When I spend a significant amount of time with someone (and I would consider 14 visits significant), I take it personally.  It's probably a small character flaw at times, but truth be told, I'm going to slightly miss those 20 minute appointments, sometimes talking hips, bikes, racing, and me asking ridiculous questions, me trying to negotiate for more time on the bike (or me trying to go on an ATV tour in Hawaii) and him telling me no.  I won't miss the "no's", but I'll miss the ridiculousness of it all.

I'm not 100%, and I still have a lot of recovering to do, a lot of listening to my body and my hips, and a lot of work to put in before I'll be anywhere near ready for the CX season in September, but at this point, I'm nearing the closing of this hip chapter.  As I reflect back on the past 8 years there are so many people I have to thank who helped get me through everything.  

 Chris loved circles

Chris loved circles

Obviously a thank you to my husband, Chris, for spinning my leg(s) in circles for nearly 56 hours over the past 2 years (subtract a few hours from the days I was in PT for that and the days he went to work).  Thank you for cooking me 3 meals/day for the first month after each surgery.  For shaving my legs, lifting me in and out of bed, in and out of the car, on and off the toilet, in and out of the shower.  For waking up at 3am every night for the first couple of weeks to take me to the bathroom.  For lying with me through the first surgery when I was crying my eyes out scared I would never recover.  Thank you for putting up with my ever expanding PT/exercise tools, for understanding that I CANNOT DO THAT because of my hip.  For putting the Compex on and taking it off my glutes, for cupping and taping my back.  For dealing with my total and complete OCD.  

Thank you to Erik Deroche at Performance Health Northwest for being my chiropractor for the past..um I don't even know the amount of years, but he's been here since the beginning of this saga.  Thank you for talking to me 2 weeks after my first surgery and telling me I was crazy for thinking I wouldn't be in pain 2 weeks after surgery.  Thank you for your continuous treatments, your man hands that release those muscles so fantastically.  Thank you for spending extra minutes talking to be during pivotal times of this process.  Thank You. 

Thank you to my PT and friend Sarah at CorePhysio.  Thank you for being such a caring provider, for getting me through my Pre-Op pains, getting me through my CX season in 2016 when we knew I was going in for surgery at the end of it.  Thank you for your knowledge, your time outside  of the PT clinic, and for talking me off so many cliffs during that first recovery.  Thank you for spinning my leg(s) in circles.  Thank You.  I think the world of you.

Thank you to Meg who took good care of me while Sarah went on maternity leave.  Meg, you got me through my first CX season after hip surgery.  Thank you for your crafty exercises and fun personality.  

Ash.  My acupuncturist.  Thank you.  Thank you for knowing what I need when I didn't even know I needed it.  Thank you for your ever expanding knowledge base, your care to learn and your care for your patients.  Bellingham is lucky to have you.

Kerry.  My massage therapist, thank you.  Thank you for your support when I did my first MRI with contrast, for letting me text you when I was worried, for your wise words, your wisdom, and your wealth of knowledge.  Thank you for your elbow grease in my TFL's, heaven knows I need it.  

My Bellingham hip sisters.  Thank you for keeping me going this second round.  I'm so happy to have you two in my life.  Without these crummy hips, we wouldn't have each other.  

My coach.  My poor coach.  A couple of weeks after we started working together I had my MRI and informed him of my labral tear in my hip.  I think nearly every check up he's asked "how are you doing, how are your hips".  Thank you for putting up with my stupid hips, working around them when we've needed to.  Thank for checking in on me after my first surgery and helping me through it.  Thank you for your patience, your knowledge, and your guidance.  Thank you for getting me back on top after my first surgery.  Thank you, I owe so much of that first season back to you.  No amount of thank you's can truly show my gratitude.

                                See ya!

                               See ya!

Thank you Dr. Nowak for caring.  I know you could have easily given in to my requests when I asked to do more, and you said no.  You cared enough about my healing to give me guidelines to make sure I would heal, to make sure there would be no flare ups, and no problems.  You pieced me back together to become a better athlete, whether you know it or not.  

Thank you to my sponsors who didn't care that I had hip surgery 7 months before the start of the season, and still supported me.  To the new ones who took a gamble on a freshly injured girl and the old ones who stuck by my side.  I'm one lucky gal.

Thank you to my community, my support, my tribe, and all of you who have reached out to me during the last couple of years.  Thank you for rooting for me, for following along on my journey and actually CARING.  Your energy powered me through that first come back.  

Heres to a continued upward direction of recovery, for this road is still long and there are still ups and downs to be had.  I'm still on a leash for PT, but we're slowly moving towards more and more FUN and exciting things!  These last two years have written a chapter of growth in life and sport.  I have more compassion for the injured, more gratitude for my body, and more thankfulness for those around me.  This chapter is a bright light in a crumby situation.  Thank you for being there, for reading, for following, for being you.  

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A Tale of Two Hips

A Surgery so nice, I did it twice.

Just kidding.  

 everything I could do to smile after waking up from surgery #2

everything I could do to smile after waking up from surgery #2

Anyone who has been through a hip arthroscopy surgery knows, it's really not nice, but I did do it twice.  Some people like to ask me if I'm glad I went through with surgery (again).  If I could make a meme of how I currently feel, the top picture would say "how I answer" and would have a picture of me smiling.  The bottom picture would say "how I actually feel" and it would be me poking my eye balls out.  

I know that's kind of graphic, but it's the truth.  I haven't blogged much about this recovery because I haven't really known what to say.  I've started a new post, then I don't finish it, then I delete it, then I re-write, don't post, don't finish, delete, try again.  My recovery timeline should (in theory) be the same as last year, I know what to expect, and I know that I CAN get back to where I need to be when the time is right.  Some people like to ask me if this makes it easier, the answer to that, is no.  Just because I did surgery once, doesn't make the second time any easier.  One time is a mystery, the second time is hard.  I'm ready to put an end to this chapter of my life, and some days I'm holding strong, and then there are days where I feel like I'm hanging on by a thread.  

All in all, things are progressing, slowly, because that's the way it goes with this surgery.  Everyone keeps telling me they think I'm doing better than I was last year, and I just smile and nod and tell them it's the same.  In reality, I feel I'm in the same place process wise last year, but I have better spirits, less overall pain, and more knowledge regarding recovery.  I think because I came back from my first hip so well, people think recovery was easy.  Honestly, this second hip at this point in recovery, compared to the first, has been a breeze (I haven't wanted to say that out loud as I'm afraid I'll curse myself).  What people don't know is how much pain I woke up with everyday last year.  Every morning for the first 2 months-ish my hip ached and throbbed in the groin, any type of internal rotation or adduction, or external rotation HURT.  A slight pivot on that foot left me crumbling to the ground in pain.  For the first few weeks post-op BEING IN A CAR HURT, not the sitting (that hurt too though) but the accelerating, the braking, the turning, it was excruciating.  I couldn't sit without irritation for MONTHS (think....6+ months).  I had joint pain for nearly 8 months.  Yes, I recovered, but it came with a lot of patience, a lot of tears, HOURS of physical therapy, weekly acupuncture visits for 7 months, and persistence.  Hip surgery is not for the faint of heart and I'm continuously in awe of people who don't take it seriously.  

 I even ate cake on my birthday!

I even ate cake on my birthday!

This go around I've had to hold myself back more often than not.  While I feel last year I was "conservative", I was still holding on to that tiny thread of hope.  Hope of being able to get back out there sooner, hope that I could hang onto some tiny ounce of fitness I had going into surgery. Hope that I could maintain my strength and muscle.  Looking back now, I realize I was holding onto so much hope, I ignored so many signs I should have listened to.  2018 Courtenay laughs at 2017 Courtenay.  I'm a much wiser recover'er this time around.  

What many don't know, because I didn't want to talk about it or go into details about, is my major flare up 3 months post-op last year.  I ended up with SI Joint Dysfunction, compressed vertebra, and a massively flared up hip.  I think I touched on it on a post at some point, but honestly, it broke me, physically and mentally.  I had worked so hard to get to the point I was at, I was (so I thought at the time) so incredibly patient, and when things flared, I lost all hope in my recovery.  I kept counting in my head how many months I had to prepare for CX, and each day as the pain didn't subside, was another day lost.  What you don't know, is it took me well over 2 months to recover from that back flare, the hip settled after a couple of weeks, but my back pain lingered into July, and on and off clear into the CX season.  To this day I'm not sure what went wrong last year, if it was a pile up of signs I should have seen before it all happened, or if the universe wanted me to learn something, I just don't know.  

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What I do know is, 2018 Courtenay learned a heck of a lot from that flare up.  I learned how to handle the back pain I've dealt with for YEARS.  It comes and goes, but when it comes, I can make it better with the techniques I learned in PT.  2018 Courtenay learned when you go through surgery, you can't hold onto fitness, LET IT GO.  This year, I let it go.  I didn't push what I thought "would be fine".  With my first hip when I was told I was allowed to do something, I went and did that something 100% of the time (which is probably what got me in trouble with these damn hips in the first place).  When my surgeon said I could ride outside for 1 hour, flat pavement, easy, I looked at it as something I could do every day, because when I'm fit 1 hour IS easy, so I rode my bike every damn day.  Funny, right?  When I was told I could go back to Yoga at 8 weeks, I went back to Yoga, 2x/week, because that's what I did before surgery, so why would it be a problem now?  I got myself back into the gym 2x/week for some upper body work.  Everything was fine, until it wasn't, and then it was awful.  2018 Courtenay laughs at 2017 Courtenay.  2017 Courtenay was kind of stupid, but I was holding onto hope I should have let go of.  

If I'm honest, I'm scared of a big flare up like that, because it was bad.  It hurt, I cried, I was humbled by life, and I don't want that again.  Everything we experience in life is a lesson, or it should be!  I learned how to be a wiser and better recover'er from that flareup.  I can look back and see where I went wrong, and I can hopefully, make it better.  I've been intentionally taking this recovery even SLOWER than my first one.  I've been riding my bike less days, I eased my way into outdoor riding, I've only been going to Yoga 1x/week, AND it's not on a day I ride my bike!  I haven't had a focus on going to the gym as much, as I would rather my hip recover and we don't have a big ol' flare up like last year.  I survived not only 1 but TWO 6 hour flights to and from Hawaii.  Along with the flights, I survived walking on sand, travel days, walking on uneven undulating lava trails, SWIMMING with KICKS (something I wasn't allowed to do until 3 months post-op), lots of car time, and on top of all that, lots of pool and beach time while in Hawaii.  

I'm continuously amazed at my body and what it is capable of.  I'm amazed every day when I get out of bed and my hips support me, I'm amazed every time I ride my bike in the pure beauty of being outside, and how far my body can take me.  I'm amazed at my resilience to keep persevering when there are days I want to give up.  I know I'm strong both physically and mentally, and when I'm on the other side of this chapter, I'll be that much stronger.  

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Hip Arthroscopy

February 9th 2017 I went into surgery to repair a torn labrum, and correct the FAI in my right hip.  You can read my back story in a previous blogpost found here.  Unfortunately for me...I ended up having the same surgery on my left hip Feb. 8th 2018, so I kind of feel like I'm becoming a pro at this whole "recovery thing".  Throughout the last year I've had a lot of people reach out to me regarding surgery, what to expect, what helped me, and any other tidbits of info.  Surgery is scary, you're trusting a complete stranger to "repair" you, in the hopes you'll be better, stronger, and in less pain.  That's the goal at least, right?  I decided one big blog post about everything would be a great place to point someone who had questions.  I don't need to discuss every detail of every week or month from surgery.  You can find the following posts from my first surgery regarding my thoughts, where I was at physically and mentally here:

Full Disclaimer: this is MY experience, what I did, what helped me, and my surgeons protocol.  I've discovered a lot of surgeons are very different with their protocols and what is allowed versus what isn't allowed.  I'm going to give MY opinions and mine alone.  You will most likely experience something very different than me, and will have your own varying opinions, and thats okay.  Do not compare yourself to me or anyone else you know who has undergone this surgery.  Every body is different.  I was and am very lucky to not currently have a job (aside from bike racing) that I need to get back to.  The time I would usually put into training I was and am able to put into rehab and recovery, as it feels like a full time job on it's own!  For this, I know I am lucky.  I also hold a BS and MS in Exercise Science, I understand the body very well, and I am highly in tune with my own body.  I know when something feels off, so I can discuss with my PT an appropriate plan of action to help it.  

Lets get to it!

If you stumbled upon my blog from Google because you googled "labral tear", stop the Googling.  Thank you for reading, but seriously...stop googling, it will only frighten you more.  That's the #1 thing I tell someone who just learned of their diagnosis.  You're going to read peoples nightmare of a story, you're going to find people who tell you to stay away from surgery and why surgery is so bad and you shouldn't do it.  I didn't want surgery after learning of my diagnosis, I know people who had undergone surgery and I saw the struggle of recovery, and no way, no how was I going to put myself through that (well..I did...twice).  The thing with surgery is, if you're dedicated, follow through, and LISTEN TO YOUR SURGEON, the outcomes can be very positive.  1 year out from my first hip and my range of motion and strength is greater than pre-op.  

I find it very important you trust your surgeon, you feel confident in their abilities, and you guys are on the same page with your recovery, your goals, and what you expect from the outcome.  Do your homework when it comes to finding a surgeon.  You want a surgeon who is competent in hip arthroscopy, not a general surgeon who also just happens to do them.  Find a hip specialist that understands HOW to perform the surgery and has done loads of them.  Like I said, trust your surgeon.  Find a surgeon who is realistic with recovery.  If a surgeon tells you you'll be good to go at 3 months, seek a different opinion.  The reality of this surgery is, yes maybe at 4 months you'll be ready to push it a bit, but your hip is still recovering from the trauma of surgery and it will be for awhile.  I was told 1-2 years for a full recovery, and being 1 year out from my first hip, it's true.  Yes, I was back out there racing at the top level of my sport 7.5 months PO, and my hip was very capable at this point, but I was still lacking in ROM in areas, and I still couldn't sit cross legged on the ground (which drove me crazy).  My hip still flared up at this point every few weeks, and I still did my daily PT for my hip.  Surgery doesn't just fix your hip, you need to put the work in for the outcome YOU want.  

My surgeon has a very conservative protocol, and honestly, for that I am grateful.  The first 4 weeks does NOT include any strength work or any active range of motion for that matter.  It is however, aggressive in passive range of motion.  As in, someone else is moving my leg for me during specific exercises, along with a CPM machine, AND stationary biking.  He also consistently put fear into me that if I did too much or pushed it too much my hip wouldn't heal.  He ingrained in me the importance of backing off when things didn't feel right and to not push through ANY pain.  Not every surgeon has this outlook, I've discovered some are very aggressive in their approach to recovery.  As my surgeon said to me when I've asked him about it, there isn't a lot of research out there as to what is better, so he sticks to what works for him and his patients and doesn't see a need to change it.  I can't argue with him either when at 4 months PO I started running again, racing at 7.5 months PO, stood on 7 podiums, won 2 races, finished 4th at Nationals, and was one of 6 selected to the World Championship team, all within less than 1 year post op.  I took the time to let my body heal during those important early post-op phases, and it paid off.  I didn't push anything, I didn't do too much, I literally spent 2 months on the couch just letting my hip heal (besides PT).  

I made a few mistakes early on with my first recovery, that I discovered were very important, mainly because I didn't listen when people recommended them to me.  I can be stubborn and competitive, and wanted to be the best...***face palm***.  I highly recommend (or had to use) the following items for Post-Op use.

  • Toilet seat riser.  My Dad has 2 fake hips, so he had one of these and recommended it to me, but I said "I'm so much younger than you Dad, I don't need it".  After about 3 days (after my first surgery) of my husband lowering me down to the toilet and lifting me up, I called my mom to bring it over.  This thing was a serious life saver after that.  Not only could I go to the bathroom on my own, I used this to get my pants on, since I couldn't bend over to put them on myself.  If gave me a bit more independence so I didn't have to rely on my husband for everything.  
  • Shower Chair.  I didn't have this for my first shower with surgery #1...I should have.  My husband planned to help me in the shower, since I would basically be standing on 1 leg and knew I would have a hard time with everything.  We did great...until we didn't.  Towards the end of the shower I almost passed out.  I thought I was going to throw up all over the bathroom, he ended up having to carry me sopping wet to the bed so I could lay horizontal.  I was afraid to shower.  We then acquired a shower chair, and showers were very uneventful after that, but I did have my husband help lift me into the shower, it just makes things that much easier.  
  • Spin Bike. Most protocols require spinning on a bike.  As a cyclist, my surgeon told me I could use my bike on a trainer and that would be perfectly fine.  He wanted me on the bike within 3-4 days post op.  So, after my first surgery I hopped on my bike 2 days post op, and it was disastrous.  The bars were too low, my hip was stiff,  and I couldn't even move the pedals in circles.  I made it maybe 5 revolutions and had Chris lift me back off.  I didn't ride the bike after that, and was reprimanded for not being on the bike yet at my follow up 1 week post op.  So...I acquired a spin bike, and it was SO MUCH BETTER!  The goal isn't a work out, the goal is to move your hip in circles for range of motion.  The spin bike accomplishes just that since the fly wheel is weighted, once you get it moving, you basically don't have to do anything as it will just keep moving on it's own with no resistance (since you aren't supposed have resistance anyways).  
  • Ice Machine.  I've heard amazing things about the GameReady.  I didn't use it for either of my surgeries...I said I swore I was going to use it for my second one, but I already had the simple machine I purchased for my first hip and it worked just fine, I didn't need to spend another $200-$300/week on another machine.  Click the link on the IceMachine title and it will take you to the machine I have.  It's wonderful, and worth its weight in gold.  
  • CPM.  Continuous Passive Motion machine...I hated this thing with a passion, and I tried to negotiate many times with my surgeon about not using it.  Not all surgeons require this, but mine did, and I hated every hour I spent in it.  You're supposed to lie flat when you're in it, and you can't accomplish anything.  I was required to be in it 6 hours/day for the first 2 weeks post op (I split it into 3, 2 hour sessions).  My first surgery I made it ten days before it started to irritate my hip and caused significant burning (oh the burning...it was awful).  The second hip I said since I only used it for 10 days the first surgery that was all I was going to use it for the second surgery.  I made it 12 days, and then called it quits.  I couldn't find any way to get comfortable in this thing, it really really hurt my butt, and was killing my sacrum and SI joints after my second surgery.  According to my surgeon, "everyone loves the CPM".  I haven't spoken to a single person who "loves" the CPM.  
  • Pillows.  A lot of pillows.  I sleep with 7 pillows currently and I'm about 9 weeks post op my second hip.  My husband calls it my pillow fortress.  Prior to my second hip surgery I was using 4 pillows at night since my last surgery.  You're going to want a couple pillows either under your knees if you sleep on your back, or a pillow between your knees if you're a side sleeper, plus some pillows to prop you up for support post op.  I was also using pillows to keep my leg from externally rotating during the first 3 weeks post op.  It also doesn't hurt to bring some extra pillows with you to surgery for your drive home.  I live about an hour from my surgeons office, and the anesthesia puts me in a coma, so having the pillows in the car so I was comfy and able to pass out, was a plus for me.  
  • Netflix.  Books.  Hulu. Oh My.  Any form of entertainment to keep you busy.  You will most likely be in bed or on the couch for awhile.  You won't realize how much your hip is involved with everything you do, until you can't use it.  Take the time to chill out and relax.  I found it was hard to read while on pain meds, so I just stuck to Netflix.  
  • Stool Softeners.  Start on those right away!  My first surgery was the first time I ever took narcotics, so I was unaware of their unfortunate side effects.  Five days post op and I was so insanely bloated and in pain.  My second surgery I was on top of this, and it helped significantly. 
  • Help.  Never underestimate the use of good help.  If someone offers to help you, please take it.  My husband has been my nurse and seen me through these surgeries.  From lifting me in and out of bed, on and off the toilet, to making sure I took my pain meds (He's a pill pusher :-P).  My particular protocol says I'm not allowed to do ANY active range of motion for the first 4 weeks.  The first 2-3 weeks are the hardest and I suggest getting help with these simple benign tasks during this time.  Plus, you're on crutches so you can't do anything anyways.  You won't be able to carry your food, you cant grab anything for yourself.  You can't even dress yourself.  You won't be able to bend down for awhile (the pinching...ohhhh the pinching), so putting on socks and shoes will be troubling.  Unless of course you live somewhere sunny and you can wear flip flops all the time, I however, do not.  I have been known to slide my husbands shoes on when no one is around to help me get my own on.  Also, if you're surgery is on your right hip, you won't be able to drive until you're off crutches.  So...you're going to need loads of help and drivers, Ubers, and good neighbors and friends.  Other things to keep in mind when it comes to help, is most of your early post op exercises are passive, as in someone else does them for you.  These exercises are done to regain range of motion in the hip and also break up and prevent the building up of adhesions in the joint. If there is one consistent thing I have seen amongst protocols it's the circumduction exercises, known as "circles" in our house.  It's 20 minutes of spinning my leg in circles at different heights and in different directions.  Chris hates them, I don't mind them, since I just lie there playing games on my phone.  
  • Compex/TENS Unit.  A little e-stim to help with pain relief, and when it's time to get those muscles strong again, a little muscle stim hasn't hurt anyone!  I used the Compex Unit during my recovery after my first hip, and I swear by that little thing.  It helped get and keeps things firing.  I upgraded my Compex Unit to a wireless with TENS for this surgery, and LOVE it.  You can start using the TENS pretty early on, as it's for pain relief only, where as the Compex is actual muscle contractions, so that needs to hold off for a few weeks post-op.
  • A PT you trust.  Never underestimate the quality of your PT.  If you feel you aren't getting from your PT what you need for YOUR recovery, don't hesitate to find a new one.  This is your body, you only have one.  
  • Compression Socks.  Keep that blood circulating.  Plus they're good for the whole blood clot prevention thing.  I use CEP Compression, and love them! 
  • Massage Table.  Totally and completely not necessary but super helpful.  During my first surgery my PT lent me her massage table for my husband to do circles on since the bed was too low and awkward.  It turns out, I LOVED having the massage table, so I purchased my own off Craigslist.  During my first recovery I couldn't even IMAGINE trying to get down onto the floor to do anything, so this gave me somewhere outside of the bed to get PT done.  It gave me somewhere to lie prone during those early post op days, gave me somewhere to do my isometrics, gave me somewhere to lay when using the Compex, and was a great place to do other PT exercises once I was further along.  Like I said, not necessary, but a luxury I use every day.  

Other Tidbits.

Some other things I did/do post op that I found beneficial for ME.  As I mentioned at the begining of this novel, this is my experience, and everyone is very different. 

  • Massage and Acupuncture.  I highly recommend both throughout your recovery.  Your body goes through so much during surgery and your muscles endure a lot of trauma.  You're going to be so awkwardly stiff. During my first hip I went to acupuncture 2x/week for the first month to help with pain relief.  My first hip hurt and ached a lot more than my second hip.  This time around I've been going to acupuncture 1x/week.  Massage I've been going every 3-ish weeks.  That soft tissue work is so vital!
  • Pool.  Use it!  If you have a pool close by, this tool can be your very best friend.  I HATE swimming, everything about it, but I stuck to the pool once I was allowed to, in order to do range of motion exercises, and a little bit of laps (with a pull buoy because you can't kick).  It always felt good on the hip, no matter how bad I hated going.  
  • Work your scar tissue.  Apparently not everyone builds scar tissue, but when your PT tells you to do scar tissue mobilization around your incisions...you do it. I didn't listen to my PT after my first surgery because I thought "oh that will just go away, I'll have my acupuncturist poke it and all my problems will disappear", plus I hated the way it felt.  It really grossed me out.  Well...I seriously paid for it because I had A LOT of scar tissue around those incisions, and they got so so so tight.  This second surgery I started gentle scar mobs before my first PT session, and here I am about 4 weeks post-op and my scar tissue is SO much better than it was at 2 months last year!  
  • Journal.  Journaling isn't for everyone, I realize that.  I'm an athlete, so I have some level of OCD ingrained in me, and keeping a detailed journal (and calendar of how I spent my hours) of how I felt and what I did, seriously helped see and measure my progress.  There will be days when you want to cry, you'll be frustrated because you feel like you aren't making progress.  Having my journal to look back and see how far I had come was an extremely powerful tool for me, mentally.  It has come in even more handy now as I recover from my second hip surgery, I can look back and see exactly how I felt each day Post Op from my first hip.  I can see now that I was in a lot of pain with my first hip, and it was very limited.  I can see what is normal for me at each phase, and it's been so insanely useful.    
  • Hip Flexion.  Careful how much active hip flexion you do.  Another thing my surgeon has ingrained in me, is the fear of Psoas Tendonitis, it is very debilitating thing that can happen post op with this surgery.  Some surgeons don't mention it to their patients, as maybe they don't see it being an issue?  Because of this, my surgeon has a very strict protocol of NO active hip flexion for 12 weeks (3 months).  That means every time I get in and out of bed, in and out of the car, on and off the couch (okay you get it now), he suggests I use either my hands to lift my leg OR my opposite foot to move my surgical side.  Is this extreme?  Maybe, but hey...I don't have any Psoas pain or problems from my first hip, so I'll keep following it.  
  • Take it easy.  Before heading into my first surgery I talked to at least a dozen people who had undergone surgery and I asked their advice and what they did.  Every. single. person. told me to "not do too much too soon".  I took this piece of advice to heart and basically spent 8 weeks chilling on the couch.  I would get up to do my PT, ride the trainer, and then plopped myself right back down on the couch to rest and heal.  If I felt ANY aches or pain in my hip I used it as a "don't do that much next time".  I'm not saying you have to do what I did, because there are plenty of people who I'm sure pushed it early and are JUUUUUUSSTTT fine.  To me though, it wasn't worth the risk of not healing. I wasn't about to spend all the money and time into my hip, only to have it not heal.  I look at everything as a risk to benefit ratio.  Is the risk worth the immediate benefit?  
  • Be Positive.  I cannot push the effects of being positive.  I am a strong believer in positivity, and there were many days with my first recovery that I had to remind myself to smile and stay upbeat.  My PT even sent me over an article about the power of the brain and recovery, and how positivity can help you heal.  There are days you might feel like you're living under a dark cloud, you might feel like you're never going to heal.  I promise, keep your head up, smile, surround yourself with people who keep you happy.  You WILL get better, this time is only a chapter of your life, and in 1 year it's going to feel like a blink of an eye.  

Some things I experienced post op.  

I was 20lbs weight bearing for the first three weeks, progressed to 50% weight bearing during the 4th week, with a gradual increase to 100%, down to 1 crutch for a few days after the 4th week and then back to walking.  For both surgeries I was able to lose the 1 crutch pretty quickly.  I attribute a lot of this to pre surgery fitness and strength, and A LOT of dedication to watching myself walk in a mirror.  I strongly believe if you aren't ready to walk mentally or physically, you should stay on your crutches.  From a neuromuscular standpoint, why would you teach your body to limp?  If you're walking with a limp and don't work to get rid of it, you're training your body to walk that way, and it's going to be significantly harder to lose the limp 2 months down the road, than it would be at this early phase.  Put in the effort to learn how to walk properly.  Once you can walk, you're going to realize just how stiff your hip is!  This is completely normal, talk to your surgeon and PT about what stretched will be right for you.  

What I noticed with my first surgery, and once again have learned this with my second surgery, is don't be alarmed if you have some pre-surgery symptoms post-op.  During the second week after my first surgery all of my pre-op symptoms came back, and I had a total melt down.  With my first hip pre-surgery all my pain was front of the hip and into the groin, when I woke up from surgery all my pain was in the front of the hip and in the groin.  With my second hip most my pain was lateral pre-op, with random aches and throbs in the groin.  Guess what, ALL my post op pain with my second hip was lateral.  No groin pain this time around in this hip.  So don't be alarmed if those pains aren't completely gone when you wake up, just because you're labrum has been stitched back together and your bone shaved off, doesn't mean you're magically fixed and healed.  

If you have both hips operated on, don't be alarmed with your second surgery if your first hip flares up.  I'm still struggling with this one, because even 1 year between the two surgeries, my first hip has flared up and all my poor muscle patterning has come back, and I did HOURS upon HOURS of PT to get that hip strong.  Which brings me to, if you've had hip pain for years, you probably have a lot of compensations and motor patterns that need to be corrected.  Surgery won't fix this, you have to put the time into it.  I now know with my first hip that my QL pain and tightness for 5 years prior to surgery was compensation from my glutes being slackers, and even thought I spent months correcting this, when I have trauma back to that hip (like crashing on my bike or having another hip surgery) my body wants to go back to what it knows.  It had 5 years to learn these patterns, 1 year isn't going to fix it.  Surgery is not a quick fix, and shouldn't be chosen lightly.  If you aren't willing to put the work in pre-surgery, you probably shouldn't have hip surgery.  Sorry to be blunt, but that's how I feel.  

For the Cyclist.

If you're a cyclist reading this, there are things you can do to help your pain and keep your hip healthy pre and post op.  Remember you are injured and your body has changed, this means your current fit needs to change.  I highly recommend a new bike fit, and finding a fit with a PT who is knowledgable with hips and familiar with FAI and labral tears.  I go to Annalisa Fish at Endurance PDX in Portland, OR for all my bike fit needs. She's about a 4-5 hour drive from where I live, but I trust her with my life when it comes to my fit and my hips on the bike.  When it comes to your fit on the bike, you want to open up that hip angle, right?  We want less impingement while pedaling.  Some adjustments you can make:

  • Raise your bars.  Look like a grandma...or grandpa.  It's okay, I'm 32 (eeeek, almost 33) and I ride like a total grandma.  
  • Saddle Fore/Aft.  Try moving your saddle forward to open up that angle. 
  • Crank Length.  I've been told I need to go to 165, I'm on 170's currently, but both Annalisa (my fit'er) and my surgeon would like me to shrink my crank lengths.  SO, think about shorter cranks...open up that hip angle!
  • Bike.  There might be a time where you can't get comfortable on your favorite bike.  I found my hips were happiest on my mountain bikes..obviously since that's where I'm most upright.  With that being said though, my first hip was not happy on my 5inch trail bike. Not sure if it was the seat angle or what, but it only liked my XC bikes.  I haven't been on my road bike in over a year, it's aggressive position frightened me post op, so I just stuck to my cyclocross bikes on any road rides.  

As I mentioned at the beginning of my post, surgery is really scary, there are horrible things about this surgery out there in the internet world, and thats even more terrifying.  If you do your homework and find a qualified surgeon (who does their job properly), follow their protocol, be patient, relax, do your PT (for life), I don't feel there shouldn't be a reason you can come out on top.  Believe in yourself, trust the process, and don't forget to smile.