Surgery

The first thing that comes to mind when I tell people I had hip surgery is "oh a hip replacement"?  A hip replacement is the most common hip surgery that people know of, so their mind goes straight there.  I didn't have a hip replacement, I'm 31 (going on 32), my cartilage looks good, and I'm not anywhere close to needing a hip replacement!  I wrote a blog last April/May about what was going on, but I'll repeat it here.  First and foremost, I thank my Dad for my quality hips, 60 years old and already has both left and right hips replacement.  Damn Dad, we were both gifted with FAI, only difference for me?  I'm younger, research is out, and my pain came on a lot earlier than my Dad, and they've figured out ways to correct the problem.  My hope is, by having surgery now, I will prolong the need for a hip replacement down the road (or not need one at all)!  

Top picture is the shaving of my femur - bottom is what it says, my tear!  Pretty good, huh?

Top picture is the shaving of my femur - bottom is what it says, my tear!  Pretty good, huh?

Onto the surgery.  

February 9th I was knocked out by anesthesia, and had a long surgery, I think 2.5-3 hours.  While I was under, my surgeon (Dr. Nowak at Everett Bone and Joint) went in, shaved my femur down (because I had too much bone on my femur, called a cam impingement) and repaired my labrum (cartilage that stabilizes the hip, and protects your articular cartilage).  He put in 2 anchors and then stitched the labrum back together.  FAI can be genetic, can occur during growth depending on the sports you play growing up, or can occur from injury.  FAI is also known as hip impingement, because of what happens during hip flexion (the acetabulum and femur impinge on each other, typically at angles of 90 or greater), and FAI consequently tears your labrum.  Not everyone who has FAI will tear their labrum (lucky them), just like not everyone who has a torn labrum has FAI, it can tear from a traumatic event.  

Apparently my labrum was bruised, no wonder it was uncomfortable all the time!  Plus, the first of 2 anchors being put in.

Apparently my labrum was bruised, no wonder it was uncomfortable all the time!  Plus, the first of 2 anchors being put in.

How do they perform the surgery?  Well I'm no surgeon, but the surgery is called "minimally invasive", which makes me laugh because it's actually quite a major surgery, but since its an arthroscopic surgery, I guess that deems it minimally invasive.  I suppose it makes sense when you think about it, but in order to get to the hip capsule they have to dislocate your hip for the surgery.  OUCH!  So basically my hip was dislocated for 2-3 hours while tools were shoved into these tiny holes on the side of my quad (I have 2 incisions the width of my pointer fingers), tools were jabbed into my cartilage, with rope looking stitches, and my bone was shaved down on the femur so it would fit better into the acetabulum.  

My repaired labrum + femur shaved down

My repaired labrum + femur shaved down

Since the surgery's focus is hip/tissue preservation, my rehab is significantly longer and more difficult than rehab of a hip replacement.  I've been put on crutches for 4 weeks, I can put 20lbs of weight on my surgical side, and after 3 weeks I can put 50% weight down, and by the 4th week I can learn to walk again!  So far my rehab has been all about passive range of motion (meaning someone else does the moving of my hip for me) through the hip joint, breaking up any potential for scar tissue build up.  For the first 1.5 weeks I was 6 hours in a CPM machine, I hated it!  Along with passive ROM exercises, I can do some small light isometrics to prevent any muscle inhibition to keep those suckers firing for when it's time to start working back on strength.  I am allowed to spin on my bike (I've chosen a spin bike for more comfort and ease of pedaling), the spinning is really just to keep ROM in the hip and again, prevent scar tissue build up.  I've been building from 1 10 minute session and now I'm up to 2 18 minute sessions (one in the AM and one in the PM).  For the first 4 weeks I can get up to 2x30 minute sessions no resistance, just light spinning.  After 4 weeks I can start working on strength and slowly add time and resistance to the bike.  I'll also move over to my bike on the trainer for my spins, and if my 2 month follow up goes well, my surgeon told me he would let me ride outside on my road bike!  Wahoo!  

The CPM machine I spent 61 hours in before I gave up on it!

The CPM machine I spent 61 hours in before I gave up on it!

While my days are filled with rehab at home, I'm also attending PT 2x/week and going to acupuncture 2x/week, plus adding in massage where I see it fits/what my massage therapists recommends.  My goal for rehab is to listen to my body and make sure I'm doing enough, but not too much.  The first week after surgery had so many drastic improvements I was so excited for the recovery, and it seemed on the 9th day the pain set in, and I mentally collapsed, I think I cried for 6 straight days.  I feel I'm on the positive upswing of the last few days, pain has subsided (don't get me wrong, it still hurts, but not like it had), the range of motion is increasing, and my tightness has decreased.  I'm still not capable of doing much, and I can tell when I "do too much" (I.E. leave the house for too long), I get tired and my hip starts to ache.  Sitting is uncomfortable, standing sucks, so I pretty much sit in bed with ice/heat contrast when I'm not doing my rehab (which is multiple times/day).  

Today is Post-Op day #16, I know I'm going to have really good days, and I know I'll probably have really bad days.  I will listen to my body, I will stay present, I will stay off google, and be positive.  

Tiny incisions

Tiny incisions