Hip Hip Hooray! Recovering from Hip Surgery

Labrum Tear Don’t Care
For as long as I can remember, I have had pain after a long walk or any physical activity. No pain no gain? That’s what I always told myself. A few years ago, the pain became worrisome. I got it checked out by everyone….until one doctor finally recommended that I go to an orthopedic surgeon.  He confirmed that there was something up with my hip –Femoroacetabular Impingement.  In non-medical terms that meant I had overgrowth of the bone that made the ball and socket not fit the way it is supposed to.  Because of this irregular shape, the bones rubbed together every time I moved. Never fear, this is more common than you think and was never life threatening to me!  Apparently, many people have this condition but never even realize it.
I tried some physical therapy but was in school and didn’t have the time to consider surgery. After physical therapy didn’t work, I just decided to suck it up and power through – BAD IDEA. I didn’t listen to my body and starting normalizing the pain. The more I pushed myself the more it would hurt until finally I knew something was wrong.  The breaking point was after a Flywheel class – I was in so much pain that I couldn’t walk for 3 days.  It was pretty clear that something in my condition had changed.  After stumbling into the surgeon’s office years later (and this time in SF), they got a better look at my hip. The labrum was torn right off and there was no way it would repair itself. Continuous pressure would lead to an eventual hip replacement [EEK]. I scheduled the surgery for two weeks later. I was given a 95% chance of making a full recovery and within 6 months I would feel as if nothing had ever been wrong. YES!!!
Thumbs up for UCSF
The first weeks were rough, but always manageable.  Crutches for two weeks, and then relearning how to walk without a limp.  I overextended myself a few times and paid for it with pain, but the trend was always on the upswing.  By 8 weeks after surgery, I was back to working out almost everyday (no impact activity) and most of the time did not even feel pain the next day.  Recovery takes patience but with time, every day will be a little better.  Some days will seem worse, but overall the trend is upwards.
First day outside
Today

While I was waiting for surgery and recovering (and still continue to do so), reading a day by day summary of other people’s experience with hip arthroscopy really helped me understand that my body needed time to get back to normal.  Here’s what my experience was like:

The Arthrogram MRI
Also known as the time they put a needle directly in my joint unsedated, and by far the worst part of the entire process.
I had no idea what was coming, and assumed that this MRI would be the same as the one that I had back in NYC.  They would inject some dye into my arm and then put me into a loud machine for 45 minutes? That is not what a hip arthrogram is.  It wasn’t until they started strapping me down that I realized the needle was going right into the inside part of my hip.  I felt everything and it last a few minutes.  By the time it was done, the room was spinning.  I couldn’t put my foot down for about a week but luckily no infection!  On the plus side, it was great that I didn’t know what was coming because I didn’t have any time to get nervous, but I would recommend asking for sedation.  This procedure was used to confirm the hypothesis that a labrum tear was present and determine the extent of cartilage damage.
The Surgery
The surgery took longer than expected, as they discovered some extra bone spurs and extra bone on all parts of the joint.  They shaved off the extra bone, and anchored my labrum back together – it was a success!
The labrum tear up close
As for the experience – to be honest the drugs felt pretty good and I was out before I could even count to ten.  The last thing I remember was asking Eric to make me some avocado toast as they wheeled me off and I promptly blacked out. Upon waking up, I was happy. I thought I was at a spa: Eric recorded me so that I would remember and wow it’s a hoot. I yelled out flirty things- and the entire staff thought I was referring to the doctor named Eric. I put ritz crackers on my face as if they were spa cucumbers.  I proceeded to call everyone who walked by “THE MAN.” All was perfect until I had to get up and go home.
THE MAN
The Recovery (November-February)
While I was recovering (and still continue to do so), reading a day by day summary of other people’s experience with hip arthroscopy really helped me understand that my body needed time to get back to normal. Here are my first few weeks:
Day 1: The anesthesia wore off and honestly I was on so many pain medications and anti nausea patches that I wasn’t too uncomfortable. Eric and my MIL kept track of my medication and took me to the bathroom whenever I needed to get up. The biggest difficulty I had that first day was getting used to my leg not responding to my commands. I couldn’t bend up my knee and I couldn’t get up without putting my full weight on someone. There was essentially no swelling or bruising and icing the area helped keep away the soreness.
Day 1
Day 2:  Luckily I was still knocked out for the entire day – I felt really really sore but I was just in a daze. My friend came over to play violin and I remember being moved by the beautiful music.  I apparently spent hours staring at the bridesmaid fabrics I had ordered – which I have no recollection of. The pain and reality would only  kick in at the end of the medication doses when I realized my body was pretty trashed from the surgery.
Day 3: Eric’s mom kept me company today. I felt bearable pain but I was able to chat it up and nap. Still a lot of around the clock icing
Day 4: Eric’s mom had to leave so this was my first day on my own. Two friends came over to keep me company but I did spend some hours alone. This was the first day that I felt pretty miserable. I did manage to go downstairs to pick up some packages that arrived (including my wedding dress!).  I still couldn’t sit up without pain or tie my shoe.
Day 5: My first day entirely alone. Also my first day attempting not to take as high a dose of pain medications. I realized that the pain was still out with a vengeance when I let 12 hours pass between the pain meds. I was a wreck by the end of it and it took hours to take the edge off the pain.  We had someone over for dinner and I had to lie on a pile of blankets the entire time.
Find the human
Day 6: My first day out of the house since surgery. Eric and I walked about 4 blocks to the nearest Starbucks.  It took over 30 minutes and I was out of breath every ten steps. Lots of people stopped me on the street to encourage me and that really made my day! Sitting at Starbucks was tough since I still couldn’t sit up. We made it home and then got up again to meet some friends at a bar.  That night was rough and my groin was throbbing – It was hard to listen to my body with all the trivial tasks.
Day 7: Today was ambitious. Church in the morning, then directly to Trader Joe’s, and then to REI for some winter gear. By the end of the errands, my leg was throbbing.
 
Day 8 [Monday]: 1 week post-op!  I made the mistake of going back to work. I had to commute for one hour on the train (luckily had a lot of space) and then sit through 8 hours of work. I had trouble getting comfortable at my desk since sitting up was still not plausible. I didn’t take any pain medications because I did not want to be drugged at work. At lunch, I tried to eat with colleagues but the pain got so bad that the room started spinning and I had to excuse myself – I was so embarrassed and had never felt faint from pain. After lunch, found a couch to lay back on and prop my legs up. It helped a bit but the pain had already set in for the day. The commute home was horrible, and cramped during rush hour. By the time I got home, my leg and body was throbbing so badly that I completely broke down in tears. I decided to work from home for the rest of the week. The doctor had initially said I could go back to work as soon as 3 days post-op – NO WAY. Luckily I was able to work from my bed for the rest of the week and minimize the pain.  Make sure to take at least a week off of work!
Ice, Ice, Baby
Day 9: Worked from home. Took meds in the evening, it was great. Life was good.
Day 10: First post-op Appointment + FIRST SHOWER- made it out of the house to call an Uber and get myself to my first post-op appointment. I got to the office without much difficulty and went in for X-rays. After my crutches were adjusted (I had been using them wrong the whole time), walking was so much easier.  Make sure to google how to use crutches! It is ok to put weight on your toes (sometimes). I saw the surgeon and had my stitches removed. Most of the incisions had healed except for one which was still oozing a little bit.  The surgeon explains that this is common, as the top layer of skin may not have healed yet. The incisions were covered with steri strips.  The surgeon went through he surgery step my step by showing me the photos he had taken during the procedure. He showed me where the immflamation had been, where they fixed and reattached my labrum, and the two sides of the joint where they shaved off the extra bone and bone spurs. The surgery was successful! I was assured that within 6 months I would forget that I ever had surgery.  I was also relieved to hear that it would take serious trauma to re-tear the labrum. As a plus, I was finally able to shower again (after over a week!) I also picked up a hot chocolate which ended up spilling everywhere as I hobbled home (no regrets).  I was able to shower myself but made sure to leave the door unlocked in case of emergency. Over this week my independence increased dramatically.
10 days post-op
Day 11: Since I could not fly for three weeks post-op, Eric’s mom came back to SF to drive me to LA (that woman is amazing, I am so lucky!).  I was finally able to put weight on the front of my toes.

Day 12/13: The long car ride had my hip throbbing the entire night, until I finally passed out at around 6am.  Made it to Target, TJs, and Michaels to get some air and test my independence.  [Bad Idea] The Michaels trip ended in a store employee needing to help me carry my bags outside to an Uber.  Thank you!

Day 14 [Monday]:  2 Weeks post-op.  Officially ready to wean off the crutches. 1.5 mile walk around UCLA on crutches.  No pain!
Day 14
Day 15: Tested the mileage to 2 miles with crutches. Tried a few blocks without crutches- body wasn’t quite ready for that yet.
Day 15
Day 16: Challenged myself to go outside for the first time without any crutches. Only walked a block but by the afternoon when we picked Eric up at the airport, I needed to sit on a makeshift wheelchair.
Day 16
Day 17: Happy Thanksgiving! Morning at the beach and Thanksgiving dinner.  Still on crutches and unable to sit up comfortably.  Thankful for a successful surgery.
Day 18: Friday – went to the movies with crutches and out for dinner also with crutches. Able to sit through both without too much pain.  This was the first day that sitting for dinner was bearable.
Day 18
Day 19: Went out to the mall and dinner without crutches. Slow but steady!
Day 20: 8 mile drive with lots of traffic back from LA. Cue throbbing hip.
Day 21 [Monday]: Three weeks post-op: First physical therapy session . First day with no crutches! Walked 15 minutes each way to PT! Did 15 minutes on the stationary bike, side planks, clamshells, leg extensions (pull one knee to your chest and let the other extend), squats. Was somehow harder than I thought and my body has definitely become a lot weaker. Took my last pain meds, and didn’t take anything but Tylenol for the rest of my recovery.  The limp is extremely obvious but will get better as the muscles rebuild.
Day 22: Back to the office. Pain by the end of the day but finally able to sit up straight with no pain.
Day 26 Saturday: went on a 5 mile walk/hike along the coast. By that evening was in excruciating pain and passed out at 8pm from the exhaustion. Definitely over extended!
Day 26
Day 28 [Monday]: 1 month post-op! PT session #2 – able to walk with a minimal limp!
Day 29: PT exercises led to soreness but not pain!
Day 35 [Monday]: 5 weeks post op – limp is barely noticeable. PT session #3.
Day 36: Went to the gym for my first full workout. 45 minutes stationary bike, all PT exercises, and arms.  Feeling good.
Day 36
Day 37: Felt yesterday’s workout. Had to leave work early – The pain was beyond soreness.  Had to lie down for the rest of the day.
Day 38: 6 week post op appointment with surgeon.  All looks great! Limp is gone.
Day 42 [Monday]: 6 weeks post op – cleared to do most activities except for high impact (running, jump rope, burpees) or contact sports.
Week 8: First Flywheel class since October! Got my lowest score ever, but that was expected given how long I had been off the bike.  Wasn’t able to get up into third position but the pain was very mild that night!
Week 8
Week 9: First barre class and wow were my thighs hung over after that.  The instructor had to modify most of the exercises since my hip flexor still can’t fully rotate backwards. Thanks Avant Barre for the welcome back 🙂  Back to Flywheel for the second week in a row, and hit the gym three times this week.  Feeling great!
Week 10:  I am starting to feel like I am officially back to my usual self.  I am weaker, but I am able to push through most exercises.  I feel my muscles rebuilding with each time that I hit the gym.  After exercise, the pain (if there is any) is much less than it was before surgery.
Week 11:  Final post-op!
Week 12:  The PT told me that I may never be able to run competitively again, but that a few miles here and there will be ok.  Labrum is officially strong enough to get back to mild running, jumping jacks, burpees, jump rope….. and SWING DANCING.
Week 13: Went to an intense barre workout and a pilates mat class this week.  I don’t think that combining two workouts that put pressure on the hip flexors is a good idea – especially these glute exercises and any lower ab work.  Core work puts a lot of pressure on the hip flexors and often times your back has to overcompensate (ouch).  Had to take about 4 days off from the gym after this to wait for the pain to subside.
Week 14: Done with PT! Back to back cardio all week, topped off with a 10 mile hike (steep and muddy).  Finally back to my pre surgery Flywheel score (Next step…beat the high score).  Only a little bit of soreness each night but it was gone by the next morning. I feel great!
Week 15: Now that I am finally back to pushing myself, I do feel remnants of pain especially when I hit the gym two days in a row.  I’ve been trying to workout 2 days then rest 1 and hope that soon I will be able to build up my stamina.  We are still 9 weeks away from the 6 month mark – which is when the pain is supposed to stop for good.
Feeling great 3.5 months post surgery!
Medication.
At first, I tried to act tough through the pain and avoided taking Tylenol or Advil unless I was desperately uncomfortable.  I realized that I was just contributing the pain by doing this.  Don’t feel weak for taking pain relievers – your body went through trauma and needs its time to heal.
The Waiting Game. Patience is a Virtue.
Recovery is a waiting game.  It was frustrating at first because I could not believe that my young and seemingly fit body would have such a hard time relearning trivial tasks.  I had never felt tired after 10 squats before, but suddenly it was a great accomplishment to get to 20.  Patience is key, and with time (and a little bit of luck) the body can recover.  I can’t believe that it only took 7 weeks to get back to more or else my usual self.By 12 weeks, I counted any morning after a workout when I woke up without any pain as a great success! I am so grateful for my team of surgeons and PTs at UCSF who helped me get my active life back.  All that will be left are a few little scars as a reminder to never talk walking for granted again.
Sleeping with Hip Pain?
For the first few weeks after surgery, night time was my lease favorite part of the day.  I had trouble sleeping, and was afraid I would damage my hip if I slept in the wrong position.  Even though nowadays those nights are rare, I still find comfort in sleeping with a thick pillow between my legs.  I find that this helps take the edge off the pain and makes it much easier to fall asleep.  The more pillows I put between my legs, the comfier I feel.  I also make sure to do some leg extensions before going to bed to loosen up my hip flexors.  Unfortunately this is still an issue even 3.5 months after surgery – the pillows do the trick!
Weight Gain? 
One of my biggest worries was that the (small but existent) muscles I had taken so long to develop would wither away during recovery.  They did.  I actually lost about a few pounds during the recovery process and watched as the muscles just turned to fluff right before my eyes.  The recovery period was the first time that I had ever seen any stomach falling over my jeans.  Luckily, with the reminder that now I can rebuild my muscles without constant pain, I have come to terms with the temporary setback.
Scarring?
All that remains are two incision scars about 2 inches long at the top of my right thigh. The scars started as thin scabs and slowly become a little wider as the scar tissue began to form.  The Physical Therapist recommended Mederma Scar Gel and the Surgeon thinks that the bright pink color will soften within a year.  The scars don’t bother me;  given how happy I am to be back to regular activity, I see the scarring as a constant reminder of how lucky I am to be back on the move!
The Prognosis
I am hoping for more insight after my 6 month post-op, but overall I feel so much better than before the surgery.  Unfortunately, my legs are still extremely sore after workouts and if I hit the gym more than twice in a row, my hips and back ache for days.  On the bright side, I am back to my daily routine and optimistic that there is still healing to be done as the remaining scar tissue is broken down.
GOOD LUCK!
Live your life & enjoy.
-L

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