FAI (Femoro-acetabular Impingement) & Karate

I had my 8(+) week followup visit with the doctor on Thursday.  He looked me over, did a few tests and asked me how I felt.  He said “At this point, I tell people they can gradually ease off their crutches and it usually takes them about a week…But with you, I imagine it won’t take more than 15 minutes, right?”  I told him I would use the crutches to go back to my car, which I did.  And that was the last I used them.  I’m still walking very carefully and fairly slowly.  But I’m walking and feel fine.  I am stiff.  But otherwise I feel completely ready to go full-speed ahead.  I will be careful.  But I will push hard at my therapy.  I will do the exercises in order.  But I have the OK from the doctor to proceed to the next step in the therapy process every time the therapists clear me on each hurdle.  I think the biggest issue will continue to be my range-of-motion.  I can build up the strength pretty quickly.  But I need to spend more time stretching.

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According to the Dr, I was to be putting no more than 20 lbs of weight on my right leg through the 8-week mark.  That was today.  My appointment with him is not until Thursday.  So I am still keeping a crutch stuck to my right side until I get the official nod from him.  Hopefully he will confirm that all is well and I can move ahead with my recovery at a quick pace.   It has been 3 1/2 months since my left hip surgery.  Although I still feel some minor discomfort in that hip with sharp turns (don’t forget that the left leg is bearing almost all my weight most of the time), it seems like it is getting very close to full recovery and will be there just as soon as my right side can do some serious catching up.

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Yesterday marked 3 months since I had surgery on my left hip and 6 weeks for my right.  My left leg/hip is just about as strong as it has ever been now.  I am just starting to add some serious resistance on my right side.  From my next session at physical therapy, I am told that I can finally pedal with both feet.  My range-of-motion is still somewhat limited on my left side.  But it is better now than it has been for the past year or so and I haven’t been pushing it the way I used to.  So I would expect to improve on that more once I am more active overall and standing around on just my left leg less.

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Can I run yet? Jump? OK. How about walk without crutches?  Not yet?  I feel like I am ready, and have been, to get rid of these crutches and get into a serious recovery schedule.  But the doctor says it takes 8 weeks for the bone to heal so I am waiting for a few more weeks.  At least I am doing more strengthening work at physical therapy.  The stretching is actually much more strenuous than the strengthening portion of the PT.  I feel like my left side is just not able to get flexible while I continue to put most of my weight on it all day.  I made a point of not doing much walking this weekend and I think that may have helped.

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Yesterday marked 4 weeks since the surgery on my right hip.  So after the usual stretching at the physical therapist’s, she started me on some light strengthening exercises for that size (in addition to all the strenuous exercises I have been doing on my left).  It felt so good to be putting some weight on the right side (slowly, with control).  Even “baby steps” are better than no steps… It is still frustrating but at least I am seeing more of the light at the end of the tunnel. I will make up for lost time later.  The left side continues to get stronger but range of motion is definitely suffering, to a great extent because I am constantly balancing on that side to minimize the weight on my right.

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Not much has changed.  I am in a holding pattern with my right hip.  It feels fine and I am able to do certain exercises so not letting atrophy set in.  My left leg/hip is strong.  I am doing lots of exercise at the physical therapist’s but since I cannot do much with my right leg/hip, there is only so much I can do on the left.  Many of the exercises are very similar; wall-sits, squats, squats holding something for stability, leg-press/holds…all on one side only…  I am trying to focus more on stretching, since walking on my left leg all the time while keeping weight off the right is doing enough to strengthen my left without any extra exercises. The problem is that all this walking with so much weight on my left has a tendency to reduce my range of motion.  Hard to believe I am not even half-way done with my crutch-time on the right side.  I expect the frustration to build further…particularly with the approach of the big karate seminars coming up in less than 2 weeks!

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I went to physical therapy twice this week.  Did some stretching on my right side (2nd surgery) but since it seems that I am already more flexible in that hip than most people ever are, it is probably not worth pushing too hard.  I have been doing stationary biking with my right foot basically just strapped in for the ride. My left leg does all the work.  I have been doing other strengthening exercises for my left leg/hip.  It’s all going well; just frustrating feeling like I could do so much more than I am… I am still using the ice pack/machine a couple hours each night and strap myself into the CPM (automatic leg exercise machine) for most of the night. The problem with this is that “most of the night” for me isn’t much.  I typically do not sleep more than 6 hours/night and the past couple nights I have been awakened by my pager around 12:30 or 1:00am (just after having fallen asleep) to work for an hour or so.  So “most of the night” doesn’t turn out to be much when I’m only in bed for a little more than 4 hours!  Oh well. Better a little than none… I am icing as I write this, by the way.

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My left hip feels stronger and more flexible than it has been in at least a year.  My right hip also feels very good and I am just holding back due to doctor’s orders and the fact that I know he’s right…He poked 15 or 16 holes in my bone and those holes and the surrounding area need to regenerate and restructure and is as yet fragile.  Back to physical therapy tomorrow.

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I went to physical therapy yesterday afternoon.  As people who know me well can tell you, I am generally a very serious person in terms of working hard and not wasting my time, but I also like to bring a smile to people’s faces as I joke around.  So with that in mind, the conversation with my physical therapist was quite interesting… As soon as I saw her, I asked her if she made it to observe any of the surgery. She had told me she was interested and I arranged through the surgeon’s office for her to be able to observe if she wanted to.  She gave me a strange look and said “I can’t believe you are asking me that! We had an entire conversation before you went into surgery!”  Very strange… They had given me a pre-anesthesia “cocktail” while wheeling me toward the operating room.  The hallway started moving in strange ways around me. I guess this is the sort of experience I missed out on back in college because I was always so serious about my studies… Anyway, she told me that she came and was talking with a doctor and that I picked my head up and said “Hey Lisa!  Glad you could make it.  I guess I won’t be doing any exercises with you TODAY!”  So I was joking around coherently and have no recollection of it.  So weird.

<> Anyway, the therapy on my right leg is basically just stretching at this point.  I spent some time on the bike with both feet strapped in, but I was under strict orders to only use my left leg to pedal.  I then did a bunch of strengthening exercises on my left leg.  I have been balancing on that leg for the past 10+ days so it is definitely getting strong again.  Not much pain in my left hip now but I am not really pushing it because I am limited so much by my right side.  While strntching out my right leg/hip, it was noted that the flexibility on that side is almost as the same level as for my left.  So I am sure that once the bone heals in about 6 weeks, I will recover very quickly after that.

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It has been a week and a day since my 2nd surgery.  I visited the Dr today for a status check and to get my stitches removed.  We spoke quite a bit about the surgery itself, the recovery process, etc.   He told me that separating the icing and exercise machine portions of my therapy are perfectly fine; that they are just usually done together for the sake of efficiency, since most “normal” (non-professional/collegiate athletes) do not have the time to do anywhere near what is recommended for each part of the therapy.  He did, however, advise me to stick to the 30 minutes on / 30 minutes off cycle for icing, instead of doing it for up to 2 hours straight.  When he asked how I felt and I responded that I actually feel better on this leg than the other, he said that this was a common reaction.  Somehow, the feeling seems to be better in this version of the surgery than with the lesser version.  But in actuality, the condition of the hip is much more delicate.  He said I should keep to the 8-weeks-on-crutches plan, putting minimal weight on my right leg.  But he said I must keep moving the leg and suggested starting physical therapy visits soon so they could help me with this.

It turns out that the doctor poked about 15 holes in my bone (microfracture), which is basically to fill with marrow over the coming weeks.  I also had a labral tear.  So there was quite a lot of work done.   What was expected to be about 90 minutes of surgery time turned out to be well over 2 hours.

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