5 weeks post op: hip labral repair

I am now 5 weeks post op from my hip labral repair and cam osteoplasty (shaving down the impingement). My physical therapist (Dr. Lucas Johnson at Atlantic PT) has been really great at helping me find my limits. He lets me do what I can but is very clear and detailed on how to progress with swimming and biking. During PT sessions, as soon as I am doing well with an exercise, they change it to make it harder, even mid set, and I appreciate that they are interested in really progressing me. They keep telling me that I am progressing very very well and it helps to know that I'm on or above the recovery curve.

Disclaimer: everyone has different recovery, even for the same surgery. I wanted to share my road back in hopes it will help others going through something similar, but keep in mind that PT and recovery from surgery is done on a very individual basis.

About 1 week post op I was able to get on the bike for 5 min in the easiest gear. I received instructions to bike every other day, easiest gear, and add 5 min each time. One I got to 60 min (this past Sunday), I was able to go down a couple gears for alternating 5 min on/10 min back to easiest gear. I have to do a workout on the bike twice before I can make the intervals harder. I can also start adding time in intervals of 15 min. I will get more clarification today but might try and bargain a little since the biking is going really well as far as no or very little post ride soreness.

Until very recently I still needed to leave my shoes clipped into the bike because I couldn't rotate my hip enough to unclip. I also had to use a step. Now I don't need the step but still have to very carefully get on the bike.

Brian got on the trainer next to me for my first hour long ride this past weekend. It was fun to ride "with" him. I'm not sure when I will get to go outside but I am looking forward to our rides together. I love riding with Brian, and have also had lots of people saying that they are willing to ride with me on my road to get back, so that will be really fun.

During my last update I had just gotten in the pool to start pulling. I would typically do one workout a week just steady pulling alternating with and without paddles, then two workouts at masters but doing the whole set as a pull. Last week (4 weeks post op) I got the clear to start kicking a little. The PT said I was allowed to do half the set (I've been doing 3000m each swim) with the kick, but to take it easy on the kick. At first swimming was really awkward and the kick was uncomfortable. Today's swim was really the first one where I felt like my kick was more natural and starting to come back. Typically I go to masters 3 times a week (or swim steady for one workout on my own), and alternate parts of the set swimming and pulling. Today I even did a little backstroke and breast stroke. However, it will be awhile before I can do the breast stroke kick, so for now I cheat (not a problem for me, I am awful at breast). Good news is my pulling is getting pretty awesome, and I'm able to work on balancing out my stroke since I was pulling too wide on the right. Swimming with the kick was making me pretty sore for a day or so. Today was the first day swimming where I felt good after, so that was extremely encouraging.

I love my masters swim group! My new shark swim cap is awesome, makes me happy :)

I have been using my Primal Sport Mud religiously because it really helps keep any post-activity soreness at bay. Sorry no pictures of the mud actually in place because of the area of my injury :P

This past week was tough on me mentally, and I want to be honest about that part. Weirdly, hearing that it was difficult for others kind of made me feel less crazy. Going into surgery, I had somewhat realistic expectations about when I'd be back running. However, I had been a bit overly optimistic about what the swim and bike progression would be like. I had gotten it into my head I'd be able to bike relatively normally shortly after the surgery. When I got to 5 weeks post op and my "intervals" were 90W and Zone 1 (out of 5) for HR, I couldn't help but get frustrated. I think a lot of that frustration stems from feeling really good biking, and feeling like I could do much more, but still having to be smart and hold back. A friend reminded me yesterday to really take one day at a time. I was getting overly excited about next season, and wanted to start training right away and it was a good reminder to just focus on what I can do now. I am still going to try and bribe my PT into slightly more biking with some treats this afternoon though :)

Truth be told, regardless of wanting to do more, I am still grateful for what I am able to do. I was looking at my training peaks the other day and it's pretty awesome that I am already up to 8 hrs of activity last week (I included PT sessions as strength sessions). Even if the activity is not as intense as I'd like it to be, and it's not training per se, it feels great to be moving. That number will just keep going up from here, and the intensity will come slowly.

I got my shark cap and this funny shirt (below) to keep workouts fun and entertaining. At this stage I am up for anything within my imposed limits and am excited about any way to have a little fun with it.

Another part of the frustration this week actually had nothing to do with triathlon. When I knew I would be taking this break, I thought it would be a good opportunity to do some different activities. Well four weeks post op, I started to realize that a lot of the activities I really love to do all happen to be outside and are mostly physical. I hadn't completely realized how limited I would be in other stuff. For example, I can walk, but not very far, so no long leisurely walks with the pups. I had hoped to get into paddle boarding but at this stage it would involve too much core strength and stability (no core until 6-7wks post op). It took me me a little to come to terms with all of my limitations, not just the triathlon related ones. Brian helped me to figure out what I could do though, and we have come up with some fun activities for me to do, such as:

Taking the pups for swims, the pond isn't too far from the parking lot, they are well behaved and it's really fun watching them play in the water.

Playing fetch with the pups in the yard out front. I can walk them about 0.5-1 mile max but can get some more of their energy out with fetch.

I can't load and unload the kayaks myself but Brian took a day off spear fishing so we could go kayaking all together with the pups. No one got wet so pretty successful first time having the pups in the boats.

I went to Starbucks on a weekend morning and just sat and drank a coffee and read a book. Haven't done that in who knows how long.

I actually went and just sat on the beach for a little while this past weekend (I wear the Zoot Sports bikini allllll the time, love how well it fits).

I always forget to take pictures, but we have also had a lot of visits and outings with friends we don't get to see enough. It's been really fun to kick back with everyone and catch up. I hope to be better about continuing to get out with everyone even when training does start back up.

Just a side remark. The Hampton Roads athletic community lost a really awesome person recently (Ernie Leber). I had only ridden with his wife a couple times and had only met him a couple times, but the outpouring of support from the community really shows what a great family they are and what a strong community we have. He was very involved in the Team Hoyt group and in lieu of flowers they have asked for donations to support racers involved with Team Hoyt and Ainsleys Angels. I hope everyone will consider donating.

https://www.crowdrise.com/ernielebermemorialracefund 

Recovery hip labral repair: 2 weeks post op

I wanted to write a bit about my recovery from surgery to repair my labrum for a couple reasons: 1. I'm a bit bored not training :P and 2. I'm hoping it might help someone else going through it since I'm learning it's a somewhat common injury.

I chose to have surgery with Dr. Andrew Wolff out of Washington Orthopedics and Sports Medicine. During my first appointment we decided surgery was the best option given my type of tear and goal to get back to full function. He was very thorough and despite my panicked email that I was making the right decision, assured me that surgery was inevitable and would be best for my return to competing at a high level.

My surgery itself was a bit of an ordeal but ended up working out very well. I had to be in DC at 8:45 AM so we had left the house around 4am. We were almost to the surgery center and got a call that there was no power due to a downed tree and they would call when I should come in for the surgery. We were so close so we went in anyway, hung out in the waiting room all morning (I was so hungry!) and then finally went out to go for a walk in a local park when they said they would call around 2pm. I was just excited that I was cleared to drink some Gatorade!

                              

The doctor actually called a while later and let us know my surgery had been rescheduled to 4pm at a different surgery center. The patient before me had a bit more going on than expected so my surgery started around 6pm. I had a wonderful pre and post op nurse. Here is a very unflattering pre surgery picture:

After the surgery, Dr. Wolff spoke with Brian and let me know that the tear was larger than what the arthrogram had indicated, so surgery had been the right decision. There was also a bony growth (CAM impingement) on my femoral head that was likely pinching the cartilage and causing the tear, and needed to be shaved down. I very slowly got down some animal crackers and ginger ale (in between naps). I finally got to try getting around on the crutches, immediately almost puked and had to wait again. We finally got to leave around 9pm. Poor Brian drove the 4hrs home, with me not being very entertaining, and we got home at 1am.

I have a couple machines that I spent quite a bit of time in. The first is a Continuous Passive Motion machine that lifts and lowers my leg at whatever degree of flexion it is set at (started around 30deg and instructions to go up to 70deg). That one is 3 hrs a day for 3 weeks.

The second is a compression/cooling machine that reduces inflammation and decreases the chance of getting a blood clot. The non operative leg piece wasn't working but my Zoot Sports compression sock was an excellent substitute. In fact, I've been going through all my Zoot gear despite not working out, since it's sooooo comfy.

I can't believe how much he was able to do in just two small incisions! Modern medicine is pretty awesome. I am definitely feeling better already than I expected I would, and I am sure a huge part of that was picking the right surgeon.

Brian was very helpful, but also very encouraging of me getting up and around and learning to do things on my own. I really think that my moving about a bit right away helped in my recovery. I was very careful, and moved slowly, and still spent a lot of time down, but it was great to at least be hobbling around. A couple days after the surgery I was getting a bit bored and sick of Netflix, so we met a couple friends at the brewery nearby. I just had some of their homemade soda, but it was nice to be out of the house. Our friend John, who just broke his knee, met us out and the bartender referred to us as Scratch and Dent.

John getting unsolicited advice that he shouldn't wear his knee brace...

Scratch and Dent out and about

June bug has been an excellent nurse and does not like to be far from me when I have to be in the CPM machine or am just taking a breather.

       

However, she is not as understanding when it comes to fetch. She is at least getting better at her drop accuracy. But if she thinks the ball is within my reach, and I disagree, she gets very frustrated.

The weekend after my surgery, I had my 28th birthday. I was kind of bummed that we couldn't do much, but Brian made me a cool pop up card and we got coffee and took the pups to the park to run around. I can at least use the throwing stick to toss balls for June. He also arranged for some friends to meet us at a pottery painting studio for some non-mobile fun, followed by Ritas and then a nice dinner out for the two of us. All in all, a really fun day, even on crutches.

Surprisingly, some of the hard things to do are: sitting for long periods, and putting on my sneakers... This is as far as I got one day before Brian intervened.

He also bedazzled my crutches with bike bar tape since the grips were all sticky.

I have started physical therapy at Atlantic PT with Lucas. He has been great and was very optimistic. At my first appointment (about 1 week post op), he said my range of motion and weight bearing capability at this stage was really great. In the first few weeks the main goal is to wean off the crutches by bearing as much weight as is comfortable and walk as normally as possible. 2 weeks post op I am down to one crutch due to a slight limp, but doing well and as soon as I master one exercise they make it harder, which I love!

                               

Up to 70 deg of flexion in the CPM machine! I drink my Beet Performer in it for all of it's anti inflammatory an antioxidant benefits.

Crutches on the beach were more difficult than anticipated...

Our friends visited with their little ones, it was tough to not be able to run around and play with them but we enjoyed brushing the pups and reading books together.

At my two week post op appointment I got my stitches out and got some instructions for easing back into biking and swimming. The top row is the tear and the third row down is the repair.

Two weeks post op and I was able to pull 2000yds in the pool and get on my bike in the easiest gear for 20 min. Definitely less than what I was used to, but it's a start to getting back. Feels great to be able to do what I can.

I had expected a much different type of wrist band the weekend of June 28th, but I am confident I will be back at it and more motivated than ever.