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Sunday, December 14, 2014

Lessons learned from my left hip

It's been six months since my left hip surgery, a labral debridement with femoral head reshaping. It was an ordeal, but I wanted to share lessons I learned in case others are considering - or just had - this surgery.

- It is a big deal. Don't let "outpatient procedure" fool you. You are under general anesthesia, intubated, and you are having major hip surgery with a long, long recovery.
- It doesn't hurt very much right after. It's arthroscopic, so it's nearly painless. The pain comes later, weeks later, as the bone heals.
- There is very little consistent information available about the procedure or the recovery, so don't let what you read on the internets make you panic. Some doctors have you on crutches for days; other for months. Some give a brace for weeks, others no brace at all. PT recs and return to activity timelines are vastly different. Reports of how you will feel at certain points can be diametrically opposed to how you actually feel. Fret not. Every hip is different!
- You must move the joint. This is so important! While you have to protect your hip flexor to avoid long-term hip flexor tendinitis, you also have to use your joint early and often. As early as the day of surgery, get it moving. You can use a continuous passive motion machine, but if I could do it again (hey, I am doing it again!) I'd hit the exercise bike, too (no resistance). You have to move the joint to promote healing and reduce scar tissue formation.
- You must rest a little, too. I went back to work Monday after a Thursday procedure. Bad idea. It was too soon, and it prolonged healing time. You CAN go back to work after a few days, especially if you have a desk job, but if you have to be active at work, I don't recommend it. I'd say take 5 days minimum.
- Do your PT like it's your job. This is major surgery, and you have a lot of rebuilding to do.
- Let pain guide you at first. While you are still on crutches, you should not do anything that hurts.
- For the 4 - 8 weeks post-op period, you will probably be in pain. You should minimize pain (do not push though pain, and tell your therapist if your exercises cause any pain), but you should not panic if you feel pain later in the day after walking or other normal activities.
- After your labrum is fully healed (8 weeks if debrided; I think 12 weeks at least for repair), you are going to have to push through some pain. The area is probably stiff and full of scar tissue, but you are now at a use-it-or-lose-it point. Your PT should have you doing more stretching and some aggressive strengthening. Listen to him. You've got to do it or you'll lose range of motion and muscle tone.
- Returning to sport is gradual, and should be guided by your pain and tolerance. Don't do anything that hurts WHILE you do it. You might feel soreness and stiffness later. Continue to aggressively stretch and strengthen!
- You will get well. You might not get to 100%, but you'll get better, and it might sneak up on you!
- It is worth it. If you are considering surgery and are on the fence, you've probably read things online like, "Almost everyone has a labral tear in their lifetime" or "It's an artifact and not the true cause of pain" or "Femoral impingement is a myth." Sorry, I don't buy that. I was in so much pain when I tore my labrum that I could not touch my foot down. Five months after surgery I ran a painless sub-20 5k, very close to my original level of fitness. The difference is astonishing. I'm not as good as new, but I'm about 98%, and that's a far better outcome than I expected. You don't want to live your life in chronic pain. Do it!


  1. This is such good info to be sharing with anyone who has to undergo the procedure or is deciding whether or not to.

  2. That's great Grace! Do you think you stretched more than normal while going through PT? Did you gain flexibility in the long run?

    1. I did a lot of very intense stretching once I was out of the brace and mobility restrictions were lifted. It helped the stiffness a lot. While in the brace, you're locked at max 0 degrees extension (leg back) and 90 degrees flexion (leg up), so I had lost a lot of flexibility. I gained more flexibility post-surgery than I had pre-surgery, but I think I had lost a lot before surgery just from being so weak and injured.

    2. Yeah, I figured the result was probably increases flexibility after the surgery, if nothing else, because you wee much more conscious of it

  3. It's so great that you can say it was all worth it. That's how all surgeries should end! This reminded me of my husband who had knee replacement about 18 months ago. He went through much of what you did (working too soon!) and would also say it was totally worth it.