Hip Rehabilitation – 6 weeks

It is quite amazing to get to this point, 6 weeks post hip replacement, after worrying and fretting like mad before the operation thinking, what if I died on the operating table or what if I ended up with no leg! They were stupid irrational thoughts, but they still whizzed through my head.

I should have known better than to think like that especially as I am a physiotherapist and do actually work as one. Still, it is much better being on this side of the operation, much better. My hip feels really good. My nasty ache has gone and I can now walk without that awful biting pain.I look back and think how on earth did I live with that pain for so long. I wince thinking of the pain I had, it was truly awful. However I do not think I should have had the hip replaced any earlier, as I was not ready for it. Mentally I mean. I felt to have this operation or any for that matter, it was really essential to come to terms with having it and feeling 100% ready. I thought not to be 100% (or as close to 100% as possible) must have an impact on the post operative care and rehabilitation.

I saw Marcus Bankes on the 20th December 2011 and he told me my hip was badly worn. At this point, ignoring the scans and x-rays, I wanted an arthroscopy to tidy up the degenerate hip, but Marcus just said I do not think I would be able to even get the camera in the joint space. Really? Is it that bad I thought? Surely he could manage a scope. He showed me the x-rays (which I could bearly look at as I couldn’t face the truth that my hip had deteriorated so badly since my MRI scan in 2006) and he too was shocked at what he saw and certainly wasn’t expecting that as my hip movement and mobility did not appear to be that bad. He pretty much said a replacement hip was the only way to go. I was gutted.

After swearing like a trooper in front of my surgeon (then apologising the next day via text for my filthy mouth) I saw my brother (who was there helping me with Lily) who looked at me and must have thought the worst. We walked to the river at London Bridge to chat about the outcome. I just sat there stunned whilst Lily was running everywhere. I needed time to think this through although at the same time I had agreed to go on the waiting list.

I waited about 5 months and during this time my hip definitely got worse. Whether it was actually deteriorating further or psychosomatic I don’t know. What did happen during this time was I decided to do less weight-bearing activity, walking, and continue with my cycling commute, swimming and strengthening exercises at least 3 x a week. I gave up alcohol for 5 weeks and ate well. I lost some weight around 2kgs. Walking did get worse and my gait pattern looked terrible from the passer-by although I couldn’t see it. I was unable to weight bear on my right leg without massive compensation and lateral spinal flexion.

1 month before the operation I probably was about 80% there in my head but still not convinced. What did help was speaking with other female hip replacements, communicating with my surgeon, doctor and physio friends, knowing all the pros and cons of your surgery and saying goodbye to your worn out hip. I think I was grieving for my loss. To accept a foreign hip felt really quite hard. I did get there in the end with he help of a lady who works on the subconscious mind and speaking with Marcus and his fellow-man on the day of the surgery. The latter part felt like a god send and set me up perfectly for the procedure.

So 6 weeks on I can do a lot more. I can drive short distances, nearly put on my sock, I can sleep on my unoperated side with a pillow in between my legs and walk without a crutch but still use an aid for long distances. What was really good was I spent the first whole day and night on my own today and managed to be ‘mum’ to Lily for the first time in ages, even before the operation. I walked Lily to the park in the push chair and put her on the swing. We even went out later on in the day just Lily and mum for a walk down the road, which felt really normal and so good to be able to do such simple tasks again without pain. Just small things like this means so much. I have a new lease and it feels it is the start of new things to come…

Hip Rehabilitation – Week 5-6

Day 36 – Drove home from the Peak District to London. Had a few stops to stretch the hip as sitting for long periods is not that comfortable.

Went to the Brockwell Lido gym to do my first session. So excited! I followed the program my physio Stef Brennan had given to me. I have two schedules to follow which I will add separately onto the blog. The exercises I am doing are functional to daily activities with a lot of weight-bearing (closed chain) exercises. Today, I followed the cross trainer for 15 minutes low resistance then exercises to strengthen the legs and core. Squats with weight over head, hamstring/leg curls on a swiss ball – this is quite hard for me so I concentrated more on bridging with my feet on the ball and holding for 20 seconds x 3, roll outs with the swiss ball for abdominals, lateral step ups on a step x 30, kettle bell squats with 4kgs in my hands. Warm down stretches.

Day 37 – Did my morning exercises to loosen the hip which is mainly hip flexion and abduction. An exercise I find useful is, stand with my back to the wall and press my lower spine into the wall. Then bend my lower back as if to slide my hands towards my toes, maintaining my abdominal bracing or core, really seems to free off my stiff lower back. I do this twice. Helps.

Marion came over to take Lily and I to playgroup. I still need help with Lily in terms of picking her up but another 2 weeks and I think I can do this myself. Right now though chasing Lily is a semi flexed position is not desirable as I load my ‘good’ leg far too much still.

Day 38 – Managed to drive the cruiser to the gym. Felt really good and at last independent! I did the second program Stef gave me. It consisted of bike for 15 minutes, then medicine ball figure of 8’s in a slight squat, wood chop exercises (rotation of the trunk) with ┬ámedicine ball, drinking bird which is weight-bearing on the operated leg. The drinking bird is very hard for me. I can only do this if holding (for dear life!) on to something and then it is not that good. I will video this exercise. I would only do this if the patient is fairly fit and stable and sensible with training and exercises. Treadmill exercises – controlled walking forwards, backwards and sideways on an incline. 1 minute each direction.

Day 39 – Tired today. Took Lily swimming with Nic. Not ready to do this on my own yet with her especially when she lies on the floor refusing to get up! Did pool exercises and managed a breast stroke leg kick with float but will not be doing breast stroke until 10 weeks post operation. Walked for 22 minutes with a crutch more for evening my walking.

Day 40 – Nic drove me to the gym for my third session. Followed my physios program for 50 minutes and felt really good. Did 15 minutes warm up on the cross trainer/static bike. The static bike is quite difficult as hip flexion feels slightly awkward. Squats with weight over head, bridging with my feet on the ball and holding for 20 seconds x 3, roll outs with the swiss ball for abdominals, lateral step ups on a step x 30, kettle bell squats with 4kgs in my hands. Warm down stretches.

Day 41 – Sunday – I am 6 weeks post surgery tomorrow which is amazing. I have been thinking how my pain has completely gone and how I can stand on my two feet without being in agony and wishing to sit down.

I had a bit of a rest day today apart from a 20 minute controlled walk concentrating on heel strike and toe off and walking backwards. I can sit better in a car and can nearly put my sock on whilst lying on my back. Hardest time is trying to bend my hip whilst lying on my back first thing in the morning. It is stiff and feels quite blocked. Hip flexion is still tricky but I it is improving slowly. I am probably about 100 degrees.

Exercises – clams x 100, hip flexion/abduction, bridges, stretches.