Hip Rehabilitation – 3 months

13- 19th August – pretty good week..

Had a good week with exercise. It really helps to do something every day and you certainly feel it if you don’t.

13th – Pool exercises and 10 lengths

14th Aug – Hydrotherapy at guys hospital to help improve hip range and power

15th – 30 min turbo trainer with 30 sec intervals x 4. Floor exercises lunges, bridges, ab work

16th Aug – Met my brother Rob who is a personal trainer at Starsgym http://www.starsgym.co.uk in Battersea. Session consisted of a sustained 30 minutes on the watt bike. The Watt bike was great for seeing how much pressure you put through the pedal comparing left and right. Also it improved your pedal stroke so you concentrated on the pulling up motion which in effect is using the hamstring muscles. It was a tough session and I did sweat! I also did 3 sets of lunges, squats with swiss ball, ab work in kneeling and bridging on ball.

17th – Brockwell lido pool swim – sunny swim in the outdoor pool. I cycled to and from the lido and I managed a 1000m swim with a few stops. Temperature was 20.6 degrees c. Quite chilly but after my friend Garith Brown said I was a wimp at not ever getting into lido (as it is too cold) I thought bugger this I’II show him! I felt my cardiovascular fitness was pretty good.  Hip is feeling comfortable and less achy. Worse time is after sitting for a while and then standing and walking. I feel quite stiff around the groin and my limping is more pronounced.

19th – Turbo trainer – 30 mins, 5 x 1 min intervals – sweating. It is boiling outside and as I leave it until after Lily is in bed I get attacked by mosses! Did my floor exercises also which consisted of the usual bum, tum and stretches

Hip Rehabilitation – Week 10-11

July 30th – 10 weeks post operation!

What I can do – I can do a lot now. Driving is comfortable, put my sock and shoe on in lying on the bed, squat down, walk without a crutch, get into and out of the bath.

What is still difficult – Still painful slightly mid thigh going up stairs, flexion of the hip stills feels awkward although the range is coming. In the morning my lower lumbar spine and sacroiliac joint (SIJ) on the right is really stiff and my hip movement is only 90 degrees (eases as the day progresses). Still difficult picking my daughter off the floor and worse when she is playing up kicking and screaming and worse still if she chucks her food everywhere (usually at my head) and I have to get on the floor and clean up, I really don’t like doing this.

Went to the gym and did bike for 18 minutes, walking 12 mins. Lots of stretching lower back and hip. Clam exercises x 120, plank x 1 20 secs, core abs, squats 12 x 3, lateral squats 12 x 3.

July 31st – Went to work for the first time! Had 3 patients. Was enough. Managed to walk to and from the train station and felt normal! What was interesting was, pre op I would catch the C10 bus from Elephant and Castle to the north side of Lambeth Bridge in order to get as close to Millbank Medical Centre to see my patients as possible. I did this to avoid my hip pain. Today I thought about walking from Elephant and Castle to Millbank (but actually didn’t have enough time) but instead, for the first time, was able to walk from the south side of Lambeth bridge without limping badly and suffering with pain. It was quite a moment. The simple tasks that I couldn’t do, I now could! Even before my operation I would even avoid the kerbs on the pavement to prevent pain. Mad eh?

August 1st – Felt really tired today. Probably a mix of working the previous day and doing a lot of walking, getting up in the night for Lily and having a bit of wine…. probably the wine?? Anyway we went to the Olympic park to watch the hockey. My thigh was achy slightly mid shaft so I thought I would take my crutch use in case. Glad I did as we had to walk for a 40 minutes to get to the stadium! I am sure the mid thigh ache will ease but it is sometimes a little disconcerting to have these niggles.

Exercise – walked 2 hours. Got on my road bike and cycled 30 minutes easy. I went to the Herne Hill velodrome where they had the 1948 Olympics. Good to be on the bike. Hip range exercises. No clams or bridges : (

Bradley Wiggins won the gold in the Olympic time trial!! Woohoo!

August 2nd – generally feel a little more sore in the leg and hip. Khilen the lead physio at fit8physiorooms videoed my walking in the gym. It was interesting as I still collapse in the lumbar spine over the right hip and my leg was rotating inwards. Perhaps this is why I hurt more. Looking at this video I feel there is a need to go back on the crutch for a while longer just to steady up the walking and level me off. Also there is a need to ‘up’ the hip strengthening exercises – abduction (clams) and extension (bridging).

Just did 20 minutes on the cross trainer.

August 3rd – did my exercises at Dulwich pool and felt really good afterwards. The discomfort before this session in my thigh has eased. Always feel relaxed after exercising in water. Clams x 100

August 4th – Nic’s dad and sister are flying over from South Africa for Nic’s 40th. Still have a slight discomfort in the thigh which makes weight bearing on the leg harder.

Went to the gym and did cross trainer f0r 30 minutes, stretches for back and hip, clams x 100, bridge on swiss ball x 3 20 secs holds, reverse wood chop really trying to weight more over the right foot which is slightly difficult, core exercises for abs, squats without weights, lateral squats. Got in the hydrotherapy pool at the gym which was soothing

Hip Rehabilitation – Week 9-10

24th July – I had my first bath with my daughter since the operation! It felt good to be sharing this with her and another hurdle I have overcome. Perhaps I could have got into the bath sooner but I only felt ready to do this now.

25th July – I managed for the first time to cycle on my road bike from home to Brockwell Park. It took me 20 minutes and I felt comfortable in the hip. My biggest worry was falling off but knew that was more irrational than anything else. It was lovely being back on the bike. I did not use my cleats, just trainers so i could walk with my bike if necessary. I also had a good gym session. 10 minutes warm upon the cross trainer and strengthen work for the hamstring and gluteals.

26th July – Khilen at fit8physiorooms mobilized my right facet joints and QL (quadrates lumborum a muscle that attaches from the pelvis to the lower ribs). He said my midline was towards the left and my pelvis on the right elevated but corrected once weight bearing evenly. When he corrected my posture it felt really wrong. Still a long way to go!

27th July – Olympics began today!

My leg does ache below my knee, around my shin. It feels like it is my back causing this

Swim session – pool exercises – heel raises, balance, squats right leg, hip flexion, abdustion, extension, cycling legs in the water – all exercises last 2 mins. Leg kick with float 8 lengths.

28th July – gym session – x trainer 20 mins, treadmill backwards walking 5 minutes on 5-8% incline, sideways walking 2 mins each way, hamstring curls with swiss ball, roll outs with ball for abs, press ups, kettle bell squats, leg press 15 kgs – 12-15 x 3 sets.

Nic massaged my leg which felt better. My back feels stiff this evening and  i am still not properly weight bearing on the right leg. My natural midline is definitely towards my left.

29th July – no real exercise routine today apart from stretching my lower back and flexing my hip. It is still really stiff in the morning and I can only manage 90 degrees. It does loosen but takes some time. My back generally feels out of balance and sitting on the right hip/buttock is foreign to say the least. You would have thought at 10 weeks post operation this would be better. Perhaps being a physio with a new hip I can see that there is still a long way to go in terms of weight bearing properly over my new hip and normalizing my gait. I was after all moving so badly pre operation it is to be expected I suppose.

Hip Rehabilitation – Week 7-8

10th July – Hydrotherapy at Guy’s hospital. Good workout as quite controlled. Spent 2 minutes on each exercise – hip flexion, heel raises, squats one leg, hip extension, hip abduction, knee flexion, balancing, lunges and step ups. Felt relaxed afterwards. The water really is key to hip rehabilitation.

13th July – Pool exercises as per Guy’s hospital routine. Swam a few lengths concentrating on leg kick.

14th July – drove to Southwark park and walked with Lily in the rain without a crutch. Felt good. No aches. Went to the gym later for a 20 mins cardio vascular session on the cross trainer and leg strengthening exercises as per Stef’s program.

15th July Sunday – felt good today in terms of my hip. Felt equal on my legs. Still have a slight weakness on right leg and this is more noticeable when standing on that leg. I can walk independently (no crutches) with a mild limp that does not really require an aid. Even so my walking is so much better than pre op it is quite remarkable.

Good week with hip. Progressing well.

Hip Rehabilitation – Week 8-9

Sunday – felt good today in terms of my hip. Felt equal on my legs. Still have a slight weakness on right leg and this is more noticeable when standing on that leg. I can walk independently (no crutches) without limping or with a mild limp that does not require an aid. Even so my walking is so much better than pre op it is quite remarkable.

16th July – Felt ill today. First day with no exercises!

17th July – gym weights – kettle bell squats 4kg 12 x 3, hip flexion using ball 10 x 3, dead lift with 10 kg 12 x 3, clams x 150, bridge with feet on ball x 3 20 secs hold, plank x 3 30 secs, press ups x 12 x3, abdominal bracing x 10 sec x 3. My core abs feel really weak and difficult to recruit, need to work harder on this.

18th July – pool exercises. Working more on hip extension, abduction and hamstring cycles in the water. Swam 10 lengths.

21st, 22nd July – Did not do much exercise apart from the odd clam and bum exercises plus trying to encourage more hip flexion. I did do more crouching down and cleaning floors plus a bit of gardening. Also did more stairs as we were refurbishing our house which has too many stairs! This did ache my thigh more especially going up stairs.

Not such a great end to the week probably because I have taken my eye off the ball and not quite as good with my exercises.

Hip Rehabilitation – Week 11-12

11 weeks post op. Not the best week. I certainly have felt better in the earlier weeks. I think the reason for this is weakness and continuing imbalance and not being able to find my midline. I am still not weight-bearing over my right leg very well. However it dawned on me that I am still not strong and that I need to do a lot more to get to where I would like to be which is walking the fells in the Lake District.

August 6th – Went to the gym. 15 minutes on treadmill (controlled walking forwards, backwards and sideways – thighs hurts during walking backwards when flex knee) and static bike for 15 minutes. Floor exercises – clams 100, bridge on swiss ball and hamstring curls, squats with medicine ball 4 kgs, press ups

August 7th – thigh hurting but more towards the knee. I am trying not to focus on it and doing my best to rationalize. Going up stairs is tricky again and I really need to hold onto a banister for support. However I felt the lowest today than I have felt so far due to the discomfort. I am not sure if I am over doing it or not, it is really hard to tell when you have a replacement hip. Even as a physio I find this very hard to gauge. Nic says my walking is so much better but I know myself it is not quite as good as a few weeks ago. It does feel slightly clicky on hip flexion but I cannot tell if this is my new hip, my pelvis, my coccyx or back! I know that my hip abductors are not strong and my hip rotation also the same. I went to sleep at 9pm as also very tired. A new day tomorrow so lets see how it is.

Went gym – 25 minutes on the cross trainer, stretches, clams

August 8th – swam 28 lengths of 25m pool, hip extension, abduction, leg circles for hamstrings.  Took it easy today. I did walk with Lily and the push chair which does improve my gait. This evening I just have a mild ache outer knee and lower leg, probably my back causing. Usually any pain below the knee is considered to originate from the lumbar spine.

August 9th – realized today I need to do a lot more hip strengthening exercises. My leg does feel weak going up stairs and standing on one leg is still difficult. It is much better but I realize I really need to do a lot more. I think I slacked off slightly after week 8 due to other distractions and life really. i had to start looking after Lily more myself. Back to being a mum.

I have done a few clams x 100 and bridges plus walking to and from the Olympic volleyball at Earls court from Clapham junction. Managed well but certainly tired on the way back,  we decided to get a bus. Walked without an aid but did hang onto to Nic a bit for more support. Wearing trainers still.

August 10th – felt good this morning. more balanced but became more achy towards end of the day. I walked from home around Brockwell park with Lily and did my clams and a set of floor exercises.

August 11th – Achy today, both hips, lower back and left knee! What an old croc I am!

Went to Dulwich pool. Swam 22 lengths and did water exercises for hip. Felt better. Did lunges x 40 each leg. Helped thigh pain.

August 12th – Got on my turbo trainer today for the first time and managed 20 minutes well. Lunges, press ups, core exercises.

I need to do more strength work for the thigh (quadriceps), buttocks (gluteals) and back of the thigh (hamstrings) in order to reduce the aches and pains I have been feeling over the last few weeks.

Hip Rehabilitation – Week 6-7

Day 42 – Monday. Did my morning stretches to bend the hip and loosen the spine. So stiff in the morning! Managed a controlled walk for 20 minutes, practiced walked backwards and sideways.

Pool exercises for 15 minutes and then swam 0.5 mile front crawl and crawl leg kick. I felt  really good afterwards. My hip flexion is definitely easier in the pool but cannot quite bring knee up to water level yet.

Day 46 – Saw Marcus Bankes my surgeon at Guy’s hospital. He seemed happy with my progress. He assessed my hip movement and we discussed the fact that my hip flexion was a bit stiff (or more awkward) and he told me that I may not achieve full range of hip flexion. I said this was my hardest movement to gain. Everything else being much easier i.e. hip extension, abduction and rotation etc.

Went to Gloucester for the weekend with Nic and Lily to visit Dawn and Greville on their farm. We had a lovely time and I managed to sit in the car at 6 weeks post operation feeling ok with some discomfort and I managed to drive on the M4 well although not for too long. I do have a cushion on my seat to raise decrease the amount of hip flexion. During the weekend I did not really do any pool or gym exercises except for a few floor exercises including the clam, bridging, abdominal exercises plus hip stretches. I managed to walk with out a crutch fairly comfortably. I also managed to climb into Greville’s fixed wing 4 seater aircraft with Nic and Lily and Fatima. It was great even if it was a little tight squeeze for my hip in the back seat! Also did my first 4×4 around Greville’s farm in the mud and pouring rain.

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  medicine 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.

 

Hip Rehabilitation – Week 4-5

Day 29 – Tuesday. Claire picked me and Lily up and took her to her house again for the day. I felt a lot more stamina today than last week and was able to do a bit more with Lily  which makes me feel more of  mum again for her. It is hard when you cannot scoop her up off the floor as you may compromise your prosthesis. I just need to do this for another 2 weeks (6 weeks post op) and then start attempting picking her up. My hip felt a little niggly today around the front/outer of the hip.

I used the gym and was able to do the cross trainer for 8.5 minutes and was quite puffed. it has been a while since doing any aerobic exercise but still it felt good! Tried back ward walking and sideways walking for 4.5 minutes. My walking has so many bad patterns that backwards walking helps undo this. In fact walking backwards looks better than walking forwards!

Day 30 – Felt tired today and decided to have a quiet day. Still did my essentials – clams, bridging, core exercises. Walked 30 minutes with crutch.

Day 31 – Had a Guy’s Hospital physiotherapy appointment to see if I could get a referral for hydrotherapy to strengthen the hip. The appointment was useful as it made me think about the quality of my exercises.

Went to Dulwich pool and managed to swim for 14 lengths – combination of crawl leg kick with float and front crawl. I felt good after this as felt like a real achievement. Did my usual leg exercises in the water.

Day 32 – Saw Stef at his place. Had manual treatment to loosen hip and spine. Hip flexion – 100 degrees but still difficult. Hip rotation is coming. Still a bit tight and pinchy on hip internal rotation but due to soft tissue tightness over incision. We went to Virgin Active exercises I did were: walking backwards and sideways on the treadmill – slightly awkward and sore in the groin and over incision, cross trainer and bike really good, weights – controlled dead lifts , squats, swiss ball pelvic rotation and sideways weight transference, lateral side steps using a block, hip flexor stretch. Felt good. Walking around the gym is hard without a crutch and seeing the hip drop on the operated side is still quite obvious.

Day 33 – Saturday. I was a bit achy after treatment and gym session yesterday so thought I would rest over the weekend. Continue to do hip range exercises and clams. I am walking well without crutch around house and garden. Just joined the gym at Brockwell Lido Herne Hill today! Great feeling to get here. Can’t wait to have a session!!

Day 34 – Managed first long drive up to Derbyshire from London to visit my sister and her family. It is my nephew Ben’s 9th birthday. Nic drove. I found the still quite uncomfortable but certainly better than it has been. I felt easier having the seat more upright. My hip does flex better but my biggest problem is my coccyx which aches like mad sitting. The coccyx pain has been with me for about 20 months (since having Lily) and I think just got worse with having hip bad and walking so badly before the operation. The reason for more coccyx pain is I am still struggling to sit upright whilst the hip is flexed to 90 degrees, it feels like there is a block in the hip.

Walked for 20 minutes with my sister at 11 in the evening after England had been kicked out of the Euro 2012. Rubbish. Bec and I had a nice chat and talked about her ailments and mine and how we are improving together! Ironic really as both of our issues have been made worse due to pregnancy and child-birth. Weight gain, loosening ligaments and decreased strength does not help any already underlying pain.

Land exercises – clams x 200 – bridging x 2 20 sec holds, hip bends (flexion) and out to the side (abduction) – abdominal exercises – walking practice.

Day 35 – Five weeks post hip replacement! 

Said goodbye to my sis and her family and we drove from Derbyshire to Manchester to view a property. Managed to break up the journey and stretch on the way. My hip and coccyx was more comfortable today than yesterday’s journey, might be getting used to sitting or perhaps the fact I took 50mg Diclofenac and 2 paracetamol?? It does help if I feel niggly. Drove back to the Peak District and stayed at the Yorkshire Bridge Inn on Ladybower reservoir.

Land exercises –  abdominal exercises – bridging x 3 20 secs holds – clams x 200 – walking practice forwards, backwards, sideways for 40 minutes – leg swings forwards, backwards and sideways. I will start my formalised gym session tomorrow at Brockwell Lido, Herne Hill.