We started our overland journey from London to Johannesburg in January 2013 – seven months after my total hip replacement. It was at this point I felt my hip and leg were mobile and strong enough to make the trip as I had a good few months of rehabilitation under my belt. However I was a little concerned about the lack of movement and sitting for long periods which could tighten up my hip flexors and weaken my gluteals.
Interestingly, I was half contemplating taking a mountain bike and my turbo trainer! I remember my brother saying I should take your bike and just do some awesome cycles through Europe and at the same time keep fit. I thought it would be bonkers for me to take a bike on such a long journey and become some rehab junky! If we were traveling alone and not with Nic’s dad in his car then possibly I may have brought the bike and Nic also and we would have then taken it in turns to cycle whilst the other drove with Lily. Instead I took my exercise mat, my trainers and a 5kg kettle bell.
Looking back I think the trip and the rest (not going mad in a UK gym) did my hip some good. Although we sat for long periods, climbed into a raised suspension Land cruiser, put up tents, made fires, collected wood, climbed up the ladder into the roof tent, pulled luggage and water containers out of the vehicle and ran after our 2 year old, my hip generally felt good. One other interesting point to mention was having to start squatting down for a wee. The toilets in Greece turned into a ‘hole in the floor’ which initially was quite challenging to do especially as the position requires a lot of hip flexion and there is always a possible risk of dislocation in the back of your mind. In Africa the toilets were mostly dirty ‘holes in the ground’ or behind a bush! However the squatting practice certainly seemed to make my hip more flexible and strengthen my leg considerably without seemingly doing any harm to my new joint. The more I practiced the better I became!
I managed to exercise well in Europe and Israel (3 x a week) by walking, swimming, doing my hip stretches and gluteal strength work. However, my plan for Africa would be to do at least one cardiovascular exercise a week which would be a mile swim (if I found a pool!), 30 minutes on a bike (if I found a gym!!??) or a 30 minute walk. Egypt was a bit more challenging. I managed to find a swimming pool in Nuweiba and we snorkelled in the Blue Hole in Dahab, Sinai Desert. Walking the filthy streets in Cairo with Lily in her push chair dodging the burnt out cars and puddles from the water cannons in Tahrir Square the night before, was all we could manage. Aswan, Egypt was a good base as we were there for a week waiting for the Lake Nasser crossing and we found the pool at the Old Cataract to be perfect! Once we were in Sudan exercising became much harder as at 45 degrees it was just too hot to do anything. Surprisingly I did do my exercise regime at least once a week through the rest of Africa – Ethiopia, Kenya, Tanzania, Malawi and Mozambique which was just enough to maintain and keep ticking over.
Overall I would say driving from the UK to South Africa with a total hip replacement was definitely manageable and worth doing!
I am now 3 months and 3 weeks post new hip. All seems to be doing pretty well apart from what I thought was a set back a few weeks ago (around 11 weeks post op) when my mid thigh started aching and I had difficulty going up and down the stairs without holding on to something. I then released that I was still very weak especially in my quadriceps. It was my friend and physiotherapist colleague Jose Marcelino who said perhaps you are not strong enough. Strangely I hadn’t thought of that. I think you get so caught up in your post op recovery and noting every sensation or discomfort with the new prothesis you forget somehow that perhaps you are just not strong enough and you need to step up the exercises. I was doing squats but thought I would try lunges aswell. Now I have increased the number of thigh strengthening exercises (lunges) I do not feel my thigh pain and walking up stairs feels stronger.
Life for me really started to improve at around 3 months post surgery but even more so at 3.5 months. The recovery was quite amazing. Since getting back on my bike again to cycle to work (16th August was the first time – 3 months) I have felt stronger and certainly more able. I have done this commute now 3 times and tomorrow I am thinking of cycling to Kingston which will take around 1 hour, as long as it is not raining…. I only got back on my bike when I felt confident enough and able.
My relationship now with Lily is quite normal now and I can lift her and hold her where by for the first 6-8 weeks I was not really able. You worry as a mother that if you cannot do the basic things with your baby it may affect them. There was a period after surgery where she did go to daddy a lot more. Now she holds her arms out to me more and I am able to hold her for longer. I was in Battersea Park today with our friends Ginty and Stuart who adore Lily. I was able to hold and carry her for much longer with out pain in my hip! Amazing. This was something I could not do before my operation and if I did it was literally for a few steps and then I would have to hand her over to Nic due to the biting pain in my groin and outer hip.
I am now just over 8 months post hip replacement and I would say now that although I am a lot better, I am not in my opinion right yet.
I am probably 75% better. The other 25% would consist of continuing to strengthen the leg, balancing on the leg, running after my 2 year old and being able to walk up and down stairs comfortably. I still am not able to hill walk (properly yet) or ski as I am not confident enough on the leg as it just continues to feel weaker. I definitely have strength issues my operated leg and I really do not know why. Perhaps as my friend said things take longer especially when you are a younger and a higher performance person and have higher expectations. This could be true but I am still unsure why I find it hard to do a mini dip/squat on the operated leg 8 months post op.
One of the thoughts I have for this are my hip abductors. They are still incredibly weak and slow to fully engage. If this muscle group is not functioning correctly then you will not be able to stand on the operated leg and squat properly. Also running will be a problem. However I feel I am doing a lot of exercises to strengthen this muscle group but still I am struggling. Admittedly I am not doing these exercises daily and it is possible if I do I may be able to make the muscle ‘remember’ again and have some carry over. It is frustrating for me as I expected that at 8 months I would be pretty good and near 100% back to normal.
At my request, Nic has begun to massage the scar. Being a doctor himself and doing a lot of orthopedics in South Africa, he could see I had a lot of scar tissue and tethering over the greater trochanter (outer hip bone) and that it needed a lot massage to break the scar down. This is most likely what is the clicking sound I feel when I shake the leg, flex or abduct it.
Also pre-op my limp was pretty bad and my hip abductors completely inhibited i.e. not working at all so I clinically reason that it will take a while for the strengthen to return to as near as normal as possible.
I will focus on regular scar tissue massage, lots of hip abductor, buttock and abdominal work for the next 2-4 months and reassess.
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