Considering that hip replacement surgery has a massive impact on how you walk and move it does seem very odd that the only physio I’ve had are the exercises I was shown in hospital which are only designed to get you through the initial weeks – getting in and out of bed, getting around with crutches or zimmer frame, up and down stairs and general mobilisation exercises. Those and a general warning of “Thou shalt nots” without any real clarification as to whether these are just for the first 6 weeks, 3 months or never again. Now at 9 weeks post-op I’m reasonably mobile but the hip is still seriously impacting on what I consider to be normal movement, and I’ve had no physio prescribed and I’m not scheduled to go back for a review until 3 months post op by which time it’s a bit late in the day to get things moving properly. I’ll have seized up completely by then.
I hated sport as a child, still do, but in those pre-internet/video game days was just generally active. In my early 20s I discovered the Jane Fonda workout and was hooked on exercising for fitness and fun without having to worry about being part of a team or compete with someone else. Over the years I’ve done aerobics, weights and circuit training, kettlebells, trapeze, riding, fencing, martial arts – which is what did for the hip, and more recently, Pilates, ballet and hot yoga.
In my 30s I qualified as fitness instructor and sports massage therapist. I’ve not inflicted training or dug my elbows into anyone in a while now but the training has always been incredibly useful for keeping myself mobile and fit and it’s really coming into its own now: I’m drawing on moves from practically every form of exercise I’ve ever done to try and get the hip moving properly.
I was warned by several doctors that I shouldn’t expect to have the range of movement that I once had and that there was a small risk of dislocation – lessened by having an anterior approach surgery and currently, 9 weeks post-op I’m in roughly the same state as I was immediately pre-op. My mission now is to improve on that, whatever the medics say. I’ve got a colleague who had his hip done a while back who bounces around class with the energy of a Duracell bunny and my martial arts guru, who had two replacement hips, couldn’t do high kicks anymore but could fold himself in half doing yoga moves. Those are my role models and in a couple of weeks time I shall be teaching for 8 hours a day for two weeks so I need to be fit for that and I’m planning to get back to my hot yoga class and even ballet soon.
So, what’s good at the moment? The big advantage is that my operated leg is now the same length as the good leg, not that it was every actually longer but the distortion in my hip and pelvis made it about 1cm longer which caused me to limp and hurt my knee and lower back. I can now cross my legs both ways – not very much but it’s at least possible and I can touch my toes with my legs straight. I can bring my left knee up enough to put on trousers but putting on shoes and socks still requires sitting and bending forwards. The time of day makes a huge difference – first thing in the morning I’m really stiff and I gradually loosen up as the day goes on. Once I’ve done my workout and I’m warm I’m really quite flexible considering.
On the down side the area in the front of the hip and top of thigh is still very tight and I get a certain amount of pain in the sciatic area in my left buttock and I’m not quite sure what’s causing that – I think it’s just muscular – groups of opposing muscles fighting each other. I can now kneel and lie down on the ground, provided I do it carefully but getting up again is a struggle. I’m still using my arms to steady myself and push myself up. Thighs and glutes feel tight and weak – just not been used very much for a long time. It’s noticeable because when I was very fit, particularly during the martial arts period, I bulked up dramatically – all of it muscle. I could give Serena Williams a run for her money. Now my thighs and bum are the smallest they’ve ever been, I’m not complaining but I miss their strength.
So the exercise regime now includes a variety of: 20 mins to half an hour on my exercise bike, doing step, kettlebell swings, ab crunches, hip bridges, abductor and adductor lifts, squats, ballet plies in first and second position, tendus and rondes de jambes from first position, yoga standing bow pose, standing separate leg stretching pose, head to knee stretching pose and general stretching exercises. I round it off with about 10 minutes on a Rumble Roller – a particularly evil bit of kit that’s brilliant at getting knots and tension out of muscles. Depending on how fit I feel I’m averaging 1 – 1.5 hours every day which was pretty normal for me before the hip got really bad and I love being able to get back to that. Afterwards I’m hot, sweaty but moving again. I can see the progress; the tightness going, the mobility and flexibility improving. I may not ever get back into front splits again but I’m going to give it a damn good try.
So, I’ve got the motivation to really try and improve my strength and range of movement and I’m in the lucky position that I’ve got the knowledge to be able to come up with a personal workout to help me achieve that. What happens if you don’t have that knowledge? If you’re interested in getting as much movement back as possible, and who isn’t, I seriously recommend that before you leave hospital you ask about post-op physiotherapy and exercise and get yourself scheduled to have some because it’s not just going to sort itself out on its own. Later on, when you’re moving well, you could see about getting some personal training at your local gym or go to Pilates but make sure that your trainer has a rehab qualification and experience so that the exercises are appropriate.