I am now 3 months out of hip labral repair surgery, and things have been moving along, with some expected frustrations and other not so expected frustrations.
I have been trying to remain patient, but this proves to be extremely hard when some weeks it feels like zero progress! But writing this now, I am realizing that since my last post at 2 months post-op, I have actually come a long way. I signed up for the Brooklyn half-marathon in May, and hope to run it to complete the distance and not really race it for a PB. I have also started using Zwift (I wrote a review here) and like it a lot, however, my competitive side needs to learn when to tone it down..seeing the other riders whiz past you when you are trying to hold back is frustrating, and so are the numbers on the screen. This has been an exercise in will power, caution and patience. But the truth is that I have made substantial progress. Here is a summary of the past month and what I am able to do now.
What I have improved on 3 months post-op:
- Increased difficulty of physio exercises
- Increasing resistance on bike (able to go up to 210 watts for a short period of time!)
- Am now able to do some single leg squats (but not very well)
- Started some yoga week 10 (modified poses)
- Started planks week 10 and deeper squatting
- Started using Zwift (virtual cycling app) week 11
- Cycling on trainer up to 1 hour and 15 mins
- Started kicking in the pool last week, light kicking
- Did my first run/ walk for 15 mins
The major set-back has been inflammation in the hip flexor, and aggravating my tensor fascia late (TFL) which is the small muscle at the side of your leg that connects to your IT band (above the IT band). About two weeks ago I was getting a lot of snapping hip, which is apparently when the hip flexor rubs over your bone (not so expected frustration). This is actually pretty painful, and I have struggled to reduce the snapping. Apparently it is worse when your hip adductors are weak and inflexible. Doing a lot of glute strengthening (especially gluteus medius) helps along with stretching too. This is because your muscles are like a rubber band: in order to use their full strength, they must be flexible as well.
What I have learned from month 2 post-op:
- Stretching AND strengthening is extremely important, especially to avoid the snapping hip as mentioned above
- Stopping the exercises for a day or two makes things worse
- Stretching hip flexor helps
- Gluteus medius exercises are VERY important
- Stretching gluteus medius helps to activate glute muscles -if it is too tight this will affect your ability to strengthen things
This website outlines some good glute exercises for keeping the gluteus medius strong.
Single leg squats and side planks are also good. It think it is best to rotate through a variety of these exercises, rather than focus on one, so that you use the muscle in different ways and optimize its strength for different conditions.
I have found that my inner thighs become very tight, because they are compensating for the weak hip flexor and glutes. I have found the triangle pose in yoga to be excellent for stretching these effectively.
Although holding back has been tough, and inflammation is not fun, I have made some significant steps forward.
I did my first walk/run this week. Although I don’t feel ready to continuously run yet (the hip flexor is still irritated and weak), it felt great to get outside and feel my feet pounding on the sidewalk again (but not too hard :)). I have really missed running a lot, and I can’t wait to be able to get out there for a regular old run! It’s been almost a year now of no running. But you know what they say, you realize how much you want something when you can’t have it. I have definitely taken running for granted in the past, and it has even become a chore when I trained for the marathon. Now, I would just be grateful to run freely for 20 minutes at any speed! Being healthy and able-bodied is really a gift we can all easily take for granted.
The plan for month 3:
I am looking forward to being able to bike with no pain, kick more in the pool and start increasing my running slowly but surely. Trying to stay in the moment and focus on optimal rehab right now is the most important thing. I have a cycling trip planned for late March in Santa Monica, which is now seeming a little too ambitious given that I am nowhere near my usual fitness levels. We will have to see how things progress over the next month. Hopefully I will turn a corner for the better soon. I would ideally like to be able to run continuously for 30 minutes, increase my bike workouts and resistance up to 1 hour and 30 minutes with some FTP training in there.
I would love to hear any thoughts or comments on your experiences.