Hip Arthroscopy Active life long Martial artist - Post surgery recovery feedback

[eggy293]

Hi everyone, 38 year old female and I had my first surgery April, 2023 in which it was diagnosis via 3 MRIs to be a right hip labrum tear. It took a while for us to get to surgery as the scans did not show it to be that big of a tear. After 6 months of PT and no progress pain wise I moved onto surgery. The surgeon found a massive bone spur which had caused the tear and was ripping up the joint. He remove the spur and put 2 anchors in the labrum to repair the tear. Fast forward 4 months and after completing PT and getting the green light to return to sport 100% I was doing good. Then after a week long stint of walking 20k+ steps a day in Europe it started to go down hill again. Range of motion had decreased and pain had returned 24/7.
Went back to the surgeon and got a steroid shot and MRI. The scan showed massive adhesions had formed over the repair. We then tried a PRP injection to bust up them up and it did not work. Therefore a 2nd surgery was scheduled and completed June 2024. This time around he removed all the adhesions and then shaved off the femur and hip bone due to ongoing impingement. This wasn’t done the first time around due to the finding of the bone spur and that likely being the cause of my pain. I am now 5 months post op from the 2nd surgery + 1 steroid injection and that deep hip soreness / pain has come back with activity. I just can’t seem to get past a certain level of activity (karate / running) without irritating it. PT is ongoing and am working on getting my glutes to fire properly it just seems never ending with so much effort being put in.
Curious to see if others have had the same type of recovery and have any pointers. I am a very active martial artist (3-4x) a week and it is killing me not able to do what I love.

 

[mendogal]

Welcome to BoneSmart @eggy293 !

I empathize very much with you: I blew out my ACL in a martial arts accident (aikido) and had to stop a full year for surgery and rehab! I ended up devising lots of successful adaptations in training over the years as posttraumatic osteoarthritis set into the knee. Eventually worsening shoulder and thumb problems led me to bow off the mat permanently at age 61 (I do tai chi but it's just not the same!!!!)

At this point with your return of symptoms I think you have a few options:

Discuss with your provider new xrays specifically to assess for developing osteoarthritis plus scans to assess for tendon, ligament, and bursa problems.

Consider consulting a non surgeon specialist well versed in soft tissue injury and imbalance: a sports medicine doc or physiatrist (physical medicine doc), or a doctorate prepared physical therapist (they are better prepared to do complex assessment than a Masters prepared PT and while getting your glutes to fire properly is definitely a good thing it strikes me as possibly a too limited approach).

And please please cut back your training. In my 20+ years on the mat I watched too many peers and teachers have acute injuries turn into really bad chronic problems because they were too impatient to allow healing to complete.

 

[eggy293]

Thank you @mendogal for your reply.

I have 100% cut back on my training, even though I may be going 3 times a week right now, 2 times for teaching and 1 time for class, it is very restricted. No kicking and limiting “impact” movements, therefore would say I am around 50% in class. The running is part of a return to run protocol per PT which is also restricted and I am up to about 25 total mins which includes a mixture of walking / running. My issue with both seems to be if I try to advance past what I have designed above the pain/soreness comes back. It usually goes away overnight but recently it has started to stick around longer which is why I am thinking the steroid shot wore off and this is just a normal “stage” in the recovery.

My PT is a PhD level graduate that also has her ortho specialty certification. I have confidence in her and her program but just keep getting told patience and time is what is still needed. My next follow up with my surgeon is early next month so just waiting to see his thoughts. Last time he told me to set expectations to more around a 8 month post op recovery.

 

[sistersinhim]

What is the exact date of your June surgery? We need the date to be able to correctly add you to the appropriate Monthly Team Thread

 

[eggy293]

Hi,
1st surgery: April 10th, 2023
2nd surgery: June 10th, 2024

 

[mendogal]

@eggy293 Thank you for taking the time to fill in details.
I'm glad you've got a good PT to collaborate with (I've always viewed my positive PT relationships as problem-solving partnerships), and relieved at your prudent current restrictions.

 

[myglasshalffull]

Welcome.
Not much to add except you may want to dial back some of the activity seeing you had two surgeries on same area. Many of us that had hip replaced took longer to recover than expected.

 

[eggy293]

Thank you everyone for your feedback. Its been a struggle coming to terms with the whole "slow and steady" / "activity level is based on stopping before it gets sore". Since I do contact / high impact activities it just makes it seems even slower since it will take a longer time to get back to those.
My glutes finally started waking up this week in PT, very targeted exercises which are mentally very challenging and it shows the right side is so weak compared to the the left. I'll take that as progress and keep moving forward. I will be dropping down to 1x/week for PT and then more ownership on me for exercise and progressing through the "Return to run" program.
Any additional advice is always welcome as I keep moving forward through this recovery.

 

[mendogal]

I hope you'll share both your milestones, large and small, as well as any concerns that arise. We're here for all of it!

 

[eggy293]

Had my 6 month follow up with the surgeon last week. He is happy that I am trending upwards / positive with my recovery (although extremely slow IMO) and mentioned my range of motion / mobility is the best it has been even since prior to my first surgery. Still have PT once a week to continue to build back strength now in the right hip muscles as it is still very weak compared to my left. That deep joint soreness / discomfort still pops up after running per my protocol or strength training but ice and ibuprofen seem to help still. Surgeon didn't seem to have an issue with that as long as I don't lose sleep over it and level set me that full recovery may be closer to a year post op.

 

[eggy293]

I am curious though, has anyone had a hard time getting their glute muscles to work after this type of surgery? I am still struggling with that and it could be a strength thing but my PT said we need to figure out how to get my mind to start turning them on to avoid my quad / hip flexor doing all the work.

 

[benne68]

I did a very quick search of the forum and can't find anyone who complained of this problem post-op, @eggy293. Perhaps you can dig a bit deeper; use the Search button at the far right of the blue toolbar to try some different key words. Hope you find something helpful.

 

[mendogal]

It's possible your glutes weren't firing great pre-op - it's not uncommon!

The best way I know to target them (or any muscle) is to do whatever exercise your PT recommends for them WHILE keeping fingertips on the glutes.

I was taught this many years ago for activating different muscles and it works beautifully.

 

[eggy293]

Hey everyone, Happy 2025!! Took some time off of karate, strength training and running for the holidays and swapped it out for some manual labor around a few houses. Hip was not a fan at all, that deep joint discomfort flared up and was back 24/7 for about a week or so. It finally calmed down late last week but the hip flexor is giving me issues with hip flexion. It is really coming down to the amount of "load" I am expecting my hip to take throughout the day and have come to the conclusion, day-to-day house stuff / karate / running / strength training is just too much throughout the week. I have stopped with the running per alignment with my PT so we can switch it out with more karate related exercises but it is all coming down to the weakness in my glutes and my hip flexor doing the work.

Is hip flexor discomfort suppose to last this long post op (approx. 7 months)?

 

[mendogal]

Happy new year @eggy293

We do call it a one year recovery for a reason.

If you're over relying on your flexor, it will not stop complaining, and you really don't want to create a chronic stress or chronic pain situation.

Please slow down and let it recover. Don't worry yet about running OR karate; they aren't going away. Work with your PT on getting the glutes firing effectively and build strength there while you rest the flexor.

Other staff here often remind our members that a key muscle to exercise post op is the patience muscle. They're right!

 

[eggy293]

Patience yes but 7 months Post op and the pain coming back with any physical activity just really gets my mind thinking the worst. Been here before and it ended with a 2nd surgery and just getting frustrated with the shut downs and pure lack of progress.