Hip Arthroscopy 3 yrs. post op and exercise has not made much difference

[frogger]

Hi Layla,

Thanks for your thoughts. You're probably right, it's probably still too early. The surgeon did tell me the process of recovery would be a bit like this:

With a plateau for a bit and then dips as I recovered after that. I know I should just practice patience but it's tough when the pain comes back.

I hope in a few months I'll look back at this and think it was nothing to be sad about at all.

 

[Mojo333]

Just to echo the above sentiments about these being early days in terms of healing and patience will get you there.
All temporary.
Here is our favorite recovery chart...

Hope your Sunday is Sweet @frogger

 

[frogger]

Ahahh. Yes that graph looks more accurate actually

Hmm. So, something I’m not sure about. Is it alright if I have mild pain/discomfort? Like a 2/10?

The kind where just lying down makes it feel better?

Is it fine to continue being in that state? Or is that a sign that I need to rest until I have 0/10 pain? Like, does that low level of pain mean I’m not healing properly?

I still pop things around my joint every day. Usually when bending over I pop my sit bone / hamstring. That gives me some relief. I just don’t know if it’s a bad thing.

 

[djklaugh]

@frogger Mild pain like you report is pretty normal at your stage of recuperation. There's no need to stay lying down all the time but do rest a bit if pain goes over the 2/10 level. Have you talked to your surgeon about the hip popping ? I'm not sure what that's about.

 

[frogger]

I think 6 weeks ago when I saw the surgeon he said the popping was still normal. Just thinks readjusting.

But the fact it's frequent still probably isn't super normal. I should clarify, it's not the hip itself that's popping. It's more the surrounding areas and specifically the hamstring / sitting bones area that I mentioned. Which has always popped and also I can pop the hamstring/sitting bone on my good hip side as well. It's just that on the right side it gives some relief if I'm feeling tension there that day.

 

[frogger]

Hey everyone. I have a question for the forum about the healing process. But before I jump into the question I’ll just note that my hip has been feeling a lot better lately. And I’ve been able to go up staircases comfortably and it has started to feel like there’s no pain or inflammation at all in the hip.

Having said that, I did some long walks over the weekend and near the end of my walking I felt the front of my hip becoming tender. Taking shallower steps made it feel better and I avoided walking anymore yesterday. I know that my labrum tear was across the front of the hip and the sensation of tenderness almost felt like something being pulled open and shut as I walked.

Today I’m feeling my hip is inflamed again and that’s ok. I had a feeling I had pushed things too far. So I will rest now and know that is my current limit.

My question for the group is… will this part actually get better? This tear in the labrum, my understanding is that the area where the labrum was sewn back to the bone can potentially heal because the bone can trigger healing back to the labrum.

But the area where the labrum itself just has a tear, this area across the front of my hip. Can that actually heal/close? My memory of discussions with doctors was that the labrum can’t heal. But I am wondering if I remember this wrong or I’m missing a detail.

I know it’s still early days at 3 months. But I wondered this because I am confused how it will ever get so much better that I could do sports again if this tear can never really heal and it will always be simply held together with sutures, ready to inflame after being pulled too much during exercise.

 

[Mojo333]

@frogger
Really is a question for your surgeon who did the work.
Repair definitely deals with the pain but I'm guessing there are varying timelines or preferred levels of activity that would be patient specific.

I am hoping someone with more knowledge than I have may comment more confidently, but the small amount of research that I have found show that many athletes returned to their sport after surgical repair of the labrum but appears it averaged at 8.5 months postop with a staged return to activity.
Not knowing your age, but remembering your labrum had completely torn away from the bone, is why I think you should ask your surgeon how you can safely increase your activity.
I am glad you are listening to your body...reducing the length of your stride when you noticed that was causing you discomfort...
Hope you have a follow up at some point?

 

[frogger]

Hey Mojo!

Yep, I have a follow up in about 6 weeks time. I'm scheduled to get another x-ray as well. Regarding my age, I'm around 35.

You're right that these questions about timelines are best suited for my surgeon. I just thought the general question about whether a labrum tear itself can mend together again was something that others on this forum might know.

I did google a bit after posting my last question and it sounded like it actually is possible for the labrum to heal after being sewn back together... This really shocks me because I'm 100% the first doctors I saw in Australia told me this wasn't possible. I'm now thinking that what they meant was that "a labrum tear that has not been sewn back together, is never going to heal itself back together".

I find it extremely frustrating that I've been making decisions based on incorrect information for the past couple of years and especially immediately after the surgery. Of course, maybe I wouldn't have been anymore careful than I was in the first 2 months, but knowing that actually there's a chance for this to truly heal and mend itself makes me way more willing to practice patience.

Today I've been taking it easy and just briefly went out to buy some lunch and groceries. I think my hip will feel better within a couple of days but I might use my anti-inflammatories tomorrow morning for 3 days to speed it all up.

I'm still overall pretty hopeful about the entire situation. When I look back on my progress, my limits were: 30 min of walking after 1 month, 60 min of walking after 2 months, now I can walk for 2 hours after 3 months. I originally thought all of this would be way faster but the fact that it has been doubling each month is a good sign to me.

 

[Jamie]

Healing from what you describe could take as long as 6 months and it is important that you VERY gradually increase any exercise or activity during that time. Your surgeon who knows exactly what your hip looked like and the extent of the repairs is going to be your best resource for any exercise or strength training. Normally we tell people to take things very easy and not attempt to stress the soft tissues that are trying to heal for at least 3 months. Any sign of more than mild discomfort when walking or exercising is an indication that your body isn't ready for that level of activity quite yet.

It's easy to get impatient with this long healing process. Try not to let that happen as the rewards for taking things more slowly are so great.

 

[frogger]

Hey Jamie

Yep. That makes sense. I was experiencing some discomfort and instability in my walking on Sunday so I had a feeling I might have pushed myself too far. Then on Monday I discovered this was true. That’s the tricky part, it tends to be that I don’t know I’ve pushed myself too far until the day after. But from now on I’ll listen even more attentively to my body and back off even if I just feel mild discomfort.

It’s very difficult to be cooped up at home as summer is now finally hitting Europe and things are reopening again. But I believe you all when you tell me these things. It’s been 3 months of up and down recovery for me so far. But I’ll endeavour to make the next 3 months as smooth as possible.

Tomorrow I still need to go out to get vaccinated but I’ll mostly be on the train.

 

[frogger]

Hello everyone!

It’s almost been 5 months since my surgery. I thought I’d share my progress for anyone else going through arthroscopy recovery.
Today I’m on the couch, icing and recovering after pushing myself too much over the past week.

A few updates since last time. I saw my surgeon, he was pleased with my progress. He felt I was actually ahead of schedule. I told him how I regularly have a cracking sound across the front of my hip as I lift and move my leg from right to left.

He explained that in the surgery he shaved bone away from the front of the leg which left a gap where the ligament is moving around. Meaning the ligament is flicking over the bone. He said with time it will go away as scar tissue grows and fills the space and the muscles get stronger in that area to provide more support.

He recommended I start swimming and try cycling. I’m not a big swimmer so I’ve just been doing the cycling and it’s been quite good.

I can also report that my walking distance limit has improved quite a bit to roughly 3 hours. Or 4 across the entire day before but I’m in pain the next day. And my cycling limit is about 20 minutes.

My mistake this week is that I’ve been itching to get fitter so I tried cycling three days in a row. 20 minutes each day. That was too much for me and I’m now icing which I haven’t done for a couple of months at least.

I must admit it’s frustrating when the hip pain flares up because it also gives me a back pain on just the right hand side. Going to the gym was starting to help with my back that but I think pushing too far set everything back.
I’ve also found that massage helps a lot if I push myself too far. But it’s a pricey solution obviously.

The cracking over my hip is a bit disconcerting but I assume my surgeon knows it best. I do find I have a desire to crack my joints around the hip fairly often to relieve some tension every day. I hope that’s still normal.

I’m excited that cycling does seem feasible now. Even if it’s still limited overall. But I’ll try three times a week of cycling instead of every day instead. Which is a frequency the physio proposed.

In terms of medication, although the surgeon gave me anti-inflammatoires a while ago, I’m just using paracetamol when I have to instead – and trying to rest if I do go too far.

I hope everyone else is doing well and that things continue to improve every month still!

 

[Layla]

Thanks for the update, you seem to be doing really well and it’s always reassuring to hear so from the OS. Thankfully you’re taking a step back when you’re overdoing it, rather than ignoring the signs. It can be difficult finding that perfect balance and often involves trial and error. Keep up the good work and stay in touch. It was nice to hear from you!
@frogger

 

[frogger]

Hello again everyone. I’ve been feeling quite terrible the last week as I seem to have again pushed myself too far at the gym. Although I also can’t help but wonder if something more is wrong than just pushing myself too far.

Today has been especially bad. Again I iced today but that was just temporary relief.
Today has been especially bad. Again I iced today but that was just temporary relief.
My hip flexor / psoas area cracks super often. And I feel a pain which makes me want to crack the hip there regularly. At least 10 times a day.

The doctor did tell me he knew what the cracking in that area was… he said it would go away but I find it hard to believe it’s meant to be like this and it doesn’t seem to be going away. And I just wonder if I should give up on exercising until much later (like another 3 months). Right now it is really feeling counterproductive…

I have brought forward my next checkup with the surgeon to roughly a week from now. Because I’m just really struggling to believe I’m on a good recovery path right now. It feels like my hip is worse than it was after 4 months recovery. Even though it has been 6 months since the surgery.

This whole thing is really exhausting

 

[frogger]

Hi everyone. Just another update. I saw my surgeon and he thinks that it’s still too early say whether something has gone wrong.

He says my bone structure is very good. That I’m almost symmetric in my range of motion etc. And he continues to believe the labrum is likely still well stitched together.

He believes my problem is the cartilage is still healing and that I had extensive damage to the cartilage. He told me he wants/needs me to continue exercising but I have to find the sweet spot.

Additionally, he believes the cracking around the front of my hip is due to that missing bone and that I must build muscle there to fill the gap. He recommended I do leg raises to target that area specifically.

I’ve done some of those exercises and I think he’s right, I think it has helped in the past week. But I tried to continue cycling as he asked and found that the day after I was once again in pain. Paracetamol didn’t really help either.

All I did was 15 minutes of cycling at resistance 4. To me that seems very concerning after 6 months.

The surgeon also explained how on average this recovery takes one year. And some people recover in 6 months. Some in 18 months. And that scientifically we don’t actually know why.

On the one hand I find that reassuring but also living with this pain is very difficult. I know I must be patient but does anyone else think that my expectations for cycling are unreasonable? Doesn’t it sound a bit bizarre that 15 min at resistance 4 would still trigger pain the next day?

 

[Pumpkin]

Doesn’t it sound a bit bizarre that 15 min at resistance 4 would still trigger pain the next day?

No, your hip is still healing and that was too much right now. Suggest you decrease you cycling time by half and use no resistance.
If that does not flare up your hip, slowly increase your time and resistance though not on the same day. Back off if your hip flares up again.

Recovery from a labrum repair and cartilage shaving can take a long time.

Was your cartilage damage only from the impingement?
Do you have cartilage damage in the weight bearing part of your hip?
Are you working on core strengthening and stability, if not a short course of PT may help to work on those areas.
If your core has any instability it puts more work on the hip to stabilize you during all upright activities.

 

[frogger]

1. Was your cartilage damage only from the impingement?

2. Do you have cartilage damage in the weight bearing part of your hip?

3. Are you working on core strengthening and stability, if not a short course of PT may help to work on those areas.

4. If your core has any instability it puts more work on the hip to stabilize you during all upright activities.

Hi Pumpkin, thank you for your advice. Answering your questions one by one.

1. Labrum was torn by the impingement. It was a big but clean tear I believe. Not much shaving was needed. However the labrum also detached and was sewn back to the bone.

2. I don’t know the answer to this question. But I imagine since the whole labrum detached that it was all potentially weight bearing?

3. I haven’t made it a focus area but my surgeon did say I needed to improve core, thighs, glutes and lower back.

4. That makes a lot of sense. No one has ever said it like that to me before actually.

Thanks a lot for reassuring me about the cycling time and resistance. It seemed a bit disturbing after six months. But if that’s very normal I feel much better.

I’ll put a focus back on core work and really keep it light with the cycling then. And I’ll try to be more patient, maybe I’ll go watch some paint dry as well, for fun

 

[Pumpkin]

And I’ll try to be more patient, maybe I’ll go watch some paint dry as well, for fun

Recovery sure does feel like watching paint dry.

Ask your surgeon if the weight bearing portion of your hip has any arthritic changes?

 

[Jamie]

@frogger .... so sorry to hear this is taking so long. That can happen with these types of surgery. Amazingly, they can actually take longer to resolve than if you just had the hip replaced.

I hope you can follow Pumpkin's suggestions for a few months and see if things start to improve. Your only other option would be to try and get a second opinion from a hip revision surgeon. Sometimes when things seem not to be going well having a different set of eyes on your hip can make a difference - even if it's just to confirm what your original surgeon is saying.

 

[frogger]

@frogger .... so sorry to hear this is taking so long. That can happen with these types of surgery. Amazingly, they can actually take longer to resolve than if you just had the hip replaced.

Thanks Jamie. I’ve read that a few times, that a hip replacement is simpler in some ways.

I’m happy if this means my hip will be good for 20 years or whatever. But when I eventually need a hip replacement then I’ll be happy to do that too.

I think the hardest part is not really knowing what’s going on. My surgeon still thinks I’m recovering but considering it’s been 6 months I’m just feeling quite lost by how easy it feels to trigger pain. Sometimes it feels similar to how it was before the surgery.

If I knew for certain that in another 6 or 12 months it’s guaranteed I’ll be better and pain free I wouldn’t really worry. But I don’t really believe it anymore I think.

 

[golfer67]

I don’t know if my comments here will help you feel better or if my comments will be discouraging but here goes. I truly hope that you are going to continue to get better and that your operation turns out to be a complete success. I am basically twice your age but due to my anatomy I also developed a torn labrum due to FAI. Because of my age the doctors told me that I would be much better off to have a Total Hip Replacement instead of the type of operation that you had. They also told me that I would recover from the THA much quicker than I would from an arthroscopic labrum repair however it has been 13 months now and I am still having trouble with pain from my THA. I am currently going through therapy and so far it has not helped. I only post this to show you that some of us just don’t get over hip surgeries as quick as we think we should, I know people who have gotten over having both hips replaced a few months apart in way less time than it has been since my surgery. So keep doing what the doctor tells you to do but also be aware that something may be wrong that is causing you to take so long to recover.



Golfer67