More healing

3 weeks and a day since surgery, and it's been a good week. It seems like every day I notice something good, some kind of progress. Today I'm going in for 20 minutes on the bike. I did 15 minutes again Wed, but I really "hammered" it, relatively speaking, still on minimum resistance. The upright bike is much easier. Walking is going well too, gait is pretty normal. If you saw me walking, you might just think I was sore from jazzercise class.

Update: did 20 minutes on the bike, the most I've sweat in months. It was challenging and the hip was tired afterwards. Averaged 600cal/hr. For comparison, my lactate threshold (pre-surgery) was about 1100cal/hr on the elliptical. Ah, the elliptical... never thought I'd look forward to jumping on that thing. Next week....and I get to aqua jog too.

Healing

As I mentioned, my hip has been having the familiar achy feeling, but when we got to Michigan, it felt much better, probably the best it's felt since surgery. And it continues to feel good today, even though I've been, uh.... walking on it. In fact, in the interest of full disclosure, I spent a good part of the weekend chasing my son and his 23 month-old girlfriend around our friend's house. OK, so technically, weeks 3 and 4 are the "crutch weaning" period, so I think I'm supposed to be doing some walking. And looking at the rehab schedule, at the end of 4 weeks (next Thurs), I should have a "normal gait pattern" for walking. Anyway, it's got me thinking about the road ahead (and behind), particularly, my return to running and what it might look like. Here's what I've pieced together for my running progression:

1) 2 Crutches, not weightbearing
2) 2 Crutches, weightbearing
3) 1 crutch, weightbearing
4) walking, strange gait
5) walking, normal gait
6) brisk walking
7) walking extended distances
8) treadmill, jog
9) treadmill, jog extended period
10) 30 minute easy run
...
11) 1 hour easy run
...
12) 1.5 hour easy run
13) tempo
14) speedwork

I'm somewhere between steps 4 and 5. I can walk, but I tend to lean over my right (affected) leg when I walk. Reading on the web, this is typical if counter-intuitive-- leaning over the affected leg reduces the forces on the hip, particularly the abductors on the outside of the hip, which on me are weak and a little sore, mostly around the incisions. I need to go over the list with my PT, but I can guess that he'll tell me that I need to go slow and make sure I can accomplish each step without pain and over an extended period of time before moving to the next step. He'll probably add steps too. The list is both daunting and helpful.... But I'm happy that I can see myself returning to running at all. Things seem to be going well so far. If I had to guess, which may not be a good idea, but I can't help myself, I'll hopefully have worked my way through the list in about 4-5 months.

I went to the gym yesterday and did 15 minutes on the exercise bike. It was easier this time, but I noticed that raising my leg can sometimes cause a pinching sensation if I raise it too high. The recumbent bikes at the gym might make this worse..... scooting the seat back helps. I'm going back today for another 15 minutes, and I'm going to try to scout out an upright bike.

Watching the Turkey Trot was fun. I feel sorta bad about this, but I can't remember ever going to a race to cheer for runners. My cheering karma is in really bad shape.... I wasn't quite sure how to do it. I was genuinely excited, and I'd be lying if I told you this didn't surprise me. The thought of watching runners didn't sound like much fun in my gimpy state. And there was a touch of bitterness, sure, but just a touch-- mostly it was really dang fun. I learned that the front of the pack is all business-- these guys are focused on the task. I recognized the expressions of concentration and felt simultaneously glad and bummed that I wasn't there-- more on this... The middle and back of the pack is where they have the spare energy to give you high-fives, etc. This was really fun. When we left for the airport, my hand was tingly and numb from slapping. Memo to self, teenage boys really like to slap hard-- it's fun, but pace yourself. I recognized lots of runners too, and had fun yelling at them. All in all, good times.

I spent a fair amount of time Friday going over the results. A couple things I noticed-- this would have been a bad year to compete in the baby stroller division. The competition was brutal, the winning stroller posted a 6:22 average pace. I sorta guessed this when I saw Kosusko pushing a stroller. Surprisingly, he came in 2nd. I also noticed that many of my running buddies had a great day, many of them coming in at around 30 minutes (6:00 pace). Those that stood out-- congrats to Alex for a huge PR, coming in just under 31 minutes. Mr. Vance ran a great race too, just a few seconds over 30 minutes-- on this course, 6:00 pace is amazing. I'd like to imagine that I could have run this course in around 30 minutes (pre-surgery, no stroller!), but I'm kidding myself.

The good and the bad

I saw my physical therapist yesterday. I look forward to these visits, because each week I expect to get to do more stuff. He gave me several new exercises, clams, and others I can't remember the names of. Many of them are "closed-chain" on all-fours kinds of deals. I asked about "water walking"-- apparently it is just walking in the water, on the ground, not with an aqua belt. Aqua jogging with a belt isn't until 5 weeks. Argh. But the good news-- I get to hop on the exercise bike, at minimal resistance, but still, a real milestone.

So I gave the bike a go for 10 minutes yesterday and that felt good. And I planned on doing 30 minutes today, but 10 minutes into it, I started thinking about how I'm in danger of repeating old patterns....the bad ones, the patterns where I push things too far. Hmm.... So, I stopped at 15 minutes. And I'm glad I did, because my leg actually felt *tired* afterwards. 15 minutes on an exercise bike at minimal resistance....wow. So now I'm starting to understand things better. My doc went into the joint compartment of my hip and did all sorts of stuff. I understand that, and I should be careful because my joint is healing, but I guess I didn't understand that the muscles, for whatever reason, would be really weak after the surgery, and I need to be that much more careful. OK, got it. I don't completely understand why, I mean, the muscles are there and they look normal, haven't gotten any smaller, but I definitely *feel* it. So, over the next couple weeks, I'm going to try to work up to 30 minutes on the bike. That sounds like a reasonable goal. One goal at a time....I'll try to be good.

Tomorrow, Thanksgiving, we're flying to see friends in Michigan. But before we go to the airport I'm going to the end of our street where the Turkey Trot course is, and I'm going to yell my head off for the 1000 or so runners, walkers, and baby joggers, many of whom I expect to know. As an added bonus, I won't be wearing my hip brace. It's been 2 weeks, and I'm tossing it.

Yada, yada, yada

I'm almost 2 weeks post-surgery and seeing the road ahead. Strangely, my hip is more sore than it was a week ago, but it comes and goes, changing from day to day. Right now I have the familiar achy feeling, not painful, just enough to know it's there. This past weekend I spent more time on my feet/crutches, so maybe that's the reason, but who knows. I gotta keep focused on the big picture here....

My stitches are out. After leaving several messages with my regular doc (not my OS, who's in Houston) he told me he wouldn't take them out, the little weenie. I should have told him there were only 2 stitches-- hip surgery? 2 stitches? He was probably imagining a 10-inch incision. So I took them out myself. You can find detailed info about anything on the web these days, and it was easy enough, literally took 2 minutes. My thinking: what's the worst that could happen? Seriously!

I've heard some advertisements for the Turkey Trot on the radio. Sigh.... I ran it last year with my son Banjo. It's one of the few races in Austin that has a "baby stroller division" and the competition is usually pretty stiff. There are guys who have run the 5 mile hilly course at 6:15 pace while pushing a stroller and their kid. Luckily, the competition wasn't quite as stiff last year, and we placed 1st, got a trophy and a coupon for a free sandwich. It was the first time I've ever won anything in an athletic event. I ran the race wearing plaid shorts and a tank-top and holding a turkey baster....you know, like a dad out on a Thanksgiving stroll, but no one seemed to notice! I joke about it with my friends, and they've heard the story about a million times, but it really was a special experience. Anyway, Banjo and I will be back next year to win another trophy and sandwich. The stroller division can wait a year. In the meantime, I can try to think of a better costume....

It was about this time last year that I first started having groin pain. I barely noticed it at first. Then I started feeling a sharp pain when I would get out of the car or abduct my right leg following a run or workout. The sharp pain would never last more than a few seconds. But sometimes an achy feeling would linger for a day or so. It was annoying, but it never got any worse or any better, in fact, I ran a PR marathon on it. But this summer it seemed to be getting worse, so I started seeing a physical therapist, but nothing seemed to help, yada, yada, yada, and they found a tear on my right labrum. I've told the story a million times. I've also read the stories of others who have experienced the mysterious symptoms for 5 years before getting a definitive diagnosis and treatment, so I guess I'm lucky it only took me a year.

Soreness gone

The hip feels pretty good lately. I went to the gym today and worked on all the major muscle groups of my left leg. My strength is a little off from normal, but what the hey.

"I think that hip brace goes under your shirt, Honey." I've been wearing the thing like this for a week, but my wife tells me this today. I laughed it off and assured her that I knew what I was doing. But I don't know what I'm doing. I have a brochure that that describes in good detail where it goes on my body, how to adjust it, how to wash it, etc, but it doesn't talk about how to dress it up or dress it down, or that you should never wear it with brown shoes or pleated pants. If someone knows, please tell me.

Sore?

I'm not sure if my hip is sore lately. The pain has always been a dull achy sensation that's hard to locate. I think I have that. Is it because I'm pushing things? Or am I just healing? I hate the gray areas of recovery..... I have a lunch date today, so no gym-- probably good to give it a rest. I went yesterday and focused on my core. Crunches went well, although they were really dang hard for some reason-- the brace? I could only do about half my normal reps. Searched around for other candidates-- ah, the ab machine. I gave it a try, did several sets of 10. But I couldn't find anything that targeted my lower back that also allowed me to sit down. Oh well, did some roman chair bent leg raises (wimpy ones), more crunches and something called a row pull. Next time I'll do some supermans for the lower back-- doing them at the gym might be gross-- too intimate with the floor.

Tomorrow I'll mix some more core with some leg stuff-- left leg. I've always had a leg strength imbalance-- more strength on my right, injured side. So strengthening my left might help. But I'm going to take everything down a notch for the next couple of days and see what happens with the soreness.

I've been getting several emails lately from my good running friends. Thanks for those. The words of encouragement are gonna stay with me. I was really sad to hear about Mel's injury. Hang in there.... If things go well, I'll be strapping on the water jogging belt the week after next. But the rehab calls for "water walking". God that's funny.

Gym for gimps

I did an honest 30 minute workout at the gym yesterday. My gym has one of those hand-cycles, so I gave that a go for my warmup. I got my heartrate up with that thing, which is good. When you've got a lame leg it's really hard to find ways to work your cardio. I then went around and found upper body exercises I've never tried (always focused on legs and core)-- lat pulldown, tricep thingy, chest deal, bench, and some other machine that worked arm muscles I can't remember the name of.

I've always hated the gym, but I sorta enjoyed it in my gimpy state. A few people even smiled at me-- that never happens at the gym. Gyms are anti-social, at least that's my take. The whole shower/change thing took forever though. I'll be glad when I don't have to mess with the hip brace-- I can toss that thing next Thurs.

I'm gonna go back today and see if I can put together some kind of core workout.

Small confession: I've been getting around on one crutch quite a bit. I'm being careful to put very little weight on my right. Doc says no more than 40 pounds. I think I'm good.

Physical therapy?

My physical therapist showed me what I should be doing for the next week or so. Isometric buttocks-- lay down and tighten my butt over and over. Isometric quads-- same, except with my thighs. Ankle pumps-- move my ankles up and down, again while laying down. Heel slides-- move my foot back and forth while bending my knee. A little depressing, but I promised myself that I'd be a good patient with this whole thing. I tend to be bad, push things too hard, etc.

I asked him if I could go to the gym and do seated exercises for my upper body-- he had no problems with that, so I'm off to the gym this afternoon...I'll be good.

Goodbye Vicodin

I'll miss the haziness, confusion, not knowing what day it is, and the intense arguments with my much hated 4th grade history teacher. Today the hip feels good enough without the pain meds. I feel like I could walk without crutches, even though that would be incredibly stupid. I can bring my knee up to 90 degrees without pain. Abduction (scissor movement) is about 30 degrees with some discomfort. Internal and external rotation are uncomfortable-- don't want to push it though. I'm not sure what I was expecting 3 days post-op, but I'm happy.

Recovery starts here

I had my hip operated on 2 days ago, but I've been too hopped up on heavy painkillers to write anything until now. OK, the surgery-- they scheduled me for pre-op and operation the same day. I'm not sure how typical that is... They kept on jacking around the surgery time while I was in the pre-op area and I ended up waiting 2 hours in those freaky gowns, which was plenty of time for me to invent new ways to freak out. They kept on asking me if I wanted something to relax, but all I really wanted was coffee. Regarding the gowns-- who invented those things? They have ties on the back that are impossible to tie without someone's help, but you don't really want help because your backside is completely exposed.

The surgery building is directly across the street from Rice University, so I had an incredible view at 15 stories high. The IV went in followed by some drugs that they referred to as the "margarita". The stuff in the syringe really did look strawberry-like, with a touch of mango. They were asking me questions and I remember feeling more relaxed, as if I had had a beer. That lasted about 5 minutes I think, and that's all I remember.

I woke up after what seemed like 15 minutes but was actually 3 hours. Strangely, my feet were killing me. They had bound them in some kind of elaborate velcro contraption that I keep trying to free myself from, but some diligent nurse was always there to bust me. It turns out they want my feet slightly rotated internally to open up the hip socket so it will heal better. Also during surgery they attach a 50 pound weight to your foot to help pull the hip socket open so they can more easily work on it. I think that's why the tops of my feet felt like I had run several miles in shoes that were 5 sizes too small. Tons of papers were signed and they gave me a 20 page instruction booklet on what drugs to take when. I have 6 prescriptions I need to take over the next couple weeks, including a self-injectable that prevents blood clots from forming. Something about a bad hip, crutches, and a half dozen drugs that makes you feel like you've skipped middle age and wound up on the other side.

I got dressed and tried not to notice the 6"x6" bandage on the right hip-- dang, why is that thing so big?? While dressing, I noticed that my right leg was completely numb. The anesthesiologist had administered a nerve block to my hip which made everything on that leg numb except for my foot. At any rate it made everything very difficult. I've been on crutches before and developed some good crutch skills, but when one of your legs is dead, it gets in the way and makes it really hard to get around with that thing dragging. Legs are heavy. I fell over once and nearly gave my wife's aunt and uncle a heart attack. I hadn't eaten for 20 hours. I was weak and really dang hungry.

I talked to my doc before I left and he showed me the pictures that he took inside my hip socket. It looked pretty messed up in there. The labrum was really frayed with feather-like stuff hang down and, I'm guessing, getting in between the femur and the acetabulum. He also said the acetabulum had started to pull away from the bone. Yikes. So he cut away the damaged labrum and ground down some of the pelvis behind the acetabulum so he would have a firm foundation to staple the healthy cartilage to and keep it in place. He also did some reshaping of my femur to get rid of the bony "bump" which was suspected in causing all this. As he was describing this, I kept expecting him to put his hand on my shoulder and say something like "son, it was a real mess in there. I did my darnedest but unfortunately you'll never run again", but he never did, and when I asked about my prognosis, he assured me that everything was fixed and I should expect a full recovery.

The day after surgery, I met with my doc again. He re-dressed my bandage. The bandage looked gruesome, full of all sorts of stuff-- I won't go into detail. But underneath it all were 2 small incisions on the side of my right buttock, each maybe 1/2" wide with 2 stitches each. Another doc I talked to during my research phase described 3 incisions, including an incision in the front of my thigh. My doc, the doc I chose, said that the 2 incision technique is relatively new, less painful and doesn't require as much recovery. No complaints there.

At day 2, my hip doesn't feel that bad. My right leg is no longer numb, and I can move it easily, especially forward and backward, side to side is painful. I get to wear a hip brace-- the kind of stuff you see serious athletes wearing. Cool. I'm skeptical that it does much, but it sure looks cool. And it complements the whole hip injury ensemble, which includes some sleek looking crutches. I only have to be on crutches for 4 weeks instead of 6 as I thought before. And at 2 weeks, I can do water jogging and stationary biking. OK, this is sounding easier than I thought, at least now...

Day before surgery

The thought that 24 hours from now I will have voluntarily submitted myself to gimpitude makes me feel a little queasy. When I was in 8th grade I had minor surgery on my "hammer toes" to straighten them out. Really minor stuff, but I remember being really frustrated the day after surgery once I realized that I couldn't do anything, like walk, where I could do so perfectly well the day before. I expect the same kind of frustration tomorrow. And then second-guessing the success of the surgery, etc, etc. I gotta remember that I won't know crap until 3 months from now. OK, gotta get my pre-lame-ass to the bus station.

The labrum actually ain't that big

What the heck is a labrum? Do I even have a labrum, or is it a female thing? I was reading on the web yesterday about the "acetabular labrum" as it's formally called. Fascinating stuff. It turns out that the labrum is only the ring of cartilage that runs around the real deal, the acetabulum, or the big piece of cartilage that takes all of the pounding from the head of the femur. The labrum is only about 4mm thick. Heck, that doesn't sound like that big of a deal. I figured that the labrum did it all, but all it really does is keep your hip from coming out of its socket. I guess that's important too. Oddly, this knowledge makes me feel a little bit better about my surgery on Thursday.

I like my surgeon-- he used to be a pro football player for the Redskins and actually played in the 1991 Superbowl. He's performed over 100 of these hip scope procedures-- labral repair and reshaping of the femur to fix my impingement issue. Arthroscopic surgery of the hip is relatively new and very few orthopedic surgeons can handle it. He's in Houston, so I'm going to take a bus there and stay with my wife's relatives. Then they are going to drive me back the day after the procedure. Nice folks.

Yeah, I'm getting a little nervous. I've been experimenting with doing daily tasks with one leg. It's convinced me that the first couple weeks will be challenging. Six weeks on crutches. That's a long time. I figure that I can still go to the gym and do some seated exercises once the initial pain goes away. Hopefully that will keep me from going nuts. I expect to go nuts.

Less than a week before surgery

I can feel my right hip. It reminds me every now and then that it's there and still screwed up. I haven't run for weeks yet it hurts when I do certain things. Today I carried a ladder, and there was something about the way it made me lean that caused it to flare up. Friggin hip.

I'm looking forward to the surgery. It's feels good to have a plan, finally, after weeks of research and indecision. Sure, I'm a bit nervous. There's a fair chance that it won't help, but I'm focusing on possibility that my hip will recover and I can return to the level of running that I enjoyed before. That's the main reason I'm doing this. The pain isn't that bad-- even when I run, it's not that bad as long as I keep my runs below 15 miles. But I fear it's getting worse. And I've read there is a strong link to what I have (femoro-acetabular impingement or FAI) and early osteoarthritis. I definitely don't want that.