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Hip Labral Q&A: How long does recovery take after surgery?

Ginger Garner PT, MPT, ATC, PYTHip Labral Q&A: How long does recovery take after surgery?

This question was when I was a mere 4 months post-surgical.

Q: How long does recovery take after surgery?

A: Spoiler alert: Specialized “hippie” PT (aka physical therapy for hip preservation surgery) is still as important at 4 months post-op as it is in the immediate/acute post-op phase.

I’m coming up on four months post-surgical this week and let me say, I will still be continuing with intensive PT into 2015.

I can say with confidence as a PT and “hippie,” that the 4 month mark as an estimated “return to sports” is not only unrealistic, but detrimental to a person’s self-confidence, self-efficacy, and possibly even the surgical repair/correction.

Retraining neuromuscular patterning and ditching “learned” (but impaired) post-surgical coping strategies for movement requires some seriously focused effort from both PT and patient.

To that end, I hope to begin writing about my hip labral adventures, in full living color (and video!), come 2015. The past 3+ years of traveling this path have taught me, you know, 1 or 2 things about “best fit” care for hips.

Response from Kate*: I do certainly hope that you can make appearances at orthopedic and PT conferences to help spread the message. Every single PT protocol from the surgeons said I would be running again at 16 weeks post-op. What a hideous joke that was for a triathlete. I’m still on crutches and in terrible pain nearly seven months out.

Response from Jane*: I just want to be able to sit at a movie with my kids or walk at the park with them. I figured “sports related stuff” is a long way away … 4 months post-op are you better than you started? How severe was your pain prior to surgery?

Me: Kate, I am so sorry to hear of your struggle, but let me say this – I feel your pain and I understand the depth and width of it. I went through 3 years of conservative therapy before deciding to go surgical. I was also newly postpartum 3 years ago – which means I was completely starting a ground zero after a traumatic labral tear during delivery of my third son. The positive point here though is this – PT for hip labral injuries is relatively new – and an INCREDIBLY powerful modality for turning these surgical and nonsurgical patients into success stories. A skilled surgeon is, as always, a fraction of the hard work that needs to be done to guarantee success. I hope to be speaking about this and expanding my (currently 16 hour) CE course on Hip Labral Injury through ‪Herman & Wallace Pelvic Rehabilitation Institute.

Me: Jane, Pain drove me to the surgical table. Grocery shopping was difficult, even, by the end. Remarkable synovitis (bloody joint), discovered at time of surgery, validated how much havoc the joint was wreaking on my physical body. But as mom of three boys, all birthed naturally – I know pain and can take it with the best of them. So for many, many years, I used yoga to “outsmart” my pain gauge – thus dampening or overcoming the feeling (but not the perception) of pain. Yoga is an excellent chronic pain management tool (right ‪Neil Pearson?), but for me, I had cultivated the skill of pain management a little too well. Other PT’s have found this to be true of mothers in pain and combat soldiers – hence the similar rates of PTSD, chronic pain, fibromyalgia, etc. It is possible to train yourself to ignore pain TOO well.

Me: To answer your post-op pre-op comparison, to date I better in some ways (with respect to compressive and distractive stability) but in many others ways I am still worse. Let me clarify: in a post-surgical situation, you bring your pre-surgical deficits to the table (whether it be an overactive psoas or loss of ROM or functional stability) but you also acquire NEW post-surgical pathophysiologies (like scar tissue, atrophy, loss of propprioception, neuromuscular patterning, myofascial mobility, I could go on and on…). Add to that the period of precaution and contraindication (immobility) and you have even more pathophysiology. That is part of the reason why 4 months is not NEARLY enough time for return to sport. Nor is 4 months nearly enough time to be completely better than you were pre surgically. I hope this clarifies my point.

Jane: Ok, that makes a lot of sense … thank you for that explanation!

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For Rehab Pros: Want to learn more? Join me at Texas Women’s Hospital this March for Hip Labrum Injury: Differential Diagnosis & Integrated Management

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