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Day 10 Slow & Steady: The Yoga of Hip Labral Rehab (Post 6)

IMG_0995Day 10 Slow & Steady: The Yoga of Hip Labral Rehab

If you have missed the other posts in the series, catch them here:

Recovery is steady, but rehab is slow. Loyal to biopsychosocial yogic care, here’s my post-op Day 10 overview, which I like to call the creatively Slow & Steady version of hip labral rehab.

Bio

  • Musculoskeletal – I had so many soft tissue and myofascial issues pre-surgically, that I have to be more patient with PT progression. Foot flat nonweightbearing (just enough weight, about 20#) to overcome gravity and protect the repair) and hip precautions are still in place, with no flexion past 90, very little abduction and adduction, and no extension.
  • Integumentary – Incisions are healing mostly fine. I’ve noted two small problems 1) The skin was sutured in overlapped, which is not going to make for optimal healing or scarring, and 2) as a result, the skin is breaking open.
  • Gastrointestinal (GI) – GI function has mostly returned to normal and my appetite is returning slowly.
  • Lymphatic – Swelling is markedly reduced, though pockets still exist globally and specifically in and around the bottom of the three incisions.

Psychosocial

  • Cognitive – Today is my first day of working a full day – reluctantly and semi-lucid. I am still taking a muscle relaxer and oxycodone at night to sleep because of the CPM (I spend all night in my CPM in order to meet the recommendations for rehab otherwise I’d have to spend most of the day in it). I feel pressure to return to work, knowing that in less than 2 weeks, I have to be on my feet teaching 8-10 hours a day, and yes, I am (still) enrolled in doctoral work this semester.
  • Social/Emotional – I am very socially isolated because I am trying to work while recovering. (As you may guess, in hindsight, this didn’t turn out too well. I don’t recommend it. Take time off to recover. Cancel everything if you can. Focus on getting better). My weight-bearing and movement precautions are also to blame for my isolation. In a house with multiple stories,  I can only climb so many stairs. I have to spend most days alone on the uppermost floor. However, family support is tremendous. I could not do this without them.
  • Spiritual – Meditation, prayer, and breath as the vehicle for both, keep me grounded and positive. Because of the strength and faith these give me, I don’t second guess my healing or my ability to overcome. And, they also help manage daytime pain without medication.

Biopsychosocial Progress: The Yoga of Hip Labral Rehab

I am slowly resurfacing. My daily mantra for this first 10 days was captured in this simple picture of my son James, playing with this “James” train from Thomas the Train. 

(c)2014. Ginger Garner.com

When I saw the photo, the words, “I think I can, I think I can, I think I can,” instantly came into my mind’s eye.

A few days later I made the meme from the photograph, and I still keep it on my desktop in my office today. The meme was my first post to facebook after surgery, and in the caption I wrote:

I am thankful to everyone for their prayers and well-wishes. Please keep them coming, I have a long way to before I can firmly put both feet on the floor again. 

(And thanks to Naomi Satterfield for capturing this photo, it gave my mantra a breathing, living soul – and helps me connect my recovery to my son’s sense of wonder and play.) 

Clinical Pearls:

  • Be patient, and do not force progression in rehab. The phrase “no pain, no gain” does NOT apply to hip labral and FAI rehab.
  • Get “pre-hab.” Rehabilitation prior to surgery is an absolute must. If your surgeon does not refer you (and he/she should), then find a PT who specializes in HLI rehab and see him/her for at least 2 visits. I am so thankful for the pre-hab I did on myself – or else I would’ve really been in a mess (see below to see what that “mess” could have included).
  • Include a contemplative science in your rehab. For me, that practice is yoga. I am most thankful for the mindful and sensitive hands, eyes, and perception that yoga has given me – or else I would have missed the signs of HLI altogether. Missing subtle signs of injury and impairment lead to bigger, chronic and hard-to-treat issues, which is a mess. That “mess” could include a range of pelvic and/or back pain conditions. Some of those include sacroiliac joint dysfunction, pelvic pain such as non-relaxing pelvic floor, dyspareunia, or pudendal neuralgia, in addition to hip pain.
  • Ask for help. At 10 days out, you still need a great deal of physical support. Before you have surgery, make plans to have at least 2-3 weeks of help at home. Even after that first 30 days, you will likely still need help with meal preparation, grocery shopping, and basic ADL completion.

Resources

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