My Hip Blog » FAI

My Aching Feet!

Jess — Wed, 19 May 2010 21:09:21 +0000

That's It? Another microscope moment brought to you by Jess's radiology

Went to the podiatrist last week. She couldn’t get in to see my xrays but managed to have a look during the week. Said she could see the area of the stress fx and had a yak to one of the sports docs who agreed that treatment should just involve taking the load off of the bone. So now I have some fancy pants orthotics in my shoes to do that job. It seems to be working as my forefoot isn’t sore, but oh my god, who would have known orthotics could be so uncomfortable! I hope it’s just a matter of getting used to them as I’ve already had them adjusted to make the arch more comfortable (feels like it’s digging into my heel or walking on a rock all day), but a trial walk around an office and a day on your feet are totally different things!

Hip is doing great. Had my trial ‘last’ acupuncture session on Tuesday, she must have wanted to go out with a bang as I ended up with a huge bruise from one of the needles lol I got a new exercise to do to activate my glutes and take the load off my hip flexors. Have to report back next week on how things are so we can decide whether I need to go back.

Off for a bike ride now while there is a gap in the rain. It’s so cold here now! Glad for my new wind/waterproof booties

Acupuncture and Surgeon Appointment

Jess — Wed, 28 Apr 2010 08:21:50 +0000

Well the ultrasound treatment really didn’t make a difference, I think it’s too gentle. We tried some acupuncture last night which was interesting…five needles in a circle around the hip and one placed in my butt cheek (gallbladder something). Waiting to see how this goes but had a fairly uncomfortable and sleepless night after that, though felt better today. I have two more treatments next week.

My physio wanted me to get in touch with my surgeon to make sure we were doing the right thing and for some guidance as to what might be going on and the treatment. He said it could well be scar tissue and has suggested I make an appointment with him so he can check my hip and we might schedule an ultrasound to see what is going on. So, appointment booked for 12th May. In the meantime he recommends stretching.

My immediate future (from tomorrow til Monday) involves a trip to Auckland with snowboarding (first time including a 2 hour lesson ), a possible trip to an island bird sanctuary, a duathlon and shopping! Eekkk. I’m a glutton for punishment.

Six Month Blues

Jess — Thu, 22 Apr 2010 05:19:44 +0000

My physio appointment could not have been timed better. I had the day from HELL yesterday. From the time I woke up I had nagging hip pain and an ache that ran the length of my thigh. All I was thinking was oh my god, please don’t let this be happening AGAIN! I just couldn’t handle it if things went pear shaped again. Thankfully after taking some painkillers it did come right and today I am back to normal. I have no idea what caused the random flare up. I biked 50km in the weekend but it is too far out for it to be caused by that. In fact, lately, cycling seems to make things better!

Had my physio appointment this afternoon. She is still too scared to do anything aggressive given my history and seems afraid she’ll make things worse. She thinks the latest snapping and tenderness might just be some inflammation from overdoing it at the gym a few weeks ago. The plan of action is to avoid the hip machine at the gym for the time being, stretch the TFL/ITB at least 3 times a day and do some ultrasound treatments then reassess. If this doesn’t help, last resort is back to the surgeon for possible steroid injection/scans/xrays. B L A HHHHH for goodness sakes I thought I was done with all this crap. I REALLY don’t want a steroid injection. I have worked so hard at getting off all medications and had been successful for the past couple of months until yesterday’s little hiccup. Feeling like life is once again on hold until good old leftie starts behaving…

Back To Physio

Jess — Wed, 14 Apr 2010 23:41:40 +0000

I have finally given in and made an appointment to see my physio next week.
I don’t know what is going on down there, whether it is scar tissue, muscle, tendon or something else but it’s finally got to the point where I’m sick and tired of it!
It is tight when walking and still have snapping at the Greater Trochanter, especially when straightening from a bent over position. I have also discovered a ‘tender spot’ at the outside/front of the hip underneath the iliac crest which I guess could just be where the labrum was debrided. Has anyone else had pain here or sensitivity to palpation, kind of like a deep bruise?

Good news? Still no groin/joint pain I’m sure the snapping issues can be sorted with physio and the bruised feeling will disappear with time. Funnily after the first couple of settling in minutes riding my bike, I have no trouble with the hip at all. I did my first hill ride last Friday, up to the top of the Port Hills for a great view of Christchurch! Didn’t think I’d make it all the way, felt a bit of protest from my glutes but otherwise it was fantastic!

11 Weeks Post Op Check – No Pain, No Gain

Jess — Wed, 27 Jan 2010 07:54:59 +0000

10 minutes and it was all over. Quickest consult ever and I got all my questions answered lol

Overall Mr. R. is pleased with my progress which made my day. I had been worried that it was going a bit slow but he assured me that it is still early days.

The swelling could hang around for another couple of months but he didn’t seem concerned about it. In the past week I’ve had a little snapping on the outside of my hip when i straighten up from bending over which I never had before. This apparently is due to the IT band. I guess while the swelling is still present this is a little irritated but he told me that as my gluts etc. get stronger this should improve. Come on buns of steel!

The residual pain and limited flexion is due to scar tissue from the capsulotomy. He wants me to push through this pain now, taking pain killers as needed (and assured me I won’t do any damage) to break down the scar tissue and prevent more forming. If this doesn’t get better he said he can do a steroid injection to help things along. I have a follow up appointment in six weeks time so it could be a long six weeks! Not at all keen on the injection though, remembering the flare it caused in my wrist.

I have the OK to get a pool/gym program so his secretary is going to send a letter of approval to ACC and they will fund it!
I have no limitations, just have to use common sense with lifting etc. and avoid twisting while lifting.

So I’m a happy chicky right now. Pleased I can push things a little without worrying it will be doing any damage. Mr R says that he can’t guarantee it will ever be 100% again, but it is already better than pre op and I am certainly heading that way

Hip Scope Recovery 3 wks 3 days

Jess — Fri, 04 Dec 2009 09:51:15 +0000

I have been pretty sore since starting my physio and pool exercises, the sorest I’ve been since I’ve been home from hospital. I can’t tell what specifically is causing the pain to increase but my best guess would be the pool exercises as they are the only thing I am doing that actually ‘uses’ the joint. Ice seems to help a bit but not a whole lot. So today was a rest day. Tomorrow I had planned to go to the gym and hop on a stationary bike as I’ve been DYING to do this, but I think I will have to just wait for that. I have a pool session planned for Sunday so will see how the couple of days rest go. I am continuing to do my physio exercises as I really don’t think they are aggravating (bar one that is hurting my knee so I’ve stopped that one). I think this is a fairly common occurrence from what I’ve read, so I’m not going to get worried, just take things slowly.

Hip Arthroscopy Recovery Week 3 – Physio

Jess — Tue, 01 Dec 2009 08:41:20 +0000

I finally made it to physio day. I had been so looking forward to today because it marks the start of my ‘real’ recovery and i can start to be more active.
I love my physio, she’s just great…even makes me laugh…saying ‘bumholes’ when you’re reading someone’s surgical report isn’t something you’d expect a professional to say, but I loved it lol.
She’s a little wary of doing too much at this time and doesn’t want to undo my surgeon’s good work, so has given me some basic exercises to do on my own. Pelvic floor exercises, pelvic tilts, very small leg lifts (1cm – lying on front and back with knee bent) and some pool exercises (walking/careful aqua jogging and forward/backward leg raises). Unfortunately because of the flexion/abduction restriction I have until 6 weeks post op I can’t stretch my Piriformis and it’s giving me grief! I’m hoping the pool exercises will help. I go back to see her on Monday.
I didn’t make it to the pool today because of a logistical hiccup, but it is the first on my list of things to do tomorrow among lunch and coffee with workmates!

I’m at the point where I REALLY want to ditch the crutches. I have been good and using them while out and have the ‘orrible blisters/callouses to prove it. I can walk pretty well but because of my restricted extension when walking and the random occasion that the muscles decide to not work and cause my leg to give out I still need them for bigger trips. My physio also instructed me to use them in busy places such as the supermarket until I am 100% confident because falling now would be a disaster. So they now live in the car lol. I don’t need them around the house and am managing the stairs ok.

Hip Arthroscopy Recovery 2 Weeks 2 Days

Jess — Thu, 26 Nov 2009 01:54:51 +0000

These blog post titles just get stupider and stupider lol

I made it to Auckland in one piece In the end I decided to take both crutches on the plane which was lucky because I really needed them to get to the car when I landed in Auckland. I had no trouble with security, just put them through the x-ray and hobbled through the metal detector and everyone was nice. I haven’t had a lot of pain, just a slight groin pinch feeling and have been quite stiff.

I have taken over Mum’s laz-e-boy which is super comfy and have to remind everyone that I don’t need to be waited on hand and foot! It is nice to have a change of scenery though and new shops/malls to explore. We spent 2 hours at Sylvia Park mall today which has resulted in blisters on the heel of my hands but I got some much needed Christmas shopping done and had a yummy lunch!

Weather is warm, I have my own room with brand new bed and snuggly pillows and had a fantastic sleep last night. Was my 2nd night with my new bite splint ($600 piece of moulded acryllic for TMJ treatment) and it went better than the first night. It’s quite tight so is hurting my front teeth a bit, but hopefully that will settle with time. It totally stops me from being able to grind my teeth so I hope it does the trick and stops my jaw from clunking permanently, though this will take a while.

Hip Arthroscopy Recovery 2 Weeks

Jess — Tue, 24 Nov 2009 06:23:19 +0000

Yayyy, had my post op today and finally got the sutures out. Still not allowed to swim for another week which is a bummer.

Mr R went over all my pictures with me and showed me why he had to do what he did, looks a mess compared to the last time. Can plainly see the CAM lesion, herniation pits and calcification. Thankfully my cartilage is great and I should have a full recovery, however he is unsure of how the labral resection will affect the hip in the long term as there is still debate as to its proper function.

Got the OK to start cycling on a stationary bike with high seat (to minimise flexion) and have made my first physio appointment for next Tuesday. I am allowed to start running when I can do a single leg squat, hopefully by January.

No flexion with abduction for a further four weeks due to the capsulotomy, I can handle that…dunno bout ‘H’ though

1 = First view of the joint and inflammation.

4 & 5 = Calcified labrum.

6 = Image showing what is left of the anterior labrum and calcification.

7 = Knife cutting labrum from acetabulum to attempt repair.

8 = After anterior labrum removal (fell to bits upon detatchment).

10 = View across femoral neck showing no offset, it should have a dip in it. (Acetabulum on the left)

11 = Herniation pits and chondral damage to femoral head. (Acetabulum on the right)

12-14 = Removal of CAM/Ganz lesion with motorised burr. (Acetabulum on the right)

15 = Finished CAM removal. (Acetabulum on the right)

These are the images from my first scope two years ago. As you can see there has been a lot of degeneration since then.

Operation Report

Mr John Rietveld @ St Georges Hospital, Christchurch, New Zealand.

Left Hip arthroscopy and debridement of labral rim which had some calcification within it, unfortuantely there was no repairable labrum here and resection of significant prominent head/neck junction.

The patient was anaesthetised and the left hip was prepped and draped in the usual manner to give a sterile field. The image intensifier was used and a 2 portal arthroscopy was undertaken. The findings showed that the labrum anterior was pretty much redundant and it was actually really just part of the acetabulum where the ossification within it, there was a small area of calcification in the anterior labrum and the labrum adjacent to this was lifted. I tried to take this down with the knife but unfortunately there was only a couple of millimetres thick and with the calcification it just fell apart, therefore I resected this with the wand. I then inspected the head and found that there was a significant area of chondral damage on the rim, then marked this area where there was a lack of head/neck offset with the wand and then used the burr to resect and recreate a head/neck offset. Following this I ran the hip through a full range of motion both with the image intensifier and direct visualisation and found that it was no longer impinging. I thoroughly washed out the joint, placed some Nylon sutures into the portals followed by dressing.

Post op instructions:

Pain relief as charted, neurovascular obs, see in clinic at 2 weeks for removal of sutures and wound check, patient may mobilise full weight bearing.

After seeing all this do I think I’ve done the right thing?? ABSOLUTELY!!! I (and my surgeon) feel I have made the right decision and because I got rid of the offending anatomy and the rest of my joint is good, I now shouldn’t need an early hip replacement.

I am able to sleep on my operated side for longer periods now and can get up the stairs without the sharp groin pain finally. I can put my shoes on and tie them, though this still remains a little difficult and have managed to shave my legs!

I am off to Auckland tomorrow to visit Mum and her partner for a few days. I will be taking my crutches as I am still needing them for longer walks and if I have any sort of flare up I need to be able to get around. At least if I don’t need them they fit in my suitcase

Oh, and drove for the first time today!

FEELING GREAT!

Hip Arthroscopy Recovery Day 11

Jess — Sat, 21 Nov 2009 10:06:39 +0000

I think things have plateaued a bit. I can manage around most of the house without crutches. I am still getting a sharp groin pain when pushing off on my op side going up stairs, so using one crutch for those but can manage coming down without. Trialled one crutch for walking a medium distance today (about 200m) and discovered that I am still relying on it quite a bit which makes my shoulder sore. I over-extended at one point which had me seeing stars and unable to flex hip for the walk back (felt like something was stuck in the joint), thankfully this settled by the time I got home, so back to two crutches for walking for now, boo. Good thing is, I have gotten a lot better at using them and it’s not quite so exhausting!

Good hip has been slightly troubled, and if I’ve taken any painkillers in the last couple of days it’s been because the good one is aching. Not that I’ve been out doing anything, I’ve gotten to know the couch very well! It must be all the sitting.

I had ‘the meeting’ with my case manager from ACC. It went well, just had to sign a mountain of paperwork and fill in a musculoskeletal pain questionnaire to keep them happy. (Orebro or OMPQ, for you physios out there). Not very exciting but she did mention that she’d read my op report and was surprised that I was able to get around as well as I am. She is going to post me a copy as I mentioned I hadn’t seen it yet!

I am dying to get the stitches out (3 days and counting) and start some form of rehab. There is a woman’s bike race at the end of February with a flat, short course (37km) available and I’d really like to be able to participate in it. My sights might be set too high but at least it is a goal for now to at least get back on my bike in the new year.

I forgot to send out a HUGE thank-you to Nicky for her amazing box of goodies that arrived for me on the morning of my surgery. What a lovely surprise, full of chocolate, things to do, hand cream, lip gloss, wet wipes, cat toys and treats, my goodness I was totally blown away. I have to say my favourite item has been the laser pointer, if ever I need a laugh and a cat is around, they go berserk! Thank you also to everybody else who has messaged, visited and sent well wishes, every single one of you have brightened my day!