Symmetry Physical Therapy and Tri ‘Training’

I am in my 8^th week of physiotherapy now; the first two being in-home physio and from then on 2-3 times per week at Symmetry.  http://www.symmetrypt.com/p_main.html      Choosing your physiotherapy company and physiotherapist is really important.  I based my choices on (as always) location – driving is baby-sitter money, and on what I perceived to be their sports emphasis. 

I am really pleased with where I go.  We work twice a week now and have built up to over 2 hour sessions which include stretching, marching with weights attached, 80lb leg press, elliptical, clam shells, hip raises, and balance exercises (including my personal favorite – the one where I balance on a sponge mat on one leg whilst assorted trainers throw balls at me  to catch - I’m very bad at this but would have been pre-op anyway).  

The physiotherapists there are all incredibly good. I work with Gary Abano who is very knowledgeable, he listens to my body’s progress, doesn’t let me push too hard, yet at the same time keeps moving me forward and adjusting my work each week. 

 On top of the physio I am managing to swim once or twice a week and I just reached the 1 mile mark, still swimming with a pull-buoy. At the gym I bike for about 40 minutes twice a week and am desperate to get outside on my bike – still not recommended but it had better be soon! I can walk non-stop for over an hour (outside of course – can’t comprehend using a running machine indoors).  I have started to build up the time on the elliptical machine.  It may only be 15 mins right now but I’ve been unable to run for well over three years and this is really hard work believe me!  I am hoping that this is working towards that first fabulous outdoor run one day (just a short one . not far or fast honest)   … fingers tightly crossed.

7.5 weeks

Things feel back to normal.  It’s great to be able to walk as far as I want, be active all day, drive long distances, lift strollers in and out of the car, cycle at the gym etc.  The reality is that things are not fully healed until 3- 6 months so my operated-upon hip reminds when I’ve done too much by swelling and feeling stiff in the evening (I’m supposed to ice it but haven’t managed to do that yet).  There’s only been once in the last few weeks that I’ve gone back to limping badly and that was on vacation where we drove for several hours and then walked for several more. It is definitely stiff when I’ve sat for too long and then I’m back to walking very strangely for a few moments whilst it works itself out…

After the vacation incident my family decided after the second day (this was at week 6) that I would slow everyone down too much on the third day’s visit to Busch Gardens. They rented a motorized wheel-chair for me.  This of course turned out to be where all the bags were kept and also the children’s favorite ride of the day!

5 weeks after surgery. Physiotherapy

I have been in Physiotherapy for 2 weeks now, going two to three times per week.  'Symmetry' in Pelham, NY http://www.symmetrypt.com/.  We focus on stretching, building strength, and balance; the sessions last from between 1 -2 hours.  As I’m learning the routines of exercises I can work more independently and the time is shorter.  It is not difficult but some are uncomfortable.  It’s good to have my boundaries pushed as I’m made to lay on my incision side or balance on one leg whilst bending forwards (thankfully the physiotherapists are trained not to laugh at my wobbles or sideways lurches). 

It has been great to drive again, this was at 3 weeks.  I pottered around locally for the first few days then of course pushed the limits and drive into Manhattan two days in a row causing my leg to painfully swell by the evenings. 

I am now at the point where I feel that pretty much everything is back to normal in terms of day to day activities but maybe that’s the reason I have more pain and swelling again in the evenings.  When it doesn’t hurt and you can get around as you used to it can be hard to limit yourself.  My physiotherapist told me that can be one of the difficulties patients have after the anterior approach hip replacement -  you feel so good so quickly that you can be in danger of doing too much too soon.  I do avoid doing the weekly food shop and don’t chase after my two year old or carry him when he’s throwing a temper tantrum.  I am enjoying swimming (still with a leg float) and biking on the bike trainer but of course no running…yet…

3 1/2 weeks later

Things are almost back to normal.  No pain killers, no crutches or walking aids.  I can drive, take the children to birthday parties, run errands - all back to a regular weekend.  I wouldn't do a big supermarket shop or go for a hike, but its great to be living life as normal already.

first swim and leg length

So, first swim today.  I was nervous, with images racing through my mind of myself not being able to climb in / out of the pool on the ladder and flying backward into the pool, arms flailing.  But it was ok; getting in a little easier than getting out.  After getting changed I walked past the mirror on the way to the pool and was distracted by my scar below the swimsuit line and the ugly bumpy swelling around it.  Not a great visual but it’ll change over time and is something I’ve decided not to dwell on.  The benefits outweigh the negatives.  Swimming felt great; I started with a strange version of breast stroke whilst I got my confidence up.  Then I used a pull buoy to support my legs whilst I free styled up and down.  How nice to move without using constant conscious thought and effort on how to do it correctly.  I wasn’t the fastest in the pool (am I ever?) but I certainly had the biggest smile when my 25 mins were up.   

 I am getting increasingly concerned that my legs are not the same length, with my operated leg being longer.  Dr Davidovitch said after the surgery he was pleased because that they were the same and so I hadn’t really given it much thought until the last couple of days….  He is an amazing surgeon and I am sure it is not easy to chop off part of someone’s femur and replace it with metal, plastic and ceramic and end up with two legs the same length.  However I am finding that as I stand straight with two feet together pointing forwards I need to bend my right leg in order not to tilt my hips. It is easier to stand with my left heel off the ground.  This seems to be pretty common with options such as redoing the operated leg, wearing supports in the opposite shoe (how does that work with stilettos?) and, waiting until the other leg is operated on and making that one longer to match.  It may also be due to muscles and will correct itself.   Hmmm,   I’ll see what my outpatient physiotherapist and podiatrist have to say on Monday.

20 days after surgery

Staples are out – the only visible marks from the operation now are a red incision about the length of my middle finger on the front of my thigh, and circle of small bruises on my stomach from the nightly injections.  Not bad.

The staple removal was pleasingly painless and the doctor’s visit all in was very short.  Once he could see I could walk without dramatic limping, my legs still looked the same length, and that I was getting back to normal life, I was dismissed until my 3 month check-up.   

The physio is beginning to ramp up a gear with some painful maneuvers to practice but, as with everything I’ve experienced in this process so far, they seem painful and even difficult for a couple of days then are pretty easy and merely uncomfortable. I am looking forward to getting back into the swimming pool – officially now allowed - but I’m nervous of climbing down into the pool so I’ll wait another week.

My walks around the block three times a day are a salvation as being trapped in the house is emotionally tough.  This is also coinciding beautifully with the start of an early spring.  I no longer take either crutch with me.  The final walk of the day I can’t walk without limping but its all going well and I’ll start walking further soon. 

X-ray of my right hip