Recently a question about hip labral surgery needs was asked on a closed Facebook page I administer. I am both a “hippie” (aka hip labral injury) PT and a patient; and as a result, I hear this question often and see it equally as much on Facebook support group pages for hip labral injury. However, since my own surgery, I realized I have yet to answer the question publically.
So today I am finally going to answer the question of “must haves” for hip labral surgical recovery. I also apologize in advance for the long post, but hip preservation surgery is no joke. It deserves careful attention and planning in order to optimize your recovery.
Question: For all those that have had hip labral surgery, if you could recommend anything that is a “MUST HAVE” for recovery I would truly appreciate it I am keeping a list and just want to be prepared. Thank you kindly!!!
Answer: A person could easily draft a dissertation on this topic; however, we don’t have that much space in a blog post! So, let me give you the short story.
Here are the Top Five “Must Haves” After Hip Labral Surgery:
- Support. Support. Support. My in-laws literally moved in with me, my husband, and our three young children for a month after my surgery. I cannot emphasize how much this SAVED. MY. LIFE. Cooking, cleaning, maintaining my business while I was on sabbatical, fielding and feeding children, packing school lunches, and arranging the shuttle schedule for school alone (I have a preschooler and 2 elementary-aged school boys) is enough to drive anyone mad. And although my husband is a stellar chef in his own right, there was no way he could do even just the cooking by himself PLUS take care of me (remember you can’t even put on your own sock or go to the bathroom by yourself for quite a while) while ALSO holding down his own jobs (he has two). So my wonderful in-laws swooped in and saved the day.
After my wonderful, amazing in-laws returned home to their lives, we still had help for several weeks with meals and my transportation to and from physical therapy, arranged by lovely friends and church family. And for several months after, I still needed help negotiating everyday tasks – so don’t be afraid to ask for help.
- A comfortable place to convalesce. You are going to spend the first three weeks, give or take, in a mostly horizontal position. You don’t want to create contractures in the psoas, nor irritate the repair, so make sure you create a “nerve center” of sorts, which was the name I gave to the place where I spent my post-operative days with all my post-surgical “toys.”
For starters, your nerve center will require a wedge that allows you to lie at an incline (laying flat all day doesn’t cut it, especially when I still had to “show up” to my virtual office at work even during the first week of recovery) and lots of extra pillows. Also, a lighter weighted blanket is helpful because you are quite unable to negotiate bed transfers very easily. I ended up using multiple sofa throws because the duvet and cover on my bed was way too heavy and bulky for my new hip to handle.
- Post-operative Toys. Speaking of “post-operative toys,” some of the necessary equipment you may need or be issued upon discharge from the hospital can include:
- Raised toilet seat. I was not issued one of these, but the hubby ran out and borrowed one as soon as he realized how laborious (and painful) it was for me just to negotiate the bathroom.
- Reacher. You can pick one of these up at any drugstore or home health supply store for less than $20. I can’t tell you how many times I dropped something in those first 8 weeks post-op, and let me tell you, once the “thing” you drop is on the floor, it is in “never-never land.” The reacher is a small life saver, so pick one up.
- Back scratcher – This little gem is just as handy as the reacher. No explanation necessary.
- Walker. Now, before you pffft in disbelief, let me first say this: Not everyone will need a walker. Most of us “hippies” (as hip preservation patients call themselves) will be cool as cucumbers on crutches. However, I wasn’t one of those cool cukes. I set aside my pride and grabbed a walker (something else my hubby ran out and borrowed without me even asking, again, because he saw how much I was struggling with dizziness, low blood pressure, nausea, and pain) within hours of returning home.
Post-operative pain widely, WIDELY varies. And, pre-operative disabilities, such as chronic tendinopathies or muscle tears, can make ambulating with crutches very difficult and can even aggravate pre-surgical injuries.
The take home message: I invite you to set aside your pride too; and be prepared to pick up a walker if crutch ambulation proves too painful or too dangerous (e.g. if you are dizzy or lightheaded, you do not want to risk a fall).
Another handy use for a walker is carrying all your stuff around. Just add a little saddle bag or pouch onto your walker and voila’, you don’t have to keep asking for helpl! You can’t carry stuff while on crutches without a backpack, which is a no-no in early post-op. Also, if you are fatigued at the end of the day or out of kilter (read: stiff or achy) first thing in the morning. Crutches require excellent balance and medications, AM stiffness, or fatigue can increase risk of falls. A walker can actually give you more independence with completing activities of daily living (ADL’s).
Note: Once you progress to crutch use comfortably, you will need to consider step down assistive devices, such as a quad cane or straight cane. Your PT will determine when you can graduate to lighter use assistive devices.
- Ice machine. There, I’ve said it. Yes, you absolutely need an ice machine, not just those ice pack thingies. Compression and moist cold, combined with elevation, is a huge life-saver that improves post-operative healing. Lingering edema (swelling) can also cause pain and prolong rehabilitation. Game Ready is a great brand, but don’t expect your insurance company to cough up the dough for it. (And for the record I have NO financial affiliation or benefit for plugging Game Ready in this blog.) Let me just say this, here’s how important ice, compression, and elevation are: As a hippie PT and patient, I don’t regret having paid out of pocket for the 4 week rental. It is totally worth it and made a substantial difference in my early recovery, pain and edema management.
- CPM unit. Well, this is controversial, but let me give you my 2 cents worth on it. If you have pre-existing injury secondary to the hip labral injury, such as psoas tendinopathy for example, the CPM can passively move your leg while allowing those chronic pre-surgical injuries to heal. This is versus the upright bike without resistance (which is typically prescribed in place of the CPM), which can still irritate the psoas.
What’s more is surgeons typically do not want you stressing the psoas (one of the flexors of the hip that help you walk and bring your knee into your chest) during the weeks immediately following surgery – for many reasons of which constitute a whole other blog post. The bottom line: A CPM can help take the stress off of the anterior (front) of the joint and psoas while restoring vital early ROM back in the hip. This little detail is critical for optimal healing. Again, your insurance company may not pay for your CPM unit. What’s my take? I had a CPM unit and as a PT, I think it was critical to getting early painfree range of motion again and provision of biofeedback to the psoas.
- Anti-internal rotation pillow. Now, I didn’t have an anti-rotation pillow, but I had a cheap solution for one. I kept my hip in neutral and stable by placing extra firm couch pillows or a throw on either side of my foot and lower leg (or rather I had someone else do it, since I couldn’t reach my foot). Problem solved. The purpose is to prevent your leg from passively (and chronically) falling into a position (internal or external rotation) which would either a) stress the new labral repair or b) cause adhesions and range of motion limitations once therapy begins.
- Brace. This is another controversial post-op toy, but I can make a professional argument for its necessity, especially for patients who are at high risk for reinjury, falls, and/or may have low proprioceptive abilities. I had a brace, and I can say it was my best friend for quite a while.
- Pain medications (and anti-inflammatories, possibly anti-clotting, anti-spasmodic, or other prophylactic medications). Yes, you are going to need them, and this is coming from a PT who shuns all medications whenever humanly possible. However, there is no way you can power through major surgery, and let’s call a spade a spade – you can’t power through HIP RECONSTRUCTION, without taking the medications your surgeon prescribes. There are very few surgeons who specialize in hip preservation surgery, so listen to them when they recommend certain meds. The meds are there for a reason, from everything to protecting your stomach lining to preventing post-surgical periosteal complications from arthroplasty to preventing blood clots and general harmful inflammation.
- Other miscellaneous but useful items. Consider the typical side effects of major surgery: you can’t move easily, you may feel nauseated, dizzy, light-headed, and yes, constipated.
You won’t be able to move around very easily, if at all, in the first few days to weeks. A good sturdy breakfast tray, a constant stash of saltines and ginger beer (non-alcoholic yes) for that early post-surgical nausea that can linger for days, and all the trappings of a “nerve center,” such as cell phone and charger, laptop, books (and more books!), movies, etc, are a must. Constipation can also be a common and very uncomfortable situation for most folks who undergo this, or any type of, major surgery. Hydration, acupressure points for digestive motility, and abdominal self-massage, not to mention supplements like fiber or magnesium, should be mainstays alongside a plant-based diet high in fiber and protein and low in simply carbohydrates.
Okay, so now I’m cheating, but I can’t close the post without giving you just two more tips.
TWO BONUS TIPS:
- Find your Center. “Huh?!?”, you may say – “What’s my center?” Your center is where the real YOU can be found. Meditation, prayer, deep breathing, and/or journaling are all ways to discover the real you, the happiest you, the you that you were meant to be.
Surgery (especially surgery as big as hip reconstruction) is a major life-altering event that provides a perfect opportunity to go inside and rediscover that spark for living, creativity, and love.
Living your best life starts by reflecting on how you got to the place you are now, and what you will do to ensure you can and will give your hip (and your self!) the best shot at longevity, optimal health, and happiness.
As your acute pain diminishes and your need for pain medications wanes, take advantage of the time that solitude and respite affords you.
- Get and Stay in Physical Therapy for the Long Haul. The last and most important “absolute” that you will need is physical therapy. Get in the game and stay there until you finish it. Don’t quit early.
It takes a solid four months of PT, 2-3 times a week, plus doing your prescribed home physical therapy EVERY DAY, to fully recover. I know, I am living it. I see and budget seeing 2 PT’s, 3 times weekly, in addition to my own PT.
And even after formal PT is finished, continue your prescribed home program and check in with your PT periodically to progress your program. The longevity of your hip depends on it. Also, allow yourself a full year before you can expect to feel “yourself” again.
Good luck and best wishes on your journey for a successful surgery and return to the life you want and deserve. And if I can give you a parting tip – Remember, stay positive, because your body hears (and responds to) everything your mind says.
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