Three hip surgeries and barely 30 years old 

Barely 30 years old, Mark, a rising Orange County management professional, has become an expert in recovering from hip surgery as he completes his third, and hopefully final, rehabilitation program following his latest arthroscopic procedure for a hip impingement.

Unfortunately for this life long hockey player his athletic lifestyle, that included working out and running competitively, took a toll on his hips. Pain and weakness, resulting from hip impingements with subsequent labral tears and cartilage damage, required surgical repair.

The first operation, on his right hip, in 2007, was done with an “open” procedure. Three rods with screws were implanted necessitating a three-day hospital stay and six months of recovery time.

Physical therapy after hip surgery takes time and can’t be pushed 

Six years later, suffering with pain and weakness in the other hip, he found himself needing a second surgery. In Sept. 2013, with improvements in arthroscopic techniques, his left hip was repaired. This time it was an outpatient procedure. He was home in the afternoon and the overall recovery time was cut in half. In fact, in March of 2014, he ran a 5-mile relay in the desert.

He credits Jennifer Unterreiner, DPT, at Progressive Physical Therapy and Rehabilitation in Costa Mesa, with getting him back in action.

“I was really lucky,” Mark says. “After researching physical therapists I found Progressive Physical Therapy and Jen. Besides being very experienced and knowledgeable, she really understood how to relate to me. Being athletically inclined, I’m used to pushing myself and sometimes that can be a bad combination in physical therapy when you need to let the injury set the timeframe for progressing. As a result, she spent a lot of time educating me on why I had to take it slowly making sure I wasn’t overdoing anything and possibly re-injuring myself.”

Recovery from hip surgery takes time and it is not something you can push. Patients have to be mindful of any sort of weight bearing activities for the first few weeks and need to give the hip joint time to heal on its own. In a surgery as complicated and detailed as Mark’s was, timing is everything.

“There are certain milestones we have to hit and just have to wait for before we can really start progressing,” Jennifer said. “From weight bearing restrictions to range of motion exercises, to strength, agility, coordination and endurance, everything has a time and place, and certain goals need to be met before moving on to the next step.

Focusing on labrum stability is the key to advancing the recovery process

“I knew I was going to have my hands full with Mark from day one. It is never easy having your life turned upside down because of an injury, and to be on your second surgery at such a young age is even more frustrating, especially for someone who is used to his body performing a certain way. I knew that the only way Mark would be successful was if he TRULY understood the process and felt like he had some degree of control over the situation. Education and knowledge really is everything in terms of therapy, but it’s more than what I know, it’s what the patient knows and what they do with that information that matters, and Mark was the perfect student.”

The early phase of rehab was the most difficult since Mark was limited in what he could do. Special attention needs to be given to the labrum, which already doesn’t heal well, to ensure it was as stable as possible. Once the acute phase passed, he could do more.

“Mark started to come around with his engagement in therapy and things started clicking for him,” Jennifer said. “We had MANY conversations about how to make sure we were doing this the right way, so he could get back to everything he wanted to do. At the end of the day, every patient has the same goal getting back to their life! By the end of Mark’s rehab, he was killing it! He was able to run, jump, go the gym and live his life.

“The best part about all of it for me, was watching him learn and understand his body better, to be able to know how to progress and adjust his routine on his own and feel confident and comfortable in doing that. To hear back from him later that he had been able to run the 5 mile relay, absolutely made my day, because at that point we had succeeded in getting him to where he wanted to be, back to his normal life!”

All of Mark’s hard work during rehab pays off when he faces a third hip surgery 

In early Jan. 2015 he began training for the LA Marathon that was just a few months away. Two days after completing a 17-mile run, the pain and weakness in his right hip re-appeared. Barely making it one-half mile, he had to stop. The original surgical procedure was failing and once again, he was facing another operation.

The only good news about the third procedure, if there was any, was the fact that the exercise program Jennifer developed for him, following the last surgery would ultimately help him in the recovery process.

“Having Jennifer spend the time to educate me on the mechanics of the exercises we were doing during our physical therapy sessions helped me visualize how they were positively impacting my body,” said Mark, who is also a personal trainer and soaked in the information. “What I didn’t realize at the time, was the home exercise programs she gave me, provided a well-rounded foundation that would ultimately become part of my regular routine, providing strength and conditioning for the long-term support of my body and hips.”

Ironically, this plan, which included additional work on his hamstrings and gluteals, became a pre-surgical rehabilitation plan. In fact, some patients with certain back, hip, and knee issues can avoid surgical intervention with physical therapy. For those who don’t see significant improvement and require surgery, the good news is that the effort and hard work put in before surgery generally results in quicker and less painful recovery. The evidence suggests that patients who are scheduled for an orthopedic procedure, should consult with a physical therapist to determine if a strength and conditioning program would be beneficial prior to their surgery in order to maximize their post-operative outcome.

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