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Hip Labrum Postop. Integrated Rehab, Day 7: Mantras & Edema (Post 5)

Attending to the Bliss Body (anandamayakosha) on Emerald Isle, before surgery (c)2014.
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Attending to the Bliss Body (anandamayakosha) on Emerald Isle, before surgery (c)2014.

Hip Labrum Postop. Integrated Rehab, Day 7: Mantras & Edema

This is post #5 in the Hip Labral Post-Operative Series. If you haven’t read them yet, check out:

Day 7 – First Day of PT

Today is the my first day of PT (administered by someone else, that is). Stair climbing, transfers, isometrics, integrated care – all that I’ve been doing on my own so far, deeply ingrained in my being after 20 years of clinical practice. If you want to know what I did in days 1-6, make sure to read the posts above.

On my first day of PT, my adductors, psoas, & ilacus are terrifically and painfully reactive and angry. I’m far from lucid or clear-headed, but I’m getting better each day. Having to climb multiple flights of stairs a day and still be a mom, keeps me pressing forward.

I have swelling (still), but less dizziness, less nausea, and less of all those dastardly side effects of surgery…but the supporting musculature around the hip is terrifically in spasm/reactive.

I am reminded of 2 proverbs that have become mantras for me.

The first is –

That which remains where there is no more grasping, is the Self.
~ Panchardasi

The second is –

Don’t water your weeds.
~ Harvey McKay

In both cases – this joint reconstruction is a chance to evaluate my Self – and make sure I am not watering any weeds.

Reflecting on day 7, a third comes to mind:

Don’t let your strivings make you weaker.
~
Laura Thompson

This quote came from my friend and spiritual teacher, Laura Thompson. I remind myself of all these phrases often – but especially now. This surgery is a chance to press the “reset” button on my path and priorities – to be better in every way.

Back to the hip –

This supporting musculature around the hip being terrifically angry/reactive makes it easy to see how my poor hip was hanging by a thread for these last 3 years, literally.

In my original journal, I am finding that I repeated certain phrases often. This is good information – my brain’s way of telling me to slow down and seriously consider the information in front of me – to learn without running out to find a dozen research articles.

I know this journey will be my greatest physical learning experience since childbirth. Why is it that faith, untested, cannot be strengthened?

Day 8  – I’ve never before had to say “When I can walk again, I will….”

We never want to deliberately incur adversity – but in the end, it’s the only certain thing that makes us stronger.

I hope that this disability ends up being a temporary one, but if I continue to have pain and impairment the rest of my life, I will only allow it to make be better – a better teacher, a better therapist, a better wife, mother, daughter, aunt, friend.

Clinical Pearls:

  • Night time CPM is the way to go – in their unconscious state, muscles relax and allow for speedier improvements in ROM.
    Compressive cold therapy (combined with elevation) helped successfully manage pain and swelling during the first 3-4 weeks of recovery. I recommend making the investing renting some kind of cold-compression unit, even if insurance does not cover it.
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    Compressive cold therapy (combined with elevation) helped successfully manage pain and swelling during the first 3-4 weeks of recovery. I recommend making the investing renting some kind of cold-compression unit, even if insurance does not cover it.

  • Restless legs can be a challenge because of immobility/movement restrictions and precautions. I highly recommend isolated isometrics and frequent positional changes, including transfers, to combat this issue.
  • Lymphatic massage in the lower extremities can help with stiffness, prevention of clots, and restless legs.
  • The CPM can be better for those with overarching pre-existing psoas, adductor, or PFM reactivity or MFR. PROM isn’t enough on its own for those folks. I can see this already.
  • Erring on the side of caution (argument for use of brace) for healing is important with early intervention for rehab. central to recovery. The brace – I have an argument for it because of its ability to assist with protection of capsule repairs and seal pressurization (distractive stability is reduced and the first line of defense is the labrum (not capsule) – and if labrum is just repaired, then the brace increases distractive stability and reduces risk of stressing new labral repair).

Resources

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