By: Maggie Gebhardt, PT, DPT, OCS, FAAOMPT
Prior to having hip labrum or impingement surgery, make sure to ask your physician as many questions as possible before the procedure so that you can make the most informed decision. All surgeons have differing protocols, so it is important to ask your surgeon what their specific recommendations are. Here are some common questions and concerns when contemplating undergoing a hip labral repair:
“How long do I have to be on crutches?”– It depends on the surgery performed. A non-microfractured hip will be on some form of crutches for approximately 4 weeks. Micro-fracture hips can take closer to 12 weeks.
“How long do I have to wear this brace?”– Some surgeons do not require a brace at all. Some require a brace when up out of bed and another bracing mechanism when sleeping. If your surgeon does require bracing then you are looking at a timeframe of 1-2 months.
“When can I drive?”– If your left hip is operated on, then it’s a matter of the range of motion restrictions and medications as determined by your surgeon. Once you can move your hip in the motion required to sit comfortably in your car you are usually cleared. Again, this is 1-2 months. If your right hip is operated on, then you have to adhere to your weight-bearing restrictions. This can take up to 3-4 months.
“When can I walk on it?”– This is going to depend on your weight-bearing restrictions and what type of procedure was performed. Even being on crutches, your physical therapist will start working on walking as early as 3 weeks and up to 3-4 months.
“How long am I going to be in PT and what does it entail?”– Your sessions in physical therapy will start usually the week after surgery. At first you will be coming 2-3 times per week, but then they can diminish to every other week and can continue through 6 months. Eventually as you become more independent in managing your home program, you will be coming more on an “as needed” basis. The focus of therapy will shift as you progress. Initially it is focused on maintaining range of motion and pain control. It will progress to strengthening, gaining more range of motion, walking, running, jumping, and return to sport activities. Therapy is going to demand a lot of time from you as well as a loved one. Initially you are going to need someone’s assistance in helping you with your home exercises as well as getting you to your appointments.
“Can I travel?”– Again, it is going to depend on how much weight you are allowed to put on your surgical leg and if you are still using crutches. Travelling requires a lot out of your hip and if your therapist or surgeon does not think you are able to navigate those obstacles, they may caution you to avoid travelling for the time being.
“When can I exercise?” and “When can I run again?”– Depends on how you define exercise…you will be doing some form of exercise from the outset but may have to wait a little longer for actual cardio. Patients who participate in a water program while going through land-based therapy do progress faster. Some surgeons even have aquatic programs built into their protocols. Cycling will start fairly early in the rehab process, but you will have to wait at least 2 months before any type of weight-bearing exercise (outside of PT) is allowed. Running will take longer and can be anywhere from 3-6 months.
The most common unexpected outcomes after surgery is prolonged bracing and/or crutches, and delayed ambulation, driving, and return to sport. This usually occurs because your surgeon had to do a microfracture procedure. Microfracture means that your surgeon had to inflame the ends of the bone forming the hip joint in order to stimulate healing. In order for that new bone growth and healing to occur, you have to stay off of it longer which delays mobility longer than normal.
The biggest thing to remember is to be flexible. Even with the best imaging, your surgeon may not know the extent of your hip injury until surgery. Remember that they are working in your best interest and want you to have the best possible outcome for your hip.
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