The Athletic Hip Series: Hip Surgery FAQs
Post by Maggie Gebhardt PT, DPT, OCS
So you’re contemplating having surgery to repair your torn labrum or you’ve already had it done. I am sure a number of questions are running through your head. The first thing to remember is to be flexible. Oftentimes, surgeons do not know how your hip truly looks or the extent of the injury until surgery. Surgeons do their best to warn you of this, but it oftentimes does not become a reality until you wake up after the procedure. Remember that they are doing their absolute best to start you on the road to complete recovery.
The most common unexpected outcomes after surgery is prolonged bracing, crutches, ambulation, driving, and return to sport. This often 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 other thing to remember is that all surgeons have differing protocols. What I’m going to tell you is the basic framework, but it will vary slightly depending on what your surgeon prefers.
I am going to do my best to answer some of the common questions patients have about hip surgery. However, it is best that you ask your surgeon as many questions as possible before the procedure so that you can make the most informed decision possible.
“How long do I have to be on crutches?”– A non-microfractured hip will be on some form of assistive device (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. 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 determined by your surgeon. Once you can move your hip in the motion required to sit comfortably in your car you are 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. This usually takes place anywhere from 3 weeks 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. As you progress your sessions can diminish to every other week, but they may 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 get-go, but may have to wait a little longer for actual cardio. I have found that patients who adhere to a water program while going through 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.
If you have questions I encourage you to talk to your PT or physician so that you can make the most informed decision regarding surgery that you can. Most surgeons will start you in physical therapy prior to surgery. This is a great opportunity to get to know your therapist and pick their brain. You, your family, your therapist, and your surgeon are a team. You are going to be going through this process for a while, so it is important that everyone collaborate together for the best possible outcomes!