Re: Pre-surgery training?

[Guest guest]

Hi Steve:

You need to think about what muscles you're mostly going to need immediately

post-op. Fahget about the ones you'd like to keep using. It's too late, mate!

Primarily the ones you need are the ones you use when you get out of bed, sit

down and stand up. Also the ones you need when you use your canes or crutches.

I found that since the leg and hip muscles are kind of tender for about 6

weeks post-op, it was a good idea to work on upper body strength. It doesn't

hurt, and it allows you to grab onto things to pull yourself up or lower

yourself,

or G-d forbid, to stop yourself from hitting the ground when you fall.

By the way, if you do fall, don't do anything heroic trying to right

yourself. It's probably better to just relax and use your hands or something

else to

soften the blow when you hit the deck.

I also found that doing isometric exercises for the legs pre-surgery was a

good idea because in a way it arrested the " wasting " of the muscle which happens

from inaction. It also avoids the problem of experiencing the pain from

trying to kick. Believe me I know about that. I attended a karate seminar in

Portugal the weekend before my surgery which was on the Tuesday. By the Sunday,

after doing about 5 or 6 hours of training, I was one sore puppy. By the time I

got to Birmingham, I was ready to be sliced.

You are correct about the adduction and abduction being problems. Again

isometrics are probably the best you can do. Anything involving ROM hurts too

much

and most likely won't do you much good anyway. Maybe when you're in the static

position you can try a bit of a stretch but don't kill yourself. The

stationary cycling is good aerobic stuff. Keep it up.

Think about how good it will be afterwards and it'll get you through, believe

me.

Best of luck,

Des Tuck

In a message dated 1/25/2004 1:08:07 PM Pacific Standard Time,

sog@... writes:

I was wondering whether anyone had any specific ideas about presurgical

training/physical therapy in an effort to improve/accelerate post-op

recovery - particularly since I'll be having a bilateral and will have

negligible post-op support.

I don't have a surgery date yet, but I've been trying really hard to

make up for the decreased activity caused by hip stiffness and pain.

I can only stand to train karate 2 or (in a good week) 3 times a week

(and there are a lot of things I just can't do, like kick worth a bucket

of warm spit), and afterwards I'm stiff and sore enough that I can't step

over a curb. To try to make up for this, I've been stationary cycling for

30-45 minutes on my non-karate days. So far, this is relatively painless

(after some discomfort during the first 5 minutes or so). I've been doing

yoga about once a week, which seems to help ROM and stability (although

it's increasingly uncomfortable). A couple of months ago, I started working

with a PT 1x/week in an effort to keep my hip musculature and my ROM from

deteriorating too far. Once I actually get a surgery date, I'm thinking about

stepping that up to 2x or 3x (while my insurance might not cover my

resurf - I'm still waiting to find out - it has *really* generous PT

benefits).

I basically stopped lifting weights at the beginning of December, when

I got new X-rays that showed I was bone-on-bone in both hips. Should I

rethink that? If so, what should I be trying to do? I can still

half-squat with a reasonable amount of weight, although I feel really

unstable. Deadlifts are pretty much impossible (not enough ROM to grab

the bar when it's on the floor). How about machines? For those of you

who've been through this, where did you have to put in the most work to

regain full function? I think adduction and abduction are going to be

the major problems for me. Does this seem correct to those of you

who've been through this?

[Guest guest]

> Hi Steve:

>

> You need to think about what muscles you're mostly going to need

immediately

> post-op. Fahget about the ones you'd like to keep using. It's too

late, mate!

How encouraging ;-)

> Primarily the ones you need are the ones you use when you get out of

bed, sit

> down and stand up. Also the ones you need when you use your canes or

crutches.

So, hip flexion/extension, abs (and other trunk stabilizers), and

dips would probably be a good idea? That's pretty much what I thought.

I suppose adduction/abduction might be handy just from a stability

standpoint. I've still got about 40-45 degrees ROM on abduction on

each side, so I can actually work these non-isometrically, at least

for awhile.

I think I'll spend next weekend rigging a trapeze over the bed to

make entrance and exit easier. Perhaps two (at right angles). Who

knows, they might prove recreational after recovery ;-)

> I found that since the leg and hip muscles are kind of tender for

about 6

> weeks post-op, it was a good idea to work on upper body strength. It

doesn't

> hurt, and it allows you to grab onto things to pull yourself up or

lower yourself,

> or G-d forbid, to stop yourself from hitting the ground when you fall.

I've been working on pullups, dips, and benches. Doing pushups is

way too difficult and time-consuming (getting down to and up off

the floor is an interesting gymnastic exercise).

>

> By the way, if you do fall, don't do anything heroic trying to right

> yourself.

No forward rolls, huh?

> You are correct about the adduction and abduction being problems. Again

> isometrics are probably the best you can do. Anything involving ROM

hurts too much

> and most likely won't do you much good anyway. Maybe when you're in

the static

> position you can try a bit of a stretch but don't kill yourself. The

> stationary cycling is good aerobic stuff. Keep it up.

I was hoping to get up to 1 hour/day by surgery. I may not manage

that, but it gives something to do besides feel sorry for myself.

> Think about how good it will be afterwards and it'll get you

through, believe

> me.

So how did you ease yourself back into training? What did you start

with? Just basic kata? How long before you could kick with a

reasonable amount of power? Can you do bag work and makiwara training now?

Thanks for the response!

Steve