Sunday, August 10, 2014

Hip rehab status, plans looking towards 2015

I've been in physical therapy for two weeks now.  Since beginning weight bearing on July 22, following 7 weeks on crutches due to my pelvic (acetabulum) fracture, I've faced these challenges:

1.  Right calf and arch weakness from non-weight bearing;
2. Left Achilles irritated from having my left leg do all the work for 7 weeks;
3. Walking with a limp due to difficulty straightening out my right leg and hip  due a very tight hip joint;
4. Incredibly weak right hamstring and glutes.

To deal with 1 &2,  I began a program of eccentric heel drops on both sides (http://fredippides.blogspot.com/p/since-oct-31-i-have-been-doing-twice.html) particularly to strengthen the calf and arch of the foot on the right;  and at the same time to rehab the achilles on the left, and strength the achilles on the right to prepare for a return to running later this year.   The right calf muscles were really weak at the start:   I couldn't do a full set when I  started out.  Beginning with a set every other day, by the end of the first week the calf was extremely sore.  The second week I started one set each day;  the third week I began two a day sets.  This week I have begun adding weight-  25lbs in a backpack.  Its progressing nicely.

The more serious issue is 3&4- walking with a limp due to tight hip joint and weak/atrophied glutes and hamstrings.

My PT has had me doing the following exercise and stretches:

1.  Two-leg Glute Bridges, 3 x 10,  for the glutes, hamstrings and lower back:  (http://backandneck.about.com/od/exerciseandsport/ht/Lower-Back-Exercise-Strengthening-Your-Back-With-The-Abdominal-Bridge.htm)

2.  Standing hip clams with a rubber strap.  Started with 3 x10;  progressed to 3 x20;   2x daily.

3.  Standing hip extension exercise with rubber strap:   3 x 10,  2x daily.

4. Supine Straight Leg Raises (3 x10, 2x daily).

5.  Hamstring stretches-  lying on my back, using a strip of webbing to pull my straight leg up, 3 x 30 sec,  2x daily.

6.  Quad stretches lying on my stomach (prone), with strip of webbing looped around my foot to pull it up against my butt.  3 x 30 sec 2-3x daily

7.  Calf stretches on ramp, 3 x 30 sec 2x daily.

7.  This week:  Started 1-leg Glute bridges.

The most difficult of the exercises above has been the glute bridges.  It is somewhat akin to trying to wiggle my ears:   my right glutes don't seem to want to "fire".  The right glute is noticeably smaller than the left;  I suspect the issue has to do with the surgical wound required to access the acetabulum to perform the ORIF surgery.

My PT has therefore directed me to do glute squeezes:  Both glutes together, then one-sided. lying down --to keep the buttocks safely shielded from view for the benefit of all concerned -:).  This seems to have been working as I am finally getting the right glute to "fire" and the muscle is sore.  A good sign that I am finally getting access to the muscle to strengthen it.

I am no longer walking with a limp!

I will continue these exercises  and assuming things continue to progress I will start walking in a month.  My program will focus on walking through the fall and hopefully I'l  be able to start running by Juanuary in preparation for the 2015 ultra season.

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