training with hip problems... how do you do it?

[JR 137]

As has been mentioned, make sure you're following your doc's advice. Make sure he/she understands what you're doing and you're doing it for a living rather than some weekend beer league softball player.

Contrary to common sense, orthopedic surgeons really the best at modification, prescription of exercise regimen, etc. Orthos know what's wrong and how to go in and fix it. They know parameters such as 15 degrees of flexion and extension the first two weeks, adding 5 degrees weekly afterwards, etc. Seek out a physical therapist or occupational therapist for specifics, as you'll be seeing them for post-op rehab.

As far as communication with physicians, that's on their assistants, be it a secretary, PA, nurse, etc. Surgeons are a mess, and they know it. Their assistants tell them where they are, where they're going, and what they're going to do tomorrow. In all fairness to them, their schedules are hectic and they've got far more important things to keep their brain occupied. Assistants are there for a reason. Bring up your communication issue to the doc, as he has an idea of what's going on.

Sorry, I've been around quite a few orthopedists. Most have been great people. Make sure he/she answers all questions you have. They get the mentality that you know what's going on and don't get too thorough in explanations.

But remember, the modifications stuff is best coming from a therapist. That's what they do. Surgeons operate.

As far as people saying this and that, so what? As long as your teacher knows what's going on (and you know), everything will take care of itself.

While you're on crutches/wheelchair? Anything seated (upper body). You can still do basic blocks, punches, etc. Maybe get someone to hold focus mitts. I know, not glamorous, but better than nothing.

Unfortunately I disagree with you on the bolded above, because as much as they can say what you can do in terms of when returning to exercise due to trauma but they shouldn't be prescribing as it is outside of their Scope of Practice and Training. Unless they have been trained and qualified specifically to do so, but many good Doctors will study and get quals to ensure that they are covered and have a scope of practice to such Training.

Although they do have a responsibility and a duty of care to their clients (People feel less stigmatised when called this) to inform them if there is anything that they should be limiting. In particular Exercise or Certain Movements or Behaviours. Example; My Surgeon informed me that I now have to take 3-4 weeks off training due to Subcutaneous Prepatellar Bursitis and be careful of any form of exercise and excessive loading of my knee.

I know over in NZ many surgeons are fantastic and have done further study (and received additional quals) to do it. Although not as much here in Australia where they seem to prescribe everything left right and centre even if they're not really trained in it.

Exercise Physiologists IMHO are the best course of action because they are specifically trained to deal with this type of problem, along with a wide variety of problems. As they can Prescribe Exercise (60-70% of their studies have been about exercise prescription), whilst taking recommendations on limitations from Doctors or other Medical Professionals.

Occupational Therapists are great for Daily Management of any conditions that you have and ensure that they don't impact you on a daily basis.

My apologies if I caused any disrespect JR or anyone, this is my point of view and i am studying to be in this field. Due to many colleagues of mine (including teachers at University) and I have found many Orthopedic Surgeons have done what you've said [Prescribing Exercise] and failed to prescribe appropriate exercise (along with Sets, Reps, Rest, Tempo and Load) and disregarded exercise specific guidelines we follow with clients.

You caught my typing error. Thanks! It should have said "contrary to common sense, orthopedic surgeons are NOT the best at modification, prescribing an exercise regimen, etc." No disrespect felt on my part; we were both thinking the same thing IMO. As far as Ex Physiologists vs OTs and PTs, Ex Physios here are harder to come by, and they mainly work with healthy clients in a strength & conditioning aspect rather than a rehab aspect. And as far as I know, they can't bill insurance companies for services, which is a huge blow. Many therapists here do Ex Phys as undergrad to get into grad level PT and OT programs. Although that's changing as most PT and OT programs recently have become exclusively 5 or 6 year doctorate programs that start at the student's 1st year of college; i.e. they get in as undergrad freshmen and go straight through until they get their doctorate. Year round program instead of semesters with no degree in between levels; it's all or nothing.

With that, where I was going with my post hopefully makes more sense. Orthos are good at getting in there and fixing it, and referring to a therapist for the long term follow up. I'll edit it if I can!

[Nidan Melbourne]

As has been mentioned, make sure you're following your doc's advice. Make sure he/she understands what you're doing and you're doing it for a living rather than some weekend beer league softball player.

Contrary to common sense, orthopedic surgeons really the best at modification, prescription of exercise regimen, etc. Orthos know what's wrong and how to go in and fix it. They know parameters such as 15 degrees of flexion and extension the first two weeks, adding 5 degrees weekly afterwards, etc. Seek out a physical therapist or occupational therapist for specifics, as you'll be seeing them for post-op rehab.

As far as communication with physicians, that's on their assistants, be it a secretary, PA, nurse, etc. Surgeons are a mess, and they know it. Their assistants tell them where they are, where they're going, and what they're going to do tomorrow. In all fairness to them, their schedules are hectic and they've got far more important things to keep their brain occupied. Assistants are there for a reason. Bring up your communication issue to the doc, as he has an idea of what's going on.

Sorry, I've been around quite a few orthopedists. Most have been great people. Make sure he/she answers all questions you have. They get the mentality that you know what's going on and don't get too thorough in explanations.

But remember, the modifications stuff is best coming from a therapist. That's what they do. Surgeons operate.

As far as people saying this and that, so what? As long as your teacher knows what's going on (and you know), everything will take care of itself.

While you're on crutches/wheelchair? Anything seated (upper body). You can still do basic blocks, punches, etc. Maybe get someone to hold focus mitts. I know, not glamorous, but better than nothing.

Unfortunately I disagree with you on the bolded above, because as much as they can say what you can do in terms of when returning to exercise due to trauma but they shouldn't be prescribing as it is outside of their Scope of Practice and Training. Unless they have been trained and qualified specifically to do so, but many good Doctors will study and get quals to ensure that they are covered and have a scope of practice to such Training.

Although they do have a responsibility and a duty of care to their clients (People feel less stigmatised when called this) to inform them if there is anything that they should be limiting. In particular Exercise or Certain Movements or Behaviours. Example; My Surgeon informed me that I now have to take 3-4 weeks off training due to Subcutaneous Prepatellar Bursitis and be careful of any form of exercise and excessive loading of my knee.

I know over in NZ many surgeons are fantastic and have done further study (and received additional quals) to do it. Although not as much here in Australia where they seem to prescribe everything left right and centre even if they're not really trained in it.

Exercise Physiologists IMHO are the best course of action because they are specifically trained to deal with this type of problem, along with a wide variety of problems. As they can Prescribe Exercise (60-70% of their studies have been about exercise prescription), whilst taking recommendations on limitations from Doctors or other Medical Professionals.

Occupational Therapists are great for Daily Management of any conditions that you have and ensure that they don't impact you on a daily basis.

My apologies if I caused any disrespect JR or anyone, this is my point of view and i am studying to be in this field. Due to many colleagues of mine (including teachers at University) and I have found many Orthopedic Surgeons have done what you've said [Prescribing Exercise] and failed to prescribe appropriate exercise (along with Sets, Reps, Rest, Tempo and Load) and disregarded exercise specific guidelines we follow with clients.

You caught my typing error. Thanks! It should have said "contrary to common sense, orthopedic surgeons are NOT the best at modification, prescribing an exercise regimen, etc." No disrespect felt on my part; we were both thinking the same thing IMO. As far as Ex Physiologists vs OTs and PTs, Ex Physios here are harder to come by, and they mainly work with healthy clients in a strength & conditioning aspect rather than a rehab aspect. And as far as I know, they can't bill insurance companies for services, which is a huge blow. Many therapists here do Ex Phys as undergrad to get into grad level PT and OT programs. Although that's changing as most PT and OT programs recently have become exclusively 5 or 6 year doctorate programs that start at the student's 1st year of college; i.e. they get in as undergrad freshmen and go straight through until they get their doctorate. Year round program instead of semesters with no degree in between levels; it's all or nothing.

With that, where I was going with my post hopefully makes more sense. Orthos are good at getting in there and fixing it, and referring to a therapist for the long term follow up. I'll edit it if I can!

Its interesting because in Aus; Exercise Physiologists who are current with their membership and have attended a NUCAP Accredited Course receive a Medicare Number (We can bulk bill if we wish; where the cost is covered by the government) and then we can apply for a Private Health Insurance Number with various Health Insurers. Obviously worldwide it will vary according to how the accrediting body works (ACSM in the US, ESSA in Aus etc)

AEP (Accredited Exercise Physiologists) [AEP & EP are exact same role], can work with any person with different Medical Conditions + not just Apparently Healthy Clients. We can work with Metabolic (i.e. diabetes etc), Musculoskeletal, Neurological, and Other (i.e. Depression, anxiety etc).

PT i am assuming you mean Physiotherapy?

It is true many OT or Physio's do Exercise Science (Undergrad) to do postgrad in that field, although usually to be able to diagnose further.

This is where i feel like some universities/colleges are very different where there is no difference between Undergrad and Postgrad because there is little to no time off.

[JR 137]

PT = Physical Therapist, aka Physio Therapist everywhere else in the world.

[twistkick kid]

Thanks for the good info JR 137, Nidan Melbourne, and Sensei8.

An update since I have had a very hectic few days since starting this post....

I had my consult with the ortho doc who will be reconstructing my socket. basically, he said that if I don't get this fixed now, I will be in miserable pain for the rest of my life- and it shows in the x-rays. So I will be having a periacetabular osteotomy and cartilage scope/repair done to correct the damage. My surgery date is September 8, 2016.

This surgery will be a game changer for me, but it will heavily impact my life and training for 6 months after the initial date of surgery. I will be in the hospital for 4 days or so, not including day of surgery. Once I get home from there, I will be on limited movement and no work for two weeks. after those two weeks are up, I can go back to work, as long as there are sufficient precautions to prevent falls. at about 4 weeks from the day of hospital release, I will be able to drive again. by three months out, I will be working my way to full weight bearing and weaning off crutches. by 4 months out, I might be able to do basic stance work and forms again (no jumps, and super slow... no deep horse stances or awkward bow and arrow stances). then, in March 2016, it will (theoretically) be a full return to martial arts. I plan to work very closely with a PT- hopefully I can get back into Dr R (who happened to have a martial arts background and understood a lot about Ehlers-Danlos Syndrome and its effects on joints)

I am utterly terrified of being out of the arts for 6 months, but I'm sure I can find ways to still stay involved and not lose all the stuff I've learned... even if it's sitting on KF all day and reading post archives.

[Alan Armstrong]

All the best for you twistkick kid. When our bodies let us down it hits harder to understand the reasons why.

All of these medical conditions that you have endured will make you more appreciative of what you still have and more knowledgeable to help others.

Hopefully your medical conditions will help you cultivate your personality in a positive way. This is what will pull you through the worst of times; combine your strength of character with your indomitable spirit.

"To endure the unendurable" Everything else seems easy from there on.

Perhaps light Yoga mind over matter exercises will keep you occupied while you are in recovery; please consult your doctor beforehand.

Karma is how many in the Eastern civilizations deal with the psychological aspects of human suffering.

Reincarnation; the more a person suffers in this life the easier it will be in the next life.

[twistkick kid]

Update!! I come bearing updates!

So, instead of having my surgery on September 8 like was originally scheduled, I ended up having to take care of my mom for a while due to her own health struggles. Surgery got pushed back till Halloween.

Halloween came and went, and I was driving the nurses in the hospital crazy cos I wanted to get up and walk around on my crutches and I was refusing pain meds only a day and a half post op. (I did have good reason to be refusing the pain meds though- they were making me nauseated to the point where I was having to take massive doses of medication to counter the nausea) Once I was off the pain meds I felt way better and was able to do what the Physical/Physiotherapists call "Touch-Down Weight Bearing" with my operated leg and only using crutches to get around instead of crutches or a walker.

I've been working from home for my "day job" and I am learning to step into a different role that is not "Instructor In Training" at my dojo. It's very strange. I'm learning how to answer the phone, write emails and follow up through them, keep the books, and basically all the things that go into owning and managing a dojo of one's own that aren't teaching classes and lesson plans.

In the meantime, when I'm not working from home or at the dojo I'm trying to keep my brain entertained by playing lots of memory games, reading my old math books, coding, dissecting forms for bunkai, sketching, and doing a lot of things like incessantly drilling 8 point blocking, Iron Fortress blocking, 10 point blocking.

I started PT on 1 December 2016 and it surprisingly doesn't feel sore yet. But, like I told one of my friends, the true test is how I really feel on Saturday 3 December. And I'm supposed to somehow be assisting at a Tournament an hour drive away that day. wheeee?

more updates soon

-twistkick kid

[Alan Armstrong]

Keep us posted!

Remember: You only need to deal with one day at a time. One step at a time. Or one moment...

[bushido_man96]

Its great to see you back! Alan makes a good point, there's no need to get ahead of yourself. Keep your pace up; it sounds like you are doing great.

By the way, I agree with you on the pain meds. I can't stand them, and try to avoid them if at all possible. Tylenol and the like are good enough for me.

[twistkick kid]

thanks bushido-man96

Small change of plans for today- no tournament chaos for me cos my mom hasn't been feeling fantastic and I needed to be home to take care of her. Which is probably for the better anyway as I am **really** feeling the soreness and it's making me cranky.

I will be spending the rest of today as a lump in bed liking and commenting on pictures my friends post from the tournament and thinking about some business related stuff for Monday and Tuesday at the dojo.

[twistkick kid]

quick update.

been through 5 sessions or so of PT. by the end of the hour I'm usually a bit sore, but I have yet to have pain afterward. one of the exercises I do is basically a front ball kick linked with a back kick linked with a side blade kick linked to a roundhouse kick. my PT just laughs when I tell her that.

I'm down to using one or no crutches around the house and putting full weight through my hip and leg when I am needing to use two crutches. I need to ask about what kind of cane I should be using.

Yesterday was the first time I really tried moving through any of my forms without crutches. so far I can do Pinan 1 (Shaolin Kempo); Pinan 2 (shaolin Kempo); Kata 1 with bad kicks (Shaolin Kempo); and Chon Ji through Do San (ITF Chang Hon forms).

might come back and edit later.