Recovering from severe trauma of the hip
Significant trauma of the hip can be frightening. You may have slipped whilst walking your dog, suffered a sports injury or been involved in an accident. There are many causes of pain in the hip and the job of a physio is to investigate so that we can help you recover so that you can get back to the things that you love.
There is great potential to recover even from a salvage procedure in the hip and physio focuses on restoring normal hip strength and mobility where possible.
When I first graduated 9 years ago I had no idea of the potential of severe hip trauma. Thanks to hundreds of determined patients I have seen even the most complex hips make good recovery with the right therapy.
One thing I have learnt over the years is unfortunately you cant rely on the NHS to rehab you to a top level. After working as head physio at Bristol Ladies for two years I saw the incredible progress that can be made from highly motivated, strict supervised routines and intensive physio.
Now yes, these are England/Premiership athletes I hear you say… young, focused, healthy. And I’d agree you can’t compare elite athletes to the non athletic population directly but you can improve your chances of a good recovery by modelling the following keys areas.
- Sleep ( 8 hours per night)
- Healthy, varied diet with protein and veg.
- Specific strengthening (Considering core stability/hip external rotators/abductors)
- Education on ‘good pain/bad pain’
- Exercise technique refinement to make sure the right muscle is being fired.
Lets look at that in more detail.
In a physio assessment the most important thing to establish is your goals. Do you want to get back on a bike? Attend the gym? Go surfing? Or perhaps you want to be able to walk independently without a stick?
By the time patients get to me sometimes they have given up hope. It may be 2-3 years after their injury and they feel that their symptoms won’t change. Often patients stumble across us as a last ditched hope to try and manage pain. They are looking for anything to help and think they have tried everything.
But the problem is this.
Most people underestimate what it will take to recover from injury.
I liken a rehab journey to a walk I did in Africa when I was 16. A team of 15 of us attempted to climb Mt Etna between the border of Uganda and Kenya.
To this day its the hardest thing I’ve ever done.
If anyone had told us how hard it would be we would have never started.
After 2 days of steep ascent we missed the sunrise at the peak due to a slow start. We continued to walk up and down endless steep terrain one hill after another only to see 5 other beyond it steeply cutting down and then up the other side, taking to our hands and knees when it became to too slippy.
It was all worth it when we reached our destination. A cave hidden by a dramatic waterfall, thousands of bats sleeping above us, their eyes glittering as we shone our torches upwards.
But my point is a challenge like that looks daunting and we often under estimate the work we will have to put in to achieve success. However the hard work is worth it and I am lucky enough to see the smiles as people push the boundary of their potential, surprising even themselves.
See my job as a physio is to show you the way. To explain that it will be tough and to push you more than you could yourself. That doesn’t mean to push through pain, this is not always appropriate but my skill as a physio is to help you understand which pain will move you forward and which pain will move you back.
Understanding the difference is important.
See some pain is due to muscle weakness. Yes muscle weakness in itself can cause pain.
If you take a can of baked beans and hold it out away from your chest in front of your body it will feel ok for the first 5 minutes. If you hold it for 10 minute the muscles may start to ache. If you hold it for 3 hours the muscles will start to become painful. Imagine you had a hip injury 3 years ago and you haven’t used the muscles properly in all that time because you have been compensating.
They are likely to be painful just due to weakness.
I am always very honest with people if I can’t help them. If they have truly tried everything.
But in all honesty the only people I haven’t been able to help are those who psychological weren’t ready to go. The people who were getting in their own way.
On most assessments we look at people’s lives and pull away all the clutter and conflicting advice from their doctor, friend, cousin and brother.
We look at the science, the evidence and we see whether the person has truly exhausted all that they have in their power to be better than they are today. Healthier and stronger.
Are they getting enough sleep?
Why? How can we change that? Is it something as simple as caffeine intake, stress, bladder problems (things we can change)?
Are they getting adequate protein for muscle building?
Are they implementing longitudinal strengthening exercises to reduce the risk of osteopenia/osteoporosis?
Do they have good education on pain and understand good pain/bad pain?
Are they doing the right exercises? Specific to their own hip?
Is their muscle pattern appropriate?
Are there compensations or fear avoidance behaviour (i.e. avoiding stairs or activities that cause pain)?
And the list goes on…
See, before major trauma, people spend money on things that depreciate in value like cars and TV’s or other material items. But when people experience serious trauma they gain a new perspective.
They start putting their health first. An investment in the one vessel you have in life has the chance to change your quality of life and maintain your independence.
Now that investment may be the time you spend sleeping, it may be the food you put in your body, the strengthening and education you learn or it may be an investment of £45 to have a physio assessment to see how we can help you.
If you have any questions about your hip injury please call 01271 594 001. Our mission is to help everyone suffering with pain reach their full potential so even if you are not local to one of our clinics give us a call and we can help decide whether physio is right for you. If it is we will help you find a chartered physiotherapist local to you.