Diary of a Tennis Hippie
by Percy
(email: percy@evcforum.net)
For those new to the hippie culture, hippie is slang for a person
who's had a Total Hip Replacement (THR).
I'm 51 years old and have been playing tennis since I was a teenager.
Entries are in chronological order (here's a link to the reverse
chronological version).
April, 2000
On Barry's Java Jive Team Tennis team at Woburn Tennis Club, help
win the spring version of the "A" league.
May, 2000
Win 5.0 tournament at Nashua Swim and Tennis, though only average
4.5 players like myself were entered.
June, 2000
Notice pain at top of right leg during stretching when I lie on my
back and try to bring the right knee up to my chest. I've never
been flexible, so I can't bring either knee all the way up to my
chest, but now my right leg hurts a little at the hip when I try
to do this. Extra stretching does not reduce the pain.
I start taking anti-inflammatories before I play (660 mg Aleve
works best for me), but the hip problem begins to affect my
tennis. I occasionally "tweak" the hip. This is a sudden pain in
the hip joint that feels like a small jolt as if the joint
temporarily dislocated. For about 5 minutes immediately
afterwards there is pain around the hip joint and I have to move
gingerly.
September, 2000
Thursday night doubles with Tommy's group resumes. This is a
strong group for me, but I'm still sort of holding my own.
Also resume playing on Barry's Java Jive Team Tennis team down at
Woburn. We're not as strong this year because we lost a couple
people, but we're probably still the 2nd or 3rd best team.
November, 2000
I see Dr. Bill Mitchell at Longwood SportsMedicine about the hip.
He takes X-Rays, says there's still sufficient cartilage, suggests
swimming or riding a bike to reduce the problem. I begin riding a
stationary bike for 10 minutes before Thursday night doubles at
Nashua Swim and Tennis. I buy a stationary bike thing for home
and ride that in the family room at night. This has no noticeable
effect, and by spring I'm no longer riding a stationary bike. I
still occasionally tweak the hip, it still hurts during
stretching, and it seems to be getting worse.
Winter, 2000-2001
I sit out maybe three weeks total on the Thursday night doubles
hoping the hip will improve. By Christmas I've stopped working
with Rocky, the pro I take lessons from, 'till the hip is better.
I do not resume playing on Barry's team for the spring.
Summer, 2001
I've stopped playing tennis except on Saturday mornings with Jim.
I'm taking it real easy, hitting without pace, Jim is keeping the
ball down the middle for me. If I move too aggressively I tweak
the hip.
Winter, 2001-2002
I don't join the Thursday night doubles, but continue to play with
Jim on Saturday mornings. I find I'm gradually able to pick up
the pace.
I start hitting pretty solid. I've smoothed out my strokes,
including my serve (where I used to land hard on my right leg,
probably contributing over time to my hip problem). This has
involved changes to the basic mechanics, and my strokes are now
more sound.
I start feeling pretty good. I rarely tweak the hip. I'm hitting
very solid. In December I call Rocky and we hit for an hour. I
hit real well. I decide I'm going to pick up the pace and begin
playing more than once a week. I call George and a couple other
people and begin playing a few times a week.
The increased activity lasts just a very short while because pain
in the right hip increases. It has long ago reached the point
where it can hurt the next day, and if I play too much tennis it
can hurt for a couple days. Getting out of the car is becoming a
little painful. I'm having trouble putting on my shoes and socks,
and especially tying my shoelaces. I realize that while I've
accommodated my tennis somewhat to the hip problem, the problem
itself has gotten worse. I return to hitting once a week with
Jim.
I begin thinking of finding another orthopaedist closer to home.
Bob mentions a couple names, but I have trouble tracking them down
(the names turn out to be close but wrong), and time goes by.
I find out about Dr. Eric Benson from Regis, who has just had a
hip replacement. I schedule an appointment.
March, 2002
First appointment with Dr. Eric Benson. He looks at the X-Rays
from Longwood SportsMedicine. He knows Dr. Bill Mitchell. He
knows all the people down in Boston. He studied under the team
that conducted one of the evaluation studies for the FDA of the
ceramic hip replacements from Europe, the same team that did Jack
Nichlaus, and now he's the "major joint" guy at NH Orthopaedic
Surgery in Manchester, NH. He's young and energetic and appears
to know what he's talking about.
I tell him about my activity level. He tells me tennis is very
hard on artificial hip joints, but he doesn't discourage me. He'd
like to get some new X-Rays, but we can't do it today, I have
afternoon meetings, so we schedule an appointment for the
following month.
April, 2002
Second appointment with Dr. Benson. We get fresh X-Rays. He
confirms the problem, which he says is loss of cartilage (but
thinks there's still sufficient cartilage left) and the presence
of bone spurs. I later figure out that the build-up of the bone
spurs was what caused the restricted motion. In fact, I later
decide the bone spurs not only caused the restricted motion, but
also the "tweaking" of the hip. I figure that when bone spurs
around the cup and bone spurs around the ball line up just right
and attempt to slide past each other that that must be causing the
jarring "tweak" that I occasionally feel during activity. Later
on, when the tweaking stops happening, I figure out that the bone
spurs caused this, too, because they've grown too large to allow
sufficient motion for them to collide anymore. In other words,
particular chance alignments of bone spurs were causing the
"tweak", but as the bone spurs became larger and more numerous
causing motion to become more restricted, these chance alignments
simply could no longer happen.
Dr. Benson strongly recommends against hip replacement. If I
weren't active in tennis (before the hip pain began, it was maybe
5-7 times a week, about an hour to an hour-and-a-half each time,
maybe 8 tournaments a year, one winter league and a weekly
high-level doubles game in the winter) it would be okay, but he
believes the current prostheses might not stand up to it over the
long term, and that I'd likely eventually be unsatisfied with the
result. He gives me a little hope by saying that the FDA plans to
approve ceramic hip replacements in April, 2003, and that he might
feel more optimistic about a positive long-term outcome with them.
He says he'd like to see me again in a year.
Summer, 2002
I continue to play with Jim once a week on Saturday. My
conditioning, never very good (just bad genes, I guess - I stand
up to cold weather better than anyone I play with, but hot weather
wears me down fast), is getting worse, perhaps because I'm playing
so infrequently, but I wonder if the hip problem affects
conditioning, perhaps makes me work harder. The left hip begins
to bother me.
Winter, 2002-2003
I continue to play with Jim once a week on Saturday. Conditioning
continues to worsen. Right hip bothers me much of the time.
Occasionally keeps me up at night. Sometimes people ask me if I'm
limping. I grunt in pain at certain motions, like putting on
shoes and socks, tying shoelaces, and getting in and out of the
car, which is sometimes a struggle. I can no longer just insert
my right leg in to the car and climb into the seat. I instead
have to sit on the seat with my legs outside the car, then swing
both legs together into the car because I no longer have enough
flexibility to spread the legs more than a couple feet apart.
Interestingly, tennis once a week (sometime more if I play with my
son Jeff, but he doesn't pressure me at all) seems to keep me
loose. If I skip a week the hip joint appears to get stiffer and
more painful. I conclude that my hip is actually in worse
condition than the amount of pain and external appearances would
make it seem, but that keeping a moderate activity level is
minimizing these effects. I think about whether it's really
appropriate to consider hip replacement as a solution, since I
hear many stories of people who seem to endure years of
debilitating pain and reduction of activity before finally seeking
a hip replacement. Am I some kind a pathetic wimp who at age 50
already can't endure a much smaller amount of pain than a 70
year-old feels? Am I just being stubborn about accepting the
aches and pains of growing older? On the other hand, I know the
hip cannot possibly get any better, that it will only get worse,
so why not replace the hip while I'm young and still robust enough
to enjoy it?
March 18, 2003
A year has gone by, and I'm at my third appointment with
Dr. Benson. We get new X-Rays of the right hip. I request of the
X-Ray technician that she include the left hip (increasingly
bothering me now, but still much less than the right hip), but she
can't without a Doctor's order, and getting one would delay
things, so we just do the right hip.
Dr. Benson looks at the X-Ray, announces that the FDA has approved
ceramic hip replacements as of April, 2003, says we could go ahead
and do it, what do I want to do?
I say that I can easily accept the pain and inconvenience, but
that it's a quality of life issue. Would it make any sense to put
off getting glasses until you were legally blind? I don't think
this analogy with glasses is a very good one, but it does make the
right point. Modern medicine can fix this - why should I put it
off?
Turns out there are some reasons why I might not want to do it.
There is the possibility of death, approximately .005% if I
remember correctly. I pay little attention to this possibility -
compared to many hip replacement patients I'm young and healthy,
and I'm pretty good at understanding and following instructions
(not as good as I thought, as it later turned out).
THR can also affect strength and leg length. There's no guarantee
I'll be able to play tennis as well after surgery.
We decide to go ahead, the surgery is scheduled for Monday, April
28th. Oh, boy, I think, do I know what I'm doing?
I tell my wife, Lois, by cell phone on the way back. I don't
recall the conversation, but she's supportive.
March 19, 2003
I inform my boss of my decision to have the surgery, and that I'll
be out one to two weeks (this turns out to be wrong, and I should
have known that). He says I should do what I think I have to do.
I'm not sure if that contains any hidden message, but that's all
the go ahead I need. Over the next month or so I prepare by
signing up for short-term disability and squaring away things at
work.
Somewhere along the line I realize I'll be out 2-3 weeks and let
my boss know. In my mind I'm thinking 2 weeks, with the 3rd week
working from home. Later this doesn't seem like such a good idea,
it feels like rushing back prematurely.
April 14, 2003
Pre-surgery checkup with my family doctor, Dr. Marshall. Since I
haven't had a physical in a couple years he does a full physical.
Everything checks out okay. He doesn't normally check hip joint
flexibility, but checks it since I'm going in for hip surgery, and
says the restricted motion is the worst he's seen in a patient my
age. Naturally he doesn't often check hip range of motion
(henceforth ROM) in his patients, but this is still reassuring
information that I'm not making a mistake.
April 15, 2003
Pre-op appointment at Elliot Hospital in Manchester. I'm
introduced to people from all the groups that will be working with
me during my stay in the hospital, which should be four days:
admission and surgery on Monday and release four days later on
Thursday.
Sunday, April 27, 2003
The day before surgery. Nothing to eat after midnight. In the
morning I can only have clear liquids. I'm nervous. I sleep, but
not too well.
Monday, April 28, 2003
I pack. I've got three books and four books-on-tape, all of which
I barely touch in the hospital. I wear sweat pants and a tennis
shirt. Elliot Hospital calls. Dr. Benson is ahead of schedule,
can we come early? We leave five minutes later.
We find easy parking, register at admissions and are walked up to
the surgical floor. Lois and I are admitted to a screened off
section of a larger room. A nurse comes and tells me to change
into a johnny, and she shows Lois out while I change and while
they prep me. I'm not following directions well and forget to
take off my underwear and socks. They install an IV. They ask me
if I've had anything to eat in the last 4 hours, I say only a half
cup of tea. Mistake, they say, but probably okay. I must have
misread the instructions.
Dr. Benson comes by, marks my right leg with his initials. He
says they're ahead of schedule because the first surgery was a
revision that was very simple, just an adjustment of parts, no
wholesale replacement.
They put TED socks on me (for circulation). My belongings go into
a plastic bag. I give Lois my watch and glasses when she returns.
We say goodbye, I think, and I'm wheeled through some doors.
The anesthesiologist, a large nurse-looking person but obviously a
doctor, asks me a few questions. Other things happen, nothing
significant, but I no longer remember them. At some point I fall
asleep. No one asked me to count backwards from 10.
Later Monday, April 28, 2003
I wake up. I forget the first few words of conversation, but I
start talking a blue streak. "Is it done? It went okay? I'm
awake! This is good - I'm not groggy. I didn't want to be
groggy. Yes, I feel a lot of pain. On a scale of 1 to 10? I
guess 9. But this is good. This is great. It's over. It went
well? It went okay? Yes, still pain around 9? What's that? I
woke up saying, 'Pain, pain, pain?' Oh, that sounds like me. I
did that last time I had surgery, only it was just moaning." And
so forth.
As soon as the pain is reduced my entire bed is wheeled out of
recovery, into an elevator, out of the elevator, down the hall and
into a room. I'm the only occupant for now, but it's a double.
Nurses come by to introduce themselves. I've forgotten everyone's
name that helped me during my stay.
I believe Dr. Benson comes by and tells me it went fine.
5 PM, Monday, April 28, 2003
Lois stops by with Jeff. They say I look good. I feel good.
Sure, there's pain, and I'm generally uncomfortable, but the worst
is over, or so I think. The only position I'm allowed is on my
back with this pillow strapped between my legs to keep them at the
proper angle to each other. My feet have booties on that are
connected to a machine that alternately squeezes each foot. This
is supposed to help maintain circulation to prevent blood clots.
Lois and Jeff don't stay long. I think a nurse may have asked me
to try to slide my right knee up. I can barely slide it up an
inch. I have no trouble moving feet and toes.
Tuesday, April 29, 2003
I can slide my right knee up a little higher today. I'm told to
do the slide exercise several times a day. Thank God they don't
strap that stupid pillow back on my legs. They leave that pillow
sitting in a chair and just put a regular pillow between my legs.
During the day I am gotten out of bed twice. The first time I
take the walker to the bathroom door and back. The second time I
take the walker to the hall and back, maybe 30 feet total. No
problem.
Lois, Jeff and Kathy visit in early evening. I'm not doing very
well. The medication has made me nauseous which has made me very
weak, though I'm actually doing fine. Family gives no outward
sign, but they're concerned. Nausea turns out to be a recurring
problem. Two of my days in the hospital are spent nauseous and
mostly out of it.
Wednesday, April 30, 2003
I can slide my knee up pretty high today. I do this exercise, 10
reps, a few times during the day.
Physical therapy person asks if I'll be using a walker or
crutches. I say I'll follow their recommendation. She suggests
crutches. She gets a pair, we adjust them and give them a try.
It takes a few minutes to keep me from leaning my arm pits into
the tops of the crutches, but after that we do fine. First we
make a circuit of the floor with two crutches, then a second
circuit with one crutch. One crutch is much easier. We do a few
stairs, too. None of this is difficult.
When Dr. Benson stops by I ask him a couple questions about how it
went. He said there was less cartilage than the X-Rays had made
it appear - it was mostly gone. The bone spurs were so bad that
he had difficultly dislocating the hip. The bone spurs on the cup
had grown partially around the ball, and he had to spend 20
minutes grinding some of them down before he could complete the
dislocation.
Thursday, May 1, 2003
Dr. Benson stops by, as he has every morning. He says they'll be
releasing me today.
I make a circuit with a PT person with the crutch. Seem to do
okay. I do it again later by myself, decide to adjust the crutch
some more to be taller. This works well. The leg is supposedly
full weight-bearing, but I can't put much weight on it without
feeling too much pain to bear, so it can't really support me. The
quadricep is stiff everywhere, and there's one place on the side
of the quadricep about four inches below the hip joint which feels
incredibly bruised like it's been jabbed real hard by the end of a
broomstick. This is where I get a sharp pain if I try to stand on
the leg. Did they have to cut the muscle there?
Around 1:30 Lois arrives. I'm dressed and mostly packed. We
finish up and prepare to go home. A nurse goes through some
paperwork with us, mostly releases and instructions, and gives us
prescriptions from Dr. Benson. I'm wheelchaired down to the front
door, Lois drives the van over (the nurses thought I'd have an
easier time getting in and out of the van, but as we later
discovered, and as I suspected anyway, the seats in the BMW go
much further back, and the BMW was much easier to get in and out
of), I'm loaded in and off we go. We're going home.
I spend the evening in front of the TV. Leg between knee and hip
seemed to swell up more around bedtime. Later figured out that it
was the coumadin (blood thinner, reduces possibility of blood
clots) that I was to take every night, 10 mg one night, 7.5 mg the
next.
Friday, May 2, 2003
Weighed myself. Gained 8 pounds? How could that be? Later
figure out that the weight is the swelling of the leg.
Darren, a physical therapy specialist from TLC, stops by around 10
AM. I'm feeling pretty good. He takes a couple hours, copies
down lots of information, checks out the house to see where
difficulties might lie, goes through some exercises with me that
I'm to do three times a day. I walk to the end of the driveway
and back.
Saturday, May 3, 2003
Leg is still swelled up pretty good, though this doesn't represent
a problem. Had a medication problem, probably the hydrocodone
Dr. Benson prescribed for pain. I'm nauseous all day. At the end
of the day Lois calls and gets a prescription for anti-nausea
medicine. It works after an hour, but I've wasted the whole day
immobile on the couch.
Sunday, May 4, 2003
I feel great, but weight is up another half pound. Leg still
swollen. I do all my exercises. Lois and I walk out to the
street, then a couple hundred feet in each direction, then back to
the house. Feel fine. I'm using one crutch, of course.
Monday, May 5, 2003
1-week anniversary of surgery.
I get up early and clean up. Darren comes by at 8 AM, we do the
exercises, I'm doing fine.
Rosalie comes later in the day to take a blood sample to measure
the coumadin level.
Mom arrives. We try to walk around the block, but halfway around
my right knee is starting to ache, probably from the swelling.
The right leg down to the knee has been very swollen since
returning home. We luck out, Lois appears in the van on her way
home, so we ride back home.
Tuesday, May 6, 2003
Dr. Benson's office calls asking if I know where the blood sample
went. I'm having more nausea problems, I ask for an alternative
pain reliever. I tell her where to find the blood sample, she
says she'll get back to me about the pain reliever. When she
calls back she says to take no more coumadin until the next blood
test, which should be Thursday. Turns out my coumadin level is
way up, my blood is way too thin, and I shouldn't shave. This
probably explains why the swelling in the leg won't go down. Sure
enough, as soon as I stop taking coumadin the swelling goes down
dramatically over the course of a couple days. She also provides
a prescription for darvoset, which works much better for me. Not
quite as strong as hydrocodone, but no stomach upset now.
I walk around the block twice, probably too much, as I do no
walking the next day.
Wednesday, May 7, 2003
Darren comes by at 8 AM, we do the exercises. I seem to be doing
well, he gives me a couple new exercises to do. I can walk
without the crutch, but after a very short while it feels like I'm
tearing myself down instead of building myself up. I continue
using the crutch.
Didn't walk at all, though yesterday's over-walking contributed,
but did the exercises a couple times. Jeff had an away tennis
match at Oyster River where the team bus was to leave
Hollis/Brookline High School at 1:45 PM, so Mom and I had to pick
him up at Brentwood at 1:00 PM. Turns out he left his tennis bag
in the school bus that morning and a madcap circus of running
around ensues. He hadn't told the bus driver he didn't need a
ride today, which means the bus driver was on his way to pick Jeff
up at the same time that we're already driving him back to the
high school. We tried to reach the bus company and the bus
driver, but no luck. We called back to Brentwood in case he was
there, which he was (great luck!), but then my cell phone battery
ran out. I give Jeff my tennis equipment, he borrows a shirt from
another boy, and off they go.
Who needs caffeine when you have adrenaline?
Thursday, May 8, 2003
I forget this day. I don't think I did too much. This may be the
day where I ate enough candy to upset my stomach, didn't do as
much as I should have. Swelling in leg continues to go down.
Friday, May 9, 2003
Had wonderful breakfast with Lois and Mom at Timeless Diner in the
morning, then Mom returned to Vermont. Shortly after arriving
home became incredibly lethargic, no energy at all. Couldn't even
read email. Did very little all day.
Called Dr. Benson's office to tell them that we hadn't been
contacted about a blood test for coumadin level. They sent us to
St. Joe's emergency room in Milford for the blood test. Results
were phoned to Dr. Benson's office, a little after 5 PM a phone
call informs me that I should take 1 mg coumadin per day. Just 1
mg? No wonder the level was elevated.
Saturday, May 10, 2003
Did exercises, walked around block in morning. Tired afterward.
Can easily walk without crutch, but there's pain and it begins to
wear after a short while so I'm sticking with the crutch for now.
Instructions from NH Ortho say not to use reclining chair, but
that's all I use. They're easy, plus the leg is raised for
improved circulation. Don't see the problem.
The rule against bending the leg more than the 90 degrees at the
hip seems a little too strong. Probably should be 75 degrees.
Dr. Benson says the danger in doing this, and in bending leg
inward or crossing right leg over left leg, is dislocation.
There's so much discomfort involved in even getting close to doing
these things that there's no danger of them happening. I wonder
if it's that if you keep doing it it takes the joint capsule
longer to firm up, or if it never gets as firm, increasing the
risk of a repeated dislocation problem down the road. I'm mostly
successfully avoiding doing these things.
I think I'm way ahead of your average 70 year old, which is where
the pamphlets I have seem targeted. Probably average for a
50-year old, but the difference from a 70 year-old is dramatic. I
should be able to discard the crutch shortly, and I won't be using
a cane. Though I'm not recovered yet, I feel like I have a good
sense for how good I'm going to feel when I *do* recover. When
can I start tennis? How long will my left hip joint last before
it needs surgery, too?
In the hospital Dr. Benson mentioned that some patients tell him
the hip joint feels like it has a mind of its own or feels very
strange sometimes. After my walk I think I understand what he's
talking about, but I don't think it has anything to do with the
joint itself. It has to do with the muscles during recovery.
Some of the muscles in the right leg were unaffected during the
surgery, some were affected a little, some a lot. The relative
strengths are much different than normal right now, and after my
walk when the muscles were tired I had the sensation of the leg
tugging itself off slightly in random directions under it's own
volition. I think once the muscles recover that this sensation
will completely disappear. This could be even more the case for
people whose motion had been more restricted than mine. But we'll
see.
Walked around the block again in the afternoon.
Sunday, May 11, 2003
Can't remember clearly now a few days later. I don't think I did
my exercises or took walks, but I'm not sure. However, it was
Mother's Day, and me and the kids went to Wal-Mart and bought a
couple presents. We had pizza for dinner, I think.
I'm walking around the house without the crutch, but anything
further I use the crutch.
Monday, May 12, 2003
2-week anniversary of surgery.
First day back to work, but working from home. Mainly read email,
didn't make much progress. Also did some bookkeeping-type
activity, like filing my work/hour sheets.
Darren came by at 8 AM. Said to keep doing same exercises, but do
them three times a day, two sets each time except only one set the
middle time.
Patty comes by to take what turns out to be the last blood
sample. She gets the vein on the first try!
Walked around the block once, I think.
Tuesday, May 13, 2003
Second day back at work. Read John's randomization white paper
and provided feedback. Read some email, but only making slow
progress. Attended afternoon meeting, boring as usual, I didn't
have much to contribute, but Josh is apparently 80% done with the
Verilog model for the LAN card.
Walked around the block twice, did my exercises twice. They are
so boring. I'm feeling pretty good. Lois bought me a cane, I
used that for the second walk.
Wednesday, May 14, 2003
Mammoth lovemaking session last night. Whoa! Hip held up fine,
just have to be careful not to lie on right hand side and avoid
the bad leg positions, which wasn't difficult. Right side is
getting less and less uncomfortable to lie on.
Darren came by at 8 AM. Gave me new more aggressive exercises.
The one where I stand up straight and move the leg out to the side
suddenly hurt sharply on the right side of the right buttock
during the 2nd set and had to stop. This is a place where it has
felt like a deep bruise since the surgery. What did the doctor do
to it? Still aches this afternoon, and I'm not walking as good as
before, but I think this will take only a day, two at most, to get
over. I'll take it easy today. I've already walked quite a bit
since I just started driving today, and I picked Jeff up at school
and took him to see Dr. Cohen and took him back, then went to
library, then to D'Angelo's. I'll let that be enough for today.
Hampshire Hills Rehab called and left message, looks like I'll be
going there - not sure when I start, I haven't called back yet.
This should have been third day back at work, but I never logged
in. Spent most of day on couch. No physical problem, but I
couldn't get my mind to focus.
Beverly called from Dr. Benson's office. I don't have to take any
more Coumadin.
Thursday, May 15, 2003
Today for the first time I don't feel stronger than the day
before. Nothing dramatic, but I'm used to feeling stronger each
day, so this is very noticeable. Right buttock still aches, not
painfully, though. Hip joint capsule feels like an inert solid
ball, I wonder if that's due to some returning sensation. In
other words, before there wasn't enough sensation to be aware of
the joint capsule, and now there is.
Did my morning exercises. New exercises are tougher, but not
dramatically so. Took walk around block, clockwise today. Going
up the steep hill is tough, took 15:05, I think counter-clockwise
only takes about 13:00. But I also felt a little slow today
because of the extra aches.
I'm back to reading work email. Boring.
Did my evening exercises. Took walk around block,
counter-clockwise, took 16:30. I'm slowing down even more.
Major milestone: not a single darvoset today.
Friday, May 16, 2003
Changing things up a little. I'm going to rest today, no
exercises or walking. I'm talking three Aleve in the morning
instead of one vioxxe, I'll take more in the late afternoon since
it doesn't last as long. And I'll ice the right rear buttock a
few times, maybe there's some swelling.
I'm still not walking as well as I did before Wednesday morning.
Also did very little work today, my mind just couldn't
concentrate.
Bob called. He had just found out about my RTHR. We talked for a
while, he told me Steve had had a rough winter healthwise, and
that he passed out in his car earlier in the week and had a
serious accident, ended up in the hospital. He's home and
recovering now. They got Steve's tennis court (it's clay and
takes some prep work) opened up for the season. Bob volunteered
to try hitting with me when I begin to try to resume playing.
Still no darvoset today.
Saturday, May 17, 2003
Did exercises in morning and walked around the block. Leg felt
much better for walking today, did it in 12:46 keeping just what
felt a normal pace.
Ran errands most of afternoon so skipped the evening exercises and
walk.
Helped Jeff restring a racket. Had no trouble standing for the 30
minute turn I took, but I probably spent most of the time with my
weight on the left leg.
Still no darvoset today.
Sunday, May 18, 2003
Probably haven't mentioned, but I've never liked sleeping on my
back, and so I've been sleeping on the left side for a while now,
sometimes directly sideways, which feels a little uncomfortable to
the new right hip until I get the leg positioned just right.
Other times I'm almost on my stomach, but angled up a little with
the right leg crooked out to the side a bit. This is the most
comfortable position.
Starting a few days ago I began sleeping on the right hip, too.
The incision area is too uncomfortable to sleep on directly, so I
sleep tilted either toward my stomach or toward my back. I think
this causes a little swelling in the incision area, and some pain
in the morning, but I need some variety in my sleeping position.
Took one vioxx this morning instead of three Aleve to see if I
can tell the difference. Before the surgery I had tried vioxx as
an alternative to Aleve and found it lacking, but today at least
the vioxx seems to be doing a very good job. Pain in the
incision area due to a little swelling seemed to diminish markedly
in only an hour.
Rate of improvement has decreased. I thought I might be walking
without a cane by today, and I give it a try, but in the end I
only walk about 10% of the distance around the block without the
cane. But while walking around in the house during the day I feel
like I'm almost walking normally, though I have to concentrate to
pull it off. I'll try without the cane again for the evening
walk.
Felt stronger for the evening walk. Walked maybe 15% without the
cane. Discovered could actually reach the shoelaces of the right
shoe without pain, so I'm tying my own shoes now.
No darvoset again today. I won't mention it again unless I find I
have to take some. Only six tabs left.
I started this diary with an eye looking forward to when I could
begin playing tennis again, but I guess there's going to be at
least three more weeks of these rehabilitative summaries before
tennis gets into the mix.
Monday, May 19, 2003
3-week anniversary of surgery.
First day physically back at work. Discovered I can tie my own
shoelaces this morning, though I still need the device to put on
my socks. Didn't do exercises or walk in morning, no time, plus
didn't want to lose too much energy. Energy turned out to be a
factor. After a couple meetings I no longer had any mental
energy.
Fortunately had to leave early for my first out-patient PT
appointment at Hampshire Hills. I'm as bad with names as ever,
I've forgotten the therapists name. She was good. She removed
the incision tape, said she could tell it was no longer adhering
to the incision and she was right. I guess I must have sticky
skin and the stuff just didn't want to come off. The bottom most
pieces of tape also covered a couple inch length of suture thread,
the kind that eventually dissolves, emerging from the bottom of
the incision. She cut this to about an eighth inch length.
She also measured my legs, says the right is an 1/8 to a 1/4 inch
longer, which is what Dr. Benson estimated it was before surgery.
Forgot to mention earlier that on my second or third day in the
hospital Dr. Benson said I'd have to be fitted for a lift for the
left foot. We didn't discuss it beyond that, but to me this
implied that he'd had to lengthen the leg. Now it seems that he
didn't. Maybe he had me confused with another patient when he
said that. I don't see the need for a lift for a 1/4 inch
difference.
She also checked flexibility, measuring how far I could move my
legs to the front and sides. 15 degrees to side for right leg, 25
for left. Right knee cannot be raised to quite reach the 90 degree
position. I asked what holds it back, she said muscles, but this
doesn't sound right to me, because I sense the resistance coming
from the hip joint. I wonder what it is in the hip joint that is
holding it back.
Lack of energy extended into evening - fell asleep on the lounge
on the back porch. Didn't do exercises and Mental concentration
seems poor - I can't read in bed as long as I used to.
Tuesday, May 20, 2003
Happy birthday 51-year old!
Second day physically back at work. This is too much. With the
commute time I feel too rushed to do my exercises and take my
walk, plus I get tired too easily. I park at the far end of the
building to make the walk in and out of the building as long as
possible, but it's still only a three minute walk. Will work from
home rest of week.
Leg aches a little in odd places unrelated to the surgery today.
During lunch I watched a net video of a hip replacement surgery.
Found the link at TotallyHip, but here it is again:
http://www.slp3d2.com/sfi_1013/broadcast_pre.cfm
Unbelievable to watch. Surgeon moves so fast it's like he's
butchering a roast. Isn't afraid of damaging a thing, just yanks
muscles, tissues and bones this way and that. I think the analogy
is with watching a cartoonist draw - they draw their lines
incredibly rapidly and casually, but the result is very precise
because they've done it so many times. It must be the same way
with the surgeon, I just can't tell a good surgery the way I can a
good drawing.
But it's still more violent than I imagined. The reamer for the
acetabular cup looks and is wielded like a drill, and the reaming
of the femur looks especially gross. The acetabular cup is
pounded into place with a hammer, as is the stem for the femur.
The ball is pounded onto a rod on the end of the stem. They test
for potential dislocation by picking up the leg and moving it
around. The surgeon is fast - the surgery part of the video is
over in about 30 minutes, though they skipped the opening.
Patient appeared to be at least 70 gauging by the slackness of the
skin, though that clue might be misleading.
Wednesday, May 21, 2003
New record for walk around the block, 11:30. Wasn't going to
attempt such a fast pace, but it was starting to rain so I gave it
a shot and felt fine. Walked maybe 40% without the cane - gait
became slightly more natural during the walk, feel good about
that.
Today put right sock on without the sock-device for the first
time, though I was definitely pushing it and probably shouldn't do
this again for a little while. Could feel pressure in hip joint.
Yesterday got rid of the commode, not sure ever really needed it.
Made getting down and up easier, but all the bathrooms have
counters and windowsills to grab onto, and probably would have
done fine without it. Was told the commode was so you don't
violate the 90 degree rule, but a lot of the flexion when sitting
on the commode comes at the waist, not the hip, and since my hip
joint currently doesn't yet approach 90 degrees without a lot of
resistance (can't seem to get it past around 100 degrees) I know
I'm not getting close to 90 degrees.
What is an IT band? Saw it mentioned at TotallyHip. Geoffrey
said that bending the leg inward would strain the IT band. I
haven't been following this stricture very well while sleeping -
am I doing myself damage?
I just got the information about my components from the doctor's
office:
Howmedica Osteonics Accolade size 3 press fit prosthesis with
132 degree neck, 36 mm and 0 ceramic head.
Howmedica Osteonics Trident acetabular component size 16 mm
w/60x36 mm ceramic insert.
And I found a marketing webpage that describes these components -
pretty interesting reading no matter what components you actually
have:
http://www.howost.com/ceramic-hip/
It turns out that a 36 mm head is the largest available, which is
good since I've heard that ROM is better with larger heads. The
webpage says they're also better for "joint stability", though I'm
not sure what that means.
Also found out what "IT band" is. IT is short for iliotibial
band. It connects from the side of upper hip bone down the side
of the leg to the top of the tibia. It is one of the abductors
that help pull the leg out to the side. I think they go through
the muscle of the IT band for THR, which is why abduction (moving
leg out to side) is so weak after surgery - at least it was for
me. It also explains why crossing the leg over or turning it
inward might stress the IT band, since it's been incised or at
least severely stretched. I have my legs modestly crossed
right now (legs mostly parallel, but right foot over left), which
is just what you're not supposed to do, but it feels fine. It
didn't feel fine just a few days ago.
Hmmm - trying to actually cross right leg over left knee now...can
almost do it. Backed off at the first hint of pressure on the
joint. I'm relying on feedback from my body to tell me when I'm
doing a bad thing because my experience since surgery is that this
has been a reliable gauge, but for the benefit of anyone who might
read this I've been told that some people get feedback in the form
of discomfort and/or pain and some people don't.
Did a bunch of walking when I picked up Kathy from horseback
riding, so I didn't do my evening walk or exercises. I love dogs
but had never met Laurie's dog Cam, a huge rottweiler. When I
approached the ring Laurie had her hand firmly on his collar and
he still dragged her all the way out of her seat and nearly to me.
I kept coming because I hadn't been paying close attention to the
dog and assumed it was the Hyde's friendly Newfie. Hate to think
what could have happened. Turns out he doesn't like strange men,
made friends with him later.
Obtained a copy of the article Tennis After Total Hip Arthroplasty
that appeared in the American Journal of Sports Medicine in issue
27 in 1999. It was originally presented at the American
Orthopaedic Association Residents Conference in Baltimore, MD, in
March of 1996, so this is actually a pretty old paper. It's
encouraging in the sense that there are hippie tennis players
playing at a high competitive level, but the sample group was
biased in two significant ways. First, the group was
self-selected - the respondents decided whether they would respond
or not. Second, only members of the USTA were sent surveys, and
those hippie tennis players who found they were no longer able to
compete after THR likely let their USTA membership lapse - it's
impossible to know how large a group this is. The article is
pragmatic in that it says the likelihood of revision increases
with activity level, though this conclusion is simply logical and
not an outcome of the survey results.
One thing that is becoming very clear - by far the dominant
failure mode is loosening of the prostheses where they attach to
the bone.
Thursday, May 22, 2003
Put sock on without the device again - I know, I said I wouldn't
do this again so soon. Anyway, less discomfort today.
Did morning exercises but didn't do my walk because I ended up
walking up and down the basement stairs a bunch of times turning
the water to the sprinkler system on and off so the plumber could
fix the exterior backflow valve. Must have overdone it yesterday
because I'm weaker today.
DSL went out - more trips up and down the stairs checking out the
DSL modem.
I think I've already done too much today - leg is weak even when
just walking. I have PT tonight, so I'll take it easy till then.
At PT she applied rubbed lotion into the incision for while,
stretched the leg out to the side, gave me some other stretches to
do, said to continue with current exercises for now.
Friday, May 23, 2003
Been a slug all day. No exercises, no walk, no nothing. But I
needed this.
Saturday, May 24, 2003
Did my exercises once, walked around the block once in 13:35, but
with 75% no cane.
Iced hip down once. Tissue beneath the incision feels lumpy.
Sunday, May 25, 2003
Did my exercises once, walked around the block once in 11:13, new
record, and with 100% no cane. Yea!
Monday, May 26, 2003
4-week anniversary of surgery.
For the first time I can walk normally. Suddenly my right leg has
passed a threshold of strength, and the right side no longer dips
down as the weight descends onto the right leg. The relevant
muscle seems to be in the buttock. Leg is still very weak going
up stairs, but descending stairs is fine.
Be interesting to see how long the strength holds up during my
walk.
Still putting my socks on without the aid, and it's getting easy.
Just tried crossing right knee over left knee and I can do this
comfortably - yea! Interestingly, after 4 weeks of greatly
diminished activity I can now cross my left knee over my right,
something I lost the ability to do about a year ago. Inflammation
must be at a low in the left hip.
New record for walk: 10:15, no cane. Right buttock pretty tired
at end. Not able to maintain a completely normal gait for most of
it, but still did pretty well.
Tuesday, May 27, 2003
Overdid it yesterday, today leg was weak and stiff. Could only
walk with bad limp, wished I brought the cane with me to work.
PT person's name is Jean-Marie - not sure the spelling is right,
I've only heard it pronounced and not seen it written. She
loosened up the leg quite a bit, and I walked out much more easily
than I walked in.
No exercises or walk today - a rest is called for.
Wednesday, May 28, 2003
1-month anniversary of surgery.
Leg feeling much better this morning, but still sense a little
weakness and stiffness. I'll do exercises and walk tonight.
Decided leg was too weak for exercises and walk tonight.
Thursday, May 29, 2003
Leg still very weak. Leg was very tired after 2 or 3 minute walk
from car to office.
PT was fine, gave me a new squat exercise. Decided leg still too
weak for exercises and walk. But it *is* feeling a little better.
Time for a useful note about where things hurt. I feel no pain
when idle. The same two places that felt like there's a severe
deep bruise and are painful when pressure is applied while probing
with fingers still feel roughly the same as a couple weeks ago.
One is below and anterior to the hip joint, but not on the
quadricep. I originally thought it was the quadricep, and I
called it the quadricep in earlier entries, but Jean-Marie, my PT
person, says it's not the quadricep (later I find out it's the
iliotibial band). I'll try to find out what muscle it is.
The other muscle that hurts is one of the gluteus medeus, it hurts
six inches above the hip joint and posterior, which is high up on
the buttock. It must be pretty near where the glut attaches to
the upper hip.
The guess from the PT people is that the doctor has to detach
these muscles and then reattach them, and they take a while to heal.
I'll modify this entry when I get the right names for all the
muscles. And I'll try to get more specifics from Dr. Benson when
I see him on June 11.
Friday, May 30, 2003
Did exercises for first time since Monday, only one set. Tried to
walk around the block, but had to turn back. Leg started feeling
very tired. Maybe did 20% of the whole distance.
Leg is feeling funny. It has little aches that weren't there
before that have gotten worse as the week has gone by. Wonder
what it means. The leg doesn't feel more swollen. Is it maybe
because it's less swollen?
I can sleep on my side on the operated leg, but it isn't too
comfortable, and it usually begins to hurt after five or ten
minutes.
I've been putting my pants on without supporting myself with a
doorframe, and when all my weight is on the operated leg and I
maneuver to get my leg into the pant hole there are tiny but sharp
pains coming from around the joint. Wonder what it means.
I don't think I'm making any progress lifting my right leg
higher. Wonder what the resistance is from?
Had brief post-op meeting with my regular doctor, Dr. Marshall.
He said it should take 6-8 months to return to my original
conditioning before surgery. Thinking about when I might return
to tennis, just to stand there and hit the ball - seems more than
just a couple weeks off at this point.
Saturday, May 31, 2003
Did exercises, walked around block in 12:24 and felt pretty good.
We'll see how the leg feels tomorrow.
I'm having trouble with two of the stretches Jean-Marie gave me,
the one for the quadricep and the one for the muscle on the inside
of the leg. I had Kathy manually pull the leg out to the side
while I was lying down for the inside muscle, but I'm going to
have to figure out something for the quadricep. I feel like I'm
wasting my time trying to put some stretch on it this way, with
the right knee on the floor and the left leg out front and trying
to push forward - I just don't get any stretch. Of course,
there's no much flexibility in the left leg, that could be part of
it.
Sunday, June 1, 2003
Leg feels okay this morning. Maybe I'm back to where I was about
a week ago. Even though I feel okay I decide not to overdo it and
I do no exercises and take no walk today.
Monday, June 2, 2003
5-week anniversary of surgery.
Leg feels good today. I ask Jean-Marie at PT which muscle it is
that hurts when I try to go upstairs, and she says it is probably
the iliotibial band, even though it has little or no muscle. She
does deep massage on the leg, and afterward and I am able to go up
and down stairs with no pain. Amazing!
During lunch I was catching up at the hip site, and the resident
expert, Geoffreyf (don't deny it, Geoff, you are), who
unbelievably happens to live in Lowell, was responding to a
question about abductor muscles (muscles which move leg off to
side), and he said that the iliotibial band (connects from upper
hip bone down side of thigh to top of tibia) is the seam of the
Fascia Latae, which is a ligament-like sub-skin surrounding the
thigh. It in turn connects to the Tensor Fascia Latae which is a
muscle that maintains tension in the Fascia Latae by pulling up on
it. I think that explains my pain when I climb stairs.
Also ride stationary bike for 5 minutes with no problem.
Jean-Marie says increasing circulation aids healing.
Jean-Marie also says I should be able to get a copy of the OR
report that details everything they did, including which tissues
were cut, moved, stretched, etc.
A couple times today I found myself absentmindedly skipping
rapidly downstairs - had to catch myself and slow down. Didn't
want to trip and fall. Felt fine doing it, but I know I'm still
pretty weak and probably not too able to recover from a stumble.
I don't know if it was the small amount of aerobic exercise, but
am tired and lethargic tonight, do no exercises.
Thinking about returning to tennis, doesn't seem so far off now.
Would be nice if I could, because maybe I could substitute tennis
for some of the boring PT exercises that I understand are in my
future, especially the EXCEPTIONALLY BORING STATIONARY BIKE!
Tuesday, June 3, 2003
Leg feels good. Did exercises but took no walk since I walked in
and out of work and then went to the Nashua library on the way
home, and that's a fair walk, too, from the parking lot, plus I
must go up and down stairs between 5 and 10 times a day. Don't
want to overdo it again.
I think I forgot to mention the time a few weeks ago, and it was
the only time, that I ran errands while using my cane. Couldn't
believe how differently I was treated. Everyone was holding doors
open for me, making sure not to jostle me.
Wednesday, June 4, 2003
Leg feels *real* good! Walking out of work found myself walking
fast. Normally I'm a slow walker, and I was trying to figure out
why I was walking fast. I wasn't in a hurry, I didn't feel in a
hurry, it just felt natural. Found myself walking fast again when
I went to the library (forgot yesterday that I had books at home
that were due). Did I develop into a slow, deliberate walker
because of my hip, and now I'll be a fast walker again? Or was
today an exception for some unknown reason.
Even more incredible, I stepped into the car! Wasn't thinking
about it, just did it, almost didn't even notice what I'd done.
Normally I have to sit on the seat with both legs outside on the
ground, then rotate into position. I always used to step in, but
had to give that up a year or two ago.
Didn't do any exercises except for the side lifts (lie on left
side, raise right leg into air). The exercises just feel so
trivial compared to going up stairs, getting in and out of car,
etc, hard to get motivated. Should have done the stretches,
though - my bad!
Thursday, June 5, 2003
Leg felt slightly weaker today. Rode bike for 6.5 minutes at
beginning of PT. Skipped evening exercises. My two setbacks were
relatively minor, but they've made me fearful of overdoing it.
Tennis seems at least a couple weeks off.
Friday, June 6, 2003
Did all exercises, increased my walk distance because I'm walking
faster and I should be walking at least 20 minutes a day. Walked
around the block twice in about 18 minutes.
Saturday, June 7, 2003
Did no exercises, no walk. Leg felt slightly weak today, didn't
want to push it.
Sunday, June 8, 2003
Did exercises, walked longer route that has two tough uphills,
took 20:22. Really pushed it.
Monday, June 9, 2003
6-week anniversary of surgery. Appointment with Dr. Benson in two
days.
Leg is tired and weak this morning. Pushing it yesterday was a
mistake.
Am concerned that strength of leg isn't returning more
quickly. I know I'm ahead of many people, but the strength in
going up stairs doesn't seem that different from 3 weeks ago.
Had Kristen at PT today (again, I'm bad with names - I'll correct
it later if it's wrong). She helped me with some stretches, then
she took me on my first visit to the exercise room. Hampshire
Hills has revamped their exercise room. Many, many machines.
With TVs. And wireless headphones. Maybe should consider
rejoining. Five minutes on the bike, two reps of 10 of leg
presses, one rep of 10 of leg curls using just right leg.
Adductor/abductor machine was in use, but we were out of time
anyway.
Tuesday, June 10, 2003
Leg feels even more tired and weak. Do no exercises, take no walk.
Wednesday, June 11, 2003
6-week post-op appointment with Dr. Benson. He said things look
excellent. Appointment was short, but he talks fast.
We talked a little about the anterior and posterior approaches.
He uses the anterior, and I guess to be more accurate it should be
called the anteriolateral, meaning lateral entry to the body and
anterior (front) entry to the joint capsule. Posteriolateral is
what they do at New England Baptist under Dr. Bierbaum, where
Dr. Benson was previously. I believe posteriolateral means
lateral entry to the body, but posterior (rear) entry to the joint
capsule. Dr. Benson learned the anterior approach, which is
apparently a little more complicated, while in Connecticut during
his residency. While at New England Baptist he did mostly
posteriolateral, but said he did do a few anteriolateral with
Dr. Bierbaum while there. He said the dislocation rate with the
posteriolateral was about 5%, and so after arriving at NH
Orthopedics he decided to use the anteriolateral because
dislocations are a burden for patients, as emergencies they're
disruptive to schedules (especially if surgery is required), and
there isn't a large residency staff to respond to dislocations in
Manchester.
He said he does around 100-120 total hips each year, around 400 so
far at NH Ortho.
We talked about flexibility. He says in the years prior to
surgery as people's range of motion (ROM) decreases that the joint
capsule loses flexibility because it is no longer being stretched
as much. A tight joint capsule is actually good post-op because
it helps prevent dislocation. He can correct a tight joint
capsule during the surgical procedure, but this increases the
possibility of dislocation and so it isn't generally done.
Stretching should gradually loosen the joint capsule over time.
It is the tightness of the joint capsule that currently limits my
ROM, the bone spurs no longer being an issue.
He said that with the anteriolateral approach combined with my
large acetabular cup and ball (60x36) that dislocation after
surgery was very unlikely. I'd have had to work at it. The
precautions aren't really that important with this approach. He
says he's had only one dislocation in his 4 years at NH Ortho.
In contrast, the posteriolateral approach apparently leaves the
patient slightly more prone to dislocation, often with no feedback
that dislocation is about to occur.
Just like everyone else has been telling me, he told me I really
shouldn't expect the Gluteus Medeus or the Tensor Fascia Latae
muscle that connects to the Illiotibial Band to have healed much
to this point. In fact, he says they should only be beginning to
heal now, and should take another 4 to 6 weeks before I see
significant strengthening.
He agreed with PT that the leg length difference was about a 1/4
inch. He asked if I wanted to try a lift for the left leg and I
said no, especially since a 1/4 inch was the difference before
surgery, so I'm already used it.
He said I can resume tennis, but recommended that I not play
competitively for a couple more months. My leg still feels so
weak I wouldn't consider it anyway, and I told him that for now I
just wanted to try tapping the ball against a wall and see how the
leg and hip feel when subjected to the twisting forces. Anyway,
that's a big HURRAY! Will probably try tapping against the wall
later today if it doesn't rain.
Leg has mostly recovered from my aggressive walk on Sunday - I
could almost walk without a limp. I'll do my stretches and let my
tennis activity be my exercise. Forecast is for rain, though, and
it *does* look dismal out there.
Thursday, June 12, 2003
My son Jeff, 15, started tennis lessons with Jason today. Jason
has to solve the puzzle of how to untangle Jeff's backhand. A
couple years ago Jeff insisted on switching to a one-handed
backhand, but he's still using the two-handed contact point. In
trying to fix it I've only made Jeff mad and discouraged, so we'll
give Jason a chance.
During Jeff's lesson I hit against the wall for maybe 7 or 8
minutes. The leg felt great. In fact, it felt better after than
before. I would have hit a few minutes longer, but I got a phone
call which gave me a chance to figure out that maybe I shouldn't
push it.
Hitting ground strokes, which is all I did, is absolutely no
problem. I was able to easily clock ground strokes off both
sides. Hitting to myself quickly became boring, so I began moving
the ball back and forth between forehand and backhand, forcing
myself to first skip to the left, then the quickly skip back to
the right. I was able to stay light on my toes and everything
worked great, but as soon as I placed the ball too far away the
weakness of the right leg became apparent and I couldn't get there
in time. There was no pain in either hip, but of course this was
pretty mild stuff and tougher tests lie in the future. I did get
slightly winded very quickly, but in my defense with three balls
and not missing much there weren't any pauses. Overall
assessment: FANTASTIC!!!
At PT told Kristen (still not sure that's her name - I can't
believe I'm this bad with names) what Dr. Benson had told me
yesterday. She did a deep massage on a tight little knot in a
muscle in the buttock, I'll get the name of the muscle at my next
visit. She wasn't sure what might have caused it. I've never had
a deep massage before - it occasionally hurt, but overall it felt
wonderful and I was walking more easily afterward. I haven't had
a woman "touching" me there since I met my wife, and that was a
strange feeling. No embarrassing reactions to report, but a very
odd and unexpected feeling nonetheless that didn't occur at other
times when they've massaged the incision and thigh.
Friday, June 13, 2003
First day after my little tennis hit. Leg feels pretty much as
before. The weakness in the leg is still there, and I've begun to
notice an accompanying ache in the joint area when I walk. This
has been there but wasn't very noticeable when the muscles were
weaker. I'm not sure what is causing this. It doesn't feel
muscular, and it definitely isn't the joint itself.
When I put my pants on and balance on my right leg, it aches from
the joint down the thigh that continues for a few seconds after
I've taken my weight off the leg. The sharp little pains I used
to feel seem to have mostly gone away.
Was going to hit again at end of day. Rain held off all day until
I was done working. Didn't do exercises or stretches. I'll try
to be good tomorrow.
Saturday, June 14, 2003
Forecast is for rain, rain, rain. Those of you in the northeast
of the US know what I'm talking about - this has been an
unbelievable spring. The best weather we've had this year was a
few days in early March.
Later: Well, it didn't rain, so I did my stretches and went down
to the courts and hit against the wall for about 20 minutes. Leg
was really weak. I wasn't anywhere near as agile as Thursday, or
at least it didn't feel like it. I could stand in one place and
hit with ease - turns out this takes almost no leg strength.
Running myself back and forth showed how slow I was, and there
were many times when I had to compromise my footwork and simply
reach.
I also tried a few serves. This proved to be really easy, too,
but I used almost no knee bend.
Both legs felt achy afterwards, the walk to the car was really
uncomfortable. But now a couple hours later both legs feel
GREAT, better than earlier today. We'll see if they feel the
same tomorrow.
Sunday, June 15, 2003
Leg felt *very* good this morning. I was able to walk up stairs
with no major aches, though naturally the leg is still weak. So
since anything worth doing is worth overdoing I decide to try
tennis again. I do my stretches at home (the adductors are
stretched further than they've been in a couple years, but the
right quad is still short, can't touch my heel to my butt yet),
then go down to the courts and hit against the wall for maybe 10
minutes. Bob happens by on his bike, so he borrows one of my
rackets and we hit on the court for maybe 20 minutes. I try the
net but make the mistake of jumping to reach a high backhand
volley but stumble and fall. No damage done, but we stop there.
Still, a very successful outing, and a couple hours later the leg
feels better than ever.
The fall confirms my suspicion that I won't be able to rein in my
instincts all the time. Wall is safer for now.
Monday, June 16, 2003
7-week anniversary of surgery.
Leg feels closest to normal that it's felt since surgery. Feels
stronger today. The ache when I balance on just the right leg
while getting dressed is still very much there, but a little less
today.
Something I haven't mentioned before, should have asked the doctor
about this, but the swelling has gone down enough now to be
certain that the right hip has been moved from between a half inch
to an inch further away from my body center. This means the
angles of the prosthesis are different than originally. Looking
about on the net I see three angles mentioned: flexion, adduction
and exension. (Geoffrey, help!) I don't know what mine were
originally or what they are now. I believe this is something the
doctor mentioned before surgery when we were talking about post-op
strength stranges. He said the changes he would make in my angle
should increase my strength, or at least increase the leverage my
muscles have.
I have PT this afternoon at 5, and afterwards I plan to stop by
Steve's and hit a little on his clay court.
Well, PT went fine and I went over to Steve's for a little tennis.
Steve, Charlie and Bob were there, so we hit two singles on one
court. I hit with Bob and Charlie hit with Steve. Hit for about
40 minutes. Had a lot of trouble if I had to move too far left or
right, but I was able to easily rip forehands when I had time to
set up. I've decided to focus on getting more topspin in my
backhand, so the backhand wasn't as good, though I did hit a few
good ones here and there. Changed to the western grip for the
backhand.
Afterward tried to sweep the court, but only finished half of one
side before letting Bob finish. I did the lines. Legs were
pretty tired and achy afterwards. Went to bed way early, fell
asleep early.
Tuesday, June 17, 2003
I overdid it yesterday. Both hips ache in the same way they used
to before surgery - I assume this means I've inflamed both hip
joints. Both legs feel like they've been used to jackhammer
through concrete. I have non-muscular aches here and there in
both legs. Right leg does not feel weak today, but neither does
it feel strong. I can walk fine but I feel it as I walk, and
especially as I get up out of a chair. I'm going to work from
home today and see if moving as little as possible helps.
Tonight the leg feels great! Stronger than ever. Pain during
walking is less than it's been in a few days. I'll return to
stretching and tennis tomorrow.
Wednesday, June 18,2003
Geoffrey convinced me I was overdoing it. Thanks, Geoff! I
decided to take another day of rest.
Thursday, June 19, 2003
Leg feels fantastic this morning. Assuming decent weather, will
do stretches and tennis later today.
Did my stretches, then played tennis with Jeff and Tyler for about
30 minutes. Tyler's a friend of Jeff's from the tennis team.
Warmed up, then played 2-on-1 to 11 about six times before I
quit. Both boys have down-the-middle-itis - it was great fun
using my ability to place the ball to tie them in knots. Tyler
figured out I had trouble reaching drop-shots, though. He also
figured he could sneak in to net while I was playing the ball.
After passing him several times in a row I finally shouted to him,
"Tyler, I'm crippled, not blind!"
Iced down the right hip afterwards. It felt swollen and achy, but
nowhere near as bad as Monday. The boys aren't much for keeping
the ball in play.
I've been trying to stretch out the joint capsule. When I do my
standing leg raises (while standing, lift knee as high as
possible) after the leg reaches it's limit, which is the thigh
horizontal, I grab it with both hands and lift it as high as it
will go for a couple seconds. Today I was almost able to put on
my right sneaker by simply lifting my leg while sitting.
Also try to stretch out joint capsule side to side, which involves
turning the leg both the inside and the outside. Turning to the
inside merely meets resistance. Turning to the outside causes a
sort of burning sensation in the joint, but not the burning
sensation associated with stretching nerves - it's definitely the
joint capsule or something near it. PT says I'm not doing any
damage by doing this.
Friday, June 20, 2003
Right hip joint slightly achy this morning, right leg still strong
but weaker than yesterday before tennis. Looks like another day
of rest is in order.
Saturday, June 21,2003
Did stretches, then played tennis at Steve's with Bob. Bob's
having more trouble with his right arm and had to hit left handed,
but he did alright - much better than I'd do.
Iced down the right hip afterwards. Hip felt pretty good -
swollen but no major aches or pains.
Sunday, June 22, 2003
Day of rest. Just did the stretches.
I have to remember to ask PT why when sitting and I rest my right
ankle on my left knee that it hurts. It feels like its coming
from the back of joint, but then when I probe a bit it feels like
a lot is coming from the buttock area.
Monday, June 23, 2003
8-week anniversary of surgery.
Went to PT early and rode bike for 7 minutes, level 3 manual.
Then used abductor machine for 10 reps. That's all I had time
for.
At PT Kristen and I talked quite a bit. I've been having my
doubts that the tennis is doing me any good, and it just doesn't
feel like a good substitute for the exercises. So I'll put the
tennis on hold for a while. New set of exercises to be done twice
a day:
- 10 stomach crunches
- 10 straight leg raises while lying on floor
- 10 straight leg raises while lying on side, 2 sets, increase by
1 every day
- 10 squats, it's a funny kind of flat footed squat, but it
really causes my leg to hurt in the IT band area about halfway
down the thigh on the outside
- 10 butt lifts (probably wrong name) using just the right leg
placed on top of an exercise ball (I bought one)
Kristen also answered the question about the pain in the buttock
from crossing my right leg. I've forgotten the muscle names, but
there are buttock muscles that attach to the Greater Trochanter,
and the clockwise rotation of the right leg stretches this
muscle. While she couldn't be certain, she said it was likely
that one or more of these muscles was in some way damaged by the
surgery.
Tuesday, June 24, 2003
Did my stretches and exercises in the evening. Feel okay.
Wednesday, June 25, 2003
Leg felt achy and weak today. I'm not feeling any forward
progress. Am a little discouraged. Skipped exercises today,
don't want to overstress leg.
One great thing about the stretching - I can now spread my legs
further apart than in a couple years. The adductor muscles had
just gotten tighter and tighter because they were never stretched
very far because the hip joint just wouldn't go very far, but now
that I stretch them every day the improvement is very obvious.
While standing I can get my feet about a foot further apart than I
used to. The separation used to be so narrow that I couldn't ride
a horse. This isn't something I do very often, but since my
daughter takes riding lessons it does occasionally come up. I
wonder if I could ride a horse now?
Thursday, June 26, 2003
At PT talked with Kristen some more, and combined with what I've
learned at the hip support site I've concluded the rapidity with
which I no longer needed a cane was due more to my strength going
into surgery, and not to a fast recovery rate. The muscles most
disabled by surgery are coming back as slowly for me as they do
for anybody, it's just that my other muscles are strong enough
that it doesn't matter for simple things like walking and climbing
stairs. But for running it's another matter. I won't be able to
run until these other muscles come back. My decision to
deemphasize tennis stands.
Let still felt achy and weak, didn't do my exercises again, but I
should mention an improvement. When I put on my pants while
standing up on one leg, the right leg no longer has any problem
with this. The muscles seem strong enough to keep the leg
perfectly stable, either that or I've merely learned how to
balance with the muscles I *do* have. But I *do* have a feeling
of confidence now while doing this that I didn't have before.
When I'm done the leg aches for a few seconds. This doesn't feel
like a muscular ache, but it's similar to the ache from the
squats.
Friday, June 27, 2003
While rough housing with Kathy last night I did something to a
muscle near the hip joint. Nothing major, but it's a little
swollen today, and it feels pretty stiff. Doesn't seem to have
affected strength, though. Perhaps I pulled a small muscle. Or
perhaps enervation is returning to a muscle. Anyway, though I
don't know what muscle is involved, it only actually hurts in
certain very specific situations. For example, if I lie on my
left side with legs below me but bent at the knee and with right
knee on top of left knee, then lift the right leg into the air, it
hurts just a little below and to the front of the hip joint.
Rolling over in bed hurts a lot.
This hasn't affected my strength. I was able to do all the
exercises, and the leg feels pretty strong today. I was able to
do the lying-on-side leg raises with no problem, in fact they were
easier than they've been, but this is with a straight leg, not a
bent leg, and seems more to stress muscles in the buttocks.
The leg *does* feel a little weaker for the lying-on-back leg
raises, but this was a small enough difference that I might be
mistaken.
Saturday, June 28, 2003
2-month anniversary of surgery.
On vacation. Hip joint still aches. Have decided to take the
easy approach while on vacation and not exercise, we'll see if
rest helps.
Three hour drive in car was no problem.
Sunday, June 29, 2003
On vacation.
Monday, June 30, 2003
9-week anniversary of surgery.
On vacation.
Three hour drive in car again was no problem.
Tuesday, July 1, 2003
Hip joint still aches. I'll take the exercise approach now. Did
my stretches and exercises. Leg strength feels the same, except
it still feels weaker for leg raises while lying on back.
Wednesday, July 2, 2003
Played tennis for maybe 35 minutes with Jeff. I'm still really
slow, slower than ever, in fact. But I think that's because I'm
learning where my limits are - I didn't push the leg to the pain
point at all.
Went to PT. After massaging the incision and leg did a couple
exercises. One was on a balance board on just the right leg and
moving it back and forth, forward and backward, then in a circle.
The other standing on was on a piece of foam on just the right
leg, which was easy, until Jean Marie started giving me little
nudges and I had to maintain balance.
Did my exercises. I'm starting to think that maybe water exercise
is a better answer. I'll call Hampshire Hills and see if my PT
pass gets me into the pool. Or maybe I won't ask, I'll just go.
HH is better than the YMCA because the pool is heated, I think.
Thursday, July 3, 2003
I can run!
I can run! I can run! I can run!
I can run fast (for a 51 year old).
And I still can't play tennis. Here's why.
Tennis requires many small quick motions of the feet for proper
positioning. I don't run to the ball, I use a series of small
very quick skips so that when I arrive at the spot my feet are
already in the proper position for striking the ball. At present
the leg is still too weak to execute these skips. Perhaps I
should try some "bad footwork tennis". Maybe this would even be a
good longterm project. As I've gotten older I've found the effort
more and more tiring, and perhaps it's time to develop less
strenuous footwork.
Took a 20 minute walk with Lois this morning. We were 3/4 done
with the walk and were talking about muscles recovering and why I
can't run even though walking is easy, and it suddenly occurred to
me that if walking straight ahead is easy, then running straight
ahead should also be easy, and that if it wasn't then
understanding why should be informative. So I started a short
jog, then stopped after 30 yards. It felt fine. So I started a
longer jog, then picked it up into a genuine run, covering
maybe around 60 yards altogether. It also felt fine. Then I
tried imitating my tennis motion to the ball - couldn't do it.
Ended up doing more walking than originally planned. Lois and I
went out to lunch with our son Jeff (Kathy's visiting a friend for
a couple days), and on the way back Jeff and I stopped at the mall
to buy him a WarCraft III expansion pack. We parked next to Sears
for easy access to Electronics Boutique, but do they have it? No!
So we have to walk clear to the other end of the mall to
Babbage's. I had to slow way down about half way there as a
muscle in the buttock began to give out. The muscle recovered
during the purchase and I was able to walk half way back before
having to slow down again.
Friday, July 4, 2003
Happy fourth of July!
Attempted a morning walk, but turned back after just a couple
minutes because the buttock muscle fatigued rapidly. However, had
no problem doing my stretches and exercises. That kind of
clinches it - walking is a pretty good exercise.
Played tennis with Jeff a little in the afternoon. I've pretty
much figured out my range, didn't overdo it for even a single
shot. Of course, this isn't really exercise, as it was much
easier than the attempted morning walk.
Saturday, July 5, 2003
Attempted to take walk in morning, but turned back after 4 minutes
because buttock muscle fatigued again. Did stretches and
exercises.
Sunday, July 6, 2003
Took 22 minute walk, but buttock muscle became very tired and I
had to slow down for much of the walk back.
Monday, July 7, 2003
10-week anniversary of surgery.
Kristen tried new exercises at PT. The two-leg board balancing
exercises were very difficult as far as balancing, but were easy
as far as hip muscles. The two-leg bouncing on the trampoline was
also easy, though I fatigued after a while. It was the one-leg
exercises that got me:
1. Stand on right leg, touch left leg consecutively to three
points marked in front of me on the floor, one to the left,
one straight ahead, and the last to the right. The one to the
right was very tough.
2. Stand on right leg, catch 3 pound plastic ball that Kristen
somehow never managed to throw to me.
Leg feels tired and achy tonight.
Tuesday, July 8, 2003
Leg is tired and achy today. Jeff needed someone to hit with
this evening, so we hit for maybe 40 minutes. Played 4 games.
Jeff, like most juniors, has down-the-middle-itis, so I'd just put
the ball away on my first shot. I was about to go up 4-0 when I
missed a placement at 40-30 by just a couple inches. Now it was
deuce. Jeff hit my next serve straight at me and I couldn't get
out of the way. The next serve he hit for a winner straight down
the line. Amazing what you can do if you move your feet, but I
wish he'd move them all the time. Sometime he's like a statue out
there, reminds of Drew Bledsoe.
Leg is even more tired and achy tonight - I overdid it. I iced
the hip down, it felt a little swollen.
Wednesday, July 9, 2003
Leg is very tired and very achy today. I need rest, no exercises
today.
Anybody reading this who's recovering from THR and thinks they're
doing well, try some tennis. Or soccer.
Thursday, July 10, 2003
Leg *hurts* this morning. First few steps after rising to my feet
are very painful, and a large part of the pain doesn't feel
muscular. Have I hurt the prosthesis?
Now, at noontime, the leg feels great, better than at any time
over the past few days.
At PT I told Jean Marie about how bad the pain had gotten and how
suddenly it abated. She said patients like me always do very
well. I think they're getting tired of my paranoia. After soft
tissue work (massage) we did some fairly aggressive exercises,
including hamstring curls.
Jason couldn't make it for Jeff's lesson today, so I hit with Jeff
after PT. Took it very easy by hitting out of the bucket and
didn't chase any balls unless they were real slow. Nonetheless,
leg hurt a lot afterward. I iced it down. Legs started cramping
later in the evening, mostly the hamstrings, probably due to the
PT exercise.
Friday, July 11, 2003
Leg feels great this morning. Continued resting it.
Saturday, July 12, 2003
Continued resting the leg. Feels great again today.
Sunday, July 13, 2003
Continued resting the leg. Started to ache a little toward the
end of the day, time to begin exercises again tomorrow.
Monday, July 14, 2003
11-week anniversary of surgery.
I don't think I'm any stronger now than at week 5.
Did exercises in bed in the morning. Discovered the weight of the
sheets and blanket on the leg is pretty much the right weight
right now. Did four exercises:
1. Leg raises while on back
2. Leg raises while on side
3. Butt lifts with one leg, but with foot positioned close to
butt.
4. Leg raises while on side, but with knee bent to 90 degrees.
Overstrained the leg walking 23:00 in the evening. Why do I keep
doing this?
Tuesday, July 15, 2003
Rested. At some point I figured out that a large part of the
weakness in raising the leg is a muscle that in the front goes
from the hip to the femur. It's called the ilio-something.
Wednesday, July 16, 2003
In the morning the leg really hurt when I put weight on it,
especially diagonally across the front from hip to knee. Didn't
go away during the day. Was limping so badly a couple people
commented.
Was able to do exercises during PT, but didn't do anything extra.
Thursday, July 17, 2003
Leg hurt all through the night. Felt a little swollen, so iced
hip joint and upper right quadricep. By afternoon leg was feeling
much better. Hope to resume exercises and walking tomorrow.
Friday, July 18, 2003
Took Jeff shopping for a few things for camp, so ended up walking
the length of the mall and back. Buttock was hurting before we
were done. That was my walk. Iced hip down later. Leg felt
tired, no exercises.
Saturday, July 19, 2003
Took walk around block in 11:00, which was about all I could
handle. Slowed down quite a bit near the end as buttock began to
ache. Reading back through this diary it seems I'm going
backwards. This is where I was about 2 months ago. I can only
guess that as more muscle becomes enervated that it is very easily
strained because of a couple months of not flexing at all.
But that's an optimistic interpretation. In my darker moments I'm
wondering if the buttock muscles are ever going to come back,
specifically the gluteus medeus that seems completely dead though
other muscles are probably involved, too, like the peri-something
that PT mentions. The gluteus maximus is fine.
Sunday, July 20, 2003
Drove Jeff to camp. He's been so looking forward to this.
His been in contact over the Internet with friends from prior
years, and he seems really excited. He somehow lost his
cellphone, so he'll have no phone at camp, but that shouldn't be
much of a problem.
The small amount of walking I did while dropping Jeff off, maybe 8
minutes total with a long break in the middle while at the
registration desk, made my leg tired. The upper hamstring toward
the outside was stiff and sore when I arrived home, for no real
reason. Iced it down.
Monday, July 21, 2003
12-week anniversay of surgery.
Thought I'd be much further along by now. Before surgery I was
guessing I'd be playing tennis in July, now August only looks like
it *might* be possible.
The recovery is not progressing the way I expected at all. I
haven't told PT how little I've been able to do recently, though
last week might have been a little early to report it. I seem to
mostly decide not to do the exercises so that I don't risk hurting
something, but when I go to PT they're talking about increasing
the reps and the difficulty of the exercises. Obviously they
expect some progression, and so do I, but it just isn't there.
Leg feels much better today. Was going to do morning exercises in
bed, but first went to the kitchen to make coffee, and though
there was no real pain anywhere, I did receive a few minor little
"feelings" that made me decide not to do the exercises this
morning.
Should have mentioned this long, long ago because it is useful
data, but I'll mention it now. If I put my hand on my butt while
walking, the good butt flexes as I walk, the bad butt stays
completely flaccid. This doesn't appear to have changed one bit
since I first noticed it around maybe week 4 or so. My guess is
that the gluteus medeus is important for walking.
Upper hamstring was stiff and sore all day. Iced it down, and the
hip, when I got home from work. Did stretches. Didn't do any
exercises or walk.
Tuesday, July 22, 2003
Leg has no stiffness or soreness this morning, feels pretty
strong, too. I hereby resolve to not overdo anything from
hereon out.
Though the leg continued to feel strong, even short walks, like
the three minute walk to my office, made it tired, particularly in
the buttock. And the hamstring stiffness and soreness came back
later on after I went to the library. I seem to be so fragile.
Over the past six weeks I've spent most of my time resting to feel
good enough to exercise again. I guess this is just something
I'll have to work through. Maybe the muscles that hurt are ones
that are just starting to come back.
Wednesday, July 23, 2003
Did exercises in bed in the morning.
At PT Jean-Marie did a deep massage on the buttock muscles, the
gluteus medeus and the periformis and whatever else is in there.
Also checked muscle strength. I walked out limping. I had
planned to do a walk when I got home, but leg ached too much.
Thursday, July 24, 2003
Leg still ached today, so didn't do any exercises or stretches
again. I may have to reconsider whether PT is doing me any good
or not. They seem to be good at keeping me focused on the need to
do exercises, but at this fragile stage exercise seems to hurt me,
and what's the point of going to PT if you can't exercise?
Buttock muscles were extremely stiff and sore in a narrow vertical
arc from top to midpoint roughly in the horizontal center.
Iced down the leg - that helped a little.
Friday, July 25, 2003
Leg still achy and weak. Buttock still very stiff and sore. Did
exercises in bed in the morning, but nothing else. I'll see later
if the leg feels stronger or weaker from the exercise.
Later on, leg felt a little more achy, so I'll take it easy on the
exercises for another day.
I literally can't believe what is happening. I'm way behind where
I was a month ago or even two months ago, and every time I make
the slightest bit of progress I hurt the muscles again. PT has
hurt me the last three times I was there, so I'm going to cancel
next week's appointment. I'm determined to ease back into this so
I can walk a mile again, and I'll go real easy on the exercises
until I can do that.
Saturday, July 26, 2003
2-week vacation starts today!
Buttock still stiff and sore, but feels slightly improved. We're
going to do some shopping, so I'll be doing some walking. We'll
see how it goes.
Shopping excursion went fine, but it illustrated just how weak the
right side is. Even with conscious effort it is very difficult
disguise a rolling tendency on the right side while walking.
While waiting for Lois I tried to walk in front of some shop
windows to see how bad it was - didn't look terrible, but it was
noticable. Sometimes the right side is strong enough to hold me
up and I walk evenly, but mostly not these days.
Sunday, July 27, 2003
Did exercises in morning in bed. Went shopping a little, not as
much walking as yesterday, but I was walking much better, little
to no rolling. Did more exercises at night, trying to concentrate
on the areas of greatest weakness, the leg lift and the buttock
lift, both while lying on back. Forgot to do stretches.
Monday, July 28, 2003
13-week anniversay of surgery.
3-month anniversay of surgery.
Went to Nashua and Hollis libraries, felt okay. Got onto a coding
roll later in the afternoon into the evening (this is coding for
my website, not for work) and didn't do exercises or stretches,
and by the time I went to bed the hip was very achy and felt
swollen. Had trouble walking on it first few steps every time
after getting up. But I'm attributing this to yesterday's
exercises - as I've said before, I believe you don't find out that
you overdid it until the next day. So it was appropriate that I
took it easy to day relative to exercises.
Tuesday, July 29, 2003
Hip was achy and bothered me much of the night. Got up early and
iced down the hip, the buttock and the quadricep, took 660 mg
Alleve. Going to Shaker Village today.
My weight goes up and down unpredictably independent of diet, but
I think I notice a correlation with swelling, which would make
sense. I've even had days where I lost a couple pounds during the
day, which never happens. Recent low correlated with least
swelling, recent high was yesterday when swelling was pretty bad.
But the question is, why am I having so much trouble with swelling
and pain 3 months after surgery? This is an especially
significant question since I was experiencing much less pain a
couple months ago. I am mystified and concerned.
Later on: it's amazing! I iced down the leg one more time before
we left for Shaker Village. Walked all over the place. I even
walked past the gardens and all the way down to the pond and
around to the peninsula to take a couple wild geese pictures, and
I was the only person to do this. Only trouble I had was the leg
got tired walking back up the hill, and I had to stop briefly a
couple times. And now tonight the leg and hip feel great!
What does this mean? I can only guess, but I think my troubles
over the past couple months are due to a minor injury or injuries
to one or two muscles, or perhaps to the joint capsule, or some
combination. Who knows? But exercise causes fluid leakage, in
other words, swelling. Swelling causes pain and reduces
circulation, slowing healing and making walking more difficult.
So I'm going to stop exercising altogether for a week or so. I
will only do stretches and walks with lots of ice. This will
hopefully give whatever it is a chance to heal and allow me to
begin exercising again without having setbacks every other day.
The important question is why didn't PT help me through this. Did
I not tell them the right information? I tried to keep the
complaining to a minimum, but I *did* frequently mention my
concern that I wasn't progressing very fast. I *did* mention
aches and pains. But I only mentioned them, I didn't emphasize
them. Anyway, I've cancelled this week's appointment.
Wednesday, July 30, 2003
Hip felt pretty good today, but got carried away with coding and
went to bed without doing any stretches or any walk.
Thursday, July 31, 2003
Today a day trip to Boston for a couple museums. Iced down the
hip and leg in the morning, it felt achy around the joint and
above the knee in front. Parked in the lot for the Museum of Fine
Arts, then walked to the Gardner Museum a couple blocks away.
Visited all three floors without problem. Then walked down
Huntington Avenue to Au Bon Paine for lunch. Then walked back to
the Museum of Fine Arts and walked through the Thomas Gainsborough
exhibit, then through the adjoining area with some Rembrandts,
Rubens, Van Dykes, Degas, Monets and even a Picasso or two. Then
walked through the Egyptian and Greek areas, then through the gift
shop, then back to the car. Leg felt a little tired much of the
time, but had no problems. Feels good tonight. The sharp pain on
the outside of the greater trochanter where I suspect one of the
muscles was stapled back on seems to have gone away. Will do
stretches then ice it down later.
Friday, August 1, 2003
Friday morning leg was fine, but I coded all day in front of the
computer, and as time went by the leg ached more and more. By the
end of the day it hurt quite a bit, and it was so late I only had
time to go to bed.
Saturday, August 2, 2003
Leg hurt so much that I had to get up in the middle of the night
and ice it down. In the morning when I woke up it still felt
pretty achy, and I iced it down again. By afternoon it felt
pretty good.
Went out to dinner with Carol. Wait was so long we went next door
to the mall and walked around for 45 minutes. Leg got tired after
a while, but held up okay. Buttock got the most tired, and there
was some achyness in the upper hamstring.
Sunday, August 3, 2003
Leg felt pretty good in the morning. Iced it down before taking a
short trip to the mall. Leg felt pretty good walking around. We
keep stopping in shops, so I couldn't tell if it would have gotten
tired on a continuous walk.
For first time in a while I did the stretches and exercises, added
a 2 lb ankle weight. I think now that I wasn't injuring myself -
I was just causing swelling and inflammation that hurt a great
deal, to the point where the exercises hurt too much to do. I
can't believe the amount of icing I'm having to do, but as long as
I do it regularly the leg seems to feel pretty good. I'm going to
become more aggressive on the strengthening.
Monday, August 4, 2003
14-week anniversay of surgery.
Leg didn't feel too bad when I first got up, but after a couple
hours it is achy. The pain doesn't feel like inflammation pain or
muscle pain, but bone pain and joint pain. I'm going to take 660
mg Alleve and ice the hip and leg down and see how they feel in a
few hours. If they feel much better then I have solved the
problem where I keep thinking I've injured myself.
A couple hours later the leg feels much the same - hip joint pain,
bone type pain in the a couple places in the leg, including the
outside of the calf. I'll try another round of icing.
Even after the second icing the pain in the leg was only slightly
diminished. Went to library and discovered that after a minute of
walking the pain seemed to go away, so went for walk around block
upon return home. Took roughly 14:00 - pretty slow. Had to stop
several times because buttock got too tired, but only had to stop
for 10 or 15 seconds at a time. Will ice leg down again - this is
ridiculous - if I weren't on vacation there's no way I could do
this much icing.
I suspect the pain may be caused by the squats - they put a lot of
stress on the leg. Even when healthy I didn't do squats like
these, though the left leg doesn't seem bothered. I won't do any
squats tonight, then I'll do one additional one every day, so
tomorrow I'll do 1, Wednesday I'll do 2, and so forth.
I should also note that I believe I can occasionally detect some
contraction in the gluteus maximus during walking. Usually it is
completely flaccid for a normal paced walk. It's too early to be
certain of this, though.
After icing the leg down it feels pretty good. I think the walk
actually helped. Perhaps I should have been pushing through the
pain when I started having these problems.
Tuesday, August 5, 2003
Leg is very slightly achy this morning, only hurts when I walk on
it, but otherwise feels good and strong. No pain at all while
sleeping last night. I'm going to write a little more code and
then check into a TiVo upgrade, but after that I'll ice the leg
down again. I should stretch and exercise this morning, got
caught up in things last night and it got too late.
If it dries up a bit more outside I might go down to the courts
and hit against the wall a little. It's been a long time, July
10th I think, and I should try to gauge if there's been any
progress in that respect.
Just got back from maybe 15 minutes hitting against the wall. The
bad news: I'm out of shape. The good news: movement was much
improved. After warming up for a couple minutes just hitting
straight ahead I started to move the ball back and forth from
backhand to forehand, gradually extending the range. I found that
when I needed to move fast I could pull the leg through
the necessary movement. This is a big improvement from four weeks
ago when the leg wouldn't respond with anything but pain. Will
ice leg down soon. Plan to do exercises and walk later.
One more thing. After hitting for five minutes or so I needed a
break and so walked around the fence to get a ball I'd hit
through. Decided to check buttock flexion and it was flexing
bigtime, even when I changed to a very slow pace. Now, a half
hour later, the buttock is completely flaccid while walking.
Hmmm, not sure what this means.
Wednesday, August 6, 2003
Went to bed last night with an achy leg, woke up with leg feeling
just great! So I did my exercises in bed, and an hour later the
leg felt very achy. So I took 660 mg Alleve and iced it down. If
the pattern holds, within a few hours the leg will feel pretty
good. If not, I'll ice it again. I have PT today, I'll have to
ask them about this. If the leg starts feeling better I'll hit
against the wall a bit. I might anyway even if it doesn't.
Later in the day, hit against the wall for about 30 minutes, but
took maybe 6 one or two minute breaks. Leg did not feel as strong
as yesterday, and it left a little stiff along the outside, but
there was still no pain associated with trying to move fast.
Went to PT directly from tennis. It had been two weeks since my
last visit, and I told Jeanne Marie what I had learned about icing
down the leg. She agreed that causing inflammation so easily
didn't seem expected and suggested I call the doctor and ask about
it, so that's what I'll do. She wants me to try pool therapy, but
I resisted. I agree it's a good idea, but I don't think I would
reliably do something I'm so averse to. So she suggested that
I do my walk or vigorously ride a bike with no resistance
immediately after exercising or playing tennis to see if the
increased circulation helps the inflammation.
So when I got home I did my walk. I originally planned the 3/4
mile walk, but felt so good that I took the turn for the 1.5 mile
walk, then turned back after a minute as I felt the buttock begin
to tire. This turned out to be the right thing to do since I ran
out of gas a minute or two from home. Still finished in 13:55,
pretty good time.
Iced the leg down for 20 minutes as soon as I got inside, and
right now the leg feels *really* good, which it usually doesn't
after this much activity. Perhaps I have turned a corner?
Should I do my exercises later tonight? Haven't decided yet.
Thursday, August 7, 2003
By the time I went to be last night the leg hurt like sixty. By
morning the pain was greatly reduced, so I did the exercises in
bed, and a couple hours later the leg hurt like sixty again. So I
iced it down once, then again later, and while the pain diminished
the leg never felt good enough to think about doing exercises or
taking a walk. I was already limping, and just a trip to the
grocery store was plenty.
Friday, August 8, 2003
Leg still has pain this morning, but it is better. Feels pretty
strong today, but I can't use the strength for doing things like
going up stairs because of the pain. Did a long icing of the
upper leg while watching the 2nd half of the Patriots/Giants game
on TiVo. Have to pick up Jeff at tennis camp later today,
probably spend about 3 hours in the car, so I'll see how the leg
feels this evening.
I called Dr. Benson and left a message about the inflammation
problem I'm having, hopefully I'll get a callback later today. I
feel at this point that the leg would respond positively to some
aggressive exercise if it just wouldn't hurt so much.
Saturday, August 9, 2003
Leg didn't hurt very much today, but it didn't feel strong,
either. Going up stairs was harder than usual. The Tensor Fascia
Latae felt stiff through the whole day.
Did my stretches and exercises, then completed a 1.5 mile walk in
20:55. Not a record, but the buttock didn't get tired, not even
close. In fact, it was my calves that began to get a bit tired.
Will ice the leg down soon. It'll be interesting to see how much
inflamation I get later.
Inflammation wasn't too bad, but got a little too aggressive with
the icing, almost gave myself frostbite.
Sunday, August 10, 2003
A routine emerges? Iced down leg, allowed it to warm up, then did
stretches, then exercises, then 1.5 mile walk in 22:17 the hard
way, two steep uphills. Buttock muscles got tired last 20 steps
of 2nd uphill and had to slow down, otherwise okay.
Monday, August 11, 2003
15-week anniversay of surgery.
No, a routine does not emerge. Leg was very weak, felt like the
Tensor Fascia Latae, which felt stiff again. Decided to give the
leg a day off.
Tuesday, August 12, 2003
Did not do the exercises, but did do the stretches and the walk
the hard way in 25:25, very slow. Had to stop maybe 8 times for
about 5 to 10 seconds because of weariness in muscles immediately
adjacent to the greater trochanter. Tensor Fasia Latae was very
stiff and weak today, I was limping, but the walk and icing down
afterward made it feel much better.
Wednesday, August 13, 2003
Went to PT early and used some of the machines in their exercise
room. Bike for 10 minutes at around 85 RPM with almost no
resistance, the abductor machine, then leg press machine. At PT
only had soft tissue massage and discussion of where I am.
Thursday, August 14, 2003
Took the day off.
Friday, August 15, 2003
Did the stretches and exercises, then the long walk but with only
1 steep uphill instead of 2 in 19:45.
Dr. Benson's office finally returned my call about the
inflammation. Beverly talked to me a little, then said she'd talk
to Dr. Benson about it. She suggested I wear the ted socks again
for the inflammation - I said okay but won't do it. In my opinion
their effect is minimal to non-existent for those with no
circulation issues. I'm not letting the nursing staff make me
uncomfortable just because they had a bright idea. She also asked
if I was taking Vioxx or Celebrex, so I told her I was using
Alleve. But since she mentioned it and since I have a bunch of
Celebrex left over from a couple years ago I'll try it. It says
once a day, I'll try two, once in the morning, once at night.
Saturday, August 16, 2003
Did stretches, exercises, and the long walk the hard way in 21:58.
Had to slow down when buttock near upper trochanter began to
weary. Still a good showing, iced it when I got home, and there
appears to be no inflammation several hours later.
Sunday, August 17, 2003
Skipped the exercises because felt some strain in back and
buttock, but did stretches and the long walk the hard way in
21:13. Decided to try stopping for 5 seconds when muscles began
aching instead of slowing down, seemed to work well. Switched
from Celebrex to 660 mg Alleve, didn't have to ice afterwards.
Monday, August 18, 2003
16-week anniversay of surgery.
Did stretches, exercises, and the long walk the hard way in 19:27.
Tried experiment, 660 mg Alleve in morning, 660 mg Alleve when
returned home in evening. Leg felt stronger than it ever had
during the day. No icing necessary so far. That's good, hope it
stays that way. I don't have time for 20 minutes of icing and 20
minutes of warming the leg back up every day, not when added to
the time for stretches, exercises and walks.
Tuesday, August 19, 2003
Leg felt slightly inflammed, particularly along the outside
between the quadriceps and the hamstring. But I did stretches,
exercises and the long walk the hard way, taking it easy figuring
I couldn't do two fast days in a row, and I was right. Had to
stop maybe five times, eventually did it in 26:58, a new record in
the other direction. Iced down the leg when I got home.
Wednesday, August 20, 2003
Leg still feels slightly inflamed, again particularly along the
outside between the quadriceps and the hamstring. Took the
Alleve, we'll see if that helps. I'm taking 1320 mg a day, hope
that's okay. I won't do the exercises today, I can feel the
bridges in my back.
Amy from Dr. Benson's office called back (I had a call in asking
about the inflamation) and said to cut back to 880 mg a day with
the Alleve.
Just soft tissue work at PT. Cut back to once every three weeks.
Thursday, August 21, 2003
Leg still feels inflamed. Took a leisurely walk, only one uphill,
same long distance, which I recently measured at about 1.1 miles.
Probably took me around 22 minutes.
Friday, August 22, 2003
Did stretches, exercises, walk in 21:59. Inflammation in leg
seems to be creeping up.
Saturday, August 23, 2003
Had guests for weekend, skipped everything today, but not a bad
idea to take a rest, inflammation is increasing. Lower Alleve
level probably isn't helping. I'll call Dr. Benson's office on
Monday and ask to try vioxe.
Sunday, August 24, 2003
Inflammation a little worse today. Did stretches and exercises,
but decided to try riding bike instead. My bike was new in 1981,
and I haven't ridden more than the tiniest bit since then, but
other than inflating the tires and adjusting the brakes it did
okay. Hope it doesn't fall apart on me. Anyway, rode around the
block 4 times, probably took about 11 minutes. Iced leg down
afterwards.
Monday, August 25, 2003
17-week anniversay of surgery.
Did stretches, exercises and bike ride 4 times around block in
about 10 minutes (that's all I can handle, I'm not in good shape
right now). Inflammation felt noticeably better afterwards.
Hopefully I'm on to a good thing. I can't increase my activity
level until I'm able to exercise without causing inflammation. It
seems incredible that a set of 4 exercises that takes 5 minutes
can cause inflammation that takes 20 minutes of icing and 880 mg
of Alleve.
Tuesday, August 26, 2003
Didn't want to mention this in yesterday's entry in case things
went south later, but my leg felt awfully good after the bike
ride. Today, same routine, but 5 laps instead of 4 in about 13
minutes. Some pain at the very top of the leg at the crease where
the leg meets the body in front is starting to get annoying, but
leg feels pretty good. Not as good as yesterday, but pretty
good. Since I'm going a little downhill, I'll make tomorrow a
rest day.
Switched to Vioxx today. One a day, with Tylenol if necessary for
pain.
Wednesday, August 27, 2003
Took the day off, but the leg felt *really* good. It's never felt
so good. At work I was going right up the stairs with no weakness
or pain, while last week I was pulling myself up using the railing.
Thursday, August 28, 2003
4-month anniversary of surgery.
Followed normal routine, 5 laps in about 12 minutes. Leg felt a
little achy on last lap so didn't push it. I usually walk off the
ride for a few minutes afterward, but I didn't this time because I
wasn't that tired and leg started to feel inflamed, so I started
walking. Leg felt better, but not all the way better.
Even though I've only been riding the bike a short while, my
conditioning has improved to the point where my legs aren't
getting that tired in 5 laps, but I'm pretty out of breath. I try
to keep a high RPM rate, not a high speed, but my RPM rate keeps
increasing and so now I'm ripping around the block in a short
period of time. I'll try to do 6 laps tomorrow, assuming it isn't
raining.
Friday, August 29, 2003
Leg felt a little achy when I went to bed, but feels great this
morning. There's some tennis in my future soon.
Did normal routine. Leg feels great.
Saturday, August 30, 2003
Hit against the wall lightly for 5 or 10 minutes. Did a little
moving back and forth. I'm able to move faster now, but I have to
be careful to move the right leg smoothly or it hurts. Was able
to work up some inflammation in that short time. Didn't do
stretches, exercises or ride. Leg felt okay by evening,
but there was still inflammation.
Sunday, August 31, 2003
Hit against wall lightly for maybe 20 minutes. Did some moving
back and forth. Leg felt same as yesterday. Rode bike 4 laps in
about 10 minutes when returned home, then walked it off indoors
for 5 minutes. Leg definitely became inflamed after hitting, the
ride definitely helped, I won't be able to tell how much for
another hour or two.
Leg felt pretty good later, but could definitely tell that it had
been under greater stress than the usual exercises.
Monday, September 1, 2003
18-week anniversay of surgery.
Followed normal routine, 4 laps on bike in about 10 minutes.
Tuesday, September 2, 2003
Followed normal routine, 4 laps on bike in about 10 minutes.
Kathy (age 14) rode with me, I tried to pass her at the end of the
last lap, legs so enormously tired afterward they hurt.
Wednesday, September 3, 2003
Day of rest.
Thursday, September 4, 2003
Another day of rest. Didn't need it, but stayed late at work and
then had to pick up Jeff after driver's ed class, so didn't have
any spare time.
Friday, September 5, 2003
Followed normal routine. Kathy rode with me again, tried to take
it easier this time, still very tired afterward.
Saturday, September 6, 2003
Followed normal routine. Kathy rode with me again, but managed to
take it easier.
Sunday, September 7, 2003
Followed normal routine.
Monday, September 8, 2003
Unexpected day of rest. Trying to get a release out, worked
through the evening.
Tuesday, September 9, 2003
Another unexpected day of rest. Had to do both dropoff and pickup
of Jeff at Driver's Ed class.
Wednesday, September 10, 2003
Played a set of tennis with Jeff. Inflammation came back big
time. Riding bike upon return did not help. I'm going to try ice
next.
Saturday, September 13, 2003
Leg felt pretty good, did regular routine, 5 laps around the
block.
Sunday, September 14, 2003
Hit the tennis ball a little with Lois for maybe 45 minutes.
Didn't do anything stenuous, felt fine later.
Monday, September 15, 2003
Day of rest.
Tuesday, September 16, 2003
Day of rest.
Wednesday, September 17 2003
Day of rest. I know, this is too much rest, but the hip flexor
seems to be getting worse with exercise, not better, so that's my
excuse.
Thursday, September 18, 2003
Did normal routine, except 6 laps. Started icing the hip flexor.
Friday, September 19, 2003
Was so focused on trying to complete a functional spec didn't even
think about exercises.
Saturday, September 20, 2003
Hit with Jim for about 40 minutes. Felt pretty good. I wasn't as
slow as I thought I'd be, I wasn't very fast, though. Temperature
was 80 degrees, my conditioning wasn't as bad as I thought it
would be. Leg did not go crazy with inflammation afterwards,
didn't even have to ice it down, except for the hip flexor. I
have a feeling this hip flexor is going to be a long term
annoyance.
Sunday, September 21, 2003
Did exercises, then did a 5 lap bike race with Kathy, age 14.
She slaughtered me by at least 1/2 a lap, and I was on a racing
bike and she was on a mountain bike. We bet $5 against she has to
play tennis with me in an Anna Kournakova outfit (the outfit part
is fine with her, I added the outfit part to the bet to make it
interesting for her because she likes clothes, she just doesn't
like sports involving balls).
I noticed she was pulling away from me on the downhills, which
mountain bikes shouldn't be able to do against racing bikes, and
back in the garage I noticed my rear tire is only half inflated,
so maybe I didn't do as bad as I thought. Also had trouble with
gear shifting. I have the little levers that are hard for me to
hit the gears in a hurry, while she has the automatic handlebar
shifts. I'll think of more excuses later, right now I have to
rest.
Monday, September 22, 2003
Did stretches and exercises, but by the time I was done it was too
dark. Tried cycling in the dark once already, it was too scary to
repeat.
Tuesday, September 23, 2003
Did stretches and exercises, then cycled 5 laps around the block.
Wednesday, September 24, 2003
Rest day.
Thursday, September 25, 2003
Did stretches and exercises, then cycled 6 laps around the block
at a slightly faster clip than normal. I had found a pretty good
rhythym and was applying pressure through most of pedal rotation
and would have gone an extra lap, but I looked up to find the road
joint that marks rising from easing incline and lost it, so I
stopped.
Friday, September 26, 2003
Rest.
Saturday, September 27, 2003
Tennis with Jim. Felt like real tennis. I was slow moving to the
right and moving forward, but moved pretty well to the left.
Footwork on shots I had to chase forward was pretty sloppy, not
sure if it's lack of practice or lack of strength, but I was
running through the shots. Little to no inflammation afterwards.
Sunday, September 28, 2003
5-month anniversary of surgery.
Rest.
Monday, September 29, 2003
22-week anniversay of surgery.
Rest.
Tuesday, September 30, 2003
Did stretches and exercises, then cycled 4 laps around the block.
Hip flexor is getting more painful. This is starting to worry me.
Wednesday, October 1, 2003
Rest.
Thursday, October 2, 2003
Tennis with Bruce. He hadn't played in a while and was pretty
inconsistent, plus it was windy. I felt slow.
Friday, October 3, 2003
Hit against the wall steadily for about 20 minutes, trying to use
it as an aerobic activity. Unfortunately my back and arms and
trunk began to tire and I had to slow it down, so it wasn't as
aerobic as I would have liked, but still good exercise.
Saturday, October 4, 2003
Played a set of doubles before the rains came. I again felt slow.
I basically sat back and did nothing. I think changing my
instincts for doubles is way overdue, and this is the right time
to make the change. I used to be the wild man charging around the
court, making the poaches and the gets, but even before surgery I
had slowed down to the point where I just wasn't a threat anymore,
and in fact was a liability at net as I made moves for balls I
once could reach, throwing off my partner as I would fail to get
there. I've got to change my doubles game to rely more on
thinking than athleticism.
So, what did I learn? Maybe just one thing. I tried to provide a
variety of looks by hitting drop shots and lobs mixed in with
normal shots, and this has potential. Low shots to net men
probably also have potential, but I didn't get much opportunity to
do that. I didn't hit but one hard ground stroke, and that was a
backhand into the net. After hitting the shot I decided it was
the wrong one anyway. The opponents were in the backcourt, I
should have hit a deep drive with moderate pace.
Sunday, October 5, 2003
Rest.
Monday, October 6, 2003
23-week anniversay of surgery.
Mark's in town, had a small group dinner. Rest.
Tuesday, October 7, 2003
Rest.
Wednesday, October 8, 2003
Rest.
Thursday, October 9, 2003
Rest.
Friday, October 10, 2003
Rest.
Saturday, October 11, 2003
Rest.
Sunday, October 12, 2003
Rest.
Monday, October 13, 2003
24-week anniversay of surgery.
Played tennis with Jim. Good long hit. Hip flexor seems to be
getting worse, pain from it gave me more trouble than anything
else. I'm still slow. I think I'm getting a little faster, but
it's hard to tell with the hip flexor holding me back.
Why all the rest? I could have exercised, but inertia caused me
to see if rest might be best for the hip flexor. I guess not. So
back to ice and exercise.
I'm very tired, including my arms. Why the left arm? Very weird!
Tuesday, October 14, 2003
Rest. Leg felt inflamed. I should ride the bike, but it's cold
out.
Wednesday, October 15, 2003
Rest.
Thursday, October 16, 2003
Tennis with Bruce. Leg felt okay, but isn't improving.
Friday, October 17, 2003
Rest.
Saturday, October 18, 2003
Tennis with Jim. We had a good hit, but my leg grew increasingly
inflamed, near the end I was considerably slowed. In fact, by the
time we finished my movement was nearly as bad as it was a couple
months ago. The inflammation has a dramatic impact. All the time
that I thought I was waiting for my muscles to recover it was
mostly just inflammation. I know I've made this observation
before, but what is new is that I'm realizing that the degree to
which my muscle weakness was due to inflammation was very large,
probably 70-80% of the problem, maybe more.
It's gotten too cold to ride a bike. 10-20 mph at temperatures
below 50 degrees for more than 10 minutes is numbing on the face.
I'm going to have to move the bike indoors. God, a stationary
bike again - I gonna go crazy!
Sunday, October 19, 2003
Rest. I haven't done anything about the inflammation. It's been
nearly six months. I guess I'm just tired of the whole routine.
Monday, October 20, 2003
24-week anniversay of surgery.
Rest.
Tuesday, October 21, 2003
Rest. Leg felt inflamed. I should ride the bike, but it's cold
out.
Wednesday, October 22, 2003
Rest.
Thursday, October 23, 2003
Tennis with Bruce. Leg was feeling pretty bad today.
Set up my bike as a stationary bike indoors. Rode for 10 minutes.
Friday, October 24, 2003
Stationary bike for 15 minutes.
Saturday, October 25, 2003
Leg felt pretty strong today, though it was achy in the area above
the knee. Stroking was extremely good, especially on the backhand
side. Was able to generate power *and* spin. Had trouble with
stamina. Hip flexor a growing problem. Inflammation in leg
pretty bad later.
Sunday, October 26, 2003
Iced leg down pretty good, feels better. Rest.
Monday, October 27, 2003
25-week anniversay of surgery.
Rode bike for 4 sets of 3 minutes with maybe 45 seconds rest
between each.
Tuesday, October 28, 2003
6-month anniversary of surgery.
Rode bike for 4 sets of 3 minutes with maybe 45 seconds rest
between each.
Wednesday, October 29, 2003
Since I had to play tennis at 8 AM tomorrow, decided to skip the
bike. Wasn't sure if this was the right thing, but didn't want to
overdo it.
Thursday, October 30, 2003
Tennis with Bruce. We had a good hit. I was hitting very strong
off both sides. We did some simple drills. I was moving my feet
extremely well and getting well positioned for shots. Stamina an
issue, but I was working very hard.
Played a few games at the end, won all 3, but Bruce played some
good points. Attempted to work the points rather than just
hitting out on every shot (my pre-surgery approach) and felt I was
fairly successful. Points didn't become too long, I didn't feel
like there were more than a couple balls I didn't reach because I
was too slow, though I'm still not fast.
I haven't been concerned at all whether we use new balls, but
perhaps it's time to always use new balls. I hit with such power
that the time the ball stays on the strings is critical, and I
know that with new balls a lot of my shots that sent balls to the
opposite baseline would have popped out by a couple feet.
Backhand is the best it's ever been. I've been wanting to hit
with more topspin on the backhand, but maintaining pace while
adding spin and still hitting under control isn't easy, but I seem
to have worked it out. Watching Justine Henin has helped. I
don't go western as far as she does, but otherwise our backhands
are pretty similar. She develops a lot of power from her shoulder
turn, and that's what I've tried to develop. The key is to load
up the tension as the racket and shoulder turn back. The torso
should *not* turn back with them, except as forced to. You must
try to maintain the torso in allignment with the direction of the
shot, and let the shoulder turn push against it to build up
tension. The shot is working great, and this is fun!
Leg felt extremely good later in the day.
Friday, October 31, 2003
Leg feels extremely good this morning. Looking back over the
diary I see that when I first resumed tennis that I was making
similar comments about how good the leg felt afterward. I think
that's why I was so hopeful that tennis could become my exercise,
instead of the hated PT exercises. I've just finished reading
those diary entries more carefully trying to detect where tennis
become debilitating rather than strengthening, and it really isn't
clear. Just suddenly on June 23rd I decided that tennis was
hurting more than helping, even though the prior days had comments
like "leg feels better than ever", though interspersed with "leg
feels achy today". I think it was that even though the pain and
leg strength off the court were slowly improving, on the tennis
court I was getting slower instead of faster.
Even so, up to that point I don't think the slowness and pain on
the tennis court were associated with the severe inflammation
problems I experienced later. In the diary I see a few days later
on June 27th I comment that I hurt the leg while rough housing
with Kathy. Even though this was minor and it felt like I
recovered from it within a week, I think it possibly marks the
point where inflammation became a problem, though it could have
been about a week later on July 3 where I ran a short distance for
the first time, though there was no pain at the time or shortly
after, so I tend to doubt this possibility. But anyway, it was
within a couple weeks after this that 5 minutes of exercise began
causing increased weakness and pain that would last a few days.
Only after I discovered that 20 minutes of icing would fix it was
I able to resume more regular exercise.
Does this help me understand what is happening more recently?
After a couple weeks of tennis with no bike riding the leg became
weak and painful, then after just a few days of riding the bike
the leg became very strong and felt very good after tennis. Do I
still have to ride the bike? Or should I only ride the bike when
the leg doesn't feel good after tennis?
The correct answer is that I should continue riding the bike no
matter what. It is very good for stamina, and I need that, and it
is very good for the leg, even when the leg is feeling good. I'll
try to keep up the bike riding, but stationary bikes are BORING!!
Rode bike for 4 sets of 3 minutes with maybe 45 seconds rest
between each.
Saturday, November 1, 2003
Great hit with Jim. I was hitting strong topspin shots as hard as
I could yet still maintaining control off both sides. We played a
few games, for some reason Jim kept serving to my forehand and I
was just punishing the ball. I hit a number of shots that were just
too hot to handle. I was up 4-1 when we stopped. I should
qualify this by saying I think Jim is having trouble getting out
of the habit of being nice to me, plus he doesn't see that well
inside and the ball was moving pretty good.
Stamina was still a problem, but I seem to bring it on myself.
The better shape I get in the more effort I put into my shots.
Today I just couldn't let up, the shots were just too beautiful, I
just had to keep nailing them. Jim shouldn't insist on only using
balls that have already been used once with me. It *does* slow
them down, but I can just hit harder and since they're not as
lively they stay on the strings longer and have more topspin and
so they stay in, where new balls would be more likely to pop long.
Ran into Regis, the guy who recommended Dr. Benson to me. I asked
if he had had an inflammation problem and he said he never had
anything like I had. He said he resumed tennis at 6 weeks and
never looked back. Two years later he's still doing the exercises
3 times a day. He was surprised when I told him I had dumped the
exercises and am just riding the stationary bike and playing
tennis. He had the left hip done, while I had the right, but he
said that just like me he had had more trouble moving to the
forehand side - try to make sense out of that (no, he's not a
lefty).
My legs are tired, the hip flexor is a little sore.
Sunday, November 2, 2003
Rest.
Monday, November 3, 2003
26-week anniversay of surgery.
Rest.
Tuesday, November 4, 2003
Rest.
Wednesday, November 5, 2003
Rest.
Thursday, November 6, 2003
Hit with Bruce. Slowed it down some as I needed to run some
errands through the afternoon. Since I hadn't been riding the
bike the leg was slow anyway.
Friday, November 7, 2003
Rest.
Saturday, November 8, 2003
Last hit with Jim, he's moving to Florida. I'll miss him.
Sunday, November 9, 2003
Rest.
Monday, November 10, 2003
27-week anniversay of surgery.
Rest.
Tuesday, November 11, 2003
Rest.
Wednesday, November 12, 2003
Rest.
Thursday, November 13, 2003
Hit with Bruce. Kept it slow. Conditioning was bad because I
haven't been riding the bike. Why not? Personal issues plus work
is busy right now, I'm just too busy, but I hope to get back to it
soon.
Friday, November 14, 2003
Rest. Iced the leg.
Saturday, November 15, 2003
I guess I'm not ready for old-guy doubles.
Played nearly three sets of doubles with Jim (a different Jim),
Paul and Dick. They're all older gentlemen between 65 and 75, but
Jim and Paul are both pretty strong players, both still playing
singles. Dick is the oldest at 75 and had a hip replacement back
in '98, so we traded a few stories. Like Regis, he also had no
inflammation problem like I am having.
I hit politely in the warmup, but once we started it was like
someone turned on a switch. I was mashing groundstrokes and
volley winners all over the place. I was hitting serves and
groundstrokes so hard that very few came back. The server's
partner stopped playing net in order to avoid being a target. I
was ripping groundstrokes from both sides, especially on return of
serve. Before hip surgery their serves had managed to hold me
off, I guess because I wasn't mobile enough, but now I was teeing
off on them, justing eating them up alive! It felt great,
orgasmic even!! I thought I was going to have to learn a new
style of doubles, more lobs and dropshots, etc, but I guess I can
put that off for a few more years.
My upper operated leg began to tire and ache in the middle of the
3rd set. Suddenly I realized I wasn't getting to balls at the net
anymore. Poor Dick was diving for balls I was letting go by me,
and I suddenly realized that what happened after my hip first
began hurting had just happened again in miniature, and now I knew
what was going on. When you're feeling okay you just react, but
as soon as the body starts hurting it somehow stops the brain from
reacting. The only way I could react was consciously, which is
too slow. This is why before surgery I was having so much trouble
maintaining my level in doubles, where quick reactions are
important. No matter how much I consciously wanted to, somehow my
body and mind were conspiring together to prevent quick reactions.
This is very good news. I've got to get back in the habit of
riding the bike on non-tennis days, but I think I'll call Barry
and see if there's a spot open on his team for the winter Team
Tennis league session that starts in January.