Prolotherapy rehab plan for the hip

So on my earlier post Pamela asked me where I’m getting my rehab program from, if I’m working with a physical therapist or just doing this through intuition.  She also asked how I know how much I can push things.

The short answer is that I am definitely not doing this alone, but I’m not exactly working with a physical therapist either.  I’m working with a “fitness specialist” at a gym who is working with my doctor to come up with an exercise routine for me to do on my own at the gym.

Now for the long answer.

I have a membership with a gym that has ties to a hospital, and one of the perks with membership is that I get a "fitness assessment", which is where I meet with a fantastic fellow named Mark who is comes up with the exercise routine for me.  I'm not sure of his actual credentials (He has many letters after his name, but I'm not sure what they all mean), but when I told him I had a torn labrum he knew exactly what I could and could not do, and explained why.  So that is where I get my rehab program from him.  I meet with him about every six weeks and we change up the program.  I plan on posting a video of the various exercises I do on each day for each phase.

With regards to how hard to push things, the first question that needs to be answered is “what are your goals?”  It’s difficult to know how hard to push when you’re not sure what you’re pushing for.  I know that isn’t really what Pamela is asking, but by addressing this issue I can write up a much more (hopefully) informative post.  With rehabbing my hip I am going to go through three different phases with four different goals: improve endurance, range of motion, strength and finally speed strength.

Endurance

When my hip was still in the early stages of healing I was kind of going bonkers because I felt that the restriction of “nothing more than 20 degrees of flexion and no external rotation” meant that I could do nothing.  But as my labrum was getting better I felt like I needed to engage the hip muscles somehow. Letting them go to waste felt like it would take me a couple of steps even further back.  So I needed to come up with something to do.  That’s when I learned of the fitness assessment my gym offered and I met with Mark.  After coordinating with Dr. Hauser, it was established the first thing with my rehab is to regain endurance/work the stabilizers.  I need to strengthen all those stabilizers that have withered under lack of use. This means I need to do low weight with high reps (3 sets of 12-15 reps).  Because I am trying to work the small stabilizers, what I am pushing for is absolutely perfect form.  I was allowed to increase the weight over time, but only after I could do 15 reps with EXCELLENT FORM ON EVERY REP FOR ALL THREE SETS.  This was perhaps the most boring/frustrating part, but it was much, much better than doing nothing.

Range of motion/strength

After about six weeks of this I’ve gone into this new phase where I will work on range of motion and strength.  This what I am working on now.  Because my hip is significantly better (hopefully my labrum is at 100% now), the doctor told me that I can do anything that doesn't cause my hip to click or snap.  The fact I can do squats, in any form, is quite the milestone. Now that my stabilizers should be strong enough to handle moderate loads I can do more functional exercises, like deadlifts and squats.  However, since my ROM is not 100% yet I have to modify both.  I am also continuing to do the exercises that I did in the first phase, but with greater ROM.

Besides the no-click rule, Dr. Hauser says that anything I do that results in residual pain for longer than two hours afterwards is too much.  Thankfully I’ve never done anything that has resulted in any residual pain, but this is another marker to see if I’ve pushed myself too far.

While I'm working on increasing my ROM, I am also increasing my strength.  I am now lowering my rep scheme to three sets of 8-12 reps.  Again, if I can do  the last rep perfectly I can go up in weight the next time.  Again, I plan on posting a video of the various exercises of this new phase.

Speed strength

After working on endurance, range of motion, and strength, there is only one last thing to cycle through: Speed strength.  The violent explosion of the hip in an Olympic lift, kettlebell swing, kipping pull-up, etc., all requires the hip to have everything working properly.  I do not know what Mark has in store for me with this phase, but I am very much looking forward to it.