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Hope By The Numbers: Returning to Sport

Updated: Jul 6, 2021

I am a western medicine kind of girl blended with an eastern inspired attitude and outlook. I believe in science and I love science. I am also a yogi who loves the focus of the mind-body connection.

I am just about 4- and 6-months post-op bilateral revision hip arthroscopies. For the most part, I feel that I am almost back to full activity with my “sports” which includes yoga, cardio and Interval Extreme. I am not insane with my physical activity. I am reasonable and measured. I have people around me that will reign me in if I fail to do so. I am also working with my amazing personal trainer, Jeremy, who puts up with me, and smiles when I tell him that I do not like him (at that moment). He has this way of saying, “we are going to do Bulgarian lunges with a kettlebell using the Bosu ball.” I think and grumble, “No, WE are not going to do this. I am going to do this, and you will be supervising.”

The point I am trying to make is that I’m fairly back to my pre-op physical

fitness levels with some exceptions which are really mostly observed by my very in-tune mind. I still have some blips on the radar and some glitches that are being worked on. The outside observer would probably not notice that my pigeon pose in yoga is lacking or my balance in a Warrior 3 is not yet stellar. In pigeon, I can get my forehead to the ground easily, but my leg is still not in the figure 7 position. My Warrior 3 is passable, but still wobbly. I am on the elliptical for 30 minutes instead of 45, but I am still making forward progress.

My improvements post-op along with many others such as the examples of Nicole, Katie and Caroline give hope. We are all patients who have had hip arthroscopy to fix the damage caused by FAI. You, also, can look at the example of Morten who had a much more invasive surgery than a hip scope to fix a much more serious problem. He is setting the bar incredibly high by participating in the Ironman in August! For hip scopes, one of the worries many patients have is, “How will my body perform after surgery and recovery? Will I be able to run? Will I be able to do Crossfit? Will I be able to do yoga?” Our answers are, “yes!" Our answers, though, are limited because they are solely based on our personal experiences. Your body may need different things and have different needs. You need to honor that.

Hope, though, can also be provided by the numbers found in research! For example, Rush University completed a retrospective study on the return to yoga after hip arthroscopy for Femoroacetabular Impingement. Their review of patient outcomes at (or later) than the year mark indicated that 93% of patients (N=39) were able to return to yoga at an average of 5.3 months post op (plus or minus 2.2). Of those 39 patients, 19 returned to yoga at a higher level, 17 at the same level and 3 at a lower level (Frank, Ukwuani,Allison, Clapp & Nho, 2018). Although this is a weaker study than, for example, a double-blind study, it does still provide patients with hope which is what we need!

I love yoga with all of my being. As much as I love yoga, I equally despise running! Running, for me, is solely a function of running away from something – it is not for pleasure and it is definitely not to get somewhere. However, and that is a big HOWEVER, there are many patients that find their Zen moments in running. They experience a challenge; they experience a rhythm to their feet hitting the ground and they feel empowered. One common theme among hip patients who love to run is the worry of whether they will continue to be able to pursue this love. The research numbers for runners also represents hope.

Rush University completed another study in which they retrospectively looked at runners and their ability to return to running after hip arthroscopy. They looked at a total of 51 patients. Of those 51 patients, 94% returned to running at an average time of 8.5 months +/-4.2 (Levy, Kuhns, Frank, Gryzbowksi, Campbell & Nho, 2016). The study did report that a reasonable patient expectation is that patients may log less miles per week after surgery.

There is also another final study done by Riff, Ukwuani, Clapp, Movassaghi, Kelly & Nho (2018) that did a look back at patients who participated in high intensity interval training and had hip scopes for FAI. The bottom-line hope for those that love this form of exercise is that you still have hope! At a two-year review, 88% of patients were able to return to this form of exercise at an average of 9.8 months (plus or minus 5.7). 88% may not seem as amazing as you may like, but please remember that this study only included 32 patients, so it is really not a representative sample of all possibilities for you Crossfitters.

Sometimes, studies can be suggestive of overall success for a group of patients recovering from hip scopes and FAI, but not always predictive of your individual success. There are weaknesses to these studies which mainly include the fact that the patients were not identified prior to their surgeries and the researchers were relying on patient memory. These studies are identified as Level 4 studies (a more subjective look back) as compared to a Level 1 study (double-blind). There are many factors including age, your BMI (body mass index), your pre-op conditioning as well as the procedure. This is something that you should be discussing with your surgeon in relationship to your body!

Yes, numbers are helpful in guiding your outlook and your success. But, at the end of the day, statistics are only numbers and they cannot measure your outlook, your motivation, your resilience, perseverance and, even, your stubbornness. In the words of Ron DeLegge II, “99 percent of all statistics only tell 49 percent of the story.”

Whether you are from Denmark, NYC, London or from rural California, find your story of success. Be that number that screams, "I beat the odds!"

Frank, R. M., Ukwuani, G., Allison, B., Clapp, I., & Nho, S. J. (2018). High Rate of Return to

Yoga for Athletes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

Sports Health: A Multidisciplinary Approach,10(5), 434-440. doi:10.1177/1941738118757406

Levy, D. M., Kuhns, B. D., Frank, R. M., Grzybowski, J. S., Campbell, K. A., Brown, S., & Nho,

S. J. (2016). High Rate of Return to Running for Athletes After Hip Arthroscopy for the

Treatment of Femoroacetabular Impingement and Capsular Plication. The American

Journal of Sports Medicine,45(1), 127-134. doi:10.1177/0363546516664883

Riff, A. J., Ukwuani, G., Clapp, I., Movassaghi, K., Kelly, D. M., & Nho, S. J. (2018). High Rate of

Return to High-Intensity Interval Training After Arthroscopic Management of

Femoroacetabular Impingement Syndrome. The American Journal of Sports

Medicine,46(11), 2594-2600. doi:10.1177/0363546518776638

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