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HOW I RECOVERED FROM A BROKEN HIP

(originally written July, 26 2010)

Searching for my own answers, I’ve been inspired by a few others who have told their own story (links below). Their information has helped greatly in my initial confusion and my eventual recovery. I am in no way an orthopedic or soft-tissue expert, but my hope is that someone can use my experience to help clear away some of the fog they may be in. I doubt anyone is going to have these exact issues, but utilizing a few different articles and further research, one should be able to put their personal puzzle together just as I did. If you recently broke your hip, you’ve got plenty of time for research and to sort it all out.

Advantageous for my rehab, I was probably in my best physical shape at thirty-four years of age when I had my accident. Luckily, I’ve always been a fast healer while physically abusing my younger body with numerous sportbike accidents, snowboarding injuries, and dumb stunts. As I’ve grown older I have better calculated my risks, eaten healthier, drank a little less, learned what lifting exercises my body responds to, and have become less and less apathetic towards cardio. More than two years prior to fracturing my hip, I became an avid mountain biker and eventually added a road bicycle to break up the monotony of running. My hip seems to have healed at a rather fast pace, and I imagine I owe a lot to all of these factors.

The Accident  
Well, if you’re gonna be dumb, you gotta be tough. I was on a borrowed dirt bike having sold mine five years prior. I had on every piece of motorcross gear except for my chest protector and yet there was one thing I had still forgotten: never ride through water if you can’t see the bottom. There wasn’t any good way around this particularly wide yet shallow body of water and I didn’t give much thought to it. I twisted the throttle to prevent myself from planting the front wheel on the other side. As I wheelied through the short span of water, I felt the rear drop just before the bike “cased” itself – there was essentially a hip-deep ditch in the middle of that shin-deep puddle. The bike stopped suddenly as my inertia propelled me into the handlebars. The transfer of energy was so great, that the impact actually caused the bike to coast up out of the water and land softly in the dry sand. I slowly tumbled over the front end and I recall thinking twice, “when am I going to land?” The fairly soft impact of the sandy ground finally came and my first thought was to get up and walk off a nasty Charley horse. My friends on their quads called to me as I tried to roll from my left side onto my back, but couldn’t. And of course, the bike never got a scratch.

It was Mother’s Day afternoon and they had to call in an orthopedist to do my surgery ...I almost had to wait until morning with the awful pain. The accident was at 1:30pm but I was finally being prepped sometime around 5:30pm. I was awake again and feeling many times better by 11:00pm. My doctor ended up doing another surgery immediately after mine since an older guy on a cruiser bike broke his shoulder after I went in. That pretty much set the standard on my one-on-one time with the doctor. I doubt I saw him a total of ten minutes during my four day stay at the hospital. I had broken my ankle on a sportbike in 1999, but this turned out to be a lot different. Not only did I not know what questions I should have asked at that time, but I also felt I wasn’t made aware of certain things that might have helped later. At the time, I didn’t feel so lucky, but it could have always been a lot worse. To my surprise, I was up doing minimal physical therapy on a walker at 1:30pm the next day. Therapy wasn’t fun, but I knew I had to stick through it and reach the goals they set in order to get the hell out of there. A lot of the recovery had to do with willpower and persistence to get better and work beyond the pain those first few days.

the emergency room - prognosis: stuff is screwed up!

Damage Details
The accident caused an intertrochanteric fracture of my right hip, as well as comminution (pulverization) just below the greater trochanter. Essentially, I had a clean break below the ball joint across the broadest area of my femur bone and had fragmented the “horn” at the top. I received the typical titanium appliance that anchors within the ball joint and plates to the femur with three screws. The great trochanter (the horn) that was floating around was reset and packed with medical bone putty (I only found this out later when I requested copies of the hospital records). Apparently an oversight, I was not initially made aware of the fragment but rather was only told that the tendon attached to this fragment (and connected to my pelvis) was tearing and I needed to be careful not to rip it from the bone. Except while lying down, I was always pulling on this integral muscle – it hurt, but never felt like it was “tearing” any more than it had. So once home, I assumed that if I didn’t feel a horrific tear, I was free to get around as I pleased …it was always sore and there wasn’t anything I could do to stop that. Despite the pain, I could finally sleep without the awful Percocets and started taking stool softeners by day six because the pain killers were causing my intestines to pass what felt like charcoal briquettes. Also, I was not taking ibuprofen because it will inhibit/delay bone healing. By this time I was able to cope with the pain. I personally like feeling the pain a little because it gives me an idea of my limitations as not to do more damage.

the alignment shots used during the surgery

Unforeseen Complications
It wasn’t until my two-week follow-up x-rays when I first found out about the fragmented greater trochanter issue. I believe my doctor to be a very busy surgeon and certain details slip his mind due to an overwhelming number of patients. Also, my “surrogate sister” insisted he appeared to recreationally be on some sort of prescription drugs. Though my main break was aligned well and mending, the film showed the fragment possibly moving away from the femur. After examining the x-rays, I'm not enitrely sure of this since the gap may be there from all the tiny bits of crushed bone breaking down there. I tried to remain immobile throughout, but at the six week mark, the fragment gap was still not calcifying (it normally takes two to three weeks from breaking for this to show in x-rays). I queried about having the fragment resurfaced and anchored for two reasons: 1) I wanted to get it locked down so it could heal and 2) I didn’t like the idea of the fragment and attached muscle being a half inch from the intended area for the rest of my life. The doctor said the current appliance is effectively in the way and that he didn’t feel it was yet warranted. A fracture isn’t considered a non-union until 3-6 months have passed. At nine weeks, the gap was still not filling in and the area remained tender (I originally blamed this very tenderness on the torn tendon). Once again, the doctor recommended I wait another four weeks. He also noted that the femur wasn’t perfectly aligned (ever so slightly rotating my toes out) and that there was another tiny bone fragment on the inside of my thigh. Neither of which are physically noticeable nor seem to cause any sort of discomfort.

these are the post-op and two week check-up x-rays

I never had an MRI done and found out once I became a little more mobile that I had some muscle issues around my right knee. A few days of lightly testing my knee with more weight got the blood flowing again and they soon healed themselves up. I would later apply this knowledge to my other dormant soft-tissue problem I immediately became painfully aware of when I started trying to walk: torn groin muscles. The doctor did not mention anything and I never considered it, but it might have been a good idea to get an MRI done of the area to prevent any surprises and delay the recovery. I also seem to have some scar tissue in my right buttocks that causes discomfort when my leg is positioned at different angles while sitting. The more mobile and normal-walking I become, the more this issue seems to resolve itself. I imagine this scar tissue will slowly work its way to nearly unnoticeable over time. Early on, I noticed that my thigh and pelvic areas appeared abnormal (looked almost shifted as if my bones were disfigured in areas) apparently from the swelling and scarring. After a few months, everything settled back into where it belonged - it now just looks like I have slightly larger muscle tone where the appliance lies under the skin when compared to the unbroken side.

Prisoner in my own house
I was very fortunate to have three great friends and a room mate willing to help me all the way through my recovery. Despite their selfless volunteering, I was always compelled to try to do some things on my own, which likely attributed to my fragment issue. I eventually accepted that more rest was the best thing for me. Aside from the bathroom, feeding my self had become the biggest nuisance. My friends did some shopping and provided me with some easily accessible food and cooked quite a few pre-assembled meals that I could heat up, and then carry in a plastic grocery bag back to my boredom-den. It took about three weeks to get used to being stuck on the recliner, but I eventually was able to mindlessly and rapidly get through the days with my PS3, laptop, Netflix, and cable television. I had developed a routine of waking (in the recliner), eating my breakfast, surfing the channels while simultaneously meandering the internet in an almost zombie-like/time-distorting state. I had probably watched Top Gun, The Goonies, Old School, Aliens, and Talladegga Nights four to six times each as they all re-aired on television that first month. The next thing I would notice is that it was 9pm.

Friends and strangers kept recommending different things for me to keep busy, but I didn’t dare break my lazy-multitasking habit (except for visitors or the occasional outing) for fear of slowing the days down again. I had just read two books the week prior, so I had booked myself out when I could have used it the most. In the end, two months didn’t seem nearly as long as I thought it would be. My tender-feeling fragment really caused me to be overly cautious earlier on, but by this time I was finally comfortable getting out of the house to do things. I eventually found out that I could put a five dollar deposit on a wheelchair at the mall’s information desk, so that was quite exciting after spending so much time in the living room. I never had much interest in it prior, but the 2010 Tour de France also ate up a lot of time as I became aware and fascinated with the interesting strategies and mind games those guys play for three weeks. All that confinement really opened my eyes and has urged me to eventually start volunteering for those that may never be able to leave a hospital bed.

Recovery
I originally went home with crutches and was told that my torn tendon should not be subjected to more than twenty or thirty pounds of weight nor should my leg just hang for fear of complete tendon separation. I would slide/skim my socked foot along as I crutched around my tiled floor. The area was tender, but never felt like it was tearing, so I was lightly hopping around in the kitchen within ten days. At this time I was unaware of the fragment and was likely causing it to drift from the “glued” position. I spent my days (and nights) in a recliner because it was a more natural/comfortable position for my hip than lying flat …plus my bed was on the second floor. It was a pretty spectacular night’s sleep when I finally made my way to it after about four weeks.

My earliest concern was my inability to get good sleep thus inhibiting my body’s ability to repair itself during that time. With the extended period of inactivity, my urination became very frequent as I maintained my normal water intake in hopes of promoting healing. More often than not in the afternoon, I was going every thirty minutes. I would also wake three or more times a night for the bathroom. Aside from the awful sleep interruption, this was a lot of extra movement that my fragment could deal better without. It nearly drove me mad as it certainly was never a full bladder amount and yet I was unable to hold the sudden urges. After a few weeks, I stopped drinking at 9pm so that I could void my bladder and sleep through the night. Once I got active again, this problem resolved itself …but not after a wasted visit to the emergency room that referred me to the urologist. Oddly, it never crossed his or my surgeon’s mind that this was only a problem of circumstance due to over-hydrating combined with greatly reduced activity.

Once I became fully aware of the fragment, I was much more careful and deliberate with my movement. The large fragment tenderness gradually became less noticeable at about the three month mark and felt like it was mending. After three months, the x-rays showed that the gap was starting to possibly solidify. I admit, when the physical therapist got me out of bed fourteen hours after surgery, it gave me this false sense that I was going to heal only slightly slower than Wolverine. The fact that my past broken ankle required plating and over a month in a cast was forgotten and I seriously thought I’d be walking within four weeks and jogging within eight weeks. In reality, not having a cast really meant I needed to be even more careful, which I didn’t start doing until about four weeks in. Instead of just avoiding discomfort, I started avoided as much movement as possible at that point. This is kind of the opposite of what your body needs in this state. The muscles needed to be very lightly exercised to boost blood flow, prevent healing defects, and prepare for the eminent restrengthening (I have since successfully used this method to heal minor sprains and injuries). It seemed to be a fine line between scarring and repairing - this became even more apparent when I was actually capable of walking and the groin problem came out of hiding.

at six and ten weeks from the accident, it is looking like the large gap is not going to fill in

however, the inner area of the fracture is showing substantial improvement at the ten week mark

Three Month Update
I returned for x-rays on the fourteenth week. At this point, I had already rehabbed my muscles and been walking (or hobbling without pain) for several weeks. It was around this time that I had finally felt that the large fragment was settling into a permanent position. The x-rays showed some haze across the large gap indicating that the soft tissue was converting to bone. The fragment is tender enough to keep me guarding it, but feels strong enough for me not to be considering another surgery for resurfacing any longer. I was told that I could start thinking about jogging in six to eight weeks while sticking to low impact until then (stretches swimming, road biking, low weight/high reps). I'm an active person that spends a lot of time on my feet, so some days are better than others. There are mornings that I wake up stiffer or sorer than the day before, depending on the level/duration of activity I engaged in. It has more to do with the muscles than it does with the bone and this usually subsides once I'm up and about for a bit. Plus, beating myself up over the years has taught me to ignore mild pain and concentrate on other things. As long as the gap eventually fills in with bone rather than cartilage, I am pretty confident that I should be back to full capacity by the end of the year...

over three months and it appears that the gap is finally starting to fill in

Rehabilitation of Muscles
I believe the past few years of lifting and bicycling gave me a cushion in regards to muscle atrophy. In theory, I had a window to rest my muscles and still have enough in reserve for a quicker rebound. My therapist had me doing simple seated calf-raises the first few weeks to speed up the repair of my quad muscle (which had to be cut and then mended for plate placement). My doctor later recommended that I get into a pool and also ride a stationary bike. I own neither, but was able to get into a friend’s pool once around week five. It took the weight away, but walking in deep water still aggravated my separated greater trochanter (though I thought it was just the tendon stretching at the time). Had it not been for this particular complication, I’m certain the pool would have been a perfect rehab environment for learning to walk again. Yes, I felt like I had to relearn to walk – well, actually unlearn how to favor my bad leg (as Barry Gee’s blog linked below had pointed out to me).

Before I was off the crutches, I was on my bicycle. I would use my road bike for support as I slowly wheeled it outside, loaded it, and leaned on the car while hobbling to the driver’s seat. Once at the paved trail, I would very gingerly swing my bad/right leg over the seat and clip my right biking shoe to the pedal. It turned out that the pedaling motion of the bicycle did not aggravate my leg in any way. As a matter of fact, for the first time I could actually feel my damaged/weak muscles getting a workout and without any feeling of stress during or afterwards. I firmly believe that biking practically every afternoon accelerated my muscle recovery and made short work of the knot in the quad where they cut through to get to my femur. I felt I was healing at a much faster rate and this gave me the confidence to get back into my home gym for my weekly upper body workouts, which prompted me to do the very important stretching on a daily basis. I also realized that before I could go back to work (bartending), I would also have to build up some endurance to standing again. So I started going to the venue, still on my crutches, during shows just to stand there where I could lean if I had to. I did this about three times yet fatigue still strained my legs and lower back my first and second night.

I eventually tossed the crutches in lieu of an adjustable cane. Finally, I could carry things! It gave me just enough stability and support to alleviate what ended up becoming the most complicated part of my recovery. My groin muscles were apparently slightly torn from my femur and I didn’t know this until I tried to rely less on the cane - I would put my arms out for balance and looked like an orangutan coming at you. I still went back to bartending, being careful to keep most of my weight on the good leg and pivot on it. However, whenever I stepped with my bad leg, my groin would force me to hobble …and the fragment/tendon issue was probably making matters worse. This really worried me and I decided to take the next weekend off to let it heal. However, it dawned on me that my groin had already had over eight weeks to heal …it didn’t make much sense. So I did some research and came to a conclusion: I needed to be patient, yet persistent; I had to go easy, but force nourishing blood to those muscles torn to boost the healing process; I had to gradually build up my strength without working them too hard. Although I had less trouble with stairs, I also realized that my mind and body were strangely reluctant to walk normally because they naturally favored/guarded the bad leg. I eventually came up with a simple little exercise that repaired my leg’s muscle memory.

I started with the R.I.C.E. method (rest, ice, compression, elevation). I continued using my heating pad and also developed a light leg routine I put together with ideas from Kevin’s blog (linked below). I took two days off with minimal mobility and then started by applying the heating pad for twenty minutes to my quad, the scar tissue in my right buttocks, and then my right groin. Once I wrapped an ace bandage around the injured groin muscles the best I could, I began my regular stretching routine then went through a short list of light exercises that built strength and increased muscle control. Afterwards, I would hit the recliner with a bag of frozen peas on my right groin for twenty minutes where the bandage remained with my feet up. The results seemed so dramatic that I was tempted to do this more than once a day and also bicycle, but I kept in mind that too much work could potentially do more harm to the torn muscles than good (although the biking never seemed to bother the groin). I patiently stuck to my plan of one light workout per day for five days, growing noticeably stronger and more controlled of the movement each time. I would take a few steps after a workout and there was always less effort than the day before. Again, I am no expert, but without the help of some other non-experts simply writing of their experiences, it would have certainly taken me longer to recover.

My Routine

  1. Heat the damaged area for twenty minutes to loosen it up before stretching. Use a heating pad or a wet towel warmed from the microwave.
  2. Wrap the area with a bandage to give it some support, but not too tight that your leg turns purple.
  3. Lightly stretch …be patient! For best results, static (never bounce) stretches should be held for at least thirty seconds. If any of these cause painful discomfort, it’s best to skip them or reduce stretch time until you’re strong enough to do them without further damaging them.
    1. Standing body/trunk/abdominal twists (feet apart, 26 total)
    2. Standing back extension (feet together)
    3. Standing toe touch or hamstring stretch (feet together)
    4. Side bend (left and right, feet apart)
    5. Standing toe touch (right foot over left; left foot over right)
    6. Standing with feet spread hamstring stretch: reach down to the center, touch L toe, touch R toe
    7. Standing groin stretch (left and right)
    8. Hip flexor stretch (kneeling stretch, left and right)
    9. Sitting with bent leg over straight leg and hold advanced trunk twist (spinal stretch). Repeat other side.
    10. Sitting hurdlers stretch (one leg bent with sole of foot touching straight leg’s thigh area). Reach for toes. Repeat other side.
    11. Sitting groin stretch (butterfly stretch, foot soles together)
    12. Butt and hamstring stretch (lying on back, pull one knee to chest – be very careful here)
    13. Sitting hamstring stretch with feet apart (reach center, left, right, center)
    14. Standing toe touch or hamstring stretch
    15. Standing calf stretch
  4. Follow stretching with light to mild exercises found on Kevin’s page. Three sets of ten to twelve reps each when possible. Maybe two to three minutes rest between sets. Go slow and easy with emphasis on smoothing out your muscle control. As you get stronger, you may not feel the muscle being worked - try doing the exercise as slow as you can rather than adding reps.
    1. Marching Bridge
      1. Lying falt on your back with knees bent, raise your hips to align them between your shoulder and knees. While keeping one foot on the ground to support all the weight, raise the opposite knee up and then back down slowly. Alternate. Three sets.
    2. Straight Leg Raise
      1. Lying flat on your back again with good leg bent, keep the bad leg straight and raise it so your heel is about one foot off of the ground then slowly lower it. This was only relevant on my bad hip side and I would keep my hand under that buttock just in case I needed extra support. Three sets.
    3. The Clam (never lay on the bad hip)
      1. Lying on your side with your shoulders and hips perpendicular to the ground, bring your half-bent knees about half way to your chest. Keeping your torso still and feet together, slowly spread your knees open as if to mimic a clam until you feel the muscles pull. Slowly close and repeat. Do The Clam until you feel that a Side Leg Lift would help more. Three sets.
    4. Side-Step (applying Barry’s unlearning theory)
      1. This is basically a modified version of the Step-ups on Kevin’s site that I came up with to repair my walking muscle memory. No matter what I did, I was walking strangely as if my right leg had forgotten how to do it. I took a foot long piece of 2x4 and laid it perpendicular in front of me. I would start with my good/left leg’s foot on the wood (my shoe covering most of the wood surface) and my bad/right leg’s foot at least twelve inches apart on the ground. In that position with my knees very slightly bent, I would sort of balance on the wood with my good leg (not tippy-toed) and raise my bad leg off the ground about one inch by straightening the good leg, then gently setting it back down. With my one foot off the ground, I still maintained the a-frame of my legs. I tried my best not to lean over as I balanced because that would not mimic actual walking – that hobble-look is exactly what I was trying to avoid. I would then step down off the wood with my left foot to the left at least twelve inches from where it was, leaving my legs at least shoulder width apart. Then I would step up onto the wood with my right foot while keeping my left foot planted. In this position, I would then straighten my bad/right leg to raise my left foot off the ground. The whole thing almost looks like a robot in old movies, or Frankenstein, walking (but not that rigid because of the joint flexion). Repeat fifteen times concentrating on slow control of the muscles …somewhat like very slow step aerobics without the leg warmers, ponytail whipping, dumb grinning, and clapping. Immediately following this exercise, I’d give walking a try to see the improvement. I was completely overwhelmed at how well this worked for me. Three supersets that include Wall Presses...
    5. Wall Press / Assisted Squat
      1. Do the Wall Press as a superset immediately following the Side-Step: once you’ve completed the Side-Step exercise and have taken a few steps, go right into the Wall Press. After the ten Well Presses, take a rest, and then do the Side-Step followed by the Wall Press again. Do this three times (making a total of six sets). The Wall Press is essentially an assisted, non-weighted squat. With your back flat against the wall, toes forward, feet about shoulder width apart and heel about four inches from the wall, slowly slide down the wall and lower yourself until your quads are parallel with the floor (if you can go that low). The key here is to keep all the weight evenly distributed between both legs and evenly across the soles of your feet (not tippy-toes or just on the heel). Also, try to keep your shoulder blades and buttocks against the wall simultaneously as this will give your muscles a more even workout throughout the motion. You should feel a good burn (the slower and more controlled, the deeper the burn will be), but nothing painful. Inhale as you lower and exhale as you rise. I found these really worked the quads into a soreness, especially on the first day, so try not to overdo them. At first, you may not want to go all the way down.
  5. Recliner: elevate and apply a bag of frozen peas/corn to the problem area for twenty minutes. Repeat later if desired.
  6. I personally slept without the compression wrap then applied heat as I ate breakfast since the muscles shorten/tighten as they gain strength. They may feel slightly sore, but this should be the good sore the day after lifting rather than the painful injury-type tenderness. This should also be a good indicator whether you are pushing too hard – be patient. You don’t want to push so hard to cause more damage or require too long of a recovery before the next exercise period. As the days go on, the soreness levels will also lessen with the same workout as the muscles get used to functioning again. If you think you are doing harm, it’s best to stop for a few days and allow yourself to heal up or consider a different plan of attack. I was very careful getting around earlier in the day as my body loosened up, even resorting to using crutches again after icing. I tend to like exercising in the latter part of the day or evening since my body tends to be pretty tight in the morning and I feel that I get better workouts after I’ve eaten a few times.
  7. Whatever exercises you choose to do, be mindful of your hip’s ball joint. This is a very critical area and damage to it is much more difficult and time-consuming to repair once it is done. The on-and-off resistance of walking is like a hammer and may be too much for your particular injury to handle earlier on like me. That is why the pool is better and the bicycle is probably the best for the joint itself. The water and bicycle maintain constant resistance (and support) while properly working that hip joint, repairing supportive tissue, and building leg muscle. I also accepted that it will be a long time before I feel comfortable to start jogging again.

Returning To Work
I was looking forward to returning to work after two months of confinement and getting that part of a normal life back. It wasn't the ideal method of strengthening my muscles, but it was a major morale boost just to get back into a groove. I bartend (predominantly on the weekends), so this was even more of a problem because of the amount of time spent on my feet. I was still relying on the cane everyday - I would use the cane to get in and out of the venue, but was careful during my shift to stay in one place and not to put too much weight on the bad leg without it. After that first weekend of work, I felt I was making matters worse and took the following one off to recover. Frustrated that my muscles hadn't healed over the eight weeks of rest, I did some research and brainstorming then decided to start the above workout routine. The routine drastically promoted healing and got me to a point where I could get around fairly well without using the cane at all.

I returned to work after that one weekend off without bringing the cane. Each day, my groin felt a little sorer and by my first day off, I was using the cane again because it hurt to walk and to allow the muscles to recover. Again, I would ice my groin muscles following work and then use the heating pad in the morning to loosen the muscles up. I would continue to use the cane to get around the house for the first few days off of work until the muscles healed. The next weekend started off really well without the cane, but the shifts were very long again that weekend and I was comparatively only slightly less sore by the end of it. I continued to ice after shifts and use the cane the first few days off. I was doing the rehab routine only on days that my muscles didn't hurt from work. It wasn't until after my fourth week back that I finally felt more mobile and on my first day off, I was able to walk fairly normal without requiring the cane to do so.

It certainly took a while because I was taking two steps forward in my muscle strengthening from the increased activity, but taking one step back to allow for recovery from the extended amount of time doing so. I believe returning to work was actually for the best, but it was just bad luck that those weekends entailed longer shifts. Ideally, a couple shorter/normal shifts each week would have been more beneficial as to allow my muscles time to heal themselves. The fourth weekend was also when I stopped doing my special rehab routine and began riding my road bicycle frequently again. I no longer felt that I needed to ice or heat my muscles at this time, as well. Aside from a tiny bit of favoring of the bad hip (and the inability to jog), everything was undoubtedly returning to normal at the three month mark.

Diet
Nowadays, people wrongly misinterpret the word “diet” as fasting or starving. “Proper diet” should help explain what I am getting at. Prior to the accident, I was hovering right around my body’s ideal weight. During the first two weeks, I lost ten pounds. Once I got my appetite/mobility back and able to eat when I wanted to, it took a few weeks to regain those lost pounds. Of course, it came back more in the form of fat than anything else, which was probably best for the damage recovery. Some people need to be very careful here, because the lack of activity could cause you to gain a lot of undesirable weight which is only going to put that much more stress on your mending limb. Therefore, maintaining a healthy, low fat, unprocessed diet is critical for a few reasons. Also, eating red meat more than a few times a week is never good for your digestive system, but it also contains loads of iron. Healthy blood needs iron, but too much iron can actually inhibit bone formation.

One of the best things for me, I felt, was milk and not because of the calcium. Your body can naturally move calcium from healthy bones to the broken ones if it has to, so you do not need to drink gallons of milk for that reason. Milk is a great source of nutrition and it became extremely convenient between meals, especially when I couldn’t get around well. The milk I drink is Smart Balance’s Lactose Free and/or Lactaid's Fat Free. I personally chose to stop drinking dairy milk (substituted with soy milk) or eating cheese a few years ago because of the phlegm produced by regular dairy became an annoyance while biking and running. I eventually decided to drink dairy milk again, but the lactose free stuff doesn’t seem to produce the phlegm problems. These brands also have plenty of extra protein and vitamins perfect for recovery.

I ate a lot of brown rice, green beans, sweet potatoes, and pan-fried chicken cutlets marinated in italian dressing or dry-rubbed with Old Bay once I could cook again. Prior to that, my friends prepared a few things like burritos that could be frozen or a meatloaf that could be easily heated up along with some frozen vegetables. Stir-fry was also something that was an all-in-one meal that could go in the microwave. Humus wraps ended up being very convenient to prepare for myself quickly and able to carry in a bag. Breakfast was either plain oatmeal with a little bit of peanut butter, some milk, and a banana -or- Mini Wheats and a banana. Junk foods are pretty convenient, but I was able to stifle those urges and snacked on healthier crackers, yogurt, and fruit. My friend also found a little fabric basket with handles that she tied a short string between. As silly as it sounds, this could go around my neck and it was just big enough to allow me to carry my bowl of cereal or soup while still using the crutches.

My doctor
By about the tenth week, I started to question my doctor. He always seemed overly optimistic, but maybe I know just enough medical crap from school to cause my pessimism. I ended up feeling that if I wasn’t asking the right questions and prodding for definitive answers, I was going to be in the dark about certain things …take the large fragment, for example. But when I did have very poignant questions, he would sometimes waffle on the explanations. An “I’m not sure” is a lot better than flip-flopping on the answer in my opinion. I like to think I am pretty good at reading people, but this guy always seemed somewhat aloof so I never knew if he wasn’t just trying to make me feel better at times. His normal prognosis with the fragment was, “well, let’s get more x-rays in four weeks and see if it mends on its own.” It wasn’t bad news, but I would wait a whole month, drive forty minutes one way just to hear the same line about something that remained an issue. It wasn't until about the three month mark that the large fragment felt better and looked like it was mending. At this point, I knew what kind of questions to ask my doctor and he was able to answer them much more to my satisfaction. In the end, he did know better. Just do your homework and have every question and scenario ready for the next check-up. Good luck.

The Appliance
There was a period when I was considering being opened back up to have the hardware removed so that my floating greater trochanter could be resurfaced and affixed permanently. Also, I had planned to have the appliance removed since I read that it can cause a stress point for future fractures. My doctor recommended that I wait a year for this surgery if I do decide to go through with it. He went on to explain that removal surgery would either be out-patient or an overnight stay and I would need to use crutches for a month while the holes fill back in. He would again have to cut through my quad to get to the plate and screws, but I'm sure rehab for that muscle wouldn't be a compounding issue considering the month I'd be on crutches. I was informed that sports and other high impact activities would also have to wait two to three months from that surgery.

Bones are like muscles: the more you work or put stress on them, the stronger they will be become. Your body recognizes when specific bones are subjected to more strain and it will make those areas more resilient than others not under stress. Conversely, the same is true for a bone that was once supporting your body weight but now has a plate to strengthen it. In my scenario, the bone density of the area near the plate (not necessarily the entire femur) will lessen since the plate is helping to do some of the work. This isn't entirely bad, it's just the body's way of evening everything out along the bone. It is also part of the reason crutches are a good precaution after removal since there is so much weight being placed along this area. I suppose there are two theories here: one that implies that extreme impact can cause the bone to break where the harder plate ends midway along my femur; and one that implies that the different sections of bone adjust so the strength of the plated area is not that different than that of the naked area, thus reducing the plate's effect from the same impact. My gut feeling is to lean towards the first theory, but I'm not convinced removal is truly going to prevent chances of a future fracture any better. I was pretty sure I was going to have it removed just as I removed the plates and screws in my ankle back in 1999, but I'm not sure now. I guess it depends on whether or not I have the time to crutch around for a month and what problems, handicaps, or annoyances the appliance develops during employment or sports.


Key Dates
Accident and surgery: May 9, 2010
Comfortable/Able to drive: June 20, 2010
Comfortable/Able to ride road bicycle: June 25, 2010
Switched from crutches to a cane: July 5, 2010
Returned to bartending (standing for six hours): July 9, 2010
Devised and began a muscle rehab routine: July 19, 2010
No longer needed a cane after work or extended activity: August 5, 2010
Able to conceal my hobble and walk without favoring: August 17, 2010
Reintroduced lower-weight squats/lunges into lifting: September 10, 2010
Jogged for the first time since the accident (2 miles; moderate hobble): September 16, 2010
Able to sprint with nearly non-existant discomfort: November 9, 2010

Nov 15, 2010: Currently, I still feel very slight stress on the inner groin muscles with certain movements and/or heavy lifting. Aside from MMA practice, there's nothing I can think of that I would hesitate to do at this point. I actually crashed pretty hard riding my mountain bike on October 8, 2010 with my refurbished hip absorbing a large amount of the impact and pedalled away with only a bruise over my surgery scar. I believe that by the end of the year (almost 8 months from the accident) I will have made a complete recovery.

February 1, 2011: Only nine months after and sometimes I forget that I broke my hip as discomfort from my inner thigh/groin (where most of the pain had been during the later stages of recovery) has become very minimal. It could be due to the fact that I have learned how to avoid aggravating it. I'm still not sure I would be ready for muay thai/grappling practice or snowboarding yet if my schedule allowed it, but the amount of weight I can squat is back to where it was prior to the fracture. However, I have opted to stop doing my 4-mile run in favor of road or mountian bicycling 12-miles (I could probably run fewer miles, but I don't feel that's pushing me enough aerobically). The running is still a little too high-impact for me - seems a bit of pain radiates from my hip joint after a run. I've decided it is just better to err on the side of caution and continue with the low-impact workout the biking provides for now. My quad is healing nicely and the scar tissue that was built up in my right buttocks is gone - I had actually forgotten about it until re-reading this. I am not sure if 100% recovery is possible but I'd say I am at the very least at a modest 95% right now. I could easily say I am lucky/happy with 95% and I think most people would feel they had made a "full recovery" at this point, but I know each month I am gradually getting better ...even if I don't realize it.

August 21, 2011: Can't believe I forgot to update on the one-year anniversary. Most of the blame has to go to my schedule, while the rest goes to the fact that it predominantly slips my mind that I was unable to walk a year ago ...a testament to how well my hip is doing today. Although I'm sure I will be sore until my body gets used to it again, I'm going to start jogging this coming week since I seem to be hitting a plateau on my road bike. The only "problems" I still encounter are related to the inner groin and quad muscles - the great majority of which occur in that intentionally-severed quad but are nothing to slow me down, just enough "irritation" ("pain" is too strong a word) to make me take notice. Over the early summer doing individual leg exercises, I noticed my problem leg tended to fatigue earlier, but that has become less of an issue. I also became aware that my good leg was doing more than half of the work on the bicycle - I had to consciously force my legs to fix that problem. Ultimately, I feel confident enough to take on any physical challenge without apprehension. There is some minor numbness along the scar area I certainly won't get back at this point, but I doubt I'm ever going to really miss that. If I had to put a number on my recovery today, 98% would be it only because I wouldn't consider 100% possible with the numbness. I'm sure there will always be something holding me from reaching that final 99%. Of course, I feel very fortunate to have made it to this point considering the destruction.

October 30, 2012: Everything is still going great. But I've realized that if I don't keep a regular strength routine going, I will feel pain in my problem quad during strenuous activity. I was basically so preoccupied with modifying my Jeep for two months that it left little time for my CrossFit workouts. In everyday life, my hip is a non-issue - sometimes I forget it even happened. But as a firefighter, there are days I'm hauling around equipment and I'm reminded of the injury with a dull pain as the once-severed quad muscle works. I am fairly confident that once I get back into a regular "gym" schedule, I'll notice this less.


Barry Gee’s story: http://barrygee.blogspot.com/
Kevin Boyd’s story: http://onlineartdirector.com/broken_hip/


(DISCLAIMER: I am not a doctor, these are merely my experiences and opinions)

CrankyGypsy (established 2001)