Hip rehab – what have I ended up doing?

As you may or may not know from previous blogs, I’ve been having a bit of a problem with my right hip. The Sacroiliac joint, and the adductors, to be exact. It took me out of running for about 8-10 weeks. I’m slowly getting back to running, as was detailed by my last blog, but the most common response (apart from aren’t you going mad?) has been “so what are you doing to get you back to running”?

I thought I would address that here.

Looking back on my diary for the last few weeks and months have shown an interesting progression… it isn’t quite as linear as I would like, rehab never is. I also have not been as conscientious as I would like… life is like that, and rehab is very rarely linear.

Rehab is NOT linear

During the first few weeks of pain, I was really hoping that a little bit of rest would be enough for it to go away, and so my initial response to injury was fairly typical of any runner. I just hoped it would go away. When it became apparent that simply running through it was not an option (it took a painful 20k, and then a VERY painful mile walk) something else needed to happen.

That something else was rest, followed by something that is a bit of a buzzword at the moment – that something is “Optimal Loading”  which essentially is a quick way of saying “not too little, not too much”.

Running on the injury wasn’t going to get it better. But equally, total and utter rest also won’t help it to get better. Optimal Loading is a balancing act between not doing enough and doing too much, ensuring that I get enough rest and recovery in between each bout of rehabilitation.

Training Diary

Luckily I keep a sporadic training diary – and if you’re interested, I’ve detailed some selected highlights of my diary since the problem…(if you aren’t, skip on!)

I’ve put in week numbers as well as the dates…

a typical weekly diary – on actual paper!

1 June 12-18, Decent week of training. Pain on the 18th. Unable to weight bear.

2 June 19-25 Walk and wild camp. Run – 8km. Agony. Flight to Chamonix. 20k “run”. Then on the next day – can barely walk.

3 June 26-July 2. Rest until FridayFriday – Row 2k. Sat Walk 3k. Pain after 1.5. Sun. Row 2+2+1k.

4 July 3-9 Hip hurts. Tuesday – turbo then difficult to walk down stairs. Sat- walk to town and back.

5 July 10-15 Front squats to 50kg, Cycling. Rowing. Swings and step ups.

6 July 17-23 Short run! 2k. Hurt by the end of it. Bike ride, Front squats. 1st 10k walk/ run in a month, with sticks. Knackered on Sunday.

7 July 24-30 Hip painful after weekend. Bike ride. Bike ride, Front squats to 55kg. Steps, slams and ski erg – HARD! Bike ride 50k. 3k run with some walking.

I can’t run, but I can cycle

8 July 31 – Aug 6 bike ride- 70km. 5k run. Beginning of specific hip/adductor rehab. Squats, lunges, adductor/abductor, box drops, leg raises. 6k run. Climbing.

9 Aug 7-13 Front squats to 50. Bike ride (snake x3) FS to 60, bike ride, turbo test. 7km walk.

10 Aug 14-20. Full on hip rehab every day. Finger boarding every day. FS to 60. Then 70, walk 12km.

11 Aug 21-26 hip rehab every day. To the alps. 17k walk. 5k run uphill.

12 Aug 28-Sept 3 Alps, walking – SHOULD HAVE BEEN RACE WEEK

13 Aug 4-10 hip rehab every day. FS to 70. Bike ride. First Race- Padfield plum fayre- 40mins. No hip pain.

14 Sept 11- 17 hip rehab every day. 11k run. Tired at the end of it, and a bit tender, but ok. 5x1km reps on Sat

15 Sept 18-24 Progressing hip rehab. Starting to run more. 5x downhill reps, still a little tender, but just going to start running every other day now.

So (at the time of writing) it has been 15 weeks since I literally couldn’t run. I haven’t been bored as there has been rowing, cycling, skiing, gym, and a whole lot of rehab to get stuck into. I’m deadlifting as much as I ever have done, and my Front squats are better than ever before.

Specific hip rehab routine

As I alluded to before, I developed a hip strength routine to help me along. It followed the principle of gradual strengthening. If the movement was impossible, the weight was reduced until it was, and then built up from there. No ego. No “I should be able to do this”. Just work from whatever base strength I had.

8-10x adduction and abduction on each leg. Increasing in band heaviness as and when I could do 10, painlessly in all configurations.

Hip flexor raise with kettlebell up to 10, If I can do 10, go onto the next weight

Hip flexor stretch. Crunches. Step ups, Step downs.

I can’t run, but I can climb

The important thing to note was the amount of discomfort I was in. I was looking for discomfort – maybe a little pain, but not masses of it. The day after training was key, if I was in pain, the rehab changed accordingly, if I wasn’t, it carried on. Not trying to run too early was important, as was not being pressured to get for my “A” race this year. Longevity is way more important than breaking myself failing to get around a course that I should be able to finish when I’m fit.

Not only that – but although I haven’t been able to run, I have been focusing on the things I can do. Climbing, cycling, turbo, gym, walking etc. Running might well be a fun thing to do but it is not the be all and end all. Other options exist.

As a bit of an update, this is now the beginning of October I’m running a bit more now, but not going crazy. I can happily do 10-15km, though I’m tired at the end – and achy in the morning. When I woke this morning, my hip hurt as I lay in bed, but now I have been up and about for a few hours, it feels fairly normal.

There is no quick and simple way to me just getting out and running. My routine is now changing as the previous one has become too easy – but I still am not at full strength by any means – rehab will continue until I am… and will continue after that as well!

If you’d like us to help you with a rehab training programme get in touch – Tim – contact@globaltherapies.com

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