I’m gonna be honest here – I meant to write a post about surgery recovery for months. A “Five Things No One Tells You About ACL Surgery” post languishes in my drafts folder. But somehow, I couldn’t get it done. Honestly, I did basically nothing so far this year.
2019 was going to be my year. I was going to launch my coaching services, put out new workout plans, really start my business, while at the same time take myself to new levels of fitness that I’d never reached before. All of this shattered two weeks into January.
Last September, I did something to my hip. I didn’t know what it was, exactly, but I had committed to completing the Spartan Trifecta and I was going to do it anyway. After about 4 months of denial, I realized something was seriously wrong.
Caving to reality, I made an appointment with an orthopedist. After an x-ray, an MRI, and a CT scan, a nasty revelation appeared. My right hip had a labral tear and complex hip impingement. In layman’s terms, the cartilage in the joint had torn and the bones of my hip looked like a “square peg in a round hole.”
The two months that followed sent me on a rollercoaster of emotions and thoughts that I wasn’t quite prepared for. Now that the surgery is over, I’m starting to think a little clearer and wanted to share some of what struggles I ran into and what helped in hopes that it will help you.
Before Surgery – or the Stages of Grief
If you’ve been living an active lifestyle, becoming injured is a major loss. Your mind processes this loss just like any other. At first, you don’t want to believe you’ve injured yourself or not want to believe it’s as bad as it could be.
It’s only natural – A sprain, strain, or a twist sets you back a few weeks on your training. However, an injury requiring surgical intervention takes months.
Personally, I put off going to the doctor so I could avoid diagnosis. If I didn’t know what was wrong, I could tell myself it wasn’t that bad. Please, do not replicate my dumb decision.
Whenever you are injured, someone always asks what happened. And then another someone asks, and another, and another. Usually, I try to spin the story to make it somewhat amusing for the listener, and a little self-deprecating.
But, I leave out one crucial piece of the story: anger.
See, I’ve got a mental habit — if something goes wrong, I figure out how to make myself feel worse about it. It’s not bad enough that I’ve torn my ACL or labrum or whatever — I have to blame myself for it.
How could you be so stupid? How could you screw up so badly?
Others may lash out at the environment, and blame others around them.
Either way, when the reality of your injury sets in, you’ve got to come to terms with a loss of control. A gigantic roadblock now stands between you and your goals and no amount of willpower can change that.
Be honest with yourself and your frustrations and utilize social resources to let it out. Talk to friends, family, workout buddies, coaches, and vent these emotions. Allow yourself to feel what you’re feeling, and don’t bottle it up inside.
Insurance providers usually have their own set of hoops you need to jump through before you can be authorized for surgery. This isn’t necessarily a bad thing! Even routine operations carry serious risks.
In the case of my hip, I needed to undergo physical therapy and try a cortisone shot before my insurance considered surgery an option. Why is this the bargaining phase? Because now, you are negotiating with your body.
If I do this, then maybe it will be better in a few weeks and I can get back to my normal life.
There are plenty of conditions that physical therapy and steroid injections alone can manage. Desperately, you hope that this is the case. I felt so certain that the cortisone shot would make the pain go away and I could resume my life. When the pain came back two days later, everything shattered.
Then, the next stage kicks in.
Depression ruled the six weeks leading up to my surgery. I had no routine anymore, and no goals to pursue. At best, I felt like I was spinning my wheels and waiting to resume my life. I just want this over with. At worst, I felt like I was losing all the progress I had gained. I thought, if I’m not making progress, what’s the point in even trying?
Chocolate became 40% of what I ate on a regular basis, and I stopped cooking meals for myself all together.
A few times I thought I had a handle on it–I told myself I was going to put myself in the best position possible for this surgery. That I would eat well, stay active, and just do what I needed to do. Turns out, these were backtracks into the bargaining phase, not actual acceptance. I could hold onto that for maybe two or three days tops before it was time to eat an entire bag of Cadbury Mini Eggs.
Depression can be harder than anger to openly discuss. It can also double back on itself, making you feel bad for feeling bad. All you can really do is try to say to yourself — this is how I feel right now and that’s okay.
Negative feelings are hard, full stop. Passing judgement on yourself for having those feelings will not make you stop feeling them.
This sucks. But I’m going to get through it.
In order to fully take care of yourself in the lead up to surgery, you have to let go of the path you thought you were on and start forging a new one. Your pre-surgery path has three main components.
- Focusing on what you can do.
- Setting new SMART goals.
- Being gentle with yourself.
Here’s what it looked like for me:
- I couldn’t do crossfit. But I could use the upright bike.
- I set a goal of biking 300 miles in the month before my surgery.
- I felt a loss of progress, but reminded myself there would be time for that later.
This process is going to look different for everyone.
If I could boil everything down to one piece of advice – it would be to take the steps you can to respect your body, your limitations, and your emotions.
Be Prepared for Recovery
Recovery can be long and boring. If you were an active person before, trying to limit yourself can be mentally exhausting. Make a list of what you think you will need after surgery and get them beforehand.
- Medication – try to get your surgeon’s office to call in your prescriptions ahead of time so you’re not scrambling to pick them up afterward!
- Mobility – Since your range of motion will be limited, you may need to have some tools to assist you. Raised toilet seats, grabbers, cup holders for crutches, ice packs, sock putter-onners. Anything that will make your life easier as you recover.
- Food – If you don’t have someone there to cook for you, make sure you have plenty of easy to prepare meals ready to go. Nutrition is going to play a role in recovery, which I’ll address in a bit.
- Entertainment – movies, tv shows, books, comics. Whether you’re rewatching something you love, or catching up on that list of shows you’ve meant to get around to, find a way to fill the hours.
Have a Support System
Even if you do not have many mobility restrictions, which is unlikely, you will need a ride home from the hospital at the very least.
When you have surgery, simple tasks suddenly become very difficult. Even something as basic as getting dressed or going to the bathroom may require assistance – especially in the first week.
Some people feel embarrassed asking for this kind of help, or relying on other people. Don’t let your pride stand in the way of your recovery. Even if you just need someone to bring you fluids or meals, there is another crucial element that a support system provides.
Surgery is draining on the body and the mind. While doctors may be fixing a condition long term, there is intense short term stress. The emotions that you dealt with pre-op don’t vanish overnight. Now, you’ve got new shiny emotions to deal with. Having someone to share that burden is just as important as physical help.
Do a quick google search, and you will find a surprising number of people looking up “losing weight after surgery.” Or how to avoid gaining weight after surgery. Of course, the sudden loss of activity level can throw energy balance out of…well.. balance. When you’re not moving as much, there’s a desire to eat less as a result. But please, do not give into this desire.
After surgery you need to eat to recover. Eating at a caloric deficit will make it harder for your body to rebuild the necessary muscle and connective tissue. The Hospital for Special Surgery recommends eating approximately 15-20 calories per pound of body weight a day while recovering from surgery.
HSS also recommends increasing your calcium intake if the surgery impacted the bone and to make sure you get adequate protein for muscle recovery.
My father tore his rotator cuff two years ago, and a full six months later he was complaining that nothing seems to help.
“Are you practicing your physical therapy exercises at home?” I asked him.
No, he insisted. They were silly.
Early physical therapy exercises tend to be small, basic movements. They might not be as glamorous as a clean and jerk, but they are the essential foundations of movement. After surgery or injury, natural defense systems kick in. Your muscles essentially have sensors that prevent it from contracting too hard or too fast to prevent further injury.
Physical therapy aims to restore full range of motion, muscular control, and strength. This is done with a progressive program and starts with strong foundational movements.
And while working with your physical therapist will help you make process, you likely will only go 2-3x per week. This means another 4-5 days that can be dedicated to your healing as well.
While simply straightening my knee and squeezing my quad isn’t super engaging, I know a few sets of these a day will get me on a path back to heavy squats.
The Fear Factor
As we heal, we think that our bodies are our greatest limiters. Unfortunately, that’s not the truth. Most of the time, we are limited by what we think we can or cannot do.
The biggest limiting factor as we recover is fear. Fear of reinjury can prevent us from getting back to previous levels of activity long after our bodies are ready to take on the strain. Our mind can cut us short long before our bodies do. This is true of any part of the fitness journey, from the first time you try a workout to every other milestone you’ve passed before.
Of course, all physical activity carries with it a risk. Of course, so does inactivity. Some people may choose not to return to the sport or activity they were doing when they injured themselves. Some people resume their passion and continue to hit new personal records.
How you move on after surgery is your choice, but try to make it out of hope — not fear.
If you’ve come here hoping to find some guidance for yourself or a friend, I hope you have a better understanding of the difficulties before and after orthopedic surgery.
Let me know in the comments how you coped with surgery and suggestions you think could help others!
I’m hoping that with this major stressor behind me, I’ll be updating Superpowers Sold Separately more often.
And make sure to check out the Archetype: Workout Series, just launched this month!