A 2017 update

It is unbelievable to think that this whole journey started around 4 years ago. I haven’t posted in such a long time so I thought I should write a little update about how things are going. I am happy to still be getting messages and questions from people reading this blog, so hopefully this update can help to inform some of you who are going through a similar process!

Where to start? I guess my last post was around the time when I had just returned to the volleyball court representing Australia in the World League in 2014. The rest of the 2014 national team season was, although very successful, a pretty tough physical battle. I was happy with how my hips were coping with the demands of international volleyball, but I was having some other pretty significant problems. I was so determined to return to the volleyball court in time for the World League in 2014 that I pushed my body to do things it wasn’t necessarily ready to do. I had spent so much time either in a wheelchair or on crutches that I lost muscle strength and also bone strength in my legs. While I had regained a fair bit of the muscle mass, I hadn’t given my bones enough time to regain the strength needed to cope with being a full time athlete. Because of this, I developed pretty bad bone stress in both my tibia’s during the 2014 national team season. Although I managed to get through the matches with the national team, I wasn’t in a position where I could fulfil the commitments of the contract I signed with a team in Greece and decided to return to Australia to rehabilitate the bone stress. It was a pretty tough decision considering it was a dream to return to play professional volleyball, but I knew that it was the right decision for my future. 

Although leaving Greece wasn’t ideal, returning to Australia gave me an opportunity to further improve the strength of my hips and better prepare my body for the life of a full time athlete. By the start of the 2015 national team season I was feeling strong, motivated and ready to return to playing volleyball at the highest level. I again represented Australia throughout the whole of the 2015 national team season, which involved travel to Iran, Italy, Serbia, Japan and throughout Australia. I had no significant problems with my hips during the season – just the occasional hip flexor tightness from the travel. A lot of effort went into maintaining my hip strength and keeping the surrounding muscles loose, which I am sure was keeping everything in check. Everything was going really well until I injured my ankle pretty badly during the Volleyball World Cup – just another injury to add to the list!

Soon afterwards I travelled to Będzin, Poland to join my club for the 2015/16 club season. I was really excited to compete in the Polish volleyball league – one of the highest quality leagues in the world. It was always going to be a challenge, and the ankle injury made it considerably more difficult. I competed in Poland for the majority of the season but eventually succumbed to the ankle injury, and returned to Australia to have surgery – keeping in mind that the greater goal was to qualify for the Rio Olympics in May. Cutting a long story short, the Volleyroos were unfortunately unable to qualify for the Olympics rounding out a pretty disappointing few years for the team.

So I write this post from my apartment in Loimaa, Finland, where I am about half way through the club season with Hurrikaani Loimaa. I have developed somewhat of a routine of hip maintenance which includes strengthening the surrounding muscles, stretching and rolling through my hips, glutes, legs and back. This has allowed me to continue to play volleyball at a high level with minimal issues. The amount of travel is always a challenge – in the last 2 weeks we have covered over 2500km and spent over 30 hours in a bus! This inevitably leads to tightness in my hips and some soreness in the hip joints themselves, but with the routine I have developed it is manageable.

I am often asked if I would change anything in the way I treated my hip dysplasia, or if I am happy that I had the PAO surgery. Firstly, I am pretty happy that I had the surgery. I can’t pretend to know what condition my hips would be in now if I hadn’t had the surgery, but I am pretty confident I wouldn’t have been able to continue playing volleyball. I think it was the best option to preserve my hips and continue to function as a professional athlete. Would I change anything? I clearly remember being told by doctors, physiotherapists and some other patients to take it slow, not to rush back into physical activity and to allow enough time for my body to heal. The bone stress that I developed in my tibias is evidence that I didn’t really allow enough time for my body to heal and to adapt to my new hips. Ultimately, having the goal to return to volleyball in time for the World League in 2014 probably wasn’t the best idea for the long term, but I think it definitely gave me something to work towards and was a clear source of motivation through the tougher parts of the recovery. Although the right thing to do was probably to miss playing for Australia in 2014 and take longer to recover, it is hard for me to say that it’s what I would do if I was given my time again. So I guess the answer is no – I wouldn’t change anything in my recovery, but I would advise others to take their time with their recovery, and not to rush getting back into physical activity.

In April last year I joined the team at Healthy Hips Australia in an attempt to help raise awareness of hip dysplasia in Australia. Healthy Hips Australia is a not-for-profit organisation that aims to support those who are affected by hip dysplasia, and help raise awareness of the condition. Head to http://www.healthyhipsaustralia.org.au/ for more information and keep an eye out for updates during Healthy Hips Week from April 23rd-29th!


I don’t know when I’ll post next because at this stage there isn’t too much to report, but I encourage anyone who wants more information or has questions to get in touch through this blog or Facebook. I’ll do my best to answer any questions you might have!

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When I first found out that I would need a year out of volleyball to correct my hip dysplasia I made the goal to return to the Australian Volleyball team in time for the 2014 World League. I am happy to say that I achieved that goal on the 23rd of May in Belgium, where we played the first World League match of the year. Before that game, I toured with the team through Iran and Italy playing practice matches and preparing for the games in Belgium. Since then the Volleyroos and I have travelled to Bulgaria, and back to Australia for the first home round of the World League. The travel has created a lot of challenges with my hips, especially since being in the seated position for extended periods isn’t comfortable, but I have found that my hips haven’t actually been the major problem in returning to professional sport. Having been off my feet for so long, I lost a lot of the muscle and bone strength required to play and train on a daily basis. This has meant I have had pain and injuries in parts of my body other than my hips. 

The management of my hips has still been and will continue to be an ongoing process. I am still working on the strength of all the muscles surrounding the area, and the rehab will probably be something that I will have to continue for the rest of my sporting career. I definitely still feel unstable and weak in some situations on the court and in the gym, but outside the sporting scene I only really notice that I have something different with my hips when I try to step over something high. I definitely feel some restriction in the abduction range of my hips and and flexion past 90 degrees is pretty uncomfortable. Luckily these two restrictions don’t have too much impact on what I can do on the volleyball court.

The rest of this national team season involves travel to Finland, Canada, back to Australia, then back to Europe once again. This will continue to challenge my hips and the rest of my body as I continue to gain back the strength I had pre-surgery. I am sure I will have little issues in the future, but I hope that for now the major part of my hip ordeal is done with, and I can continue with my career and my life. 

Back on the court…

It has been 164 days since the PAO on my right side, and 2 weeks ago I stepped back onto the volleyball court for the first time since. The training session was basically an opportunity to test out a lot of the volleyball actions that are hard to replicate in the gym and get an idea of where my hips are at in dealing with these new stresses. At that stage it was still quite an unusual feeling to be running, so a lot of the actions felt foreign and unusual, but overall I was pretty happy with how I felt at the end of the session. There were no major pains during the exercise, and the only pains felt afterwards were just from general muscle soreness. I did feel like a lot of the movements were slow and uncoordinated, but that was to be expected.

The next few training sessions went much the same way – getting used to some different movements and positions for my hips, and testing the boundaries for what they were capable of. Apart from developing a bit of sharp pain through the front of my right hip, which has since disappeared, the trainings went well and I found I was able to deal with every situation that I put my hips in. Over the last two weeks of training I have noticed dramatic improvements in the speed of movement, and how comfortable it is for me to move around on the court. Movements are starting to become more natural, easier and more explosive. Recovering from these sessions is where the issues have arisen. The day after a full training session of jumping, running and changing directions I have a lot of soreness and fatigue in my calves and knees. Funnily enough I haven’t felt any issues with fatigue or soreness in my hips. Here’s hoping that my body can adapt to this load quickly, as this pain is the only thing really holding me back at this stage.

Tonight I got through a set of gameplay with no real issues, which is a step in the right direction considering the start of National Team training is about 4 weeks away. I am pretty hopeful that I will be able to cope with the full training load by that time. There are still many areas that need some more strengthening and control work, but I am glad to say that my hips feel almost ‘normal’ for the first time in 10 months. The plan for the next period is to continually increase the court-based training load to a stage where I will hopefully be unrestricted.

 

February

It has been 20 days since the screw removal procedure and things have healed nicely. There were a few small spots along the new incisions that were lumpy, and the dressings needed changing a few times after pool sessions, but nothing too major. The main issues arose when pulling on or stretching the skin, so that ruled out some overhead exercises for a little while. Other than that the bone surface on my pelvis where the screw heads were was pretty tender for a few weeks, and when using abs connected to that surface it was slightly painful. Both those areas have settled down nicely. I am much happier knowing that the screws have been removed – It already feels that diving and any impact in that area will be much less of a problem now that they aren’t there. It also makes a difference knowing that if all goes well I won’t need to have any more operations on my hips. There is no longer the knowledge that there is one more operation to go hovering over me.

I have started to do some running on the Alter-G, which is basically a treadmill that has a balloon that you harness yourself into, and it inflates to different amounts according to how much of your body weight you want to go through your legs. I started with some walking with 50% body weight and built up to 80%. Then I started to do some running at about 70%, which was quite difficult, but didn’t produce any major issues. Along with this running I have been working on a few more movement skills in the gym. Some basic sideways movements, stop/starts, changing of directions as well as some landing training and small jumps. The jumping and landing stuff has been no problem at all. The movement work has also been pretty good – no problems within the hip joint, but the movements still feel pretty foreign and slow. I’m sure it will get easier and faster the more I do it!

Today was the day that has hopefully fixed the major issue I have had since the start of the year. I have been having some problems with one of the smaller rotator muscles around the back of my right hip – or more likely a bunch of muscles around that area. I had a fair bit of pain when laying on my left side with my knees bent, and lifting my right knee up. It felt like a sharp almost ripping pain. After allowing it to rest, and attempting to slowly start to work the muscle again it didn’t really settle down, so the next option was to try getting some cortisone injected into the problem areas. Under ultrasound the specialist identified many problem spots in the region that he thought would benefit from an injection and spent half an hour jabbing and injecting. I can count about 13 different visible needle holes surrounding the scar on my bum! It was pretty unpleasant to say the least! He also spent some time moving the needle in and out of the muscle that is giving me the most trouble in the hope that the healing of the damage from the needle will help promote the healing of the damage that was previously there. So after all that the area is pretty sore and achey, but hopefully after a few days rest I will be better off from the whole experience. 

Every little activity that I add to my program is an exciting step towards getting back on the court. Although a lot of the activities I am doing are at a much lower level than pre surgery, I can definitely see the progress and can’t wait to be doing it at the highest intensity again. It has also been an exciting week with the announcement of the home rounds of the 2014 FIVB World League. It isn’t very often that the Volleyroos play international matches in Australia, so it is very exciting that this year there will be at least 6. It is another bit of motivation to get back onto the volleyball court and hopefully work my way back into the team. Exciting times!

 

A little less screwed

Getting the screws out was much less of an ordeal than any of the other procedures I have been through in the last 9 months. It came up pretty quick because I was busy with rehab in the weeks leading up to it. Things were progressing well – all of the bone pain had settled, and I completed my first jumping session in the pool with no negative response. The only real issue was with the obturator externus again. It became pretty irritable after a few exercises specifically targeting the area. I went down to Melbourne for the screw removal knowing that a little rest post surgery could be just what the obturator needed to get back on track. 

Before I knew it I was back in the familiar position on the hospital bed – waiting to be wheeled up to theatre. I was admitted at about 1030am and was expecting a long wait. I asked the nurses (many of which knew me by name) where I was on the theatre list and got the bad news that I was dead last. That meant that heading up to theatre after 10pm was likely – quite a long time to wait considering I had been fasting since 8am! I was surprised then, when at about 4pm the nurse came in and said they had called for me. I was quickly prepped and wheeled up to recovery where I waited to head in. Turns out I had somehow jumped about 3 spots in the queue! Probably because the staff wanted to help out a regular…

I woke up in a fair bit of pain coming straight from my new wounds. There was no ache or pain deeper in the pelvis which was reassuring, but the pain from the wounds was pretty bad. After about an hour and some drugs to control the pain, I was wheeled down to my room at about 8pm. Even though I was exhausted, I didn’t sleep all that much overnight. I think it was a combination of pain from the wounds and generally being uncomfortable laying on my back. 

After a quick visit from the surgeon and the usual discharge procedure in the morning I was off to the airport to head back to Canberra. The surgeon said to give the wounds a week or so to heal and then to progress rehab as normal – there is no concern about the strength of the pelvis with the rehab I am doing at the moment, so thankfully this whole thing shouldn’t put me back too far in the rehab schedule. 

Unfortunately I wasn’t allowed to keep the screws! Apparently hospital policy is that no one can keep them, which is pretty disappointing really! I was looking forward to having them as a bit of a souvenir of the whole process, but I guess I will just have to do with the scars.

The cut on the left side is around 10cm long, and is straight over the top of the old PAO scar. The right side is also over the PAO scar, but is only about 5 or 6cm long from what I can tell. The left side has bled a little in the past few days, so the dressings have been changed a few times, but the right side has been fine. Hopefully the wounds heal quickly so I can get back to rehab and get closer to getting back on the court!

 

Good news!

It’s funny how things can change in just a few days. The last post was just before heading to Melbourne to catch up with the surgeon and I was hoping to get some answers as to why I still had an achey pain. I had an x-ray and then sat in the waiting room that is all too familiar. I was relieved to hear that he was very happy with the healing of the bone on my right side and my range of movement in both sides. The only cause of the achey pain that he could see on the x-ray was some soft, osteoporotic bone in the right side. This means that I have to be careful with any sort of impact and need to limit walking to acts of daily living – but in general it’s good news! I can now be a bit more comfortable with just dealing with the achey pain and continuing rehab as planned.  

Another thing that the surgeon said was that the screws are no longer supporting the bone, and are ready to come out. After a bit of discussion and organisation it looks like I will be having the screws out on the 4th of February. I think it will be a good feeling to know that all the surgery is over, and that I won’t be held together by some titanium, but it will actually be all me. It will also be nice not to have to worry about those screws when it comes to getting back to volleyball. The screw heads are right on the front of the hip bone and would be smacking into the ground if I did a dive – so I am glad that I will be getting rid of them and wont have that to worry about it. Recovery from the screw removal is apparently only about 10 days, so it shouldn’t disrupt rehab too much and won’t delay my return to volleyball. 

So for the next few weeks I will be continuing with the rehab program and trying to get as much strength into my legs as possible before the screw removal. It is a relief to now know that things are back on track, and that I will be getting back onto the volleyball court soon!

Fully healed bilateral PAO!

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13 weeks

I am usually pretty excited to post on here because it meant that there was progress, but the last month or so hasn’t given me too much to be happy about. After the flare up in pain before Christmas I rested a few days and it settled, so the plan was to do basic rehab work while at home in Adelaide, and not too much else. Unfortunately the pain shot up again the day I got back to Adelaide, so it was back to minimal weight bearing on two crutches for another week. Having allowed it to settle over Christmas, I started to put a bit of weight through it over the new year period with the idea that I would continue to slowly increase the load. It all went well, so upon returning to Canberra I started to use one crutch, and the plan was to do so for a week, and if all went well for that week I was to start doing some unaided walking during the day. I was also to start using a vibration plate for around about 10 minutes a day which is supposed to stimulate bone healing. The first 4 or so days with one crutch I didn’t have any troubles at all – no sharp pain and no aches, but around the 5th day I started to get a slight ache in the same position as before. It wasn’t much at all, but it was there, and it was in the same position as the previous flare ups. Because the pain was minimal, it was suggested that I continue walking with 1 crutch, do a little less on the vibration plate, and to hold off on progressing any of the rehab exercises. It went like that for a few days with no change in the slight dull ache, but the doc was happy for me to start to walk unaided as planned.

A few days of doing a little bit of unaided walking each day there was still no change in that slight dull ache. It was only until the third day that the ache jumped up a level, and now it is at the stage where I have a dull ache almost constantly. I don’t have any sharp pains when walking or with any movement – there is just a constant ache in the front of my hip. I don’t know if this is just part of the healing process, or if it is actually aching because it isn’t ready to deal with full weight bearing. Thankfully, I will be heading down to Melbourne tomorrow to see the surgeon, so hopefully he can shed some light on the situation and advise how to progress from here. At this stage I am just hoping that it is all part of the process and it is not because of any growth or union problems in the front part of the hip. I am already behind with this right hip, so any extra time that I need to rest is time taken away from preparation to play volleyball again in May. 

An annoying setback

The last few weeks have not been the best period in my recovery. I had just progressed to using just one crutch and things were looking really good to be walking unaided well before Christmas. I was doing the rehab exercises and the hydrotherapy, and things were progressing well. I was getting up from laying on the couch when I felt a bit of pain in my right hip, just a bit of a sharp, catching pain. From then on I had a constant ache, and with some movements felt a sharp pain through the front of my hip. I felt this sharp catching pain in walking, and in certain movements of my right leg, but it was hard to identify exactly which movements brought it about. I was really annoyed at this stage because things were progressing well, and I was getting really excited about ditching the crutches. 

I rested for a day or two but the ache and the sharp pains lingered, so I feared that I had done something to the labral repair or to the capsule around the socket. The pain didn’t feel like the normal boney ache that I was used to, and the sharpness of the pain worried me. I had an x-ray that showed that the bone had probably not healed quite as fast as my left side, but there were definite signs of healing. I still wasn’t convinced that the pains I was getting were from the bone, but we decided to wait for the area to settle down and then reassess. I stopped all the rehab and started using two crutches again, but the ache lingered and the sharp pains I was getting in certain movements were dulled, but still there. From there I had a CT scan and an MRI – mostly to rule out infection and a few other things. I got the results from the CT first, and that didn’t show too much more than the X-ray – just that the bone was still healing and that it probably wasn’t quite ready for full weight bearing.

The MRI was different though. Firstly – it was agony laying on the MRI table. I was there for about 40 minutes and by the end of that the ache in my hip was really bad. I was relieved when I started moving out of the machine, but it turned out I was just getting injected with some sort of dye before being sent back in to complete the scan. Another 15 minutes or so laying flat and still, and by the end the pain was really bad. I left an outline of sweat on the table because of it! Luckily the pain subsided once I was out of the machine and free to move around again. The results did show that there was some boney stress around the joint – the specific patches were highlighted on the pictures from the dye that I was injected with. The pictures also showed a tear in one of the muscles in my hip – the obturator externus. How I managed to get a tear there I have no idea. I can’t think of any rehab exercises that would be able to create enough stress in that muscle to tear it, but somehow I managed it. I guess it could have happened when I was sitting up off the couch, but again – I wouldn’t have thought that movement would be enough to tear a muscle. I guess it goes to show just how fragile that whole area is!

Anyway – for now I just have to rest. The only thing that heals both the boney stress and the tear is time, so its back on the crutches, and a cut down on the rehab exercises. It is really frustrating – especially since I was so close to getting off the crutches and walking properly again, but as always, it could be worse. I am still hopeful that I will be crutch-free by christmas, but that will depend on how well it heals over this week and a bit. 

Almost 7 weeks!

It has been a busy few weeks in Canberra! I have spent most of my time at physio, in the pool, in the gym or at the volleyball courts, and I am loving being so busy! I have about 40 minutes of daily exercises in physio – mostly basic movements to get the muscles working again. I have 3 sessions in the pool a week where I am doing a lot of movement and range of motion work, plus a bit of loading through the right hip. So far in the gym I am just doing upper body exercises, but I hope to soon work towards getting some of the muscle back in my legs! I have even started doing some static setting reps on the volleyball court, and even though its a long way from playing, it is great to be touching the volleyball again.

My hips have been feeling pretty good through all of this as well. My right is still a bit sore generally, and I get tightness and pain through the front of my hip pretty regularly, but massage and some acupuncture helps. I have been building up the weight bearing over the last few weeks and I feel like I am close to ditching the crutches. I can now put 100% weight through my right leg in the step-on, step-off exercise with no pain, and when I walk I have tried to put as much weight through my right as possible with no dramas. Now I’m just waiting on the go-ahead from the doc and then I can hopefully ditch the crutches forever! Both hips crack and pop a fair bit, but it is rarely painful on the right and never is on the left. Most put it down to the psoas moving over a bit of bone, which is harmless – so as long as that’s what it is I’m happy! The scar on my left hasn’t changed too much really, but that is fine by me. My right side looks great apart from one little spot right at the bottom where I think there is some leftover stitch right at the bottom of the scar. It has sealed over, but I don’t think the skin is as strong at that point because of the stitch just below the skin. For now it’s okay but I’ve just gotta keep an eye on it. 

Right (almost 7 weeks):

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Left (17 weeks):

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I’m hoping that once I start walking unaided it will start to quickly feel normal again, and I will start to gain more strength and balance through the right hip. From there I guess it will be step by step progression through walking, running, jumping and then volleyball! It is still a long way away, but I see the loss of crutches as a big step towards getting back on the court and getting back to a mostly normal life. 

5 weeks + Canberra

It has been a busy and testing week for my hips. I have now relocated to Canberra to start the next part of the rehab process, and the packing, travelling and settling in has put a fair bit of strain on both my left and right legs. After a day of walking I felt fairly tight and sore through the front and back of both hips, but since it feels like a muscle pain/fatigue I’m not so worried. Hopefully the extra activity is helping to build up some strength in all the surrounding muscles!

I have started to put a bit of weight through my right leg, and it’s coping well. Even though it is only 50% weight, it feels fine and I think it will be ready to test with more weight fairly soon. The scar has healed pretty well, and is looking a bit thinner than my left, although I assume as I start to move more and more the skin will continue to stretch.

The plan from now is to start pool this week, start some daily exercises to get the surrounding muscles working, and start upper body exercises tomorrow. It’s really exciting and fun to be back at the AIS and moving towards firstly walking again, but then getting back into the athletes life.