Emily's Story: hip replacement and new to exercise

I met Emily in April 2016. Emily was in her early 30’s, working in Pharmaceuticals, a very elegant women but clear from our first meeting she was scared and apprehensive about training and exhausted from living in pain. Emily was recommended to me by a physio friend of mine Laura Fidler, who’d advised her to continue to develop her strength outside of her physio sessions.

Emily had hip dysplasia in both hips and had an extremely long history of hip pain, steroid injections and flare ups resulting in her becoming very deconditioned over the years. She suffered for years with pain and limitations in movement. It got to the point she was struggling to walk more than 10 mins, working a desk job was causing her a lot of pain and she generally had a low quality of life due to pain and loss of function. In July 2015 she had periacetabular osteotomy surgery in her left hip under the care of Marcus Bankes and was then referred to Laura for physio.

Emily’s surgery went well and she gained a lot of strength working with Laura but she hit a plateau at the beginning of 2016 and had a flare up when going back to work after some time off, she lost her confidence, hence needing some extra help from me.

When Emily started with me in April 2016 she had a huge goal of her wedding and honeymoon coming up in August 2016. The honeymoon was in South Africa and Emily’s very active husband to be wanted them to be able to do many hikes together. Understandably Emily was very fearful that she wouldn’t be able to keep up and that it was too much for her.

From our first session I could see Emily was very sympathetically driven, her nervous system was in overdrive from years of pain and fear of moving so I had to begin with making her feel safe both with me and in her own body.

We started with a lot of work on the ground to help her feel safe - breath work, basic core work, pelvic floor exercises, Pilates and stability work. We worked on gradually increasing the range of motion and feeling in Emily’s hip joints to then in turn to relieve her of the referring pain elsewhere in the body.

Emily had been made to feel very fragile and easily ‘breakable’ so we gradually built her confidence in what she was actually capable of. The key was that Emily really wanted to get stronger so with time she trusted that I was going to help her and not just ‘beast’ her.

We continued with a lot of core, glutes and hamstring work to balance out her pelvic and rib cage alignment. Emily’s body was overusing her hip flexors and adductors in an effort to try to stabilise her pelvis causing them to feel tight and her pelvis to be in an anterior tilt.

Emily struggled with proprioception (awareness of where your body is in space) to begin with which I find is very common when you’ve been living in pain and also if you have no experience of movement and sport so she needed subtle cues and reinforcement of her form to help her feel her body.

We then went on to cover all the basic movement patterns, most of them Emily had never been able to do before. We had to really work to limit the intensity and volume of the sessions for a long time as Emily built resilience so as not to affect her work as her body would often feel exhausted and wiped out the day following training.

As Emily started to see a change in her body and feel the things she never thought she could do, she started to enjoy it and feel great. As Emily’s strength increased we added some specific strength work to help with her upcoming hikes. We did a lot of single leg training, balance and core strength work.

A big milestone was going on her honeymoon and completing hikes she had never dreamed of being able to do which then gave her encouragement to get even stronger for her next holiday and the adventures they had planned.

Emily worked with me twice a week until she moved out of London to Kent at the end of 2018. Emily has now made movement a regular part of her routine and is improving in her strength and movement every week.