When Dr. Bryan Kelly explained Alex Rodriguez’s hip injury yesterday, the explanation took more than a half hour and could have gone much longer. I didn’t come close to transcribing everything the doctor said, and I still have a file of well over 3,000 words. It’s a lot to take in, and that’s simply scratching the surface.
Last night, I tried to explain the basics of the injury itself — what happened and what it means — but that left out a lot of what Dr. Kelly had to say. Here are two key points that he seemed to focus on: The pre-hab and the rehab.
What’s happening before the surgery
Obviously there’s a reason Rodriguez hasn’t had the surgery yet. Most of Dr. Kelly’s explanation for the wait matched everything we’ve heard before — need to strengthen the area, want to get the inflammation out, by strengthening now the rehab process will be quicker — but Dr. Kelly also brought up something I hadn’t considered.
The right hip seems fine, and the doctors want to keep it that way.
“Alex’s case is complicated by the fact he has a (right) hip that’s already undergone surgery which has been successful,” Dr. Kelly said. “During the post-operative period of time, immediately post-operatively, he’s going to have to really rely on his right hip because there’s a period of protected weight bearing that can last anywhere from 10 days to four weeks depending on how strong the muscle is going into it. Want to minimize the amount of time he has to spend relying on his right hip, because the last thing we want to do is compromise the thus far successfully repaired right hip because we prematurely operated on the left side. He’s got a lot of complicating factors that make timing an issue.”
What’s going to happen after the surgery
Dr. Kelly outlined several reasons this surgery is different from many others — most of them because of the unique nature of the hip muscle itself — but among those differences is this one: In theory, Dr. Kelly is actually going to make Rodriguez’s hip able to do things it couldn’t do originally. By reshaping the hip bone, doctors will actually add range of motion that didn’t exist when the bone was misshapen.
“When we improve that motion arc, we help the joint in terms of providing clearance, but there’s an accommodation phase that has to occur for the muscles to allow them to become reeducated to this new motion arc,” Dr. Kelly said. “Fortunately, muscles have a degree of compliance that allows them to stretch and be flexible, and it happens over time. … We’re literally trying to increase range of motion, so this requires a tremendous amount of muscle reeducation post-operative, that is very different from traditional rehab, and in that respect, the rehab component of this is really critical.”
Dr. Kelly outlined a rehab schedule that includes roughly six weeks of healing, followed by an “early strengthening phase.” It’s not until three months after surgery that Rodriguez can begin his true strengthening phase, and it’s only after he builds strength that he can begin to build endurance. After he builds endurance, Rodriguez can begin what Dr. Kelly calls, “the coordination phase… (which is) the functional return to the sport.”
Associated Press photos