As an avid long-distance runner and triathlete, Brad Clarkson is no stranger to aches and pains. But while training in fall 2016 for a local marathon, a prelude to an upcoming IRONMAN® competition, the Shorewood resident started experiencing something more serious: a stinging pain in his right hip that radiated down the side and back of his thigh.

“I’ve had bursitis before so I initially thought it was something similar to that, a severe inflammation of some kind,” said Brad, 32, a mechanical engineer. “But at times, it got so painful I couldn’t run at all, just walk or hobble along.”

When several months of weekly physical therapy did not resolve the problem, Brad had an MRI and saw orthopaedic surgeon and Medical College of Wisconsin faculty member Demetrios Douros, MD, at the Froedtert & MCW health network. The diagnosis was a femoroacetabular impingement, a mismatch in the bony structure of the ball and socket joint of the hip, which increases the potential for injury.

The diagnosis derailed Brad’s plans, but thanks to a successful surgery, he is now training for the IRONMAN Wisconsin competition in Madison in September. How Brad went from hobbling to training for a triathlon reflects the value of the Froedtert & MCW health network’s multidisciplinary team approach to health care.

Physical Therapy Follows Successful Surgery

In July 2017, Dr. Douros performed outpatient arthroscopic hip surgery to correct irregularities in the hip socket that prevented the femur from rotating without injuring cartilage. “The impingement damages cartilage and other soft tissues around the hip like the labrum, creating pain and loss of motion,” Dr. Douros said. “In Brad’s case, the damage included a torn labrum and cartilage damage.”

To eliminate the impingement, Dr. Douros reshaped Brad’s hip socket by shaving off bone and then repaired the torn labrum. He said it is typically a two- to three-hour surgery with about a 95 percent success rate.

Post-surgery effects were minimal. “I stopped taking pain medication by the second day,” Brad said. “The hip felt fine, as long as I had ice packs on it.” Brad also wore a brace for six weeks that restricted hip rotation and limited his hip to 30 degrees of flexion (lifting the thigh upward).

Dr. Douros said recovery time depends on patients’ lifestyles. Relatively sedentary people can expect about a four- to six-month timetable. Athletes like Brad might need six to nine months or more to ensure they are ready for more rigorous activities like training or triathlons.

One week after surgery, Brad started physical therapy with Griffin Ewald, MPT, at the Froedtert & MCW Sports Medicine Center, focusing on regaining range of motion and strength training.

“Brad’s case was unique because his big goal from day one was to regain strength and motion so he could do an IRONMAN,” Ewald said. “One of the advantages of our program is personalization. We structured his rehabilitation in such a way that he could reach his goal.”

Brad did more strength and core training than most people. About 13 weeks after surgery, he started working out on an anti-gravity treadmill. “Using this technology gave us a distinct advantage to help Brad reach his goals faster,” Ewald said. He started by bearing only 70 percent of his body weight, but three weeks later, he was running on a regular treadmill.

“There’s a mental component involved,” Ewald said. “Patients have to trust that they’re healed and are getting stronger and that the aches and pains they feel are part of the process, not a sign they’re heading backwards.”

Performance Enhancement Program

After 16 weeks of physical therapy, Brad transitioned to more specialized workouts offered through the Froedtert & MCW Performance Enhancement Program (PEP) at the Sports Medicine Center in Wauwatosa, where he worked with licensed athletic trainers Ryan Koeberl, MA, and Duane Mueller. “They’re always showing me something new and pushing my boundaries,” Brad said.

By April, Brad was in full triathlon training mode, each week running 25 miles, biking four hours and swimming 7,500 yards.

Brad enthusiastically vouches for the power of the Froedtert & MCW health network’s team approach. “Everyone talks to each other and works together,” he said.  “The whole team was great.”

“Dr. Douros is right down the hall, so it’s easy for us to talk, provide feedback, bounce ideas around and come up with a plan,” Ewald said.

“We offer a coordinated, hand-in-hand approach from pre-op evaluation to surgery to rehabilitation,” Dr. Douros said. “Our therapists work in concert with us, not only to let us know how patients are doing but also to fine-tune our protocols. Griffin is always looking for ways to optimize and streamline peoples’ recoveries, so we rely on each other to set optimal rehabilitation protocols. Surgery is the easy part. The hard part is all the hours of rehabilitation.”

Find an orthopaedic or sports medicine provider near you by visiting froedtert.com/ortho or calling 414-777-7700.

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