- Jan 11, 2018
In April of last year I returned from a short (and not atypically grueling for me) backpacking trip to Dark Canyon with odd symptoms. I had right hip pain in the trochanteric region accompanied by severe quad pain medial to the iliotibial band to the point that I had to manually lift my right leg when getting into my car. I am no stranger to hip flexor tendinopathy, which I've had a low level for over a decade, but the quad pain was unusual. I tried stretching and foam rolling without much relief after a month.
My sports medicine doctor diagnosed me with GTPS (greater trochanteric pain syndrome), a common ailment in aging women [sigh]. A cortisone shot provided no relief, so I started the LEAP trial PT regimen, took occasional NSAIDs, and continued to hike. I was still able to hit the Tushars that summer, and in the fall hike into Scotty's Hollow from the Grand Canyon rim and Mt of the Sun in Zion.
But by late Dec my hip was very unstable. I was limping continuously, and I couldn't keep my normal pace on a winter holiday trip to the Supersitions. I could no longer bike, and the PT regimen was aggravating my symptoms. I continued to limp through local hikes, but I knew it wouldn't last. Had I not been distracted by a major house remodel and a major platform release at work, the injury would have taken a severe toll on my mental health.
In February I finally went back to my doctor and was insistent that there was something else going on. Despite my lack of typical symptoms, an x-ray confirmed that I had advanced osteoarthritis in my hip and I had been grinding down my femoral head for months. In 2007 I had a labrum repair in that same hip after an ultrarunning injury, so it wasn't completely unexpected that I had worn away the rest of the cartilage at a pre-AARP age.
I spent some time researching orthopedic surgeons and prosthetic material side effects. From someone who used to work on FDA regulated biologics, the lack of medical device regulation is appalling. I knew I wanted a direct anterior approach hip replacement, as the recovery time is much faster. The downside is that there are only a handful surgeons in the States that are experienced at the technique, and UT has a stupid law that you have to be licensed in the state to do virtual appointments for residents meaning potentially multiple out of state trips. Traveling to the EU for surgery, where the technique is more commonplace, was unlikely in the near-term with the pandemic.
I cancelled my surgery with the first surgeon due to his sociopathic scheduler, who bragged about her propensity to wait until the last minute to submit insurance preauthorization paperwork (a potential $40K+ out-of-pocket surprise). Luckily I was able to find a competent in-network surgeon at the University of UT, and with COVID-19, the surgery queue was relatively short. I distracted myself with work and home remodeling projects until my April 23rd surgery rolled around.
My friend, Cindy (also an excellent PT), kindly drove me up to Salt Lake for my surgery. We both laughed during my pre-op interview when the attending surgeon told me that "I should have a 6-week endurance goal of 0.5 miles". I was told to "walk as much as I want" after surgery, but no running, climbing, mountain biking, or canyoneering for 3 months; I could live with that. The surgery was uneventful (minus the administration of fentanyl against my consent), and that afternoon I was released.
Some Bishop, CA friends and I had planned a belated group birthday party in 2 months, and I was hoping to be able to do at least some short Sierra hikes. I refused to take opioids, so I was able to go back to work immediately and drive within a few days. I was pleasantly surprised at the immediate stability in my hip. I used a pole for the first week on loose inclines, but I didn't need crutches. Within the first 9 days after surgery I had logged a slow, but steady 11 miles. I am thankful to my friends and neighbors during this time (and pre-surgery) for patience with my slowness on our hikes and the various food care packages.
After doing my usual shorter, local hikes, I sought out long, flattish hikes (upper Hurricane Rim, Chinle Trail and Deer Trap Mt in Zion). For the first month, there was residual swelling and my quad would ache after longer hikes. As my friend who had a bilateral hip replacement put it, "What do you expect after someone hammered a huge titanium spike into your femur?" She has a point.
I was anxious to add in steeper hills and altitude, especially with the rapidly increasing temps and my June trip. I started with a few trips to the Pine Valley Mountains, at times turned around by snow banks in steep sections covering fallen logs. I wasn't yet ready to risk a fall and hip dislocation. At 5.5 weeks I met with my surgeon, who was shocked at my rapid recovery. He advised me to "not overdo it", but as long as it wasn't painful I could continue on my trajectory.
Finally the Pocket
At 6 weeks out, I decided that I was ready for the Tushars. I remember the comment from @WasatchWill on my prior Tushars trip report about how I had repeatedly skipped The Pocket, so this time I decided to loop it in even if it meant a lot of road walking. The Big John Flat gate was still locked, so at least I wouldn't be sharing the road with ATVs and 4x4s.
I started out from Skyline trailhead, taking my usual SE route toward Mt Holly. It was still early for most of the wildflowers, but I saw plenty of elk throughout the day. Given the extra elevation gain I would experience later in the day, I used the Lake Peak saddle to gain the Holly/Delano summit ridge instead of dropping down to the south toe of the ridge first. It was quite windy, but pleasant when the sun was not obscured by clouds, and it kept the gnats away.
After Holly I continued on to Delano Peak, thankful that the steep chossy section was free from snow and ice (although I had brought tent spikes for self-arresting). There was little snow on the summit plateau and the mountain goats were sparse today. Delano Peak was likewise deserted. I dropped down the South Fork basin, and encountered my first real snow. It was somewhat slow going, as I alternated between tiptoeing across suncups and postholing. I turned off at the 216 trail junction and was feeling the altitude on the steep climb to the Pocket. The views were beautiful, similar to the steep northern aspect of Mt Holly, but without the meadows. The forested trail down to Bullion Canyon was somewhat hard to follow. It was indistinct this early in the season, and was blocked in multiple places with snowbanks. I kept an eye out for cut logs and blazes.
At Bullion Pasture I cut up through the trees on what looked like an old mining road for a more direct line back to the dirt roads. The road walk back to the car took forever, with more climbing, mud, and postholing. It was nice not to have to dodge vehicles though. Finally, I made it back to the car.
As of today, 7 weeks out from surgery and with 2 weeks to go, I am feeling good about my recovery and upcoming Sierra trip. I'm hovering ~30 miles per week with on average 6800' of weekly gain. I guess my stubbornness in hiking up until my surgery date and ignoring the recommended recovery timeline paid off. I fully admit that this same obsessiveness has been the cause of prior repetitive stress injuries (as well as some major endurance achievements). This time I'll chalk it up to a win.