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Originally Posted by Jean-Paul
He is in his mid forties...
I agree that he let it heal improperly, but I do think that a trainer has an obligation to do what is in the best interest of the client, and clients can't always be accountable for proper program design if they trust a supposed expert. That trainer's ego is just huge, and he pushed a guy who doesn't know how to listen to his own body all the way to his breaking point (literally).
I do think that he is probably bone to bone. The problem I foresee then is when he is recovering from surgery. I am probably not going to even touch him till he's done with PT (even though he wants to start right back up). But when he does return, the problems his hip has will only come back because his muscles that control flexion, extension and rotation are so tight that he jump into that fire from the frying pan.
I'll try to get some more information today.
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So, pretty young for THA ... I agree with Russ that the criteria are pretty rigid ... especially for the "very young"!
I do agree that his muscular/soft tissue limitations will be worse after surgery, especially because he will be limited in what movements he can do. Around here (Greater Hartford, CT) surgeons vary what they say with respect to hip precautions ... some say to abide by them for 6 weeks, some 3 months, some 6 months ... and some for life. Not only does it vary from surgeon to surgeon, but also patient to patient from the same surgeon. Although I will say that I see more "6 weeks" now than in past years.
What this means is that although there will be certain positions after surgery that he will not be "allowed" to do (flex hip beyond 90 degrees, adduct beyond midline, and internal rotation of any kind), he will benefit greatly from any soft tissue work that you can do prior to surgery.
Having watched several surgeries though, the surgeons put the patient through a pretty rigorous range of motion test ... so the good news will be that the joint and muscles are capable of greater ROM than he will likely have unsedated. The key will be retraining his muscles to restore proper mobility and reduce excess tension.
I also agree with your statement about the other trainer at least being partially responsible as he is a "professional" dispensing advice ... the consumer has no real way to know that the advice he is receiving is incorrect or in this case harmful. Too bad there is no state board you could report him to ...
Keep us posted on how he's doing ...