THR Weakness in thigh & buttock at 11 weeks^

[Spicychic]

Hi all,

I had my hip replacement (posterior approach) on March 26th this year after waiting and suffering for nearly 2 years with OA. I am now 11 weeks post op and struggle with weakness in my buttock and side of my thigh! I struggle to put full weight on my leg to get up the stairs... I am fine getting down stairs? I can only walk for maybe 20 minutes and I get severe muscle cramp in my operated thigh/buttock! In Scotland we don't get ANY physio after surgery just a routine follow up appt with someone in the surgeons team 10-12 weeks post op, where i was told 'don't worry it will settle down'.. I was just wondering if anyone else has this same issue? I'm starting to worry a bit as it's not getting much better?

Thanks in advance and sorry for the rant

 

[Pumpkin]

@Spicychic,
Welcome to BoneSmart, glad you joined us!
I am going to tag @Josephine our Forum Nurse and Director to address your concerns.

You are not quite 3 months out, still early in recovery, your hip needs more time to heal. Some of us heal faster, some slower, be sure not to compare yourself to anyone else.

Here is your copy of Hip Recovery Guidelines, the articles are short and will not take long to read.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for THRs​

6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

 

[Spicychic]

Hi Pumpkin,

Thanks so much for your reply.. any advice is appreciated I think maybe I'm expecting a bit too much too quickly but work is on the cards soon lol...

 

[Jaycey]

@Spicychic If you limped around for 2 years prior to your THR I am afraid it's going to take awhile to get your strength and muscle tone back. Lots of walking will help - you really don't need any PT.

 

[D|2ew]

I'm 5 weeks post-op on a right THR and had been limping around since I was 13 with AVN. I'm 28 now and have a lot of atrophy on the leg due to the long period of time I had the injury.

I still have a limp going on 6 weeks, but my physical therapist said it's solely due to the muscle weakness. My surgeon had me do self monitored PT 3x a day for the first 5 weeks then prescribed me outpatient PT for strength and gait improvement.

Contrary to most on this forum, I believe PT makes a huge difference, especially if you have a lot of atrophy. It's helped improve my range of motion and strength, and it relieves a lot of the soreness and pain I experience in the mornings.

Anyhow, the weakness you are experiencing is normal, but yours does seem to be prolonged

 

[Jaycey]

Contrary to most on this forum, I believe PT makes a huge difference

Let's just say for some PT makes a difference. If you have atrophy issues (or any other strength issues besides the hip) PT can help. But PT just for patients who have just had THR with no other issues can be counter-productive.

Anyhow, the weakness you're experiencing is normal, but yours seems prolonged due to absence of PT.

No it is not due to lack of PT. Having experienced atrophy due to a collapsed hip I can confirm walking and just getting back to daily activities is all that is needed.

 

[Josephine]

In Scotland we don't get ANY physio after surgery

Don't worry - that's done you a favour! I've worked with scores of hip surgeons over the years and not one of them ever ordered exercising as a hip replacement.

But I have some thoughts about your pain. So would you show me where your pain is using thus chart?
Note the smaller image for how do use it.

 

[Spicychic]

Hi Josephine,

I would say it is YR1B right up to WR1B & WR2B..

It's not so much pain but weakness that then cramps when the muscles are pushed (which doesn't take alot at the moment)..

Thanks so much for having a look at this for me and giving me your thoughts

Jen

 

[Ariel]

Could not agree more and it is a minority here that have such a negative attitude to PT. In England we receive PT routinely after surgery but not in Scotland, this is more to do with economics north of the border rather than sound medical practice. I owe a lot to my Physio Therapist as I do to my Surgeon, Anaesthetist, Nursing and others from the NHS that worked their magic to get me back on my feet.

 

[HertsHippy]

I agree with Ariel. My NHS physio was excellent. She told me which exercises were appropriate for me and made sure I was not over doing it. She monitored my progress, answered any questions I had and managed my expectations of recovery. From reading other threads it seems that PT in the US is sometimes quite different from my UK experience.

 

[Mojo333]

Let's just say for some PT makes a difference. If you have atrophy issues (or any other strength issues besides the hip) PT can help. But PT just for patients who have just had THR with no other issues can be counter-productive.

I totally agree with this.
I dropped PT as it was too much too soon and the walking, stretches and light exercises I deemed to be helpful were common sense and I didn't need a physical therapist to do them. I also didn't feel obligated to do a certain amount.
I suffered for over two years with debilitating endstage OA, had bilateral hip replacement and am back to an extremely physical job, and an active happy life.
Hope Things ease soon, Jen.
Month four was my biggest turnabout!

 

[Josephine]

So your pain is here?

This could be one of two things

1. ITB (ilio-tibial band) issues and maybe Trochanteric bursitis
2. or Piriformis syndrome​

Personally I'd pitch for 1, as 2 is a bit too far out. On the other hand, you just might have both!

In England we receive PT routinely after surgery

@Ariel and @HertsHippy I'm surprised to read that because throughout my career, no hip surgeon I worked with (and there were many!) ever required exercises after a hip replacement, just activity - walking, doing stairs for normal activities and walking. But that was a while ago so perhaps things have changed!