THR One year anniversary THR

Sohowarrior

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Apr 7, 2022
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149
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69
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Hi all, new to the site. I’m 67, female, very active: spin, Pilates for over 30 years, barre class and golf. Had right THR on Tuesday 4/5 and was home the next morning, sailed through PT clearance. No issues with walker at all, using cane as of yesterday in apartment (but walker also), can walk unassisted. No swelling except in hip. Just taking Tylenol and Celebrex for pain, some totally manageable butt soreness and stiffness. I am finding the exercises easy. I know I have a way to go and I know to take it easy and be patient, but I’m feeling grateful and fortunate so far.
 
Welcome to the happy side, your recovery is off to a great start!
 
:welome: to BoneSmart @Sohowarrior and congratulations on your new hip that will be your ticket back to your active life.:happydance:
Slow and steady is definitely the way to go.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines can help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
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

5. At week 4 and after you should follow this

6. Access to these pages on the website


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.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
@Sohowarrior :wave: welcome to the healing side, sounds like you're off to a good start.
 
This gives me such hope for my own recovery. I hope everything continues to be smooth sailing for you.
 
Had a solid sleep last night on non operated side instead of my back. Prior to surgery, I bought a small pillow on Amazon with curved indentations for my knees, and I highly recommend it. Was very comfortable and stayed in place. I can sleep on my back for short periods but this is so much better.
I’m shocked at how good I am feeling. The right ankle and knee pain I had is gone. My right foot had started to turn out while walking pre surgery and that’s gone as well. Still have thigh swelling and bruising but minimal soreness at incision and hip. Going to increase my outdoor walk today and some stairs with the cane and maybe try without for a few steps. Even had a glass of wine last night since I’m not taking narcotics. Wishing everyone well.
 
I absolutely hear you. The last thing I want is to overdo it. But being as active as I am for so many years, I’m very much in sync with my body and the second I feel I need to pull back, I will. When I say a longer walk today I’m talking about less than an additional block! It’s a beautiful but chilly day in NYC and I need some air, accompanied by my walker and husband.
 
How wonderful that you're feeling great and ready to go :dancy: No more hip pain, hooray!

Please be aware that often you won't feel the need to pull back on activity but will feel the results later in the day or the next day. Then you're set back for a while with pain and/or swelling.
You absolutely do not want a membership in the OverDidIt Club :groan: even though it's free and and easy join.
 
Hello and Welcome to the healing side! :SUNsmile:
I do agree with, subie, above that you often don’t feel the effects of overdoing it until the next day, but it seems you’re taking a measured approach, so that’s good! I hope your suggestion of the small pillow you described works for others, I found it never stayed in place. If anyone deals with the same, an inexpensive Body Pillow works great also. I can’t sleep without mine. It sounds like you’re off to a great start. Life is so much better without the pain of a deteriorating hip.
Have a great Sunday in that NYC sunshine!
@Sohowarrior
 
Tomorrow marks two weeks out from surgery for me and my short time in recovery so far has hugely exceeded my expectations. I’m doing all the exercises prescribed by my surgeon two or three times a day (as prescribed) and I begin outpatient PT on Wednesday. But as someone who has worked out in some form or another on almost a daily basis for over thirty years, and still very much keeping in mind the admonition to not overdo things, the forced inactivity is driving me completely insane. My follow up x ray and surgeon consult is not until May 13. My at home PT said there is no reason I cannot do some upper body work with light weights and resistance bands while seated in a chair, so I’m going to try that remotely with my trainer on Thursday, observing all precautions like no bending, twisting etc.
Does anyone have any other ideas for some safe things I can do physically at home while I count down the days to May 13? Any links I can look at? I would clear anything new with my surgeon, of course. But I am especially thinking about some gentle stretching to begin working on ROM.
Last question: I don’t know why, but HSS no longer includes standing adduction leg lefts in the protocol for posterior approach hip replacement. I’m not doing them once I was told about this by the at home PT, but they felt good to me, and I was by no means going anywhere out of my safety zone. Curious if anyone can shed some light on this.
 
Hi!
Good that you're feeling so great, but feeling great doesn't mean that all that surgical trauma is healed. It's easy for those of us who have smooth recoveries to let our brains or (dare I say this? Yes, I will...our egos) get ahead of what's going on inside our leg/pelvis. Your new hip and the accompanying injured tissues are only two weeks old. That's not enough time to have finished the four stages of healing .
Instead of ramping up exercises right now, maybe you can look for other things to do to keep you occupied and moving. When I was having my But-I-Wanna! meltdowns, doing little household tasks like organizing the utensil drawers in the kitchen helped. Having the countertops as support, I could incorporate some pt into it, like alternating standing on one leg for 10-30 seconds. Using a grabber, I could straighten up under the sinks and such. Getting outside for little walks was good too. I took an aid with me, just in case. Up and down the driveway is almost a quarter mile. It wasn't much, but it helped with the boredom and mollified the ants in my pants haha.
That's interesting about the adductions. My early pt did not include them, except for the therapist very gently moving my leg for me as I was supine on a table. She only went for about 6 inches or so, if that.
Keep in mind that you have years ahead to get back to your former activities, and that no one gets an award plaque for how quickly we resume. Why risk a set back from overdoing now, when waiting it out for a few more weeks won't hurt anything?
Build up that Patience Muscle! Don't let it atrophy, or it'll come back to bite!
Best wishes...
 
That is such great news! so so happy for you. Such an exciting way to start your recovery! Can't wait to see how your progress. Make sure you don't overdo it because you're feeling good now! make sure you give this little beauty time to heal.
 
It sounds like you are progressing well, but do be cautious about trying to over-extend yourself. You will get back to your usual activities in good order, but you have a lot of hardware that needs to settle in and trauma to heal. Did they cement your prosthesis or are they letting it grow in? That may be why they have removed the adduction leg lifts. Time to sit back and read a book with lots of action in it - live vicariously for a bit until you can safely resume your normal schedule!
 
If I’m reading the operative notes correctly, looks like it is cemented. I know I sound like I am ready to be off leash but I’m the first to admit that I know I’m not healed after two weeks. And I am certainly not letting PT push me into an injury or other bad situation. I generally move at the speed of light but I’ll just consider this enforced slow down a huge mental challenge to embrace. Thank god for Netflix!
 
Ah yes, Netflix saved many through the pandemic ... and replacement recoveries!
 
@Sohowarrior - you asked about leg lifts on another thread but thought it might be better to answer here. Leg lifts are something many PTs seem to think are required therapy after a hip replacement. My physical therapist didn't believe in them - he felt they were too stressful to all of the muscles and tendons that have already been aggravated. They did cause significant pain for me. I couldn't even lift the leg off the ground but the hospital was trying to have me use a strap to assist the day of surgery!

As you look at any activity, don't just look how it feels at the time. Consider how it feels that night and the next day and the day after that. Most of the time, the pain or discomfort comes later or is worse later. You should take inventory and make sure your PT knows any pains etc before you start the next session. If they are worth anything, they won't view it as complaining but as constructive feedback that helps them optimize your treatment/recovery.
 
Since I see so many different points of view on PT on this site, I thought I’d chime in with my first outpatient experience today, which felt very safe.I had done a lot of paperwork in advance and I forwarded all my hospital notes and records so therapist had a lot of background. He spent some time massaging the area immediately around the incision in order to start to break up scar tissue and help reduce the swelling. Took some measurements to assess ROM. Most of the tenderness has subsided so this was pain free. He gave me three exercises to incorporate at home as I was able to do these at the session without pain or difficulty: 1) clamshells lifting right leg as part of bed exercises, pillow between legs. 2) right leg posterior leg lift, pillow between legs. 3) shoulder bridge with yoga block between legs, Theraband tied above knees. Part one to lift glutes, part two is press outward twice against the band then articulate the spine down. For all of these, 10 or 12 reps once a day, a second round later if I am up to it. Plus two very gentle stretches: first is addiction of right leg while lying on the bed, the second is to let the leg dangle off the bed to stretch the quad (I am definitely tight in here). And of course to stop any of these if painful. I walked home (about 15 minutes), now icing, elevating and hydrating, took Tylenol when I came in. I know it sounds like it was a lot for a session this early in recovery, and a bit aggressive, but I’ve done these exercises for years, they are all done in Pilates mat class, the goal here being to strengthen the glute muscles that were stretched and loosened during surgery. The rest of today and tonight is rest and ice and relaxation, though.
Both surgeon’s office and PT encouraged me to do some seated upper body and back work with light weights and resistance bands just making sure to follow all hip precautions. Not going to do that every day of course, just a few times a week, around 30 minutes.
Last and unrelated: I did not go for a second COVID booster pre surgery but as COVID cases are unfortunately rising here in NYC and with surgeon clearance I did get boosted today, surgeon saw no reason to wait.
Hope everyone is doing well.
 
Hello @Sohowarrior
Thanks for sharing an update. It’s pretty early for PT at only two weeks post op, but thankfully you were cautioned to stop if anything hurts. I will share some info that you can take, or leave, but hopefully you’ll read it. I do wish you the best and hope your PT works well for you without any set-backs.

BIG TIP: (From the BoneSmart Recovery Guidelines) 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.

http://bonesmart.org/forum/threads/bonesmart-philosophy-for-post-op-therapy.37103/

Have a great rest of the week!
 
I have the utmost respect for your point of view. Nonetheless, it’s not shared by my surgeon nor, I believe, by most of the other THR specialists at HSS, consistently acknowledged as one of the elite orthopedic hospitals in the world. My PT began at home two days after I was discharged from the hospital, with three visits the following week. That is consistent with HSS practice. For me, I found it gentle and safe. The immediate objective was to get me up and moving with some simple early strengthening exercises. There was absolutely no pushing me beyond my comfort zone. Similarly, my surgeon encouraged early outpatient PT and gave me a prescription for it. This approach, and the therapy I had today, is likely not for everyone. Clearly, we are all at very different levels and will all heal differently and at different speeds. And I’m not out to set some sort of recovery record, or do something reckless to jeopardize my healing. Is there necessarily an absolute right or wrong approach here or might it depend in part upon the surgeon’s assessment, how the surgery itself concluded, and his or her recommendation together with that of a qualified PT with THR experience? I don’t mean to be combative, everyone’s journey will be different, but I firmly believe PT will be of use to me in recovery in addition to walking. I plan on continuing on that path and will continue posting in that vein. Looking forward to some community support although I do feel like a bit of an outlier!
 

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