PT (Physio) - The great debate

[Dingbat7]

Physio - don't worry about it. Hips have a neat way of sorting themselves out in the end and really, walking is the best form of physio anyway.

Sorry but I think giving this advice without knowing the full medical history is not helpful and could cause someone more problems , physio has helped me a lot I would advise people to take the advice of their surgeon and if they have PT needs consult the EXPERTS.

To many it not only the hips that will cause problems it's the muscle wastage around them , without physio or a plan to get the muscles working again you may not fully get the benefits of a new hip as I have found out.

My surgeon told me I would need PT due to muscle wastage in my calves and due to shortening muscles in my back and groin since having physio and hydropherapy and also being given a list of exercises to do at my own gym I am walking much better.

Sorry and no disrespect to those that HAVE worked in the medical arena but more and more I am reading posts that are advising those on here to take a course of action with regards their medical treatment or medication , the ONLY people that should be giving this advice are current medical practioners who are aware of that persons FULL medical history ie their own Surgeon or GP and yes the hospital Physio

 

[Poppet]

Re: Hello everyone, new THR here!

Sorry but I think giving this advice without knowing the full medical history is not helpful and could cause someone more problems , physio has helped me a lot I would advise people to take the advice of their surgeon and if they have PT needs consult the EXPERTS.

To many it not only the hips that will cause problems it's the muscle wastage around them , without physio or a plan to get the muscles working again you may not fully get the benefits of a new hip as I have found out.

My surgeon told me I would need PT due to muscle wastage in my calves and due to shortening muscles in my back and groin since having physio and hydropherapy and also being given a list of exercises to do at my own gym I am walking much better.

Sorry and no disrespect to those that HAVE worked in the medical arena but more and more I am reading posts that are advising those on here to take a course of action with regards their medical treatment or medication , the ONLY people that should be giving this advice are current medical practioners who are aware of that persons FULL medical history ie their own Surgeon or GP and yes the hospital Physio

Hi Dingbat7

I am thrilled for you that your varied exercise regime is working so well for you, that is wonderful, and certainly everyone must be guided by the expertise of their own medical team. I don't believe it is ever Jo's or any of the staff's intention to try to interfere with the personal advice being given to each of us.

I have tagged you @Dingbat7: and Jo @Josephine: to give her the opportunity to speak for herself.

Once again, I am very pleased for you that you are doing so well and from reading your thread you are well on your recovery path and it is good that you are repairing muscle tone and wastage, that is wonderful.

 

[Dingbat7]

Re: Hello everyone, new THR here!

Sorry but getting a bit fed up when Physio is being dissed ( even if the forum "experts" do post a disclaimer) and people being advised to not have any , if it wasn't for the physio I have received in the past I would be in a worse state than I am today.

I don't want to turn the post into a spat and appreciate the general advice I have received but some people may treat the advice they are receiving on here specific to them as read and may NOT seek the advice of their own medical team.

My suggestion is that if an expert makes such comments they should add " however I suggest you speak to your surgeon or consultant who will be in a better postion to advise " likewise if they start suggesting pain relief medication.

 

[Poppet]

Re: Hello everyone, new THR here!

Hi again, I understand what you are saying and I do understand. I note that Jaycey is online so will tag her. @Jaycey: @Dingbat7:

I am sorry Poppy to high jack your thread. I do believe that all discussion is good discussion and very valuable

 

[Jaycey]

Re: Hello everyone, new THR here!

Hi Dingbat, hope you are having a good Saturday.

I am in agreement 100% about the need for physio. I too had other issues that did impact my THR recovery and without PT I would still be in a state.

I don't think PT is getting a bad name here. Nor is it recommended by anyone that you don't have PT. It's just not normally prescribed here in the UK unless there are other issues.

And yes, you should always discuss your particular issues with your OS, GP or PT.

 

[Dingbat7]

Re: Hello everyone, new THR here!

Nor is it recommended by anyone that you don't have PT.

???I beg to differ on that see above, hence my post


Disagree on the not being prescribed I know four friends who have had knee and back surgery on the NHS and have all had physio prescribed , even if it was just only an exercise sheet to follow .

Obviously going private meant that I was given it as covered by my health insurance provider.

I think we are hijacking a thread and don't wish to comment any more , my main point is I don't think people should be advised on here not to have physio and rely just on walking , some may have associated conditions that need Physio that they may not even realise until they see a PT.

 

[Poppyfields]

Re: Hello everyone, new THR here!

I don't mind it being hijacked as interesting discussion!

I am totally in favour of physio....... the physio in hospital was fantastic as was occupational therapy in getting 'aids' sorted for me to have at home. I moved on to four sessions of group physio.... again fantastic..... I also have a private physio and she has added to those given to me by hospital..... do them without fail as I have PMR ( polymyalgia rheumatica) and my muscles affected...... so my physio and I were working prior to surgery on strengthening my affected hip in particular....... if it was not for all the exercises I would not be up and about and walking well now....... long live physio and to each his own....... what works for one does not always work for another.......:wink1:

 

[Anniepops]

Re: Hello everyone, new THR here!

Poppy, I'm sorry Dingbat has chosen your thread to point out his concerns about Bonesmart. This thread is about you, your journey not about anyone elses issues. Perhaps a mod can move the related posts to a new thread so the matter can be discussed seperately.

Dingbat I would just like to say about your quote 'I know four friends who have had Knee and back surgery on the NHS and have all had physio presecribed', you are talking about knee and back surgery here, not hip surgery. Post op in hospital(NHS) I asked why the knee patient next to me was given PT advice and appts for further PT. I was informed that after a knee replacement the key to a good recovery is to keep the knee moving and doing constant PT to make for good healing and progress. In a hip patient, the key is to rest and let it heal with only gentle exercise through walking at a slow pace then building up as we get stronger.

I can totally understand where Jo is coming from on this issue as I was not recommended any PT (I didn't even get a 'sheet of exercises' when I left hospital, nothing,nada,nowt)and had to pretty much insist on it at my 8 week check up. I have been doing some home PT on the suggestions of some very informed forum members but will never know if I would have been any further forward if I had only stuck to walking.

I agree some patients do need PT and some hospitals prescribe it as routine, it depends where you live, or your surgeon or whether you are NHS or private

All I know is every professional who I dealt with during this process has to,d me that PT is not usually prescribed for hip patients as walking is the best form of exercise we can take.

Anyway, hopefully a new thread will be made so you and others can discuss this further

Ann

 

[Dingbat7]

Re: Hello everyone, new THR here!

As Poppy doesn't mind me hijacking it , re your point Anniepops there were two other in my hospital having THR's all had physio,

I have attended numerous physio and hydro sessions since and at each one there were patients who had THR having physio.

Like me Poppyfields seems to have benefited from Physio

If it is not required having spoken to ones consultant/surgeon fine but I don't think people should be advised against having some if the person advisng doesn't know their medical history as I have said the physio may not be required for the hip itself but for muscle wastage or other issues, my hip is fine it's my muscles that need stretching and building up in order to walk straight otherwise have wasted my time getting it done.

 

[Josephine]

Everyone is entitled to their opinion but the majority of those opinions are only based upon personal experience and in most cases, of one episode of surgery. A story of one can only offer experience as it pertained to them.

I, on the other hand, have had a lifetime of working in this area, I keep up to date by reading prodigiously, attending conferences and discussing issues with other professionals. broken link removed: https://www.nmc-uk.org/SearchRegisterResults?pid=0 and I still work. My input in this forum is overseen by the broken link removed: https://www.farmortho.org/bod.php of FARM and I can assure you that thus far, there have been no adverse comments from them.

Of course there are occasions where a patient needs physio for reasons other than THR recovery but in general, hip replacements really don't need aggressive physio other than that described in this thread Some suggestions for home physio (PT) and activity progress which you will note is entitled some suggestions for home physio. If, at the end of the basic recovery phase, a person wants to progress into retraining for an athletic activity, that's quite different and not something that comes within the remit of this forum.

 

[C Mac]

Maybe what we are talking about here boils down to whether physical therapy for THR is "medically necessary" as that is what is often the issue here in the U.S.

My OS doesn't routinely prescribe PT for THR patients. He was happy to prescribe it for me when I requested it. To me it seemed like too big of a leap to go from having had THR, resting at home & doing some tiny exercises, to a return to my own gym and exercise routine... I needed a hand to hold to both physically and mentally to transition back to my own routine.

After a dozen or so PT sessions my therapist told me that my insurance would not authorize more because it was not "medically necessary" I could return to the gym without being a hazard to my self.

Do I still have muscles that are weak?
Do I still limp?
Do I still have dysfunction in my gait and stride?

These are items that can now be addressed through a personal trainer at my own expense vs. PT at the expense of my health insurance. Maybe it's a murky line but there is a line there somewhere for each of us.

Enjoy your new hip,
Cardie

 

[Dingbat7]

Everyone is entitled to their opinion but the majority of those opinions are only based upon personal experience and in most cases, of one episode of surgery. A story of one can only offer experience as it pertained to them.

I, on the other hand, have had a lifetime of working in this area, I keep up to date by reading prodigiously, attending conferences and discussing issues with other professionals. broken link removed: https://www.nmc-uk.org/SearchRegisterResults?pid=0 and I still work. My input in this forum is overseen by the broken link removed: https://www.farmortho.org/bod.php of FARM and I can assure you that thus far, there have been no adverse comments from them.

Your qualifications and what you read are not in dispute , however in your "expert" capacity advising people not to have physio based on their forum posts , without knowing their medical history isn't in my opinion helpful nor is advising them on pain medication , they need to consult their own medical professionals who know their FULL medical history and if physio would benefit them or not.

You wouldn't get a consultant or a pharmacist coming on the forum and giving specific advice to an individual re treatment or medication, it is obvious that some on here are in a bad place and may follow some of the advice given in good faith without consulting their own doctors/pharmacist with adverse results.

I have mentioned in my posts what medication I take but am not suggesting it is suitable for someone else

In my case I have had various episodes of surgery and treatment over the years and trust my care to "practicing" medical professionals who are in possession of all my notes,scans and history and who know what medication I am unable to take , more than happy to use the forum for the other stuff.

I am not trying to be disrespectful but feel that some of the advice should be given to the posters by their own medical professionals and not by the forum "experts" who are not in posssession of all the medical history and can only give a general opinion which may not be suitable for them

 

[Jaycey]

Dingbat, no one here is telling you what to do or how to do it. As my signature indicates nothing on this forum replaces a talk with your health care providers.

However there are many members who either are not given pre or post op information or who want confirmation on the way forward. All the mods and admin staff have been through this process - some more than once.

Just as you are taking a position on PT - we take a position on what worked for us as well. Anyone is free to take that advice or experience and chose use it as they see fit.

BTW - as I posted earlier no one has "advised" against PT on this forum.

 

[Dingbat7]

BTW - as I posted earlier no one has "advised" against PT on this forum.

I think you will find a certain moderator advises against it or poo poo's it it at every opportunity without knowing if it would benefit the person or not , hence my post.

Physio - don't worry about it. Hips have a neat way of sorting themselves out in the end and really, walking is the best form of physio anyway.

And as to the disclaimer people in a bad place don't read the small print they grab at what the forum "experts" tell them even if could be the wrong advice hence it needs to be reinforced that they need to see their own GP's/Surgeons especially if asking advice re medication or specific treatment.

 

[Jaycey]

Thanks Dingbat7! As I indicated no one has recommended you should not have PT.

 

[Dingbat7]

And as I indicated yes they have

Time to go out in the real world , have a good evening :wink1:

 

[Jaycey]

Hey - we all have an opinion.

You have a great evening as well Dingbat7!

 

[Thedogtales]

This may be a matter of semantics.

Although no one has officially advised against PT or recommended anyone to not have PT, I sense that Dingbat is concerned that some people on this forum who would really benefit from PT (wasted muscles, etc.) may not pursue it if they read not to worry about PT.

Everyone really needs to do as much research as possible here and elsewhere and most importantly, consult their doctor in order to make their own personal decision.

Sally

 

[stan794]

I was not told to do any either when I left hospital, but just been for my check up this week and I have been referred to the physio as they told me I have some muscle wastage due to limping etc pre op. I agree it's important to research and get advice from surgeon, GP etc so I'm happy to start some pt if it helps me get back to work, all this sitting about drives me nuts lol.

 

[Jamie]

I'm entering this discussion a bit late, but I would like to say I believe BoneSmart does support therapy when needed.

It is true there are differences in routine treatment among the USA, Great Britain, Canada, Australia and other countries. You'll see those differences reflected in various comments. But in all countries, there are people who need assistance getting their muscles and ligaments back into condition and who receive assistance from therapists.

When people come to BoneSmart to ask questions it is usually because they are not able to talk with their medical team at that time and they want information. For us to just give them the response that they should talk to their doctors would do our members a great disservice. I give our members the utmost credit for knowing that our advice is a suggestion and is never meant to take the place of a discussion with their doctors.

Among the moderators and members, we have a lot of collective experience available for people. Usually they will get a variety of suggestions in regard to a question and they are free to take it or leave it, give it a try or not. We have never, ever had a member suffer setbacks or problems from taking the advice given here. Quite the opposite....we get a HUGE amount of feedback with thanks for the detailed information and guidance found on BoneSmart!

The fact that we do support the idea of therapy when needed or desired is evidenced by the articles we have purposely posted in the BoneSmart Library. We have a couple of members from the therapy community that we encourage to post to our members and they are even tagged at times for their input.

I think it is not a good idea to take quotes out of the context of the thread in which they are posted. In a number of cases people are fearful and worried that their new joint will "freeze up" or otherwise have problems if they are not signed up immediately for therapy sessions. This is not true and comments like the one quoted at the beginning of this thread are meant to ease their minds and to let them know they have time to let things settle out with their new hip or knee.

I am posting my opinion on this matter not to be argumentive, but to put some ideas out there that have not been presented. As others have said, having or not having therapy is an individual matter. There is no "one size fits all" solution. People are entitled to their opinions on the matter and it is the diversity of those opinions that continue to enrich BoneSmart and make it an important tool for people seeking reliable information from a single source.