THR 6 weeks post op progress

Normhel

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Hi,

I've been lurking in the background since finding the forum a few days ago, all I can say is I wished I'd found it sooner!

I had a RTHR on 19 July 2017 so am just past the 6 week mark. I've been doing regular PT sessions and am making good progress. I just find it frustrating that I still need a crutch to get around on.

I haven't had any pain meds since about the 2 week mark and once I managed to get a full nights sleep at about 3 weeks (I started sleeping on my non operated side). My surgeon takes a progressive approach to recovery in as much as the usual 90 degrees rule, crossing legs etc don't count. I was told to just do what I feel I was comfortable with.

I guess the reason I am posting is because I've read some info on here from admin re PT and I'm a little confused! Should we be doing any physio? Should we only be doing what feels comfortable?

I'm due to have my post op follow up next week and wondered if I'm wasting my time doing PT or does it help strengthen my pelvis and rid me of the wobble I have when I walk? Just for info, I'm walking about 2-3 miles a day.

Thanks in advance for you replies :)
 
@Normhel Welcome to BoneSmart!

Yes it is confusing all this talk of PT. Frankly I never found any of the prescribed PT of any benefit. It only created more discomfort for me. Walking is all hips really need. And just getting back to normal activity levels was my goal.

The BoneSmart approach to PT is don't. Just go about your normal routine. Increase your activity level slowly. If it hurts, don't do it.

If it were me I would stop all the long walks and focus on gaining strength for short walks so that you can get rid of that crutch. 2-3 miles at 6 weeks out is pretty aggressive.

Here is some reading for you.

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!)
don't overwork.

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:

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.
 
Thanks Jaycey,

Just out of interest, how much walking would you recommend?

The 2-3 miles isn't too difficult but it does tire me out!
 
@Normhel I'm just a week ahead of you. I think you are amazing walking so much. Do you take breaks or is it all at one time? Perhaps you've traded being without walking assistance for walking more. I'm no expert, but trying to walk with no assistance little by little even around the house is where I started and I was able to progress within a week. I do find I have to be very careful to keep my posture straight. Hope that helps.

My doctor said no PT for the first 6 weeks just like the others here. I overdid my desire of "getting back to normal" and it caused a step back so in my case I found slower really is better. Pat yourself on the back for being open to finding answers and taking such good care of yourself. You'll get there!

Best wishes
 
Hi Staystrong,

I don't use any support when getting around the house. I can get up and downstairs easily enough. I've also returned to doing all the cooking, washing, ironing and shopping.

I try to remember the heel toe method when walking which does help but always take my crutch when I go outside. I can get around pretty quickly to start with but then the tiredness catches me.

I go on holiday in 3 weeks on a 4.5 hour flight and it would be nice to not have to rely on my crutch.

How pronounced is your wobble when you walk? I know we're all different but I'm finding the forum really helpful.
 
Hi @Normhel
Yes I'm so much happier now that I found this forum.
If I stand up really straight, shoulders back and all, I have no wobble or limp - just a nice smooth walk but after limping before the surgery it takes conscious intention to maintain this posture. When I knew I was due to be out for a long time I was taking my hiking pole with me even at 5 weeks. A modern hiking pole is much easier to work with, can collapse, and was recommended by my doctor and pre-op physical therapist. I found mine on Amazon. That said - if you have any walking assistance device with you the airline allows you the pre-boarding status. This can help you conserve your energy for the rest of the travel, so don't feel bad about using it.

It sounds like you're doing wonderfully and maybe just finding out that sweet spot of walking just to the point of exercise but before fatigue is all you need. What I found and have read since all suggests the need to take it slow and steady... the old tortoise and the hare idea. I must say, I found this site after I had already done too much too fast and am still working on recovering from my mistake... ah well it is an individual vectoring process but still we seem to find full recovery in the end.

3 weeks until vacation gives you loads of time to recover that much more. With your proactive attitude I'm sure you'll see much more recovery in the days to come... and certainly something special to look forward to. I lived in Geneva for 4 years and can only imagine your destination will be someplace warm and relaxing.
 
Just out of interest, how much walking would you recommend?
It's different for everyone. I just started my walks measured on how many houses on the block I could walk past. It's best to start with half as much as you think you can do so the return trip isn't too tough. If you feel good the next day, go a bit further. Don't worry about how many miles you are doing. It's a slow and steady approach to building up your stamina and strength.
 
My surgeon takes a progressive approach to recovery in as much as the usual 90 degrees rule, crossing legs etc don't count
In my experience, very few UK surgeons do.
I had a RTHR on 19 July 2017 so am just past the 6 week mark. I've been doing regular PT sessions
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.
how much walking would you recommend?
Did you read the articles Jaycey left you? I suspect you didn't because this question is addressed in this article Activity progression for THRs in which this is specifically addressed.
 
@Josephine,

I understand from the hospital staff, my surgeons approach is far more progressive than a number of his colleagues in this area. Even the PT's have confirmed this and offer different advice to his patients.

As far as PT is concerned I will be raising this with him at my review next week, there's so much conflicting information on the Internet and I just want to make sure I'm doing the right thing for me and my recovery.

I did read Jaycey's links but as I feel comfortable doing the 2-3 miles without pain I didn't feel this really answered my question.

Appreciate personal advice can't be given and so I joined the forum just to see how other patients are progressing at a similar stage and to understand the level of activity they are all doing.

There a some marvellous, inspirational people and stories on these boards however, given the tone of your response which I found a little upsetting, I think it's better if I don't post any more comments.
 
Hi @Normhel
Have to laugh because I also was a lurker for a time before becoming a BS member. I'm so glad I finally joined and have yet to regret it. The information I've received has been invaluable. I've become aquatinted with so many lovely people who were encouraging to me when I needed it and I've enjoyed paying it forward.

Ultimately it's your body and your recovery. You can choose what you care to follow and leave the rest. No judgement here. I will say in Jo's defense that a few of her exclamation points initially frightened me off, but I've now been around long enough to appreciate her knowledge and have learned a lot through her posts and years as an orthopedic nurse. She does care. Possibly you could have a PM exchange with her and gain a better understanding.

I think your progress sounds great! Why not see what your OS suggests at your next appt and go from there. Tell your OS what you're comfortable with and what you're struggling with and find your own sweet spot. We're all uniquely and wonderfully made and no two recoveries are alike. Not even on the same individual with each hip!

I wish you the best in your recovery and please continue to post. We'll be here to weigh in on questions, offer support and cheer you on.

A great week to you!
 
I understand from the hospital staff, my surgeons approach is far more progressive than a number of his colleagues in this area. Even the PT's have confirmed this and offer different advice to his patients.
How do they define 'progressive'?

As far as PT is concerned I will be raising this with him at my review next week, there's so much conflicting information on the Internet and I just want to make sure I'm doing the right thing for me and my recovery.
I would warn you that any conversation with your surgeon and/or physio is unlikely to result in a meaningful discussion. It's much more likely they will shrug off 'internet' info as being unreliable and they are at liberty to think so. Generally it's up to you. Either you feel this advice I've given you is sound or you don't and you're perfectly at liberty to do whatever you want to. I give you the benefit of my lifetime's experience but you are in no way required to accept or following it. Entirely up to you!
 
welcome @Normhel -- You are one day ahead of me, so we're hip sisters! I am doing my second hip quite differently than my first. My OS assigned PT, I had the home care PT, I had exercises, which the PT said only do something if it doesn't hurt (good on him!!!), and I pretty much gave the exercises up after a couple of weeks because I was getting too tired. A couple of the exercises worked my hip flexors very hard. I had anterior, both hips, and that's where all the trauma was. Between that PT, my insistence on using my regular toilet and not pushing up off of seating with my arms, and an unfortunate shoe-shopping trip, I gave myself chronic tendonitis. It is a pain. I really don't want it with the new left hip, so I told my OS's PA, no PT. She said, that's great-- hips only need walking anyway! (talk about feeling vindicated!)

I was very fortunate with both hips that I was able to give up walking aids early-- right hip by one week, except outside "long walking" and for self defense, and this hip I never actually used either the walker or the cane. No two hips are the same. However....I sure can't walk 2-3 miles! My hands are wrecked from a lifetime of professional music, and if I had to walk more than a few hundred feet using a cane, never mind a crutch, I'd be in severe pain. I feel like I could probably walk a mile at once, but again, my reason to not do it is to do everything in my power to prevent that tendonitis.

On the completely other hand, lots of people here do aggressive PT and are fine with it! As Jaycey says, it's up to the individual. If it feels good and you're not dead after, you might be a good fit. If it hurts like crazy, that's clearly not good. I have heard that in the UK there is a tendency to not do PT, and here in US it's the opposite.

If you read around the recoveries, you'll see that one person went back to work at an alarmingly early stage and throve, and another dreads having to go back after several months, for example. We really are all over the place! I am doing things with this hip that I didn't dream I'd be doing this early-- and yet I am unable to do other things that I could do at this stage with my first hip. Go figure...

Do come back-- we don't bite! :heehee: This place has been my hip salvation, twice!
 
Hi @Normhel
Just stopping by to say Hi. Hope you had a pleasant weekend.
Good luck with your follow up visit this week. It will be nice to have all
of you're questions answered.
Wishing you a great week and a smooth continued recovery!
 
Good to hear from you @Normhel I'm just moving along, thanks for asking.
Ten weeks for me today. Time is flying, Kind of surprises me still.
I had my first post op at three weeks with the Physician Assustant
from my OS's office. Will see my OS for the first time since surgery in a couple weeks.
Look forward to your update, enjoy the rest of your day!
 
Hi @Normhel
I hope your follow up visit went well, your questions
were answered and that your recovery is coming along.
Continued healing to you and best wishes for a great weekend!
 
@Layla

Sorry, lots going on (not hip related)

My OS was extremely happy with my progress. He said I was at an advanced stage of recovery when considering the average persons progress. I have been signed off now and don't need to see him until the 1st anniversary of my op!

I also saw the PT, told him I'd done all the exercises he'd set me (I haven't done them for at least a week) and demonstrated the side leg raises. He said I'd got incredible strength considering only 7 weeks have passed.

That'll be down to the walking I do! He also discharged me and I don't have to go back.

I'm now walking without assistance and am getting better each day.

How are you? Hopefully doing well...have a great weekend xx
 
Hi - I had my hip replacement surgery on 6/28/17. I have residual pain in my legs - sore and aching. I do exercise but continue to have pain in my legs (especially at night). Does anyone have any suggestions about easing my leg pain? (My doctor has cut off my pain pills.) Thanks!
 
Hi @Brunhilda

I can't advise on your situation but if you start your own thread you'll get more exposure and probably more answers.

Take care.
 

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