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THR A hiker's tale (male, age 49)

Do the google and look at the muscle groups especially the IT band. I honestly don't remember the length of having knee pain but I'd say the first 3 mos roughly, and especially when walking hills. It was worse with my left than my right.
 
Did you say twelve PT appointments? My alarms are going off at that many appointments this early in the process. Please, don't let the PT person cause you more knee pain and hip pain.

There is no exercise cure for your knee pain right now other than walking and healing and time. There are nerves that connect the hip and the knee and there is stress that goes from the hip to the knee and all kinds of twisting that occurs during the surgery. Those were all affected and aggravated during the surgery and afterwards. Twelve PT sessions just a month out--I don't see what the PT could possibly accomplish this early other than exacerbating the soft tissue which is healing.

Just commit yourself to speaking up if you end up in more pain after PT.
 
If, during the surgery, they lengthened my leg back to where it was pre-arthritis, then suddenly that leg is going to seem "longer" if my pelvis is lower on that side
I had exactly the issues you described - shorter leg, twisted pelvis. Because my leg had shrunk over many years I wasn’t really conscious of the discrepancy (though over the last twelve months I could definitely feel that my pelvis was all wrong) - but now, as my body adjusts to the new length, it feels very strange.
 
Me, too. I have mild scoliosis and have been lopsided my whole life with a decided lateral pelvic tilt. After my first THR, the surgeon kept asking if I felt like one leg was longer than the other. I didn’t. After this recent surgery, I reallllllly felt the difference. I feel like my right leg is a good two inches longer than my left leg. I know that’s an illusion but still, disconcerting. I feel like a mountain goat. I’ll probably end up waiting on PT and finding someone who can help me work on my gait and strengthen the various muscles that will stabilize things.
 
I feel like my right leg is a good two inches longer than my left leg. I know that’s an illusion but still, disconcerting.
Exactly this (although it is my left leg that is now freakishly long). I feel decidedly off-kilter. But my pelvis and lower back feel happier than they have in years. On my birthday, just a week after my surgery, I went out for a walk with three of my oldest school friends. We took a photo to commemorate the occasion - and I was amazed to see that I was suddenly the tallest. Over the last decade I had lost so much height through my shorter leg and associated twisting through my pelvis and spine - and it has been instantly restored. Nice work Mr Surgeon, although it feels weird right now.
 
@pdx_hiker Does your insurance have a limit of number of PT visits you can have? Mine did. So I went into see the PT folks every 2 weeks and did the exercises they gave me diligently every day between visits. That worked very well for me both for the BTHR and for both of my shoulder replacements.
 
Did you say twelve PT appointments? My alarms are going off at that many appointments this early in the process. Please, don't let the PT person cause you more knee pain and hip pain.
Does your insurance have a limit of number of PT visits you can have? Mine did. So I went into see the PT folks every 2 weeks and did the exercises they gave me diligently every day between visits.

They wrote me a referral order for 12 appointments; I'm guessing that's what my insurance will allow. There's obviously nothing that says I have to schedule all of them, or any of them.

(And frankly, I don't want to have to go to appointments of any kind after December 31, because when the new calendar year starts, I'll have to start paying out-of-pocket again.)
 
Day 22: I walked about a mile in the neighborhood last night, and the knee pain seemed a little better. For the first time, I didn't bring a trekking pole, and I didn't miss it. If anything, it might have been messing with my natural gait. Here's hoping things keep progressing in the right direction...

The knee gets totally man handled during THR.
Even with the posterior approach, where you're lying on your side? I can't imagine they'd have much reason to move your knee at all, except when testing the new parts.
 
Even with the posterior approach, where you're lying on your side?
Yes, they grab your knee to dislocate the hip. Then they grab it again while testing your ROM once the implant is in place.

You also had your leg length evened up. All the muscles that probably atrophied pre-op are stretched to even the legs. My leg length difference was only 1/4 inch. But I certainly had sore muscles post RTHR.
 
Hi @pdx_hiker !
49 and very active as well here. Just want to say don't overdo it like me lol. I've had multiple setbacks due to pushing myself too hard. Currently taking another break from lower body exercises this week to recalibrate because I just can't seem to learn my lesson. In the meantime my arms are getting pretty ripped:rotfl: (this can actually put strain on your hip I've noticed trying to stabilize as well) 2 steps forward and 1 step back. Don't be a me! Good luck!
 
Even with the posterior approach, where you're lying on your side?
Yes, they grab your knee to dislocate the hip. Then they grab it again while testing your ROM once the implant is in place.
Oof, that's right. I try not to think about the actual surgery too much... what a horror show.
 
I had my first hip problems at age 47. I wish I had been smart enough to go to a doctor about it. I was stubborn. As a result, I endured 10 more years of arthritic hips, which only decreased my physical health.

You are wise to have gone ahead with it at that age!
 
Day 25: Did some yard work today (just raking up old hedge clippings and loading them in the compost bin). Got on a ladder and changed a light bulb. I'm not limping when I walk (at least not that I can tell, but an orthopedic specialist might disagree), but my left knee still hurts a little when my foot hits the ground.

PT starts on Wednesday (day 29).
 
Ladders?!! :yikes: Yikes...please be careful.
Good luck with PT on Wednesday. Let us know how it's going for you after a few sessions.

If you realize you're limping...Here’s a tip, try heel-toe walking when you're limping.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It takes a concentrated effort, but I believe you'll notice a difference. Give it a try!

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[Bonesmart.org] A hiker's tale (male, age 49)

@pdx_hiker
 
If you realize you're limping...Here’s a tip, try heel-toe walking when you're limping.
I have tried that a couple of times when out for walks. It does seem to help with obvious limping, but I'm not sure if that's just a superficial improvement, so I'm not making it a habit just yet. I'm definitely going to ask the PT about it on Wednesday.

Overall, it seems like my recovery experience has been quite a bit different (i.e., faster) than most of the stories I've read on this forum. I'm guessing that's down to two factors: (1) Pre-surgery, my legs were in great shape and I was walking without pain, so there was very little atrophy. (2) A lot of people come here because they're struggling and looking for support; people with few or no problems are less likely to seek out a recovery community.
 
pdx-hiker,

Factors that I have noted, assuming no significant physical problems like obesity and no surgical issues, include age, physical condition and need/determination to get back to normal.

My first as a 46 year old went very well and I was back to being active (Jetski and using chainsaw) and work at about a 4-5 weeks, but I started slower because I followed the painkiller recommendations which made me very groggy and detached - it was also a bit earlier in the replacement era - my sense is that surgical techniques have improved.

Second time (see link, below), I decided to only take pain meds when it felt like they were needed (after the one night in hospital, only Tylenol was needed) - yeah, I know this is counter to some of the great advice on this site from really smart and experienced people, but it worked for me - I wanted to know where the edge was - and, it turned out the edge was buffed down by a lot of Tylenol.

Yeah - I still joined the ODIC - not from simply walking, but from walking aggressively and too far too early and being overconfident :)

And, based on my experience of simply doing some basic exercises, and lots of walking - in my circumstance, no PT was required.

If I can do this - anyone can!

 
Day 26: Put me in coach, I'm ready to play!

[Bonesmart.org] A hiker's tale (male, age 49)


Don't worry, I didn't actually play softball! (You can tell by my footwear.) But I did play catch, and then walked around picking up stray foul balls... and it sure felt good to be out there.
 
Look at you back out on the ball field.:egypdance:

Wishing you a Happy One Month Anniversary...two days early.
Hope you're using the golfers reach to pick up those soft balls.
Stay safe and enjoy! @pdx_hiker
 
Day 31: Two days ago (Day 29), I had my first visit with a physical therapist. She didn't seem too concerned about the pain in my knee/IT band; she was optimistic that it will resolve over time. And she said I'll probably only need to see her a few times; she's mostly just going to give me homework rather than working on me at the office.

She did recommend trying to get into the heel-toe walking habit — not just for now, but forever.

She assigned me six exercises to do every day:
  • Supine active straight leg raise
  • Side-lying hip abduction (straight leg)
  • Side-lying clamshell
  • Hook-lying clamshell with resistance band
  • Supine bridge
  • Standing hip abduction — both sides
The straight-leg abduction ones (supine and standing) can be tough, the rest are no sweat. Next week I'll ask her for a more resistant resistance band.
 
It seems a bit early to me for those types of strengthening exercises. I would be especially cautious about pushing those straight leg raises, especially the supine ones, if they're causing you any trouble. Those soft tissues are still healing and it can lead to tendonitis if you aggravate those particular muscles too soon. If you do get sore, back off of the exercises and ice the sore areas. Slow and steady wins this race. You're doing so well and we don't need anyone else in the over did it club (ODIC.)
 
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