Revision THR AJ’s LHS THR

[AntJ]

Hi all,

I’ve been reading about people’s experience of THR, looking for some kind of similarity of experience. As is noted, no two are the same.

I had my op on Oct 28, so am about four and a half weeks post-surgery. The procedure was noted as anterolateral. The reason for surgery was bone-on-bone as a consequence of hip dysplasia.

I’ve been doing my physio exercises, although not to excess, and have been getting around with the aid of a stick for a couple of weeks. With great concentration, I take up to ten steps unaided, although this is dependent on pain levels.

The only pain medication I’m taking is paracetamol osteo.

As progress slows down, I’m getting increasingly frustrated, but I do understand that this is a short term thing with a long term gain.

The main issue I’m having at the moment is groin pain. It’s the one thing that seems to be holding me back. It feels like an impingement. I try stretching it but I’m not that’s helpful as it hurts to do so.

Any insights, observations or advice is welcome!

Thanks,

Anthony

 

[mendogal]

Welcome to BoneSmart!

I'll leave you our general recovery info - lots of articles to peruse! - then add another post addressing your queries.

Welcome to BoneSmart. Here are some resources to get you started.

HIP RECOVERY 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.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

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

The recovery articles
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. 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.

 

[mendogal]

@AntJ

I assume your surgery was Oct 28, not Nov 28?!

Well, many of our staff and members' hip surgeons feel that no formal physio or exercise is necessary after a total hip - just walking and progressively increasing activities of daily living (ADLs).

So it's entirely possible you're doing too many exercises or too many reps and sets, which early in the healing process will definitely increase swelling and pain. Overdoing to excess can create tendonitis or bursitis.
Can you describe your daily exercise regimen? It will help us assess this.

At four and a half weeks, muscles haven't healed. Tendons and ligaments take a good 12 weeks. So it's definitely not good to work on strength exercises (beyond walking) yet. Gentle range of motion, very gentle stretching is good.

Groin pain can be upper quads, psoas, or other structures that had slowly adjusted to your worsening arthritis being suddenly "reset" in surgery. It's pretty common for hipsters to experience low back, groin, or knee pain as the entire weight bearing structure readjusts to your new reality.

Icing and elevating the surgical area at least 45 minutes several times daily helps with pain and swelling.

For pain well away from the incision and surgery, moist heat may be more helpful than ice.

 

[AntJ]

Yes, 28 Oct! Thanks for that.

The current exercise regime is (all are 2 sets of 10 reps):

- Step ups
- Sit to stand
- Heel raises
- Forward toe taps
- Standing hip flexion
- Standing hip abduction
- AROM hip extension
- Sideways walking (with support from bench)
- Full length, unsupported strides.

Then I do my own:
- lying down hip flexions which are totally fine
- glute squeezes
- cushion under knee, squeeze down and raise heel.

Plus walking and ascending/descending stairs.

Forgot to mention that the surgeon repaired a gluteal tendinopathy.

 

[myglasshalffull]

Welcome.
Many of us here recovered by just walking no formal PT but we are all different & recover at various rates of speed.
Groin pain is very common after surgery.
The way your body is contorted to remove hip & place in new parts can make rest of your body quite sore for awhile.
Are you icing? Ice will be your best friend. Sometimes better than pain meds.
Rest, elevate & ice. Maybe step back from exercising everyday & take one day off one day on? Day off rest & ice.
Exercising a part of your body that is trying to heal sometimes makes your recovery more difficult.
All my best, you will receive a lot of good advice & support here.

 

[Phoebie]

I was sent home from the hospital with very detailed exercises for each stage of my recovery and encouraged to do them three times a day. I started that way and found them easy to do. Then I found I suffered from a lot of swelling and more pain than the first weeks. It was suggested here to try reducing my exercises and to use walking and rest for my recovery. It worked a treat. Swelling and pain reduced. I still moved forward in my recovery but without aggravating the soft tissue healing. That trauma seems to be the cause of a lot of people's pain.

I am not in any way an expert or a qualified health practitioner. I can only say it made a huge difference when I was at a very low point. I still have a long way to go but understanding it is a process requiring a lot of patience helped me adjust my thinking. Everyone's recovery is personal and different. You will find what works for you.

Good luck.

 

[Eman85]

I came home from my first THR with the list of PT exercises and they were for the most part not too hard to do. Certain ones seemed to cause pain but trying to be a good patient I pushed through them. I found Bonesmart and started reading and learning. My first THR had plenty of overdids and setbacks from them. With my second THR I threw the PT instructions in the trash and concentrated on a pain free recovery, or as close as I could get. I did a few of the simple moves mostly to check ROM and how the healing was going. I did more easy walking with no push for speed or distance, just all about form and stopping as soon as my form wasn't good because of pain or fatigue. Overall I'd rank my second THR as the better way to recover and it's working just fine after 5 years.

 

[AntJ]

For a couple of days, I used a massage gun on my glutes. I didn’t go hard because the muscles were very tender, just enough to feel some relief. Only after I’d been doing that for a while did I think to see if it was okay. Apparently, not the best thing to do. So I stopped. But I can’t help wonder if it stirred something up or even loosened the joint. My neighbour, a rehab physio, says that it’s highly unlikely that it would do any damage, but that using it on inflamed muscles wouldn’t not help. But at three in the morning, you tend to go down rabbit holes!

 

[benne68]

But at three in the morning, you tend to go down rabbit holes!

This is true... but next time, try icing instead. It helps with both pain and inflammation.

What you are experiencing is actually normal for less than a month post-op. It can take up to 12 weeks for the tendons and ligaments to heal from the surgical trauma. Hammering on those tender tissues is only adding to the trauma.

You are still early days. Give yourself time to heal. It does get better with time.

 

[AntJ]

This morning, as I was standing in front of the bathroom basin, I conducted an experiment. I lifted my left leg from the hip, not bending my knee, and not employing any muscles. There was a strange “dropping” feeling in the joint. Not as defined as a pop, but it definitely felt like movement.

With the sudden increase of pain over the last few days, and it’s consistency, I am worried that it’s come loose.

EDIT this was a bit of a panic post! My neighbour, the rehab physio, took a look and isn’t concerned. Reckons, as you’ve all been saying, that I’ve likely overdone it!

 

[Layla]

EDIT this was a bit of a panic post!

That's ok! Glad you had your physio neighbor there to reassure you. Rest and ice helps when we overdo it.
Feel better soon!

 

[AntJ]

Thanks!

 

[benne68]

this was a bit of a panic post

We've all been there! During the early weeks of recovery, our imaginations tend to run wild over anything that feels different. You are fortunate to have a neighbor with the expertise to help you relax about this.

All those tweaks and twinges do eventually fade into the background. It just takes time.

 

[Eman85]

All I can say is stop thinking and start sitting and icing. We have all thought the implant is loose, broken or infected in the early days and thanks to Dr. Google. The loose movement, clicking and or popping most of us experience is all of the soft tissue. The trauma of this surgery isn't much to do with the bone or the implant, it's about the soft tissue and how far it's been stretched and how much it needs to heal.

 

[AntJ]

The great thing about this forum is that the info represents a more realistic version of the journey. Pretty much everything you read about post-surgery presents recovery as being linear, and when your own experience doesn’t match that, that’s when rabbit holes appear. So, thanks everyone for your insights and observations.

 

[benne68]

everything you read about post-surgery presents recovery as being linear, and when your own experience doesn’t match that, that’s when rabbit holes appear.

Here is BoneSmart's graphical representation of joint replacment recovery:

 

[msart]

@AntJ everything you are describing is everything I went through. The groin pain-omg!! I know it is frustrating because I’ve been there!! I am recovering (hopefully at the tail end) from THR posterior-last surgery Sept 9, I had 2-long story. It does get better, I promise you. You just have to go through it to get to it. And everything you know-as in no pain, no gain-is off the table during your recovery. You will find less is more & it is difficult to get your brain wrapped around it, I know. Hang in there & hopefully this site helps you navigate through!!

Welcome to the club & happy healing ‍

 

[Morgan Le Fay]

This morning, as I was standing in front of the bathroom basin, I conducted an experiment. I lifted my left leg from the hip, not bending my knee, and not employing any muscles. There was a strange “dropping” feeling in the joint. Not as defined as a pop, but it definitely felt like movement.

With the sudden increase of pain over the last few days, and it’s consistency, I am worried that it’s come loose.

EDIT this was a bit of a panic post! My neighbour, the rehab physio, took a look and isn’t concerned. Reckons, as you’ve all been saying, that I’ve likely overdone it!

Hi @AntJ
I am 3 weeks post op (THR right hip) and when I saw my surgeon last week he reassured me that the implant is extremely stable and that I would literally have to fall hard in order to cause damage.

We all think the same.

 

[AntJ]

Thanks for all of the reassurances! I can’t describe how much they help!

I love the Bone Smart graphic! Very accurate.

 

[Phoebie]

This morning, as I was standing in front of the bathroom basin, I conducted an experiment. I lifted my left leg from the hip, not bending my knee, and not employing any muscles. There was a strange “dropping” feeling in the joint. Not as defined as a pop, but it definitely felt like movement.

With the sudden increase of pain over the last few days, and it’s consistency, I am worried that it’s come loose.

EDIT this was a bit of a panic post! My neighbour, the rehab physio, took a look and isn’t concerned. Reckons, as you’ve all been saying, that I’ve likely overdone it!

Hi @AntJ
I am 3 weeks post op (THR right hip) and when I saw my surgeon last week he reassured me that the implant is extremely stable and that I would literally have to fall hard in order to cause damage.

We all think the same.

This is so true. My overwhelming concerns leaving hospital were blood clots and dislocation. I would not be reckless but do now understand that dislocation is a very low risk.