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THR Anterior Approach Walking Guidelines

Layla

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Thanks for sharing! I’m sure someone will benefit. Happy to read it’s helping.
A great rest of the week to you! :)
 

Elf1

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As Layla mentioned, the pillow is really helpful. I'm just about 9 months and notice some nights if not using the pillow that I wake up with one, sometimes two really sore, really stiff knees.
 

CricketHip

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I so agree @Elf1 ! I always use a large king sized pillow. I always will. Even with our biological hips and spine, the pillow helps. I wish we had a pillow emoji!

@djacksonsf this is why it's so good to post on your thread, you've helped others if and when they have an issue like this. thank you so much!! :thumb:
 
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djacksonsf

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So a couple of things have happened since I started resting:

I spoke to my OS, who didn't think the symptoms indicated an implant issue. He said the chance of that was extremely low, and this was somewhat of a relief despite how big of a set back this is. There would be clicking, popping and instability if it were the implant and he thinks that whatever is happening will take 4-6 weeks to improve. My hip flexor is weak, but I can lift my leg without problems and stand in the stork position easily.

I also realized stretching makes things worse, and so does even a little walking. I spent maybe 15 minutes picking up food, and that was enough to cause the thigh to get tight and cold/tingly and the buttocks to start aching again. Going over bumps in the car also produced some buttocks pain. Afterwards, a light stretch felt good, but later on there was some throbbing pain in the buttocks when lying in bed.

Where I am now is walking as little as possible and using ice, heat and ibuprofen. Fingers crossed for some sustained improvement in a few weeks.

-Doug
 

Elf1

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Unfortunately this recovery road is a long and slow one, especially if we have a set back and end up in the ODIC. I've had to deal with trochanteric bursitis for months now. Didn't really do anything to bring it on, my doc said that because I'm female my hips are wider and just kind of sets us gals up for it. I know how hard it is to be patient and sit it out, especially when we feel like we're good to go. You just have to take it slow, ice and or heat, whatever works for you.
 
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djacksonsf

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Thanks @Elf1 , I know and I get it. It's just a big setback - not feeling comfortable walking on the leg - compared to where I was. I just don't get the neural stuff - the tingling, muscle contractions and coldness. I guess it's the sciatic nerve, but it would be reassuring if that much went away. I'll hunker down and see how it goes. Thanks for the kind words and stay safe.
 

Hip Hip Hooray!

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Congratulations on healing so well. I had the anterior technique for my bilateral surgery, too. My surgeon recommended that I work gradually. I was shocked to find I could walk unassisted one week after the surgery. I still took my walker when out in public, to keep people from running into me. I was real protective of those hips for quite a while.

Several months ago, I was walking my Labradoodle, and two huge dogs came out of nowhere and attacked her. ( a Great Dane and a Rottweiler.) They were running off leash. Thank God I was fully healed by this time. She recovered, but they could have killed her. They flipped her on her back, and one was at either end of her body. It happened in a very nice neighborhood up in the San Gabriel mountains. It looks like a Christmas card up there.

I think it's good to be cautious and prepared. Now I carry pepper spray, my phone, and a rod iron bar. You just never know what's going to happen...

It takes quite a while to heal, and that joint is very delicate at first. With time it will anchor itself.
 

CricketHip

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Awe Doug, I'm sorry, I can feel your pain and frustration. So glad you had a positive conversation with your OS. Just focus on that and try to keep your mind busy while resting and recovering.

It sounds like it's going take some time. :console2: I've been there and done that, many of us have.

Just take it one day at a time. It's all you can do, and one day things will start healing and improving.

Take care.. please keep us posted?
 
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djacksonsf

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Thank you @CricketHip ! I'm starting to foam roll, hoping that loosens things up a bit. When I think of the IT band and some of the other stuff going in, it just seems like things are really tight and nerves are compressed.

I tried to loosen them up with walking, but uneven terrain and too much of a good thing got the best of me. I'll check in from time to time to let you know how I'm doing. I guess I'm waiting for this to resolve in much the same way we are all waiting for the virus to abate. We all just want to get back to our own and our collective versions of what normal is.

I did a search on foam rolling after hip replacement, but didn't see much. If anyone has tips, I'm taking them!

-Doug
 

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Hi Doug, I'm so sorry that you have had such a setback.

I tried the roller. Early on it felt really weird so I stopped. It might be easier to control the pressure with a roller stick. If you have a massage therapist that you really like, maybe you could get a video visit? Truly not the same but what can we do?
 
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djacksonsf

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Thank you @cstinchcomb . The roller feels ok and it really helps with the tightness around the knee/IT band and butt. I can try the rolling pin approach I was using before, but the width of the foam roller feels so good.

I wonder if some of this is due to leg length, which is still pretty noticeably different. I know that when I was walking uphill the legs were moving differently from one another. Standing, the op leg is always flexed.

A while after all this came to a head, I slipped a thin paperback under the non-op leg. To feel that my pelvis was level, I needed between 3/8" and 1/2" of a lift. I know this is functional LLD and likely a product of all this tightness I've experienced.

Seems like a vicious circle where the solution is stretching and walking, but doing either at this point leaves me with a butt that's more sore, a thigh that's more tight and those weird neural sensations.
 

Bfam85

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Hello @djacksonsf … was surfing around and saw that you still have LLD....I had that also and it lasted for quite a while. You can go to my page and hopefully be encouraged by it. It took a while (several months), but I am almost one year out, and the LLD has completely resolved. There were times that I would put a wedge in my shoe just because it felt so awful! I felt that it was definitely hampering my recovery, but in the end, the leg did settle down and all is well! HTH
 
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djacksonsf

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Hi @Bfam85 , thank you for your input! Do you mean that adding the heel wedge helped you or that doing that hampered your recovery? I read your page and was also wondering if you had other tightness - IT band, glutes, etc. I've read that LLD - whether structural or functional - can in combination with weak glutes cause the IT band to tighten, and that's what I started experiencing when I walked on uneven surfaces and hills a few weeks back. Now it stings in addition to being tight around the outside of the knee and up the thigh.

Like you in your early recovery, when my feet are together the disparity is pretty obvious. Reading your page really helps me remember that this is temporary, even if I'm having a hard time figuring out the right thing to do now. Walking promotes healing, but I'm not able to do much of that right now because of the muscle tightness.

@cstinchcomb , do you mean rolling pin when you say rolling stick? Just curious because the foam roller seems to be a bit too much at this stage after all. It felt great in the moment and relaxed things right after, but the day after it's a different story.
 

leejaa

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@djacksonsf , I have a muscle roller stick that I used when I had some issues with tight muscles. I got mine on Amazon and the brand is supremus sports but I am sure there are others it is a bit knobby and not smooth like a rolling pin and it feels good when I overdo and my quads or calves get tight.
 

cstinchcomb

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My thoughts were that if using the foam roller feels good, and if it's not worse a day or two later, that it is good. I guess that means that if it's worse the next day or two days ... then it's bad. Darn.

My surgery is of course postponed. My right (needs to be done) side is off by about an inch. If I limp around on it, my whole body is a mess; low back, good hip, calf etc.

So it seems to me that your persistent LLD will cause all kinds of problems, and that whatever you can do to resolve it will help. Then again all the actual medical advice seems to be to rest and let the soft tissue heal up ...

If you do the paperback test again, is it getting better?

I have an oldschool rolling pin, but that really never worked well for me. We have a stick (search for "muscle rolling stick" on amazon). I think ours is called TheStick. BUT -- I would get the "RAD Rod" if I were to get another one. We have one of their original Rad Rollers, which is kindof like two lacrosse balls stuck together (for the spine) -- that thing is great. I also have a softball and a lacrosse ball, both of these might work for the area where your IT band inserts around the knee. The softball is great on the glutes but I would think only very gently at this stage of the game.
 
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djacksonsf

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Thanks @leejaa and @cstinchcomb ,

@cstinchcomb , I'm so sorry to hear about your postponement, especially with that big of a discrepancy. As soon as things lift, it's going to be important to call right away to get on the schedule.

To answer your question, I held off on measuring LLD for a long time. I first checked LLD yesterday, and my feeling is that it's been exacerbated by connective tissue that is both tight and weak. I think LLD is definitely playing a role in the symptoms I've experienced. I was going to use the lift until I can get back to some kind of muscular balance, then gradually remove it as the legs equalize. Will check in with the PT tomorrow and ask.

Sounds like you both have rollers that are used with upper body strength only, and not the kind that you lie down on - which is what I have and did. In a moment of late-night inventiveness and a smidge of desperation, I used a kitchen rolling pin earlier on. It didn't have much effect, so I tried the bigger foam roller on the floor and it was too much. I sat on it and gently worked my glutes, then lightly and slowly rolled across the length of the IT band, quads and hamstrings without allowing my full body weight to rest on it. Two steps forward, one back.

It's almost the weekend, so that's something to be happy about!

-Doug
 

Bfam85

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Hi Doug @djacksonsf … I agree that all the swelling in that thigh and surrounding area does contribute to the LLD. Once that starts calming down, it makes sense that the entire leg will settle down as well and become more level with the other leg.

I had all sorts of aches and pains which traveled all over my leg/knee, including my other leg as well. The lift only gave me momentary relief as it helped me to feel balanced again. My OS did not want me using the lift at all as that would prevent my hip/leg to align itself naturally. He told me from day one that the LLD was temporary. I guess they see that the legs were even with their measurements during surgery.

There was one exercise that helped: If you lay on your back, and squeeze your glutes, that will gently stretch the front of your hips. Those muscles relaxed more and I did get results. I actually did that movement standing up as well, but it's hard to describe that to you :)

Walking was the ONLY thing that helped me without hurting me into the bargain. If you take it easy for a few days, and start walking short distances, you should be okay. Only you know your body; you will know intuitively what it needs.

Of course, ice, ice, ice!!!
 

Layla

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Stopping by to say Hi and wish you a Happy Four Month Anniversary!
I wish you were feeling better on a daily basis and not dealing with the pain. I hope it eases soon for you. Wishing you comfort and a peaceful weekend. :)
Happy Easter!
@djacksonsf
 
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djacksonsf

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Thanks @leejaa and @Bfam85 - meant to say so sooner!

I'm feeling a bit better, which is great. Fingers x'd symptoms continue to diminish. I took a short walk on Easter - maybe 2 blocks - and felt a little stiff from all the rest these past few weeks, but no weird sensations or weakness when I got home. Also drove to the market and didn't get that jolt of buttocks pain when the car goes over a bump. I think that was SI joint.

Ordered some heel lifts, which arrive Thursday. Planning to take it very slowly, adding 1/8" at first. Also talked to the PT, who recommended getting back to simple strengthening exercises, including some that target the lower abs. So far so good. I'm avoiding stretching since that caused problems earlier.

I did a ton of research and found that there's a connection between weak glutes and a tight IT band, and that there's also a connection between leg length differential and a tight, nerve-compressing piriformis and misalignment of the pelvis/sacrum.

I think all these things came to a head when I started routinely walking hills after only walking on flat surfaces. Making this worse was the fact that the streets were sloped uphill/downhill and sloped left/right. That's a lot to ask of weak glutes, etc.

@cstinchcomb , hoping you get an appointment as soon as it's possible to do so!

-Doug
 

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