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THR Anterior Approach Walking Guidelines

Thanks, Eman,

I've been careful not to have the operative leg behind me when bending to avoid the golfer's bend. When I bend, both feet are usually pretty close together and well planted.

That said, every once in a while there's a twinge of pain in the area of the joint itself, not the incision. It can happen when walking in a straight line if my stride is too long, or when I catch myself moving my operative leg's knee away from the midline when I'm lying on my back in bed with my knees bent and feet close together.

I'm guessing there's nothing to be worried about, as earlier posts have indicated that there will be moments of pain for several months to come. I mention it because it seems like everything is very stable, but the pain did surprise me a bit. I can ask the PA on Friday for more information, too.

Happy New Year,

-Doug
 
Strange pains are common. When I first would roll onto my non op side the op side felt like it was pulling the joint, very uncomfortable. With my first if I sat and dangled my legs like on the DR.'s table it gave me an odd sensation of pulling. Just my theory but beyond the dislocation part of restrictions I think it help us to keep from pulling on the joint. This allows the muscles to tighten and the capsule to form around the joint quicker.
As far as pain goes I still get pains on my left side at over 1 1/2 years, nothing bad but I remember it's a compromised area.
 
I think you're right - I've had that sensation a couple of times and it makes a lot of sense. When the joint is extended, there does seem to be a pulling effect.

I'm thinking that some of the simple exercises I was given - tightening glutes, shallow squats, tightening quads, standing abduction - all help with rebuilding strength of the muscles surrounding the implant. That in turn would seem to promote rebuilding the capsule necessary to support stability going forward, and I guess that process is complete sometime between the 6 week and 3 month timeframe given the duration of the post-op movement restrictions.
 
These are early days...so I wouldn't do any type of PT that caused me distress or pain during or after.
Lots of Healing still Happening.
I just had to remind myself often -
Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing... If a long full step right now is causing pain and limping, don't take long full steps. Take smaller steps. Take a short walk several times a day, instead of longer walks. Use your cane. Use ice. Rest a lot.

This isn't the time to do anything to excess. Baby steps now, and lots of patience, pays off big time later. Recovering from self-induced tendinitis can end up taking weeks or months. Consider yourself as still recovering from surgery and structure your return to your life as a slow, gradual process where you introduce very small increments in activity, and then give yourself time to see how you react to it.
All temporary, and worth the patience. I am certainly glad I am able to get back to a full happy life
 
Thanks, Mojo,

I'm doing just as you say - very moderate with the exercises and taking entire days off to rest. Yesterday, I didn't do much walking at all. Today, I walked a mile this morning and that will probably be it. For me, these seem like good baby steps, because I'm not feeling drained and I'm not in any pain.

My biggest question at this point is what the doctor's team means when it says the surgeon realigned the hip due to preexisting dysplasia. I still haven't gotten a complete answer, so I've requested an explanation at tomorrow's post-op follow up.

The reason for the question is that sometimes after walking a few hundred feet after having been seated (e.g. driving), the hip feels a little out of alignment, and then it corrects itself. It's a momentary sensation that I've experienced three times - a little tenderness, then walking as normal. The doctor's team has said this is expected because the hip wasn't just replaced, it was realigned. They also say it should resolve in about 2 months.

I don't know if anyone else has experienced this - but if you have, please let me know :loll:

Regards,

-Doug
 
djacksonsf said:
My biggest question at this point is what the doctor's team means when it says the surgeon realigned the hip due to preexisting dysplasia. I still haven't gotten a complete answer, so I've requested an explanation at tomorrow's post-op follow up.
Click to expand...
I've read of several different approaches to dealing with realignment and re-centering due to hip dysplasia and would love to know what he did to help in your situation. Do let us know what you find out.
I would think that if your hip has been realigned then there is bound to be stressors and a period of adjustment that is bound to have discomfort accompanying the adjusting.
Keep everything slow and easy. Two shorter walks vs one might actually be better for a bit.
Follow up with ice and elevation.
Im glad you are feeling pain free but you dont want to end up with self-induced tendonitis or other issues if they can be avoided with a little patience.
 
Will do. This all goes back to - "I'd like to talk to my surgeon."

It's also a big deal for me because my mother, who had bilateral hip replacements and really bad outcomes, has hip dysplasia. I don't think it was corrected in her THRs. My left hip is fine - it was just the right (operative) hip that had the dysplasia.

Having had tendonitis in my ankles, I also want to avoid that in the hip by overdoing anything. I'm doing well with the shorter walks and plan to keep that up. I'm off work for 3 more weeks, so I have time to recover and get stronger. So thankful for that!
 
Hello :wave:
Stopping by to say Hi and wish you a Happy New Year!
I hope you get all your questions answered by the PA tomorrow and feel reassured. Let us know how it goes.
Enjoy the weekend and the rest of your time off work. :)
@djacksonsf
 
@djacksonsf definitely keep us posted with what you find out tomorrow and hope you get a good, clear answer. Slow and steady wins this race and ice is your best buddy! :ice: :ice: :ice:
 
Got all my questions answered. The realignment is the same type of procedure they now do with younger people when dysplasia is identified before it can cause arthritis later in life. The aches and pains I've had are all part of the soft tissue getting used to the new position of the leg, and the doctor and his team only become concerned if these symptoms don't resolve in the next two months or so.

The perceived leg length discrepancy is part of this process, and the PA advised against using lifts on the nonoperative side. Contrary to earlier input, my legs were not measured radiographically. They only do that later on if aches and pains persist.

Other than that, the PA was pleased with my progress but reminded me not to overdo it. The X-ray was unremarkable other than being consistent with the ones taken upon discharge - and the fact that it indicates a great outcome. I can sleep on my stomach as well as lie on my side when watching TV, which is wonderful!

I did mention my concerns about not having seen the doctor after the surgery, and the PA apologized for that. It's apparently quite unusual for this to happen, and he'll definitely be at my next follow up on Jan. 31.

Best regards,

-Doug
 
@djacksonsf that sounds like a good follow up, even if it was only with the PA and it was explained that's not the norm. Good that you'll see the OS at the end of the month. It's always so good when you get the ok to lay some way other than on your back! Good advice about not overdoing it as you are still very early on in this recovery.
:yay::egypdance:
 
Hi Doug. Sounds like you got a very good explanation.I have dysplasia in both hips. This right hip was very sore, soft tissue wise, more so than the left.
I think it definitely had to do with rearranging and lining things up and in fact, for the first time in years I’m not pidgeon toed on the right any longer.
Time and taking things slowly are our best friends. So very happy that your PA was able to explain things and ease some of the niggling worries for you.
Have a great weekend.
 
Last edited:
Thanks Crucjet and Elf. Yes, it was a good appointment and I'm happy things are on track. I'll continue taking it slow and see what the next month brings. Also relieved that I'll be able to speak to the OS at my next visit!

Regards,

-D
 
Apologies for the typo Cricket.

Does anyone have advice on when to go back to work? I have a desk job that doesn't require a lot of walking except for a few blocks to and from transit. I'm scheduled to return to work in two weeks - at the 6-week mark in my recovery.

I feel good, am sleeping well and moving with more and more confidence.

I could delay my return by a week or two. Just trying to make the right decision. I haven't had this surgery before so I'm soliciting feedback.

Thanks in advance,

-Doug
 
Twelve weeks off is what's recommended with a Phased Return To Work -
bonesmart.org

Phased return to work

For return to work at 10-12 weeks as patient feels able, the following schedules are suggested week 1: Tues, Thurs 5hrs week 2: Mon, Wed, Fri 5hrs week 3: Tues, Thurs 8-9hrs week 4: Mon, Wed, Fri 8-9hrs week 5: normal duties The thing to remember really is that so often when people think of...
bonesmart.org bonesmart.org

While not possible for all to have that much time off, if you read the article it gives you a better understanding of all the energy it takes that most don't consider. If you're able to delay your return by a week or two, I would give it serious consideration. Upon your return, since you'll be returning a bit early, I wouldn't plan on doing much more than resting and icing once back home from work each day.

Have a great week!
@djacksonsf
 
Can you return part time with shorter hours. I returned to work after 6wks when I had my knees replaced and it was tough due to the tiredness. I also had an administrative position so was at a desk in my own office. Also, keep icing at work if you can even if you have to bring a lunch cooler with ice.
 
On RH, 20 years ago, was at work in four weeks - desk and attending meetings.

On LH last year, was back at desk with full, but painful mobility (due to being stupid and overdoing it from about day 8) by around 15-16 days ... could have been at work, but would have been a bit more logistically challenged :-)
 
I never went back to work, fail to see the big attraction! Seriously what's wrong with time off especially to recover from a major surgery? FMLA gives you 90 days if you fall under that.
 
In my case every week I'm out means my imminent retirement is pushed back a week, so I definitely have some motivation to go back.
 
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