THR Anterior Approach Walking Guidelines

[Layla]

Happy Two Month Anniversary!

And, of course, I won't do anything to jeopardize my recovery.

We'll hold you to that
Best wishes for a good week. Let us know how Thursday goes.
@djacksonsf

 

[cstinchcomb]

So glad that your walking practice is working. At this stage your body probably doesn't need any supports; it's all about the mind/body connection. I'd love to hear what you learn from your PT on all of this. 2 months out, awesome, congratulations.

 

[cstinchcomb]

And OMG, you just squatted down, reflexively, YAY.

 

[djacksonsf]

Thanks all!

PT went well. The therapist is one I've seen before for ankle issues. She's very conservative and made some good observations, all of which stem from her assessment that my glutes are weak.

She gave me some exercises to do and I tried a few to see how I felt. No immediate reaction, but I'll wait 24 hours and see how I feel before trying them again.

They include abduction while lying on my side, a low bridge, squats that end with balancing on my toes and another that's tough to describe without a photo.

I'll let you know how it all goes.

Best regards,

-D

 

[Eman85]

I hope the PT works out well. Lateral leg lifts and bridges were not good for me. I tried them with my first THR at around the 2 month mark, not good. I did some lateral leg lifts at about 2 months with this one and it's not ready yet. Not even fooling with bridges for a while.

 

[CricketHip]

Hi @djacksonsf I'm glad you found a conservative PT.. They are worth their weight in gold!

How are you feeling after the first go with the bridging and abduction leg lift?
Those can make a person in recovery very sore, but if she is advising slow and gentle with very few reps, you may just get along just fine.

If not, don't worry, Try again in another month.
I did several isometric type butt squeezes to re engage my glutes.. I would do this when resting and when standing. I felt, and this is just my own personal opinion, but I felt that did a lot towards strengthening and getting my muscles to re engage.

You are doing well, and was glad to catch up on your thread and see you are making progress with the dedicated heel toe walking. You are getting things done, hippie friend!

Happy Valentines Day!

 

[djacksonsf]

Thank you Eman and Cricket!

I did 3 sets of 5 reps of each exercise and was careful not to push it or overextend. There was no pain during the exercises, and I really felt the glutes and stabilizers working on the exercise I call the "tipping bird." From a standing position, it starts with raising one knee so that it's at 90 degrees. Then I keep my torso and elevated leg in the same plane and bend forward. My head and torso are in front of me and the bent knee leg is behind me.

I feel fine today, but I'm going to wait to tomorrow to do them again. It is satisfying to be doing more than I have done to date. Steady progress is all I ask for, and my goal is to get back to some light yoga, biking and to walk more fluidly. I'm going to an island off Italy in the summer where there are lots of steps, so I want to feel confident walking up and down. Seems like this is a good start to getting there...

The therapist did mention that my right (operative) hip is slightly higher than the left, but that this should resolve in the next few months. We've also covered this in earlier posts to this thread.

I'll let you know how things go. Tuesday will be 2.5 months!

-D

 

[djacksonsf]

Hi there,

Question for anyone who may know: I’m moving on 2/26 - a week shy of my 3-mo. anniversary. I’m hiring movers, so I won’t need to do anything strenuous.

I will check with my doctor but I’m wondering if there are any weight restrictions to consider at this stage of my recovery. I have some framed art that’s light and some clothes I’d like to move myself. None of this is more than 20lbs.

Has anyone been in a similar situation or received guidelines about what you can carry from your doctor?

-D

 

[leejaa]

I was told not to lift more than 10# for the first month and then at my 1m appt. I was told I could increase 10# per week as I progressed with recovery. Seems like 20# should be no issue. I am just a bit over 3m and have lifted 20# of bird feed with no issues and some other items heavier than that.

 

[djacksonsf]

Thanks Leejaa, that's helpful. Not that I'm going to try, but using that formula I should be ok to lift nearly 70 lbs. at this point. I would imagine that if I am going up or down stairs, I should err on the side of caution and minimize what I carry.

One reason I asked is because at my 2-month post-op visit with the surgeon, he cleared me to ride my bike but only on flat surfaces. I haven't ridden because I don't want to risk a fall during the first 3 months, but it seemed like he was saying that putting the extra strain of going uphill on the implant was not advised.

Given his input and the impending move, I thought I'd check with the forum...

-D

 

[Eman85]

I'd have to go find the paper work but at 3 mos I believe my OS allowed 25lbs. on the work release restrictions. He also advised me to not screw up his work that I paid him to do.

 

[djacksonsf]

Thanks Eman, a lot of online content says to avoid pushing, pulling or lifting more than 25lbs repetitively, as this will reduce the life of the joint. I don't plan on risking that.

The hard part at this stage for me is that I feel so good - and with that sense of well being comes the need to catch myself before I do anything that puts too much stress on the implant. I can think of one time when I probably overdid it lifting something while squatting, so I just keep that in mind as I move through the next 2 weeks - to the 3-month mark - and beyond.

 

[Jaycey]

content says to avoid pushing, pulling or lifting more than 25lbs

I would not say this is a life time restriction. But I can confirm you hip will quickly let you know when you have over done. I moved house at 4 weeks out of RTHR and did no lifting. It's hard to watch everyone else being active. But as Eman says - why mess up all the good work your surgeon did!

 

[djacksonsf]

Thanks Jaycey, agree completely. I've been doing things like taking out the trash for a while now, but I wouldn't ever consider moving anything really heavy like a piece of furniture, etc. One dumb thing I did a week or so ago was pull a heavy plant out of its container, but there's been no negative reaction hip-wise.

Sometimes I think for the anterior approach it would be good to include more restrictions for younger, active people in case they progress well and because the tendency is to do more than less when you are feeling mostly normal.

Other than the external rotation and no lunge restrictions, I was told to move as I normally do. For people like me who are always doing something - cleaning, organizing, walking the dog, washing a car, doing errands - that could backfire.

It would also be good to explain more about the stages of recovery. My doctor advises against PT until the 2-month mark because - as the PA said - "he doesn't want anyone to screw up his good work." I get that, but does that mean the bone has grown into the implant sufficiently by 2 months to avoid the risk of implant movement? I'm guessing yes, and I'm guessing that may also be because the implant may not have been cemented.

At this stage and for some time to come, my body is healing, so I won't be helping the movers ;-). But it would also be good to understand what's happening when during the healing process.

-D

 

[Jaycey]

But it would also be good to understand what's happening when during the healing process.

This article will give you a good idea of what is going on: Healing: how long does it take?

 

[Mojo333]

Sometimes I think for the anterior approach it would be good to include more restrictions for younger, active people in case they progress well and because the tendency is to do more than less when you are feeling mostly normal.

I agree...I had to find my lines the hard way often.
Listen to your body was great advice to me.

 

[djacksonsf]

Yes, some sites say it’s good to avoid stairs during the first 3 months to safeguard the new hip from being overloaded, and this is something I can’t do in practical terms.

It’s all very individual - and the last thing anyone wants is to research peri prosthetic lucency or aseptic loosening :-/

 

[Mojo333]

Yes, some sites say it’s good to avoid stairs during the first 3 months to safeguard the new hip from being overloaded, and this is something I can’t do in practical terms.

I think this is overly conservative and most of us can't practically avoid them.
I toddler stepped stairs one at a time for many months post op...since I had bilateral it was almost a given as things were still erratic strengthwise...plus I Did Not want to fall down and Go Boom.
All temporary and was all normal by about 4 months out.

 

[djacksonsf]

For what it's worth, I did check with my doctor's team today. For me, carrying light stuff is ok. What they want me to avoid is exercise with resistance until the 3-month mark. In the meantime, a single lifting movement with resistance is nothing to worry about, but doing squats with weight repetitively is. I have absolutely no desire to do the latter and will sit on the sidelines during my move.

Happy Monday to all,

-D

 

[Eman85]

Sometimes I think for the anterior approach it would be good to include more restrictions for younger, active people in case they progress well and because the tendency is to do more than less when you are feeling mostly normal.

Maybe the health professionals should stop selling the anterior approach as having such a quick recovery. Everyone's restrictions or limits to enter the ODIC are different but it does seem that many have a unrealistic picture painted for them pre-op.