THR Anterior Approach Walking Guidelines

[djacksonsf]

That's a good idea. In my case, I didn't feel as though I was being sold on the operation - I actually chose it over the traditional approach because of some of the complications my mother had had.

More details about healing and precautions would be helpful. No offense to physicians in general, but expectation setting and good communication are not always skills everyone has. Even in business, good communication is often regarded as a soft skill that's nice to have until something really goes wrong...then, suddenly, it's important

 

[kimbarella]

I'm in week 4, anterior, and find myself using the cane a bit more than in week 3. Yesterday I didn't use the cane around the house, and that felt okay, but I was hurting by day's end. I'm working with a PT who keeps saying don't over do it. I appreciate his gentle guidelines. Walking may be the best PT but I appreciate his insights into different muscles and how to baby them along.

 

[kimbarella]

No way I can do a lateral leg lift (post-op day 28, anterior) while lying in bed with one knee bent. I can barely scoot the operative leg to the side. So I'm working on the things I can do and my very conservative PT person can help with the rest.

 

[djacksonsf]

Good to hear you are progressing well and moving forward cautiously. I couldn’t do leg lifts at 1 month and didn’t try. There’s no rush.

I have overdone it twice and it’s not fun. Better to bide your time and pause before just doing something you’re feeling good enough to try - or something you do out of habit.

-D

 

[djacksonsf]

The move is done and I was good - I let the movers do their job. It was still a lot of standing and going up and down stairs. I'm a bit sore today and am sitting on an ice pack to be safe. I had some startup pain mid-thigh yesterday, but it's gone today.

Next Tuesday is 3 months, so that first period of healing will be over. I'm still a bit concerned about having done too much during this past month, as I know the first three months are critical to osseointegration. Most online content advises against bending, stairs, lifting, etc., to promote complete implant fixation.

By doing too much I mean carrying things and going up and down stairs, but none of this was mentioned by my surgeon when I met him on 1/31. He really only wanted me not to exercise with resistance - especially anything repetitive. I also wasn't aware that NSAIDs should be avoided for the first 6 weeks because they interfere with bone growth. Thankfully, I never took any.

Now that I'm moved into my new place, I'll just stick to walking and will visit the conservative physical therapist to work on improving my gait.

Thanks all for helping me through this!

-Doug

 

[Elf1]

Happy the move is done and you're not feeling too much pain and that you're being smart and sitting on an ice pack.

I would think of your OS had any worries about your activity he would have mentioned them. I think you're probably close enough to that 3 month mark that you shouldn't have caused any problems with the lifting boxes and climbing stairs. If you do feel something has changed though, please check with your doc. I think you're doing great, keep it up!

 

[djacksonsf]

Thanks Elf!

I just feel a few more aches and pains than I have in the past, but they usually pass in a week or so. I did reach out to my care team and they said that if anything were significantly amiss, it would be noticeable when I walk. I haven't had that, so I think I'm good. Now it's time to enjoy the new hip!

-D

 

[Mojo333]

Glad you are settled in after the move and not too much worse for the wear.
I've always been accustomed to doing alot of the offloading at my job and my new hips would complain about alot of weight, especially the first year.
Hope you have a good weekend @djacksonsf

 

[CricketHip]

You sound like you are doing so well.. congrats! I like how you are taking things slowly and steadily.
I thin it took me to around 4-5 months to feel that the soft tissues around the hip begin to settle down.
I'm 8 months post op and oh my goodness, I can't wait for you to get to that stage.. I took my nightly 2 mile walk again last night and it's so amazing how it feels to have easy fluid movement from my hips.

 

[cstinchcomb]

Hey Doug, so glad your move was successful. And that at least the first phase of moving is complete. You are so lucky to have had quality help.

On the overdoing it ... we are all different ... but I think that you haven't overdone it too much, at least compared to what I did with my first (eft) -- and my left side works really perfectly and has worked perfectly from the start. The house we lived in at the time had 45 steps to the front door, and three story house once you got inside. The first week, I pretty much stayed upstairs in the master bedroom. But after that, wowee, no real way to avoid it. So all the best for your continued recovery, and hoping that you are walking both without limp and without pain for the coming years.

 

[djacksonsf]

Thank you, cstinchcomb!

Appreciate the feedback. I mainly did what you did, but also carried some items and did a fair amount of bending and stretching as part of the way I normally move. My doctor and his team didn't mention precautions against any of this - they just said move as you normally do - so I didn't really learn there were other things to avoid until I began reading posts on Bonesmart.

When I saw precautions about not carrying more than 10 lbs, avoiding stairs, not bending or putting the hip in extreme positions (some of which include tying your shoes), I began to wonder if I'd overdone it.

As you say, it's different in each case. I think I'm ok, but the additional precautions just gave me pause from time to time. I don't mean to be a worry wart, but sometimes it's unavoidable

-D

 

[Elf1]

All surgeons seem to have their own set of rules and restrictions. But it doesn't hurt to try out best to follow some of the basic ones in the early days of recovery. Better safe than sorry. And I think we all wondered from time to time if we were pushing our limits.

 

[cstinchcomb]

I'm not trying to advocate for doing too much. But since what done is done, I provided a rather extreme example that did come out better than OK in the end. In fact, for this second upcoming recovery, I intend to take it easy, and do less. We've moved from the mountains to the flatlands, this house has no steps higher than a door threshold -- that makes me . We even have a ramp if necessary.

So ... this week, even though your new house is calling for your attention ... maybe some downtime is in order. You know best. We all want to heal up as well as we can. Those first few months are so short, compared to the rest.

 

[djacksonsf]

Thanks all!

I've been really good, but the buttocks pain while sitting has not really changed much in the last week. It's much better than two weeks ago, but I still I feel a little discomfort in the morning when I wake up followed by increasing soreness throughout the day. I've been icing and using heat.

This pain is low and in the center-outer part of the buttocks, so I'm thinking it's where the glutes and hamstrings meet. Trying to ignore it, but it sure would be nice if it went away.

Perhaps it's just a really bad strain of the glutes and connecting tendons?

The other thing I've noticed is that the leg length discrepancy hasn't gone away. Maybe this is because soft tissue irritation/tightness around the joint is preventing that tissue from relaxing around the new hip - I don't know.

I see my physical therapist this week, so will ask for her input. I've already told her I'm not doing any exercises because I want to play it safe.

-D

 

[CricketHip]

The area you are describing as sore sounds like the exact muscles and tendons that are involved with lifting and bending a lot ( like in moving to a new home).

Hopefully your PT will do some manual work on your glute muscles and possibly show you some gentle stretches to ease the tightness.
Here is a Bonesmart article about a pesky muscle that might be part of your problem. Maybe reading this will help ease your mind and maybe you could try gently doing some of the stretches to see if it helps? Or at last ask your PT about it when you see them next week.
For what it's worth, I still get tightness in my piriformis and do the stretches when needed. they are very helpful for me.

Piriformis syndrome

Basically, simply a muscle spasm with consequences, piriformis syndrome is far more common than people (including doctors) realise and really is a pain in the butt on two fronts. First it's extremely distressing and can almost totally disable the sufferer Secondly it can be a long term problem...

bonesmart.org

 

[djacksonsf]

Thank you as always Cricket!

Tuesday was my 3-month mark and things have been improving slowly. I saw the physical therapist today and she agrees it’s a soft tissue problem.

Her input was to use heat and avoid stretching the butt muscles. She recommended some milder strengthening exercises than I’d been doing before and noted that the rotation involved in a clamshell irritated the deeper gluteal muscles. That exercise is off the list.

I’ll wait a day or so and see if starting what she suggested helps. I think her approach of gently strengthening makes sense.

Otherwise it’s just nice to walk mostly pain free as spring approaches. So grateful to do little things like walk the dog, etc.

-D

 

[FCBayern]

Isn't it amazing how good it feels to do things like walk the dog again @djacksonsf? The idea of living pain free again was hard to even imagine just a few months ago, but here we are!

 

[Eman85]

I've still got a tightness in my outer butt, I feel it when I reach for my foot. It's getting better and I've been doing some stretches. I pull my heel to my butt when sitting in my recliner. Also lying on my back I bend a knee and then cross my leg over it and stretch the muscle.

 

[djacksonsf]

Yes I've seen those stretches and tried them, but they really upset the deeper glutes and piriformis so I'm going to wait a while to try them again.

I know that running is not advised after a hip replacement and that it should be avoided completely during the first three months, but is it ok after that to jog for a few seconds to get out of the way of traffic or to jog down the block to catch a bus? And by jog I really mean jog - not an all out run. I'm too old for that anyway!

I know that doing these things on a regular basis can wear out the implant earlier than it otherwise would, but are we really meant not to run at all, ever? I ask because I commute to work and think it's probably inevitable that at some point I'll need to avoid something in the street or catch a bus or train.

Thanks,

-D

 

[Mojo333]

Hi...I had to "jog" away from a cottonmouth snake that flipped over in a canoe at 5 months out...and a quicker jog from a runaway firework at 8 months...
Wasn't trying to...but no harm done as long as you don't fall...
You will be stronger as the months go on...so the longer you can wait to try it, the safer you can be if you need to...in my humble opinion.