THR Anterior THR - May 25th

[Coopdville]

Just discovered BoneSmart and am so excited to read everyone's stories, the ups and the downs.

I'm 61, male, and had been suffering from osteoarthritis in my left hip for several years (and probably longer than I realize). I'm athletic and have been physically active pretty much since I was a kid. I played sports growing up, and became an avid runner at around age 22. I've also done a lot of cycling, hiking, skiing and other activities. In 2019 I joined the Orangetheory fitness center and have done over 300 classes there (would be a lot more if not interrupted by the Covid lockdown). I really love Orangetheory and I feel the whole body workouts I'd been doing has really helped me in this recovery.

In the last year my hip became increasingly painful to the point to where I had to proceed with the THR. I am now one month in (31 days), and all-in-all my recovery has been great. I only used a walker for about 3 days, then switched to a cane for about 3 more. After that I felt very comfortable carefully walking without any assistance. After 1 week I started taking some short outside walks, and at 10 days I walked a mile (with a couple of rests). I use a Pedometer app and on day 12 I saw I had taken over 10,000 steps that day and decided that was probably too much. I had a goal of increasing my walk distances, but I have since pushed that goal back some.

My sleep has been great. I was sleeping terribly in the weeks/months before the surgery because the arthritis pain would keep me awake. Now that pain is completely gone, and the post-surgery pain (at least at rest) is nothing in comparison.

I started to drive at one week. I realize all this sounds too fast, but I was perfectly comfortable getting in and out of the car, and the surgery was on the left hip which makes driving easier.

But, I think I did finally join the ODIC over this last week. I haven't really done more, my walking distance didn't increase and I've averaged about 7000-9000 steps a day. But last weekend I started feeling pain in the front of my hip (around the implant). I wrote to my surgery/nursing team and they had me get an x-ray. The surgeon called me (to my surprise) and told me the x-ray looked perfect, there was no sign of movement or loosening (whew!). He said, of course, to slow down, ice, and elevate.

Since then these last few days have been up and down. One day will feel good and the next the pain is back and walking is painful (mainly steps forward with my left leg). Sometimes I have to stop myself from thinking the worst, like something is wrong. I know I need to take it easy, and I'm trying. I've never been someone that likes to sit around, and even when I'm holding myself back from exercising I still find myself on my feet doing something. Patience, patience, patience.

I'll keep posting as the days/weeks go by. I really enjoy reading about other people's progress (and struggles). We're all getting through this, and we all have our own timelines.

 

[djklaugh]

@Coopdville Welcome to BoneSmart! It is hard for active people to shift to neutral when recuperating from surgery. And hip replacement is major surgery. It takes much more time than one originally thinks for everything to heal up. It's not just the incision that needs healing - muscles, tendons, nerves and blood vessels too need to heal. Plus bone needs to grow around the implant. It can take as long as 12 months to fully heal from a hip replacement.

It does sound like you rushed things a bit and did join the ODIC - most everyone does do that at some point. Do as your surgeon recommended - take it easy, ice your hip, elevate the leg.

Here are our post op articles and suggestions:

Hip Recovery: The 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.
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
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.

 

[Jaycey]

@Coopdville you are only one month out of major surgery. Please slow down and let that hip heal. All this is temporary.

I like this visual of recovery:

 

[myglasshalffull]

Welcome,
You are not trying out for the Olympics, you are recovering from major surgery.
Trust me, I had to learn patience, I am not patient either and like you was very active prior to falling on ice and fracturing my hip.
You will get back to your activities in good time, for now grab a book or watch a move and relax!

 

[Caison113]

@Coopdville - welcome to Bonesmart and thanks for sharing your story. Your recovery sounds pretty similar to mine in terms of time and level of activity, however I did give myself a full month before I started doing any real exercise beyond walking and the little movements recommended by my doctor. My main activity is kickboxing and other self defense so I just went real slow and week by week added more and more. Definitely had to work through some pain issues, but the needle continued pointing in the right direction. Your body is very good at telling you when you are doing too much and we just have to convince our brain to listen. Feel free to poke around in my history to see how I progressed. With my second hip I kept a pretty regular diary. Good luck!

 

[CricketHip]

@Coopdville I love your name for our forum, I smiled when I saw it.

I agree with the crowd here, you did kind of over do it. We have a great saying on BoneSmart-
"just because you can doesn't mean you should."

Hopefully you can exercise your patience muscle and let things calm down for a bit.

When you are up and walking, please remember to focus on your gait. You want to aim for a heel-toe walking stance, meaning as you take a step you want to strike with your heel, then roll forward and through your foot until pushing off of the ball , then toes of that foot.

It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.

Additionally, are your walking shoes the ones you used before your surgery? If yes, they are probably worn in a bad way, from your limited gait or limping.. maybe find some new walking shoes? I know it made a big difference for me.

Glad to hear that your recovery is going so well! Just ease up a bit and your success story will continue.

 

[Coopdville]

Thank you, I’ll more into walking shoes.

And thanks everyone for your responses and your support! I know I need to be patient and take it easy. I’m making a concerted effort to slow down.

 

[Coopdville]

*I’ll look more into walking shoes. Do you have any recommendations where to start?

 

[myglasshalffull]

There are several good companies Orthofeet, OOFOS, Skechers come to mind. I have OOFOS and Skechers. Skechers makes a nice slip on sneaker/shoe. Good support.
My slides are OOFOS and I love them.
I'd google for more companies.

 

[Elf1]

@Coopdville welcome , happy to see you here on the healing side. As far as new shoes go you can basically just go with whatever brand you've been using, you just need new ones. Yep, that patience muscle is a really hard one to exercise during recovery, especially when you're normally such an active person.

 

[CricketHip]

I tend to need a more supportive shoe which means Oofos and sketchers don't work for me.. If it's at all possible, I'd recommend going to a walking of running store. I swear by a good running store where they know how to access and fit you correctly.

But like @Elf1 said above, if you have a good brand that you are happy with, just update them (new pair)
and who doesn't enjoy a new pair of shoes, right?

Good luck and happy recuperating.

 

[Layla]

Happy Two Month Anniversary!
I hope recovery is moving along nicely for you.
Let us know how you’re doing next time you’re around.
Best wishes!
@Coopdville

 

[Coopdville]

Wow, so it's been 2 months. I've been counting it in weeks and missed my monthly anniversary yesterday. I keep thinking that 'next week' will be a better time to give an update, so I keep delaying. My recovery is going well overall, with some ongoing annoyances and maybe a concern.

The good: Right out of the gate following my surgery the absence of the arthritis pain was obvious. Even with stitches bothering me, swelling from hip to foot, and surface nerve pain in my front thigh I slept 8 hours a night. The arthritis pain was interrupting my sleep terribly and it is delightful that it is gone. Secondly I was up on my feet walking, even without a walker or pain after the first week. After my 3rd week I started having pain in my front thigh. I was probably doing too much in the first 3 weeks, and folks here in this thread gave me the ODIC badge of honor, which I took to heart. Since this time, up to present, I am still struggling some with this kind of pain.

More good: Now at 2 months, stretching and flexibility is noticeably better than before surgery. I can sit on the floor with my legs criss cross without pain. I can do a groin butterfly stretch without pain. Stretching feels good I am doing PT exercises, and walking on a treadmill (slow at incline), and spinning on an indoor cycle.

Some frustrations: From weeks 4 to 6 I was very frustrated. I started having sharp, nagging pain in my front thigh. It was most bothersome in my walking strides and the weight impact on left side footsteps. I slowed down a lot, not doing any outside walks other than going to the store. I spoke with my surgeon and, while he thinks this is likely illiopsoas tendinitis that will resolve in time, he wanted to be conservative and he ordered a CT scan.

The CT scan showed no fracture, and no significant movement of the implant. Other findings were indeterminant but not of concern. On my regular follow up visit with my surgeon 2 weeks ago, I told him that I continue to have this front thigh pain that impacts my walking stride. It is the interior thigh, with pain activated directly while sitting and lifting my left foot up to rest on my right knee, or raising my left foot/leg to get into the car or into bed. My surgeon thinks that is is most likely iliopsoas tendinitis, and should resolve on its own. But I can tell he's still concerned that there could possibly be some impingement that is more difficult to resolve, and he has ordered an MRI. It is scheduled for Aug 16th but I'm on an urgent list and hope to get in sooner. Hopefully the MRI will be able to identify the cause of the pain by examining the soft tissue.

I have good days where the pain is almost not noticeable, and other days when it's cranky and I walk with a limp. It's frustrating because I can feel my hip overall getting stronger all the time. But this front thigh pain is persistent and has been for the last (almost) 6 weeks. I'm somewhat concerned because there are numerous studies that show there is a not insignificant rate of iliopsoas tendon problems after THR that are difficult to resolve.

So the recovery continues. I know it's only 2 months and in many regards I'm doing great and maybe ahead of schedule in some ways. But the persistence of this pain is impossible to ignore, starting week 4 (day 22) and now it's day 62.

 

[myglasshalffull]

Hang in there, do you sit and ice and relax a bit? Sometimes when I have an ache I just go lay down with my trusty ice pack for 1/2 hour, read or watch TV and seems to feel better after.

 

[Mojo333]

@Coopdville
This recovery business is tricky, for sure!

The good: Right out of the gate following my surgery the absence of the arthritis pain was obvious.

Isn't it amazing...I was so excited ...now the surgical trauma must heal.

Now at 2 months, stretching and flexibility is noticeably better than before surgery. I can sit on the floor with my legs criss cross without pain. I can do a groin butterfly stretch without pain.

I'm always taken aback somewhat when I see members discuss these sorts of movements at such early points in recovery...
Not sure why this seems to fascinate folks or perhaps they feel like this is a benchmark to range of motion but I think it is super unhelpful to still healing traumatized soft tissue.
Stretching does feel good as does other movements, but it seems that we overdo and it never hurts until afterward.

My surgeon thinks that is is most likely iliopsoas tendinitis, and should resolve on its own. But I can tell he's still concerned that there could possibly be some impingement that is more difficult to resolve, and he has ordered an MRI. It is scheduled for Aug 16th but I'm on an urgent list and hope to get in sooner.

Scaling back and rest and ice will be the best regimen for tendonitis.
Boooring, I know.

I'm somewhat concerned because there are numerous studies that show there is a not insignificant rate of iliopsoas tendon problems after THR that are difficult to resolve

No, it isn't uncommon and, in my opinion, is the result of the surgeon not making clear there is a very real risk of causing tendonitis by trying to jump back into activity too soon.
We do this to get back to life, yes, but the Healing takes the time it takes and All Temporary
I do hope MRI doesn't show any concerns.
Most of us have been guilty of overdoing things (myself (included)as we navigate this recovery, and even very fit folks need to take things slow after this major surgery as recovering from tendonitis can take weeks and even months to resolve

Please let us know how the imaging comes out.

 

[Layla]

Wow, so it's been 2 months. I've been counting it in weeks and missed my monthly anniversary yesterday.

Yes! Two months already! We need to go by months as it’s easier than trying to count weeks and after a time, you won’t be counting weeks anymore either, instead going by the date of the month.

Please share updates as often as you like. Many use this as their healing journal of sorts to reflect back on at a later date.
I hope you have a nice day and weekend!

 

[Coopdville]

'm always taken aback somewhat when I see members discuss these sorts of movements at such early points in recovery...
Not sure why this seems to fascinate folks or perhaps they feel like this is a benchmark to range of motion but I think it is super unhelpful to still healing traumatized soft tissue.
Stretching does feel good as does other movements, but it seems that we overdo and it never hurts until afterward.

The stretches I mentioned don't directly stretch the psoas. I find that I feel better after these stretches, not worse. I do them gently not forcefully. Lately I'll sit on the floor when I'm watching TV and find I feel better after. There is a tricky balance of rest vs. proper movement and exercise that is part of this recovery. The advice is to do both. I agree that I did too much too soon (mostly too much walking), but I have been much more careful since then. I take full days off from exercise other than necessary walking to get around, elevate and ice my hip/thigh, and take NSAIDs.

My surgeon theorized that, due to my chronic hip arthritis and pain, that I have "muscles that have chronically shortened and laid dormant for many years". This resonates. I remember some years ago a physical therapist commenting on my very tight psoas. I think, and hope, that my recovery is going to be a very delicate mix of rest, patience, proper exercise, patience, setbacks, patience, and slow, steady, eventual recovery.

I do appreciate the feedback. It is a constant reminder to take it easy.

 

[Mojo333]

I certainly didn't mean to sound like I was scolding you... every one is Different
and I did both-at-once so the idea of sitting cross legged at 2 mos out sounds crazy to me.
I had groin aches for up to 6 months and some glute knotting....it's definitely a lesson in patience...

 

[Coopdville]

Thank you. I didn't mean to sound defensive either. I really to appreciate the feedback, and also hearing about your experiences.

 

[Hip4life]

I’m sorry you’re dealing with this. Your situation is so relatable to me. It does take time. I think I like the part of our post op recovery guidelines that says: if it hurts, don’t do it or if it causes you pain the next day, stop doing it. If the tendon is really angry, even gentle stretches can aggravate it. I remember just running into a cardboard box at 6 months how I strained an inner thigh muscle and made it sore.

When I dealt with the tendonitis, it was wait and see, first. Then we tried the prescription anti-inflammatory again. The next step was injection. So, it took a little time to realize that it wasn’t going away on its own (mine was caused by impingement.) During that time, I tried not to aggravate the muscle/tendon in any way and just moderately walked as I could tolerate. I couldn’t get away from that with my job, in any case. Patience is going to be your friend as this gets sorted out. That’s not easy as all you really want is to get back to your life. Best wishes going forward. Keep us posted.