THR Continuing pain after one week

[FraidyCat]

Thank you, Mojo333. For whatever reason I’m unable to access the article about tendinitis using the link, at least not on my iPhone. I will try it again on my PC.

Eman85:

It seems to me using a cane on the stairs would be harder and almost dangerous. I used the handrail and went one step at a time using my non op leg as the one doing all of the work, so no strain on the op hip and leg. 5 times a day up and down depending on how many steps might be a bit much.

I started out using the handrail when I returned home from the hospital the day after the surgery. After three days of doing that, disabling pain set in. The theory was that I was placing too much weight on the operated hip by using the handrail only, which is why the PT switched me to using a cane on the stairs. She is arriving again soon and I am going to pose this question to her again.

 

[Zoebichon]

I nailed the short set of hospital stairs no problem. But once home, I didn’t touch those 14 steps to my upstairs until one week out when the PT took me up them.

She had me put both hands on the one railing and I hauled myself up that way. I felt pretty wiped out after that and I didn’t attempt the stairs again until 2 weeks out. Then only as absolutely necessary! I used a little backpack to carry things to avoid unnecessary trips.

Now at 9 weeks, I go up and down all day and don’t hold on. Once I even ran up them although I didn’t realize it till I was at the top!

 

[Eman85]

How many steps? When you go up which leg do you lead with? Which leg going down? Are you going 1 step at a time or trying to walk up and down normally?

 

[FraidyCat]

Approximately 15 steps. I am leading with the bad leg going down and the good leg going up and going one step at a time, not normally.

 

[Going4fun]

So sorry about the pain.

Just a double-check here ... it might be irrelevant, but just to be sure.

Climbing stairs--the technique is:
Going up, you lead with your good leg (the one not operated on).
The good leg pulls up the weaker leg, step by step.

Going down is the opposite:
You lead with the operated-on leg.
The stronger led is actually keeping you balanced, holding the weight, while the weak leg is dangling between steps.

I'm going to guess you have this down, but frankly, I found this confusing until I took care of my ailing parents, and had to learn how to direct them when climbing their stairs.

 

[FraidyCat]

Going4fun:
Thanks, yes, I have been using that protocol on the stairs all along. The stairs aren’t actually where I’m experiencing the pain anymore. It’s occurring with movement and mobility involved in most other activity.

 

[FraidyCat]

I nailed the short set of hospital stairs no problem. But once home, I didn’t touch those 14 steps to my upstairs until one week out when the PT took me up them.

She had me put both hands on the one railing and I hauled myself up that way. I felt pretty wiped out after that and I didn’t attempt the stairs again until 2 weeks out. Then only as absolutely necessary! I used a little backpack to carry things to avoid unnecessary trips.

Now at 9 weeks, I go up and down all day and don’t hold on. Once I even ran up them although I didn’t realize it till I was at the top!

Hi Zoebichon, thanks for your response. I’m unable to avoid the stairs in my house as I live alone and the kitchen is on the lower level. I had lined up a home care company well in advance of the surgery, anticipating that I might need help with household tasks. However, the company let me down immediately by failing to provide employees who were suitable, so I’ve been mostly on my own, using a patchwork of a couple of friends and a tasker whom I pay for random visits.

That said, the stairs ceased being a source of pain after the PT showed me the cane-and-railing technique. It’s basically every other movement and even at times while at rest that the pain and discomfort levels are far exceeding what I would have expected 3 1/2 weeks postop.

 

[Layla]

pain and discomfort levels are far exceeding what I would have expected 3 1/2 weeks postop.

This little diagram is simple, but true!

It's your one month anniversary. I hope its a happy one and I wish you a great day!

 

[FraidyCat]

I am now at going on five weeks postop. Recovery, in terms of pain and mobility, still seems concerningly slow. The PT has been pushing me to transition from a walker to crutches and I’ve been using the latter for short walks outside the house and inside the house unless I am needing to transport food using the walker tray. I have two types of crutches: the basic underarm and the forearm Lofstrand type. Over the last day, I’ve felt muscular pain in the crook of the elbow; I’m not sure which type of crutch is more likely to be causing this. I am taking close to the maximum safe dose of Advil for pain each day. The pain hasn’t been that bad after the outdoor activity, but when I wake up in the mornings it is a 10 in severity on a scale of 1 to 10 and persists for hours.

Wish I could report more confidence in my progress (such as it is), but it is so drastically less than what I experienced at the same juncture when my other hip was replaced in 2016. It’s hard to avoid feeling as though this surgery was a mistake, since my mobility before having it was so much better than it is now.

 

[Jaycey]

Please stop letting PT push you into anything. You will transition to another walking aid when you are ready. There is no timeline for this.

 

[FraidyCat]

Please stop letting PT push you into anything. You will transition to another walking aid when you are ready. There is no timeline for this.

The timeline for ADLs on this site suggests I should be doing significantly more walking than I'm doing at this point. I can't take "walks" of more than a minute here and a minute there inside the house on a walker; that requires crutches and some time spent outside. The PT says that muscular strength isn't regained without pushing oneself ... I'm not trying to be contradictory; it's just that I've gotten a lot of contradictory information. The surgeon's nurse assistant, in phone conversations--my postop appointment isn't for another week--has shown about as much interest in my concerns as would an employee at the takeout window of a fast-food chain.

 

[Jaycey]

The PT says that muscular strength isn't regained without pushing oneself

Yes, but at only one month out of major surgery it is not the time to build strength. Let that hip heal and you will gradually be able to increase your walking.

The timeline for ADLs on this site suggests I should be doing significantly more walking than I'm doing at this point.

It's only a guide - not necessarily the route for everyone. Every recovery is different - even on the same person (as you are seeing).

In the end, the direction of your recovery is your choice. Do what works for you.

 

[subie2021]

It sounds like you're having a rough time of it. Maybe take a few days' break to step back from the pain?
Can you get more steps in with the walker by going back and forth on the best route through your house? My house allows only 20-30 steps from one end to the other, so it meant going back and forth several times to rack up my step count.
Would a couple of hiking or walking poles be enough support for you?
You can tell your PT that you aren't ready to ditch the walker yet...maybe next week. It's her job to work around your limitations and to find alternatives for you. It's not your job to hurt yourself so she can check off something on a work sheet. Please, cut yourself some slack and go at a pace that doesn't hurt you.

 

[Snoopy55]

ou can tell your PT that you aren't ready to ditch the walker yet...maybe next week. It's her job to work around your limitations and to find alternatives for you. It's not your job to hurt yourself so she can check off something on a work sheet. Please, cut yourself some slack and go at a pace that doesn't hurt you.

I sooo agree with @subie2021!! PT is meant to help strengthen the muscles but sometimes that does involve pain and soreness. I started PT in home for 3 weeks which was great. Once I transitioned to out patient I was going 3 times a week as if I was training for a marathon ( I was actually going abroad and thought I should "train" to be able to walk places whilst on vacation) BIG MISTAKE. Put myself in so much pain that I ended up back on the opioids every 4 hours. Gave myself a break of 3 weeks and started with another PT group which was fine initially but then started pushing so I ended up just ditching the whole PT thing and going with the bone smart ideology which is to walk and not to excess and that hips don't really need PT...Truth be told I do tend to walk in excess sometimes but I am also 5 plus months post op and I still have to use a heating pad. Take it slow. There's alot of healing that needs to happen and you are only at 5 weeks.

 

[Eman85]

Comparing your new hip to your previous hip doesn't always work, no 2 are the same and memories fade over time. Pain the following day is common when you push too hard, it's telling you that you're not building strength just causing strain. None of us on here have any medical qualifications but I bet none of the people telling you to push have ever had a THR. If you sit and rest for a couple of days none of us will tell any of them and the only thing that matters is that your pain stops.

 

[FraidyCat]

If you sit and rest for a couple of days none of us will tell any of them and the only thing that matters is that your pain stops.

 

[FraidyCat]

The thing is that I’m really doing very little in terms of exertion, yet the pain is still severe in the mornings and at other times often considerable as well. The anterior approach, which is what my surgeon used, is generally touted as producing a more rapid recovery. Most of the pressure I’ve felt from the PT has come from her wanting me to transition from the walker to crutches in a way that felt abrupt and that seems to correspond to the fact that I have only a couple more allotted sessions.

 

[FraidyCat]

It sounds like you're having a rough time of it. Maybe take a few days' break to step back from the pain?
Would a couple of hiking or walking poles be enough support for you?
It's not your job to hurt yourself so she can check off something on a worksheet.

 

[FraidyCat]

Thank you, subie2021. I’ve never used hiking or walking poles but I don’t think they would provide enough stability, given my pain level. The PT actually occurs only twice a week and is now about to decrease to once a week, so I don’t think the problem has been not giving myself a break. The pain seems to be triggered after having sat in my chair watching television and upon getting out of bed in the morning, which I assume is due to stiffness. I know long periods of immobility aren't good, but it's hard to manufacture reasons to move around constantly.

 

[myglasshalffull]

I'm still stiff when I first get up in AM as well as after sitting for long periods. My GF called yesterday and wanted to go for dinner, just didn't feel like driving the 35 minutes to the destination, then sitting for 2 hours eating and chatting, then drive home. My hip doesn't like it.
So I stayed home and walked around my yard several times. I had walked a big walk Saturday and I was a little sore yesterday so Iced and walked around here off an on, by later in afternoon felt totally fine.
I think you just have to listen to your body, I've taken my body's clues and I have a good idea now on what I need to do for any particular day.
Don't let PT bully you and if you only have one more session then continue what you've learned at home. I find PT to be very repetitive and once you learn the techniques easy enough to do on your own.
Prior to transitioning from walker to cane I'd hold on to backs of my dining chairs and walk around the table, same at kitchen counter, that gave me the courage to go to the cane.
Also had a friend who is PT and she came over and helped me.
You will transition when your body and your mind are ready. A lot of my fears were in my head (and still are) due to the fall the necessitated the surgery in first place. Then OS keeps saying "don't fall." So this is also a mental battle as well as physical.
Keep us posted.