Went to my Physical Therapy assessment meeting yesterday. This PT was recommended by my revision surgeon and specializes in joint replacement. I was very impressed by his knowledge and approach. He did a very thorough assessment of my ROM and strength. He also confirmed what I suspected... I likely have a real LLD of about 1/4 to 3/8 inch (6-10 mm), but he doesn't want me to start using a shoe lift yet. This is disappointing, but if everything else works out, it will be a small price to pay.
I'm still having weakness in my psoas muscle and soreness in my psoas tendon. It's not as severe as it was pre-revision, but that may be because I haven't used it much yet. The PT recommended stretching and strengthening exercises. The strengthening exercises are designed to avoid psoas contractions which he said would only aggravate the problem. Instead, I'm to do a passive straight leg lift using a strap to lift the leg about 12-18 inches and then lower the leg slowly over a 5 count (15 times, every other day to start). He'll also do psoas muscle massage by pressing through the abdomen (ouch!). I've had a massage therapist massage the psoas in my upper thigh, but the PT points out that 75% of the muscle is above the groin in the torso, behind the abdominal muscles.
I've had some pinching pain and inflammation deep in my hip that is in a group of small muscles that include the inf/sup gemellus, the obturator internus, and the quadratus femoris. He found that I had absolutely no strength in these muscles and said that these were likely cut and subsequently repaired to allow access to the joint in my original posterior surgery. I had always thought the muscles were only separated, but not actually cut.
The PT said still too early to start strengthening of quads, hamstring, etc. He wants to wait at least a few more weeks for that.
I'm increasing the length of my walks. I'm now doing about 1.5 miles every other day at a pretty good pace of about 3.5 MPH. During and after these walks, I'm getting pain in my operated hip (R2B T and S) that I suspect is piriformis syndrome. I'm icing it after my walks, but probably need to do some stretching. I don't know if piriformis stretches are ok from a dislocation risk this soon after an anterior approach. I'll wait till I discuss it with the PT.
@Josephine, do you see anything in the info that I got from the PT that looks odd to you? Your candid feedback and experienced guidance has been invaluable for getting me to this successful outcome.
Despite all thee minor challenges, I'm feeling very positive and doing much better than I was at this point after my original THR surgery. I hope this physical therapy will help me regain the strength and activity level I had prior to the onset of my arthritic hip, but I still have a way to go. I just want to take it slowly and avoid doing damage by being too aggressive. This physical therapist seems be well-aligned with that approach.
@Hipster63, let me know if you'd like his name. He works closely with our surgeon.
@chalcedonian1, I read the latest post on your thread and couldn't be more happy for you! It is remarkable how we've moved from such despair, disappointment, and anxiety to our current successful outcomes.