THR Five months post-op THR

[overthehill]

Hi everyone. I hope I can get some insight and support here. It's been 5 months since my surgery on my right hip and it was a successful THR I believe. My issue is that I am still having a lot of discomfort throughout my upper leg. Specifically my quadricep and knee. This is only when I put weight on it though. I guess I would describe it as strained, pinched, sharp & weak. Sometimes I can't put weight on it and it's still not 100% okay even if I take Tylenol. I can ride a bike - no problem. So sometimes I still limp and my leg gets tired easily and I have to walk slow.
I'm hoping this is normal and it will just take more time to heal and adjust any muscles or tendons that were injured. My hip got quite arthritic after I slipped and fell getting out of unstable small fishing boat. I went 2 years limping around and compensating for it. I'm guessing it didn't help anything to walk around for 2 years with that injury.
The hip itself is great! Like I said, now I can ride a bike whereas I couldn't before.
Is it worth a trip back to the physical therapist at this point? Should I just keep doing the exercises I was given after my surgery? Has anyone had this experience?
Thanks for any help or suggestions.

 

[myglasshalffull]

Five months is still early in your recovery. I was still using walker 3 months after my surgery due to small fracture that was detected after the replacement. I had to do partial weight bearing for a month to see if the fracture healed and as time went by it did heal.
Then onto cane for a few months. I always felt it was best to use an assistive device rather than limp. I also paid close attention to heel/toe steps. You may want to use cane to help or walking stick, it's better to use cane than to limp.
I recently returned to work and now I have a strained back (sciatica) and I believe the retirement Gods are trying to tell me to stay retired! LOL! I've been nursing with ice/heat and Tylenol along with stretching exercises. I went for X-ray to be sure hip was not affected and that was fine but still getting pain in that area as well as some groin pain.
I think the area is still very sensitive well over a year later. I was 100 percent fine but some setbacks when we overdo are to be expected I guess.
I hate when I can't do what I want.

 

[Layla]

Hello and welcome back! Please give us the exact date of your surgery and which hip was replaced so we're able to create a signature for you.

Wondering if you've ever had your knee x-rayed? I think before I'd try PT, I'd contact the surgeon's office to speak with a member of his care team and see how they advise after asking you a series of questions. You may feel better receiving reassurance / direction from them.

Try not to lose sight of the fact that you are only five months into a recovery that can take a full year and even longer for some.

Here’s a tip -
Try heel-toe walking when you're limping.

This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.

What exercises are you doing and how often? Possibly your exercises are continually aggravating healing soft tissue, you may want to consider that also.

I hope you are able to find relief soon! Please keep us updated.
@overthehill

 

[Layla]

Since you never received our guidelines, I will leave a copy of the BoneSmart Recovery Guidelines even though you are five months post op, you may benefit from returning to some of the basics.

HIP RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

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​

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.

 

[overthehill]

Thanks Layla. My surgery was November 29, 2022. Thanks for really helpful advice. I'm thinking I need to slow down a little and that maybe I'm pushing it too much. I've given up the walking devices, but I think I will get them back out. I never considered the soft tissue, actually I don't know what to consider. I've been biking (10 miles) maybe it's too much.
I am glad I did it though because of my age. I don't want to get any older and be immobile!

 

[Layla]

Yes, it's likely you've been overdoing it. Our bodies are amazing in that they are constantly in a state of repair. Your body is doing as it should....healing, but you're probably, innocently enough, interfering with the process.

It is not necessary to exercise your injured hip to promote healing. The controlled trauma sustained through THR will heal on its own. Often though, we're impatient and want to move the process along. In doing so we run the risk of struggling with pain and setbacks stalling the healing process. The best therapy for recovery is walking, but not to excess. Start slowly increasing time and distance incrementally in an effort not to overdo it. Give yourself the TLC you deserve and reap the benefits of a successful recovery.

Dial it back and see if you notice a difference. Good luck!
@overthehill

 

[Eman85]

I can tell you that at 5 years I can over do it especially with my left and have soft tissue pain. Those old rubber bands don't just snap back like they used to.

 

[Gloucestergal65]

@overthehill - my operation was just two weeks after yours. I had some problems with my knee and thigh and my physio did some pressure point release work which seems to have sorted it out. I think it releases the knotty bits of tension in the muscle. I just have one small area now which is a bit irritable but doesn’t stop me doing anything, just complains a bit from time to time. I think @Jamie knows about pressure release. I seem to remember reading about it there. Might be worth asking about if you are still seeing a physio.

 

[Jamie]

My hip was replaced in August of last year and I’m still working with my soft tissues which aren;t allowing me to walk properly yet. I have stiffness and varying amounts of groin or quad pain when I first get up. My muscles are weak still.

Around the first of the year I was even worse, though. I decided to try pressure point therapy with a therapist and stayed with her for a couple of months. My quad muscles at that time were going into spasm and there would be little tight, hard knots that she had to release regularly until they quit going into spasm. She taught me how to do the pressure release too in case the problem returned. It hasn’t, but now I’m just feeling a bit stiff and weak. I’m going to start on my treadmill and recumbent bike just as soon as they are repaired. Going to some more therapy is an option too. I’m pretty sure I need some core exercises as well.

You may want to invent in at least a few weeks of therapy if for no other reason but to learn what exercise will help you in your specific situation.

 

[overthehill]

I had a restless night of sleep last night and now my hip feels a little tight and swollen. It's been 8 months since my surgery and it's going well. I'm thinking I just stressed something not to be worried about.

I just went back to Physical Therapy 4 days ago just to stay on top of things (limping a little) and she is having me do strengthening exercises again- which felt just fine!

Do I just treat this new pain today as if I twisted a regular hip? She suggested that I'm pretty good and don't have limitations. I don't really want to take any medication, but I don't want to sit around either.

 

[Layla]

Hello overthehill,
If this new discomfort is in relation to starting up PT again, you may want to step back. It sounds like the therapist doesn’t really feel you’re in need of PT.

If you haven’t tried heel-toe walking for the limp, try it.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe.
It takes a concentrated effort, but I believe you'll notice a difference

Please notice that we have merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting.
Please post any updates, questions or concerns about your recovery here.
Thanks for sharing an update. it was nice to hear from you. Hopefully things will still improve over the next several months of this, most often, year long recovery.
Enjoy the weekend!

 

[Layla]

 

[overthehill]

Thanks for the response. Actually, the pain is from twisting in my sleep I'm pretty sure. I've just never twisted it like this or had this mild sprain-like discomfort since my surgery. I'm walking fine. I think I'm actually being a little less careful and more risky if anything.

So, it's not Physical Therapy related. It would be like if you stumbled or bent wrong, as a normal person. It's not dislocated or infected, just mild sprain or strain.

 

[myglasshalffull]

I'd ice and relax, take some Tylenol for the discomfort if needed.
Most of us have bumps on the recovery road.

 

[Layla]

just mild sprain or strain.

Take it easy for a bit and hopefully it eases soon.
Have a nice weekend!

 

[overthehill]

Thanks Layla. That's what I did and I'm better - 2 days later.

 

[overthehill]

I'm not sure if this is a new post so I'm replying to myself in hopes of getting responses.
Basically I'm 11 months from my THR and my leg still feels longer. It's not a lot, but enough to make me walk funny and it feels like a struggle to walk -- not natural.
I added about 1/4" pad in my un-operated leg shoe and it feels normal then!

Is it possible it will still normalize and they will feel the same without the pad? Is there anything I should do to deal with this?

 

[Newhip_Pol]

I've no experience of this but at 11months out it might be worth speaking to your physio or surgical team.

 

[Layla]

As far as Leg Length Differential goes many feel this sensation post op. In most cases it eases with time. We advise giving it 3-4 months, as it can take that amount of time for things to balance. If at that point, you are still concerned we suggest you visit a reputable podiatrist or PT for a measurement. Since you are past that point, I am wondering if by chance you've done this, or if you have a one year exam coming up at the end of November? If so, definitely talk to your OS about your concern so he is able to advise.

Here's an article from our Library Leg length differential - LLD.
Best Wishes!
@overthehill

 

[overthehill]

Hi Layla, thanks for your answer. Yes I am concerned and bummed out to be honest. I am close to 1 year since my surgery. I did go to a PT in July which was 7 months and she said I was still limping because there was still weakness in my operated leg. She started me on another regimen of strengthening exercises.

I don't think it's weakness anymore. I really do think my operated leg is longer - but not by much. When I put an extra shoe pad in my un-operated leg it seems to even out and I walk normal.

When I asked the PT if my leg could be longer she just shrugged. I don't know why, but I felt very discouraged by it.

Right after the surgery the doctor went to tell my husband I was done and he said, "I'm sure they are now the same length". I wonder if he was just covering his own A_ _.

So what do I do now? I googled some exercises for LDL after hip surgery and there are some, and the article claims you can even it out. I would love to hear if anyone still had this issue at the 1 year mark.