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Groin Pain after hip replacement

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Betsy

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I have had both of my hips replaced. The right hip was done almost a year ago. Since that time I have had bruscitis in the right hip along with groin pain. The pain has been in the psoas tendon which the doctor had injected with a steroid. I still can feel a tightness and restriction when I walk. I have pain in the adductor, psoas and IT band, basically all around the hip. It is not a "snapping hip" problem as the tendons feel too tight for that.

My doctor is wanting to take a two part approach to the problem after weeks of physical therapy and shots that have only helped a little. He wants to release the adductor muscle first, then if necessary, release the psoas tendon and IT band.

Has anyone ever heard of this pain in the groin without the "snapping hip" problem? I was born with the left hip being dislocated and the right one being mildly dislocated. My muscles are extremely tight all over my back and neck as well as the IT band on both sides. The left side never had a groin issue but my adductor tendon was released before the left hip was replaced.

Thank you for your information!!

Betsy Marshall
 
Hello, Betsy - I am so sorry I never saw your post before this. Major lapse on my part.

And to answer your question, yes I have heard of it without the snapping as the two are not necessarily connected. This tightness is quite common. As the arthritis develops and the bone and cartilage get inflamed, the surrounding structures also get inflamed. As the joint gets more and more difficult to move, the muscles and ligaments suffer from lack of proper movement and contract even going into spasm as well. In short it all gets locked up and solid. Now when you consider that this has taken months to develop during which you have adapted to minimising the movements that will cause you pain, along comes a surgeon and puts in a prosthesis that restores the hip back to it natural, anatomical norm. The surrounding muscles and ligaments are going to complain bitterly about having to lengthen and loosen up again. Sometimes they just won't and that's why the surgeons have to take action and divide them.

Now the big question, will it get better? That's not easy to answer. Many see significant improvement but has to be said, some are left with a problem. But that would only be a small percent of the whole for MOST do find the problem abating and disappearing over time.
 
Thank you for your answer!! Your explanation made perfect sense to me. No one ever took the time to explain to me what the muscular problems would be and since I didn't have those issues with my left hip replacement, I was completely surprised by the problems I am having now.

In saying that, I have another appointment with my doctors in a couple weeks. It has been a year since my surgery. I still feel tightness everywhere and pain off and on. I'm assuming the shots are still working some. Is it wise to see if the problem will "fix" itself or should I take the risk of another surgery that will weaken those muscles? I realize yours would only be a guess. I'm just curious if anyone else has had this problem and what their outcome has been.

Thanks, Betsy
 
It's unlikely that, after a year, this problem will fix itself. Seems to me like some intervention is needed. Ultimately, having a tendon release doesn't exactly weaken the muscle as there are only a certain amount of the muscle fibres that are tight and those would be the ones the surgeon will target. Others will be there to take up the slack, so to speak.
 
Thank you for the information once again. I go to the doctor on April 25th to see what they want to do. I have had three cortisone shots in the IT band and one in the psoas tendon. The last shot seemed to help for about a month but have worn on off. I am glad to know that releasing those tendons won't necessarily weaken my whole leg. I have always worked really hard in physical therapy to get stronger so I would do that once again. They had me in physical therapy using the Graston tools. It was painful and did help loosen up the knots and balled up muscles but not deep enough to make a huge difference.

I will let you know what the doctors say and get your opinion then. Thank you so much for the information!

Betsy
 
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