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[THR] Hard to know how much walking is good for me<

Discussion in 'Hip Replacement Recovery Area' started by Brokefemur, Mar 25, 2019.

  1. Brokefemur

    Brokefemur junior member
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    Hi! I'm a healthy 73 year old gal and I fell, broke my femur, had a partial anterior hip replacement about 2½ weeks ago.

    Using a walker and on good days not much pain. Saw surgeon today and he wants me to start PT. On painful days I can't walk without leaning hard on the walker. Pain is in SI area and butt muscles. Have an unstable SI and seems to have been worse since my surgery.

    Doctor said it may settle down in a couple months. How can I go to PT on days when the pain is bad and it's so hard to walk?

    I walk around the house all day, take care of pets, fix meals, etc. I read here that PT isn't necessary and am hesitant to do it. Any experience would sure be helpful from you all!

    Thanks so much!

    Maybe I'm expecting my hip to be stronger too soon in my recovery.
     
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  2. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi,
    Welcome to BoneSmart. Thanks for joining us! So sorry to read of your fall.
    I wouldn't advise PT, especially since you're in pain. It sounds as though you're way more active than you should be at only two and a half weeks post op from a major surgery.

    Please read the Recovery Guidelines below and pay special attention to the Big Tip -
    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.

    Take any meds you were prescribed on schedule and if you're not taking any, I'd advise you speak with your surgeon regarding some effective pain management. I'm also wondering if you're icing at all? There is an article below on "ICE" and the forum Nurse recommends icing for 40-60 minutes per session, no less, several times per day. Target 4x daily.

    Please read the Recovery Guidelines. I believe you'll find the info beneficial. Stop back often, we'd love to follow your journey and offer encouragement as you're healing.

    A great week to you!

    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 discomfo
    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
    5. At week 4 and after you should follow this
    6. Access to these pages on the website

    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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice. @Brokefemur
     
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  3. Debru4

    Debru4 graduate

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    I did not do PT and have had a very successful recovery. My surgeon did not recommend PT, but I kept hearing from other friends and family members that I should do it. I joined this forum and asked for input from others who had gone through hip surgeries. Most of the folks on here did not feel it was needed, and in some cases set them back. My experience was that simply by walking, doing daily activities as I was able, and building up to longer walks and stairs, I was using all the muscles I needed to, in a very natural, holistic way.

    It sounds like you are already doing lots of walking and daily activities for being so early in your recovery. Don't pressure yourself to do more than you feel comfortable doing---your body will heal better if you take things slowly. :SUNsmile:
     
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  4. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    If you are in this much pain I would not start any PT. You need to let that hip settle. And yes, if you have had previous issues with your lower back surgery can aggravate this. Ice and elevate - and rest.
     
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  5. Brokefemur

    Brokefemur junior member
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    Thank you so much for your replies! I think I may be overdoing it too. I live alone wuth my cat and little dog so am doing what I have to to take care of us. My family does help me with laundry, cleaning, etc when they can. Won't be doing PT any time soon and if I can get stronger on my own won't do it at all. This forum is so very helpful! Glad I found it!
     
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  6. SE Florida

    SE Florida graduate

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    I'll be 4 weeks post-op this Thursday @Brokefemur and experienced the same thing as you with leaning so hard on the walker. I even have the start of a callus on my palm from the handle! I also do a lot of the same activities that you described but I quickly learned that I needed more rest, ice and elevating. The more "little" tasks that I did around the house made me more tired which lead to some serious leaning on the walker. And with all of the walking just to take care of pets, fixing meals, bathroom trips, etc. it was easy to see that I didn't need any additional PT. I was told to get PT too but I declined and only did the exercises I was shown in the hospital and of course, the walking. I am just now starting to use the cane but still keep my walker handy as I tire throughout the day. It's hard when you're used to doing most things yourself to break that habit but it's best to try and get plenty of rest as needed....you'll find it will help ease some of that pain too! *As a side note, I did have full blown PT with my left hip replacement 5 years ago. And no PT with the one I had Feb. 28th, 2019. The left hip did no better with PT than my current progress with no PT. In fact this hip seems to be recovering quicker and with less pain from the PT.
     
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    Last edited: Mar 26, 2019
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Good, that's the right way to do it!
    You can't - it's as simple as that!

    Perhaps you would show me the site of your pain using this chart

    aa hip-references-horz.jpg


    After that, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  8. Brokefemur

    Brokefemur junior member
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    My pain is at R3BTV and R2BTV. Have had SI issues for about 10 years and did physical therapy and chiropractic before my hip surgery. Right SI gets out of adjustment. After surgery it hurts if I walk too much apparently. I ice that area 4 to 5 times a day. Hip doesn't really hurt. When low back pain hits it's very hard to walk. I'm taking 50 mg. Tramadol every 5 or 6 hours. Helps some but not always
     
    Last edited: Mar 26, 2019
  9. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    So your pain is here?

    brokefemur.jpg

    Is there any radiation down the back of the thigh - similar to this?

    p1.jpg

    Also, you never answered this question.
     
  10. Brokefemur

    Brokefemur junior member
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    I would welcome any questions you have for me. Yes, the pain is where you show it and a little over to the side. Slight achyness down back of thigh but not as painful as the butt pain.

    Thanks so much
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are

    1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

    2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    4. are you icing your painful area at all? If so, how often and for how long?

    5. are you elevating your leg. If so how often and for how long?

    6. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    7. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  12. Brokefemur

    Brokefemur junior member
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    1. Anterior partial hip replacement. New ball

    2. 2 in morning, 7 some evenings. Butt pain increases as day goes on.

    3. 50 mg Tramadol with 2 extra strength Tylenol every 5 or 6 hours.

    4. Icing low back and hip 4 times day, 45 min. each

    5. Have not been elevating leg. Lay with small pillow under knees.

    6. I do minor cooking, mostly heating frozen entres, sandwiches,
    Feed, give water, clean cat box. Change dogs potty pads, very small load laundry once a week.

    7. Walking with walker every few hours to kitchen, bathroom, and 2 times across living room and back twice a day.

    8. 10 heel raises twice day up on toes and down
    10 ankle flexes up and down twice a day.
     
  13. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    Hi @Brokefemur and glad to have you on the forum.
    I'm sure Josephine will have some good advice and hopefully some reassurance as you sound like you are having some struggles that are causing you concern.

    Please leave the date of your surgery and which hip was replaced so we can add it to your signature.
     
  14. Brokefemur

    Brokefemur junior member
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    Hi! It's so kind of Josephine to take the time to advise me. This forum is wonderful! In the hospital they send you home with very little information on what to expect in recovery. My surgery was March 7, 2019, right hip had new ball put in because I fell and fractured my femur.
     
  15. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I can imagine. But this is to be expected since you are only about 3 weeks out.
    I would suggest that you adjust your pain meds to be taking 2 Tramadol at night. and the rest at 6hrly intervals. This is my chart that I created when I had my knee done but it's just as suitable for a hip

    aa Tramadol routine 1.JPG

    Though this chart shows 100mgTramadol during the day, you can of course, choose to take just 50 any time you want to.
    okay
    Laying with a pillow under your knee is not a good idea. It should be like this, similar but different!

    cushion elevate 1 small.JPG

    "Change dogs potty pads"? What on earth! You mean like this?

    Dog-Diapers.jpg

    Good
    Not only are these unnecessary for your stage, they are unnecessary for HIPS!

    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.
     
  16. Brokefemur

    Brokefemur junior member
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    Thanks so much for your suggestions! I will definitely do that.

    I laughed so hard at the dog picture with the diapers! Potty pads are big square wateroroof on the underside and absorbent material on the top that I place on the floor for my dog to do her bathroom duties on since I can't take her outside since my surgery. I don't have a fenced yard for her.

    Your help is so appreciated!
     
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  17. Carriemay60

    Carriemay60 post-grad

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    :flwrysmile: Hi @Brokefemur . Pets can be a huge challenge after surgery of any kind I know. I am wondering if the cat litter tray is also on the floor and you are breaking restrictions by bending down like that for litter and potty pads. Just a thought. :)
     
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  18. Brokefemur

    Brokefemur junior member
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    Carriemay60: Yes, the pets have been a challenge. At first it was really hard to bend down to the floor because yes, the cat litter is on the floor. I've noticed it's easier now but I go very slowly. My surgeon said since I had anterior type surgery it was ok but only when I have to.

    I have been icing more and yesterday got a short massage on low buttocks and back of thigh and today my pain was much less! She released a lot of tight muscles. Today I could use a cane for part of the day! I am so encouraged. Also took more pain medicine at bedtime thanks to Josephine s suggestion. Really helped!

    You're all so helpful and your advice is much appreciated.
     
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  19. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Hi there,
    It sounds like you're making some good progress.
    Lessening pain and using the cane more often are both great signs.
    It's always nice to get a good night's sleep, especially while you're healing from major surgery.
    You're doing well! I hope you have a wonderful week. :wave:
    @Brokefemur
     
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  20. Layla

    Layla FORUM ADVISOR Forum Advisor

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    Happy One Month Anniversary!
    Dropping by to say :hi: and see how you're doing.
    How are your efforts with the cane coming along?
    Leave us an update next time you stop by. We'd love to hear about your progress.
    Hugs and best wishes for a lovely week ahead! :SUNsmile:
    @Brokefemur
     

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