THR Having a rough recovery

Tlew67

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After suffering for several years with hip pain I finally went to the doctor about it. I have issues with both hips but my right hip was the worse. I’m an active 54 year old healthy lifestyle man and not overweight. I work a physically demanding job, I’m a self employed auto mechanic.

I went to the doctor this past July to focus on the right hip pain. My usual orthopedic doctor moved so I went to a doctor I’d never been to before at the same clinic. He recommended a THR on the right hip. I was reluctant to get it done but after having many friends and customers that I know that have had hip replacements recommend doing it I went forward. Out of about 20 people I talked to all said they were very satisfied and had immediate pain relief and wish they hadn’t waited. They told me they were walking fine in just a few days and didn’t need pain meds for more than 2 or 3 days.

I scheduled the surgery, went to the joint class and felt more at ease about it. I had my surgery on December 6th 2021. When I came out of surgery I was in intense pain even with the pain block. Anyway I was released the same day.

The first week was pure hell, worst pain I’ve ever had. I called the doctors nurse and talked to her because of the unreal amount of pain I was in. She said I had a tight hip joint and that the doctor had a difficult time getting my femur to pop out and he had to cut away a lot of scar tissue.

The next week wasn’t much better but in home PT came and got me moving more. By the 3rd session I was feeling I was making progress until a different therapist came to the house and had me walk with a cane. I wasn’t ready, it was excruciating pain and it set me back a week.

I went through Christmas and the new year with marginal improvements. I’m doing out patient therapy now but still have a lot of pain.

I went to my 6 week post op appointment with my Dr. last Tuesday and explained my pain. The pain is sharp groin pain that radiates down my thigh when standing. It’s not constant but it’s unpredictable. I can get out of bed and be able to put my weight on the leg and walk with a cane most mornings. I’ll fix my breakfast and sit and eat. When I stand up it’s like being stabbed with a dagger down my thigh and I’m unable to walk unless it with my walker. Most of the time it’ll calm down enough that I can walk with a cane until the next time I sit and the pain is on as soon as I stand. On occasion it’s tolerable but most of the time it’s not.

I’m now 7 1/2 weeks post op and still use a walker most of the time. The doctor didn’t give me any answers. My wife asked him if this is normal and he said no but it’s not unheard of. He said just keep taking the pain meds and to come back in 6 weeks and we’ll revisit it.

I’m trying to keep a positive attitude about this but as the days go by with little progress I’m starting to feel some depression. I don’t like the opiates because they make me weepy and depressed and I don’t want to deal with having to come off of them after taking them for so long.

I’m sorry for the long post I’m just looking for some encouragement and some answers. I’m hoping that someone will have had a similar experience and will say that its going to get better soon. It’s been tough being off this long with no income and now I’m wondering if I’m even going to be able to go back to full time anytime soon. Thanks for any and all help.
 
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Sara61

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@Tlew67 :welome:to BoneSmart

I'm sorry to read you are still having trouble with your hip, not all surgeries are similar and uou shouldn't compare yourself to your friends and acquaintances, we each heal differently.

I want to leave you our Recovery Guidelines.
Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.



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 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

6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital


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
 

Jaycey

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@Tlew67 Welcome to BoneSmart! Sorry you had a rough start with this recovery. You might want to trying ice and elevation. Ice for 45-60 minutes per session, several times per day. Ice is a natural pain killer. Be sure there is cloth between any ice pack and your skin.

We all heal differently. Sounds like your friends and customers forgot the tough parts of their recovery. Please don't compare your experience with any other recovery.

Regarding work return - the recommended time off work post THR is 10-12 weeks and then a Phased return to work. You are right, going back too early may just delay your recovery process. Remember it can take a full year for this recovery.
 
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Tlew67

Tlew67

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Thanks for the guides and advice. I do ice 4 times a day along with elevation. I keep it elevated at night also. As far as the pain meds I’ve taken them as needed. I don’t take them at night because fortunately I don’t have much pain at night. They have also started lowering my dosage to ween me off of them. I will have to say that PT has you doing things that can be painful but they back off when I let them know. I have 2 more PT sessions and then I’ll do the exercises on my own. I feel like I’ll have turned the corner when I can put my weight on it without the sharp pain and put the walker away but for now I have to take it everywhere I go. As far as work I’m considering changing professions. I’ve been a mechanic for 34 years and have blown my L4 and L5, and have chronic back arthritis. I also have 7 bulging disc in my neck. So I’m pretty wrecked and have always had a high pain tolerance but this THR has been at another level. It’ll be hard when it’s time to replace the left hip. Thanks again.
 

Eman85

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Sorry to hear you're having such a bad experience. Many of us had to learn the hard way that the professionals don't seem to know a lot about what it takes to recover from a THR. The PT prescribed seems to cause a lot of undue pain and setbacks. Then there is also the short memory people that had the instant recoveries, you won't hear much of that here as we've all had THR's and give real world advice. Just my opinion but I'd take a few days and do nothing but resting, icing, and a little walking and see how you feel after that. None of us will tell your OS or your PT that you slacked off.
 

CG'sknees

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I’m sorry to read of your pain. I had surgery last Friday and am now experiencing the pain that comes after the nerve block wears off. I honestly don’t believe all these people who claim to be doing so fantastic after 2, 3, or 4 days. If you caught me at the right time on any day of this recovery, or my recovery from LTHR in June 2021, I might also have claimed to be a nimble sprite. Maybe it’s like giving birth, the bad parts are forgotten. Or the opioids affect their memory. If I don’t mark my med chart, I forget what I’ve taken and when, maybe they just forgot that time they took it.
I’m praying that you “turn a corner” soon with the pain, and that you get reassurance that you’ve made the right decision.
 

CricketHip

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Oh my, you have been through the wringer, my first question is why didn't they adjust your pain meds to help you more through those first couple of weeks? That's a real shame..
I see you mentioned icing 4 times a day. My suggestion is maybe ice for longer periods and more often. Just protect your skin with a layer of flannel sheet or thin towel.
Take care and It will get better!!
 

Layla

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Hello, welcome to BoneSmart. Thanks for joining us.
I‘m really sorry you’re having such a rough time of it. Friends or acquaintances telling you they were off pain meds in two to three days is not the norm. It sounds like these people have short memories. There normally is pain relief in the area of the joint, but you sustained trauma, albeit controlled, in the surrounding muscle and soft tissue. This takes time to heal. Seven and a half weeks is still very early in the entire scheme of things. I’m wondering if your Physical Therapy is your problem. Would you be willing to share what you’ve been doing in PT? The therapist forcing you to walk with a cane during week two, especially since you mentioned you didn’t feel ready, makes no sense.

It is good to read you’re taking the steps necessary to get off the opiates so at least your your mood and outlook improve. Give some serious consideration to canceling or delaying those last two PT sessions in favor of lots of rest and icing for a few days and see if you notice a difference. Wishing you comfort and speedy relief. Stay in touch!:wave:
@Tlew67
 

Hip4life

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Take heart! There will be better times. Your recovery is so similar to mine. If your leg was aggressively manipulated during surgery (and it sounds like it was) there is more for those soft tissues to recover from. I had a lot of swelling that first week and was not expecting the amount of pain I had. I also didn’t find BoneSmart until after my surgery as well. It was great to have the real world perspective and advice that encouraged me to have patience, not compare my recovery to anyone else’s and not get too discouraged. The recommendation of rest, ice, and elevate became my mantra and a great life lesson.

There is no hurry to stop using assistive devices. You’ll know when you feel stable and no longer limp. I used my walker for about four weeks slowly relegating it to longer walks outside while I transitioned to the cane. I did use my cane to my 6 week post op appointment. Surgeon had no problem with that. He was very encouraging to do what I needed to do because “this surgery takes a lot more out of you than you expect. The recovery just takes the time it takes.”

Bottom line: let your hip guide you about what it’s ready for. Soon you’ll accidentally forget your cane and will be surprised you’re doing okay for that little bit. It is a marathon for some of us. That’s okay. Make note of your victories big and small and you will see the progression.

Getting back to work will be the next big challenge. I originally said I’d be off for six weeks. It stretched into 14. I also had a physically challenging job and knew I would be expected to be back 100% when I did get back. My boss allowed me to come back a little at a time. The fatigue is real until you readjust. I did eventually decide I needed to go to part time. Only you can decide what you are ready for and if the job can accommodate that. Your other joint and spine issues may push you in a different direction. I can only recommend you try and find a solution that keeps you the most healthy while supporting you at the same time. Like a wise person once said: it sounds simple but it’s not necessarily easy. We’re here for you. Blessings as you continue your journey.
 

Elf1

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@Tlew67 happy that you've joined us but sorry you're still having so much pain. I agree with the others about taking a break from PT and any other strenuous activity, rest, ice, ice and more ice, elevate. Some of us actually iced anytime that we weren't up and moving around.

You may even want to try heat as long as you don't place it near your incision. It may help if the ice doesn't.

Double check item #5 Activity Progression in the list that @Sara61 left you. If you need to back off even more please do so. And as was said previously, there is no hurry to stop using assistive devices. We all heal differently and the longer you were in pain, limping, etc before surgery can also affect the length of your recovery. Unfortunately we just can't rush this. :friends:
 
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Tlew67

Tlew67

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Thank you all for your guidance, it is much appreciated. As for the PT, my out patent therapist is a personal friend of mine and he did back off when I told him what was hurting. I’m going to finish the last 2 and just listen to my body and go from there. The pain in the leg is getting better, I hardly used my walker yesterday and so far I haven’t used it today. I have pain all over and it’s worse now from what I believe to be my posture from using the cane and the crazy weather, it seams a cold front comes through every other day and my body has always reacted negatively to weather change. This is my first surgery ever and I’m really surprised just how fatigued I get. I’ll definitely have to start back slow when I’m able and hopefully get back to regular hours by April as the spring and summer travel season is when business is the busiest. I’m hopeful that I’ll have a full recovery and now that I know what to expect maybe my experience will be different when I have the left hip replaced.
 

Eman85

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Grasping the recovery timeline and having the patience is the hard part of a THR. Whether a surgeon or a PT I don't think they understand what the THR recovery is unless they personally have gone through it. Basically what we did was have a pre-arranged traumatic injury in an operating room, and were then put back together. Our bodies need a lot of nutrition and rest to even begin to be able to build back energy and strength. By doing much you steal all of the fuel needed for healing and increase the need for fuel and rest. No different than trying to build strength in traumatized muscles you can't build endurance when you're bodies fatigued from trying to heal.
 
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Tlew67

Tlew67

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Grasping the recovery timeline and having the patience is the hard part of a THR. Whether a surgeon or a PT I don't think they understand what the THR recovery is unless they personally have gone through it. Basically what we did was have a pre-arranged traumatic injury in an operating room, and were then put back together. Our bodies need a lot of nutrition and rest to even begin to be able to build back energy and strength. By doing much you steal all of the fuel needed for healing and increase the need for fuel and rest. No different than trying to build strength in traumatized muscles you can't build endurance when you're bodies fatigued from trying to heal.
I notice you have a race car as your avatar. Are you still able to get in it? The reason I ask is that I have a MB SL55 AMG and don’t know if I should just sell it or wait a few months to see if I can still drive it. It was getting hard enough to get in and out before the surgery. Also I’m a fellow Tennessean but in the West. I’m hoping to move to East TN in the next few years.
 

SaraK

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@Tlew67 - When you're a hammer, everything looks like a nail so take the following with a grain of salt. I had psoas issues and some of what you described rings a bell for me. I keyed in on your description of having pain in the groin after sitting for awhile. Then, when you move around a bit, the pain lessens.

When you sit, the psoas muscle is its shortest and can tighten up. The longer you sit, the more it can tighten. When you stand up, it can cause pain at the groin if it is tight. I used to describe myself as the human evolutionary poster - my ability to walk upright improved with every step. Certain exercises, like leg lifts can also irritate the psoas early in recovery.

One thing you can try (in addition to ditching leg lifts or high marches or anything similar that might get the psoas go) is to stretch when you stand up after sitting for awhile. If I reached my arms over my head to stretch or arched the back, it helped to loosen the psoas and make it easier to walk (and with less pain). My PT also had me walk backwards on the treadmill (very slowly) because reaching back with that leg was also a gentle stretch for the psoas.

I hope it all improves soon!
 

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Speaking of psoas troubles...
Mine eased up when I started using a wedge shaped foam cushion. I bought it for use in my car since bucket seats set you butt low, knees high which is bad for psoas - too scrunched up! The cushion came indoors after surgery to help firm up my squishy chairs. The little bit of lift really helped with the groin pain.

D2723AD7-C407-4CF9-815B-461CCA3FB4BA.jpeg
 

Eman85

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@Tlew67 Race car is tucked in it's trailer right now but it will be ready to go come spring. After my 1st THR when I had a win I gave my OS the winners circle pic and promised him another after my 2nd. Covid had me sit out 2020 but I was back for 2021. After my right it was a little harder to get in, it's just the way I have to go over the bar and into the seat.
 
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Tlew67

Tlew67

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@Tlew67 - When you're a hammer, everything looks like a nail so take the following with a grain of salt. I had psoas issues and some of what you described rings a bell for me. I keyed in on your description of having pain in the groin after sitting for awhile. Then, when you move around a bit, the pain lessens.

When you sit, the psoas muscle is its shortest and can tighten up. The longer you sit, the more it can tighten. When you stand up, it can cause pain at the groin if it is tight. I used to describe myself as the human evolutionary poster - my ability to walk upright improved with every step. Certain exercises, like leg lifts can also irritate the psoas early in recovery.

One thing you can try (in addition to ditching leg lifts or high marches or anything similar that might get the psoas go) is to stretch when you stand up after sitting for awhile. If I reached my arms over my head to stretch or arched the back, it helped to loosen the psoas and make it easier to walk (and with less pain). My PT also had me walk backwards on the treadmill (very slowly) because reaching back with that leg was also a gentle stretch for the psoas.

I hope it all improves soon!
My chiropractor did some Psoas streches for a few months before I had the THR. I was trying everything else before I went under the knife. He said it was tight but it didn’t give me any problems at the time. I believe you’re right that the groin pain could be the psoas. The weird part is I may sit for a while and have little pain when I get up. Then I might sit for less than 5 minutes and stand up feeling like I have fire running through my groin and a hot poker down my thigh. There’s no rhyme or reason to it. I have seen improvements the last couple of days. I started yesterday without my walker and it was later in the afternoon the pain was back although not every time I’d stand from sitting. When it hits I cannot put weight on it but after standing or walking around the house on my walker for a few minutes I’m good until the next random attack. I appreciate your input and all the support. I feel better emotionally just from finding this forum and the support that’s offered.
 
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Tlew67

Tlew67

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@Tlew67 Race car is tucked in it's trailer right now but it will be ready to go come spring. After my 1st THR when I had a win I gave my OS the winners circle pic and promised him another after my 2nd. Covid had me sit out 2020 but I was back for 2021. After my right it was a little harder to get in, it's just the way I have to go over the bar and into the seat.
I had a 67 Camaro race car but sold it years ago, I couldn’t get in it anymore because of my back. Good luck this racing season!
 
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Tlew67

Tlew67

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I wanted to give y’all an update and thank all of you for the helpful information. I had been doing my exercises the PT gave me religiously even through the pain (I was instructed to do so). So I quit doing the exercises that hurt or would quit while doing them when they’d start hurting instead of finishing my reps. I also took several days of doing minimal exercises and lots of rest and ice. I haven’t used my walker since Friday morning, I’m using just a cane! I still have pain when standing sometimes and it can be pretty bad. What I do is stand a minute and walk it off. Sometimes I can just sit back down a minute and get up and it’s more tolerable but It has gotten better the last few days. I went to PT yesterday and took control of the session more by limiting the exercises that caused the most pain. I have one more session tomorrow and then I’m done with PT. My surgery was 8 weeks ago yesterday. I can’t help but think that PT has held me back from a quicker recovery. My next Dr. appointment is 4 weeks from today and I’m finally feeling some hope that the worse is behind me. I know I have a way to go before getting back to a normal life but I’m more prepared to face it. I’m glad I stumbled upon this forum, it’s been the most helpful tool for me during this recovery even though I’ve only been on here less than a week. It’s given me more peace of mind. When I get the left side replaced I’m not doing any PT. I’ll do it on my own.
 

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