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[HIP ARTHROSCOPY] Hip Arthroscopy ups and downs

Discussion in 'Hip Replacement Recovery Area' started by Alfie888, Aug 30, 2017.

  1. Alfie888

    Alfie888 member
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    This is my first post so I'd just like to firstly say hello. This forum looks like a great resourse.

    I had a hip arthroscopy 8 days ago and have been doing pretty well over the past week. I've stuck to the exercises given me when leaving hospital and managed to get around the house and up and down the stairs relatively pain free with crutches. I've only been taking the pain meds (codeine) before I go to bed, more to help me get off to sleep. I've had some discomfort sleeping, more due to back ache from having to sleep in the same flat position but generally getting up and having a stretch has made this better. So, all in all doing ok for my first week.

    I had my first physio session yesterday although I don't see the consultant till next week, so don't have the full story of what has been done. The therapist gave my hip a pretty good pulling about to seeing how much movement I had, pushing my leg way beyond the 90 degrees I'd been told to avoid. By the time I got home I was in quite a bit of pain. The result was a very painful day yesterday with not much sleep and pain in my groin, hip, back and down my leg this morning. Not even my last couple of codeine tablets, ibuprofen, paracetamol and ice has had much of an impact.

    Is this normal procedure? I would have thought pushing the joint around like this only a week after surgery would not be a good idea!

    Does anyone have any thoughts on this? Any help would be much appreciated.

    Alfie (age 49)
     
    Last edited: Aug 30, 2017
  2. gwenc

    gwenc member

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    I am not a doctor or nurse, but it seems to me that you were doing well until this PT session and now you are in a lot of pain. Rule of thumb: it it hurts don't do it - and don't let anyone do it to you!! Make sure you tell him or her at your next visit about the pain they caused and don't let them cause you any more pain. I am sure one of the admins will be on here shortly to answer more thoroughly.
     
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  3. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @Alfie888 Welcome to BoneSmart!

    Shame on that PT. There is absolutely no need to push anything - especially so early out of surgery. I recommend that you not go back to PT. But if you must - I suggest you ask for someone with a more sympathetic approach. If you have a 90 degree restriction what that PT did was downright risky!

    Are you icing and elevating that op leg?

    Try and pillow under your knees when you are sleeping on your back. It takes the pressure off your lower spine.

    I'll give you our official reading list. These articles refer to THR but much of your recovery will be the same.

    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!)
    don't overwork.

    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:

    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.
     
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  4. Alfie888

    Alfie888 member
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    Thank you for your replies.

    I had my surgery at a private hospital that was a referral from the NHS. The PT is also part of that hospital. I have another appointment booked for next Monday then right after I'm seeing the consultant so I'm going to mention it to him and also tell the PT I'm not happy. The PT I was suppose to have is off sick so it looks like I got a stand in.

    Yes I am using ice a few times a day. I've not been elevating the leg, but I'll give that a go now.

    Alfie
     
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  5. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    I'd cancel the physio appointment - you don't need it!

    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?
     
  6. Alfie888

    Alfie888 member
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    Sure, fire away.
     
  7. Alfie888

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    Hi Josephine, are you going to ask me some questions? :what:

    My pain has settled a little over the last couple of days although on a night I have still been getting a lot of pain in my back and groin. I saw my GP yesterday who has prescribed me Tramadol and a suitcase of laxatives :flabber:. I took my first dose last night an hour before bed time but didn't get a great nights sleep. It was better for the pain than the codeine I was taking but didn't have the same sedative effect. It also gave me a strange out of body feeling, a bit like levitating or being suspended in water. Not a bad feeling, just a bit strange. I also felt pretty groggy and a bit nauseous this morning.

    Has anyone else had any experiences with Tramadol? Should I persevere with it?

    Alfie
     
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    Last edited: Sep 1, 2017
  8. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Sorry, I had an internet outage since then and it only came back recently

    Oh yes. I always recommend it and I took it for both my TKRs
     
  9. Josephine

    Josephine FORUM ADMIN, 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


    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.
     
  10. ljpviper

    ljpviper junior member

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    Alpine,

    I had hip arthroscopy and your hip capsule is still very delicate. Not sure why they pushed you so hard. I would speak up. You don't want to damage what the OS did.

    Thanks,

    Larry
     
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  11. Alfie888

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    Hi Josephine

    Here are my answers. I hope they are clear enough. I look forward to your reply.

    2.
    Mainly pain in my groin
    I’m back on pain meds so probably about 2 at the moment during the day. Without the meds I'd say 5-6. During the night my back will go into spasm due to sleeping on my back in one position, I'd say this was 7 as the meds have worn off before I would normally wake.

    3.
    Tramadol 100mg on a night then 50mg every 5 hours.
    Ibuprofen 500mg every 8 hours
    Paracetamol 500mg occasionally
    Dalteparin Sodium 0.2ml injections once a day in the evening

    4.
    Icing 3 times a day for 20mins groin and hip

    5.
    Elevating leg for about 40min a day

    6.
    Not very active at the moment. Up and down the stairs a couple of times a day, moving around on crutches for about 10mins every hour. My partner is taking pretty good care of me. I'm not sure if I should be moving round more!

    7. Exercises all 2 -3 times a day
    Ankle rotations x10
    Foot forward stretch x10
    Foot backward stretch with knee flat x10
    Leg lift with backward foot stretch with pillow under knee x10
    Sat on chair lift leg to straight and old for a few seconds x10
    Holding onto top of table squat down to about 20% x10
    Leg pulls with strap under foot laid on back to 70% x10

    PT: Hip pushed beyond limit to see range of movement. Laying flat on stomach with inspection of my back. General bending and side to side movement. No real exercises as such. He was supposed to email me some exercises but hasn't done as yet.


    Larry: How are you getting on now, after the op? You are about the same age as me.

    Regards
    Alfie
     
    Last edited: Sep 1, 2017
  12. ljpviper

    ljpviper junior member

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    I am 46 it failed due to arhtritis and had hip resurfacing with Dr. gross, in APR-16. Doing well other than some psoas issues.

    Thanks,

    Larry
     
  13. Alfie888

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    Sorry you had to go through it all twice. I too have some arthritis. I won't know the full extent till I see the Surgeon on Monday.

    On a brighter note I managed to sleep a full 7 hours without waking up, which is amazing. And my back wasn't as bad as previous nights. Just got a bit of stomach ache.
    Alfie
     
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  14. ljpviper

    ljpviper junior member

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    Just stay away from impact sports , it will last longer as yua have arthritis. Asked the OS what stage the arthritis is and how big the chrondal defect is. My left side is still holding up after the scope. Also the location of the arthritis is key as well.


    Good luck


    Larry
     
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  15. Mojo333

    Mojo333 FORUM ADVISOR Forum Advisor

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    @Alfie888
    Your PT was reckless in my opinion. It has only been a little over a week so I think you are walking plenty enough. It is really hard to be patient these first weeks but more icing and more elevating is gonna give that hip an extra boost. Your hip is hurt and needs some tender loving care.

    Also if you stay with those meds the fact that they are making you little more sedate is actually helpful.
    I don't like feeling "out of it" either but it really does have its place after a procedure.
     
  16. Alfie888

    Alfie888 member
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    Larry/Mojo333

    Thanks for your advice, I'm all iced up as we speak.

    Alfie
     
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  17. ljpviper

    ljpviper junior member

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    I have you any questions feel free to ask, I have had two scopes and one hip resurfacing.

    Thanks,

    Larry
     
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  18. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Sounds like you need to set an alarm to take your midnight dose! You are, after all, only 2 weeks out yet and still in the very very raw state.
    I suggest you try this schedule I made for my first knee.

    aa Tramadol routine 1.JPG

    And ditch the ibuprofen - it's a rubbish pain med! Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers
    You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
    Elevate when you ice!
    Good for him! And that sounds about right.


    Exercises all 2 -3 times a day - exercises once a day and none at all at the weekends!
    Ankle rotations x10 - okay for another week or so but after than and as your activity inreases, stop them.
    Foot forward stretch x10 - you mean like pointing toes?
    Foot backward stretch with knee flat x10 - like this?
    hamstring 4.jpg

    That's a hamstring stretch. Are your hamstrings tight?

    Leg lift with backward foot stretch with pillow under knee x10 - I know what a leg lift is but do you mean like this?
    half raise.jpg

    They're okay but don't do 10 - it's too much. 5 is more than enough.

    Sat on chair lift leg to straight and old for a few seconds x10 - hey wait - that's a second leg lift exercise. You only need one and 5 is plenty
    squat down to about 20% x10 - squats are very bad for your muscles, specially this early ut. Stop doing them
    Leg pulls with strap under foot laid on back to 70% x10 - like this? No, no! Don't do anything 'assisted'!
    heel slides assisted.JPG


    Well when he does, put them in the bin!

    Remember: 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.
     
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  19. Alfie888

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    Hi Josephine

    I've had quite a traumatic time since my last post. We had our garage broken into last night, well more like ram raided. We were woken by the police at 3 in the morning as one of the neighbours heard something going on at the bottom of our garden. We have quite a lot of stuff in the garage and most of it was all over the street with the doors smashed in beyond repair. Luckily not much was stolen as they were disturbed. I've had friends over all day trying to fix it up. I haven't really slept for 24hrs and have been on my feet much more than I'd have liked today, so I'm in quite a lot of pain now and pretty shaken up. The whole experience has made be feel very vulnerable and helpless.

    As for the exercises:
    Foot forward stretch x10 - you mean like pointing toes? Yes
    Foot backward stretch with knee flat x10 - like this? Just like above but in reverse
    Leg lift with backward foot stretch with pillow under knee x10 - I know what a leg lift is but do you mean like this? Yes

    Sorry about my descriptions regarding the exercises I only have pictures and not titles of what they are called.

    Thanks again for your help with this.

    Regards
    Alfie
     
  20. Josephine

    Josephine FORUM ADMIN, DIRECTOR Administrator

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    Thank you and I'm so sorry you had your garage broken into. That must have been a very traumatic experience.
    Thought so - I suggest you stop them all! They are not helping you.
     

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