Hip Flexor Pain!!

[Foofy610]

Hello everyone!

I've been reading the posts on this forum for several weeks. Great group of people! Thank you all for your "indirect" support. That being said... I need to ask your opinion regarding my leg pain.
I had my right hip replaced on January 5, 2012. I was diagnosed with traumatic arthritis as a result of an auto accident several years ago. My recovery has gone very well. The only issue I've had is a slight pain at the top of my leg when I lift my knee. My therapist told me in the beginning of my rehab that the hip flexor takes on a lot of responsibility after hip replacement. I've tried heat, ice, and stretching. All with little affect. The pain is really starting to make me nervous.

Is this normal in the recovery process, or should I contact my doctor?

Any information would be greatly appreciated!

Thanks,
Phillip

 

[Z15]

Philip,

You and I DO have some things in common.

Our surgery date and our most problematic muscle...

My hip flexors were not really an issue till a few weeks ago when they started getting angry. I blame mine on a Leg Length Differential (LLD) that is starting to settle out. By settle out I mean that parts are shifting a bit to accomadate the LLD, and as a result, some muscles are complaining.

The first thing that I wanted to assure myself of was that it was muscular...and not bone related. Then PT gave me some new hip flexor stretches that seem to help if I do not force them too much. I HAVE overdone them at times and come up hobbling for a day or 2.

Do you see anyone for PT? Or could you?

this is the one I do now:
http://www.teachpe.com/stretching/hip_flexor.php

the new hip is the one with the knee on the ground, and I gently push my pelvis fwd...as I keep my shoulders tall

Z

 

[Foofy610]

I had PT for 3 weeks, then I continued on my own. I could go back if there was a need. I'm waiting for my new recumbent exercise bike. Maybe that'll help with strength & stretching.

Honestly, it's a little discouraging. I've come such a long way, only to have this nagging me!

Thanks for the link.

 

[rider1960]

My hip flexors tightened up after surgery too. I had to constantly keep them stretched out from pretty much the 1st or 2nd week on. I still do stretching when I feel them twinge. I find we work so hard to strengthen them, that they get tight ... so we have to stretch them to kind of balance things out.

I can't do the stretch that Z gives--too uncoordinated and I worry I will fall. All I do is lean into a wall or grab a counter for support put the non-operated leg forward, and then lean forward, letting the operated leg kind of stay out in back. You'll feel that muscle stretch--you know you have isolated the correct one.

Another thing I do is lie on my back and let my leg(s) and feet drape off the edge of the bed. The lazy person's stretch!

I try to hold stretches for about 30 seconds and do them about 10 times a day and an additional couple of times after I get up from sitting and feel the hip flexor tightness setting in.

Stretching shouldn't hurt, but you should be able to feel that the target muscles are engaged.

Hope this helps.

Dorothy

 

[Foofy610]

I finally saw my surgeon this past Monday because I can't lift my leg without excruciating pain. He said I have a severely strained psoas muscle. I am to rest the muscle and take ibuprofen for a month. Does anyone have any hints as to how I can alleviate the pain? The surgeon gave me a script for a steroid injection. Do you think that would help?

I would really appreciate ANY advice!!

Thanks
Phillip

 

[C Mac]

Hi Phillip,

Here is a link to one of the threads in the library about iliospoas syndrome and it includes some stretches for when you are done resting it some. It is a pretty common complaint here in the forum among those of us that have had THR. I hope you will feel better soon and would suggest that you try the stretches and a return to PT before you contemplate an injection.

Take care and welcome to the forum,
Cardie

 

[Foofy610]

...would suggest that you try the stretches and a return to PT before you contemplate an injection.

Cardie... do you see a problem with getting an injection?

 

[C Mac]

Hi Phillip,

Personally, and this may sound strange -- I am a minimalist when it comes to medical intervention. I try to take the least invasive approach when I have an ailment and work my way through as many options as I can find before I venture in to something like a surgery or injection. Yes, I do have a fake hip but it took me many years and many other treatment approaches before I finally acquiesced to trying the surgery.

Like yourself, I have found myself & my fake hip in a quandary a number of times over the 9 months since my surgery. As long as the OS said that my hardware bundle was in its proper place and working the way it was supposed to be, I have tried to find other ways of dealing with the soft tissue issues in order to adapt.

Some of these alternatives have been things like chiropractic manipulation, utilizing the foam roller to massage areas that were stubbornly painful, pulsing on and off of tylenol and anti-inflammatory medications, rolfing, returning to a supplement that I'd taken prior to surgery, total rest from all activity and I have an acupuncturist I've used in the past that I'd go back to if needed. I've also been in PT early on in my recovery and have contemplated that venue again at some point if needed. Right now I am addressing some of the atrophy issues that have been causing me quadricep pains with a limited round of exercises in the gym.

I'm fortunate that I've never gotten to the end of the path (knock on wood) and continued having trouble and needed to go for an injection, but I will say that many of the practitioners (including my OS & his PA) have said that they'd rather avoid cortisone injections.

So, that may be more information than you really wanted to know -- but, I hope you will find relief with some other things (including resting the sore muscle) and I'm sure you'll hear from others here in the forum as psoas issues are commonly mentioned and many have followed the path of injections.

Oh, and welcome to the forum as well

Take care,
Cardie

 

[Foofy610]

Cardie... thank you so very much for taking the time to respond. I do appreciate it.

 

[bobslp]

Oddly enough, I just got off the phone with my joint clinic and was advised to start flexor stretches. In an earlier post, I mentioned I was in the yard today and took a wrong step and really felt it.
I think you are in good company with this particular part of your anatomy.

 

[The Cappuccino Kid]

Hi Philip, welcome to Bonesmart.

I had both my hips replaced last year and I still have hip flexor pain. It's not severe, but it's there. I'm continuing my exercises and stretching. Gradually, very slowly, they are easing.

I hope you get some relief from the stretching; I share Cardie's opinion on the jab - try other options first.

 

[Josephine]

I finally saw my surgeon this past Monday because I can't lift my leg without excruciating pain. He said I have a severely strained psoas muscle. I am to rest the muscle and take ibuprofen for a month. Does anyone have any hints as to how I can alleviate the pain? The surgeon gave me a script for a steroid injection. Do you think that would help?

Hi Philip. Just what I was going to say - how about doing nothing! These aches and pains don't always need 'something' to resolve. You've overdone it and now you need to underdo it! As for pain meds, you could try the Tylenol/ibuprofen cocktail which is a very effective, non-prescription method of treating pain.

 

[bobslp]

Jo, do you know if this cocktail is effective with opiates? Ie. Help, detract, does nothing? @Josephine:

 

[sharonslp]

Phillip, I think you've clarified some (perhaps all?) of the pain I've been experiencing for the last three months or so. I just ran off to google hip flexor pain, and I am fitting the profile. Mine is not all that severe, and I've been doing a strength training program that involves some of the exercises recommended for hip flexor issues, and I think they are helping a lot.

At three and a half months, you are still in the early stages of recovery. In fact, it's around this time that we start to feel a lot stronger so we start to do a lot more. Sometimes too much more. It's also around this time that we've cut back significantly on pain meds; maybe even cut them out altogether. The combination of doing more and no pain meds can easily backfire.

So patience, grasshopper!

Oh....about the cortisone shot? I'm just wondering...if a person gets one, and it works really well, doesn't that up the odds of overdoing without realizing it? I don't love pain, that's for sure. But it does send a clear message to quit doing whatever is causing it.

Do keep us posted on how this all works out. We are constantly learning from each other's experiences.

Sharon

 

[Foofy610]

Josephine... I've been taking Tylenol/Ibuprofen for a week with no affect. Shouldn't I feel a little relief by now?

Sharon... the main reason I would get the injection is to be able to sleep at night. It's so painful to roll over at night!!

 

[VThereandnow]

I'll join Sharon on the "patience grasshopper" and what Jo said. There are times when nothing for a bit if time is the only way to settle a muscle down. Hope it resolves soon. I know it is difficult to wait. -Cathy

 

[Jaycey]

I am not a big fan of medication either but sometimes these things need a bit of help to settle. If it were me I would go for the injection and see how it works. Very often we hear that one injection in the right area is all that is needed. Up to you of course but if you are not sleeping and in considerable pain - life's too short! No points for being a hero!

 

[Josephine]

Jo, do you know if this cocktail is effective with opiates? Ie. Help, detract, does nothing? @Josephine:

Yes - but do make sure the prescription meds you are taking don't also have paracetamol in them otherwise you would go over the daily maximum.

Josephine... I've been taking Tylenol/Ibuprofen for a week with no affect. Shouldn't I feel a little relief by now?

Honey, this problem wasn't cause in 7 days and it's not going to resolve in 7 days! Last time I had something similar (piriformis syndrome) it took over two months to get better! Be patient and rest as well. Also use ice and/or heat.

 

[sharonslp]

the main reason I would get the injection is to be able to sleep at night. It's so painful to roll over at night!!

Phillip, are you talking about rolling onto your new hip side, and being able to sleep on that side, rather than on your back? If so, just be aware that side sleeping comes eventually, but it's still pretty early for it. Even after a year, I can only be on my side for an hour or so before it gets too uncomfortable. Maybe other hippies will chime in with when they could start sleeping comfortably on the new hip side.

Or are you talking about rolling over to your unaffected side, but the new hip still hurts too much? That's a different story entirely. You should be able to do that.

I was under the impression that shots in the bursa are for bursitis. Do they work for muscle pains and strains too?

Sharon

 

[haldox]

Hi Phillip-Sorry to hear of your pain.

My RTHR was a day after yours and I am still stretching my hip flexors(both legs)-using stretches shown in the library and also the pigeon pose Alex as shown us.

I agree with lots of rest and the med cocktail, some ice/heat and gentle stretching. If the stretching makes it hurt worse/aggravate it then lay off those for a bit and just rest.

For pain while sleeping at night a pillow between your legs would help. I know laying on the OP side can take a while to achieve and sometimes sleeping on the non OP leg can cause an uncomfortable stretch on the OP leg while trying to sleep(make sense?)

Me personally- I would give it a little time before I got an injection. :biggrin: