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THR Hip Recovery Stiffness at 8 weeks

Golfer68

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HI

I am new to BoneSmart and this is my first post.

I had my right hip replaced by lateral direct method on July 7th, 2020 as was told I was bone on bone and had necrosis of the femoral head. I had not had hip or leg pain until February of 2020 but wanted the hip surgery done right away due to the femoral head issue.

After a lot of pain during the first two weeks after surgery, and after two x-rays and a CT scan it was determined that my femur had a crack in it and at about the two week mark the crack expanded and the stem fell about 1/2 inch. I went in for a second surgery on July 24th. The stem was replaced and was cemented at the bottom of the stem (previously it was a total non-cemented stem), and the femur was wrapped. My right leg has always been slightly shorter (maybe about 3/8 inch shorter than my left but the surgeon has now made them the same length.

I have struggled with being very stiff where the incision is, and having pain in different places, especially the butt muscles and at times down the front of my thigh.

At almost 8 weeks after the second surgery I am wondering if I am at the place I should be in recovery. I just had an x-ray done and the doctor (not the surgeon) said it all looks ok.

I still have swelling at the incision site. I am very stiff when I get up from sitting or lying down causing me to limp for the first few steps and then after a few steps it feels better but never without any pain except when not moving at all. If I am not putting weight on the leg there is no pain. I do not know if this stiffness and pain is normal at this stage of recovery.

I currently use two hiking poles when I go for a walk so as not to limp (I walk up to 3 miles, and all of my walks include hills as I am currently at my condo in the mountains). I can walk with no limp as long as I concentrate. I only have to put a bit of weight on the poles. I take 2 500 mg of Acetaminophen before going on the walk to make it more comfortable.

I also do a selection of exercises that I found on the internet for stretching and strengthening after a hip replacement. The exercises can take up to 1 hour to complete.

I am hoping I can start golfing again at the beginning of November.

I would also like to start biking again but not sure when I should attempt that. Any ride I would do has some fairly steep uphill and not sure if that would put too much weight on the new hip joint.

Any comments would be appreciated.

Thanks
 

TomT

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Hello and welcome, a mod should be by shortly to greet you. I just want to thank you because you have just typed out exactly the symptoms I'm having at about 2 months out from my THR on my right leg. When I get up from sitting I have a very stiff first step that is kind of a big limp and as I take a few more steps I can then start walking normally. I was hoping that that this was normal being only a few months out from the surgery and since you're experiencing basically the same symptoms I'm guessing it probably is.
 

Jaycey

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@Golfer68 Welcome to BoneSmart! Sounds like you had a bit of a rough start to this recovery. You are basically recovering from 2 major surgeries in a very short space of time. All the stiffness you are feeling is totally normal.
I also do a selection of exercises that I found on the internet for stretching and strengthening after a hip replacement. The exercises can take up to 1 hour to complete.
Sounds like way too much activity for a hip that has been traumatised. I would back off all of this for now. You are not in training - you are healing. Give that new hip a break.

Are you icing and elevating regularly throughout the day? Icing will help ease this stiffness.

This recovery can take up to one year or more. Early days for you.

Here is some information you might find useful:

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
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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access 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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

Elf1

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:wave: @Golfer68 and welcome to the healing side. You have definitely had a time of it. I agree with Jaycey about icing/elevating and stopping the exercises for now. Sounds like way too much especially when you add in that you're walking up to 3 miles and in hilly conditions. You've had two major surgeries in a very short time, you really need to take the time to heal properly.
 

leejaa

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Hello and welcome to bonesmart. Recovery takes lots of patience and some time and you have had two surgeries close together. You need to let your body heal before doing so much strenuous exercise. Hills are difficult on a new hip or at least they were for me. Lots of ice and elevation to reduce the swelling and moderation of activities will actually do more for you.

Please read some of the articles left for you and it will help explain so much about recovering from joint replacement surgery.
 

Eman85

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My left is over 2 years and I get stiffness. Might have something to do with the date on my drivers license and the stretching they did on my muscles to wrangle the hardware in there. It sounds like you're doing a lot of physical activity and with swelling it would seem your body doesn't like it. Taking something for pain before exercising or walking might be masking pain and making it worse.
 

Layla

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Whoa! Hills, three miles, taking OTC meds preventatively. I’d s-l-o-w down as others have mentioned. Heal first / exercise later, you’ve been through a lot in a very short period of time. Sorry you had such a rough start, take it slow and easy and I bet you’ll be feeling great by the holidays. Happy Friday and welcome to BoneSmart, thanks for joining us!
@Golfer68
 

Greg555

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I’m about 12 weeks out and still have periods of soreness and pain. I have found that I’m not where my expectations thought I should be at. I still need to be careful not to overdue it. I have returned to the gym and do leg training on machines. I’m always careful that I give my muscles and tissues time to heal before I go back. Sometimes it’s two days, sometimes 5. I listen carefully to my body and rest when sore.
 
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Golfer68

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Thanks for all the comments and welcoming me to BoneSmart. Being who I am I figured the harder I worked the hip the sooner it would be ok. Sounds like that is not the case. I will slow down on the distance and number of walks and on the exercises and will see how that goes. I think I will also drive down the mountain and try some walks that do not include all the hills.
 
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Golfer68

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One more question, will I be able to downhill ski again. I am an advanced skier and do not fall often but do like the black runs and skiing in nice powder. I do not ski when it is icy.
 

Jaycey

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will I be able to downhill ski again
Yes - it's not ideal to fall on a new hip but once you are fully healed you should be able to ski again. These implants are tough but just be aware that you will be healing from this major surgery for up to one year or more.
Being who I am I figured the harder I worked the hip the sooner it would be ok.
No, you are not in training for anything. You are healing. You would not work a broken leg very hard to recover. Same with this hip.
 

FCBayern

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Being who I am I figured the harder I worked the hip the sooner it would be ok. Sounds like that is not the case. I will slow down on the distance and number of walks and on the exercises and will see how that goes. I think I will also drive down the mountain and try some walks that do not include all the hills.
I think you will find this is a great decision. After following stories for quite a while here those that get too active too soon usually end up causing themselves problems. Take another look at the activity guidelines and take it slow and easy. Instead of dealing with tendonitis or something similar taking a slow approach will soon result in regaining life without constant pain @Golfer68 .
 
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Golfer68

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Before getting onto this site I was doing upper body free weights. I have had very bad pain in my glute muscles for the last 3 or 4 days. Could that be related to carrying the weights. I have been trying to figure out why my butt is hurting so much the last few days, since I have cut back on the walks (only 1/2 hour with no hills) and not doing the other exercises. Could it be caused by the weights. I had not thought abut how walking with the weights would be putting too much weight on the hip. Icing and taking acetaminophen to relieve the pain. The pain has gone down a bit in the last day but still very sore when I put any weight on my operated leg.
So disappointed, I sure thought I would be further along after week 8 (after second surgery).
 
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Golfer68

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I’m about 12 weeks out and still have periods of soreness and pain. I have found that I’m not where my expectations thought I should be at. I still need to be careful not to overdue it. I have returned to the gym and do leg training on machines. I’m always careful that I give my muscles and tissues time to heal before I go back. Sometimes it’s two days, sometimes 5. I listen carefully to my body and rest when sore.
Greg I just wanted to thank you for all your posts. I went and read your whole recovery thread. Makes me feel a bit better about my recovery or lack of recovery. You have done really well with your recovery. I think possibly the extra complication of my second surgery and the fact my femur was cracked could be why I am behind. Reading your recovery thread gives me hope I will get there myself.
 

Greg555

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I’m about 12 weeks out and still have periods of soreness and pain. I have found that I’m not where my expectations thought I should be at. I still need to be careful not to overdue it. I have returned to the gym and do leg training on machines. I’m always careful that I give my muscles and tissues time to heal before I go back. Sometimes it’s two days, sometimes 5. I listen carefully to my body and rest when sore.
Greg I just wanted to thank you for all your posts. I went and read your whole recovery thread. Makes me feel a bit better about my recovery or lack of recovery. You have done really well with your recovery. I think possibly the extra complication of my second surgery and the fact my femur was cracked could be why I am behind. Reading your recovery thread gives me hope I will get there myself.
Yep, you’ll get there. For sure that second assault on those delicate soft tissues and nerves did effect length of recovery. Yesterday and today were/are difficult for me. The weakness in my left glute muscles continue to frustrate me. They just don’t respond as robust as they once did to training. I also have to skirt that line between pain and effort. The mind muscle connection that has to get rebuilt is also part of the equation. Rebuilding the mind muscle connection through concentration is actually more exhausting than doing the actual physical work. I can’t have any distractions when I do that work. No music or conversation with the other gym members. I’m pleased that my writings have been a positive influence.
 

Jaycey

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The mind muscle connection
Don't under estimate the impact this has during recovery. My PT post RTHR stressed this. The brain does have to "reconnect" with traumatised areas. For some this is just a progression. For others it's a long process. Just keep at it. What seems impossible one day is easy on another.
 
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Golfer68

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Yesterday I did not take my 2 acetaminophen at my bedtime dose. I woke in the night with so much thigh pain and cannot put weight on my operated leg without a lot of pain. I took 2 acetaminophen at 3am and then again at 9am but leg still hurting way more than it has over the past month.
I am scared I did something to the femur. Maybe the stem has fallen again.
should I still be experiencing this type of pain when I am almost at 9 weeks post op.
 

Layla

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Sorry you’re dealing with some pain. Wondering a couple things...Are you doing any exercise in addition to walking, and if so, what? Do you have another post op coming up any time soon?

If OTC meds, rest and ice aren’t helping after a couple days, consider phoning the office of your OS and through some questions they should be able to offer you the reassurance you’re seeking, or decide you need to schedule an appointment.

Wishing you comfort, please stay in touch and let us know how you’re doing.
@Golfer68
 
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Golfer68

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Thanks for your reply.
Currently I have stopped all exercises other than a short walk each day.
I am icing and resting and elevating.
I do not have an up coming appointment.
I did go to emergency and they xrayed my hip and nothing appears to have changed since my last X-ray on Sept 15. I am in a small town in Canada right now and no orthopedic surgeons are available to me in this town. The emergency doctor told me to not put weight on the leg and sent me home with crutches. Not sure that is the best route or not.

My initial surgeries were done in Mexico so surgeon not available to me right now.

if the pain persists after a few days of rest I Think I will head into the city to go to emergency where there are orthopedic surgeons.

I have been trying to find on the site if other folks still had to be on OTC pain meds this far into recovery But not having much luck.
 

leejaa

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Everyone is different and if you are having discomfort and pain then maybe the OTC meds on a schedule for a while would be a good idea while you are also icing and resting the hips. I took Tylenol for quite a while but I do not remember precisely how long.
 

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