@hiphoser I haven't been on your thread for a bit, but I just read through it and I am so sorry you are having your ups and downs and all arounds with your recovery. It really stinks to have PT make such a hash of things. I went with the no PT post op first hip for one major reason, I've rehabbed two horses with soft tissue injures in the past few years, and worked really closely with my vet, as I've been the one doing all the hand walking, icing and watching a horse on stall rest suffer and finding ways to keep them entertained. I learned that injured soft tissue requires slow and steady rehab, so the healing tissue is able to lay down in a uniform way, which is best for ROM and healing. The vets would NOT put horses with soft tissue injuries (I'm talking about strained tendons or ligaments...nothing as extreme as what is done to us during hip surgery!) through anything like the ridiculous PT we as humans are asked to go through by certain OSs post-op THR. It is insanity! The rehab schedule for a horse with a suspensory ligament/tendon lesions or strains is so methodically slow and steady, with icing after every walk in hand, and then gradually moving to under saddle work for months and months...nine months to be exact for ligament injuries, as they have poor blood supply, six months for tendons. The only feedback we get as owners and vets is the ceasing of swelling and heat, an ultra-sound every eight weeks and a lameness check at those junctures. Many horses get brought back too quickly, with lots of promises of faster recoveries with additional treatments that have no research to support the expense of said treatments, and they go lame again. It takes time and patience to heal the horses' soft tissues....
Anyhow, back to hips. I stumbled upon theBoneSmart site, and was thrilled by the slow steady walking approach to rehabbing, along with the icing, here. It made so much sense to me. I had posterior THR, and the OS explained what soft tissue "disturbance" (seriously?
) occurred with this surgery. He explained about the ligament(s) that have to be moved to access the joint and that facia has to be cut between the two larger muscles (I forget which ones they are) and he described it as "parting a curtain" (more
). I guess that it has to be couched in a certain way for us humans, but for those who have worked with horse vets get a giggle out of it! I asked my OS a million questions pre-surgery and "played" with the prosthesis in his office etc. He was so thrilled when I forgot my phone with all my questions on it at my six week post-op check first surgery - he does have a sense of humour thank goodness! I worked for a vet in my early twenties and assisted in surgery for dogs with hip dysplasia....it definitely is carpentry, no matter what language it is dressed up with! Luckily my OS was all about walking for the first six weeks, building up slowly...but don't get neurotic about it. I listened to my body most of the time, but did hit the boundaries a couple of time along the way. But I did no hip PT but did do modified upper body and core work that I need to keep up with for second surgery. Literally it was tightening my transverse abdominus, and doing push ups and dips to comfort off the kitchen counter, and I didn't measure my walking, I just started slowly around the farm, or out in a box store if the weather was bad, but mostly around our farm, on the tracks and driveway...gravel.
It makes me so mad when I hear about folks who have been unnecessarily injured by PT. I have read about it so many times here. It seems those who have gone the heavy reps PT route right after surgery have had the hardest time as it literally add insult to injury, and then it takes forever to undo. It also makes me so angry about folks who are told ridiculous stories about how fast recovery is etc. The less muscle "disturbance", the easier the first six weeks are for sure, but by six months post op, the posterior patient is in exactly the same place as the the anterior patient. No matter what, we need to give our bodies time to heal, before we can strengthen again.
Unfortunately, my husband injured himself when I was four weeks post-op first surgery and he could no longer muck out the two horses (one is a mini). He couldn't do any heavy lifting, and will be having surgery in January to fix his hernia. So we had to scramble to get help for the horse care. Last surgery, by six weeks I was helping with feeding grain to the horses, and our wonderful neighbour was lifting hay nets and mucking stalls for us. By seven weeks I was mucking two stalls, feeding and doing the hay. At nine weeks I was back in the OR with hip #2. I asked my OS at six weeks if I could lift, and we talked about weights etc. He said the lifting would be fine, as long as I didn't break the 90 degrees. I did mini wheel barrow trips. I iced and elevated after each barn session and just did my activities of daily living and no extra walking at that point. I used the golfers reach a lot. My husband could still lead the horses out to pasture. I went into second surgery and went home the same day, despite the hospital PT insisted on making me review exercises and actually do them. She couldn't believe it was possible for me to go home same day. Those exercises set me back for two days post op. Anyway that is over and behind me. I fully intend to go back to riding and competing, but am taking it so slow this time too. It works. Please don't lose faith, you will get back to your active lifestyle, but you have to stop the PT for now and let all those muscles heal. In saying that, I will see my personal PT to work on my upper body and now start slowly strengthening my first surgery leg, as I'm 12 weeks post op next week. However, he'll give me things to do, but no set reps, merely suggestions. He will also start more work on my first op leg to release muscles that have been tight for so long from protecting that hip, and give me more stretching exercises. My OS promotes swimming and the elliptical for after six weeks post op.
This surgery we have help for the first four weeks (I'm just over two weeks out second surgery), and then our teenage son is off school for three weeks over Christmas and hubby can do the feeds. In January I'll get some help again, as I'll have DH's surgery to contend with, and he'll be off for six weeks. No date for that yet, just somewhere between early and mid January. All I am doing is walking. I could probably lose a few pounds for less stress on the prosthesis, but I'm not fat or even plump...just a bit unfit right now for riding. However, I feel the success of my surgeries thus far is from having a good surgeon who does my surgery all the time, and just as importantly, from not doing formal PT on my hips and walking only, slowly and steadily. This time around I will take it even slower (and have done so far), barring any other health issues coming up with my family!!!
I wish you every success in saying no to PT for now and allowing your poor muscles and soft tissues to heal once and for all, before you start slowly building up your walking again and get hiking once more. Slow and steady wins the race, you just had a false start. As they say here, you wouldn't ask yours body to do PT after a car accident, you'd let it heal first. Muscle memory stays with you, and you will be hiking again. Don't lose heart.
Sending big healing hugs your way!
United Kingdom
yep, I just said all that. Try it, it helps, lol.
exercises she asked me to do, as I wanted to come home, and she had to sign off on it. I mentioned it to my OS at my ten-day check-up. We all know my hospital (small but growing) needs to shift in their PT thinking, and all that, but OS just asked me what had happened and kinda rode the fence on it. I recognize he has his work cut out with it all, so I didn't take it any further. I know what I have to do to get going again...but it is so hard to read stories of folks being injured like yourself. It is a huge surgery and we do feel really vulnerable afterwards, no matter what level of activity we are used to previously. Just wanted to give you some support and encourage you on. The slow and steady wins the race really works, particularly for those of us who have had more "muscle disturbance"!
hard to find that balance sometimes. Nice to get out in the world.
