THR Illiopsoas tendonitis and bursitis

[Butterfly77]

Hi. I had my right hip posterior approach 11th july, so am 10 weeks post op. I am fairly young at 44 and in good health. I have found my recovery to be very slow, well that is what I thought reading the NHS website. I found this forum and see that actually it is not a case of after 6 weeks you should be good to go back to your daily activities and everything should be hunky dory. I have been having private pt since about 3 weeks post op. We have been working on my gait and building strength in the muscles. My question is, despite all of this and walking regularly I am still limping and feel a weakness in strength on the operated side. I also experience some low pain, especially near the end of the day and after rising from being seated for a while. Once I get moving my mobility improves and the discomfort eases. Some of the exercises the pt has recommended seem to aggrevate my hip afterwards and the limp is worse for it. When I first get up in the morning (after a pretty rubbish sleep lol) I can walk with only a very slight limp. After doing the exercises I’m experiencing some discomfort which forces me back to limping. I have not yet returned to work. I am self employed and a driving instructor, and as sitting in the car causes me discomfort I am not rushing back yet. Any advice would be most welcome.

 

[Jaycey]

@Butterfly77 Welcome to BoneSmart! As you have already found here, limping at only 10 weeks out from THR is pretty normal. If you limped around pre-op, there is weakness and muscle atrophy. It will take time to strengthen and build stamina.

I would not continue to do any exercise that aggravates your new hip. You are not in training, you are healing. Walking is the best exercise for a new hip. Plenty of time for strength training when that hip is healed.

Here are your recovery guidelines:

Hip Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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 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

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[myglasshalffull]

Welcome, you have come to the right place.
Everyone recovers differently and at different rate of speed.
You cannot judge yourself by others recovery, this is your story and you need to be the author.
If PT is doing something that hurts, stop.
Are you using cane to help walk? If you are limping you probably should use an assistive device, that really helps.
Your operated side will feel weak for awhile, I know mine is just starting to feel normal again.
All I've done is walk, do household chores that I know I could accomplish, cook, clean kitchen and dishes.
I can now do just about everything on my own and back to majority of my daily life.
This recovery can take a full year for some, yes some are up and doing everything in a month but that's not the norm.
Read through some of the posts here and you will see you are not abnormal.
I wish you the best.

 

[CricketHip]

Hello and welcome to the forum.. I'm sorry you were made to feel that you are behind in your recovery, yet glad you now see how unreasonable that mentality can be! It's a very traumatic surgery, our bodies are trying heal on so many levels.
I agree with Jaycey that maybe easing off the PT exercises for a bit may help. If you aren't certain about that, maybe you could take just a week break, better yet a two week break. Then you can reassess and take note of the differences.
I found icing frequently was still a great help to my new hip.

 

[Butterfly77]

Thank you for the kind replies and encouragement. Going to ease of the pt for a week or two just focus on the tasks around the home and a bit of walking, with the cane. It has taken its toll on me, my shoulders, wrists, the other hip and leg that have been over compensating are all feeling the strain. Doesn’t help my eldest has to view lots of universities as he is off to uni next year, and I hoped to be able to manage this for my son.

 

[PolarIce]

Welcome to the forum!! You have to remember 10 weeks is VERY EARLY IN YOUR RECOVERY. Every single one of us improved at different rates and that is normal. I limped for so long before surgery that it took me months to NOT limp when I got tired and my old muscle memory kicked in and caused my limp again.
Don’t worry about what anyone says in regards to how far along you should be in your recovery. Everyone is different, and everyone improves at different rates. Keep in mind to that one’s story isn’t always as accurate as they want you to believe. Don’t worry about anyone else, do the exercise that your hip can tolerate and you will get there. I know it can feel discouraging at times, because you will plateau at a few different places during your recovery-and during those phases it’s hard to stay focused and not get discouraged, but these stages are NORMAL. You’ve got this, and you will get there! Focus on your new hip and she/he will tell you how much it can do, and every day pushes that stamina and limit just a little more. You will get there, trust the process <3

 

[Layla]

Going to ease of the pt for a week or two just focus on the tasks around the home and a bit of walking, with the cane

Wise choice!
I'm guessing you'll notice a difference. Maybe if you step away from the PT and simply engage in the activities of daily living along with some walking, but not to excess, you will be able to assist your son as you planned.
It is not necessary to exercise your injured hip to promote healing. The controlled trauma sustained through THR will heal on its own. Often though, we're impatient and want to move the process along. In doing so we run the risk of struggling with pain and setbacks stalling the healing process. The best therapy for recovery is walking, but not to excess. Start slowly increasing time and distance incrementally in an effort not to overdo it. Give yourself the TLC you deserve and reap the benefits of a successful recovery.
Best Wishes!

 

[Butterfly77]

Fairly new to this wonderful forum. I posted the other day about how I am still limping after 10 weeks post right hip replacement by posterior approach. Decided to give the pt a rest and focus on walking and daily chores etc. I feel so down today, I struggled to get to the shop at the end of the road and back. Suffering groin discomfort, terrible limp and weak feeling in the operated hip side. I’m barely sleeping, and seem unable to sleep in my bed without so much discomfort, so I have spent the best part of 11 weeks sleeping on my reclining sofa getting maybe 5 or 6 hours of very broken sleep. I am beginning to worry something is not right, and that I should by nearly 3 months be able to do much more than I can. I spend most days crying at some point out of sheer frustration. I am a single mum with two teenage sons, self employed and unable to return to work yet as I’m a driving instructor and sitting in a car is so uncomfortable on my buttocks after about 30 mins. I’m only in my 40’s and just feel so fed up. The last three weeks has seen no improvement for me, I just don’t know what to do. Life is tough right now, it seems people around me don’t understand why I am not doing better than I am and it’s really dragging me down mentally. Please tell me it will be worth it and I will get there. At my 6 week follow up my x ray showed up ok, wound healing well except for some swelling on the outer thigh, which is still there but down slightly. They noted my gait and weakness on the operated side and told me to keep with the physio. Sorry for the rant but I am really having a bad day today.

 

[Ocean]

I had my left hip replaced on the same day as you. I’m sorry that you are feeling so down and it’s hard when people comment in a negative way.

I don’t know if you are taking any medication for the pain because pain can drag you down and put you in the wrong frame of mind for healing. Are you icing? Have you talked to your GP?

We both still have a lot of healing to do and we have to try not to compare ourselves to the super humans who were back to normal very quickly.

 

[Butterfly77]

I’m managing with paracetamol and sometimes I take a codeine if needed. The pain isn’t terrible just niggling. I haven’t contacted my gp because for one it’s nearly impossible to get through and get an appointment and he is not very nice with no bedside manner. I’m considering phoning the orthopaedic nurses up just for reassurance. My physio I was seeing said not to worry and it is typical at this point but I’m so frustrated with the weakness more than anything. When I walk with a cane I get terrible lower back ache on the opposite side. Guessing it’s the change in gait and still over compensating. It was a very big incision I had with 28 staples removed spanning nearly 30cm, so keep telling myself all that muscle and soft tissue has really been through the mill. I do hope you are progressing well with your recovery.

 

[Ocean]

Thank you @Butterfly77, I am doing well I think and in much less pain than before the operation and I can move my leg more. I use a crutch on the operated side to support the right side which I am having replaced in a couple of weeks time.

Your incision site sounds like it would be sore and take a while to ease. I still won’t lay on my op side because although it’s not painful it’s tender.

I’m sorry that your GP isn’t approachable, perhaps you could swap and he could have the pain and you could try having the attitude!

 

[myglasshalffull]

Depression and crying come with this recuperation and if friends and others are not encouraging you then avoid them for now.
Fortunately I am older, retired and my kids are grown and gone and I do have a wonderful man in my life. Even so, I spent many days sobbing and feeling sorry for myself and wondering why I wasn't doing better/sooner.
You will get better, it's a process and one you have to just kind of give into and let your body heal.
I know it's easy to say but time is the great healer. Just know you are not alone in the way you are feeling.
I wish you sunnier days, all my best.

 

[Butterfly77]

Thank you for your kind words and encouragement. I keep getting up and I keep trying so I guess that’s all I can do really. They never mention the mental health side of things when you talk to the medical staff about the surgery. For me it has been the hardest part of all of this. It’s nice to know I’m not alone with these feelings.

 

[cold_brew]

30cm? Wow that’s quite the incision. Your leg must have gone thru quite a lot, hope it gets better soon!

 

[myglasshalffull]

Butterfly,
There's an article on this website about post op blues and depression which may be helpful to you.
I always say the surgeons fix the broken bones but not much help on healing our minds and emotional needs.
Stay well.

 

[Shenick]

Hi @Butterfly77

So sorry you are having a hard time at the moment but I know this site has really helped me so you are def in the right place.
I will be four months post op at the end of this month and my recovery slowed down at about 8 weeks. I too am still struggling with weakness and some limping on one side. Following the advice on this site I cut out PT for a bit and have just returned to focus on improving my gait but am refusing to do anything which makes things feel worse!
We will get here I'm sure even though it often feels like recovery is going backwards...
Take care of yourself and best wishes for an improvement soon

 

[Butterfly77]

Shenick, the same happened to me at around 8 weeks. I hope you soon make some more progress. I think it doesn’t help as I’m not sleeping at all well as I just can’t get into and stay in a comfortable position. Getting such a broken sleep every night. Thank you for taking the time to reply.

 

[Eman85]

On the sleeping I used a few pillows to block myself into the position I was comfortable in and they held me there. As for your incision if I remember 30cm is about 12in which is about what mine were, I can barely see them now.

 

[Magsklein]

I’m now at 12 weeks post THR. I’m still sore and limping but I seem to manage better every day. I ditched the pt long ago and have been walking and concentrating on stretching, gait and posture. A friend keeps reminding me that the surgeon basically cut my leg in half so I should expect it to take several months to heal! Oh, I’m also trying to eat really nutritious food. I’m 55 years old and overweight but trying to lose about 50 pounds. Keep the faith, friend!

 

[HollyNY]

Hi @Butterfly77,
So sorry to hear you are struggling.

There is a lot of healing that has to happen beyond the incision healing over.

The femur has to re-grow around the implant. New bone takes time.

Each recovery is unique!

I am behind you a bit but I already find icing the hip as much as I can really does help.