THR Impingement

[lucinda007]

Josephine, here are the answered to your questions:

AT 6 WEEKS
1. Pain level was only about a 1
2. Medication prescribed Celebrex, oxycodone as I truly had no pain. None.
3. Icing a lot for about 3 weeks.
5. Before this started, I had gone to California and took a long bike ride, then on to Hawaii and hike up a step incline, then back to California for more walking (shopping) and a TOTAL of 20 hours sitting on a plane within 3 weeks. During all of that, I only had the “normal” twinges of burning and tingling and numbness around incision. no pain on lifting. About 1 month after the Ca/Hi trip.
6. Exercises. I’m doing none now

NOW:
1. Pain level a 10 sharp stab like a knife when trying bend knee up as in marching. Also while laying flat on back and lifting leg straight up. If I move “wrong”, even in bed, it’s a searing, screaming #10.

2. Medications prescribed are none. Called doc yesterday and was told to start Advil. 4 and 6 hours later 4 more. I have just started today on that regimen. Taken 3 this morning.

3. Icing. When I do any activity like walking or biking I ice

4. Elevating leg about 3 times/day for about 10 minutes.

5. I am on vacation so no housework but, I’ve been taking walks (less than mile on flat surface), biked short distance (adjusted seat higher so the up stroke wouldn’t hurt as much), swimming with NO kick. Taking elevator. Driving (I had to lift leg to brake! I’ve stopped driving)

6. Exercises. Ones I did after release from PT about 6 weeks ago were:
hip flex stretch (hold about 1 minute)
calf stretch 10 x2 day
open book (stretches spine). When feel tight
seated piriformis stretch during day often
wall squats (never hurts)- 10/2x day
standing 3 way hip (all with bans) 5/2x day
hip flexion ( this one hurts to do)
hip extension (no hurt)
hip abduction (no hurt)
basic core exercises I didn’t do
I only did the first 4 stretches regularly.


I hope this format is ok for you.

My OS office told me to get an X-ray here in Fl. I’m going on Friday. I have an appt with my OS at home May 7. Weird thing is that when I’m in the pool up to my shoulders, I can bring my leg up waist high in a marching motion with no pain. No pain on flexion. (It was a test for myself. I'm not doing that) when I swim, I only use my arms.

 

[lucinda007]

I forgot to say that I did take the Celebrex for 10 days after surgery as requested.

 

[Hipster63]

Lucinda - the pain you are describing sounds a lot like what I experienced almost 10 months after a partial hip replacement. My groin pain started after became more active and tried exercising to build my quad and glute muscles. Before the new exercise regime I could lift my leg straight up, drive, stairs. No true problems other than I was still limping badly and had no muscles to hold me up. My surgeon and PT both agreed I must have irritated my Posas muscle trying to build muscle. I quit the lower body exercises and rested a lot. I stopped using my recumbent bike. It's been 2 months and it is better but on occasion I still have that sharp pain. My x-rays are ok and a MRI was fine. Just lying still for 45 minutes to get the MRI bothered the Posas. Sitting for a while bothers it too. My PT showed me some exercises to stretch it but those truly hurt and I felt made it worse. I hope you find an answer.

 

[lucinda007]

Hi, the more I investigate, the more I’m thinking it’s the psoas muscle. It’s just so frustrating to have sailed through the replacement and physical therapy and now have this. The question is why is your psoas so sensitive to exercise and strength training 1 year after your surgery? Am I understanding it was April 2017? I am a very active person and to think I will always have to baby my body, is horrifying. I will wish I never had this thr done (that’s how I feel this moment). Has your Dr and pt told you that it will never settle down? I’d love to hear how you feel about your situation. I hope you have good news.

 

[Hipster63]

@lucinda007 Yes my surgery was in April '17.

I fell on concrete near our pool trying to get away from a water moccasin snake. I broke the shaft below the ball. I had no choice of hospital nor surgeon as it was an emergency. Well, I suppose if I had had my wits about me I might have called my family Dr to request a transfer to a better Dr. But the pain meds had me out of it.

Anyway, the Dr did a partial ugh. Now I need to have that redone. So I'm looking at a revision soon. I'm dreading that as my recovery has been horrible. I'm a young 63 and was fairly active. I rarely leave my house now. I go to the gym to do light weights on my upper body, visit Dr's and I'm finishing up PT. I can't walk far without the psoas letting me know I've done too much. I still limp and use a cane when I tire or leave the house. I know I injured my psoas. But I have read that it seems to pop up after many months after surgery on some people.

My pain has settled down but it's still there. I spend way too much time in bed, just resting. Yesterday my PT had me go through all the muscle building exercises he and the Dr want me to continue. I had been doing a series of light band work and was fine with that.

But the new exercises he added really wore me out. And I'm hurting again. Ugh.

Because the psoas is in the groin region, I always thought it was just the psoas causing my pain. It is/was but I also learned the hip joint also presents pain there too. My x-rays show the device in place but also show the ball might be rubbing on the socket.

This was an issue I feared when my new Dr explained the partial was a bad choice because the rubbing/thinning was bound to happen. I am scared to death to have a revision. I'm far from recovered. My only advice is to rest, rest and rest.

I've tried all kinds of pain creams - nothing helps. Ice helps a little but as my PT says the psoas is so deep, that really will not help. I dunno about that. This psoas is one sneaky mean little muscle!

 

[Josephine]

I hope this format is ok for you.

Actually it was the exact opposite of what I was request which was

First answer them ALL for the first 6 weeks
Then answer them ALL again for now.
Two separate sets of answers​

Still, it's the way I wanted it now! Hope you don't mind!

Also, I discovered that you never told me the sire of your pain though I did post a chart fr you to do that. So until you tell me, I shall have to hold off on the answers

 

[lucinda007]

V-R2F.

Thank you for redoing my list. I have had trouble with the app on my iPhones so I have used the bonesmart.org instead (like I did when I first joined before my THR). I thought I had already sent the designated “spot”. I am sending this info on the app now.

The other problem is that the app didn’t recognize me so I changed my user name to Lucinda008! But, I can sign in now with my old one, Lucinda007. I apologize for being a “pain”. This new pain after such an easy surgery/recovery has thrown me. Frustrated and depressed to the point of crying.

 

[Josephine]

Which app are you using right now? There are one or two that were used in the past but are now defunct, like TapaTalk.

R2F-V is likely to be Psoas pain

 

[lucinda007]

Hello,
I have waited to respond until I saw my OS. My appt was 5/7. He agrees with you. He believes it is tendonitis of the Iliopsoas. I am reading as much as I can about it. He suggested that I rest it my leg. I have been doing that for 1 month with some slight improvement (I can lift my leg 6”. Before only 3”). The super sharp pain is gone. I can roll over in bed without pain. He ordered a blood test to rule out infection (standard procedure). I’m waiting for results. He said I can do whatever I like that doesn’t cause pain...I guess he considers that rest???? I can walk and go up and down stairs at this point. I am taking Advil 400mg morning and night. If I still can’t lift my leg after 1 month, I will ask for a guided cortisone shot. In the meantime, I wait. I wonder if I’ll be having a tendon release in the end. Who knows.

 

[Mojo333]

Maybe the rest will help the most.
Hope it gets better soon

 

[Josephine]

He agrees with you. He believes it is tendonitis of the Iliopsoas.

Jolly good! Nice to have one's opinion verified!

I am taking Advil 400mg morning and night. I will ask for a guided cortisone shot. In the meantime, I wait. I wonder if I’ll be having a tendon release in the end.

I suggest you stop that and take 1,000mg Tylenol instead. Advil has some unfortunate side effects Medications: acetaminophen (Tylenol, paracetamol) and NSAIDs, differences and dangers

 

[lucinda007]

Hi. I feel like I’m getting a little better. I can lift my leg while lying on my back and I can flex my knee a little better, but pain occurs if my foot is about 12” from floor. Wow! This is very slow recovery. My dermatologist is a horse person and said that tendonitis in a horses leg is so serious that they have to stay in the stall for 4-6 months not even walking. (The horse doesn’t like it and neither do I). I would love to hear from someone who has overcome tendonitis.

 

[lucinda007]

Hi,

My RTHR was Nov 28, 2017. I had an easy recovery for the first 6 months, but in the last 18 months or so, I’ve had groin pain on lifting my leg. I can walk with no pain. I have to lift my leg with my hand to get into the car or get on my bike.

I went to a dr who did an ultrasound and diagnosed as an impingement of the ilio psoas. I had some sort of shot (I don’t remember the cocktail) but it didn’t help the groin pain on lifting my leg.

I went to OS who felt that was the correct diagnosis and said I could consider a tendon “cutting” ( don’t know the correct name). He said if it was only bothering me to lift my leg, he wouldnt recommend it since “it’s one more surgery and that there can be a chance of infection, plus, it might not take care of the pain”. However, he said if I wanted to do it, I could.

I’m frustrated. I’m an active person. I’m in great general health except for being 25 lbs too fat!!! I’ve gained all of the weight since my THR. And, that’s another question: do you think it might go away if I tried really hard to drop the weight? I think I’m sort of depressed about my pain and have been eating.

I’ve been doing gentle ilio psoas stretches but it doesn’t help.

Any advise? Anyone have the tendon cut with good, bad, or no results? I’m trying to research as much as I can and of course, I came back to bonesmart where Josephine, et. al have lots of information. Thanks in advance for still being online.

 

[Layla]

Hi @lucinda007
I remember you! Your surgery was just a few moths after mine.
I'm sorry you're struggling. I'll tag @Josephine for you. Check back periodically in case she has questions.
Since you already have a recovery thread, this thread will be merged with your original.
I hope you have a pleasant holiday weekend!

 

[Pumpkin]

@lucinda007
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[SaraK]

Hi, Lucinda! I had my 2nd THR just a few days after yours. I developed psoas problems just a few months later and searched for months to get it diagnosed. In the meantime, I did complete rest, massage, PT, NSAIDs, muscle relaxants, etc. I did enough research that I was pretty sure it was psoas impingement. 3 different PTs were skeptical at first and convinced there was an impingement with 1 month of starting therapy. I did the cortisone shot and it made such a huge difference but only lasted about 2-3 weeks. Mine was bad enough that I had pain rolling over in bed and just about any movement that activated the psoas. It got worse and worse and, at the end, was hurting after walking even short distances.

I did have an arthroscopic tenotomy (release) done near the acetabular cup. It has made a world of difference for me. Recovery was very quick and with very little pain. PT was helpful but I do have some residual weakness (I can't lift my knee higher than my waist without using my hands to assist) but I have no pain and the range of motion is there if I manually assist. I've been told I can get full active range of motion back but it will take several months of PT. I'm putting that on the back burner for now and enjoying what I can do now.

I'm on vacation and we did some hiking in Chattanooga. Now we're on the beach and I've been doing beach walks daily and a walking tour of the historic district. Today we did a 2 hour kayaking trip and I had no trouble getting in and out of the kayak.

I agree with the doctor that you need to weigh the degree that this is interfering with your life, try more conservative approaches first and then decide if the risks are worth the benefits. For me, I'd exhausted the conservative options and the cortisone injection showed me just how good life could be again so I went for it. I'm glad I did!

 

[Fit4Family]

Hello @lucinda007 I am so sorry to read you are dealing with pain. I live in Northern VA too. Really hope this improves for you. I’m right there with you on weight gain. Have been trying to really get serious about reducing and finally watching the numbers move in right direction. I’m a comfort eater, so this last 8 months has been easy to reach for wrong things. Hope you have a good weekend. Take care.

 

[lucinda007]

@lucinda007
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

Hi. Thanks for bumping me. It’s been so long that I forgot. Can I keep “Impingement” or do you want me to go to the original? I’d like to keep impingement if it’s ok. Just tell me if I need to do something different.

 

[lucinda007]

Hello @lucinda007 I am so sorry to read you are dealing with pain. I live in Northern VA too. Really hope this improves for you. I’m right there with you on weight gain. Have been trying to really get serious about reducing and finally watching the numbers move in right direction. I’m a comfort eater, so this last 8 months has been easy to reach for wrong things. Hope you have a good weekend. Take care.

We are in Naples FL for 1 month. So it’s a good opportunity to get serious about this weight loss. I’m going to something I’ve never tried before...eat half of what I would normally eat. I swam in the Gulf this AM and a little at the pool this afternoon. Done for today. Have you heard of the Whole 30 challenge? Sounds interesting.

 

[lucinda007]

Hello @lucinda007 I am so sorry to read you are dealing with pain. I live in Northern VA too. Really hope this improves for you. I’m right there with you on weight gain. Have been trying to really get serious about reducing and finally watching the numbers move in right direction. I’m a comfort eater, so this last 8 months has been easy to reach for wrong things. Hope you have a good weekend. Take care.

Hi, Lucinda! I had my 2nd THR just a few days after yours. I developed psoas problems just a few months later and searched for months to get it diagnosed. In the meantime, I did complete rest, massage, PT, NSAIDs, muscle relaxants, etc. I did enough research that I was pretty sure it was psoas impingement. 3 different PTs were skeptical at first and convinced there was an impingement with 1 month of starting therapy. I did the cortisone shot and it made such a huge difference but only lasted about 2-3 weeks. Mine was bad enough that I had pain rolling over in bed and just about any movement that activated the psoas. It got worse and worse and, at the end, was hurting after walking even short distances.

I did have an arthroscopic tenotomy (release) done near the acetabular cup. It has made a world of difference for me. Recovery was very quick and with very little pain. PT was helpful but I do have some residual weakness (I can't lift my knee higher than my waist without using my hands to assist) but I have no pain and the range of motion is there if I manually assist. I've been told I can get full active range of motion back but it will take several months of PT. I'm putting that on the back burner for now and enjoying what I can do now.

I'm on vacation and we did some hiking in Chattanooga. Now we're on the beach and I've been doing beach walks daily and a walking tour of the historic district. Today we did a 2 hour kayaking trip and I had no trouble getting in and out of the kayak.

I agree with the doctor that you need to weigh the degree that this is interfering with your life, try more conservative approaches first and then decide if the risks are worth the benefits. For me, I'd exhausted the conservative options and the cortisone injection showed me just how good life could be again so I went for it. I'm glad I did!

Hi SaraK! Thank you so much for telling me about your tenotomy. I kayak too and remember right before my THR that I went out by myself. Wasn’t a problem getting into the kayak, but I had to wait until some guy came to the shore to pull me up. Talk about embarrassing!! I haven’t been since my operation. I’m waiting until we get back from FL. I’m having a terrible time getting on my bike. I have to lift my leg with my hand. I’m not experiencing terrible pain as before when the psoas really acted up. It just a pain every time I lift my leg. I can walk up stairs but is with a pain of about a 2-3. Ok tmi. Have a nice Memorial Weekend .