THR Incision scar tissue

[BruceH]

On my first hip, I was having some pain and then my PT did massage on my scar area. She explained that the scar tissue has to be broken up or it can be painful. Sure enough, by the end of that session, my pain improved dramatically. There was some crackling and then immediate relief from the massage. This time I don't intend to go to PT, but am wondering if scar tissue always needs to be massaged and will i have that pain again without someone to relieve it?

That is what I've been told by PT and a Hellerwork therapist for some of the other things I've experienced. It hurt having it broken up and took multiple sessions but it did work. They always said to drink lots of water after a session to help the body flush what had been broken up.

 

[VSlowLife]

In my experience, it was easier to have PT work on it, vs. slowly, having periodic ”zingers” as I would describe them, for 18 months after my hand surgery.

 

[CricketHip]

I've not heard that it needs a deeply applied massage to "break up scars" and that it's the only way.

I did a gentle circular massage up and down my scar as soon as I was cleared to do so.
Clockwise and then counterclockwise up and down the full length of the scar and making sure to cover the areas on each side of the incision/scar. It helps to rearrange collagen fibers and help to align it along the direction of our muscle fibers. Maybe I wouldn't have had an issue regardless, but I figured that would be easier than trying to break it down later on. My scars look and feel fine, if I do say so myself

 

[Richardp6]

Had 2 week checkup with Dr. today. All is well. Interestingly, when I had my 1st hip done 5 years ago he prescribed 4 weeks of PT. This time he says experience and studies have shown that it is not necessary and just walk and try to increase flexibility. So Kudos to bonesmart for being ahead of their time!

 

[Elf1]

Congrats on a good follow-up with your surgeon. Happy to hear the surgeon is on board with no formal PT at this time, walk and do daily activities.

 

[Layla]

Happy One Month Anniversary!
How are you doing? We’d love to read an update on your progress if you’re able to leave one next time you stop by.
Until then...all the best!
@Richardp6

 

[Richardp6]

one month has gone by quickly. Not sure where I should be at one month but I am back to leading a normal life in all respects. Using Tylenol for the t winges i get when walking sometimes. Have to remind myself to walk correctly or sometimes I favor it. Had a couple of 6k steps days this week! Probably late afternoon stamina issues would be my biggest complaint but that will phase out. I consider myself very lucky to have come through so well!

 

[CricketHip]

Very good @Richardp6 ! Glad you are aware that you need to be mindful of your gait. Getting that under control will serve you well as you continue to recover.
I am at 8 months and I still have bouts of exhaustion.. but am also keeping a pretty hectic pace so maybe it's just me at this point.
I do love my little naps, though!

You are doing very well and I am happy for you.

 

[Elf1]

Good update @Richardp6, you seem to be doing really well, especially one month out. Definitely stay mindful of your gait, it is very easy to slack off and have to start over. Totally understand the late afternoon stamina issues, especially if it's been a busy day. That will eventually continue to taper off as time goes by.

 

[Richardp6]

Meds- I finished my eliquis. Though I'd prefer to just use tylenol, I've been experimenting and the celebrex works the best. It drives the discomfort to zero and helps me with my gait. However, it works so well, it doesn't give me the feedback of whether I am overdoing or not. Any opinion about which is more important?

 

[Layla]

Hello Richard
While well managed pain allows for better mobility, I think if you were overdoing it, you’d feel it. I’m not sure what you’re doing in a day for activity but at approx 5 weeks post op you could use the Activity Progression for THR for a few more weeks. It will pretty much ensure you’ll stay out of trouble. I recommend it often because I loosely followed it and did well. Maybe you’re getting to the point where you’ll forget a dose and realize you didn’t really miss it...

Activity progression for THRs

For THRs. Activities of Daily Living (ADLs) are assessed in hospital as a means of assessing your fitness to be discharged home. Your domestic circumstances will be taken into account as in if you are living alone, etc. ADLs include: ~ Personal hygiene and grooming ~ Dressing and undressing ~...

bonesmart.org

I hope you have a nice rest of the week!
@Richardp6

 

[Richardp6]

I think the activity progression chart could be more stratified either by age or by level of health. Ever receive that feedback before? Lord knows, this forum is a lifesaver and the activity progression is a nice set of milestones but it seems skewed towards older ages, mentions activities I don't do(when can us guys cut the lawn?) and return to work advice doesn't address whether you are a laborer, office worker or somewhere in between. (Please don't shoot me for raising these points. I'm not trying to nitpick but I think there's validity in what I am saying ).

 

[Layla]

Thanks for your kind words in regard to the forum, Richard. We’re happy you've found BoneSmart useful. We hope you will continue to share your recovery journey here. We all learn from one another.

Personally, I’ve never read the opinions you’ve provided in regard to the Activity Progression for THR from any other members. However, I‘m guessing others may agree with you. I will bring it to the attention of Admin.

I’m assuming, Josephine, the Nurse Director Emeritus was purposely cautious in advising what’s safe, and what’s not, within those first eight weeks of recovery knowing there will always be those who push the limits. I believe I mentioned I followed it loosely and often advise others to use it as a “rough gauge”. Because no two recoveries are alike, it’s difficult to judge who is capable of doing what at any given point of recovery. It’s always best to follow the instruction of your surgeon, moving slowly and cautiously early on, slowly building on activity as your body allows.

As far as mowing the grass, you can get a nod from your surgeon, or a member of his care team at your next post op visit, or through a quick phone call to the surgeons office. Mowing the lawn has been discussed here many times. If you type “mowing the lawn” into the SEARCH located on the dark blue navigational bar at the top of the page, I’m sure numerous threads will pop up discussing the topic, which may give you an idea of the average amount of time it took before others were back mowing the lawn.

All the best as you continue the journey!
@Richardp6

 

[Jamie]

We came up with this guideline years ago to satisfy the large numbers of members who were asking us to tell them when they could do particular activities. It is on the conservative side purposely and is just a guide.

The real advice we give people is to pay attention to how their body reacts to a particular level or type of activity or exercise. Each of us is different and our recoveries are different as well. If someone feels ready to attempt a certain level of activity (return to work, walk a little farther, etc.), we'll say go for it as long as you then give yourself a day or two to see if there is any new pain or swelling. If not, you're good to go.

At some point we probably will take a good look at our guidelines and possibly revise them. I appreciate your feedback and we'll definitely consider your thoughts when deciding how to update things. For one thing, these guides were developed before surgeons began using the multi-modal pain treatments immediately after surgery that appear to be successful in keeping post-op pain and swelling minimized for many people. That appears to be changing the time schedules slightly.

You're correct that as far as going back to work is concerned, it makes a difference if you have a job where you are on your feet a lot, lifting heavy items or walking great distances. But you might be interested to know that office jobs where you must sit for long periods are really hard on recovery as well. That is why we advise people to get up and walk around for 5 minutes every hour. You can have increased pain and swelling from sitting too much.

Age has not proven to be much of a factor in recovery, although you'll hear people talk about how they think they should heal faster if they are young and/or very active. It works now and then, but not consistently. So making age designations for activity isn't a good idea. Much better to advise people to listen to their body and make decisions about activity based on that.

Thanks for taking time to present your ideas. We always appreciate input from our members. We learn what works and what doesn't from learning about your experiences.

 

[Elf1]

As @Jamie mentions above, office jobs requiring a lot of sitting and computer usage are some of the worst jobs for your spine and hips. My basis for this is the neurosurgeon that did my spinal fusion. He actually wanted me to stay out of work for 12 weeks and go back with a phased return.

 

[Richardp6]

Elf1 That's really good for people to know. I bet most people think just the opposite like me. I work in an office and I thought that was the best possible work scenario. I do have my fitbit set to prompt me to walk a certain number of steps each hour and that is working very well. Otherwise, i am quite stiff when I get up from behind that desk.

Thank you for sharing your experience.

 

[Elf1]

I was just like you until I had the back surgery. The doc actually attributed a lot of the back and hip problems out there on this sedentary lifestyle where we're putting so much pressure on these areas. Who knew?!

 

[Layla]

Happy Two Month Anniversary!
I hope you’re doing well. We’d love to hear how you’ve been progressing in your healing journey, if you care to update us. Stay safe and well!
@Richardp6

 

[SurreyGirl]

I git very stiff from sitting g in an office chair and not taking enough breaks. Stretching at the desk before getting up and also taking paracetemol for stiffness (I think BoneSmart recommended this) really did help. It got a lot better but the first six months back at work were hard and I was surprised at how much a desk based job contributed to that.

Once i got back into walking and particularly swimming, it got much better. I really miss the swimming with this lockdown and confess to finding it hard!

 

[Layla]

Happy Three Month Anniversary!
I hope you continue to enjoy steady progress. We’d love to hear from you if you care to share an update.
Best Wishes moving forward.
@Richardp6