THR Lablawrence (Lisa) Joins The Hippies

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@lablawrence, that you are having these difficulties with your second replacement. I am going to tag @Josephine for you.

Take care and keep us posted. We care.

 

[Josephine]

Sadly, I am having a great deal of pain in my quad muscle and my inner thigh muscle. No one seems to know what's going on. This time, I might have pushed too hard on the pt at first because my quad hurt so much I had to be on crutches. I can now walk small distances, but the pain returns quite quickly. What type of x-ray would show soft tissue issues? Could I have torn a muscle(s), and now it needs to be surgically repaired?

Hmm, Methinks your surgeon has the right idea! I would be most surprised if you have torn a muscle. But let's start at the beginning

Can you tell me the exact site of your pain using this chart?
Please note the instructions in the smaller image

I'm also going to ask you some questions and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what approach did you have for your surgery? Anterior, posterior, lateral? You can look here to see the various types THR approaches or incisions

2. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

) Also don't forget to include other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness

3. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

4. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

5. what kind of PT exercises and exercises at home are you doing? How much and how often? (and detailed details would be appreciated, please! **Reps, sets and sessions** and all that) - I know you said you can't do much now but I want to know what you were doing before this occurred


** If you're not familiar with this, it goes like so:
1 lift of your leg = 1 rep (repetition)
5 reps and then a brief rest = 1 set
5 sets and finishing = 1 session.

 

[lablawrence]

@Josephine:
Thank you so much for your reply.

My pain is at EFGHL5F and EFGL4F

1. I had the posterior approach.

2. My pain level is a 3 while sitting. I am stiff when I get up.
When I walk, unassisted, my pain level is a 7 to 8. However, I can't walk very long or it increases to a 9.
The pain is an intense stabbing one that remains if I put pressure on my leg by walking. It will often transfer to
the inner thigh as the same stabbing pain. I can massage my thigh without pain unless I use a device other
than hand manipulation.

3. I take no pain medication. I am still taking 2 aspirin per day for blood clots as prescribed by my surgeon. He said I could take Tylenol but not an anti-inflammatory. I have not taken the Tylenol.

4. My activity level consists of light cleaning. I just quit physical therapy yesterday because I can't work on the strength aspect. I had been doing exercises for range of motion and will continue those at home. I want to walk my dog, but it's impossible.

5. The pain began in week 3 after my surgery after a physical therapy session. I was stepping up on my left leg on a soft rubber square. I was to do 2 sets of 10 reps per session. I was going 2 times a week at that time. The pain was sharp and stabbing -- definitely a 10. Since then, I have been going 3 sessions a week for range of motion. The following is at physical therapy:
I ride an exercise bike for 10 minutes to warm up.
My pt stretches my hip before I do my exercises. He used to massage my leg but it did not help so I quit that part.
Exercise 1. I lie on my back and lift my fully extended leg with a rope device I can put my foot in to assist the lift. I lift it to the height of my other blended knee and hold for a count of 5. I do 3 sets of 10 reps each session.
Exercise 2. Lie on my stomach and lift my bent leg using the device above. I hold for a count of 5. I do 3 sets of 10 reps.
Exercise 3. Lie on my back and place a soft rubber ball between my bent knees and squeeze for a count of 5. I do 3 sets of 10 reps unless my inner thigh is too painful.
Exercise 4. Lie in my back and put an elastic band above my bent knees. Stretch the band moving my knees outward and hold for a count of 5. I do 3 sets of 10 reps.
Exercise 5. I do standing mini-squats. I do three sets of 10 reps.
I used to do electrical stimulation at the end, but I saw no benefits.
I do not exercise at home.

 

[Josephine]

I see your pain is here

My pain level is a 3 while sitting. I am stiff when I get up. When I walk, unassisted, my pain level is a 7 to 8. However, I can't walk very long or it increases to a 9.
The pain is an intense stabbing one that remains if I put pressure on my leg by walking. It will often transfer to
the inner thigh as the same stabbing pain.

I understand ...

I take no pain medication. I am still taking 2 aspirin per day for blood clots as prescribed by my surgeon. He said I could take Tylenol but not an anti-inflammatory. I have not taken the Tylenol.

Why are you not taking the Tylenol? It's probably the best pain med for you right now - 1,000mg 4 times a day. And the only reason you cannot take an anti-inflammatory is because aspirin is also an NSAID and you can't take two at the same time.

My activity level consists of light cleaning. I just quit physical therapy yesterday because I can't work on the strength aspect. I had been doing exercises for range of motion and will continue those at home. I want to walk my dog, but it's impossible.

Well, you are only 8 weeks out which is quite early in the process. Did you read the articles I left you in post #4? There is one entitled 'activity progress' which you should visit again.

The pain began in week 3 after my surgery after a physical therapy session. I was stepping up on my left leg on a soft rubber square. I was to do 2 sets of 10 reps per session. I was going 2 times a week at that time. The pain was sharp and stabbing -- definitely a 10. Since then, I have been going 3 sessions a week for range of motion.

The following is at physical therapy: my comments in bold
I ride an exercise bike for 10 minutes to warm up - okay
straight leg raises assisted hold for a count of 5 - 3 sets of 10 - far too much, 5 would be plenty
lie on stomach lift my bent leg assisted, hold for a count of 5 - 3 sets of 10 - what a dreadful exercise!
soft rubber ball between my bent knees and squeeze for a count of 5. 3 sets of 10 - and another one!
stretch band moving my knees outward and hold for a count of 5 -3 sets of 10 - and another!
mini-squats. 3 sets of 10 - squats are very punishing for a hip

I would say that the five I had struck through are responsible for this thigh pain. Because what you have is an inflammatory condition in your quads muscle which is going to require a significant amount of TLC to get it to recover. The first thing you need to do is to rest a lot more, ice the quads and take the Tylenol. Essential you take a painkiller else it will be ages calming down.

Then you could try this Acupressure massage.

And remember this that I left for you before: hips actually don't need much 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.

 

[lablawrence]

@Josephine:
Thank you so much for your reply and suggestions. I realize I'm an overachiever and need to let myself heal at a reasonable pace instead of forcing the process. Obviously, that doesn't work. One additional question and I will leave you alone. My surgeon suggested the possibility of bursitis. I'm not sure how it is diagnosed, but would your recommendations regarding the Tylenol be the same if it is bursitis? I thought bursitis is a joint issue. Not a muscle issue. I have researched a bit on the Internet, but I find it confusing and dangerous to self-diagnose. I hope the next time I post my news of recovery will be positive. Than you so much for this site.

 

[Josephine]

Oh bother me all you want, my dear. That's what I'm here for!

As for the bursitis, it's a condition all of its own, neither joint nor muscle. And you don't need to search the internet, try searching our Library instead! It's much better than Google! Iliopsoas syndrome
This article explains the nature and function of bursae in more detail Trochanteric bursitis with THR