THR Leg length discrepancy after THR / Physio & exercise in general

[benne68]

Walking really seems to be all I need

Yes! This is so true.

Great to read that you are feeling stronger every day!

 

[Firecracker]

Yesterday I was back at the hospital where I had my surgery for physio and to have my clips removed. The physiotherapist was really pleased with my progress and gave me some less punishing exercises to work on. These are mainly for balance and strength and I'm happy to do them. We chatted about my concerns around my leg length discrepancy and he said I was lifting my right hip up as I walk. He wasn't concerned about it and like all you lovely people here, thinks that in time my pelvis will adjust and my gait will be just fine. My wound is healing well with just a bit of soreness in the surrounding area which I am keeping an eye on. Back to physio in three weeks when I will hopefully be a bit further along my recovery road.

 

[Firecracker]

Just wondering if anyone has experienced this...3 years ago I broke my right ankle after a fall. It was a stable fracture and I recovered well. That ankle aches from time to time but nothing I'm worried about. TRHR 10/10/24 and there's expected swelling in my thigh, knee and calf which is settling nicely with rest and elevation and hydration. My right ankle though seems to be bearing the brunt of the swelling. I'm sure gravity has something to do with this but I just wondered if anyone else has been in a similar situation. Other than that, I'm really pleased with my progress so far.

 

[myglasshalffull]

You will discover various joints in your body will ache & swell. I broke my left ankle about 3 years before I fractured my hip & had similar issues. I had pins, rods, etc in my ankle & after my hip surgery felt like the rod or pins were "moving." Well of course they weren't but more than likely way I was walking made it feel weird.

 

[benne68]

My right ankle though seems to be bearing the brunt of the swelling. I'm sure gravity has something to do with this

You're right -- it's gravity in action. You are still early days, so it is not uncommon, but you can mitigate the swelling by making sure to elevate and ice often throughout the day. Be sure your leg is high enough -- we like to say, "toes above nose". Some people also find compression stockings helpful.

 

[Firecracker]

Hello again I am three weeks post operative right hip replacement and I'm doing well with my progress. I just wanted to ask if it's normal at this early stage in my recovery for my right knee to be flexed when I stand with my feet together? It straightens up if I move my leg to the right which I see as a good thing but I'm wondering how long this might go on? The swelling is getting less around my knee which is good too.

 

[benne68]

At 3 weeks post-op, your muscles, ligaments, tendon and other soft tissues haven't recovered from the trauma of surgery. What you describe is just your body trying to deal with all that "upset" soft tissue. It can take 3-4 months for everything to settle down.

When I was in my early THR recovery, my right foot splayed out to the side when I walked -- something it hadn't done before. It took months, but the problem eventually went away.

Try to be patient. You are still very early days!

Glad to read that the swelling is down.

 

[Firecracker]

Today I am 24 days post operative total right hip replacement and just wanted to check in with my progress. Friday November 1st was my daughter's birthday and we went out for coffee and cake. It felt great to get dressed up in nice clothes, put on my favourite jewellery and lipstick and the feeling of my jeans fastening after three weeks of resting on the sofa doing not very much was incredible. I asked my daughter if she thought I was limping and she walked behind me to watch. Her saying "you're walking just fine mam" actually made me cry! I still feel like my right leg is longer than my left one but to be able to get in and out of the car, walk around the cafe and two shops without being in awful arthritic pain was better than any lottery win! My physiotherapist cleared me to use my static bike for as long as I'm comfortable and I am really happy to be back in the saddle. I'm very careful with the 90 degree precautions and certainly don't overdo anything but being back on my exercise bike is just what I need because it's something I truly enjoy. My progress is going well and I am really happy with myself. When I had my left hip replacement back in 2017 I didn't hydrate enough, elevate enough or rest enough. This time I have and I am delighted that the swelling in my right leg is nowhere near as as much as it was with my left hip. At 24 days my new hip is still a bit sore and stiff first thing in the morning but other than that I'm almost pain free now

 

[benne68]

Nice update, @Firecracker! You are doing remarkably well for less than a month post-op.

When I had my left hip replacement back in 2017 I didn't hydrate enough, elevate enough or rest enough. This time I have and I am delighted that the swelling in my right leg is nowhere near as as much as it was with my left hip

Isn't it amazing how much better we can make our second recovery by learning from the first one!

You've got this!

 

[Firecracker]

Hi everyone
Just wanted to ask a couple questions...
My wound has healed really well and I am pleased with it except for one thing... Towards the bottom end of it there's a small area that is a bit painful and the pain is a burning sensation, especially when I stretch my thigh to move. There are no signs of any infection or break down but I am wondering if this is normal as I heal?
Also I've noticed that after I've been stood up or walking for a while, my lower back starts to ache a little. Common sense tells me it's my pelvis adjusting to my new hip but back ache isn't something I have ever had problems with. Grateful for any help and advice.

 

[Layla]

Hi Firecracker,
As far as your incision goes -
Small sensory nerve fibers are cut with the incision. These nerve fibers run from the inside to the outside of the hip and cutting them causes the hip to feel numb after surgery. It is a temporary sensation that normally resolves over a period of six months to one year post op.

While healing you may experience sensations of tingling, pins and needles, itching, burning and even the feeling of a minor electrical shock. These are usually good signs that the nerves are spontaneously firing through the regeneration process.

Since you mentioned the back pain was not present pre-op, Its likely due to a change in posture and gait. After surgery we may unconsciously change our posture / gait as we compensate for the new hip joint. This is likely putting a strain on the muscles in your back. You may also be sitting and sleeping differently and your muscles may be tight or inflamed. Consider icing your back in addition to your hip, if you're still doing so, and hopefully as your body continues to heal and adjust to the prosthetic the back pain will dissipate.
Wishing you comfort and a good weekend!
@Firecracker

 

[Firecracker]

Thank you @Layla for your very informative and helpful reply. It's good to know that my wound is responding exactly as it should. At four weeks post op I'm still sleeping on my back so that could account for my back ache as well as the new hip. I'm nowhere near ready for side sleeping but I know that will come in time and I sleep.well on my back which is good. I'll work on my posture and sitting position and see if it helps my back. As ever, I am very grateful for your help here in the forum.

 

[Layla]

We're happy you joined us, Firecracker!
Happy One Month Anniversary and best wishes for a wonderful week!
@Firecracker

 

[Firecracker]

Hi
I'm now 6 weeks post op after my right hip replacement and I'm doing well. The back ache I had is responding well to the exercises my physiotherapist gave me and although I still sense that my right leg is slightly longer than my left one, I'm optimistic that it will settle down in time. What I'm wondering now is if the pain in my right knee is normal? It's mainly in the left side of my right knee cap and occasionally I feel it in my groin too. My common sense approach is that my biomechanics have changed and my knee is now trying to adapt to this. My irrational mind is thinking that my hip replacement is failing and I'm reading horror stories of loosening femoral stems and revision surgery! The pain responds to simple analgesia so hopefully that is a good sign? As ever, any help and advice would be appreciated very much

 

[Eman85]

I had pain in my knee post-op on both sides. Many times it was a burning sensation or pain just above the kneecap. Took a little googling to figure out it was the IT band being aggravated. Ice helped a lot and in time it eased off just like the other sore muscles.

 

[EMB]

Just curious. Do you know how much a leg length difference you have?

 

[benne68]

My common sense approach is that my biomechanics have changed and my knee is now trying to adapt to this

Yes, your common sense is exactly right. I had a similar issue with pain around my knee and in my groin after my hip replacement. It's fairly common, as you'll find if you read through other THR threads.

My surgeon explained that this happens because our bodies are struggling to adjust to their new structural alignment. Prior to surgery, as our hip deteriorates, our bodies make adjustments to ease the pain. These changes are subtle and, because they occur slowly, we don't even notice that we are favoring the leg or limping or splaying our foot out to the side. We live with that bad alignment for so long that, when the hip is fixed and our body is properly aligned again, all the surrounding tissue has to "relearn" what to do.

It does get better. It just takes time.

 

[Firecracker]

Just curious. Do you know how much a leg length difference you have?

Hi @EMB my surgeon told me it was approximately 4millimetres but I'm not sure how he measured this while I was in theatre. When I first came home from hospital it felt like a difference of 4 feet but as time goes by it's getting better. I still have the sensation of leg length discrepancy but I'm not limping so I'm optimistic about everything settling down in the fullness of time.

 

[Firecracker]

My common sense approach is that my biomechanics have changed and my knee is now trying to adapt to this

Yes, your common sense is exactly right. I had a similar issue with pain around my knee and in my groin after my hip replacement. It's fairly common, as you'll find if you read through other THR threads.

My surgeon explained that this happens because our bodies are struggling to adjust to their new structural alignment. Prior to surgery, as our hip deteriorates, our bodies make adjustments to ease the pain. These changes are subtle and, because they occur slowly, we don't even notice that we are favoring the leg or limping or splaying our foot out to the side. We live with that bad alignment for so long that, when the hip is fixed and our body is properly aligned again, all the surrounding tissue has to "relearn" what to do.

It does get better. It just takes time.

Thank you so much @benne68 , this really does make me feel better. I really appreciate your help and support

 

[benne68]

@Firecracker Another thought: I found some gentle massage followed by heat a couple of times a day -- just on those sore areas -- helped. Just be sure to keep the heat well away from the incision area.