THR Leg length discrepancy question

[oh2sew]

I have several other friends who had a THRs done and they have all been very active right after. Fortunately, they didn't have a leg length discrepancy, so they had no problem. I know everyone is different, so I just have to do what works best for me.

I never really had "bad hips". My hips never hurt. I had a labral tear and the groin pain I would have occasionally over the years is why I went to the Dr. But it was due to the labral tear. Unfortunately, I'm not sure the Dr fixed it during my surgery. I will find out in the next couple of days. So, my case is a bit different because I just wanted the groin pain fixed. Other than that, my hips were fine.

Oh my! @Bellydansr this sounds so much like my situation with the labral tear and groin pain. When I first started going to the doctor about the groin pain, I had an MRI done in which it was determined that I had a torn labrum in my left hip. I could ride bikes, etc. and nothing would bother me, but then about an hour later, the groin pain was pretty bad. Due to my age (55 at the time) my doctor said that having the torn labrum repaired would open me up to arthritis in my hip and he recommended a hip replacement. I put it off for over a year and had it done in December 2016. Just like you, I wanted the groin pain fixed and gone... My hips never really hurt even though on the x-ray you could see that the joint space was getting pretty narrow.

My left leg (hip replacement side) was also longer so he shortened it by about 1/2 inch.

My question I'm trying to figure out is (and my doctor hasn't/won't answer) is the labrum removed during hip replacement surgery, or if it is torn, is it fixed?

I know I am only 9 weeks out, but I have the same symptoms now as I did before hip replacement!

 

[Bellydansr]

Hey @oh2sew ! I have the answer for you!! I went by my doctors office today bc they had not called me back to answer this exact question. I also got a call back from them about 4 hours later, not knowing that I had stopped by their other office. They DO remove the whole labrum during surgery. So, now I have no idea why my groin hurts so bad unless it's just referred pain or something. Of course, I have only used ice on my thigh, not my groin area, so that might have something to do with it.

And it is my surgical leg that is now 1 inch longer than my non-surgical leg. I guess that is the Dr's way of getting me back in to do the other hip. They did say I would be lucky if the muscles etc tightened back up which would pull it up a little, but it wouldn't help a full inch. I have my followup on the 27th and I will be talking with the Dr. then about a bunch of stuff.

I am exactly 4 weeks out, so I'm really hoping in the next 4 weeks, things improve a whole lot. I have a bellydance workshop schedule and I'd hate to lose the $$ I paid for early bird registration. I just bought a new (larger) pair of ballet shoes to put my orthotics in. It was really funny trying to see what size would fit best. I just took the last of my steri-strips off my incision, so I'm now waiting to find out how long I wait before I can start swimming laps. I gotta lot of extra "padding" to get off now. ;-) The nurse said there is more **** in a pool than in the lake here. Ewwww!! That sounds awful!

 

[oh2sew]

@Bellydansr - Thanks for clearing up the labrum issue! I thought that it was removed during surgery, but could never get (or find) a definitive answer.

I'm sure that you will start recovering quickly over the next few weeks. Even with the anterior approach, 4 weeks (in my opinion anyway) is still pretty early in the recovery. It took me about 4 weeks before I started to feel like a real human again (I didn't have anterior). I just passed the 9 week point.

From reading the posts here, it seems that groin pain is pretty common post surgery and that it will go away. But, like you, having pre-op groin pain that replacement didn't fix is so frustrating.... I went to my first "official" PT appointment last night. We focused alot on rotation - both internal & external. I explained my groin pain to her. She took my operated leg, massaged the upper inner thigh and hit a muscle that about sent me through the roof! In my case, there's a muscle that I wish I could cut and release as it is having a negative impact on the rotation/flexion of my hip. So, going forward, we are going to work on getting that muscle stretched out as she said it was super tight (duh!). It is in the fold/hip crease of my leg. She suggested that doing dry needling will help to release the muscle as well. Have you asked your PT about your groin pain?

I had an MRI of my lower lumbar done and of course, my OS thinks my groin pain is still from my lower back (L4). I think it's more muscle related. But he likes solid evidence and proof - not "ah, it's probably this muscle". So, I guess time will tell.

I hear you about the pool. I try not to think about it! My doctor cleared me at 6 weeks (which I think is pretty standard) to do most anything (still haven't been cleared to go Rollerblading though - that's about another 8 weeks off).

Your vacation sounds so exciting! I can only dream of taking a month long vacation!

Keep us posted on how your follow up goes with your doctor - and what they say about your leg length.

 

[Bellydansr]

@oh2sew ...The vacation is only bc my it's my in-laws last "big trip" and they wanted us to go with them so they are paying. Trust me...we couldn't do it ourselves!

I wonder what muscle that was?!?! I have never heard of dry needling. What is that? If it's inserting a needle anywhere, I'll pass!!!

I have something that I thought is a ligament or tendon or something that is really tight that keeps that leg from the flexibility it used to have. I too wish I could just "snip" it!! My PT says I have more groin pain than her other patients, but then again, I don't know how many anterior hip pts she has seen either. That will be my next question to her.

Some of the things we are doing are 8-10 mins warm-up on a recumbent bike, double leg press then single leg press, step ups to the front and to the side and then step backs on a smaller to step to help get me ready to walk down the steps with alternating steps, mini squats, some balance board that rocks forwards and back and then side to side, and then we go to the table for bridges, leg lifts (ouch in the groin area!!! LOL) front and side, clams with theraband, and I can't remember what else.

Then we ice and I head out for work. I have been back to work since the beginning of the week. I work 12-5, but the sitting gets to me so I do get up and walk around pretty often. I can't imagine me roller-blading!! It's been so long that I'd be back in for surgery again probably. LOL I had someone invite me to their ballroom dancing class/competition, but told them I was still a ways away before starting something like that!!

 

[Jaycey]

@Bellydansr just a caution, you are doing way too much PT for only 4 weeks out. I would stop all this and focus on getting to a pain free place. Continuing may only result in chronic pain issues.

And if you are already at work - more reason to decrease stress on that new hip! THR is not equivalent to getting your toenails clipped. It's major surgery. Slow down and you will have a lifetime of pain free living.

 

[Jamie]

Boy, I agree with Jaycey!! No wonder you are having pain. Going to work this soon is a real push. And all that therapy is simply not needed. Some walking is all that's required for hip recovery and you're getting that with your daily activity. Please slow down and allow your body time to heal. Otherwise you are going to hurt and you risk having chronic pain that is very difficult to treat.

 

[Josephine]

Some of the things we are doing are 8-10 mins warm-up on a recumbent bike,
double leg press
single leg press
step ups to the front
step ups to the side
step backs on a smaller to step
walk down the steps with alternating steps
mini squats
balance board that rocks forwards and back and then side to side
bridges
leg lifts front and side
clams with theraband
Then I head out for work.

I agree also. If you are doing 10 reps of each of these, that comes 110 reps per session but I bet you are doing more than 10 reps, yes? All this at 4 weeks out? Jiminy Cricket! And ontop of all this you are already back at work? Let me tell you two things:
1. 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.
2. if you are mobile enough to be back at work, the you really don't need all that!!!

So, now I have no idea why my groin hurts so bad

There is no doubt in my mind whatsoever that your pain is being caused by all those exercises! Particularly things like clam shells and leg presses. BoneSmart philosophy for sensible post op therapy

Of course, I have only used ice on my thigh, not my groin area, so that might have something to do with it

Do not on any account use ice on your groin - there are major nerves and blood vessels that are very superficial there and ice could do damage.

They DO remove the whole labrum during surgery.

You thought they didn't? The use reamers very similar to cheese graters in the acetabulum that rake out all the diseased bone and remnants of cartilage including the labrum which is made of a type of cartilage.

 

[oh2sew]

Oh my gosh @Bellydansr! I cannot even begin to think about doing even half of those exercises at this point! I think I would definitely stop, or at the very least eliminate the majority of them.

Please take care of yourself and not overdo it as you don't want it to have an impact on your workshop or your vacation.

I know it's hard to slow down (ok, it sucks!) and everyday is a struggle to keep telling myself that I don't have to do everything and that its ok to "just walk".

 

[Jamie]

@oh2sew .... how about creating a signature for yourself so we can tell when your surgery was with each of your posts. Mouse hover over your username and select the link to do that from the drop down menu.

 

[oh2sew]

Hi @Jamie, I tried to create my signature, but it keeps giving me an error stating that "you cannot modify the field" (or something like that).

But I had a left THR on December 15, 2016

Thanks!

 

[Jamie]

It's fixed for you now, @oh2sew.

 

[Bellydansr]

Okay folks....I will compromise...LOL!! I will cancel therapy for now as I can NOT not go to work. My boss would not be a happy camper at all!! I know it's medical, so he would wait till I took my vacation in June. I brought in a stool to prop my leg up on and I have heavy duty ice packs in the freezer.

From the research I have done, I think the guilty culprit is the straight leg raises. There is a lot out there about psoas problems after THR and I am pretty sure that is my problem. I was thinking about going to my PT appt tomorrow morning and asking them about this. The only problem is that I decided to go off my Oxy and just stick with my extra strength tylenol. Now I'm going thru mini-withdrawals even though I was only on 5 mg twice a day. Ugh!! I had to work today for the full-time girl who took off and I feel miserable! Hopefully, this will only last a few days and I will be back to my normal perky self. LOL

@oh2sew ...Yes, I had trouble with my signature line as well. I think there is a glitch in the system. @Jamie will get it all taken care of.

@Josephine ...it was 30 reps, but the straight leg raises just weren't happening like that! That is when I remembered (later on) about the psoas. And yes, I had forgotten that the labrum is totally removed as well. Duh!!

 

[Josephine]

Now I'm going thru mini-withdrawals even though I was only on 5 mg twice a day

I very much doubt you are getting withdrawal symptoms after taking such a small amount for only 5 weeks.

just stick with my extra strength tylenol

Out of curiosity, how much Tylenol (mgs) are you taking and how often each day? FWIW, I've known hip patients do very well on just Tylenol (paracetamol) at this stage.

 

[Bellydansr]

I may have the flu then. My boss is about to send me home from work. I have had the chills and then sweats back and forth all day and was sick about 20 minutes after I got to work. Sneezing, yawning, eyes watering, no sleep at all last night. It sucks!!
I had 2 extra strength tylenol before bed last night and I've had 2 today. I figured, depending on how I felt, I might take 2 in the morning and 2 before bed. I usually take 3 if I have a bad headache, so 2 is pretty blah for me.

 

[Bellydansr]

I hope I'm not getting Pancreatitis again. I had it once before due to crappy eating habits and I've been eating horribly lately. I've thrown up 3 times today now and no idea why. No fun! :-(

 

[Jamie]

Please do not take 3 Extra Strength Tylenol at one time. That is overdosing yourself and you risk damage to your liver when you take that much at once. Tylenol is excellent for pain relief, but it is not benign. You need to be sure that you take no more than 1000mg at a time in doses at least 4 hours apart with no more than 4000mg in any 24 hour period. And you need to could other sources for acetaminophen (the active ingredient in Tylenol) in that 4000mg total. It is frequently found in sinus, cold and flu medications as well as others. So read the label on anything you're taking. Also, you should not have any alcohol to drink while taking Tylenol, as it also is processed through the liver. If you're having a lot of discomfort, it would be best to take the 1000mg of Tylenol on a set schedule of 1 dose every 6 hours. That way you keep constant medication in your system.

If you have had pancreatitis before, you probably need to see your GP with all that throwing up. It's not something you want to fool around with. Hopefully this is just the flu. But your GP will be able to tell you.

 

[JennyHipcakes]

Oh, Josephine! The cheese grater pic really got to me! I know that my labrum is wrecked and I need a second total hip, but still have not had the nerve to watch a TH video. And I'm a nurse. I've seen stuff. All that being said, I applaud your work on this site. I am a big fan of BoneSmart.

 

[Hip Hip Hooray!]

I am close to two years out from my bilateral surgery, and I still get pain if I attempt any straight leg raises or the hip work that we used to do in the Russian strengthening class I took with ballet. I don't think I should ever do them. It feels wrong. The cheese grater thing explains it. That's a great photo, Josephine.

It's amazing how quickly those exercises can take you from being pain free to feeling like you did with chronic hip pain. Take care of yourself. It's so worth it to go slowly and gently and to be patient.

 

[Horseshoe]

@Hip Hip Hooray! @JennyHipcakes gotta love that cheese grater pic

Good to read your posts today. Monday at work I carried a few heavy banker's binders up and down two steep staircases (broken elevator argh..) and I am paying the price! Have moderate to severe pain on the outside muscles around the left knee. Pain on weight bearing so it's back to using a cane to take the weight off, icing and an advil which helped. Feeling a little dejected, this thr leg is almost a year old and thought I'd be well past having to mollycoddle it. Made me realize the hips/legs are still fragile, life really has changed. Glad to know it's normal

 

[Hip Hip Hooray!]

Hi @Horseshoe, Yes I think it's normal. I'm real cautious about lifting anything over 20 lbs. because it always makes my hips burn a few days later. The second year makes a big difference, I've found. I've gotten a lot more flexible without trying.

I do think it's different after THR for the rest of our lives. I hiked for a couple of hours yesterday, and I needed to ice when I got home. If I do one hour, I'm fine. Still, I appreciate being pain free, and remember how it was before the surgery. Hope you're feeling better today.