THR Leg propagating pain after knee bending

[TazHungry]

Hello guys, I'm the next one with AVN and today I had my THR surgery which seems went well. I'm 40 years old male from Sofia, Bulgaria.
I'm not sure if there is already existing topic so please point me to the thread if there is one. For my day 1 I was wondering what should be the right toes direction when laying down on my bed? If let's say it's my left surgical leg then shoud it point to the ceiling e.g. 12 o'clock or it doesn't matter? Currently when I'm at rest it points around from 9 to 10 o'clock. When googling I wasn't able to find a good answer, only one video explaining that I should put a support pillow on the left side of my left surgical leg so that it points to max 12 o'clock otherwise a dislocation might happen it it is less than 12. Is that true what do you thing? On the other hand I know there is a rule to not move the toes to point to each other again because of dislocation risk.

Thank you guys and bear with me English is not my native language.

 

[Schaargi]

Hi @egeorgiev!

Congratulations on your new hip!

Your restrictions depend on which approach your surgeon used. If you had the anterior approach, your toes should not point out. They should point straight ahead or inward slightly.

I had the anterior approach. When I woke up, I found that my surgeon had taped my two big toes together so they wouldn't separate.

I can't speak specifically to ather approaches, but I know that it is safe for all approaches if your toes point straight forward.

 

[TazHungry]

In my case it is lateral which i think is called posterior approach. Being said that should I use support pillow wedged on the leg side for that approach, because for a single person hospital bed it is not stable or the pillow drops when i try to fit it in. Is it bad if toes point out even in 10 o'clock when in rest?

 

[Schaargi]

I asked my first surgeon that question and he said it wasn't a problem if my legs relaxed a bit toward the side while I was sleeping.

You want to avoid pressure on the joint, so the weight of your feet shouldn't be excessive. (Unless you have extremely large and heavy feet)

Again, that is only what my surgeon told me, and it made sense. But I'm not a surgeon, which is a good thing.

 

[Mojo333]

Hi @egeorgiev
to BoneSmart.

Can you please leave the date of your surgery and which hip you had replaced so we can add it to your signature?

I think you are fine with your foot resting to the side...
Generally, the restrictions I see most are not to cross the knee past midline and do not bend too far forward from your waist or pull your leg up past your waist. This bending is called hip flexion. Avoid hip flexion greater than 90 degrees (a right angle).
Check with your surgeon, but often these restrictions are required for about 6 weeks.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Hip Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary​

2. Control discomfort​

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this ​

Activity progression for THRs​

6. Access to these pages on the website​

Oral And Intravenous Pain Medications​

Wound Closure​

​

Pain management and the pain chart​

Healing: how long does it take?​

Chart representation of THR recovery​

​

Dislocation risk and 90 degree rule​

Energy drain for THRs​

Pain and swelling control: elevation is the key​

Post op blues is a reality - be prepared for it​

Myth busting: on getting addicted to pain meds​

Sleep deprivation is pretty much inevitable - but what causes it?​

BIG TIP: 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.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[TazHungry]

Hi @Mojo333 thank you for the guidelines you provided me. Today I made my first getting out of bed and first small steps using a walker and guided by PT. While walking I noticed that my leg is pointing out and it seems it got used to point in that direction. Will that issue disappear over time though or is it related to my 1 day and half having my leg on the bed pointing out?
I appreciate you help!

Here is the info you requested for the signature:
Surgery was on Nov 8th, THR on my left leg.

 

[Jaycey]

@egeorgiev If you are very concerned about the position of your foot please discuss this with the PT and your surgeon. You may have weakness on that side that can be addressed once that hip has healed.

It will take time for all the soft tissues and muscles to settle. Very early days for you!

 

[Mojo333]

Thank you.
Your signature is now updated
I know the relief I felt after my surgery, with the anxiousness Ieading up to The Date, was quickly replaced with anxiety of "Is this Normal?"
Thankfully, I found this site and was advised to try and relax and heal.
As Jaycey said, Early days... and we are not only recovering from the surgery, but from the years of bad gait from compensating for our bad hips.

 

[TazHungry]

In my case AVN was between 2 or 3 (ficat) and when I started using crutches then 4 months I didn't have any need for pain management pills. If I put more weight by mistake then it has some fading pain till the next day, nothing more. Without pre-surgery pain maybe I would have higher expectations after the full recovery, hopefully at the end of that healing I'm not getting disappointed of the outcome.

 

[Layla]

While walking I noticed that my leg is pointing out and it seems it got used to point in that direction. Will that issue disappear over time though or is it related to my 1 day and half having my leg on the bed pointing out?
I appreciate you help!

You may be focusing on this too much. I experienced what you’re mentioning. As my hip deteriorated, my foot turned outward, away from my body, which is called external rotation. I didn’t like it for obvious reasons and it’s something I brought up at my first visit with my OS. He assured me that surgery would correct this. After surgery, I still noticed it although somewhat improved. I brought it up once again at a post op visit and was told to give it time and it would correct itself as my body readjusted to my new hip. And guess what…it did! If it bothers you, bring it up for reassurance, otherwise try to be patient, you’ll probably forget about it and then one day notice that it’s gone.

Thanks for joining us here! I hope you have a good week.

 

[Eman85]

With my right THR I had it where my foot would have a tendency to not point straight, it stopped over time. I kept a pillow between my legs when I laid on the bed, it was to keep me from having my legs cross or crossing over my centerline.
I don't think you'll be disappointed with the outcome if you were experiencing deep joint pain. For me all of that was gone completely post-op.

 

[TazHungry]

Hello, I'm in the 3rd week after THR (DLA) and I have a strange pain in the leg. When I'm laying on my back in the bed and try to bend and then straighten my knee then a pain is starting initially from my thig and in about 3 seconds propagating to the lower leg down to the heel. In a few minutes the pain tapers off. Does anybody have any explanation about that? After the 1st week I no longer feel any pain from the hip or from the surgical wound that's why I stopped icing and pain killers.

 

[Going4fun]

Nerves run up and down the leg. Nerves aren't just confined to one area. Nerves for the hip connect with nerves for the knee and so on.

I suffered excruciating knee pain before my surgery. I went to a top knee specialist. He looks at my knee X-rays, puts me through a few exercises and his conclusion: I had a hip problem. Hip. Excruciating knee pain turned out to be a hip problem.

After hip surgery, I had tingling up and down my leg and in my feet even.

You're just a few weeks out. And it sounds like things are going well. Yes, you will have random kinds of pain. And it won't be confined to one small area. Nerves got seriously disturbed in your surgery and there was a lot of bleeding and twisting and turning and pulling and hammering and cutting. The hip device got banged into your bone and that occurred in an area far larger than the incision site, which looks really small after its sewn up.

Imagine that whole site being open, and the surgeon and a bunch of staff working in that area with clamps and suction devices and hammers and on and on. So basically yes, that is hip surgery pain you're likely experiencing.

You can try icing both ways ... icing at the hip incision site and in the area that you're feeling the pain. And you might still need some pain medication.

Good luck. Nothing to really worry about. Hip bone connected to the ....

 

[Schaargi]

Hi @egeorgiev

I'm at 3 weeks also, although this is my second THR.

During the first recovery, I felt like it was a giant game of "What hurts now?"

It's amazing where the aches and pains pop out.

Hang in there!

 

[Layla]

Welcome to BoneSmart. Thanks for joining us!
This early into the healing journey it’s hard to guess as there are so many odd sensations and even pain that we question. One episode usually forgotten when replaced by another. Unless the pain is unrelenting and escalating in intensity, I’d try to ignore it, or consider a quick call to your surgeon‘s office for some reassurance. Possibly you have a post op visit coming up when you can address it also? 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.

I‘ll leave our Recovery Guidelines which include a lot of beneficial info. Please stop back and let us know how you’re doing, we’d love support you along the way.

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

4. PT or exercise can be useful BUT take note of these

BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: 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.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

@egeorgiev

 

[Reanda]

Hello, I'm in the 3rd week after THR (DLA) and I have a strange pain in the leg. When I'm laying on my back in the bed and try to bend and then straighten my knee then a pain is starting initially from my thig and in about 3 seconds propagating to the lower leg down to the heel. In a few minutes the pain tapers off. Does anybody have any explanation about that? After the 1st week I no longer feel any pain from the hip or from the surgical wound that's why I stopped icing and pain killers.

Hi, yes I'm getting similar pain as you describe - I'm only 12 days in, it's when I bend my leg whilst lying down trying to do those prescribed exercises! It's a newish pain I'm trying not to bend it like that for the time being as it hurts! My incision pain is minimal and no other sharp pains going on.

 

[TazHungry]

Yep this is a newish pain that I've got recently 5 days ago. Usually it happens when I haven't had an activity recently e.g. after a sleep. I'm solving it by just getting out of bed and have a walk. Unfortunately during the night sleep I wake up in the middle because I still cannot get used to sleep on my back and the only thing I can do for a quick relief is just a knee bending which is now hurting.

 

[Reanda]

Sleeping is a conundrum isn't it? Physio at hosp told me on discharge I could sleep on my non operated side with pillow between knees. I was surprised at this advice since I'm on hip precautions (posterior procedure). So didn't try this till last night when I was (as usual) awake in the early hours - I didn't last long lying on my side as the new hip seemed to drag and pull a bit due to gravity, and felt very weird so I gave up and returned to back. As you are further along in recovery I wonder if you could try side sleeping with pillow? You may need to get the ok from your practitioner.

 

[TazHungry]

Yeah sleeping and all the rules that are not allowed to do is by my opinion the toughest things in THR recovery, even the pain is not at any significance. I haven't tried to sleep on the non operated side yet because of the same experience you had and because I don't see it reliable when I'm asleep how would I move my leg. Before the surgery when I slept on my side I used to put my upper leg a little forward which is not allowed if I do it now.

 

[TazHungry]

I was trying to find info about how should be the proper way of weight bearing throughout the THR recovery, taking into consideration that the recovery for one goes well.
At the time of my hospital discharge I was told to have partial bearing. Then 2 weeks after the surgery my OS told me that now I should have 100% weight bearing using crutches. I imagine that this should happen gradually and would like to know how are the other hippies doing it the right way.
I'm 40 years old male with THR using DLA approach. Maybe a good explanation per recovery weeks would help all the guys like me to know what to expect and how to do proper weight bearing the right way?