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THR Mar1gold's recovery thread

Mar1gold

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Hello, I have just found this Forum, very helpful. I am just over 2 weeks after my THR. I am concerned about the real stiffness at the back of my knee. My next physio is next week so I can ask again then, but just to ask you guys please. I do sit quite a lot (high-ish hard chair at the table) to do some online work. I try to remember to get up and walk about every half hour but quite often forget to (my fault). I am doing my sets of post op exercises 4 times daily and icing when real pain. Hate the right swollen leg I have now but of course its to be expected, but this sore stiff back of the knee is a pain. Thanks guys x
 

Josephine

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@Mar1gold - as you can see, I've moved your post into a thread of its own. The reasons for this were that you'd posted in a thread that was last posted in on January 2018! The members who posted then have not been on the forum since then so it's unlikely they would see much less respond to your post!

Anyway, welcome to BoeSmart! It would be very helpful if you would tell us the actual date of your surgery. We cannot really advise you without knowing that.

However, I would first give you the most crucial bit I advice we have which is what we call the BIG TIP!

This is: 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.

The next advice is our Hip Recovery: The Guidelines Do read them all and study them closely. They contain important information and advice.

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
5. At week 4 and after you should follow this
6. Access these pages on the website

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?

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.




Thirdly, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

GrannyC

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Good to see you in the recovery side. My OS said I didn’t need PT for my hip to recover. Like many, I thought I needed to “work” on my recovery so I did got to a few sessions. It didn’t take me long to realize they were not helping so I stopped going. By that time I had also read all the posts here on the forum saying no PT needed. I recovered just fine with the same range of motion as everyone else. It is good to walk a bit each day though and gradually increase the length of time you walk as time goes on. Sending healing wishes your way.
 

Layla

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Welcome to Recovery!
Please provide your surgery date so the info can be applied as your signature.
Make sure you're icing and elevating the back of you knee if there is swelling and it's bothering you.
Josephine, the forum Nurse recommends icing for 40-60 minutes per session, no less. Target several times daily.

Consider using a timer or your phone timer as a reminder to get up and walk periodically while you're working. It's easy to forget when your mind is engrossed in work.

I hope you have a nice week!
@Mar1gold
 
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Mar1gold

Mar1gold

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Hi, I am 5 months after my TRH. Needing a THR was out of the blue, I thought I had an IT band injury.

I am a fit, perfect weight 60 yr old, I imagined I would recover very well. I have kept to the exercises from physio (only saw her at 3 weeks and 12 weeks post op) and walked every day. Only been without a crutch for 2 weeks.

I have pain in my affected butt, stiffness and pins and needles down the back of my leg and especially behind my knee and outside of my knee, often traveling down my shin, same pain as shin splint pain.

I raise my legs when I can and apply ice. I have a seated job and this is the worst. When I stand up the pain is awful and it takes me a while to be able to step out. I try not to but it's hard for me not to limp. I am worried I will always limp.

I have read other member's posts that they lost their limp at 3 months. I feel as if I have a nerve or something trapped behind my knee. I don't have a lot of fat on me or around the hip bone, it nearly always feels stiff and painful. The worse thing is sitting down, I feel as if I am sitting on my hip bone and it is so sore.

I saw my consultant who ruled out a cyst behind the knee and couldn't find anything, but it was a 10 minute appointment. Also, in the last month I have noticed both the front of my knees are often red in colour and on my affected leg I now have quite a few purple thread veins on my shin and more on my calf, I have never had before.

I had hardly any pain walking before my op, if I walked or ran for a fair while it would be. Now it is painful all the time, I wish perhaps I had not had the op but I was told it was totally necessary. I read about piriformis syndrome, the symptoms sound similar to mine.

Many thanks if anyone can tell me if there are exercises to help me or any advice, reassurance, their story, to help me, I would be so grateful.
 

Layla

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Hi,
Welcome to BoneSmart. Thanks for joining us. At five months post op it sounds like you're struggling a bit. Let me tag the forum nurse @Josephine to stop by and review your issues. Please check back in case she has questions for you. In addition, please provide your exact surgery date below and the hip you had replaced. The info will be applied as your signature.
Wishing you comfort, answers and speedy resolution.
@Mar1gold
 
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Mar1gold

Mar1gold

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Hi @Layla, my hip op was 25/2/2019. My right hip was replaced. I was 60 in January this year. Thank you for any help.
 
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Jaycey

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@Mar1gold you will notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. If you would like a new thread title just give a shout.
 
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Mar1gold

Mar1gold

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Thank you @Jaycey. I couldn't locate my first thread, I had to log in again with new password and thought I had to start again. About the post I made today, 5 months after my hip and still limping and stiffness and sore pain, it is really getting me down. After sitting, when I stand it is sooo painful to move for a while. When I read about trapped sciatica nerve and piriformis syndrome they sound similar symptons, thanks for any advice
 
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Josephine

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I couldn't locate my first thread,
You need to check in this area How To Use This Forum and look for 'How To' articles.
Specially this one How can I find my threads and posts?

As for your comment about Piriformis syndrome, you are spot on! Everything you said points to it, even the pain down your leg. And I am shocked/surprised that your surgeon didn't spot this as it is verycommon after hip replacement.

Many of these issues are activity related though, so on that note, I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 

Josephine

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Here y'go then!

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 forget to factor in 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. are you icing your painful area at all? If so, how often and for how long?

5. are you elevating your leg. If so how often and for how long?

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

7. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
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Mar1gold

Mar1gold

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Thank you @Josephine

1. posterior,

2. Pain level 7/8. I have a lot soreness, burning, stabbing, throbbing, aching, swelling and stiffness most of the time in my operated leg - especially side of my hip, back and front of my knee, down the back of my leg. My knees are very red even at this very moment, after a bath and standing drying myself, my toes and front of knees go bright red, the thread veins, that have appeared in the last month, get darker purple, behind my knee and shin only on my operated leg. I have shin splint pain in operated leg most of the time.

3. I am now taking paracetamol 2 x 500 mg tablets, 4 times throughout a 24 hr day. I try to take less but then the pain is worse.

4. icing: yes, it doesn't seem to make a lot of difference though, I sit on a ice pack, wrap one around my knee, I often soak a muslin in cold water and wrap around my affected leg shin

5. elevating: yes, 3 times a day for 10 mins. I have started to wear flight socks, both legs (not the strongest, and they do seem to give me support, I'm worried about all the thread veins and hoping they will help give support.

6. Not very much, my husband and I work from home, and he does so much. I have to sit at the computer a lot and it is very painful especially when I get up. The pain is having a real affect on my life, I hate this hip op .(sorry).

7. The exercises I was given on leaving hospital. 3 or 4 sessions of
ankle thrusts laying on back on bed x20
Pushing straight legs down on bed x10
knee bends laying flat on bed x10
lifting the affected leg, on bed x10
ankle pumps standing x10
swinging the affected leg to and fro x10
lifting leg behind straight legged x10
lifting leg to the outside x10


I only saw the PT at 3 weeks and 12 weeks, both times I think I was progressing ok, so she seemed pleased, told me to go down to one crutch and then none, didn't want to see me again, not everso thorough but busy I am sure.

It has really been in the last 6 to 8 weeks I have had more pain and stiffness than I ever imagined. I have stopped using a crutch 2 weeks ago but I limp and it is painful. A dull pain is always in the back of my leg and it is sharp pain deep in the butt and side of hip. no redness (apart from knees and toes as above).

PS. I try to walk at least ¾ hour daily but not last 3 days, have tried restarting, but not much better.
 
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Mar1gold

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@Josephine - I hope I have answered correctly for you, many thanks for your time and help
 

Josephine

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Yes, perfect, thank you


20 weeks
2. Pain level 7/8
That is high!
3. I am now taking paracetamol 2 x 500 mg tablets, 4 times throughout a 24 hr day. I try to take less but then the pain is worse.
If your pain is that high, then you need to ask your GP for some extra pain meds, something like Tramadol. If you don't treat pain, it has a tendency to build upon itself without control. This is why it must be adequately managed.
4. icing: yes, it doesn't seem to make a lot of difference though, I sit on a ice pack, wrap one around my knee,
Okay, I understand that.
5. elevating: yes, 3 times a day for 10 mins.
Well, there's probably little point in icing and elevating now
6. Not very much, my husband and I work from home, and he does so much. I have to sit at the computer a lot and it is very painful especially when I get up. The pain is having a real affect on my life
It has really been in the last 6 to 8 weeks I have had more pain and stiffness than I ever imagined. A dull pain is always in the back of my leg and it is sharp pain deep in the butt and side of hip
This concerns me. Perhaps you would show me the site of your pain(s) using this chart
aa hip-references-horz.jpg


The exercises I was given on leaving hospital. 3 or 4 sessions of
ankle thrusts laying on back on bed x20
Pushing straight legs down on bed x10
knee bends laying flat on bed x10
lifting the affected leg, on bed x10
ankle pumps standing x10
swinging the affected leg to and fro x10
lifting leg behind straight legged x10
lifting leg to the outside x10
This is the cause of all your problems. You've never needed to do any exercises. Did you not see this paragraph in the Recovery Guidelines I left you in the second post of this thread?

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.​
If you had complied with this advice, you wouldn't have developed all these problems.

I'll speak more when you tell me where your pains are.
 
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Mar1gold

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Hi @Josephine, thank you for your reply.

I could not open the chart image. The pain I have is like a stabbing pain deep in the middle of my butt/operated leg especially when I stand from sitting or even stand from raising my legs 10 mins. I have to stand tall and wait until the pain eases and then step forward, bad limp for first few steps and then it eases and is a dull sore in same area of butt. I so want to stop walking like a wooden top.

I saw this week the piece on 'leave your hip to mend on its own'. I lost my initial thread conversation on this site with computer problems, then I couldn't seem to return/log in until a friend helped me this week.

So are you saying I should not have done any of the standard exercises the physio tells you to do when you leave hospital, 4 times a day? In my little mind it makes sense to have to improve and strengthen the muscles etc.

I stopped running 6 years ago, and power walked, I stopped that 2 years ago. for the last 20 years I have always done morning and night a 40 mins routine of Pilates floor exercises and daily walks to keep in shape.

I am 5' 4" and 7 st 9 lbs. I like to keep toned. My husband's worry was that I would try to exercise too early after my op and I listened to that. But I did add a few extra exercises about 6 weeks ago (when I seem to be progressing quite well) - as I could see I was so losing muscle tone , sitting knee raises and upper body exercises and stretches.

It was a little after that I noticed the purple thread veins in operated leg, worse stiffness behind that knee and red knees and toes (both legs) when I stand. When I walk from the bedroom to the bathroom in the morning as I stand and clean teeth I look down and see my knees and toes going redder and the purple veins on shin and calf and behind knee on operated leg getting darker. I put flight socks on as soon as I can. Obviously I stopped doing the extra exercises.

Regarding pain, to be honest, 2 days ago it was very painful, when I was answering you last, I did take co-codamol that day but yesterday and today I think the pain, more of a stiffness especially behind knees, and the sore pain in butt after sitting perhaps is more a 4/5 I think.

It kills me to sit on a chair without a cushion, I feel as if I am sitting on a stone (operated side). I find my self lifting my heel of operated leg when sitting because the back of my knee is stiff and I always feel I want to lift it from the end of the seat. Do you think this still sounds like Piriformis syndrome.

I feel that there is a trapped nerve in the hip area and causing the numbness down the back and outer side of operated leg. Should I be looking at exercises for that if so. I wonder is it possible to see on our site what other post THR can do at 20 weeks. I cannot walk up stairs properly yet, putting weight on the operated leg, is that normal? I can walk downstairs normally.

Sitting here typing this it is the sore pain in my behind, my operated side knee - soon I will have to go and raise my legs to alleviate the stiffness. I have flight socks on, even in this hot weather, cant imagine a time when I can not wear them, they seem to give support to the calf and shin.

Will I be able to walk again without this limp? I have a young husband who has been so helpful in my recovery (10 yrs younger, we are married 15 yrs). I don't want to feel so slow and limping, that is getting me down.

Thank you for your time and advice.
 

Josephine

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I could not open the chart image.
Not at all? That's odd. I'll email it to you.
So are you saying I should not have done any of the standard exercises the physio tells you to do when you leave hospital, 4 times a day? In my little mind it makes sense to have to improve and strengthen the muscles etc.
That's exactly what I was saying. I'm not sure I could say it much clearer than I did!
It kills me to sit on a chair without a cushion, I feel as if I am sitting on a stone. I always feel I want to lift it from the end of the seat. Do you think this still sounds like Piriformis syndrome.
Exactly like Piriformis! Did you not read this article? Piriformis syndrome - a pain in the butt!
I feel that there is a trapped nerve in the hip area and causing the numbness down the back and outer side of operated leg.
You do have a trapped nerve - it's the sciatic nerve which is described very, very clearly in the article.
Should I be looking at exercises for that
Absolutely not!
Will I be able to walk again without this limp?
Eventually it will.
 
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Mar1gold

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Just to ask, did you have any further guidance how I can treat the trapped sciatica nerve, piriformis syndrome after my THR?

Have you come across purple blotchy, sometimes warm, front of both knees when standing, at 20 weeks. Had it for a while now. Really don't think it is an infection. What are your thoughts on me wearing compression stockings, up to me or could they me making anything worse? They do seem to give me support to sore shins. Thank you when you have time.
 

Josephine

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Just to ask, did you have any further guidance how I can treat the trapped sciatica nerve, piriformis syndrome?
Only what's in the article? You did read it, didn't you?
Have you come across purple blotchy, sometimes warm, front of both knees when standing
I'm afraid not.
What are your thoughts on me wearing compression stockings, up to me or could they me making anything worse?
It's up to you. And if you feel they are making things worse, then stop using them
 
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Mar1gold

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@Josephine - I just wanted to ask you opinion again.

I have had a really bad few days. The pain the last 2 nights has kept me awake all night almost, I took co-codamol, didn't really touch it. It is like shin splint pain down the shins (both shins!) Numbness and sore pins and needles. The shins and the inside of knees now up towards the inside middle area of inner thigh. I am still having tightness at the back of both knees, worse on the right operated leg. When I stand, the front of my knees go a red purple colour and the veins, thread veins and I feel pressure on lower leg of operated leg. I quickly put my compression socks on and they give some relief. It is all really getting me down.

The pain in the butt is now when I sit and when I stand after sitting. The pain in my butt is awful and it takes me a minute to steady it and then I limp for 5/6 steps and then it eases. I try to lay and raise legs when I can and apply ice to hip and back of knee.

You mentioned Piriformis syndrome, I phoned my hospital PT (who is very busy also and only seems to say give it all time). He says it is probably a Bakers cyst, but this has been 2 months now and I cannot see any obvious swelling behind my knee like I imagine a cyst would. I have read about meralgia paresthetica, symptoms sound similar but I do not have the sore pins and needles particularly on the outside of hip, more inside. Although I do have pain at the pelvis. Scar etc looks ok.

Can I ask you should I see a chiropractor? Don't know where to start finding one in Norwich but will google. Or an osteopath perhaps? Would you suggest either?

As I am sitting and typing, behind the knee of the operated leg it is very tight and sore.

Thank you so much if you have time for a reply.

I have a one year trip planned 31/10/19. I am so worried about getting this all sorted before then.

Thank you for your reply and when do I review the Moderator, I have been asked to, do I do this at the end of the helpfulness?
 

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