THR Muscle Problems?

[HipGal2021]

I’m 67 Female. 8 weeks post op from anterior THR.
I’ve had both hips replaced. But with this one the leg length is off and I’m limping. My operated hip hurts when I walk, it feels like in the joint area.
I’m still swollen at the thigh/leg. I’m still running a low grade fever most days.
I’m diabetic also. I’m not taking pain pills or muscle relaxers.
I’m hurting and limping worse than before my surgery. Any ideas?

 

[Eman85]

I'd say the best thing is to contact your OS and see what they say first. I've had 2 THR's and they were different from each other as far as how they felt and how I walked in recovery. I'd let the professionals judge on the fever and leg length. As far as the pain goes are you icing? Are you doing PT or overdoing?

 

[Jockette]

Hi and Welcome!

Icing and elevating are important this early in recovery, are you doing that? Ice can help the pain. Does pain medication not agree with you? Does it affect your diabetes?

The wrong kind of PT can also increase your pain levels. If you are going to PT, what are you doing there?

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. 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.

 

[HipGal2021]

I'd say the best thing is to contact your OS and see what they say first. I've had 2 THR's and they were different from each other as far as how they felt and how I walked in recovery. I'd let the professionals judge on the fever and leg length. As far as the pain goes are you icing? Are you doing PT or overdoing?

I’ve contacted my OS, he is going to look at the different hip implants. Not icing as much as I should.

 

[HipGal2021]

Hi and Welcome!

Icing and elevating are important this early in recovery, are you doing that? Ice can help the pain. Does pain medication not agree with you? Does it affect your diabetes?

The wrong kind of PT can also increase your pain levels. If you are going to PT, what are you doing there?

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. 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.

I just stopped taking the pain meds.
At PT she massages the incision and has me to leg lifts, stretching the hip on an incline. Knee bends.

 

[Jockette]

You might want to consider stopping those exercises until you heal more. This is in the Recovery Guidelines:

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.

Walking around your home and doing your daily activities as you are able, count as PT, I like to call it “natural PT.”

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us.
I‘m sorry you’re dealing with pain. You’re only two months into a recovery than can take a full year, even longer for some.

Please consider backing off the exercises for a few weeks and see if you notice a difference. You definitely should be icing and elevating since you’re not taking anything for pain. Ice is a natural pain reliever and elevation will help with swelling. Our lymph system rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on it’s own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there. So get those legs up when you’re able to. Toes above nose.

You can ice as many times per day as you’re comfortable, for as long as you like. Always place fabric between bare skin and the ice source.

Wondering if OTC pain relievers may be an option for you? Something like Extra Strength Tylenol. We have often recommended Extra Strength Tylenol at 1000 mg, every six hours, but no more than 4000 mg in any 24 hr period. You must also calculate anything else containing Acetominiphin into the 4000 mg so you're not exceeding that amount. If you’re able to take this temporarily, it may allow you to stay comfortably mobile.

Regarding the fever, I‘m wondering if you have a post op visit scheduled any time soon? If not, please consider calling your surgeons office to inquire about the fever. I don’t think you should be running a fever at this point.

As far as the leg length differential, I will leave an article for you to read -
http://bonesmart.org/forum/threads/leg-length-differential-lld.6173/

*Please let us know when you had your first hip replaced and we’ll edit your signature to reflect that date.

We’re here for support if you need us, let us know if we can help further. I hope your pain eases soon.
@HipGal2021

 

[djklaugh]

@HipGal2021 Welcome to BoneSmart and the 2 new hip club. Another suggestion. Check the bottoms of your shoes. If you are wearing shoes that you wore alot before having hip replacements the old worn down gimping pattern might be contributing to your current problems. If they are worn down either get favorite shoes reheeled and resoled or buy new shoes.

 

[Eman85]

I’ve contacted my OS, he is going to look at the different hip implants. Not icing as much as I should.

Not understanding what you mean, is he looking at a revision or differences in the 2 implants you have?
Have you tried a couple of days of doing nothing and icing and see how it goes?

 

[HipGal2021]

He’s looking into the 2 different implants, one is a zimmer the other a depuy.

 

[Eman85]

He’s looking into the 2 different implants, one is a zimmer the other a depuy.

So are they looking at doing a revision? Do they see something wrong? What about the fever?

 

[Layla]

Hello @HipGal2021
In an effort to gain clarity in regard to your situation, I have a few questions. In your initial post, you asked for ideas and collectively we’ve made some suggestions. We are wondering if you’ve considered any an of our ideas? We’d like to help if we’re able with the hope it brings you some relief.

Have you’ve spoken to your OS about the fever and if so, what did he advise?

Also, have you stopped the PT appointments and exercises temporarily and considered OTC meds for the discomfort you‘re dealing with, or engaged in more frequent icing for the pain? Hopefully you have and it’s lessened.

We are not clear on the reason your surgeon is discussing your implants.

It will be helpful if you leave the date of your first surgery, your right hip replacement, so we can add it to your signature.

Will look forward to hearing from you soon.

 

[HipGal2021]

My RHR was March 2009, my LHR was Jan. 2022.
I am done with my 4 weeks of PT.
My right hip replacement is a zimmer implant, my left is a Depuy implant, that’s what my OS (PA) is looking into regarding the leg length. He has not mentioned a revision at all. He was not concerned about the low grade fever. He told me to ice and elevate.
I’m now at 2 months post op, still swollen and running a low grade fever. 99.7.
I have not been taking Tylenol or Advil daily.

 

[Layla]

Hello HipGal, I hope you’re having a good week.
Thanks for providing the date of your right hip replacement. We added the information to your signature.

I’m not sure when your Physical Therapy ended, because you’re only about nine weeks post op and some members don’t even begin PT until they’re six weeks post op. Did you end your four weeks of PT recently? Asking because if you did stop recently, I’m wondering if your hip was aggravated by something you were doing in PT, and possibly continue to do? If you are still doing exercises on a regular basis, what exercises are you doing, how often and how many reps?

Thankfully your surgeon hasn’t discussed revision. I believe the only reason it was brought up was most likely due to confusion around you mentioning the brands of your implants.

As far as Leg Length Differential goes, you're not alone, many feel this sensation post op. In most cases it eases with time. We advise giving it 3-4 months as it can take that amount of time for things to balance. If at that point, you are still concerned we suggest you visit a reputable podiatrist or PT for a measurement. Possibly your surgeon expressed something similar. If you haven’t had a chance yet, please read the article on Leg Length Differential in Post # 7 above.

If I were you, I’d take the surgeon’s advice and ice and elevate as often as you’re able to help ease the pain and swelling. There are articles in the Recovery Guidelines above on both ICE and ELEVATE, under Number 2, if interested.

You may consider an OTC pain reliever such as Tylenol, short term, to help with the pain. I hope it eases soon for you.
@HipGal2021

 

[HipGal2021]

My surgeon didn’t recommend PT, I mentioned it on Feb 15, I started PT the next day. I had anterior approach. So no PT was recommended and no restrictions.
I’ve just been walking and trying to do housework, laundry, cleaning etc. it’s hard because of the leg length and pain in the operated hip at the joint (I think).
I’ve been cleared to take Advil.

 

[Eman85]

My surgeon didn’t recommend PT, I mentioned it on Feb 15, I started PT the next day. I had anterior approach. So no PT was recommended and no restrictions.

Your OS didn't recommend PT? Then you started PT the next day? And you said you did 4 weeks of PT? Must be me but I'm confused again.
Having 2 different implants isn't a big deal many have mix and match. I know mine are different despite being the same brand for what it's worth.

 

[CricketHip]

@HipGal2021

We have had several members with LLD that bothered them for several, if not longer, months. One member that came to mind is @Bfam85 Maybe take some time to read through her recovery thread, it may ease some of your concerns. If you want to see other incidents with LLD, you can do a search with our search feature above in the toolbar,,to the upper right of this page. I had that same feeling with my THR's then one day it was gone.. but it was mild, I think Bfam85 felt a significant difference like you are feeling.

Hopefully you can rest, ice and just, well, rest and ease off of some of the things you are doing around the house and you will see a difference.

Swelling and inflammation can cause your body's temp. to elevate-- just another reminder to take it a bit easier.

BTW I know what you meant, your OS didn't recommend PT to you initially but at your 4 weeks check up you asked about starting and he must have agreed and you began PT the following day.

 

[Layla]

Well, that makes two of us that are confused. I’m so sorry, but I’m not clear on all.

Is what, CricketHip, surmised above correct?
No PT was recommended, but you ok‘d it with your surgeon and began Physical Therapy on February 16th for four weeks? That would mean you just wrapped up PT last week?

If that’s the case, depending upon what you did in PT for four weeks, how often you went, the type of exercises you engaged in and the number of reps all may be clues to your ongoing pain. If we had that info, it may help us advise more appropriately. We don’t recommend some of the exercises done in PT and have reasons why we suggest you abstain from certain movements. If interested, please feel free to clarify.
I wish you comfort and relief from the pain.
@HipGal2021

 

[HipGal2021]

My surgeon didn’t recommend PT, I mentioned it on Feb 15, I started PT the next day. I had anterior approach. So no PT was recommended and no restrictions.

Your OS didn't recommend PT? Then you started PT the next day? And you said you did 4 weeks of PT? Must be me but I'm confused again.
Having 2 different implants isn't a big deal many have mix and match. I know mine are different despite being the same brand for what it's worth.

My surgery was Jan 21, my PT started Feb 16. Yes I did 4 weeks of PT. I asked PA about starting PT and I started PT on Feb 15.

 

[Layla]

Ok, got it!
How many PT sessions did you attend per week?
What exercises did you do in PT?
How many repetitions of each exercise?
@HipGal2021