THR New left hip

[oh2sew]

I had a THR on December 14th on my left hip. My surgeon used the posterior approach. I had to keep the incision covered for 7 days (with the original dressing they put on it in the operating room).
Once I took the dressing off, I was pleased - and quite surprised that the incision had no draining/oozing. My surgeon used glue vs. stitiches or staples, so once I took the original dressing off, I didn't have to keep it covered or use any type of additional dressing/bandage.

The reason why I had a replacement was that I was having constant groin pain. I am quite active, walking, gym rat(bike, rower, elliptical, weights). It got to the point that I could not stand or sit for any length of time, nor use any cardio equipment at the gym. He showed me on the x-ray my hip joint, and it didn't look good.

I was on a regimen of pain medication of 2-325mg Tylenol every 6 hours, Hydrocodone - 10-325 as needed (or 1 every 6 hours), 50mg Tramadol every 6 hours and 300 mg Gabapentin 3 times a day.

I have had the restrictions of not bending past 90 degrees for the first 6 weeks, along with lying on my back with a pillow between my legs (it was the wedge pillow when I was in the hospital). The only "exercises" I was allowed to do was walk, and after 2 weeks, ride the bike at the gym (even though I waited for 3 1/2 weeks before going to the gym).

I officially went back to work on January 3 (I have a desk job). I was using crutches up until that point and since have switched to a cane.

My husband has been so helpful during this time - laundry, cooking, putting my shoes and socks on We have someone who is coming to clean for us during my recovery.

Once I started to bike, the groin pain came back. I didn't have any groin pain from surgery to this point. I "only" biked at a level 1 resistance for 15 minutes. Just like prior to surgery, I didn't have any groin pain while biking. It starts about an hour after the activity. Even taking the pain pills, nothing seems to help it except time. It usually takes about a day (sometimes 2) for the pain to subside. (As a side note, I attempted a straight leg raise, but the groin pain is too much for that).

I am still walking with a cane as my left leg feels as though it has lost all strength. I can go up and down stairs only if I use the cane or hold on to the railings. I cannot lead with my left leg going up stairs.

My surgeon had asked me prior to me biking if the groin pain had gone away and I said yes. Now I feel he doesn't believe me when I say I now have groin pain when I didn't before.

I realize it's only been 6 weeks, but I am so frustrated that I had the replacement for nothing as I still have the original pain. It's so depressing that I still am using a cane to walk and the pain pills aren't really working. People are comparing me to "I know so and so had a hip replacement and they were walking fine within 2 weeks", etc., etc. The surgeon just says "it's the soft tissues healing". And maybe it is, but why am I still having the original pain?

I'm sorry for the long story, but once I found this site, I felt like everyone here would be the only ones who understand...

 

[jp4199]

Oy the groin. I too am a total left hip replacement, though I got to it a little differently than you- after first having a labral tear surgery in June of 2015. Abductor muscles, iliopsoas muscles, try and look up which ones specifically are the ones that are the source, so that when you describe the pain you can speak the physician's language. Try a heating pad, and alternate with an ice pack. Because now you know it is no longer bone issue!!! Yay for that!
Oh2sew- be patient! A cane is still a vast improvement over a walker or wheelchair! I am just a week behind you and only returning to teaching next week. Be gentle with yourself.


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[oh2sew]

Thank you jp4199. I did have a torn labrum in the same hip, but my surgeon said at my age (57) that he wouldn't fix it as that surgery would probably lead to a hip replacement sooner(?)

I am going to start PT next week, but I am going to be doing a pilates-based PT vs. the "traditional" therapy. I will also ask there about the muscles.

And of course the area around my incision is still painful so that it's tough to get comfortable.

It's so frustrating and depressing as I feel I should be farther along with what I can do. I am wondering if I made the right decision in having surgery. There are times when I just want to cry :(

 

[Paddler]

@oh2sew I'm sorry that the groin pain has returned.

One important point I've learned here through my reading is that everybody's recovery is unique.

One other important point is that you gain little by rushing your recovery. I had my LTHR posterior approach on January 3rd 2017. Prior to surgery my doctor had told me that I would be able to return to work two weeks post-surgery. My first follow-up with my surgeon was at the 2-week mark. There was no way I was ready to return to work then and I asked him why he had even suggested it. He explained that he couldn't stop people from returning to a sedentary job but he didn't recommend a return to work before 6 weeks. He focused on the need to rest frequently and take life gradually. He also described the intense fatigue which can overwhelm in the weeks and months post-surgery. I am now three weeks post-surgery and I experienced an example of that fatigue this morning when I stayed in bed dozing until nearly 11 o'clock.

Like you I consider myself a very active person when I'm not recovering from surgery. The only activity I'm doing right now are walks and the physio exercises prescribed bye the clinic. I can't even imagine getting back onto an exercise bike at this point in my recovery. In fact, my personal trainer said she would not start working with me again until I brought her a clearance from the surgeon. The surgeon said he would give me that note at six weeks.

It's possible that you have done too much too soon and I really hope that you can now take some more time to let yourself fully recover. All the best to you.

 

[Hip Hip Hooray!]

I'm sorry to hear you are having a rough time. It's important that the pain pilla do work. I didn't feel anything from the tramadol, but the percoset gave me tremendous relief. Everyone is so different. It sounds like the bike is really causing you pain. I have a feeling if you stop riding it, you will feel better. It's important not to do any exercise which aggravates that hip, so that you protect it. Walking is what is recommended here as the best exercise. It's nice that you have help. The exercises you described can really cause problems. I didn't do any straight leg raises for a year after my surgery. It takes a long long time to fully heal. The more patient you are, the better your body can recover. I hope you find the right meds and take your time. I had to do a lot of crying after this surgery. It really did an emotional number on me. There's a lot of grief. It's a major life event. I felt good physically, but was emotionally up and down. Getting that out of your system is very helpful. As the saying goes, "The only way out is through..." You'll get there.

 

[Jaycey]

@oh2sew Welcome to BoneSmart! To be honest I think you are doing far too much for only 6 weeks out. All that exercise and activity and then going back to work too early - it takes it's toll and you are seeing the result. If you stop the exercising (including biking) and ice and elevate does this pain ease?

When you start any new activity post op you need to do it very gradually. Do half the amount you think you can do and then add more if there is no discomfort the next day.

I'll leave you some reading to do. I know you are 6 weeks out but it sounds like you have had a rocky start. Try going back to the basics for awhile. Patience will pay off. Ice and elevate - it addresses the pain. You have had major surgery and your body needs time to heal from all the trauma.
First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

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
Activity progression for THRs
Home physio (PT)
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?

 

[jp4199]

Hey again- I am checking back on you.
I wanted to let you know my opinion on biking. Please know this is my opinion only- but I think you should stop. Find something else. Walk on a treadmill, or just don't actively "work" that hip.
Your body and your mind are disconnected about what needs to happen to heal. Your muscles are barking at you in response. Usually that is a good thing, but maybe not right now. I'm pretty convinced that all that really needs to happen is for you to heal. You have gone through a serious surgery. Take time to heal. Breathe.
Be gentle with yourself.


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[beachgal]

Gym rats are the worst PT patients ever! Sorry....I'm married to one and I was ready for the funny farm after his shoulder surgery. My THR (left hip, posterior method) was July, 2014. I had an amazing recovery...ups and downs, but always could see progress....BUT....I did not get back on a bike for six months. Even then, I started very slowly, for short intervals. I'm still super-cautious about any exercises than involves my hips or knees. You may find that walking is your best friend, especially for this first year. I know, I know, it sounds like forever, and while you didn't post your age, in the grand scheme of things, 12 months is a small price to pay for a lifetime of no hip/groin pain. Your body is healing at a pace you can not dictate. Please give it time to do its thing without your interference! Good luck! It's still the second-best thing I ever did!

 

[Glenbud]

until

6

emotionally

Before I had my hip replacement done I could barely walk... the orthopedic surgeon told me I needed to lose 30 pounds which seemed impossible because I was in so much pain.... I bought a recumbent bicycle which was easier on my joints... I would ride for one hour in the morning and 1 hour in the evening... that along with watching my diet allowed me to lose 30 pounds in about 2 months and I was able to have the surgery performed... the recumbent bicycle really did good for me because it was low impact on the joints but it strengthen the muscles in the hip area at the same time. I was able to walk normally two days after my surgery because my muscles were strong and they were taking the impact of walking instead of the joint itself.

 

[oh2sew]

Thank you everyone for your comments and support! I can't tell you how happy I am that I found this site

I have given up the bike. I honestly thought that even at a level 1 resistance, it wouldn't be that bad. Lesson learned! So, the only "exercise" that I am doing is walking.

If it wasn't for my boss, I wish I had taken more time off. He has been less than understanding during this process. He keeps comparing me to a relative of his that had shoulder surgery! He keeps asking me why I am still using a cane, why I still am on pain medication, etc. He also makes snide remarks about how I walk now.

Yesterday I talked to my surgeon about the groin pain and that it had come back. He acted as though he had never heard of this before. He did mention that I am the only patient that has even ever mentioned groin pain before/after a hip replacement. He did mention that he corrected my leg length (my left leg was longer by about 1/2 inch so he shortened it. According to the post-op x-ray, they are now the same length). Other than talking about it could be the leg length, no help or suggestions were offered by him, so I feel as though I am on my own in getting this resolved. (but the groin pain was there prior to surgery...)

I am going to my first rehab appointment today at a pilates studio, so I will be asking about the psoas muscles, etc. to see what they think. They work a lot with post-op/rehab patients that have had joint replacements.

Still walking with a cane - more on longer walks than just around the office. I still walk with a limp - not sure if it is because of the leg length adjustment or my muscles being atrophied (or both)

Now that I have passed the 6 week mark, my doctor did release me to do anything (within reason!). My husband said that I need to really start pushing myself as that is the only way I will "get better". I think I'm doing good to walk!

This has been more of an emotional roller coaster than I ever thought. My hubby keeps comparing me to people that he has met that have had hip replacements (both anterior) and says to me "well, so and so didn't have all this pain you are complaining about", "so and so went skiing 3 weeks after their hip replacement", etc., etc...I didn't have an anterior approach, didn't have the same surgeon and I am not them! My body is healing in its own way and time...

 

[Jaycey]

@oh2sew I am SO sorry to read you are getting those story tellers who have not been through any of this but think they know how the who process should go! Complete rubbish! At only 6 weeks out if you are still using a cane it is perfectly normal. Sounds like you are working on gait issues as that leg length is now balancing. This can take awhile (been there and done that). Please do not get discouraged and no - you do not need to push anything.

Work with your rehab to address those atrophied muscles. They actually contract if not used pre-op. Gentle stretches and strengthening will help. Pilates is a great way to get more core stability as well.

I didn't have an anterior approach, didn't have the same surgeon and I am not them! My body is healing in its own way and time...

First off - approach really does not have anything to do with the rate of recovery. But you are right on - your body is healing in its own way. Listen to it and just keep doing what you are doing. You've got this!

 

[leejaa]

I am sorry that your husband is not supportive of your need to go slow and steady to recovery. I know some people here have suggested showing their loved ones a video of the surgery so that they can get a clearer picture of what your body went through in order to get a new hip. Might be worth trying. Otherwise, ignore him or ask him for his medical license. You are doing great so keep up the great work of recovery.

 

[Hip Hip Hooray!]

Please take care of yourself and don't listen to people who compare you to others or tell you to push. It's not worth it. It takes time to rebuild the muscles and to relearn how to walk. The limping uses completely different muscles.

I wasn't able to do Pilates for quite a while after my anterior bilateral surgery. I think I had to wait months. I still had an excellent recovery. I just did the basic exercises that I learned in the hospital, (not too many repetitions...) and walked. I found household chores were excellent therapy, but I was off work. Please be careful. It's very difficult to go back to work so soon after this surgery. I feel for you.

 

[Paddler]

@oh2sew I'll be interested in reading about your Pilates rehab and exercises for rebuilding atrophied muscles.

I'm at 4 weeks post-op LTHR today and I am suddenly getting niggly pains, including both groins, all over my hip region. I will mention them when I see my surgeon again in 2.5 weeks but I'm wondering if they aren't connected to all the muscles in that area being re-activated after so long. I'm doing 3 sets of physio each day at home plus a progressively longer walk each day. I was in very good shape going into this too but a bad hip took its toll.

Wishing you more healing!

 

[Cas]

@oh2sew Hi there just to let you know that I had severe groin pain prior to the op. So much so that I could not walk anywhere without pain and lost a lot of my mobility. After the op the groin pain went completely. At 3 months post op I still get the odd groin twinge if I overdo things - I forget to be careful!!! LOL. So you can tell your surgeon yes some people do have this. At 6 weeks you should really just be looking after that hip and no one should be telling you to "push" yourself. Let your body tell you if you're doing ok and let it heal. You are doing fine if you can walk about and do the odd chores it's early days and you will get there it just needs patience - not that I'm good at that. I also cried for no reason after the op but that's normal. The blues do pass. You are so brave going back to work after 6 weeks. I couldn't have. Look after yourself and take care.

 

[oh2sew]

Well, I had my first Pilates session Tuesday afternoon. I knew I had a lot of work in front of me, but I guess I was shocked at just how much strength I DON'T have in my left leg! We alternated upper and lower body exercises - in part to give my leg a rest and not overdo it. While on my back on the reformer, pushing back with just my left leg, well, it was a tad harder than I would have liked (I know, patience!!). My leg is in a wobbly/wonky state and wobbled back and forth both pushing out and then returning to a bent position. I could see my knee moving left and right, so I tried to concentrate on keeping my knee stable. She also took her hands and helped to keep my knee/leg in line. The signal from my brain to my leg seems to be disconnected at times It feels like I can't really contract my quad muscle much to help control the movement. Hopefully, by continuing to go to Pilates, walking, etc., this will help. I can also feel a weakness in the front of my hip too (which I guess is still to be expected the way the muscles are moved around during surgery).

One of the exercises she had me try was to lie on my back with my feet in straps with a very light spring resistance attached to them. I raised my leg (keeping it slightly bent) off of the table, then proceeded to bring it back down. WOW! That was quite an eye-opener. It felt as though my left leg was going to just flop off to the left even more and off the table - I had almost no control on the downward motion. Thank goodness the trainer was standing next to my leg and re-assured me that she would not let anything like that ever happen.

I'm happy that I signed up for Pilates and have my next session tomorrow (Saturday) morning.

The even better thing is that I wasn't sore or didn't ache after the hour long session - it actually felt good to do some gentle stretching!!! (Although I did feel a twinge during one exercise, so she put that one on hold until I get stronger).

Not sure at this point if I will do any "formal" physical therapy or just stick with Pilates....time will tell I guess.

 

[oh2sew]

@oh2sew Hi there just to let you know that I also cried for no reason after the op but that's normal. The blues do pass. You are so brave going back to work after 6 weeks. I couldn't have. Look after yourself and take care.

@Cas Thank you! This surgery has definitely been an emotional/mental rollercoaster for me. I have had leg surgeries in the past, but never experienced the blues like I have with my hip.

I ended up only being out of work for 19 days. It was not the best decision to go back so soon, but unfortunately, my work is not very understanding.

I am sorry that your husband is not supportive of your need to go slow and steady to recovery. I know some people here have suggested showing their loved ones a video of the surgery so that they can get a clearer picture of what your body went through in order to get a new hip. Might be worth trying. Otherwise, ignore him or ask him for his medical license. You are doing great so keep up the great work of recovery.

@leejaa - ha! sometimes I do ignore him - hip or not!

Thank you all so much for the positive reinforcement and encouragement!

 

[mlsread]

You sound like a little miracle to me. Be good to yourself. I took a lot of the recovery information that I found here, made a little booklet and passed it on to family members so their questions could be answered and they could get a clear idea of the recovery process. I often need to reread it as a reminder to myself.

 

[oh2sew]

You sound like a little miracle to me. Be good to yourself. I took a lot of the recovery information that I found here, made a little booklet and passed it on to family members so their questions could be answered and they could get a clear idea of the recovery process. I often need to reread it as a reminder to myself.

@mlsread I'm not sure if I would consider me a miracle, but thank you. I do like the booklet idea. When I had my leg surgeries, I made a pre-op list of things to consider for other Twisted Sisters as there are alot of things that you don't think about, until they present themselves....

I did alot of reading this weekend and to me I have an inflamed iliopsoas as this article I found describes my situation perfectly: (especially the second sentence).

Symptoms of an inflamed iliopsoas muscle
Iliopsoas inflammation causes pain in the groin, particularly when the knee is lifted up towards the chest against resistance. The athlete may enter a cycle of pain where the pain disappears during training only to recur worse after exercise stops.

I talked to my doctor again about this. He still isn't convinced that this is my situation. So, he is now recommending blood tests to test for inflammation, infection, etc. He also ordered an MRI of my lumbar spine. (Most people I know have L5/S1 issues) Since my left (operated) leg was longer than my right leg, at first he wasn't going to adjust my leg length. But during surgery he decided to go ahead and adjust. When I talked to him today, he is now re-thinking that decision (what?!) But it's a case of "what if". I had groin pain prior to surgery with a longer leg. I still have it after with an adjusted leg length. Same symptoms. For 3 weeks after surgery I had no groin pain - I thought it was gone forever. But the first time I got on the stationary bike, boom, it was back.

My surgeon wants me to go to "formal" physical therapy vs. pilates as he feels they can give a "more official" diagnosis. He was also throwing around the possibility of another surgery to lengthen my leg back to what it was. He also mentioned adjusting the "cup" of the hip prothesis. I may be getting way ahead of myself, but I just can't imagine going through another hip surgery.

So, I don't know where all of this is going or where it will end up. I'm still walking with a limp (due to leg length - I don't know).

All that I know is I would like to be rid of the groin pain and be able to exercise again.

 

[Irish Joe]

oh2sew.
Please take the Pilates very easy. You are very soon to be doing so much after posterior THR I think. This might be the source of much of your pain what with you back at work also. I love yoga but didn't go back to it for 4 months and found it very challenging. Be careful that you are not overstretching those traumatised muscles and tendons.
One more thing DONT LISTEN TO ANY MORE EXAGGERATED HIP STORIES. Either you or your Hubby. Everybody is different. I got 2 hips done One got Better in 8 weeks and the other took over 6 MONTHS.
But they got better.
keep well.....
Joe...........