THR Not going as planned

[Eman85]

I had and still have weakness somewhat. I could do straight leg raises the next day after surgery and did them at home but they didn't hurt. Everyone is different and in the group PT class at the hospital many couldn't do a leg raise.

 

[upsman]

Tomorrow will be 12 weeks PO. Things are slowly getting better it seems. 3 days ago I actually went 2 days with no aches or pains. I’m thinking “ok, the pains are gone, I may actually be able to go back to work soon.” Nope. I wake up yesterday morning, get up, and there’s tightness in the groin area, and a little on the outside of my thigh. Same thing today. I didn’t do anything strenuous or different than I’ve been doing. So now I’m a little down again. On the “good” side, the surgeon extended my short term disability by a month. The nurse said if it hadn’t gotten better by then, that they’d have me come back in to check it out. I sure hope it will. I’m tired of not working.

 

[Layla]

Hi @upser
Sorry you're feeling a little discouraged. You mentioned you had tightness in the groin and the outside of your thigh. Is there pain involved? Wondering if you're exercising or engaging in any PT?

 

[upsman]

Sorry. Tomorrow is 11 weeks, not 12.

No “pain” involved. The discomfort on the outside of thigh I’ve had before. It comes and goes. The groin pain feels like simple muscle tightness. And yes, I’ve been doing PT. My PT has been a bit perplexed at why my hip flexor is still weak and inflamed. Last week was the first time I could do a straight raise. Up until this week, PT has been mostly stretching. Last Friday he wanted to start on strengthening. So Sunday evening I’m walking around with absolutely no “tweaks.” Same thing Monday. Had PT again Monday and worked it pretty hard, but I was fine that evening. I woke up yesterday morning and I notice the groin tightness. I’m assuming it just got aggravated. PT said to stretch it and ice it.

 

[Layla]

Since you're dealing with some discomfort and have a desire to get back to work, I'm tagging the forum nurse @Josephine who may want to pose some questions. Hopefully she'll gain some insight and be able to offer direction to get you on track.
@upser

 

[Josephine]

Indeed I do! 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?

 

[upsman]

Indeed I do! 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?

Sure

 

[Layla]

Hi @upser
Let's tag @Josephine to make sure she sees your response. She can get busy on the forum. I notice she's not online currently, but could show up again...not sure of her schedule. She does reside in the U.K. and she's about 6 hrs ahead of you timewise so please check back periodically for the questions she'll post.
A great evening to you!

 

[upsman]

Ok thanks.

 

[Josephine]

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.

 

[upsman]

1. Anterior right hip.

2. Pain level 1. Sitting in recliner. When I get up to walk it might be a 3 or it might still be a 1. It comes and goes. No swelling.

3. I was prescribed Tramadol and oxycodone but have taken nothing since week 2.

4. When I do have pain, I ice it for 45 min to an hr. Got that from you. I ice it usually once because the pain goes away.

5. No elevation.

6. I wash dishes, feed the dogs twice a day, go to the grocery store, and take my kayak and go fishing. I’m usually never on my feet for more than 30-45 minutes at one time.

7. Almost exclusively stretching at home.
Hamstring stretch x 2 a day.
Standing quadriceps stretch x 2 a day.
Lying knee to chest 20 reps x2 a day.
Supine gluteus stretch 2 sets x 40 seconds x 1 or 2 times a day.

At PT twice a week -
sit to stands 1 set 20 reps with 20 lb ball and raised seat.
Clamshell with resistance 1 set 20 reps.
Supine bridges 1 set 30 reps.
Step ups 1 set 20 reps.
And also the same stretches done at home between the exercises.

Also, the groin soreness that I had has pretty much gone. I did lying groin stretches for a couple days and it really seemed to help the tightness and soreness.

 

[Jamie]

Amiright/upser....it seems you have two accounts here on BoneSmart under these two usernames. Please tell us which one you prefer to use and we'll get them merged for you.

 

[upsman]

Amiright/upser....it seems you have two accounts here on BoneSmart under these two usernames. Please tell us which one you prefer to use and we'll get them merged for you.

“Upser.” I don’t know where the other one came from.

 

[Jamie]

I will merge them under the name upser.

It appears that you or someone at your location entered both accounts at different times. I've sent you a Personal Message (PM) with the information on both accounts.

 

[Josephine]

2. Pain level 1. Sitting in recliner. When I get up to walk it might be a 3 or it might still be a 1. It comes and goes. No swelling.

Okay

4. When I do have pain, I ice it for 45 min to an hr. Got that from you. I ice it usually once because the pain goes away.

Jolly good!

6. I wash dishes, feed the dogs twice a day, go to the grocery store, and take my kayak and go fishing. I’m usually never on my feet for more than 30-45 minutes at one time.

Very good

Almost exclusively stretching at home.
Hamstring stretch x 2 a day.
Standing quadriceps stretch x 2 a day.
Lying knee to chest 20 reps x2 a day.
Supine gluteus stretch 2 sets x 40 seconds x 1 or 2 times a day.

At PT twice a week -
sit to stands 1 set 20 reps with 20 lb ball and raised seat.
Clamshell with resistance 1 set 20 reps.
Supine bridges 1 set 30 reps.
Step ups 1 set 20 reps.
And also the same stretches done at home between the exercises.

I think you must have missed this: 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.

 

[upsman]

Okay. So now I have a couple questions. I’m 12 weeks PO.

Things have progressively gotten better. I actually did 8 straight leg raises today. Two weeks ago I could barely do 3. I’ve been walking with less and less pain. I might even go a day or two with zero pain and no limp.

I might have a small bit of pain in the groin for a minute then it goes away. Or it might be on the outside of the thigh about 2/3 down between hip and knee. There’s no rhyme or reason to when I get these pains. They never last long.

But now I’m scared that the hip is failing. If it was, would the pain be worse? Would the pain be more consistent? I really thought at 12 weeks, I’d be totally pain free. What do you guys think?

 

[Bfam85]

@upser please don't be concerned at all....I will be 12 weeks PO on Monday...and I have never done any straight leg raises...they hurt too much. Besides, when you think about it, when do we ever functionally need to do that move?! If I were to guess why some of your aches and pains are still coming and going, I would bet that to be the one main reason. We are sold a bill of goods that we will have "forgotten" hips by this time...nonsense! It will take a full year and more to feel completely healed and the implant "implanted"...The word you used is "Progressively" gotten better. That's the way this is. You are doing great....enjoy your new life.

 

[CricketHip]

Well, I just got to say, I think you are doing very well! Bfam85 gave you some really good advice.. it doesn't happen overnight, to be sure. The part I noticed is that you have days where there is no pain and what you are getting are more like little reminders to take it a little easier. We all face this multiple times throughout our recovery, which can be over a year long.
Straight leg lifts? I scrolled up and read Josephine's advice to you and I want to remind you of what she said.. some of those exercises are more harmful than good for you.
You are doing very well and am not sure why you would assume your hip is failing and to answer your question, if it was, I doubt it would be so subtle.

Try to relax and appreciate your new hip and remember all of the dramatic tissue upset that occurred in having it replaced.. you are doing really well!

 

[Layla]

Hi @upser
BFam85 says it best below -

I will be 12 weeks PO on Monday...and I have never done any straight leg raises...they hurt too much. Besides, when you think about it, when do we ever functionally need to do that move?! If I were to guess why some of your aches and pains are still coming and going, I would bet that to be the one main reason. We are sold a bill of goods that we will have "forgotten" hips by this time...nonsense!

Heal first, exercise later. You're not completely healed yet, you have quite a way to go. IF you stopped all of the exercises, Josephine, crossed off (advised against) above and you're feeling better because of it, why go backward now? I recall a lot of fleeting pains as I was healing. I'd be concerned by one, only to have it disappear and replaced by another. Slowly it all eased. It will for you also. Unless something is unrelenting and increasing in intensity, I'd try to ignore it and it will most likely disappear.
Have a great Thursday!

 

[Eman85]

I really thought at 12 weeks, I’d be totally pain free. What do you guys think?

I thought the same thing at 3 mos. But guess what?,I was terribly wrong. You're at a great point to really have a setback. My OS said 1 year, it took a little more than 1 year, to get to the point you think you're at. At 3 mos I thought I was good to go and attempted to rejoin my life. I didn't go back to a job but a couple of days of catching up on work around the house put me back in a chair for almost 3 weeks. I had all of the thoughts about the hip failing, which were incorrect. it was those 3 weeks re-recovering that taught me a lot about my body and this surgery.
As far as the PT goes what they say about the hips healing on their own is true. I had basic PT to do at home from my OS and none of it was strenuous. Everyone's body is different and how they manipulate you is different too. I could do straight leg raises the day after surgery with no problem. My OS warned me not to go to outside PT as they would hurt me. From what I read on this forum he's right.