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THR Pain after activity at 7 months<

Pickler

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Had posterior THR on the right side in Sept 2018. Progressed quickly through crutches and cane, unaided after 4 weeks. PT was done at home with no therapist. Did exercises given by surgeon for 8 weeks.

Met with surgeon at 8 weeks. He said I was free of any restrictions at that point and could do anything that I could tolerate. I asked if I could start playing Pickleball, he said OK but no running.

I started playing Pickleball, riding bike (no hills) and walking. I did only one activity a day and took 1 or 2 days per week off. I would have some pain and stiffness but it would be gone the next day.

Starting at 6 months I began to get strong pain in my upper thigh after activity and some joint ache along with limping. No pain sitting or laying down. I now have backed off all activity except short bike rides and walking less than a mile. I am still getting pain and I limp the day after any activity. If I do nothing for 2 days the pain mostly goes away. I do take an Aleve most mornings that seems to help some.

Could this be a complication or just overuse?
 

Jaycey

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@Pickler Welcome to BoneSmart. Can you please give me the exact date of your THR. I'll pop the information in your signature for you.

What you are describing sounds like overuse to me. All new hips complain when you start to get more active. It's all about building up the activity level very gradually. If resting 2 days resolves this - plan an activity followed by 2 rest days for now.

Are you icing and elevating your op leg - especially after these activities? Ice is a natural pain killer and will help ease this.

I'll leave you with some reading. Even at 6 months out much of this information still applies.

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 this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
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?

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.
 

Josephine

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Pickler, 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.
 
OP
OP
P

Pickler

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1. Posterior

2. No pain when sitting or laying down. 1-2 when walking

3. Aleve once per day in the morning.

4. Icing after activity

5. When icing and in the evenings while watching tv

6. I backed off on most activities 3 weeks ago. Now doing basic house work daily. Go out for dinner & shopping every couple of days. Bicycle on flat roads for 30-45 minutes every other day. Was much more active until 3 weeks ago, played pickleball 3x week, walked up to 2 miles several times per week, bicycled up to 2 hours once or twice per week.

7. Until 3 weeks ago was doing 2 sets of 10, leg lifts, side leg lifts, clam shells, standing from chair. Also single leg stance 30 seconds 3x, abductor side lift with band. I am now only walking in pool 15-20 minutes a day.

8.No PT
 

Josephine

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A little more detail please
For #3. Aleve once per day in the morning - the question was "how much are you taking (in mg please) and how often?"
For #4 & 5. Icing after activity - the question was "If so, how often and for how long?"

For #7. Until 3 weeks ago was doing 2 sets of 10, leg lifts, side leg lifts, clam shells, standing from chair. Also single leg stance 30 seconds 3x, abductor side lift with band. I am now only walking in pool 15-20 minutes a day - the question was
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​
 
OP
OP
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Pickler

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#3 Naproxen Sodium 220mg, 1 tab in the AM.
#4 Icing once per day 30 minutes
#7 have stopped all home exercise except pool walking 20 minutes per day
 

Josephine

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Until 3 weeks ago was doing 2 sets of 10, leg lifts, side leg lifts, clam shells, standing from chair. Also single leg stance 30 seconds 3x, abductor side lift with band.
Then what was all this about?
 
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Pickler

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The exercises seemed to cause more pain than good so I quit doing them after reading various posts on this site.
 
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Pickler

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Josephine-I have noticed that I am very tender on the outside of my thigh which also seems to be the area that hurts when I walk. I read elsewhere in this forum about the Iliotibial Band causing issues after THR. Since I was too active too soon after my surgery, could this be what causing my limp and pain? BTW, I am doing a lot of icing and much less activity which is helping the pain and limp somewhat.
 

Eman85

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I had a tenderness down the outside of my thigh for quite some time after my THR. I could rub my hand down the outside of my thigh while sitting and it would be tender. Took quite a while for that feeling to go away.
 
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Pickler

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Hi Josephine- I sent you the incorrect info on the location of thigh yesterday.
R1F—V
R1F-W
R1F-X
R1F-Y
R1F-Z
In addition. I am still getting some pain in the joint
R2F—V
 
OP
OP
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Pickler

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Just a follow up on my pain and limping. After my last post, I continued to take it very easy until June. Started walking again, only a mile or two. Slowly the IT pain disappeared, as did the limp. Now I am pretty much back to normal, playing Pickleball 3-4 times per week with no discomfort. Also playing golf with no issues. Thanks for your help.
 

Layla

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What wonderful news! Thanks for taking the time to share your positive update.
Wishing you a (early) Happy One Year Anniversary! Only three weeks away.
Good Luck moving forward. Stop by and say :hi: on occasion. We'd love to hear from you again.
@Pickler
 

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