THR Pain and stiffness 11 weeks after hip surgery

[tawnygirl]

Hello all,
I am a 67 year old female and had a nasty fall 11 weeks ago. The fall was so bad that they had to do a total hip replacement. I have always been very fit walking miles at a time and love gardening. However I now find that I have a lot of pain at the top of my leg when I first get up and try to walk. Once I am on the move things are ok and I can walk for a little while. After that I have to stop and the pain starts again. Is this normal or should I be worried.

 

[CricketHip]

Hi @tawnygirl and !! I will leave you some of our Hip Recovery Guidelines to look at.
Then will discuss more in regards to your question. So glad to have you here on the forum.

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:

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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

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BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for THRs​

6. Access to these pages on the website

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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.

 

[CricketHip]

So, please take time to browse through those guidelines. Sometimes less can be more at first.
Many of us have that stiffness and discomfort when we first get up out of a chair or couch/bed.
We joke about our stutter steps while trying to look natural to others.

Can you please post here with your date of surgery and which hip was it? That is most helpful, and one of the moderators will add it to a signature that will show when you post. if you look below my post here, you will see mine and will notice that I've had both hips replaced.

The most recent hip has been a longer recovery and I did the stutter steps after getting up for at least 7 months.

I hope this helps.. must have been a horrible shock to you to have such an accident and need a THR. I'm sorry you had to go through that.

 

[Layla]

Hello and Welcome to BoneSmart. Thanks for joining us here! I’m so sorry to read about your fall. Such an unfortunate accident. It‘s great you found us, I think you’ll enjoy the encouragement and support you’ll receive on the forum.

You mentioned that you find you have a lot of pain at the top of your leg when you first get up and try to walk.
Is the pain at the top of your leg upon rising and starting to walk a new pain for you?

Once I am on the move things are ok and I can walk for a little while. After that I have to stop and the pain starts again.

Is it the pain that stops you from walking, or does the pain begin after you finish walking?
If it’s afterward, do you mind if I ask how far you’re walking and how often...wondering if there’s a connection?

I’m also wondering if you’ve tried icing for the discomfort for at least 45-60 minutes each time you ice? If not, please give it a try as it can relieve pain.

You‘re still early into your recovery journey and pain and discomfort is not unusual at this point, especially if you’re overdoing it activity wise. Sadly, it often doesn’t hurt until we stop. Your best bet may be to look at your activity level. If you don’t believe it’s a possibility that over activity is contributing to the pain you can always phone the office of your OS and through conversation they will hopefully offer you the reassurance you’re seeking.

Take care, be safe and stay well!

 

[tawnygirl]

Thank you so much, I am already feeling a little happier with my situation after reading your replies
I fell on Friday 17th of January after getting my heel stuck in an expansion joint at a DIY shop landing on a concrete floor The trauma team on duty that weekend decided they needed a surgeon in from a different hospital to perform the operation. This meant that my operation didn't take place until Monday 20th of January. I was sent home on Tuesday 28th of January. It was my right hip.
I was given some exercises and was told a physio would be out to see me. Two weeks later she arrived and gave me some more exercises, told me to go for a gentle walk and said that I should stop using my frame and walk with a stick. This caused a problem straight away because of a weakness I have on my left side I had to use the stick on my right One of the exercises I had to stop straight away because of the pain it caused in my knee. Off she went on holiday and would be back in two weeks.
After going for my first walk around the street I was in some pain but continued to try and do a little each day.
When the physio returned she told me that I had been doing one of the exercises incorrectly (I wasn't to know). I told her about the pain after walking and she said that it was because of the muscles being used. I also asked her about using the stairs normally as I had been going up one at a time without any difficulty. She watched me and said that it was fine to use them normally (we have a banister on each side). She also told me to stop using my stick if I could
I realise now after talking to you, that some of the pain that I am getting started after this but just thought that it was normal.
I have also been trying to walk further (with my husband) each day venturing probably up to a mile.
I don't have any pain when at rest, it is when I stand and try to take the first few steps that I have quite a lot of pain at the top of my leg at the front. Once I start walking it isn't to bad although there is still some discomfort. Once I stop, sit down and then get up it starts all over again.
I was told this magic time of 12 weeks and things would be back to normal and that is one of the reasons I have been so concerned.
I'm sorry if I have gone on so much, it has just been nice to get it off my chest and realise that someone is listening.
Thank you, I am so pleased I have come across this forum.

 

[Layla]

Hello again,
Physio wasn’t really necessary at three weeks post op and depending upon the exercises you were doing and how many reps of each, could be an answer to how your problem began. Would you mind sharing your early and current exercise routine? We may be able to pinpoint what is causing your pain, especially if you’re still doing any of the recommended exercises.

You mentioned that after your first walk around the street you were in pain but continued to try and do a little each day. Please understand that pain is your body asking for change. Pushing through pain will only stall your recovery. Pain is a signal to stop, rest, ice, re-evaluate what you’re doing and whether it’s helping, or hurting you.

was told this magic time of 12 weeks and things would be back to normal and that is one of the reasons I have been so concerned

This is not realistic so please don’t feel anxious about where you are currently. This recovery can take up to a full year and even longer for some. Members frequently continue to note improvement after a years time.

Consider stopping ALL exercises for now, except for walking, but not to excess. You likely have some soft tissue inflammation. I’d ice preventatively after each walk for 45 minutes. Try this for a week or two and see if you notice any improvement.

Please, no apologies necessary for giving us more detail. It helps all of us to have the info in an effort to offer sound advice. Check out @Fit4Family thread. She is also recovering from a fall that resulted in a THR and eventually a revision. She’s doing really well!

Have a great weekend and stop back often, we‘re here for you!

 

[tawnygirl]

Hello,
Thank you again. The exercises are:-
1. keep my hips straight and put my leg out to the right keeping my foot at an outward angle and hold it there (husband has to hold my hips straight)
2. put my leg behind me resting it on my toes
3. go up and down on my tiptoes
4. sit in a chair and bring my knee up
I have been married for 47 years and have a wonderful husband but still like to be very independent and I think perhaps I am trying to hard to be normal again. I will start and ease back a little and restrict my walking to a shorter distance and try and listen to my body.
So nice to talk again and so relieved.

 

[ForumUser]

12 weeks and back to normal ... er, no.

Everyone heals differently - and, at a different rate.

I found that walking was all that I needed ... and, then only when it felt comfortable. Some are walking almost normally at 3 months, and some are not. Relax your pattern at bit and see what happens. I kept pushing and ended up delaying my recovery. Don’t do this!

Are you still elevating and icing the hip?

 

[Jaycey]

@tawnygirl So glad you found us! Please remember not only did you have THR - you also suffered a major injury. Recovery for you may be longer as muscles and soft tissues will need to settle from all the trauma.

And please do not feel pushed into not using any walking aid. When you start leaving your cane/crutch/walker behind that is a sign you are weaning off using it. Continue to use your aid so that you don't develop a limp.

 

[Hip4life]

I was also glad I found this forum. Eventually. Lol. I iced and elevated and used my cane long past 12 weeks and my THR was not from a fall. Yes, be even more kind and patient with yourself. I am from the club of walking will get you there. That was my OS advice before I found BS. He said something else: you don’t realize how much this surgery takes out of you and it will just take the time it takes. Wise words from someone who should know. Wishing you continued healing blessings. Do check out Fit4family. It is a story worth reading and a wonderful person to get to know. Keep us posted. Stay safe. Pat.

 

[Going4fun]

Joining the others, I say drop those exercises. The PT is often useless so early in the process. If you do want to use some PT exercises, you have to get to a really smart therapist who knows what they're doing and who really learns your specific body and who helps you tune into your body ... and who can help you learn to notice small, small improvements.

Oh ... and congrats for identifying that you may be putting pressure on yourself to recover fast and regain your "independence." You really want to push that kind of concern to the side and follow your body. Lots of icing, as others have suggested. You'd be shocked at how good icing can be, but you have to do it for the times mentioned above in the guidelines.

Question: you say you can walk up the stairs pretty much with ease? Do you use a cane or anything when walking up the stairs?

And for walking: you use a stick and not a cane? Just trying to imagine your situation.

 

[tawnygirl]

There are tears in my eyes as I write this. I can't believe how kind and understanding you all are. I have never once been told until now about icing. I literally have just been left to get on with things. As I mentioned earlier, the physio told me to stop using my stick. Indoors I walk without any aid at all, when walking outside I link my husband. I did as I was told which seems to have certainly been the wrong information as I now do limp when I walk. Could you please explain exactly what icing is. This might seem a silly question but I have never heard of it before.
Take care

 

[Layla]

Hello again, tawnygirl
Icing means using a gel pack, ice machine, bag of frozen peas, whatever you have access to. You place it over the area of pain, or discomfort, for no less than 45-60 minuts to help reduce inflammation (swelling) which causes pain. You can do this several times per day. Following is the article on ICE from the Recovery Guidelines - Tap the title in blue to expand the article.

Ice (Cryotherapy) to control pain and swelling

Updated 22 November 2020 Please note that though this article primarily talks about knees and hips, the information applies equally to shoulders and other joints as well. Using ice (cryotherapy) is an excellent means of controlling pain and swelling after joint replacement surgery and it...

bonesmart.org

Make sure you have cloth / fabric between your skin and the ice source.

You can get rid of your limp by practicing heel-toe walking
A tip - Let your heel hit the ground first followed by toes.
It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.

It is advised you use an assistive device until you’re no longer limping. Use your stick and practice the heel-toe walking and before you know it you’ll walk away from your stick, without a limp, forgetting it because you’ll no longer need it.

Just relax, breathe and take it all slow, you will notice positive changes. It’s early days in the entire scheme of things so no worries please. We are here to guide you through, we’ve been there, we understand.
Hugs
@tawnygirl

 

[Going4fun]

Yeah, please reverse that physio's advice. Get a stick or a cane. Walking with an assisted device, as Layla says, is crucial. And you do build up muscle and balance and neuromuscular coordination in doing so.

You will gradually get off the device ... but that just happens ... you don't really need to work hard and push yourself. It'll just happen. You'll forget to use the cane or whatever ... and you'll take a few steps and you'll notice, "hey, not too bad." ...

Later on ... you can practice ... walk with cane ... decide to practice a few steps by holding cane in your hand (not using it for assistance). But you don't have to push this. If your balance is off or as you fatigue, you use the cane again.

Walking with a device absolutely helps recovery. I'm so sorry that your physio told you otherwise.

 

[FCBayern]

I'll chime in about using a walking assist device as long as you have a limp. I used a cane regularly outside the house even after I had stopped using it inside. You are typically walking farther when outside and people give you a little wider berth when they see the cane (Although having space to walk may be one of the few positives as we social distance). I used my cane outside until the day I left one store for another and realized when I got to the second store that I had left my cane in the basket in the parking lot of the previous store.

 

[CricketHip]

I am so sorry that you've struggled like that. But the best news is that you can start icing/ resting more and regain ground that was lost in your recovery.
I cringed when I read that they wanted you off a supportive cane, because it's the best way to walk without limping and it retrains your body by strengthening muscles that were impacted by your injury and surgery.
You will begin to see a difference in how you are feeling/walking.. just by taking it slow and easy. Skip the exercises and let your body heal.
Then, as you heal you will notice you're doing more activities of daily living and smiling because it feels good to do so! I think many of us continued to ice and elevate for several months, especially after activities, then I enjoyed icing each evening when resting and watching t.v. or reading a book. It became a nice, comforting habit.

What a shock it must have been for you, to fall and end up in surgery days later. But things will get better. Hang with us here. We have a good time supporting each other.

 

[Eman85]

This may sound odd but I think they did you a service by performing a THR as a repair for your accident. It seems that many get repairs done to their hip and then have to have the replacement done afterwards.
Your pain when first standing is common and I had it for quite some time before it eased off. Being able to walk without the limp takes some time also. Taking your time while walking and practicing heel toe walking with good posture is hard but more productive than walking longer distances. I would try and walk slowly but very purposefully and would get to where my cane would only touch the ground every other step.
As someone else said you had an injury and on top of that the trauma of a THR. To replace your hip they move things around a lot in very unnatural ways. The muscles need to heal before they can strengthen.

 

[Layla]

Hey Tawnygirl
I hope you’re doing well and feeling confident in your progress.
We would love to hear from you if you have time to leave an update.
Wishing you only the best. Stay safe and healthy.
@tawnygirl

 

[Layla]

Happy Four Month Anniversary!
Hopefully all is well with you. We’d love to hear from you soon.
Until next time...all the best!
@tawnygirl