THR Post op question

Dolby

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Hi. My physical therapy for my posterior THR right hip 2 years ago was not complete due to the pandemic. This past Oct, I had the other hip replaced due to overstress from right side. My left side is coming along, but right side is still weaker. Seems that the two sides are not lined up yet, gait being off? Pt is trying to discharge me, saying I'm ok, but my doctor agrees I need more. I don't know who will win, but my question is what do I do to improve my gait, to feel both sides in synch. I hold my cane gently, as I don't feel aligned enough without it. If I don't have the cane, muscles that are weak (left glutes, quads) get too strained, limiting my walking routine. My hips feel good, it's how do I get the gait and balance better and what in physical therapy is needed to straighten this out. Question is: When is pt complete? Do I leave pt when my gait is off, and what exercises should they be doing for me so Im discharged with balance. Im concerned Im being discharged too soon. Appreciate your feedback. (sigh)
 

subie2021

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It sounds like you need a therapist who is well schooled in gait and gait analysis. Would that be available to you? Prior to my THR my pt worked to correct my horrible gait; unfortunately because of painful hips we didn't accomplish much but I remembered what she told me and used it post op. Specific exercises would depend on your weaknesses and strengths.

If you look on this page, you will see an ad for OneStep Digital PT. I signed up a month before my surgery and continued for 7 or 8 months post op. I found it to be wonderfully helpful. They have a gait analysis program and their PTs work to help correct your problems. I work with performance dogs and gaited horses, and to improve their performance a golden rule is "Work the walk" so this program seemed a natural for me. My first analysis scored something like 58/100, and I finished up with an average of 96/100.

The exercises I was given were gentle and I could progress as able. I started out with simple things like standing on a wobble cushion - that little dude works your legs! I progressed to things like step ups, step downs, and step sideways and the usual squats modified for my needs.

One Step offers Bonesmarties a deal, and a two week free trial. To analyze your gait, you open the app, stick your phone in your pants pocket, and go for a 30 second walk. Their algorithm miraculously pops out a score, based on your symmetry, stride length, and speed. You meet with your therapist via zoom and she organizes exercises just for you. My therapist would ask me to walk during our sessions so she could see for herself what needed attention. The routines take about 10-15 minutes a session, and you can give feedback as to difficulties or questions. My therapist usually responded within hours, and was very good about making modifications to my exercises.

When I began OneStep, the therapist asked for a short video of me walking. My DH filmed it for me, and at the time I was having a 'good' hip day, and I perceived myself ro be striding right along. But when I viewed that little walk, I was appalled at how awful I looked. No wonder my friends and relatives would comment or ask if I was OK! I've kept that horrible little souvenir just to remind myself how far I've come.

I hope you find your answers. Best wishes!
 
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Dolby

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Subie, I can't thank you enough for your detailed answer. I was wondering about that program. It seemed a shame that we go so far and still feel unfinished. Thank you again for all your share.
I'll be posting one more concern, but if you don't mind I will run it in this reply as well in case you have a thought.
I can't go up a step yet with confidence of my strength with the left end of Oct. post op side. I'm sure it's a matter of which muscles to get stronger, glutes, quads to give me that strong enuf feel that won't overburden my knee or left glutes. We've done squats, leg lifts, etc. Again this therapist says I just have to do more, but I feel there's a muscle area not being tapped. It's not fear to go up the step as some say. It's knowledge that my knee will unnecessarily suffer and other muscles will be overtaxed. I still use a cane tapping it on ground to give me that support for that issue. My hip feels fine and I know I just need the workout but the squats and bridges, and leg raises are not hitting it. Any thoughts would be appreciated.
Thanks again..Dolby
 

subie2021

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What's been working for me for doing steps, is to do steps.
My first post op pt sessions included step ups with a little two inch step...up and down, up and down. When that got easy, I graduated to a little bit higher step. This kept going in small increments up to normal sized ones. Also, my therapist started to include step downs forward and backward, and step off sideways, which work muscles in different ways. If any are too difficult, I revert to a lower step ( I just happened to have a set of two plastic ones left over from when I thought I'd try step aerobics - UGH!).
Whether I use the regular stair steps or the plastic ones, I always make sure to have something to hold onto if I need it; the railing, or by setting the plastics in a corner of the kitchen counters. Safety first!
My operated hip seems stronger than the one with original parts, which might be wearing out.
Doing stairs is getting better. I can climb the 4 porch steps with grocery bags now, and stairs in general aren't a problem most days...but there those times!
Keep working at it, you will get there. Most of us were probably in more of a physical mess than we realized pre op, so it takes time and work to get all these functions back.
 

BellaMac

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Congratulations on your new hips. Hope you get good food and rest.
 

Eman85

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I can't tell you much about any PT as I never went to any. My OS gave a handout of real basic exercises and I did most with my left and few with my right. I wanted to walk so that's what I did. I learned with my first that speed and distance was counterproductive. Slow, steady with good form was what worked for me. I've told many about my shopping cart PT. I used a shopping cart at the Super Walmart. It worked great and no one knew I was actually doing PT as I walked slowly around the store.
 

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