THR Post op regression questions

[ArthriticCanuck]

I’m at day 10 post right hand THR, and have regressed significantly in my recovery. Surgery was awesome; I had numbness and unresponsive muscles in the operative leg for over 36 hrs but eventually that went away and I could do all the PT exercises no problem, walk easily with a walker and slept well on both my back and side (with pillow between knees) However, I had some popping/clicking noises when walking right from day 1, and a LLD of around 3/4” (probably inaccurate diy measurement using wood blocks under non-operative leg and laser level to gauge centre line when standing)
On day 6 pain increased, with three distinct pressure points: outer edge of upper thigh (very near incision), groin, and centre of operative buttock. Walking became more painful, then I could no longer lie on my left side due to pain, now I can no longer sit in a chair either. I can still do the exercises, but both squeezing the glutes and drawing the leg back to centre during adductor movement are extremely painful. Now I hear the clicking noise with almost every step. I’m feeling like this isn’t normal. Thoughts? Advice?

 

[Eman85]

Let's discuss the PT exercises, that's usually where the problem lies. My experience and most others on here is to sit, ice read, watch TV and walk a little then repeat. From my exerience there is no gain in ANY exercises in the first weeks if not months post-op. I have no medical training, but I have had 2 THR's and done my share of overdoing and causing unnecessary pain that others should avoid.

 

[djklaugh]

@ArthriticCanuck Welcome to BoneSmart! Please give us the exact date of your surgery and we will create a signature for you. You are still very early days out from having major surgery. There could be several reasons for what you are experiencing. As Eman85 mentioned it could be you are doing too much for such an early stage. Another aspect might be your shoes - IF you are wearing shoes that you wore frequently before this surgery, look at the bottoms. See the wear pattern on the soles and heels? That is the old limping pattern and that can keep your gait now in that old pattern -- which is NOT good for new hips. So IF this is the case -- get new shoes.

Also here are our post-op articles and suggestions to help you through the recuperation period.

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 these
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for THRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital
The Recovery articles:
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.

 

[ArthriticCanuck]

My surgery was February 7th, 2024. I’m only doing the gentle movements as prescribed by the PT at the hospital, plus walking for five min or so every couple of hours. My husband watches like a hawk to be sure I don’t do any of the restricted movements! Visible swelling is gone, bruising almost cleared up.
I’m walking with a walker, barefoot. Well, now I walk with a shoe on the other foot as that reduces the pain and I feel more stable.

I can add that I’m in the Great Canadian land of Free Flawed Healthcare… so I’ve needed this replacement for almost three years. The joint has been bone on bone since June 2023 so the surgeon had to make adjustments to the component fit in order to stabilize the joint, because of the excessive wear to the joint and pelvic twist from my body’s compensating for the pain over time. I only learned this information after hounding his office to answer my questions.

 

[Chocolatine]

Hello, Fellow Canadian Hippie!

I had a RTHR on Nov 13, and I have gotten amazing advice and support here. It's nice to see another Canadian

I can add that I’m in the Great Canadian land of Free Flawed Healthcare… so I’ve needed this replacement for almost three years.

Free but flawed is a great description of the healthcare here. My surgery was delayed for many years as well. All kinds of time for me to develop a bad limp, among other things. Sorry that you were in pain for an extended period.

I am no expert, but the things you are describing sound familiar to me. I had many of the same worries

I felt like I had an enormous LLD after surgery. You can look through my older posts to see my concerns. I am laughing at your laser level measurements- my husband and I attempted the same thing. I thought we were the only ones! I am still not certain if there really is a difference, but I am happy to report that things feel pretty much equal now at 3 months. I think you will have to give that some time. IIRC, they don't like to do shoe lifts before 6 months because things tend to resolve.

I had to stop that adductor exercise because it caused me terrible pain. I took a complete break from it. Then I tried a few weeks later and it was easy, no pain at all. Funny how it improved without any reps! Are you assigned to a PT?

Sleeping is just tough early in the recovery process. I am impressed that you are able to lie on your side at this stage- not sure I could even roll on my side unaided at day 10, never mind sleep that way. If sleeping on your side is causing you pain, could you switch to back sleeping for a week or two before trying on your side again?

Where do you get pain when you sit? Is the chair the issue? The length of time in the chair?

You are very early in the process- hang in there!

 

[ArthriticCanuck]

Thanks so much for your encouraging reply! I’ll go check your posts. It’s so hard to know what to expect - all I hear are happy, miraculous recovery stories. Glad to know I’m not alone in this experience, and things might work out just fine

 

[mendogal]

A few reassuring words about leg length...
Over years of your structure slowly adjusting to pain, limping, etc, things got really skewed from feet through pelvis and sacrum - just as you noticed.
Over a short period of time in the OR, the surgeon changed the hip, a key system component (along with disrupting some muscles, tendons, and ligaments).
Well, it's going to take tincture of time for all the muscles, tendons, ligaments, and even bones to find their new improved "normal."
All of those affect your perception of, and even measurement of, leg length.

 

[Layla]

Hello and Welcome to BonrSmart! Thanks for joining us.
Your leg endured major trauma, in a very small area, although controlled. Your muscles, tendons, ligaments and other soft tissue is going to cause you discomfort and pain for a while yet. Take prescribed meds for as long as you need to in an effort to remain comfortably mobile and able to rest easy.

Clicking, clunking and popping sounds are common and it's natural to be concerned and wonder if something is wrong. Most often the noises aren’t indication of a problem. It takes time for the soft tissue surrounding the implant to heal and settle in with the implant and begin working smoothly.

As far as Leg Length Differential goes, many feel this sensation post op. In most cases it eases with time. We advise giving it 3-4 months as it can take that amount of time for things to balance. If at that point, you are still concerned we suggest you visit a reputable podiatrist or PT for a measurement.
Here's an article from our Library Leg length differential - LLD.

Keep in mind that it is not necessary to exercise your injured hip to promote healing. The trauma sustained through THR will heal on its own. Often though, we're impatient and want to move the process along. In doing so we run the risk of struggling with pain and setbacks stalling the healing process. The best therapy for recovery is walking, but not to excess. Start slowly increasing time and distance incrementally in an effort not to overdo it.
Best Wishes as you continue healing!
@ArthriticCanuck

 

[CricketHip]

I’m walking with a walker, barefoot. Well, now I walk with a shoe on the other foot as that reduces the pain and I feel more stable.

I have to ask, why are you only wearing one shoe? I think that will add to your feeling of a LLD.
That new hip (and your entire body) needs the support of a good shoe also.
Another thought is try not to wear your old shoes that are worn in the pattern of how you walked and limped before surgery.
Things will improve.. just be kind to your body.

 

[Layla]

Happy One Month Anniversary!
How are things going for you? Please let us know, we'd love to support you as you're healing
I hope you have a nice weekend!
@ArthriticCanuck

 

[Sohowarrior]

I also went barefoot in the house with my walker. Just felt so natural to me and the at home PT was ok with it. And I liked watching my ankle pumps.