THR Post-op swelling-please help!

[52andHippy]

Hi, I’m 52, female, and had my first (and only) THR on September 6th, 2019, so I’m 10 weeks post-op. I continue to have what I call a “large handful of swelling” posteriorly and below my incision. There is also swelling/tightness from hips to knees bilaterally (although not easily seen, but knees and thighs feel full and tight). I feel like this is limiting my ROM and possibly the cause of my headaches. Does anyone else experience this? Is this normal? And if so, when might I see a change for the better. My surgeon did say swelling could last 6 months, but honestly I am super-tired of the discomfort! I take Aleve 220mg am and pm. I’m small/average size. Is it more notable in smaller framed people? Thanks

 

[FayeL]

Hello @52andHippy - my hip birthday sister! (right THR September 6, 2019)
I too had ridiculous swelling over my right hip, extending around my operative hip towards the back and down my thigh- I was so distorted it was (almost) laughable! Someone here on this website answered my call out ("What the heck is this!!!") and told me she had named her swelling her "saddlebag." Now at 10 weeks, it has definately gone down at least 80% bit still noticeable.
Do you ice routinely? I spent most of my first 6 weeks icing all the way down my operative leg and my non-op knee as well. You might also try some isometric muscle engagement in your lower limbs (clenching and unclenching thighs and butt while seated) to help mobilize fluid out of the tissues.
How is the rest of your recovery going? Are you doing any focused walking? physio routines?

 

[52andHippy]

I’m going to PT twice a week and do the routine at home every day not in PT as well. I went back to work at 8 weeks and do walk a lot there (9-10 k steps) and do a 10 min treadmill walk at home on days off. I’m icing after exercises and if I feel warmth at the site of swelling. Funny, I call it my saddlebag too! I just don’t get the headaches-they are my whole head and when I check my blood pressure it’s fine. Thank you for your response-it’s good to hear from others! I’ll just keep on trudging through and pray for improvement!

 

[FayeL]

Sounds like you are doing everything @52andHippy ! Glad that your blood pressure is not responsible for your headaches- NSAIDS and acetomonophen based meds can also result in medication "rebound headaches" when levels of the medications in your system are at their low point- perhaps your family doctor can assess and advise? We have enough on our plates in our recovery process without adding headaches into the mix!

 

[Jaycey]

@52andHippy Welcome to BoneSmart! Everything you are describing in your first post sounds totally normal for post op. Healing does not happen in a straight line. It's a bit of a roller coaster ride.

Are you icing and elevating? Icing for 45-60 minutes in a session will reduce that swelling and tightness you are feeling.

Sounds like you are doing way more PT and treadmill than you need. If your job includes that much walking I would stop all that PT and treadmill. It's just not needed and your hip is telling you this.

I just don’t get the headaches-they are my whole head and when I check my blood pressure it’s fine.

I would check with your family doctor on this. Are you taking any pain medication?

I'll leave you our recovery guidelines. You are 10 weeks post op but 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

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 that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[52andHippy]

Ok, thank you very much. Again, it’s nice to have reassurance. I will try to take it easy a bit more!

 

[CricketHip]

@52andHippy Welcome! Glad you found this forum and can get some advice and comfort.
I can't agree with Jaycey enough about stopping exercises when your work is that activity based. that is a lot of steps!
If you'd like I can leave you some things that you can do at home to possibly help ease your swelling, In fact I'll leave it here for you and you can decide if you want to try it.
I still do this at night and I am almost 5 months post op and have a very active job.

Good luck and I hope the icing and resting more will help. The info that I am leaving you is part of a Lymphatic drainage routine and it's for lower limb swelling.


****
Take deep breaths.. deep, as in breathing in to a count of 5, or 3 or 4, whatever is best for you. hold it for another count of 5 then blow out completely, still using the count that's comfortable for you. A series of at least 6 of these could help get your excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up.
Do this whenever you feel up to it during the day or night. The more supine that you could get in the recliner or bed, the more effective this can be.. you have lymph nodes seated there in your groin and sitting up too much can cause a restriction of the lymph flow.

You can, after the breathing, place your hands lightly on your upper thigh, right where the crease is in your groin and lightly stroke upwards towards your naval.
I did this quite a bit post op and while it takes a while for the body to wake up and respond, it will, and it will help get things moving.
The reason this can help is because our lymphatic system doesn't use our cardiovascular system to help lymph fluids move.. no assistance from the heart pumping. Our breathing and our physical (muscular) movements keep it flowing.
****

 

[52andHippy]

Thank you!! I’ll try it for sure!!

 

[52andHippy]

Alrighty, I talked to another physical therapist and he agreed with all of you that I need to chill out a bit and ease up on exercise, so I talked to my PT and we are changing to seeing her only 1 time per week and exercise at home every other day. I am going to focus on walking and stretching for the next 2 weeks and hope for improvement. Thank you all so much!
I do have one more question- have any of you found it very uncomfortable to sit? (Ishial Tuberosities). I’m hoping easing off exercises will help this as well!

 

[Layla]

There is also swelling/tightness from hips to knees bilaterally (although not easily seen, but knees and thighs feel full and tight). I feel like this is limiting my ROM and possibly the cause of my headaches.

Have you spoken to your OS about this?
Also wondering if you'd consider a week, or two week break, from PT and exercise to see if you notice improvement? The choice is yours, but you may be pleasantly surprised if the only exercise you engage in is some walking.

I found sitting relatively uncomfortable for several months. I felt like I was sitting on a golf ball. Sitting in the car being the worst because there was no room to stretch or move. It does gradually ease with time.

Happy Wednesday....hope you're having a good week!

 

[Calgal]

have any of you found it very uncomfortable to sit?

I found sitting uncomfortable for a very long time! Ended up getting a memory foam cushion off Amazon to take out to restaurants and also use to sit on at home in the office chair still...after 6 months! I have a sheepskin on my recliner right now. Really, some things just take time. I feel like I have no padding on my 'sit bones'. The hip is ok, just sitting isn't. By the way, I'm also still stiff when arising from sitting for any more than 30 minutes. So you're not alone. Hang in there it does get better.

 

[52andHippy]

Thank you!

 

[Debru4]

It is possible you have some concurrent things going on, in terms of the headaches. If it were me, for peace of mind, I'd probably want to follow up with my family practice doctor (or my surgeon's office if you wanted to start there ) to see if they have any ideas about the headaches, and if the replacements and headaches could be related. Sure hope you get it figure out.

 

[Mojo333]

Hi @52andHippy
Hoping you are seeing some improvement by following the Less is More philosophy.
Hoping you are doing well!

 

[52andHippy]

I do think it’s helped a bit; no miracle cure-I’ll have to make my “impatient “ self be more “patient”. Thank you for checking on me.

 

[Layla]

Hello and a Happy Friday to you
Happy Three Month Anniversary!
Wishing you a nice day and a great weekend.
Please stay in touch, we're interested in following your healing journey.
@52andHippy

 

[52andHippy]

Thank you! I’m still dealing with the tightness due to swelling-it’s been up and down, but the surgeon did warn me that it might take 6 months. It’s just hard not want it to hurry up!

 

[Layla]

I understand. We all want instant results but complete recovery can take up to a year, even longer for some. A sentiment from a member's OS follows -

Look upon this operation as an investment in your future.
Look after it now and it will serve you well for years to come.

Something to keep in mind as we're healing.
Good to hear from you. I hope you have a nice week!
@52andHippy

 

[Layla]

Happy Four Month Anniversary!
Wondering how you're doing? We'd love to read an update if you have a few minutes to leave one next time you stop by.
Wishing you all the best in the New Year!
@52andHippy

 

[52andHippy]

Hi! Thank you for checking on me! I have seen a little improvement by way of a little less swelling and a little easier to sit on my “sit bones”. I work at a middle school and yesterday was our first day back since Christmas break. Yesterday went well swelling-wise. Today is tougher. Hoping that gets better again as I get used to walking a bunch. I don’t have a follow up with the surgeon until end of February. I’m guessing (hoping) I won’t have much to complain about by then.