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THR Pre-op hip conditioning

isledancer

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I had so much great support here when I had TKR in 2013. I got back to my active life and thought I was in great condition. Until last month when I saw ortho about what I thought was a pulled thigh muscle from dancing . Shocked to hear I need an immediate THR! He ruled out PT And suggested using stationary bike 5x wk. for 30 min each. Anyone know how much I should push myself? Pain after I workout. What about resistance, time, etc? I Also still walk, but it bothers me a lot at night. I haven’t yet scheduled surgery but as pain intensifies, I’m thinking soon.
 

Jaycey

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@isledancer Welcome back to BoneSmart! Sorry you are facing more surgery.

My advice is to baby that hip. If your hip is at the stage that it needs immediate treatment it must be pretty damaged. Please don't try and push through any pain ,at this point. I did and the result was a collapsed hip. Believe me you don't want that pain. And the recovery with that much damage is far more complicated.

If you are comfortable with 30 minutes 5X per week - fine. But if there is any discomfort it is that bone on bone pain. Adding more wear and tear to an already damaged hip won't be any benefit.
 

Going4fun

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My view: pushing yourself just gets you more pain.

And let me understand: did your surgeon say this is an emergency? If so that's huge! I mean huge! For most of us our surgeons say "let me know when you're ready."

My mother was a rare case where her hip was so bad her surgeon ultimately ordered her to have the surgery because she was in danger of having the hip collapse, as Jaycey talks about. And of course, any fall could have led to head injuries.
 

Schaargi

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Ugh. That sounds painful!

I'm getting ready for my 2nd THR. I did pre-hab both times, with gentle exercises. My physical therapist told that it's good to use your muscles, but if it hurts, that means inflammation and that will make it more difficult for the surgeon.

I'm surprised your surgeon rules out PT. Some PT (depending on the practitioner) can be very beneficial.

Everyone always suggests the bike. For me, it feels like I'm a hamster on a wheel, but that's just me. If you enjoy it, do it, but stop before it hurts.
 

Layla

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Welcome back! Sorry it’s under these circumstances. We’re happy to read you’ve been here before and felt supported. Thanks for sharing that.

Given what you’ve typed in your post above about your surgeon mentioning you need a THR “immediately” and the fact that we’re all as young as we’ll ever be, there is no time like the present. Wondering if you’re aware of how far out your surgeon is scheduling? Depending upon his schedule and given the state of your hip, you may want to get something on the books. I’d hate to see you suddenly get worse and have months to wait until surgery.
Wishing you comfort during this waiting period.
@isledancer
 

CricketHip

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Well, phooey! I remember my shock at hearing needed a THR- silly me, I thought I had strained my groin.
Hands down the biggest mistake I made was to wait and delay the inevitable. That last 2 months waiting for my surgery date to arrive were some of the toughest months, ever.

Light resistance at an easy pace sounds like it would be enough to keep your body moving.. as others have said, anything more and you could ramp up your symptoms, big time.

So sorry you got that dreaded news when not expecting it.. but soon you will be all fixed up and ready to dance again.
 
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isledancer

isledancer

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Ty for all your comments and support!
I was surprised my surgeon nixed PT. He ordered it prior to my knee replacement and it really helped. It’s good to get feedback about intensity of biking and walking. As a lifelong exercise enthusiast, I’m always tempted to ouch harder. It’s strange that I have no symptoms while exercising, but I do later. Nights are the worst!
I had very little pain when I saw surgeon, so I was shocked it was my hip. He was surprised I wasn’t in major discomfort but said it could go south quickly! When you say hip can collapse, what does that mean?
Now that pain is worse, I’m adjusting to the idea of THR. So I’m sure I’ll schedule soon. I’d like to wait till March. But I’ll see how far out I have to wait.
 

Jaycey

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When you say hip can collapse, what does that mean?
This is a collapsed hip joint. In my case the femur was partially dislocated as well. Bone on bone pain is bad. Collapsed joint pain is just horrid. Baby that hip - you don't want this complication.
Collapse.png
 
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isledancer

isledancer

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Yikes! I appreciate all ur advice to slow down my activity. I think I’ll check with surgeon and get more details in my situation. I usually ask lots of questions. But I was so shocked that my muscle pull meant THR I just left without asking.
 

Eman85

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I can only relate my experiences not any based on medical knowledge. I had bad hips for decades, I mean you need a hip replacement bad. I'd never heard of a collapsed hip from anyone before reading on this board so I just kept on with life. The only thing was told in my thirties was to stop playing competitive sports. That was the only thing I stopped, and yes I had pain after doing things. I can say the pain doesn't get any better until after the THR. A change in diet possibly helped put mine off for a while. Muscle tone and upper body strength help in recovery but an active person will have that already going in. I'd say the biggest problem active people have about a THR is accepting the fact you have to have it. Then the acceptance that it's a slow recovery that no amount of effort will speed up. The no pain no gain thing doesn't work with THR recovery. You know how doing things now cause that deep aching pain that won't let you sleep? Post-op that pain is long gone. But what happens is we get to feeling good and over do and much like the post activity pain causes the bone ache in recovery the over activity causes soft tissue pain for quite some time.
 

wessexmario

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"No pain, no gain" is a false friend.
Pain is nature's way of telling you your body is damaged. Now, when you're exercising muscle, a little over exertion and rest afterwards causes the muscle to repair, usually stronger. But, if the pain is being caused by you creating more physical damage to an already damaged joint, all you will do is create more pain, the joint won't repair itself.

I also found that pain at night was worse than immediately after exercising. I discovered that quite small changes in sleeping position could make quite a difference in how much pain I had, In my case there was obviously "hot spots" in my joint that caused the pain at particular angles and orientations, so I can only suggest trying different sleeping positions, if you normally sleep on your back, try sleeping on your front, or vice versa. If you normally sleep curled up, try sleeping as straight as a log, or vice versa.
 
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isledancer

isledancer

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Ty for your sleeping suggestions!
Im finding exercise a challenge. Knowing how far to go is confusing since I don’t feel pain at the time. It’s definitely a balancing act!
 

Jaycey

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Knowing how far to go is confusing since I don’t feel pain at the time.
I found the best approach was to do half as much as you think you can. If you have no problems the next day, add just a bit more. Stay at the same level as long as you need to. This is a marathon, not a sprint.
 

Coddfish

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In my experience the more fitness you can retain prior to surgery, the easier it will be to recover. So try to find activities that help maintain fitness but don’t overly stress the hip. If you can swim and have access to a pool, go swimming. If you don’t swim well but have access to a pool, walk in the water. Work your upper body in any way you can without loading the hips. All of this is particularly important if you have to wait a while for surgery.
 

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