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THR Psoasis Relief

SaraK

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I wasn't immediately able to lift my leg while seated. That took some time and was the hardest part of PT for me. It was about 4 days when I could lift it enough to be comfortable driving. Whether lengthening or release, it takes time to heal and retrain. Set aside all expectations and timeframes. Just relax and let things happen.
 

Jamie

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@Jws. It's not the healing that's going to tax your patience in this recovery. It's the retraining of your muscles to take over the duties of lifting and moving that leg. This is months, not days. It may take some targeted therapy for you to be happy with the result. If you haven't had this discussion and asked these questions of your surgeon, please write them down and talk about it during your next appointment. He is the best one to give you time frames as he knows what he saw and did during the surgery.

Your first order of business is to allow your body to heal properly from the surgery for several weeks. When do you go back to see your surgeon? Priority number one should be healing between now and then. You will have lots of time after healing to work on function and strength.

I suggest you consider enrolling in a program we have available now at no cost to our members for the OneStep therapy app. If you're interested, I can send you information. The app is unique to most therapy programs in that it is based completely on gait analysis. Exercises are tailored by your therapist to your particular requirements. It's not a one-size-fits-all approach.
 
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Ok.. @Hip4life @SaraK @Meldoy So now it is day 7 and I can lift my leg maybe 3 inches and then I encounter sharp "back pain" as I try to lift it higher. Getting in bed is easier but not there yet. in and out of car, difficult, etc.)
Hopefully , the back pain will go away and the leg will be able to go higher. (The lifting movement is absolutely tied to this one area of the back...if I am not attempting to lift the leg there is no back pain when standing or walking and I don't want to cause a "permanent back pain" so I am hesitant to keep trying to lift the leg or push too much.)
I have started walking for the last two nights maybe 40 minutes and that seems fine except the new reality is somehow I have no "rudder" because the I have NO psoas. The psoas pretty much keeps your legs in check in the walking process much like synchronizing them.. I can feel a subtle change required now to more coordinate both legs from going to apart from each other.. In addition, since the psoas controlled a lot of the balance mechanisms, I sometime will feel my body going slightly more forward than I want it to and have to manually correct and stand back straighter.
I am hoping my brain will adapt and synchronize these movements as time goes by but now when I read the "duties" of the psoas I can see the lack of the psoas exemplifies physically that those "duties" are somewhat lessened and /or gone and have to be retrained. I am just keeping this update diary for myself and other BS members so if they have this procedure they will feel comfort that their after effects are not solely theirs alone ...

Given, that I have had both the lengthening and the TOTAL RELEASE, I can tell you the lengthening at this point in time was much easier and less complicated to live with(second day ,leg could be lifted higher, getting in car ok, bed ok, etc body and walking still regulated by the Psoas.np)
but unfortunately I ended up still with groin pain not being relieved.
Therefore, if you're stuck on the acetabulum cup, an adhesion, or a spur, with the lengthening you will possibly still HAVE GROIN PAIN like I did as you did not release enough to overcome the obstruction and need the full release to make sure that the psoas pain in the groin is definitely gone.
( You could also get very lucky and be totally fine like many who have the partial release ,lengthening, etc. at the central compartment, peripheral compartment and it's done there and then.)If you have any questions re: either of the two releases bring 'em on...would be happy to answer them..
Any thoughts would be appreciated as well ..JWS
 
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SaraK

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I'm glad you're seeing some improvement. Is the back pain related to the piriformis? The psoas and the piriformis affect each other. I don't know if you could be triggering something in the psoas where it attaches at the back (not sure if that could even happen). Are you going to PT? The PT or the surgeon might be better to address those questions. You may also benefit from some PT targeted at strengthening the other muscles. That can help to give you a better "rudder."

Be careful about that much walking when you're still having that feeling. You're just starting training with those other muscles and they'll get tired more easily. After my hip replacements, I would start limping or leaning if my muscles got tired. After some rest, they were good to go again. Can you break up your walk into smaller chunks of time with a good rest in between?

I basically sat on the couch for a few weeks after my shoulder surgery. Then I had issues with that rudderless sensation. So it is important to keep up with the exercise - just remember that it takes time to train for a marathon.
 
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@SaraK @Hip4life @Jamie @Layla Sara , prior to this surgery , I was having pain in the Trochanteric bursa and the piriformis. (you know how the psoas can "mess" with all these tendons, so my OS and I decided to give me while I was "out " a Peritrochanteric cortisone shot during the surgery since he had the xray right there in the OR. (he was really a "caring" nice guy who went the extra mile to get me better). The peritrochanteric shot is a shot right in between the troch and the piriformis and the cortisone 'bleeds" over both tendons. When I awoke had no pain whatsoever in either of those tendons.
However , it may be that the piriformis is so attached to the psoas that this extra strain of lifting my leg breaks through the cortisone shield and gives me pain when I try and lift. I am trying to walk just enough to prevent adhesions and bring blood to the area and just enough not to irritate anything else if I feel pain..
This time I will take it easy for the next three weeks to let the surgical pain heal and not upset healing process . "very short not intense walking -20-30 min to prevent adhesions every other night.")...yesterday after I walked I felt nauseous 5 hours later so I will definitely not be walking tonight.
I am feeling swollen in the groin area and I am hoping its not the psoas (but I have no psoas) so that concerns me..It could be the swelling from the cutting of the psoas being inflamed by the walking too much.(trying really hard not to get to aggressive and balance-but you know very well what that's like.)

Any other suggestions how to keep the scarring down to a minimum,. I really need this surgery to work, as we both know total REVISION is not what I want nor do I think at this point it would do any good. Might as well work with the "devil" I got and I think this full release may work in time...fingers (all of them crossed!) all thoughts welcome!...best JWS
 

SaraK

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I just remember from my various hip surgeries that shorter sessions but more frequent allow you to get the same amount of exercise/loosening but are more well tolerated. They also give you the ability to see how the last session affected you before you try another. Overdoing it is kind of like being in the sun too long. You don't realize how sunburned you are until it fully develops hours later.

Another analogy from my lifting. I can do a greater total volume of weight if I rest a few minutes between sets. It allows me to lift more weight and a larger total number of reps. Rest is as important as exercise! (And yes, don't quote me on that on my thread!)
 

Mojo333

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Rest is as important as exercise! (And yes, don't quote me on that on my thread!)
Important indeed, and yes... You may see this quote again.:heehee:
 

Jamie

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@Jws. Sara is right on target. You're just out of surgery. Trying to walk for a 20-30 minute session is way too much. Break it down to no more than 5 minutes at at time spread throughout the day. If you overwork your soft tissue and keep them irritated, the tissue can be "hotter" and less lubricated. The dryer tissue may be more likely to stick together in places where the surfaces should be gliding over one another. This is what happens when you get adhesions.
 

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Yes, it’s such a balancing act to do enough but not too much. There are generalities but everyone has unique degrees of soft tissue reaction and recovery. I found walking was the best those first weeks and gently starting doing everyday movements, like stairs in short sessions. My instructions were to resume activity as tolerated and that’s what I did based on how I was feeling. I was cleared to resume work (12 hour shifts in healthcare) anytime after 1 week but took 3 just in case. My job included all sorts of regular daily activities and then some so I needed to be ready and I felt I was. Sure there was some lingering strength issues and stiffness with various aches and pains. Ice, rest, and elevation all helped with that initially. Then it wasn’t necessary. It will take time, however long that is for you, to build up those muscles that will now take over the job of the IP. The rest of the pelvis and back/spine will align more normally so there may be some aches and pains there as well. I pretty much got back to normal within 6 weeks and really stopped thinking much about it after about 3 months when I felt things finally had “settled.” Like I’ve said, some minor residual decrease in active ROM is what I’ll be living with but it doesn’t limit me in any significant way. I’m confident you’ll be there soon as well. Blessings, Pat.
 

Jamie

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@Jws. It's been a couple of weeks since we've heard from you and I'm hoping you're doing well. If you have time, an update would be appreciated. You know we all care about you!
 
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@SaraK @Jamie @Hip4life @Grammy57 ...Ok short update..wrote longer one and lost it in computer..30 days post surgery...lifting leg 3 -4 inches..than pain in back s-1 if I go further, getting in car better..walking better..not concerned about weakness see improvement day by day in all hip flexor movements...VERY CONCERNED about the pain and swelling (I think) in groin area again with nausea ...(however we just moved into new house so a lot of pushing,shoving, lifting. etc. you get the picture ) and that could be causing the above plus hip pain and this "rubber bandy pain" and tightness between groin and the lower part of my original THR scar in butt area. Also saw PT recommended by Doc and he said I should try :
1Hemibridge
2 Right sidelying adductor pullback
3 Left posterior capsule stretch
4. Left sidelying right glut max
because my brain has to acclimate and my right leg has to clear my pelvis more...
(are these really necessary and does anyone recognize them and think they would be helpful)
all I know is I didn't expect this PT ,etc..and thought I would be as lucky as Pat and Sara and heal and then "dance" and ???
So now with the similar pre-surgery groin pain and swelling in that area that ominous voice in my head is coming out " Jeffrey -it didn't [email protected]"....
Since it's only been 30 days post op , I am probably being impatient and maybe the "House thing" did not help much.
Anyhow , I was in a rush and this may be a bit convoluted but you get the picture...any words of encouragement would be greatly appreciated..or thoughts on time parameters on the different segments of the healing that you have gone through with this surgery. Thanks and best JWS
(Have not talked to Doc since surgery ..was to have virtual today but rescheduled until next week.)
BTW..any thoughts on light "spinning "to loosen things up...20 min only
 
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Administrative note: @Jws. Here is the post you lost. It was in another member's recovery thread. I moved it to yours so that other thread wouldn't get derailed. Even though it's pretty much a duplicate of the post above, it provides a little more detail, so I'm going to leave it.

@Grammy57 @Hip4life @SaraK @Jamie ..ok I wasn't going to post as I am not feeling it today...I am now officially 30 days post LT psoas Release and I'm going to call it like I "feel it"...I can lift my leg up maybe 4inches when sitting,(higher than that I hit my nerve in spine or s-1 and get pain), I finally yesterday got in the car stepping in w/some mild pain) as opposed to sliding in and lifting my leg in..I never had problems w steps and don't now, .
So we are fixing up and moving in new house and I am lifting.pushing ,shoving, (you get the deal for the last week. ) Prior to that I was walking with some groin pain and swelling in the groin, now today significant groin pain with nausea, when walking. My walking before this "house" thing was much "looser"and felt freed up most of the time.
I am not so concerned about getting strength back in the leg as I can see it gradually coming, I am REALLY CONCERNED about the swelling and groin pain which feels like I had before..but at times is much better..doc told me to talk to PT and he said this is what I need to do..
1Hemibridge
2 Right sidelying adductor pullback
3 Left posterior capsule stretch
4. Left sidelying right glut max
all with my left leg...
he says that the right leg is "not clearing the pelvis as well as the left"...and I have to reeducate the brain.. any thoughts on this?
I don't know- I wanted to come out of this surgery lucky like sara and /or pat and go on with my living , no PT ...didn't t have to be perfect , just no groin pain, and walking fine, and maybe some weakness...
Maybe I am being impatient and it will be that (since only a month post) but I* fear that ever present ominous voice in my head saying "IT DIDN"T WORK!" ...(because the groin pain and the swelling are so similar to before surgery. any suggestions, thoughts, and time parameters for the different parts of the post healing with this LT Release...ty..
 
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Jamie

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Since you just had your release a little over a month ago, the activity you have been doing in trying to move into a new home is most likely the source of your pain. Please try to scale this type of thing back for a while. You're still recovering. Call on friends and relatives. Hire work done. Do whatever it takes to allow yourself the time your body needs to heal properly and rebuild itself.

I'm going to tag @Pumpkin to respond to the exercises and length of time for healing and strengthening. If you can talk with your surgeon, ask the same questions of him as he knows your situation better than anyone. If he feels some therapy might help you, he could order it for you.

I know you want this to all be over and behind you, but please don't try to hurry the process too much. The pain you're experiencing means something and shouldn't be ignored. Most likely it's what you suspect....you've done too much for this stage of your recovery.

Rest for a week or so. Ice or heat (whichever feels best) and take something for any pain you're having. Then let us know how you feel after a few days or a week.
 

Jamie

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@Jws. A week or so ago I sent you some information about the OneStep therapy program. Were you interested in registering? Do I need to resend it to you? It was a Personal Message here on the forum.
 
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@Jamie ,
Please send me the copy of the email and resend the one step therapy personal message...thanks
 

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Hi, Jeffrey. You went a long time with the IP issues. I think it may take a little more time for your body to heal and adjust. Even though I had significant relief initially, I still had my days where I got stiff and sore if I did too much. It took a little over 3 months for me to feel like everything finally settled and felt “normal.” Even though I didn’t require PT (nor was it “ordered”) if I had had ongoing issues, I’m sure it would have been recommended. However, I still did my own stretching/strengthening routine. Yes, there is no IP muscle tendon to get sore anymore but those other muscles are learning their new jobs and are in the same general area. It may require some PT to help get everything stretched out and playing nice again. All those muscles and the pelvis in general have been limited in their movements by the sore IP tendon. Yours even more so due to the time involved. I know it’s hard to be patient but 30 days may be just too soon to expect it all to be okay. There is much improvement to start but then, like the THR, it levels off and takes a while for all the niggly-wigglies to go away. I also had to retrain my brain to not interpret the decreased ROM and slight stiffness as pain (like I was in the habit of expecting pain?) I know that sounds kinda weird but it was true. As time went along and I was able and brave enough to do more normal movements, it helped me to differentiate the two. Healing is more than the surgery site and initial soreness to go away, as far as I’m concerned. There is so much more involved with chronic issues. Be patient with yourself, my friend, and use all the tools you’re offered with a hopeful and open mind. It just will take a little more time. Blessings, Pat. ❤
 

SaraK

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I agree that it takes time to get back to normal. You've gone so long with your body and brain making adjustments in how you move that everything is out of whack. I remember my secretary commenting after my cortisone shot that I was walking more upright and more fluidly than I had in a long time. The One Step program Jamie mentioned might be a very good tool for you to help identify and reverse those accommodations that are now bad habits creating their own issues.
 

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Honeybeast,
That was sn excellent article from the Holy Cross center with Dr. Leon. His advice is spot on concerning what to tackle first ? Hip, Knee or Back. This is a must bread for those who have multiple areas of concern. I had my rt hip done , then my rt knee and it has definitely improved my back pain.
 

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I still have pain, especially if I do too much. For me, too much is usually too much walking or too many stairs. But, I am learning to recognize when to stop. My worst pain is still at night. It always has been and still is. I am going on 3 months post-release and still healing. I still have trouble lifting my leg very high. I hope you do better soon.
 

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