THR Psoasis Relief

[Layla]

Hi @Jws. I hope you’re having a good weekend and enjoying some progress. Still early days and time for improvement. Hang in there, we’re rooting for you!
I apologize for the mini derail below -

Hello @smokey1
It was thoughtful of you to thank Honeybeast for the article she left under post No. 5 in this thread several years ago. Just an FYI, Honeybeast may not respond since she hasn’t been on the forum in over two years. Possibly others will reference the article due to your recommendation. Happy healing to both you and Jws.

 

[Jamie]

@Jws. We now have a FastTrack registration page for OneStep that no longer requires emails back and forth. Just click on this link and sign up! It's still completely free for now, but that's not going to last much longer.

OneStep App Request

Since December, BoneSmart has offered a number of pilot tests and special promotions with our partner, OneStep. Members were allowed to use this unique app at no charge to help us evaluate the program’s effectiveness for prehab and recovery for joint replacement patients. Feedback has been...

bonesmart.org

 

[Layla]

Hey @Jws.
Its been two months to date since your latest procedure. We haven’t heard from you in awhile. I hope that’s a good thing and you’re back to enjoying life without pain. Please let us know how you’re doing next time you stop by.
Wishing you all the best!

 

[Jws.]

@Layla @Hip4life @SaraK @Jamie @Meldoy Ok It's now 3.5 months post Psoas Release. It has been a roller coaster (as always) of healing. The surgery went really well (ty- Pat- got your message you're more than welcome!) So I have to do some housekeeping for those who are thinking of this surgery are clear as to what it actually is. It is a FULL release of the Psoas Tendon at the lesser trocanter (i.e less risk of infection , no instability issues since its not near the implant, and you will have weakness in your operative leg which will only affect you mainly for me at getting my operative leg in the car, picking leg up to tie shoes and put sox on and groin pain when walking )
The actual surgery is a breeze compared to others 45 min- beginning to end tops (prep, iv, ,recovery-GA) .
Rehab- basically none just healing , time and ???

The main glitches I have are:
1. In the area of my posterior scar (not the scar) but either the greater troch or piriformis or ??? and if anybody knows I would appreciate the info as it STOPS me walking and causes groin pain ..The pain in the "butt" area pulls on my groin, causes groin pain and makes me limp... The interesting part is that it must be some sort of inflammation as it is relieved somewhat with nsaids. Have virtual with Surgeon next week and will find out...may need shot of cortisone.
2. Given the three surgeries I have had , I was unable to work out and gained 25 lbs. That caused a lot of soft tissue issues. In process of losing it now and feeling better.
3. Lifting leg only about 6 inches now when sitting and able to get in car but putting my right leg in has to be just at the right angle or I will have pain in back.
4. Don't know if anyone else had this after a FULL RELEASE not lengthening but full release, I would be tilting forward as their was no PsoasTendon to stop me. Had to compensate for that. (weird feeling)
5. Still have that initial electric jolt of pain in groin area by crease of thigh and adductor after sitting ,when getting up ( OS says that the body even though you don't have a psoas tendon will still push up like there is a tendon and be sore ??
6. Also still cant pick my leg up and put on my sox and shoes (don't think that will ever resolve? feels like "iron" is there holding me back.??)
All in all best surgeon ever to date..easiest surgery to date... have to GET RID OF THIS BACK BUTT PAIN and groin pain.\\

All thoughts would be appreciated!..

 

[Hip4life]

Hi, Jeffrey. Even at this point I believe your body is still learning to adjust back to a new normal for you. Now you have a more normal gait, your other muscles are still learning their new roles, and you’re adjusting to it all. In my experience, the aches and pains in the soft tissues continued to shift around a bit until it finally settled.

I do have some limited active range of motion in those exact movements: getting into the driver’s side of car (my operative right leg) and putting on socks and shoes. I can manually assist these movements into a larger range but without the iliopsoas, it is what it is. It is something that doesn’t significantly limit me or bother me and has just become “normal” for me at this point.

Stretching out those muscles that may have become tightened during the long duration of the IP tendonitis you experienced is very important at this time. It might take some time and you might want some PT to help. One thing you reminded me of was that my piriformis did seem to bother me as well as the IT band once that tendon was released and the gait then shifted again. The one thing that really helped me was foam rolling those areas, especially the piriformis. That with some specific stretches eliminated that pain. The IT band pain also resolved.

I still think it’s still just a matter of time and a little more work and you will be putting these things in the rear view mirror. I expected things might not be 100% perfect afterward going into this type of surgery. However, the relief from the tendonitis pain and ability to resume 100% of my physical activities were worth the very small amount of limited range of motion I wound up having. I have every confidence that you will get there, too. Keep the faith and hang in there. Let us know how the tele visit goes. We’re here for you. As always, Pat.

 

[Jws.]

All
I don't get it at all...was ok for 5 months (walking better)after full psoas release at lesser troch.. but always kept the "groin pain " when getting up..but had no psoas anymore ?... in the last two weeks I got hit with pain by the greater troch, then pain traveled intensely to the groin while resting and for the last two weeks it has been kicking my butt intensely.
I started having shooting pain in my upper thigh off and on...and significantly worse groin pain (no right hip,no psoas ???so why groin pain) and my knee started buckling ...went to hernia doc to see if hernia and she asked where pain was ..i showed her by troch in butt and she palpated it and said "feel this" and she said is this where your pain is ? I said yes and she said that's all bone ..there is no muscle (glute) there like on other side covering the bone ..set me up for ct to see if i got a glute tear..in addition i thought if not a glute tear then maybe "loosening" (thigh pain, buckling, groin pain) ...had xrays taken today and ct of the r hip and no glute tear and no loosening (so they say)..i am so damn tired of this hip and its up ands downs...pain & nauseas diminishes with zofran and nsaids...almost 4 years of this constant pain and emotional up and downs.. need help if you got it...thanks...thought the psoas release was it!!..not yet.. my pcp says do mobic for two weeks and blow the inflammation out of the pelvic area... @Hip4life @SaraK

 

[SaraK]

Ugh! You've been thru so much! Meloxicam (mobic) was better NSAID for me than other meds. It might provide some symptomatic relief. If not a tear, what did doctor say RE possible reason for difference in muscle on the 2 sides? Are there other tests that can be done (MRI with contrast, etc.)? Have they looked at any possibility of spinal issue causing the pain? Cortisone injections might help but only if they target the right spot. I'm just spitballing here about some of the things suggested by doctors when I had my issue (pain management doctor before my first hip replacement decided after 2 minute non-exam that it was my spine not my hip and wanted to prove it by giving me oral steroids - I refused because of my diabetes).

Have you seen a physiatrist? Different focus from surgeon and may be more likely to diagnose soft tissue problem.

 

[Hip4life]

Oh, wow, Jeffrey. I’m so sorry. How frustrating this must be for you. I can only agree with what your doc has done and suspected so far. Since there are other muscles taking on the job of the IP, perhaps something has gotten overworked there. Does backing off of physical activity for a bit and icing help at all? I know I’ll have various “aches and pains” depending on the level of activity but nothing lasting any length of time to send me to a doc for evaluation.

The only other thing that comes to mind that it might be is trochanteric bursitis. Did she say anything about that possibility? If I’m not mistaken, the doc initially removes the bursa in that area but it can grow back. It could get aggravated as you get back to all the usual activities. I know I injured my left hip (non THA) with a fall and the bursa on that side was really sore and made the thigh sore as well. My PCP said that my left hip could take up to 6 months to heal completely and then if it was still bothersome, we would investigate further. My OS messaged me with the same. It has improved with time, ice, and NSAIDS. You know me, I also haven’t been sitting in a rocking chair that whole time, either. Lol.

I’m thankful that none of your imaging is showing anything major of concern. Let’s hope the anti-inflammatory does its job and you are feeling better very soon. I feel for you, my friend. Keep us in the loop.

 

[Layla]

While I don’t have any advice to offer, I am sorry you continue to be plagued by set-backs with your hip. It’s been an awfully long road for you. The results of your last procedure looked promising and hopefully in light of nothing serious showing up on the imaging you soon find relief through some TLC and rest. Wishing you comfort and a return to the way you were feeling after healing from the Psoas release. Hope you get to feeling better soon.
@Jws.

 

[Jws.]

I don't know if I am posting in the right place but you guys will fix it. I am in a real dilemma with this hip. I have serious groin pain every day when I wake up and pain in the posterior part of my glute where the surgery scar is and it impinges me from walking easily. It is a burning feeling. I contacted Mayo Clinic and talked to an ortho there . He suggested I come see him and maybe " hydosection" or something like that would work where they go in with a revolving needle an pull out scar tissue that may be impinging a nerve. However my main problem is I was diagnosed with Prostate cancer with a PSMA PET Scan and I am literally frozen and holding back getting a transperineal biopsy for fear of getting the hip infected and then you all know the nightmare that entails and that just about puts my "winter years" gone fighting with a spacer,iv's, revision , 25% higher rate of dislocation...etc,etc.. does anyone know the rate of infection from a transperineal infection..this hip may be literally killing me. I am driving myself nuts. All this from a hip that shouldn't have been replaced in the first place...it's going on 4 years now of constant pain everyday.. and there is no out..Revisions won't work. The last ortho I saw said to me "LIVE WITH IT" there is nothing more we can do "unless you go see PHIlipon in Aspen Colorado and maybe he can fix it as he is the best in the world" ..this was the orthos response. If anyone has any suggestions I would appreciate it. anyone know if hips get infected easily from infections caused by prostate biopsies or a way out of this pain. Thanks Jeffrey

 

[Layla]

You are posting in the right place @Jws.
I am really sorry you continue to be plagued by issues with your hip. I haven’t heard of the procedure you mentioned, but plan to read up on it. I’m sure you’ll receive some responses here, so please check back. If the option you mentioned turns out to be your course of action, I hope it brings you permanent relief. Your journey has been long.
Wishing you a peaceful weekend.

 

[Layla]

This is what I found -
Nerve Hydrodissection is a medical procedure that aims to free up scar tissue or adhesions on a given peripheral nerve (1). The procedure utilizes ultrasound guidance to visualize both the needle and the targeted nerve. Medication is then injected through the needle to free up the scar tissue. Nerve Hydrodissection is a minimally invasive treatment option for many peripheral nerves that are compressed or entrapped by scar tissue.

 

[subie2021]

For your biopsy you might talk to your OS and/or the urologist to see if a course of antibiotics would be appropriate if you worry about infection.
The skin in the area of the biopsy will be cleansed/disinfected, and the needle will be sterile; and you'll probably get instructions about aftercare.
I hope you get everything sorted out soon. Best wishes.

 

[Hip4life]

Hi, Jeffrey. I’m so sorry that you’re still dealing with that hip PLUS your new diagnosis. With any big diagnosis, it’s common for your brain to go into panic mode and get overwhelmed. You need to prioritize your action steps. You need the biopsy. That’s your first priority.

I had major abdominal surgery in 2020. They gave me IV antibiotics for that surgery so I didn’t even worry about my hip except that it might get stiff during the long surgery. Everything went well. I feel that anything you need to get done concerning your prostate, should be your priority. The rest will fall into place. Just make sure you talk to your doctors about your concerns. No reason to worry about something that may not even happen. We do know what will happen if you don’t take care of your prostate. Blessings as you navigate this new challenge. Keep us posted. Pat

 

[Layla]

@Jws.
I noticed you edited your initial post today after my two responses. I‘m sorry for your recent diagnosis and wish you healing and good health going forward.

 

[Sohowarrior]

You must have the biopsy as soon as possible. Your doctor will take all adequate steps in advance to insure that your hip implant does not get infected, including administering antibiotics. That’s your priority now. Then deal with the nerve procedure, just make certain you find a physician highly skilled at this.

 

[Jws.]

I see Pat is staff now and doing a wonderful job as always...going to have to figure out how to re-navigate and post here. Suffice to say it feels good to be back. Joint and hip wise nothing new except "old age" aches and pains". This site introduced me to, Pat, and Dr. Burt. I can never do enough, or praise enough that doc..he literally saved my emotional and physical life with his exceptional Psoas Tendon Release, which is part of my life now..barely noticeable. Always willing to offer support or encouragement to others facing the same situation. Jeffrey

 

[Hip4life]

@Jws. Hi, Jeffrey. As you discovered, we have a new format. Here’s a little more about that, in case you might be interested. There are two tiers to our membership now: Basic Member, which enables you to only search the forums, read about other recoveries, and post on your recovery thread.

The second tier is the Insiders Club that gives a more personal and interactive experience, as well as in depth input from the Bonesmart Staff. It’s available through a multi-level contribution. Here’s a link that gives more detail:
Membership/Insiders Club

As a non-profit organization, the small contribution cost goes toward keeping BoneSmart available for everyone.

Since we last interacted, I’ve had a few adventures: left hip abductor repair, a shoulder replacement, and two thumb joint arthroplasties. I’m glad you’re still doing well and that you’ve gotten the relief from the tendon release that I also continue to enjoy. It’s been great to hear from you. I did pass along your interest in helping others on the forum to the appropriate people. -Pat

 

[Layla]

Hope you had a nice Christmas, jws. It's good to read that you're doing well after all these years and all you've been through. May it long continue. Best Wishes for 2026!
@Jws.