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Hip Arthroscopy Question about Post-OP Pain (5 Weeks)

EricC

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I recently had a hip arthroscopy done for mixed FAI and a labral tear. The doctor said my labral tear was rather small, but my impingement was worse than he expected and he had to spend some extra time shaving away at the bone.

The initial post-surgical pain did not last long. In fact, I had more pain in my ankle than the hip joint itself. After a few weeks, I was pretty much pain-free.

It has been 5 weeks now, and I have started to become more active. My PT now has me doing things like using an elastic band with leg raises and partial squats.

It has been one day since I've done these new exercises, and my hip joint feels a bit inflamed. On a scale of 1 to 10, it's been sitting between 2 and 3 for most of the day. Is it normal to feel inflammatory pain after exercise at this stage (5 weeks)?

I have another PT appointment coming up a few days. I intend to ask my PT about it, but in the meantime I figure it couldn't hurt to ask others about their recovery experience.
 

Sara61

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:welome: to BoneSmart. Please et us know your exact date of surgery so that we can add your signature for you.

Meanwhile I'll leave you some guidelines for your recovery.

Please read these guidelines.

Hip Recovery:
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

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
 

Celle

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Hello @EricC - and :welome:

Please will you tell us the full date of your hip arthroscopy and which hip it is, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately in the future.
Thank you.:flwrysmile:

it sounds as if the exercises your PT had you doing were a bit too much for your hip at this stage of recovery. Feeling sore and inflamed after them is your indication that your hip isn't healed enough for you to do them yet.

So, ask her to scale back the exercises to the less demanding ones. Hips don't really need much exercise. What they get during your daily living is usually enough.
 
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EricC

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Hello!

The date of my surgery was on March 11th, of this year. I think I will ask her to scale back on the exercises on our next meeting. She did advise me not do any exercise that cause pain. I think the leg raises are the recent irritant
 
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FCBayern

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If you aren't icing at this point you should consider it @EricC particularly if the hip is inflamed. It can help for weeks to months afterward, a minimum of 45-60 minutes at a time to be effective. :ice: :ice: :ice:
 

Mojo333

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Hi @EricC
Welcome to the forum. Certainly was a great source of advice, information, and encouragement for me during my recovery from bilateral THR.
It has been 5 weeks now, and I have started to become more active. My PT now has me doing things like using an elastic band with leg raises and partial squats.
The resistance bands were unhelful and too much stress on my injured legs...ditto for squats.
Too much too soon, in my opinion.
Walking is all that's needed at this point and icing is key to teduce inflammation and control pain.
Some targeted PT can be helpful later on if needed for a particular issue but I would consider just giving it a rest.
Your legs are weak because they are injured and time will certainly be the greatest healer.
 
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EricC

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If you aren't icing at this point you should consider it @EricC particularly if the hip is inflamed. It can help for weeks to months afterward, a minimum of 45-60 minutes at a time to be effective. :ice: :ice: :ice:
Thanks, I do ice the hip down after PT sessions, and it definitely does seem to help!

Walking is all that's needed at this point and icing is key to reduce inflammation and control pain.
I did rest it yesterday, and the pain seems lower today. I'll likely continue my PT exercises, but only the ones that cause no pain. I plan on talking to my PT about straight forward leg raises in my next session, as those seem to be the most problematic for me. I got what felt like minor pain in my adductor muscles while doing them, and then the inflammation later on. Interestingly, backwards leg raises and sideways leg raises cause no pain.
 
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Elf1

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I agree with @Mojo333 that right now what your hip/leg needs is some gentle walking, daily activities and icing :ice::ice::ice: and elevating. Hips don't really need formal PT, they're pretty good at recovering on their own. And, usually when you're feeling pain either during or after PT it's your body saying stop.

I'm also very surprised that your PT is open with the virus going around. All the ones around me were closed in the hopes of helping to stop the spread. Don't know that I'd be wanting to risk any type of infection, especially this early in your recovery. Wishing you the best.
 

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Hello and Welcome to BoneSmart. Thanks for joining us!

I echo the same sentiments above. PT is not really necessary and I certainly wouldn’t be doing anything that causes pain. I’m not understanding either why during this time of social distancing PT is still seeing patients. Unnecessary, unsafe, risky. Please reconsider for a time and allow your leg to heal on its own without pushing it.
Wishing you the best. Be safe and stay well! :)
@EricC
 
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EricC

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My past few sessions have been virtual PT sessions. They are not currently seeing people in person. I talk with them over the phone in a video conference and they give me exercises to do.
 
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EricC

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Quick update with some additional information - I had been relatively pain free on the second and third weeks after my surgery. On the fourth week, I felt mild inflammatory pain after doing PT exercises, but that pain never lasted for more than a day. Week 5 has been the first big setback for me, as the pain has lasted for 4 days now since my last PT session.

On the first day after my last PT session, the inflammatory hip pain averaged 2/10 for most of the day, though it did spike to 4/10 for a short while. The pain settled to 0/10 before bed.

On the second day after my last PT session, I did do some exercises, but only the ones that I had been doing while pain-free. I used a static bike with no resistance for a few minutes and walked more than usual as well. I felt minor pain throughout the day, between 2 and 4. Once again the pain seemed to settle to 0 before bed.

Yesterday was the worst. The pain averaged 3/10 during the day, and would occasionally spike up to 5/10. At night, it went up to 7/10 and I had to take a couple of IBUProfen to sleep. Prior to this, I had not taken any painkillers for weeks.

I am not sure why it hurt so much yesterday, other than the fact that I was walking around more than usual the day before. I have not been cleared for full weight bearing yet, so I currently walk with a single crutch. There was no pain while I was walking.

Today I am resting and elevating my leg, and minimizing my activity. My pain is currently only 2/10. Here's to hoping that it stays this low.
 

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When I have recovered from any surgery or injury, there always are increased aches and pains that accompany more activity and movement. But those are understandable and manageable, and typically subside quickly. If the pain keeps returning, or worsens, I do a "reset" where I stop any extraneous activities beyond meeting my basic needs, and I spend a few days doing the things I did right after the surgery. So I rest, drink lots of fluids, ice, elevate, and basically let things settle down for a few days. Only then do I gradually increase walking and movement. I think sometimes when we try to just back off a little bit,(like doing a few exercises, but not all, or switching from one colored band to a lesser resistance one) it may not be enough to really let the whole area rest and recover. It might be worth a try for a week or so if you continue to experience daily pain!
 

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Hello Eric,
Would you be willing to step away from PT for a week, at least? Please consider it.
You could use walking as your only form of exercise, but not to excess. I’d also recommend you continue icing several times per day for no less than 45-60 minutes, each time you ice and take OTC pain relievers as needed.
I am not sure why it hurt so much yesterday, other than the fact that I was walking around more than usual the day before
I think you probably answered your own question. At not even six weeks post op, you’re still very early into recovery. Please take it slow and easy and I believe you’ll enjoy steady progress.

Be safe and stay well.
 
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EricC

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Thanks for the replies, and sorry for my late response. I've been in bed resting for most of the day and have not checked the thread. Earlier today my pain was in the 2 to 4 range, and now it's between 0 and 2. So, it's already improving with rest. I have decided to continue to just rest and do gentle walking for at least the next few days, until I my next PT appointment where I'll reassess things.

On these forums I have read many stories of PTs who force people to do painful things, resulting in injury. Thankfully, my PT does not seem to be like that. She does not try to force me to do anything painful. In fact, she tells me to stop the exercise if I feel any pain at all. This is likely my fault, not hers, as I first started to feel mild inflammation off and on during the exercises on the 4th week. That pain was mild and went away within hours, so I assumed it to be muscular and a normal part of the healing process. I should have said something when we upped the intensity this week.

Anyway, I will be taking it easy and focusing on walking.
Cheers!
 

Eman85

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Sounds like you've got the cause of the pain figured out. Generally it doesn't hurt when you're doing it but either later that day or the next day is when the pain comes. Even if it's mild pain when you go back to the activity it really compounds in the following days. The cure is always rest and ice. I can say from experience it's months instead of weeks before I did simple exercises without pain.
 
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EricC

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Update:
I rested the leg for most of week 6, and walked with a single crutch. There were some ups and downs. On some days, I would have no pain or next to no pain. On some days, I would have pain, which was generally between 2 and 4 out of 10. I couldn't identify a reason for these ups and downs, as I was mostly just resting and gently walking. My hip seems to have a mind of its own sometimes.

At the beginning of week 7, my pain was very low, and I began to get off the crutch and put my full weight on the leg. I started using the exercise bike again, at a low setting. The combination of these things probably caused mild pain the day after. Currently my pain is sitting between 2 and 3.

When the pain comes on I mostly feel it in the abductor muscles and glutes, though I sometimes feel it in the joint itself. I assume that is normal at this stage and I just need to rest it when it comes on, as I have been doing?

I have noted that when my hip is irritable, sitting for prolonged periods of time near 90 degrees seems to irritate it - I guess because it puts pressure on the surgical site when it is inflamed.

Lying face down on my stomach seems to with a massage pillow to support my neck seems to be extremely therapeutic and great at relieving pain.
 

Mojo333

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:wave: Just wanted to pop by and say I hope all is steadily improving. It was very hard for me to stay patient and find the line between enough and too much...hopefully you are working this out and feeling better by the week.
Hope today is a Good Day!
 

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sitting for prolonged periods of time near 90 degrees seems to irritate it -
I experienced this for quite awhile myself. Especially while driving. It did disappear with time.

Lying face down on my stomach seems to with a massage pillow to support my neck seems to be extremely therapeutic and great at relieving pain.
Thankfully you‘ve found a comfortable position that brings you relief.
I hope you have a nice week and an enjoyable Memorial weekend! :SUNsmile:
 
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EricC

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Things have been going better for the most part! Towards the end of week 7 I was back to a painless state. I had another PT session at the end of week 7, and we did gentler exercises that did not cause pain.

I continued doing exercises through week 8 and 9, and by that point the exercises that had set me off before caused little to no pain. I began walking more as well.

This week my hip became inflamed again, after I went on a longer outdoor walk on uneven terrain for 20 to 30 minutes. I went at a slow pace, but I think the uneven terrain messed with me. The hip was inflamed for about 3 days, but not as bad as last time and it has started to get better with rest again.
 

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I would try and ice it and elevate it as well. Even now I do that when things get a bit irritated. Always seems to help.
 

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