THR Sarak - There's Life After a Hip Replacement
- Thread starter SaraK
- Start date
OP
OP
Good morning, Mojo! Yes, I will have a post op check at the 2 week point with PA. It sounded like there would be another followup with surgeon later but I'm not sure.
What a week (or should I say 5 days). I am now at least where I was presurgery on range of motion and ability to move and have virtually no pain - even on things that hurt before (like putting on socks and shoes). Other than a "just in case" bedtime dose on Tues, no narcs since first day.
Every day I had noticeable improvement in the stiffness and range of motion from morning to night to the next morning. When I went back to work Thursday (timeframe doctor said was common), I had to have my son take me to the mass transit station and pick me up in the afternoon because I couldn't lift my right leg enough to hit the pedals. Friday, I comfortably drove to work.
I slept in the recliner for the first 4 nights to be able to keep the ice on my thigh (and because I thought moving around in my sleep might be problematic). Last night I slept in my bed with no pain rolling over.
I had my first PT Thursday. Measurements, massage, stretching and then a few exercises. Things that primarily use other muscles like bridges, etc. are easy. Things that use the psoas not so much. We'll need to rebuild strength. PT approved going to the gym and doing some of the exercises I've been doing without problems but trying a couple different ones each time and building up on weights to give time to see reaction afterwards. So far at about half of prior weights on a few with no issues.
It's still early and the real benefits are yet to come, but so far, I'm so glad I was finally able to get this surgery!
What a week (or should I say 5 days). I am now at least where I was presurgery on range of motion and ability to move and have virtually no pain - even on things that hurt before (like putting on socks and shoes). Other than a "just in case" bedtime dose on Tues, no narcs since first day.Every day I had noticeable improvement in the stiffness and range of motion from morning to night to the next morning. When I went back to work Thursday (timeframe doctor said was common), I had to have my son take me to the mass transit station and pick me up in the afternoon because I couldn't lift my right leg enough to hit the pedals. Friday, I comfortably drove to work.
I slept in the recliner for the first 4 nights to be able to keep the ice on my thigh (and because I thought moving around in my sleep might be problematic). Last night I slept in my bed with no pain rolling over.
I had my first PT Thursday. Measurements, massage, stretching and then a few exercises. Things that primarily use other muscles like bridges, etc. are easy. Things that use the psoas not so much. We'll need to rebuild strength. PT approved going to the gym and doing some of the exercises I've been doing without problems but trying a couple different ones each time and building up on weights to give time to see reaction afterwards. So far at about half of prior weights on a few with no issues.
It's still early and the real benefits are yet to come, but so far, I'm so glad I was finally able to get this surgery!
Harryn1
member
Hey @SaraK , I am really happy to hear that you are doing well and that the op was a success.
But, Please satisfy my morbid curiosity by explaining to me, like I am 2 years old, what they did to you.. ie. What is a psoas release, and how does it help.
And why was it not done simultaneously with the THR ? I guess this latter question is a bit stupid.
But, Please satisfy my morbid curiosity by explaining to me, like I am 2 years old, what they did to you.. ie. What is a psoas release, and how does it help.
And why was it not done simultaneously with the THR ? I guess this latter question is a bit stupid.
OP
OP
@Harryn1 - The psoas muscle runs from front of spine, around the hip joint and attaches at the lesser trochanter of the femur. It is the primary hip flexor (i.e. used to lift the leg). The tendon is fairly long and extends from the femur past the hip joint with muscle attached to it all along the way.
Sometimes the tendon rubs again the part of the acetabular implant (and it can even be a problem without a hip replacement). Causes can be your native anatomy, the cup being too large treating an overhang), the cup being positioned a bit too far out on the side closest too the spine, etc. The outside of the implant is rough - that is supposed to help with bone ingrowth. So, if the tendon rubs against the implant, inflammation occurs, the tendon thickens (making it worse) and the muscle spasms.
If it isn't fixed by PT (to stretch the muscle and tendon), NSAIDS and muscle relaxants or a cortisone injection into the tendon, they consider a release. A release is basically cutting the tendon. Because they don't cut the muscle any more than necessary, you're left with the muscle intact and the release basically lengthens the tendon to eliminate the rubbing. Some surgeons cut it near the lesser trochanter but mine cuts it near the joint. He feels it gives you better stability and fewer issues with weakness of the muscle down the line. Procedure used to be "open" but now is usually done through an arthroscopy.
Sometimes the tendon rubs again the part of the acetabular implant (and it can even be a problem without a hip replacement). Causes can be your native anatomy, the cup being too large treating an overhang), the cup being positioned a bit too far out on the side closest too the spine, etc. The outside of the implant is rough - that is supposed to help with bone ingrowth. So, if the tendon rubs against the implant, inflammation occurs, the tendon thickens (making it worse) and the muscle spasms.
If it isn't fixed by PT (to stretch the muscle and tendon), NSAIDS and muscle relaxants or a cortisone injection into the tendon, they consider a release. A release is basically cutting the tendon. Because they don't cut the muscle any more than necessary, you're left with the muscle intact and the release basically lengthens the tendon to eliminate the rubbing. Some surgeons cut it near the lesser trochanter but mine cuts it near the joint. He feels it gives you better stability and fewer issues with weakness of the muscle down the line. Procedure used to be "open" but now is usually done through an arthroscopy.
Harryn1
member
So happy you are doing so well.
- Joined
- Jun 26, 2017
- Messages
- 39,125
- Country
United States
- Gender
- Female
OP
OP
Hi, Layla! Not much new since Saturday - just continuing to skip along doing my happy dance! 
I can basically do almost everything I could do before but without the pain. The only things I can't do that I could do before is that it's more difficult to lift the leg/activate the psoas. Instead of pain, though, it's more a "heaviness" feeling. I was told to expect that, though, because the muscle has been lengthened significantly and needs to learn to effectively contract in this configuration. Time and PT will help to strengthen and retrain the muscle and then I'll be good to go! I'm increasing activities/exercises bit by bit every day to see what the new limits are. I climbed 4 flights of stairs in 1 go yesterday and then did step ups, cycled 1 mile and walked 2 miles (along with other exercises and stretching) at the gym last night with no problems during or after.
Energy level is improving and so is sleep patterns. I have decreased the muscle relaxant dose and plan to try discontinuing it next week and the meloxicam the week after.
Life is GOOD!
I can basically do almost everything I could do before but without the pain. The only things I can't do that I could do before is that it's more difficult to lift the leg/activate the psoas. Instead of pain, though, it's more a "heaviness" feeling. I was told to expect that, though, because the muscle has been lengthened significantly and needs to learn to effectively contract in this configuration. Time and PT will help to strengthen and retrain the muscle and then I'll be good to go! I'm increasing activities/exercises bit by bit every day to see what the new limits are. I climbed 4 flights of stairs in 1 go yesterday and then did step ups, cycled 1 mile and walked 2 miles (along with other exercises and stretching) at the gym last night with no problems during or after.
Energy level is improving and so is sleep patterns. I have decreased the muscle relaxant dose and plan to try discontinuing it next week and the meloxicam the week after.
Life is GOOD!
Last edited:
Bone-obo
graduate
I freakin' LOVE this report! Go SK go!
- Joined
- Jun 26, 2017
- Messages
- 39,125
- Country
- United States
- Gender
- Female
SurreyGirl
supremo
@SaraK what a lovely report, I have been following your frustrations and now superb progress and so happy you have your lift back. It is so good for the rest of us to read reports like this.
Re stairs, what is it like for you going downstairs? I can go up with no problems but having issues making the step down and wondered if I have issues there or if time alone will resolve.
Re stairs, what is it like for you going downstairs? I can go up with no problems but having issues making the step down and wondered if I have issues there or if time alone will resolve.
OP
OP
@SurreyGirl - Thanks for the kind words! Going down stairs was never a problem for me since the psoas isn't as involved in that process. Before the surgery, it wasn't unusual for me to take an elevator up a few floors to get to a meeting and then take the stairs down. Similarly, I can do a seated leg press with 170 lbs and deadlift 140 lbs but can't even get my foot off the ground in a straight leg raise. If you're having significant problems going downstairs, would a visit with a physio be possible to see if they can help highlight the muscle causing the issue and provide a solution?
SurreyGirl
supremo
Thanks Sarah. I am getting some help. Physio mentioned gluteus medius and piriformis. I am doing some stretching to help with this and my knee. It is starting to work. I can go down steps with a small height tread now and improving all the time and can walk upstairs without holding on to anything. Nearly six months out there is some real improvement now.
Scar hurts if I overstretch but quads etc so much better.
So glad your long term issue is getting resolved!
Scar hurts if I overstretch but quads etc so much better.
So glad your long term issue is getting resolved!
I am scared every time I come over here.
OP
OP
Yes at present and fully authorized by doc and PT Mojo! And 140 lb deadlift. They don't impact the psoas and don't cause pain and help build the glutes which is what they wanted. My PT has me doing one legged shuttle leg presses (same as seated but on back) and had to keep adding tension to get to a point where it was sufficiently challenging. I'm a Missouri Mule and I guess I can now kick like one (quite a punch backwards but not so much forwards).
OP
OP
Not sure if I'll get to the gym today - instead I'm about to go out and tackle at least a foot of snow in the driveway! That may be enough of a workout. Not as scary with new hips!
OP
OP
My 2 week followup today ended up being with surgeon instead of PA. He's happy with my progress (loved that I went out and even danced the night of surgery) and agreed the weakness was to be expected. He gave approval to begin the psoas strengthening exercises. Also cleared to begin massaging the incisions and to take a nice long bubble bath. Calgon take me away! (Funny autocorrect - tried to change Calgon to Calvin - hmmmm)
BoneSmart #1 Best Blog
Staff online
-
JamieStaff member since Feb, 2009 -
EalingGranStaff member since January 23, 2024
Forum statistics
Latest posts
-
-
-
-
2024 May Marvels - Are you having knee surgery in May?- Latest: sistersinhim