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THR RGLieblein’s Second Recovery Journey

Update for 7 weeks isn’t great. Groin pain (hip flexor) is pretty relentless, regardless of how much I dial back my activity. I let my OS know that this was going in the wrong direction. He offered to do an injection, which surprised me this early in the process, and I told him I wouldn’t consider it until at least the 3-month mark.

So, “frustration” is the operative word right now, as I’m feeling extremely limited and my return to work is now entirely unknowable.

Feels like I’m stuck in a holding pattern. Resting, icing, making sure I don’t let the hip and groin get too tight but also being super-cautious about movement and making the hip flexor even angrier.
 
You are still so very early in your recovery. I don’t have much advice other rest & ice and short walks. I sure hope things improve but please stay positive. It’s difficult when there is pain but some of us take a little longer to recover. And recovery is different for all of us.
 
Are you sure it's the hip flexor? I had issues with groin pain during my hip recovery and my physical therapist said it was coming from the psoas tendon. He taught me how to do a tendon release, which helped, although it took a couple of weeks.

Since you are still very early in this year-long recovery, @RGLieblein, you might consider renewing your Insider Membership so the BoneSmart staff can provide advice to help you through these post-op hurdles. If you are interested, just click on your user icon on right side of the blue tool bar, and then Membership in the drop down menu.
 
7 weeks is still so early. I had my right hip done in July 2022 and I wasn't doing "well" until probably 3 months and I was on precautions for 6 months. I couldn't drive until 5 weeks because I had "log leg" and couldn't lift my leg. Everyone heals at a different pace. Rest and ice and elevate. Don't push it. Let your body heal.
 
Thanks @benne68. I just re-upped my Insider membership.

When I say "hip flexor" I really am referring to the iliopsoas, and my pain is presenting just like IP tendonitis--pain even with minor flexion movements, like lifting the foot to put it into a shoe. And if I sneeze...dang! Feels like a bolt of lightning to the groin. There's some degree of pain pretty much all the time.

I'm struggling with finding the balance between rest and activity that keeps the hip from tightening up while also allowing the tendon to calm down. It seems like it doesn't take much at all to make it angry. Tylenol has been working to calm things down when it's really bad, but I want to limit my intake to spare my liver.

My brain keeps going to impingement, so I'm trying to stay grounded in the present and not project into the future. I'm thinking of doing a consultation with a PT I know who's in private practice--no insurance accepted, but she'd be able to devote meaningful, hands-on time to my situation as opposed to "10 minutes of attention then off to your exercises" model at most PT centers.
 
A good therapist will spend a considerable amount of time evaluating you at the beginning of your program and each and every time you come for a session. Make sure whoever you see has a Doctorate of Physical Therapy (DPT), which means they are trained to diagnose problems. The diagnosis is often more important than just “exercises.”
 
Perfect.
 
RGLieblein said:
she'd be able to devote meaningful, hands-on time to my situation as opposed to "10 minutes of attention then off to your exercises" model at most PT centers.
Click to expand...
Yes! That's exactly the right kind of therapist to see for these more complex issues. Seeing her would be a smart next step.

Meanwhile, take a look at these articles to see if anything here resonates with what you are experiencing.

Remember that at 7 weeks, you are still early days. It takes our soft tissues at least 10-12 weeks to heal from the trauma of surgery, and then they need to adapt to the structural changes in our bodies created by the surgery . I'm at 15 weeks post-op and still seeing my PT to address some "pain points."

Keep us posted.
 
Thanks for this treasure trove of information @benne68! I have little doubt that it’s an iliopsoas issue, and a couple of the articles you provided support that idea.

The PT doesn’t have an open appointment for a couple of weeks, so I’ll continue to rest (but not too much) and do what I can to keep things moving and loose (but not too much) in the interim.

I’ll also keep my OS updated. I’d like to know at what point he’ll think it would be appropriate to do more imaging.
 
@RGLieblein My OS just did xray plus history of my symptoms. Most docs are going to want to give it more time to see if the tissue inflammation resolves on its own. I took Celebrex to aid in that as well. If the pain is persistent, injection is usually the next step. This is into the tendon using ultrasound. It has a twofold advantage: it should relieve the pain and thus, confirm the diagnosis of tendonitis. Hopefully, if it's just a stubbornly angry tendon, it will eliminate your pain, period. If not, then that's another bridge to cross.

I like the idea of a good PT to evaluate you as well. It's always better to go the non-invasive route if an option. I'm hoping that between the PT and what your surgeon has to offer, they will get you on your way to a more comfortable, complete recovery. Hang in there. Keep us in the loop.
 
Ok, so I have an appointment with the PT on 10/21 (waitlisted in case something opens up sooner) and another follow-up with my OS on 10/15.

This comes just in time, as my right hip (the June surgery) is becoming increasingly unhappy. For about a week I’ve had the sensation of a tight band around my upper thigh, which I thought might be from a combination of reduced activity and Lateral Femoral Cutaneous nerve issues that are common with anterior approach.

But last night I started getting a burning pain across the hip crease that kept me up a good part of the night. My understanding is the LFC nerve only affects the center and outer part of the thigh, so I’m left with wondering and worrying.

It’s more settled this morning, but I’m becoming more and more paranoid about any kind of movement, and just as worried about the impacts of not moving enough.

Really hoping to get a handle on things in the next couple of weeks.
 
I would be the same way. Concerned about moving the wrong way but also concerned about not moving enough and getting stiff. Have you tried ice? I remember after my first hip surgery that ice was my best friend for many months, not just in the first few weeks. From all the reading I've done and from remembering the last hip surgery, it takes a good 6 months to 1 year for things to be normal again. For me it was a full year. I expect this next surgery to take a full year to recover as well and will need you all to remind me when I start complaining that it's not going fast enough. One thing I remember happening the last time was I had swelling in my knee and pain there. The surgeon said that was normal too because he had to twist and bend me in ways I don't normally go. Our body takes a beating during the surgery with all the saws and hammers. Ewww... just thinking about it creeps me out. I hope you can find some relief and good luck at the dr next week. Let us know what you find out.
Barbara
 
Thanks @barbloki. I always thought I was a patient man… until I got my hips replaced! Plus, I know I have certain personality traits (worrier, over-thinker) that I have to stay on top during a long rehab. Bonesmart is definitely helping, and I appreciate your encouragement.

I had started to move away from the ice, but it really is a big help so my freezer is once again stocked with hip packs and smaller gel packs and I’m back on a regular(ish) schedule.
 
Try not to worry or over-think, easier said than done, but you are being proactive with your appointment on Wednesday and hopefully its enlightening and your OS is able to offer you guidance and reassurance. Wishing you comfort and all the best. Please keep us in the loop, we're here for support.
@RGLieblein
 
@RGLieblein As a worrier I always found going for my OS opinion on what I was dealing with very comforting. He was always sympathetic and did all he could to reassure me and put my mind at ease. It was nice to be heard and he never was dismissive. I may be a worrier but never a complainer. The docs learn that and are generally respectful of that. Good luck on your appointment. I'm looking forward to your update.
 
Happy Four Month Anniversary, Righty and Happy Two Month Anniversary, Lefty.
Best Wishes for tomorrow. Please let us know how it goes.
@RGLieblein
 
Saw my OS yesterday and he’s convinced it is indeed a very stubborn case of iliopsoas tendinitis I’m dealing with. He speculates that something happened not long after the surgery, like a torn capsule suture from overexertion, that made the tendon extremely angry.

He recommends an injection, and even though he typically likes to wait for a full year before taking that step he believes the severity of my case, coupled with the displeasure my “good” hip is starting to express, make it the appropriate move.

We discussed the risks of infection (not zero, but less than 1%) and how steroids can inhibit the immune system. He feels confident that since the hip is otherwise in pretty good shape in terms of strength and ROM, and that I’m young, it should turn out well. Only in the world of hip replacement do I qualify as “young”! :heehee:

So I’m scheduled for an ultrasound guided injection on October 24. Earlier in the week I’ll be meeting with the new PT, who I hope will be able to address the other aches, pains, and tightness that have set in during this period of very limited activity.

Will keep you updated, as always.
 
This sounds hopeful for you. If he’s right, the guided injection should bring noticeable relief. I’ll be watching to see what you report.
 
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