THR Right THR 12th June. Mobility question

[Lumpyloo2]

Hi all, I have been lurking here for a while and have found the threads and advice really helpful. I am 52 and had a right THR on 12th June so will soon be 4 weeks post op. I can get about the house easily and for flat walks using one crutch but still need 2 crutches for anything up/down hill - and I live at the bottom of a hill! When I try to take a few steps in the house without a crutch I limp a lot and can only take little short steps. Have others experienced this at this stage in their recovery? I do have some muscle wastage in my right quad following a tibial plateau fracture some years ago and my right glute is not as strong as my left for the same reason. Any thoughts would be very much appreciated. Happy Friday all.

 

[Mojo333]

@Lumpyloo2
to Bonesmart and congrats on getting that hip done.
I am certainly sympathetic to your geography because uneven terrain is stressful on still healing soft tissue.

My quads were super sore and any inclines/declines were certainly more taxing than cruising about the house.
All normal and all temporary!
Keep using your assistive devices for those situations...it will get better and easier with more time.

I want to Ieave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines may help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Hip Recovery: The Guidelines

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 to these pages on the website​

Oral And Intravenous Pain Medications​

Wound Closure​

​

Pain management and the pain chart​

Healing: how long does it take?​

Chart representation of THR recovery​

​

Dislocation risk and 90 degree rule​

Energy drain for THRs​

Pain and swelling control: elevation is the key​

Post op blues is a reality - be prepared for it​

Myth busting: on getting addicted to pain meds​

Sleep deprivation is pretty much inevitable - but what causes it?​

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[myglasshalffull]

Welcome! You are so early in your recovery I think all will be fine you just need a little patience during this time. Don't go w/o crutches and then limp, it's better to use these devices and walk correctly than to limp w/o them.
Hills are not what your recovering hip need or want to do right now. In all due time you will be able to navigate hills, but it's way too early for that now, you are healing.
Take advantage of your down time, relax, elevate and ice.
I wish you the best in your recovery.

 

[benne68]

will soon be 4 weeks post op. I can get about the house easily and for flat walks using one crutch but still need 2 crutches for anything up/down hill

I relied on the walker for a full month post-op when I left the house. Only when I could manage around the house did I graduate to a cane.

Use those walking aids as long as you need. The dangers of falling on that hew hip is too great a risk to take.

You are doing fine!

 

[Lumpyloo2]

Thank-you for your replies. I am being good, honestly, and using my aids for getting out and about and round the house. I know there is a reason you get signed off work for 3 months, and as I'm only 1/3 of the way through that time I just need to develop a bit more patience. I think that as the pain and discomfort diminishes the expectation we put on ourselves increases. Your responses have helped remind me to take it steady and appreciate the time I have to recover and rehab properly. Thank-you

 

[Lumpyloo2]

Hello fellow June Sunbeams. I had a right THR on 12th June via posterior approach. I've had arthritis in my hip for a number of years and had arthroscopy and debridement in 2009. This wasn't particularly successful and my surgeon at the time suggested I would need the hip replaced within 10 years, I eventually made it to almost 14 years. I am generally an active person but this had tailed off to swimming and pilates only by the time I got the date for my op, and even pilates was becoming a struggle. My op was straightforward but an issue with low blood pressure kept me in bed the day of my op and the following morning. However, once up I quickly went from zimmer to crutches and home. My op was first thing Monday morning and I was discharged Wednesday afternoon. I was relatively mobile the first couple of days but surprised by the amount of swelling from about day 5 onwards. From that point on I established a routine of mobilising for 5-10mins followed by lots of rest, ice and elevation. I didn't really leave the house for the first week or so and let my family and friends look after me
Over the next few weeks I gradually increased my mobilising from round the house and garden to my local area. I'm fortunate to live on the coast and there is a flat walk I can access from my back garden, it's about 700m out and back. I started by just going 100m or so, resting and then returning. It took me to the end of week 2 to make it all the way to the end and back. Still using crutches of course.
Tomorrow, I will be 4 weeks post-op. Much of the pain and discomfort has disappeared. I was on nefopan and paracetamol 4 times a day, but I have gradually reduced that to twice a day and will shortly cut out the nefopan. I still have a little bit of swelling round my wound but nothing much anywhere else. Though I do still have altered sensation in my thigh which is quite uncomfortable when my cat decides she want to sit on my lap!
I have noticed that my gait is different now. My right leg used to rotate inwards when I walked, it is now lovely and straight. This causes me a little discomfort, especially round the knee and shin when I walk, but I guess this is my soft-tissue re-aligning following the op.
I am still sleeping on my back as advised for the first 6 weeks. I have to say, I am not enjoying this and can't wait to sleep on my side again. However, I am really scared of dislocating my hip so will persevere - only 2 more weeks
How is everyone else getting on?

 

[sistersinhim]

I‘ve moved your post above out of the Monthly team thread. That thread is reserved for surgery date information. Having this monthly team thread allows members to see who else has surgery in the same month as they did. All other comments and discussions should take place in a pre-op or recovery thread, such as this one. Enjoy interacting with and learning from others who are on the same journey as you are, here in this thread.

It seems like you are doing really well with your replacement! Enjoy that new hip.

 

[Zorro]

Hello Lumpyloo2,

Congrats on a successful RTHR.
Yes, please sleep on your back for a few weeks more, despite how uncomfortable it is.
Be conservative in all activities. Progress will occur sooner than you realize. You are barely four weeks post op and it seems that you are doing fine. Keep up your good attitude.
Try to be really mindful of keeping your hip-to-torso ratio at 90 degrees or more.
Stay positive and continue to heal. God bless!

 

[Eman85]

Having a flat area to walk is great, the only flat area I had was in the house until I could drive to the park or the store. You mention your walking gait and lower leg pain. Do you have a new pair of shoes? Older shoes that we walked in pre-op many times have a wear pattern from our walk that compensated for a bad hip. When we walk post-op it can cause problems with our new way of walking. I too am not a back sleeper so it was tough to sleep. I did keep a pillow between my legs and when I was able to roll to my non-op side the pillow kept my leg from falling past the centerline. I actually found it comfortable and still sleep with a pillow between my legs as it has helped my back.

 

[Layla]

Yay...you did it! You made it through your first month.
May it only get better. Happy One Month Anniversary!
@Lumpyloo2

 

[10spro]

@Lumpyloo2 Congratulations on your 4-week milestone. I am also a June Sunbeam, a couple weeks ahead of you, also had posterior approach. I just passed my 6-week milestone, but have decided to take the conservative track until 8 weeks. All of my daily activities are getting easier, but I do still sleep on my back, though I really dislike it, and will transition soon to side sleeping again using a pillow between my knees. My incision has been slow to heal, still a little swollen, and sometimes itches like crazy, so do my best to keep it clean and dry. Before surgery, my left knee turned inwards, and after surgery, my left knee still turned inwards. With every step I take, I am extremely mindful of proper posture and walking with the correct gait. All those muscles and tendons need to remember how to work together in the normal way. It will take time, and you must be persistent, but be sure to celebrate the small wins and take confidence from every milestone you successfully navigate.

 

[Lumpyloo2]

Hi @10spro and thanks for your reply. I've had a quick peek at your recovery thread and I'm totally in awe of what you were cleared to do at 4weeks post op - that's amazing! You mentioned trying your bike. Was that a static bike? I've not tried anything like that yet, though I am walking an average of 4500 steps a day over a couple of walks, using one crutch. I've been pretty focussed on keeping things conservative until the 6 week mark which is Monday coming

 

[10spro]

You mentioned trying your bike. Was that a static bike?

I have a recumbent bike at home that I wanted to try, but my new PT guy says an upright bike is recommended for hippies, so I haven't done it yet.

I am walking an average of 4500 steps a day over a couple of walks

That's amazing you're getting 4500 steps a day. I'm still averaging about 3000 a day, and every so often I'll do a few steps over 4000.

 

[Lumpyloo2]

Almost 7 week post-op recovery update
I continue to need one crutch to walk upright and without a limp, though when I take a couple of steps unaided I do try to walk heel to toe but sometimes find myself using only my toes on my operated side. It really does take a conscious effort to walk correctly, must try harder, lol!
Reverting to side sleeping wasn't as easy or as comfortable as I thought it was going to be. I place a pillow between my knees and also 'hug' a pillow to stop me rolling too far over. Whilst not 100% comfortable, being able to alternate between back and non-operated side is quite nice. Poor hubby is still in spare bed due to all the pillows I have round me, I'm getting quite used to the kingsize all to myself!
Walking with a crutch is no problem, and I can walk a good few km at a time, but if I do a lot of bending down I find the area around my scar and my glute aches. I consider this notice to stop what I'm doing and rest. The twinges usually subside after a short while. Talking about bending down though, I have just managed to cut and paint my own toe-nails for the first time in a very long time. Feels like a little win on the road to recovery
I do feel very weak on my operated side and can see a lot of strengthening exercises in the future, but not quite yet. Sometimes it does feel as if I will never walk without the aid of a crutch again, but I am trying to stay positive.
We are off on our family holiday to the Scottish island of Tiree tomorrow for a week. Journey is approx 3hrs by car and then 3.5 hrs by ferry. I am very much looking forward to the change in scenery and spending time with my husband and daughter. I love being in and around water but not sure if I'll venture in just yet as I'm quite anxious about entering and leaving the sea when I can't walk unaided. When have others returned to the water? Thanks all x

 

[Eman85]

Sleeping on my non op side was odd at first, felt a pulling in my op leg at the hip and it was uncomfortable. It will get better, just takes time, I know at 7 weeks you think it should be all over but it's not.
Getting to your feet is a milestone and is great progress.
I wouldn't get all worried about exercise and building strength, the strength will return when the muscles heal. They are still there just not healed yet and ready to function fully, you'll get stronger just by walking. A 3 hour trip by car will not be any fun unless it becomes a 4-5 hour trip with plenty of breaks along the way to stretch and walk.

 

[Layla]

Journey is approx 3hrs by car and then 3.5 hrs by ferry

Hello and Happy Weekend!

This may feel exhausting to you. Do make sure to allow time for
stretching / walking breaks on your three hour car trip. I don’t know how long you’re comfortably able to sit in the car post op, but it took me several months before I could travel any longer than 30-40 minutes without becoming truly miserable due to the tight confines and inability to stretch or change positions.

When have others returned to the water?

My surgeon was really strict on this and he advised against baths, hot tubs, pools, basically any body of water until I was three months post op. I have read from a handful of members that their OS advised the same. Not many though. It’s best you check with your surgeon on this topic.

Stay safe and enjoy your vacay to Tiree! Let us know how it went once you’re settled in back at home. Maybe you’ll have some tips for others traveling shortly after THR.

 

[Lumpyloo2]

Thanks for the helpful advice which I only managed to read when I got WiFi at the ferry terminal! I managed the car journey with just one comfort stop but it was getting quite uncomfortable toward the end and I will definitely be taking more breaks on the return leg. Boarded the ferry a short while ago and have already completed a number of laps of the deck to stretch and mobilise and feel much better for it As I’ve not been able to contact my surgeon about accessing water I will hold off until I am able to do so.
Have a great weekend all x

 

[Hip4life]

@Lumpyloo2 About the water entry: I love the water and I'm a swimmer and my OS was very emphatic that I wait 8 weeks, which you are still about a couple of weeks or so away. Better safe than sorry, especially in a natural body of water. In any case, I do hope you enjoy your holiday and change of scenery!

 

[Lumpyloo2]

@Hip4life thanks for your reply. Wifi is patchy were I am so I have only just picked up your message. Despite some fabulous beach days I have been chief photographer and stayed out of the water. I am hoping on my return to find my follow up appointment letter at home, where I can ask my surgeon about returning to the water. For anyone out there who loves beaches and water, I hope you enjoy this photo

 

[Layla]

Beautiful photo! Thanks for sharing, LL.
Enjoy the last few days of your vacay and safe travels home!
@Lumpyloo2