THR Right THR January 27, 2022

[Flamingo]

I don't really know all the names of the PT exercises. I go twice a week for at least an hour. They start at the parallel bars and I do side stepping, squatting, heel and toe raises, then I do laying down exercises, leg raises, bridges, leg slides then I do 10 minutes on the step type of bike where I sit down and just move my legs back and forth on the pedals. This is very easy to do. Then I usually follow up with moist heat wherever I think I need it which many times is on my back. I have gotten the walker out again to use it just for walking in my long upstairs hallway. From what I'm reading this is the best exercise. I still need the cane for going up and down the stairs and when someone else is here they can carry the walker up or down for me. I realize there is a way to go up and down using the walker but that scares me.

 

[Eman85]

Pretty ambitious PT for 6 weeks. Bridges didn't do anything for me except put me in terrible pain, I tried some of that with my first THR. With my 2nd I did none of that, funny thing same results with no pain. My goal of a THR was to eliminate the pain I'd had for years. I never went to any formal PT, my OS warned me not to he said they'd hurt me unnecessarily. Walking was best for me and then stretching and doing some mild Yoga.

 

[CricketHip]

Hi Flamingo! I love your name!
I am catching up on your recovery thread and will say that your PT exercises seem quite a lot for where you are in your recovery.
I did my PT exercises with caution and if something hurt or created muscle pain after, I stopped doing that exercise and retried in a few days later. like 5-7 days later. Being cautious with the PT exercises will not affect your recovery except to make it less worrisome and painful.
There's plenty of time to strengthen the muscles, etc. after the initial discomfort eases.
Your ADL (activities of daily living) will be enough for now.

It's difficult to say no to PT but many of us did say no and we are all just fine and dandy now. Honest!!
Maybe, would you consider trying a little experiment by canceling your PT appointments for a week and see how you feel?

 

[Layla]

Hi Flamingo,
Given the exercises you listed, PT may be your problem. Many of the exercises you mentioned are not recommended. I’d hate to see you continue and run the risk of dealing with chronic pain. I’m not sure if you had a chance to read the article in the link I left you, if not, please do. You’re not the first to be experiencing pain this early on and while it’s difficult to go against what your surgeon or PT are recommending, many do and discover their pain resolves. It’s up to you whether you want to experiment with a respite from it all and see how you feel using walking as your only form of exercise aside from the activities of daily living.

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.

Consider dropping the PT for a few weeks and see if you notice an improvement in the pain you’re struggling with. You can always go back if you decide you need to work on something in particular.

 

[Layla]

I was typing to post while CricketHip was also. While we both had some of the same thoughts, hopefully our ideas serve as confirmation that we may be on to something
and our suggestions will hopefully bring you relief if you’re willing to try abstaining for a time.

 

[subie2021]

Flamingo,
While I'm a fan of PT and consider that it's helped me tremendously, your regimen seems really ambitious. Some of those exercises I didn't attempt for 3-4 months or later.
I'd think about the advice to dial back on PT to see if less is more in your case. For my early weeks, the exercises focused more on balance, less on strengthening. The balance exercise was to help reconnect my leg and hip muscles and nerves to my brain, since pre op limping and the surgery had disrupted all that.
Also, after every one of my sessions, my therapist offered to let me rest with ice on hip or leg.
If you decide to stick with going to PT, remember that you are allowed to say no to certain moves and ask for something less demanding and more gentle. Don't do moves that cause you pain.
Good luck to you, best wishes for a good recovery.

 

[Klassy]

I too love your username @Flamingo . Why didn’t I think of it !?!

Ditto to what others have said. After my first hip replacement 3 years ago, I did some of the exercises prescribed. Intermittently, as I alternated between listening to my physiotherapist (MUST DO IT. AND MORE) and taking advice from this forum (OOER, SOUNDS LIKE YOU ARE DOING TOO MUCH). I had pains just like you describe. Currently I’m 9 weeks into recovery after having my other hip replaced. This time I have done NONE of the exercises, except for wiggling my feet a bit when I was spending all my time in bed, to fend off DVT. Just walking, plus the incidental exercise involved in resuming normal activities (getting in and out of bed, getting dressed, meal prep, light housework, careful hobbies) as and when the hip was ready. So far the second recovery is progressing just as well as the first. But with much, much, less in the way of ongoing aches and pains.

And don’t worry about what your surgeon said. I went to the 6 week follow up with the surgeon for my first hip still using two crutches. He wasn’t bothered. But I felt I was slow. This is a quote from what I posted then. “I asked, how is my progress compared to his other patients? He said “It’s not a race, don’t worry about it, you’ll end up in the same place as a person who is ahead of you at this point. This isn’t a hip for 6 months, it’s a hip for life.” All very true of course, but I pushed him, do his patients generally walk in for their 6 week follow up without aids? Well yes, he conceded, but if I wanted to be cautious that was fine, he would much prefer that to a patient who was overconfident and did themselves an injury. I guess I should be happy with that, but I do still feel a bit pathetic.”

Looking back, I can’t think why on earth I felt pathetic. This time round, I know that the hip will take the recovery time it needs, and I am fine with that. I know how wonderful my new hip will be for years and years and more happy years to come. Yours will be too.

 

[Flamingo]

I actually haven't been to PT in a week. I went last Monday and had to cancel my Friday appointment. I feel like I am about the same. The surgeon stressed the need for outpatient PT as he felt it worked better. I am scheduled until April 1st and then stop. She definitely doesn't do anything with me that causes me pain, however it is not helping my leg pain. I am thinking that is just going to have to heal on it's own. I spoke with a friend's daughter who has a PhD in Physical Therapy and has had two hip replacements herself and she seemed to think what I was doing was fine. So, I just don't know???

 

[Hip4life]

This isn’t a hip for 6 months, it’s a hip for life.”

Exactly what I figured and adopted it for my username. Lol.

@Flamingo This just proves the point that no two recoveries are the same. It’s so easy at this stage of recovery to get ahead of ourselves especially when we think we’re lagging behind. We get conflicting advice. We’re all at different levels of strength. I was a “slow” recovery. I had spent a long time before surgery literally limping along dealing with the pain. I did not do any PT post op nor was it recommended beyond those basic post op exercises. I just had to be more patient and give the moderate walking more time. Leg raises and squats can be challenging to those soft tissues that are still healing. They don’t necessarily hurt at the time in PT but can cause a lingering soreness if they get irritated. I used ice for quite a while whenever my hip complained after exercise.

If you want to scale back to basics, like just walking, PT will always be an option down the road if you really feel you’ve stalled out. The simpler you keep things like walking and adding regular activities in slowly, the easier it is to gauge progress or if something is causing discomfort. Only you can decide what’s best for you. Just continue to keep in mind that it’s still early with lots of improvements to come in the time it takes YOUR hip to heal. Blessings.

 

[subie2021]

Flamingo, please don't regard this as picking at you or nagging - I'd like to put this here in case another hippie can use it.

Remember the hip and the healing is *yours* not the surgeon's, not the therapist's, not the friend of a friend's. Each body heals at its own rate in its own time. All our circumstances leading up to THR are different also. A chubby old lady like me will have a different journey than some young athletic dude or dudette.

In my experience a pt exercise doesn't have to hurt at the time you're performing it to cause pain. I've found that it often takes hours or overnight for my body to object to certain exercises. For example I can do all kinds of hip flexor stretches, but my non-opped side will complain like crazy the next day if I overdo. So I've learned to adjust and maybe cut down on reps or to not go for full range of motion, and slowly build up to the prescribed amounts. It took weeks of avoiding any flexor stretches on the bad side for my leg/groin to not hurt; just recently I've been able to add those moves back in.

Again, good luck to you, and best wishes.

 

[Tlew67]

You never said what PT you were doing. I used ice past the 3 month mark, near went near heat. By my math you're at 6 weeks, don't see how you're recovering later than most of us did, sounds like you're on schedule for how the majority of our recoveries went. Just my opinion but if you're in pain now those elastic bands probably aren't going to make it better.

PT hindered my recovery. Once I took control and told the PT something was hurting I quit doing it. The elastic bands need to go in the garbage in my opinion. I feel for you, my recovery has been slower than what I was led to believe. I’m coming up on 14 weeks and I’m still having issues.

 

[Magsmom]

Hi @Flamingo
I had my left hip done in Sept 2021 and my right just after Christmas. So I’m 6 months out on the left and almost 11 weeks on the right.

I sailed through the first surgery/recovery though it didn’t feel like it at the time! It was a relatively easy and pretty quick recovery. There was discomfort and pain, but it was manageable. My biggest issue was, and still is, sleeping at night.

In both cases my surgeon didn’t want me doing any kind of PT until I had seen him for my follow up - both were at about 6-7 weeks. He felt it was important to just let the hip heal for a while bc of the “trauma” it had been through and to give it a rest before starting any kind of PT. His main advice was to just walk as much as I could. Others in this grp have heard this, but I watched a hip replcmt surgery on YouTube- the real thing, not an animated version. It’s tough work and we definitely do get “manhandled” in the OR.

I did do some PT on the left one but only went 4-5 times and was so unhappy with the place, I just stopped. The therapists spent more time talking to each other than paying attention to their patients. The happy hour-style gabfest just annoyed me beyond belief. So I used some of the exercises they gave me and did them, as well as a few others, at the gym in my own.

My right hip, on the other hand, has been slower and way more challenging. I guess I was too cocky after the first. I also have thigh pain that pops up in various places…..often unexpectedly. I’ve learned that multiple in/out of the car irritates it. But the pain hits in different places - sometimes near my knee, even down to my ankle, my glute and my quad. So - I think what you’re feeling as it relates to thigh pain is pretty normal.

Lots of views Re PT here. What I will tell you is that any time I’ve had physical therapy (knee, shoulders, cervical spine …..and now, hips) I’ve always started with 10 min of moist heat to loosen things up and finish the hour with ice. I continue the ice at home too. It really is helpful and I found a good reusable gel ice pack for hips. The main part sits right on the groin/hip flexor area And the ends are long enough that you can wrap it around your butt and get the cold on your backside as well.

Good luck!!

 

[Flamingo]

Thank you again everyone. I am thinking about cutting PT back to once a week. I honestly don't think anything I am doing there is what is aggravating my thigh. Like Magsmom said it pops up in different spots every day. I am starting to get very aggravated with the whole thing, the cane is annoying to use, it hurts my back and this leg pain! I have so much I am trying to do and if it weren't for the leg pain I would be fine. I'm still not driving, I haven't even practiced yet. Another issue is bending my affected leg at the knee, it doesn't go back very far. It makes it feel swollen but it isn't swollen. Wondering if my muscles could just be extra tight. I asked the doctor for muscle relaxers to give them a try and took one before bed. I can't take them during the day. So, we will see if they help at all. I am a person whose muscles were always very tight anyway.

 

[Magsmom]

Hi
A couple of things. Plz keep in mind I’m not a doctor but this is what helped me.

Muscle relaxant- my OS believes it’s needed by many patients. I took Robaxin and/or flexeril. They made me drowsy so only took at night. I’ve also been prescribed Skelsxin for day time. It’s one of the ones that is supposed to not get you drowsy. When I’ve taken it during the day, I don’t have any side effects.

The random pains that show up are so frustrating, aren’t they. Most of mine are not in the joint and just kind of show up. Mine, I believe (and discussed with OS) are related to nerves either waking up or doing whatever they do after a very difficult surgery like ours.

I take Gabapentin for nerve pain and it’s a lifesaver for me. I learned of it a few years ago and took quite a bit of it before my spinal decompression/fusion surgery. I never would’ve gotten through that waiting period until my surgery date without it.

Maybe some ideas to discuss w your dr?
Good luck

 

[benne68]

Another issue is bending my affected leg at the knee, it doesn't go back very far. It makes it feel swollen but it isn't swollen. Wondering if my muscles could just be extra tight.

I had a similar experience following my THR (2+ years ago) with pain and tightness popping up in different places. I didn't realize it, but had been keeping my leg and body "stiff" post-op. I found relief in massage therapy. My PT did some for me, then showed me some techniques to use at home. I did self-massage twice a day and noticed improvement within a week.

You might want to ask at your next PT session if your therapist does this kind of treatment.

 

[Flamingo]

I'm not sure which type of hip replacement you had. From what I understand the Anterior affects nerves more than the posterior like I had. Mine involves cutting muscles. He did give me Flexeril. I took Mobic before the surgery for arthritis but am hoping the arthritis is gone now. I did try to take it one day to see if it helped the thigh pain and it did not. I have better luck with Aleve but of course you can't take that for too many days in a row.

 

[Flamingo]

beene68 - Yes, my PT has tried to do massage and I thought it hurt! She also has a massager that I don't like at all. I have been using moist heat which I've been told helps to relax muscles better than ice. I've got PT for two more weeks and then my referrals run out. I think I am going to stick it out for that time and just be very careful of what I am doing there. Like I said, nothing has been painful while I am there.

 

[benne68]

She also has a massager that I don't like at all

I agree with you on that! I hated it when mine tried it and told him 'no more'!

 

[wander03]

Reading this thread has helped me understand even better why my physical therapist has been so intensely massaging the muscles that connect my right hip and knee. My muscles are/were more taunt than usual because of the complications from the overly aggressive physical therapy on my knee, and by massaging the muscles, my recovery is expected to proceed better.

My physical therapist suggests using a walking/hiking stick rather than a cane after using a walker. I have a hiking stick that fits my height and has a rubber cap on the foot. Chris demonstrated how using the hiking stick enables one to walk more erectly than a cane does. I bought the hiking stick at Mount Nebo State Park shortly before I started having problems with my right knee a few years ago and have not used it for hiking. I am looking forward to using it when I graduate from the walker. I have not seen this suggestion before on BoneSmart, but I have not read all of the threads.

 

[Eman85]

I spoke with a friend's daughter who has a PhD in Physical Therapy and has had two hip replacements herself and she seemed to think what I was doing was fine. So, I just don't know???

She's got a PhD in PT and more importantly she's had 2 THR's, what's not to know? Funny thing about THR recovery that most of us figure out is it never hurts when we're doing things. It only hurts later or the next day.