THR Right THR November 19, 2025

[Lilibet80]

I had my first visit today with my physical therapist. My surgeon ordered PT because I can’t straighten my leg and stand up straighter (I’m never straight due to back issues). I like him. He gave me some really easy exercises that don’t hurt. But I made sure he understands the pain I’m in.

Of course, his opinion is that everyone who has a hip replacement needs PT right away, whereas my surgeon only requires walking, which is not unusual. Mark, the PT, explained his reason, involving muscles, which makes sense, and I’m not sure why the surgeon believes differently.

He said I should not be having this much pain after three months (as of Feb. 19), whereas my surgeon said this is common and will go away (this was in early January).

So I don’t expect the PT to do anything more than help with flexibility, although Mark said the more I move the less pain I’ll have. Right now, it’s the opposite, so we shall see. Thankfully, he comes to my home, so I don’t have to go anywhere and hurt more.

I want to thank you all for your support and kindness. It means a lot and helps me have hope!

 

[Deni444]

Sounds like everything is going in the right direction and that you have a good team supporting you! There is a sweet spot for movement during recovery in my humble experience. I think it's impossible for anyone other than you to fully identify it. There's movement that includes tension and then there is movement that is very gentle and passive. Like the difference between swinging a leg and kicking. Passive movement can be excellent for reducing pain. It's about intensity and the degree muscles and soft tissue have to work. In my mind I imagine how many calories I'm burning. There are many different movements that would burn very few calories because muscle isn't engaging. When we feel swelling and pain after activity it is because we have taken our soft tissue to the limit and beyond its current strength. The recovery journey involves learning to read the signals. A little bit of discomfort and swelling after activity is fine if a short rest, maybe with some ice gets rid of it. Swelling, pain and discomfort that lasts for hours and for a day or more is a good indication that we overdid it. I found I had to experiment to find the sweet spot. Often getting it wrong but that is how I learnt.

 

[Lilibet80]

A little bit of discomfort and swelling after activity is fine if a short rest, maybe with some ice gets rid of it.

My physical therapist did say that the exercises would increase my pain temporarily. Based on what he had me do today just to learn the exercises and how I felt all evening, he wasn’t kidding! The exercises (except for walking) didn’t hurt while I was doing them, but definitely revved up the pain anfterward. Ice did calm it down eventually to my usual pain level. I live with ice packs, large and smaller. You should see the stack of them in my freezer!

Thanks for your explanation of the “sweet spot.” Very helpful.

 

[benne68]

The exercises (except for walking) didn’t hurt while I was doing them, but definitely revved up the pain anfterward.

Pain from overdoing often shows up later in the day or even the next day, rather than in the moment you are exercising.

A little discomfort is fine, but intense pain in the day following a workout is a signal that you are asking your body to do more than it is ready to do. Remember that your PT hasn't been through this recovery and doesn't know what you are feeling. Listen to your body and adjust your activity level according to how it responds.

 

[Layla]

Happy Three Month Anniversary, Lilibet.
I realize this hasn't been the smooth recovery you hoped for. I'm sorry you're still dealing with pain. I admire your patience and strength as you try to work through these challenges. I hope brighter days are on the way.
Here for you always.
@Lilibet80

 

[Lilibet80]

A little discomfort is fine, but intense pain in the day following a workout is a signal that you are asking your body to do more than it is ready to do.

I saw a different PT today (more for balance issues). He was very informative and stressed listening to my body and stopping if the pain increases very much even while I’m doing the exercise because it means I’ve gone beyond what my body is ready for (as you said @benne68). He wants me to keep track of how long it takes to get to that point so that I know if I’m improving or not.

I hope brighter days are on the way.
Here for you always.

Thanks so much @Layla!

 

[benne68]

I'm so glad you have a different PT who better understands this recovery. Take his advice and listen to your body!

Hoping you feel better soon.

 

[Deni444]

I'm relieved you have a second opinion on the intensity of your physio regime. Just today, I managed to overdo it. Same exercise I'd been doing regularly but I did it with more speed. I knew within a couple of hours I'd overdone it as my hip swelled up with unpleasant pain. Nothing a bit of elevation won't fix but I'll have to rest up more over the next few day's to calm it down. There really is a fine line between strengthening and over stressing soft tissue. I'm learning that one step at a time is far better than two steps forward and three steps back. Recovery is a learning curve

 

[myglasshalffull]

You have already received some great advice I’ll just add that the first few months of recovery is such a roller coaster ride.
Listening to the cues your body gives you will direct you in right direction. My early days I would have some sort of idea of how I wanted to spend my day. A list of chores or places I needed to go. But sometimes the hip decided it was done for the day. Or maybe just for a couple of hours. So I’d lay on my ice packs for a while then get up & resume what I was doing.
On the days Miss Hip wouldn’t cooperate at all she won! It was always so interesting that next day I could get up and I’d be just fine.
Hang in there, we are here for you.

 

[Layla]

How's this week for you, Lilibet?

I saw a different PT today (more for balance issues). He was very informative and stressed listening to my body and stopping if the pain increases very much even while I’m doing the exercise because it means I’ve gone beyond what my body is ready for (as you said @benne68). He wants me to keep track of how long it takes to get to that point so that I know if I’m improving or not.

Hopefully it's getting more comfortable for you. Be gentle with yourself, healing takes time and it can be challenging for sure. I hope each week brings a bit more strength and relief.

 

[Lilibet80]

How's this week for you, Lilibet?

I saw a different PT today (more for balance issues). He was very informative and stressed listening to my body and stopping if the pain increases very much even while I’m doing the exercise because it means I’ve gone beyond what my body is ready for (as you said @benne68). He wants me to keep track of how long it takes to get to that point so that I know if I’m improving or not.

Hopefully it's getting more comfortable for you. Be gentle with yourself, healing takes time and it can be challenging for sure. I hope each week brings a bit more strength and relief.

It’s been an interesting week so far, Layla. PT on Monday and pain specialist today. Sorry this is so long!

I’m back to the original physical therapist, which is fine. He didn’t add any exercises because of the pain I’m in, which was good. As I mentioned, I can do the sitting exercises without added pain (while I’m doing them), but walking as exercise definitely revvs up the pain during and after. I think I need to limit the distance I do the walking exercise for now.

The pain specialist was good. She really listened. I provided reports from the X-rays, CT scan and nerve conduction study I’ve had since surgery. The nerve conduction study indicated the pain could be originating either with a pinched nerve at L-2 or in my hip (mentioning heterotopic ossifications). She asked me where I thought it was originating and I said my hip. The reason is that I didn’t have this pain before surgery and if it’s originating in my back it seems that I should have had it beforehand. She said she agreed.

She said the doctor could do a diagnostic obturator/femoral nerve block in the hip. If that reduces the pain, the next step would be radiofrequency ablations of the nerves. The problem is that my surgeon said I should not have any injections in my hip because of the possibility of infection. I called his medical assistant last week and asked if that was for a particular length of time or forever. She said forever. So now I will call her back and tell her the specific injections the pain specialist mentioned and have her ask the surgeon about those specifically and if he again says no, I want to know the reasons. And I also want to know what he suggests I do about this pain.

The pain specialist said that they’ve done many injections after THRs, but that they would not go against my surgeon’s instructions. She also agreed that I’ve gone as far as I can go with pain meds, having tried Journavx unsuccessfully. She did suggest I increase the dose of Gabapentin I take (900 mg for restless legs) to a maximum of 3600 mg. The higher dose didn’t help the pre-surgery pain in my other hip, but I’ll give it a try. She also prescribed lidocaine patches.

I want to have an MRI of the L-2 and also my hip. I assume an MRI would show heterotopic ossifications, which is a whole different ball game than a nerve issue in either my back or my hip. Ugh. But it seems to me I should get that figured out before doing anything further.

I discovered many threads on Reddit about post-surgery hip pain. Apparently, it’s not unusual for pain to last many months or even more, so I’m not sure if I’m being impatient or not. I guess I can decide to be patient once I’ve determined that there is no particular diagnosable reason for this pain.


I’m open to any ideas/suggestions, etc. Thanks!

 

[Layla]

No worries about the length of your posts, Lilibet. You will later view this as a journal of your recovery. I can't count the number of times members have lamented over wishing they would have documented more than they had on their thread.

Please do limit the walking for now if its causing pain to ramp up until you have a sound diagnosis.

So now I will call her back and tell her the specific injections the pain specialist mentioned and have her ask the surgeon about those specifically and if he again says no, I want to know the reasons. And I also want to know what he suggests I do about this pa

I will be curious to see what your OS has to offer. Also wondering what his opinion is on the MRI. I'm sorry you're struggling as you are, Lilibet.

It is true that pain can continue for longer than many expect, but it usually gradually improves with time. At three months post op soft tissue is still healing and you will have some stiffness after being off of your feet for awhile and often discomfort after long days of activity. However if, its constant, not improving or getting worse instead of better, it's wise to dig deeper.
Wishing you a good nights sleep and many moments of comfort in the coming days.

 

[myglasshalffull]

I’m sorry you are still experiencing so much discomfort.
I’m not a doctor but might I suggest taking time away from PT and just walk for a few days and see if the pain lessens.
You are only 3 months into a recovery that can take many of us up to one year to feel better. You are irritating the soft tissues with the exercises and exacerbating the pain.
You know your body best & by all means you should continue to do what is right for you but sounds like the PT might be part of your issue.
Just my humble opinion.
You cannot exercise a hip into recovery.
I wish you the best & hope you fine the answers you are in search of.

 

[Lilibet80]

Thank you both for your thoughts and suggestions.

 

[Layla]

Hi Lillibet,
I hope you're having a good week so far. Just want to remind you we're here for support if you're ever in need.
May today be a good day.
@Lilibet80

 

[Layla]

Happy Four Month Anniversary, Lilibet!
First day of Spring tomorrow. I don't know about you, but I'm ready!
I hope you're doing well. Wishing you a lovely Spring 2026!
@Lilibet80

 

[Lilibet80]

Hi all,
I stopped PT a week ago. It was causing pain flares no matter how careful I was. The PT thought it was a good idea to see if the MRIs pinpoint a cause before continuing and I agree.

My lumbar MRI was its usual mess. My PCP referred me to my back surgeon to see if there’s any tweak he can do that would help the hip. The last time I saw him he said the issues in my back are so complicated (scoliosis, stenosis and more) that it would require really complex surgery to address. I said “Nope” and he looked relieved! So we’ll see if there’s something small he can do.

I had to move my hip MRI from April 26 to May 12, unfortunately. I hope the solution lies there. Interestingly, I was reading comments on a “Medical Mystery” article in the Washington Post. A woman said that her husband had been in pain since his hip replacement a few months ago. Nothing was wrong with the implant and there was no solution until a new doctor did a new set of X-rays and discovered that the implant was moving when her husband walked because it was loose, causing pain. I am definitely filing this in my back pocket when I get a second opinion. The fix requires surgery…I guess a revision…and that’s not fun, but neither is pain. It would be nice to get off this hamster wheel!

So that’s the latest. I’ll check in after my hip MRI and whenever I see my back surgeon and also get a referral to a different hip surgeon for a second opinion.

Have a lovely spring whenever it arrives for you.

 

[myglasshalffull]

Good idea to stop PT for a while. Have the MRI & go from there. Interesting article you mentioned about the replacement moving around when that man walked. I think these surgeries have become so cookie cutter that when one doesn’t fit the profile we are put in limbo!
Keep,us posted.

 

[Layla]

Hi Lilibet, It is nice to hear from you, thanks for taking the time to post an update.
I am sorry you're dealing with multiple issues all at once.
I do hope the MRI on May 12th gives clear answers and that anything it reveals is something that can be easily addressed so you're able to move forward with ease. I will look forward to your update post MRI results.
Until then, I wish you comfort.
@Lilibet80

 

[Lilibet80]

Hi everyone!
I’m finally getting back here. I’m too tired right now to go into detail, but here’s the gist.

My MRI May 12 was a mess…so many possibilities, most requiring surgery. My surgeon wanted to rule out an infection before doing anything else, due to my labs. So he sent me for an aspiration of the minimal fluid shown in my hip. They couldn’t get any. He sent me back for a second try, which was this week July 2. Again, no fluid. So no way to determine if there is an infection.

I seriously don’t think there is an infection since the pain started right after my hip replacement Nov 19, but what do I know! I have no other symptoms of infection. So I should hear from my surgeon this coming week. Or I will call and bug him. When I have a chance, I will post the MRI results for your insights.

My back surgeon has ordered an injection thankfully, so I’m awaiting an appointment for that.

Most of May and June have been exhausting. My husbands bad leg that needs a laminectomy collapsed on May 16. He fell in the bathroom, breaking his good leg near his hip replacement, but no surgery needed. After a few days in the hospital, he went to rehab May 20 for PT and is finally coming home this Wednesday July 8 after seven weeks! Fortunately, it’s a decent place and the food is very good, so he survived. I tried to see him several times each week which required getting a ride from friends to go the fifteen miles. Hence, my exhaustion. He’s doing really well and can put half his weight on the broken leg and use a walker, although we bought a portable wheelchair for when he gets tired (or I do!). PT will continue at home.

More later. All for now.