ROM improvement??

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Rohanknitter

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This is kind of a crazy angle for this picture because I took it of myself, but I think I'm doing about a 45 degree angle here. That hutch my leg is on is 31.5 inches tall. Not nearly as impressive as Sugaplum's pictures, but considering I couldn't even cross my legs at the ankle before surgery, I am pretty pleased. Also - I can just about sit cross-legged ("indian-style") on the floor - haven't been able to do that for YEARS. Just a little demonstration for those worried they won't be able to do the things they want to after surgery.
 

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What picture, Karen? :pzld:
 
Yup, Karen. Gone again!!!:doh:Jo, Ive had the same problem. Her WHOLE file got downloaded earlier. That's exactly what was happening to me...
 
Hi Karen,

I do not see a picture either. It sure sounds like you are recovering great and getting your life back. :jump: :thmb: I have been meaning to ask you, Peta, or anyone else that has done the Outpatient PT if you thought it was of help to you. I only had the PT for the 2 days in the hospital and then I was on my own with a book describing what exercises to do. I just got finished trying to do the couple of exercises that I just do not seem to be able to conquer yet. One is laying on my side and trying to lift the operated leg, I just don't seem able to lift the leg much at all. I also have a stationary recumbent bike that I am not sure if I am allowed to ride or not, so I have not used it because it would definitely make my knees go higher that my hips. Were you put on a recumbent bike or told anything about it at your PT?

My OS is very well known and supposed to be a TOP Surgeon and is a surgeon that people go to for revisions on the hips and knees, but I just wish he gave hip patients some outside PT or at least a little more instruction. I was told that he wants you to walk, walk and walk. I had one Post Op Visit and then told to come back in a year. I keep debating whether to call and try to talk to a PA or nurse and see if I could get some outpatient PT, but just undecided if it would help or not. I am still limping also. I also have a tilted pelvis on the other side which I think has caused my leg discrepancy on the good side and that maybe why I am limping. Just not sure. I guess I have a fear of not knowing what I can do and cannot do so that I do not do any damage to my hip.

Maybe Jo would have some thoughts on this. I probably should have started a new thread on this, but I really would like to know your thoughts on the outside PT.
 
Oops! The thumbnail shows now I've come back to it!

Very good, Karen!
 
Ok, the picture is showing up for me now. Ever since flickr changed it's format I've had trouble posting pictures here. I hope it works!! I've gotta go start dinner for guests so I can't play with photos any more tonite - fingers crossed. It shows up for me as an attached thumbnail.


Hi Toni - please forgive a rather lengthy answer here....also, I'm not sure when your surgery was so that makes a difference also, also what restrictions your dr gives you. I don't have any restrictions other than no jumping or running.

My OS has his patients learn some simple pt exercises in the hospital and that's what we do at home for 8 weeks. My husband was convinced I should have outside pt so at 8 weeks I requested and was referred to that. Frankly, I wasn't too impressed. 90% of what he had me do I could have done at home with a handout to describe what to do. Also, my back muscles started really bothering me from some of the things he was having me do. I ended up having to start restricting normal activities because my back hurt, so I stopped going. I was supposed to go 8 times and I went 6. I think I'm better off doing my old exercises, I've also added the things from pt that don't bother my back, and also riding my bike and swimming. I want to try pilates for some core strengthening but I just haven't gotten around to it. Another factor for me was that we live out in the country, it's a bit of a drive and all that time and gas didn't seem worth it to me for what I was gaining.

I don't have a limp anymore except when really tired, the thing that helped most with that was the advice here on this forum to concentrate on going heel, toe....that and just practice walking and strengthening the muscles gradually seemed to do the trick. If there are exercises that you can't do , just keep trying. It may take time but you'll get there.

As for the bike, pt didn't have me do any but I could have at that point. I know my PA told me I could ride a regular bike after 8 weeks as soon as I was strong enough to get on and off without falling. Rode my bike almost 5 miles this weekend!! So there's my personal opinion, for what it's worth. I know many people on this forum have been helped by pt. If you go, make sure they take it easy on you. Pushing too hard really doesn't do any good. Good luck!!
 
I started outpatient PT, four days after I was discharged from the hospital and continued that twice each week for six weeks. It was a huge chore, but it got me moving. I was not ambulatory for the nine months before my THR, so that was a big deal.

For me, personally, I think PT helped. I'm not sure that is the case for everyone though. Karen and I had surgery at almost the same time, had very different experiences with PT, and it seems that, four months out, we are in similar places with our recoveries.

So, I'm reluctant to make a recommendation. Maybe try PT and see if you get anything out of it?
 
Karen and Toni, I have the same problem with my back as Karen does. I had to ask my OS for an RX as I guess he will give one IF you want to go. But the truth is I've always had a problem with my back when I have ever gone even though I ask for gentle exercises. I see on the RX that he gave me that it too says "aggressive" strengthening exercise which I will NEVER be able to do. I have ordered an exercise ball and 3lb hand weights but haven't had them delivered yet. If you look on Kathall's last thread I believe there are a few exercises (thank you again Kathy and Alex) And other posts from Jamie and others with suggestions. This is a GREAT place for getting ideas...:thmb:. Best!
FYI: It is helpful to put your surgery date(s) in with your signature. I believe there are instructions in the User Control Panel. Very Easy!
 
Way to go Karen! (I've just checked and I can do the same thing - haven't tried before! lol) :hehe:

Toni I can only speak from my own experience but as far as I'm concerned, my on-going physio post-op was essential as far as getting my full range of motion back again.

After my LTHR my then surgeon told me I didn't need any PT and to just do the exercises they showed me in hospital - which I did. After my recent RTHR, my new (read wonderful) OS regarded on-going PT as an essential part of my recovery process - and I can't tell you what a difference it has made! Yes - a lot of it was exercises that I could have done myself at home - but knowing I was seeing my physio each week kept me motivated and focussed on actually doing my at home PT!

The difference between my two recoveries was like chalk and cheese (for a multitude of reasons - not the least of which was a new OS) - I can honestly say, at 4 and a half months post-op, that I don't even feel like I've had surgery on my right hip! I am moving strongly, no limp at all - ever, totally pain free and feel like a new woman.

And I have to believe that all my hard work at physio has contributed to my fast recovery - after all, I'm 51 yrs of age, carrying too much weight (although I have lost 7 kgs since the last surgery) and NEVER thought I would feel this "young" and physically strong ever again!

So in a nutshell - if you're asking for my personal opinion - I would say definitely have PT if it is available! :thmb:
 
It's really encouraging to read posts from those who have had surgery prior to mine. Although I am feeling quite positive about my recovery, I still have a ways to go... sitting cross-leg on the floor, riding a real bike, getting dressed without a grabber. Thanks for your sharing.
 
Karen,

Thanks for your response. My surgery was on March 16, 2010, just shortly before your second surgery. I think my procedure was a Direct Lateral (Incision 5" on the side of my leg when I had my husband measure it.) I really have to get my records. I realize that I have not been told a lot. Top Surgeon and I guess a busy surgeon.

My restrictions were:

Do not cross your legs
Do not bend your hip more that a 90 degree angle
Do not lean forward more than 90 degrees (such as reaching to your feet for covers,
or picking up an object off of the floor.)
Keep legs, 6-10 apart
Use elevated toilet seat
Use a cushion for all low chairs (minimum 21" high)

NO sleeping on side until Doctor tells you it is okay (usually 6 weeks) Pillow between
knees
NO Driving until Doctor tells you it is okay (usually 6 weeks)

Do not rest in recliners (actually it was a big NO to recliners and rocker/recliners)
NO sports for the first 3 months
DO NOT use exercise equipment, whirlpools or spas until your Doctor tells you it is
okay. You may eventually return to golf, swimming, dancing and bicycling.

My book does not tell me how long I am to stay with these precautions.

Funny part is that I was not really told anything other than the driving at 6 weeks and to "Loose my Fear" of falling without the walker. Use the walker in the driveway and the cane in the house until I felt more secure. This was at my only post op visit at 5 weeks. I had a list of questions, but didn't get to ask most of them.

The PT Lady in the hospital is the one that told me that there is no Outside PT for HR, just the regular exercises that I see most everyone is given to do at home. The Doctor just wants you to walk and walk.

My back is another issue for me. Actually went to a Spine Surgeon in Nov 2009 and it was his PA that sent me for hip x-rays and then the Surgeon came in and said he would not touch my back until I had a Total Hip Replacement on the right side. He said I have two issues, my back and my hip. I was supposed to go back to him and have not done that yet either. He is the one that told me about the Tilted Pelvis. He was not and did not discuss my back issues with me at that time. I know that I have Herniated Discs from L2, 3, 4 and 5 plus other issues. Actually after this hip replacement my back is not bothering me as much as it did. I really thought it was all my back, had no idea it was my hip. I still would like to know what he has to say though, while I have the referral and the current MRI. I have a lousy young female FD, so I had better get back to see the Spine Surgeon while I have the chance.

FD sent me to PT in 2006 for my back. I was given 12 visits and then she refused more and said that the PT took care of my Herniated Disks. Like she can see my spine. PT had sent her a letter requesting more visits. All this time it was my hip also and no one mentioned it. Even the two Chiro's that I went to after that.

I have been following your progress and you are doing great. I guess I am just going to have to write out a list of questions and call the OS's office and get them answered.

I am not sure if PT would help me or not. When I get back to the Spine Surgeon he could send me for strengthening exercises for my back also. I still think that I would not be limping if it were not for that tilted pelvis and the leg discrepancy.

Two more things on my to do list I guess.

Thank you for your response and help and keep up the good work.

Sorry for the long post.
 
Alex,

I have followed your posts and you, Karen and Peta are the ones that made me wonder if some Outside PT might help me. I am just unsure of what I am allowed to do and when.

I really do feel that these Surgeons should send you Outside PT at some point after in your recovery. I would of had a very hard time getting there until I was given the okay to drive though.

You are right, I could quit if I didn't think it was helping me.

Karen mentioned concentrating on the "heel-toe" and I do try to do that since I saw it posted on this website. I am still doing my exercises and trying to walk as much as I can. I have to do my laps in the driveway here as there are no sidewalks.

You are doing great in your recovery with all that you have been through. :thmb:

Thanks
 
Toni, as you've written more, I think you should ask for a referral to PT. What happens is that you will see the PT for an initial consultation and evaluation. Then the PT finds out from the referring doctor what your limitations are. Actually, the right PT can be a good source of information about your recovery. I know that mine was a much better communicator than my surgeon and his assistants combined.

You know, I had a tilted pelvis too. The surgeon never noticed it because he pretty much just sees my hip and the rest of my body just happens to be attached to it. My PT was the one who noticed that I had that tilt and he was the one who fixed it. I don't know if the surgeon ever even knew about that, but PTs see a lot of people with back problems and it seems to be more on their radar.

For me, one thing that went along with the tilted pelvis, was that I wasn't bending the knee on the "up" side when I walked. It sort of made sense, at one point, because it hurt to bend that knee. By the time it didn't hurt, the habit had already been formed. Once the PT got me to bend that knee again, the pelvis leveled out on its own and that eliminated my lower back pain.
 
Peta,

Thanks for responding. I see that you have really come a long way since your second surgery in March. Reading your posts has been very encouraging, but I just don't feel that I am where you, Karen and Alex are at in terms of regaining the strength and ROM that I feel I should have.

I guess I have a decision to make whether I go back to the Spine Surgeon first or call and ask for PT from the Hip Surgeon. I really need to do both.

Thanks again for all of your helpful posts. :thmb:
 
Way to go Karen! Looks like you are doing just great. Thanks for posting your photo.

Toni05 - as a person with a history of back problems as well, PT for me was more about confirming what I could do (how I could progress) and then giving me the tools to go do it on my own. Building the strength in the back as well as the muscles around your hip/leg is important. My back surgeon also did not have the time of day for me and didn't think PT was important after my back surgery. I had to self refer and I am glad I did. My hip OS fully supported outpatient PT.

It just takes a few visits to get you on the right track. I would give it a try and see how you get on.
 
Toni,
If you don't feel like you are progressing as you would like, then I would definitely see about pt. If you don't feel it's helping you can always stop going. I would also call your surgeon's office and ask about your current restrictions - they should be able to tell you how long each of those restrictions should be followed. Also, you have some extra stuff going on because of your back, maybe pt would help with that. I don't have any disk problems, mine tend to all be muscular and are generally alleviated by rest, ice, and getting my core stronger.

I think much of my back issues were caused by my hips being so bad, and now with some time, rest, and gradual strengthening, my back seems much better. It used to really hurt if I was on my feet much and that has disappeared.

There were a couple exercises my pt had me do that were straining the back muscles and he kept having me do them even when I told him my back was bothering me. That and the fact that almost everything he had me do, he showed me on the first day and just kept having me do the same thing, is why I stopped going. Maybe I just didn't luck out with the pt that I got....or maybe he didn't think I needed a lot of extra help??

ps. I don't want to give the impression that I don't think pt is helpful, I still do my exercises I learned in the hospital almost every day. The therapists at the hospital were invaluable for helping me get moving again and teaching the right form for the exercises they had us doing.
 
Hi Karen
Great photo and I'm amazed at how far you've come in such a short time..
Your story is inspirational and certainly keeps me in my postive frame of mind for my upcoming surgery..

Thanks for sharing so much of yourself to all your Bonesmart friends.
 
Hi Toni, My first surgery date is the same as yours but I can't count that as I had to have it done over on 4/6/10! I agree with Karen's last post. I am definately NOT opposed to PT. In fact I said I asked my OS for the Rx for it. All I meant was in the past they have been TOO AGGRESIVE with the exercises with my bad back as it is. In my case less would be more. As for the hip that's another story. I think it could ONlY help me at this point and I do intend on going. I would rather work on back strengthening at home until I have a little more strength so I don't get set back and become unable to do the hip excersises, unless they will be gentle. And Karen I have NEVER in my life been able to sit indian style. I wonder about the shape of my pelvis now...:sct: I also think the PT would communicate my problems to my OS in a better way than I was able (or no able) to do. Perhaps he would listen to her...more so than he did to me :evil: !
 
I have to add that PT has been most helpful to me and to share my mother's story. She had both hips replaced in the mid 1990s (2 years apart). She had lots of physio BUT has continued to faithfully do exercises twice a day, every day. She is now 91, lives on her own in a condo and the OS says her replacements look as good as they did when he performed the surgery. He said those exercises are for life...not a bad deal if the results end up like hers have.
 
Nonsense! It's good to do exercises but don't be fooled into thinking it's essential for the THR. The new hip would have been that way anyway, not because of any exercises she did.

Glad she's good, though.
 
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