THR Six weeks since surgery and still can't do a straight leg lift.

[Erushka]

@webbie73 , you bring up an interesting point regarding levels of fatigue in PT.

Here's my 2 cents worth. I have spent considerable time lifting free weights in the gym, and I worked for years as a rehab counselor, but those are my only qualifications. I'm not a medical professional, so please discuss matters with your treatment team.

Muscles get stronger when they are stressed, then recover. You won't get stronger if you don't stress the muscle to some degree. The questions are: How much is enough? and, How much is too much?

In the weight room we often refer to muscle failure. With complete muscle failure, you simply cannot complete the exercise at all due to muscle fatigue. This is not a good idea in PT as it leads to muscle destruction, increased pain, and lack of progress.

Partial muscle failure is also a bad idea in PT, IMHO. Here you can complete the exercise, but only by compromising exercise form, in other words, by "cheating." This opens you to possible injury, and more muscle stress than you can easily recover from. A good physical therapist will keep a close eye on your exercise form.

I think that pre failure is the way to go in PT. You feel some muscular fatigue, but stop one or two repetitions before failure. That is, you are a bit tired, but stop before it gets painful and before your exercise form is compromised. That way, the muscles are stimulated enough to trigger strengthening, but they are not pushed to the point of damage or over-fatigue.

This is how I conceptualize exercise intensity, and it has worked out well for me in PT. I hope this might be useful.

 

[webbie73]

@Erushka, Very well put! I plan to continue my rehabilitation with that mind set.

 

[Erushka]

@webbie73 , it sounds like that is your PT's mindset as well. Best of luck.

 

[catdemar]

Thank you for the reinforcement. I've been wondering if I was not pushing myself enough. I'm feeling strong but don't want to hurt anything and just want to get into a good routine to get back to the gym and exercising every day. After so many years of pain I became a lazy about an exercise routine. Love riding the bike at the gym. Not to much resistance but feels good to move.

I want to get back on a bike (outside). I can't seem to get my left leg lifted enough to to get over bike. Can you suggest any stretching or exercise that could help that? My left gets over fine. My young some wants to go riding and that's why I did this
I had both hips done at the same time.
Have a great weekend.


Catrina

 

[Erushka]

I don't know much about biking. Suggest you contact Josephine who has quite a bit of experience. Maybe your PT can help with exercises specific to getting the leg up there.

 

[Josephine]

The joint could not be dislocated and the parts had to be removed "piecemeal." The channel for the stem was too narrow and the bone was "reamed out" to make it fit.

This often happens but patients usually never know about it! As for the femur being reamed out, this is a usual and very essential part of the process of every hip replacement. So don't worry about it meaning your hip was extra specially difficult. Sounded pretty routine (for a protrusio) to me!

My major frustration and the thing preventing me from enjoying my new hip is that try as hard as I might, I simply cannot lift my left leg from a straight lying-down position, no matter how much I engage the quads, the glutes, the abs, dig in my right heel, and use all my mental effort.

don't ever get anxious about this. Try using a leg lifter to help, or doing half leg lifts. It' helps to get things back into kilter.

I've begun to wonder if all this straining and trying is worth it and will be productive, or if I should just give myself a break and let the muscles come back when they have the nerve supply and requisite healing to do it.

Now you're talking! But you need to give them some encouragement to remind them what they are supposed to do. Just don't get over demanding about it.

As an overachiever, this failure to be able to lift my leg has been very difficult for my spirits.

Please bear this in mind - it is NOT your failure! Things like this happen but it's the consequences of the surgery that causes it.

I didn't know I had a long screw placed in my hip socket during surgery.

That's quite normal for certain types of prostheses - part of the design requirements!

Muscles get stronger when they are stressed, then recover. You won't get stronger if you don't stress the muscle to some degree. The questions are: How much is enough? and, How much is too much?

@Erushka you couldn't be more wrong! The only reason we get fatigued is because we'vejust had major surgery with a major anaesthetic to go with it! Read this Energy drain.

@catdemar please ask questions about your recovery in your own recovery thread.
This is EditorER's recovery thread.

 

[catdemar]

I'm out. Too many restrictions on a very confusing site.


Catrina

 

[EditorER]

@catdemar Please don't leave. I've enjoyed sharing with you since we had surgery on the same day. (And I am still figuring out how to use this site, too.)
I also have been wanting to get back on a bike but wouldn't dream of trying it at this stage of recovery. I'd be terrified of a fall. I am amazed that you consider it when you've had bilateral hip replacement. You are fearless!

 

[EditorER]

I had a challenging yet good weekend traveling for the first time with my new hip. The car rides from Santa Barbara to southern CA were about 2-3 hours long. With a pitstop midway I didn't get too sore. It helped that both drives were in the morning when I was most rested. I was the passenger, not the the driver.

When I rented an AirBnB apartment I checked out the access and was told there were a few steps. I decided to give it a try. A few steps meant a full flight. I managed okay, having just had a stair climbing lesson in PT. More challenging was the fact there was no parking provided. My husband always had to drop me off and then circle around the neighborhood looking for a free space. On a holiday weekend in Laguna Beach this was quite challenging. The other issue was that the bed was not on a frame. Just a mattress and box spring on the floor! The first night I had my husband haul me up for my frequent trips to the restroom (a residual issue from surgery). The second night, I slept on the couch. Lesson learned: ask more questions about the facility! After tripping twice over throw rugs, I pushed them all aisde with my cane. Another lesson: do a survey when arriving for potential safety issues.

If I had it to do over, I would have spent more and booked a handicap-access hotel room. Even if it meant staying just one night instead of two.

I used a cane for most of my walking. I also brought along a shopping cart/walker with a seat. It is a zippy device that moves along quickly. It was great for strolling the shopping district and for sitting on the main beach without having to get down too low.

By Day 3 I was confident enough to go down a LONG flight of sandy steps to the beach (hanging on to handrails on both sides and taking each step deliberately and carefully). By long, I mean at least 50 steps. Probably more. What a thrill to reach the sand and surf on a more rugged part of the coast. My husband brought down our usual beach chairs. I folded a beach towel to sit on to make the seat a tad higher and lowered myself, lower and lower, with trepidation. Managed that fine, too, and was able to push up from the arms when it was time to go.

Bottom line: getting out of the house is good. Undertaking challenges, if done sensibly, give a new sense of pride and freedom. At almost seven weeks post-surgery, life is becoming more normal.

 

[Jamie]

I'm out. Too many restrictions on a very confusing site.


Catrina

I'm sorry if you feel you must leave BoneSmart. The reason we ask folks to post questions like yours in their own recovery thread is that it can derail someone's thread when responses are made and side conversations start up. We've had this happen in the past and vital questions or concerns made by the thread's original poster (OP) were lost.

We care very much about all of our members and want to do our best to help them as quickly as possible. If you have any questions or would like to discuss this in more detail, please send a private message to any of our admins or moderators.

 

[EditorER]

Seven weeks and thinking I'm doing well until I go to PT and discover more things I can't do yet. Tried the hip flexor stretch by dropping operated leg off the table and the groin muscles were very painful. I couldn't get past them to feel the stretch in my quad. Tried balance exercises for first time and found myself very wobbly. Asked about sleeping on my operated side and was told that is a long ways off yet. (I absolutely hate sleeping on my back and need a second position for when I get achy sleeping on my right side.) Don't misunderstand: I like my PT and find him very reasonable. I just get so discouraged when I find out how far I have to go yet.

It doesn't help my mood that somebody parked right next to my car making it impossible for me to get in after PT. I had to give myself a little talk to steady my voice and then find a valet to move my car. He had to wiggle his way in and boost himself over and around the door. Without his help, I'd still be in the parking lot waiting for another patient - probably in worse shape than me - to come out. I was embarrassed to not have any cash to tip the valet. I'll make it up next time - and probably return to using the valet service.

Any advice on sleeping on operated side? How do bilateral patients sleep? If I get a piece of memory foam for padding could I do it? I've tried a few times on recent nights with a pillow under my body and was able to sleep that way for an hour or so. The pillow does create a shelf that is uncomfortable and strains my back.

Thanks for any tips, fellow hipsters.

 

[Jamie]

Sometimes you can place pillows to one side lengthwise to your body. Then you lean into them slightly with them behind your back so that you are on your back, but slightly tilted up on one side. You could give it a try.

 

[zauberflöte]

Why are you "a long way off" from sleeping on op side, have they explained? I had anterior, with no sleeping restrictions, but it was several months before the pain of my weight on that otherwise very happy joint was low enough that I could fall asleep. I knew someone here who had both hips done, posterior, about three months apart, and for the second one she was sleeping on that new op side at about two weeks-- how different we all are!
You know, I tried that flexor stretch at 7 MONTHS and screamed!! At 18 months I was able to begin letting the leg hang, and over about six weeks reached my full potential at five minutes per night. And then, dangitall, I pushed a little harder, and re-upped my odic membership in the OverDidItClub!! Sigh...
I do hate it when people park me in like that-- so glad there was a valet around to help you!



My phone sent this using BoneSmart Forum, clever phone!

 

[Nannyannie]

Hi @EditorER - was that your earlier post, you had 18 YEARS of adapting to pain? Wow, you expect all those muscles and tendons to get back to "normal" (whatever that is!) in just a few weeks. If only! I know I am the world's worst at resting but your body can only heal when it rests, even top athletes build in rest days in their training schedule.
I'm still wobbly but I always have been (ear problems!) and really need a new knee but I'm very flexible thanks to yoga. My doctor is impressed that someone with a LTHR and arthritic knee and spine can touch her toes - then stand up straight again!
I have a "blue badge" in the UK which means I can use special wider parking places at the hospital, shops, etc. as I need to open the car door wide to get in and out - do you have anything like that in the USA?
And as for all those restrictions - every OS seems to have their own list of what you can/can't do! Listen to your body, if it hurts - STOP doing it. Try again in a couple of days or so.
Nagging Annie is now going to sign out! Best wishes.

 

[EditorER]

Thanks for the encouraging messages.
@Nannyannie , I do have a handicap card for parking in the wider spaces. Often, those spaces are already filled. I usually can manage in a regular space, if the car parked next to me is parked properly. At least I had a kind young man to help me out the other day. I find people show a great deal of respect and consideration when they see my cane.

I did hear so much before surgery about how easy it is to recover from the anterior approach and how much easier recovery is from a hip replacement than a knee replacement that I truly did believe I'd be back to normal in just a few weeks, once the incision healed. Call me naive! I know better now, which is why I so dread the second replacement. I am sure it will go better, though, because my expectations will be more realistic.

I do not have sleep position restrictions. It is a little hard to turn on to my operated side but I can fall asleep on it. I wake after about an hour with a burning feeling. I asked my PT for advice on something to lay on to make it more comfortable on that side and that is when he told me I was months away from sleeping on that side. I think he meant it would take that long before it would be comfortable. I still believe that if I could find a thin memory foam or gel pad I could sleep two hours on that side now. Two hours is the best I can get out of any position.

I went to a special drugstore yesterday to look for anything that could make sleeping more comfortable. I left with a triangular shaped wedge for behind my knees (to replace two pillows stacked on top of each other) for back sleeping and a block to put between my knees for side sleeping (instead of one bed-size pillow). On impulse, I also bought an electric blue collapsible cane. I haven't found either sleep device to be very comfortable, but I do like my snazzy new cane!

@zauberflöte I've decided to work on gentler stretches before tackling that scary bed dangling stretch again. Thanks for helping me get some perspective on what is "normal" -- or not -- at this stage.

I am coming up on 8 weeks and hoping to see some major improvements in the next couple of weeks. I know, I know, "It is a marathon, not a sprint." I just so badly want to get to a point where I feel better NOW than I did before surgery. I think that will make the surgery and all this frustrating recovery feel worthwhile. Until then, the only improvement I see is in the pretty x-ray.

I appreciate everyone's stories, advice, and encouragment-- even the nagging!

 

[zauberflöte]

I bought a 3" memory foam mattress topper which makes any bed nearly as good as the water bed flotation system I had for recovery and 20 years before that. I bought it at Amazon, made in USA, and lovelovelove it! pricey, but good for many years


My phone sent this using BoneSmart Forum, clever phone!

 

[EditorER]

I need to change the title of my thread to "I made it!"

Finally did the straight leg lift last Friday - at 8 weeks 2 days. Have repeated the feat a few times since. It takes about 30 quad sets to get those muscles ready for lift off and then I can do just two. But I am overjoyed to know those hip flexor muscles are going to work again!

PT says I will need to use cane for a logn time, until no limp from leg length discrepancy or second hip surgery. I don't mind too much. I find it helps people to give me wide berth and consideration when I am using the cane. Bought a cute bright blue collapsible one with a gel grip handle. I like to be able to fold it up in a movie theater or church to avoid those embarrassing loud crashes when the cane inevitably falls over.

Speaking of church, I took my first tumble there yesterday, courtesy of dear husband. Our church meets in a performing arts center with theater style seating. For some inexplicable reason, he flipped down a seat for me without asking if I preferred to sit or stand during the singing. I crashed right into it and fell forward into him, dropping cane, communion elements, and dignity. I felt wrenching in my ankle, shin, knee, thigh and hip and was pretty paniced. Everything eventually settled down and now I know I can survive a slight fall. As for my marriage....

Really beginning to feel less tightness in the operated leg. I braved cold water and got in the pool yesterday, whi felt wonderful. I didn't swim but walked back and forth and then "rode" a noodle doing all kinds of wonderful kicks and jogs.

Next time, I am going to know that it really takes 8 weeks to begin to feel on the brink of normal. I am going to nap more, take more time off work, and (hopefuly) cry less. This recovery process has been so much harder and frustrating and depressing than I ever could have imagined. And I've not had setbacks and have had good support from friends and family. We THR patients really are braver, stronger, and smarter than we think we can be. We have to be!

 

[webbie73]

Glad that you did the leg lift. I personally don't see the need to do a full leg lift at this stage of the game. I am looking for function. In time I will heal even more and then I will worry about strengthening my hip flexor if needed.

 

[Constanze]

Hi @EditorER ,
I was both interested and amused to read your thread about the straight leg lift.

I agree with Kathy on this point. Straight leg lifts are not essential. Neither for keeping fit nor for everyday life. The aim is to walk without a limp - because limping not only looks horrible - it's not very good for our backs.

But what really amused me was how you called yourself an overachiever. You take everything with a good sense of humour and that's good and helps your recovery. I saw some similarity to me: I could also call myself an overachiever. After decades of working life I found out that I couldn't really get ahead much more with the big career, and decided to just enjoy work but channelled all my ambition into sport: Did 10 marathons. But then my hip got too painful and needed replacing. While I thought I was a good girl not overdoing it and not doing too much too soon with my recovery - uups, I did it again after all - being ambitious and also a little bit vain - trying to walk without walking aids at 3 1/3 weeks. Immediately got told off by people, including one of my adult daughters. The message was - use your crutches until you are confident walking perfectly symmetrically and without a limp. So I used them for another week, but not at all times .

Apart from that, I'm fine now. Good luck for your future recovery and life -
Best wishes - Constanze

 

[EditorER]

Hi Constanze,

Thank you for your affirming message. I do try to write humorous and positive posts - even through tears! Life is so much sunnier now at the 13-week mark. I am not completely back to normal, but am getting close enough to smell it. I am just back from an 18-day trip to visit family and friends in the U.S. heartland. We flew to Minneapolis and then rented a car and drove 2,000 miles through Wisconsin, Michigan, Minnesota, and North Dakota. All went well. My cane came in very handy for getting priority seating on airplanes, flagging down the airport carts, walking on beaches and lawns, and negotiating lots of steps. And for clearing doorways of the many nieces' and nephews' tennis shoes and sandals carelessly left where their owners stepped out of them.

I am still using a cane due to back pain. Best guess for the source of the pain is the leg length discrepancy that won't be corrected until I have my right hip replaced. I am loathe to do that at present. I am using the cane less and less in the house and office as I am finally walking without a limp. My PT recommends I use the cane as long as I have any back pain. This morning, my doctor gave my a prescription for more PT for my back. And told me to come back in one year for a hip birthday checkup.

I've begun biking and feel quite daring when I do it. I've gone for two one-hour rides and several shorter ones. Every time I get on a bike I think of you riding to your 3-week post op appointment. What a dare devil you are!

My daring vacation adventure was descending a step ladder propped against the dock to get into the lake at my parents' cabin in northern Minnesota. With two people holding the ladder and very slow and careful steps, I made it without mishap! It felt so good to go for a swim!

My best to you and all the other April surgeries who must also be back to enjoying life by now.