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THR Spongebob's Recovery Journey

@Charlie33 you rock buddy! That was such an informative post, not only for Sponge bob but the rest of us as well. And I love that you explain your issues in easy to follow, everyday language.
 
Charlie,
Such a great informative post.
Once again seems no matter what our issues are after THR someone here on bonesmart has already gone through it & can speak to what their resolution was.
Hope Sponge reads it.
 
@Spongebob hope you are doing ok. An important thing: no one, including me, has 100% mastery over this stuff. I have had several setbacks due to surgery not because the surgery wasnt successful, but because my tissues (specific to my situtation) were 'frozen' for a long time.

So I went back to my primary surgeon and got a second opinion on issues related to this last march, even bringing in MRIs of both my operated hip and back from my physiatrist for review. Basically both were 1) offended I had used a physiatrist not affiliated with their office and 2) basically said 'live with it', which means other than exercise etc, no surgery would help.

Hmmm.... so just 'live with it'. Sort of a bit disheartening, and then you realize most folks in healthcare actually dont give a care at all, they just move you along due to volume and all sorts of other reasons.

So now I just 'live with it', although know my second hip has given me grief for two years since first surgery but I'm still not disabled enough to have them replace it. Which technically they are right...I'm not in debilitating pain, can still function etc....

So I just live with it. Do I wake up every day and feel normal? Since surgery? Briefly for a 3 month period, but no. But to be clear: the replacement is a miracle! But not perfect... Plus my right hip is higher than my left operated hip due to the arthritis which affects me most days. I need to stretch, loosen up and still have aches and pains most day... but not Pain on a 3+ scale of 1-10. So I muddle along, because what I also learned is if you let this stuff take too much of your life, those around you suffer and I choose not to burden them....bacause any chronic health issue tends to drive people away if one overly focuses on it (lots of research on this).....so I just live with it.

Sorry..bit of a depresssing take... but showing the other side of 'charlie' who also has his own day to day battles. I wish the you tube videos of THR success stories were me, skiiing after two weeks...... LOL!
 
@Charlie33 …. Thank you for an honest and thoughtful post that describes your situation. It can help to focus more on the positive results from a joint replacement than whatever negatives are going on.

But I also want to say that in my own hip replacement case, I am so surprised at the length of time it can take to get long-standing problems on a more positive path. I had pain and gait issues after my hip replacement two years ago that are still “a work in progress” with my physical therapist. It took me over a year to find the right person (my therapist) to properly diagnose why I had pain (not horrible pain, but enough to disrupt my gait), but the implant looked great. The problems in my case were a bit of spinal scoliosis, a twisted ilium (part of the SI joint in your spine), and poorly functioning muscles in the hip and thigh. All of this had probably been going on long before my hip replacement, which told me it was likely to take an extended effort to get things better. So, after 10 months of therapy, my ilium is finally staying in its proper position. The hip joint is doing the same. My Gluteus Medius is gaining strength. The muscles in my groin are stretching a little better. And now I’m working to improve the strength and balance I’ve lost during this two-year struggle to “get right” again. So….my belief is there is always a chance for continued improvement when the problem is related to soft tissue. It’s my story and I’m stickin’ to it!!!
 
Charlie33 said:
Sure do. My physiatrist and PT educated me on my situation a while back, so here we go!

Normal Hip Flexor Contraction:
This occurs during activities like walking, running, kicking, and even sitting. These muscles contract to help lift your leg or bend at the hip.

Me: Abnormal Hip Flexor Contraction (Hip Flexor Contracture):
This refers to a condition where the hip flexor muscles become chronically shortened and tight, limiting the hip's ability to extend fully. This can cause pain, limited range of motion, and changes in posture. This is me!

My left hip flexor, which is the Psoas muscle oft referred to in recent posts, has damage from a bad fall where my leg was twisted behind my back at age 20. This led arthritis and partial fixed flexion contracture,a condition where my hip joint became stuck in a slightly bent (flexed) position and had trouble straightening out, even with passive movement.

I have been managing this since I was in my early 20's. I am now 55 and had THR almost two years ago. I have led a fully active life with my family but had to 'manage' this since that time (more later on this). Did THR help? Yes! But...because I had muscles shut down for such a long time (15+ years) it means I have to consistently work on it more actively than most who had shall we say 'normal' hip replacement (pain at 65, 3 years later THR 68 etc). All of this leads to the biggest thing I've had to focus on....

Neuromuscular Re-education: Arthritis and tissue injury sends signals to your muscles to shut down and stop working! So....deep breath haha... we need to retrain the communication pathways between the brain and muscles. It involves teaching the brain to send the correct signals to the muscles to perform specific movements. I cannot stress enough how specific this is to each person in terms of intensity and type of exercise. Also..

Massage: tissues that don't work for a long time get stuck together. A talented massage person will get deep enough to break up the adhesions so you can improve tissue quality. And after a massage when the tissue is released I go for a walk and just do normal stuff, avoid sitting and no exercise for 24 hours. This also helps the brain figure out you've been 'adjusted'.

Lifestyle adjustment: get a standing desk and make sure you move around and dont sit too much!

The tricky issue? Pain. See, when tissue shuts down and you try to move it, it will hurt. The mantra here is if it hurts dont do it, which I agree, but work with your care team on 'discomfort' v. 'pain'. I have discomfort off and on all the time for 30+ years. I don't take meds, just know for me its part of the game.

To sum up: while we share many of the same isses with folks here, perthes and my situation likely means we have to manage this as a chronic issue: when tissue shuts down around a joint for a long time, the THR helps but some of those tissues will simply be chronically grumpy. We can only do the best we can and keep moving! I had to deal with gluteal tendonopathy and Trochanic bursitis around my hip replacement over a year out, simply due to tissues being inactive for so long. While the archive here can be very helpful, it was hands on work with my care team that got me through!

For me, acceptance was a hard pill to swallow: so many folks seem to bounce back and be 'perfect' after THR and forget about it. True or not, many years ago I had to accept my situation was different than most, and chronic from a young age which helped my frame of mind and forward path. Everyday I can walk and spend time with my family is a miracle, which I can do.

Please share this with your care team to see if they agree or disagree. The most important thing? Never give up, and always always always keep moving!

Hope this helps!
Click to expand...
This is good to read but I have noticed ache in the non operated hip and knee so in essence both my hips and knees ache is this due to the THR surgery and after 38 years of my body suffering and dealing with perthes dieseae now my body having to realign all over again with a different way of walking and moving my body that is my question
 
Jamie said:
@Charlie33 …. Thank you for an honest and thoughtful post that describes your situation. It can help to focus more on the positive results from a joint replacement than whatever negatives are going on.

But I also want to say that in my own hip replacement case, I am so surprised at the length of time it can take to get long-standing problems on a more positive path. I had pain and gait issues after my hip replacement two years ago that are still “a work in progress” with my physical therapist. It took me over a year to find the right person (my therapist) to properly diagnose why I had pain (not horrible pain, but enough to disrupt my gait), but the implant looked great. The problems in my case were a bit of spinal scoliosis, a twisted ilium (part of the SI joint in your spine), and poorly functioning muscles in the hip and thigh. All of this had probably been going on long before my hip replacement, which told me it was likely to take an extended effort to get things better. So, after 10 months of therapy, my ilium is finally staying in its proper position. The hip joint is doing the same. My Gluteus Medius is gaining strength. The muscles in my groin are stretching a little better. And now I’m working to improve the strength and balance I’ve lost during this two-year struggle to “get right” again. So….my belief is there is always a chance for continued improvement when the problem is related to soft tissue. It’s my story and I’m stickin’ to it!!!
Click to expand...
Reading your post this is definitely my situation I don't have horrible pain but enough to distrupt my gait (my opposite hip and knee ache and on the scans they are fine) that is what makes me think its a gait issue casuing inbalnces in muslces making them work harder.
and my implant looks great on all the scans I have had also so I'm not sure what my issue actually is but that's what I think
 
In my case the twisted bone in my lower spine created an imbalance that affected my gait. That, in turn, caused the Gluteus Medius to not function properly and eventually weaken to the point that other muscles in the hip joint tried to compensate. That resulted in a poor gait and some continuing pain and weakness. Your situation may or may not be the same issues. But because it could be something similar (given your history), I believe continuing to work with a therapist who understands this balance and can routinely check your individual muscles and joints to be sure each is working as it should, will help. Someone with this knowledge can give you specific pressure point therapy and exercises that may eventually get you out of this problem. Although I’ve made improvements in the past year, I’m still working on mine.
 
Jamie said:
In my case the twisted bone in my lower spine created an imbalance that affected my gait. That, in turn, caused the Gluteus Medius to not function properly and eventually weaken to the point that other muscles in the hip joint tried to compensate. That resulted in a poor gait and some continuing pain and weakness. Your situation may or may not be the same issues. But because it could be something similar (given your history), I believe continuing to work with a therapist who understands this balance and can routinely check your individual muscles and joints to be sure each is working as it should, will help. Someone with this knowledge can give you specific pressure point therapy and exercises that may eventually get you out of this problem. Although I’ve made improvements in the past year, I’m still working on mine.
Click to expand...
Bingo!!! This is the PERFECT response. I could not have said it better @Jamie . Why perfect? Because it covers all three of us (Jamie, Sponge, Me) in this 'mini' discussion: individual biomechanical issues that are causing issues, whether it be the glute medius or opposite knee and hip, that were have to continue to work on for foreseeable future. We love our replacements, three successful surgeries, but yet ongoing soft tissue / gait / strength issues that require persistence and patience are part of our daily life.

And to widen the lens a bit: MANY joint replacement folks have the same issues and just build this into their day. Trust me, we just never hear about it.... Folks I meet in day to day life with replacements will quietly admit their issues to others who are 'in the replacement club', but to the 'non replacement' world we all say 'its perfect we are just fine'. Which leads to why youtube and the internet generally STINK (bonesmart exception!) as it just reinforces this notion everyone with joint replacement is jumping out of helicopters skiiing in Colorado.

@Spongebob you have had shifting pain in different spots, some on operated side, some on opposite hip and knee....just like me. It all comes back to tight, weak muscles and connective tissue OR tissue that has been immobilized for so long it may not ever come back to 'normal' status. Now... what does that mean? Mostly we have to 'live with it', working with trainer, getting soft tissue work or massage, smoking a hooka (kidding on last one!) but you get the idea: grinding away and persistently trying things to improve. And like Jamie said it takes MONTHS and MONTHS to see incremental improvement. I am living proof of that. My setback in February/March is only just now showing marked improvement and still not back to where I was almost a year ago. But hey thats life and we keep grinding away every day!

@Jamie really taught me a lot about pressure point therapy and massage which I have integrated more heavily into my day to day life - I don't even call it 'recovery' anymore - am almost two years out!

Best wishes to all, and never ever give up: this is a mind over matter game in many respects!!!!!!
 
I just wanted to jump in, although my experience is pre-op my journey has involved a lot of physio to delay surgery on severe hips. I have a curved spine, leg length discrepancy and severe arthritis in both hips and moderate arthritis in both knees. I'm at the end of my physio journey now but it can help to focus on gentle stretch and release exercises that start at the head, all the way down the body. You'd be surprised at the strange places that can be causing joint or muscle pain in hips, back and legs. For me I was able to identify the huge difference crunched up shoulders and a stiff upper body was having on my hips and legs. I didn't even realise, I had crunched up shoulders and had no idea I'd stopped moving my rib cage in a natural way. My abdominal muscles had also become very lazy, not engaging when they should. All kinds of things. A good physiotherapist who has a system wide approach is a good place to look for help. Some very gentle but focused strength, release and then relax made a huge difference to pain. I went from never sleeping well to sleeping like a log and being able to sit in comfort on the sofa.
 
Morning my wonderful hippy friends hope you all had a wonderful Xmas with your family's and friends.
Does anyone know why after a long walk or exercise the next day why my operated thigh hurts but then fades off after a couple days ?
 
Good AM Sponge & Happy New Year to you!
I'm guessing it's just muscles that get annoyed. I walk up to 6 miles a day. Most days totally pain free & other days I need to ice my thigh/surgery area & rest.
I'll be 3 years post op in February.
I just go with it.
 
Hi SpongeBob!
I agree with myglasshalffull.
If it's not affecting your ability to walk and function normally throughout the day, I wouldn't worry especially because it fades within a couple days after possible over exertion.
Wishing you a Happy New Year, SB!
@Spongebob
 
Thanks for the feedback your all great basically what I'm struggling to get my head round is at the 12 month mark of recovery my operated hip hardly ached and my good hip was fine now at 2 years post op my operated hip aches and if I do activity it hurts and the next day my operated thigh hurts bad then fades off after a few days and also my good hip now aches but I have had x-ray on my good hip and it says it's fine but a sports physio told me it's adductor tendonitis as it hurts when I squeeze a ball between my legs he said it's over compensatery from my left and also because my left has been inactive for so long ( while I was recovering not going to the gym) it affects the good side in terms of my good hip is not getting used like it was before to the range of movement like it was before ( he said it's like if I was a cyclist and they took the bottom of my leg off do you think after 12 months my other leg would be at full capacity having not cycled for 12 months not a chance)so it in essence it tightens up but the more I do dynamic stretching the more my hips will open up and loosen up and the stronger they get the less aches/pains I will get. I just want to live my life without this pain so I won't give up I will keep going mentally and physically I will keep working hard to put a end to this nightmare
 
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Your sports physio is probably correct. Various soft tissues are either too contracted and others too lax. Are you able to work with him on a regular basis to address these imbalances?
 
@mendogal unfortunately not no unless I pay £50 each session which will clearly get very expensive so unfortunately I'm on my own now to try and sort this issue out
 
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