THR Struggling after emergency THR

[BlueSkiesHere]

@Cillacat Just what I needed to hear this morning. I just popped in with you in mind and here you are with a reassuring message. Yes, in the States the insurance companies are slower to embrace any alternative methods and it is usually out of pocket. Since the last time I was on I've been doing some DEEP diving to find anyone (of trustable note) that could offer the trigger point therapy at a semi-affordable price. Did you have difficulty walking? I can only walk a few steps before that forward motion really hurts and aches on the inner thigh which affects my groin area. geezzzz.....

@Jamie and @mendogal I will tag you guys also. This is what I have found - the ONLY therapist I could find that offers this. This person offers 1/2 hour sessions @ $65 which still too expensive but if it could help alleviate ANY of this discomfort - I'll have to bite the bullet. She offers an hour at $110 and that is not doable. What do you guys think of her training: It says...

" **** graduated in 2011 from Texas Healing Arts Institute in Austin, TX, and specializes in Trigger Point Therapy for injury recovery and chronic pain. She has studied and practiced a wide variety of modalities, including Myofascial Release, Cupping, Kinesio taping, Lymphatic Drainage, Reflexology, Aromatherapy, Hot Stones, Ayurveda, Reiki, Prenatal, Oncology massage, and Somatic massage for PTSD and anxiety.

She taught Trigger Point Therapy and Self-Care Techniques at the Burke Williams Academy in Inglewood, CA, and has personally trained over 400 therapists at the luxurious Burke Williams Spa in several locations in southern California.

She aims to create experiences that are both deeply relaxing and extremely effective. Every massage is customized, goal-oriented and includes a creative combination of modalities and techniques. She is also available to assist in helping create and adjust self-care routines to optimize energy, peace of mind, range of motion, and decrease pain."

I went ahead and set up two 1/2 hour appointments a week after the CT scan. I just want to make sure there is no occult fracture or torn tendon/muscle. My After Care PA believes it is muscular because of my movements and where the pain is located.

Does this person sound legit to you guys?

 

[mendogal]

@BlueSkiesHere
I would try one session to see how it goes, if she's responsive to your needs, etc.

There's some of "grains of salt" that might be taken with her credentials. Over decades I have seen both body workers and martial artists claim to have "studied xyz" which can simply mean that they attended one day of a three day basic seminar.

However her certification and years of experience are definite pluses.

There truly are people who simply have an innate feel, reinforced by long experience, for "reading" other's bodies and whose touch almost immediately is therapeutic. There's no substitute for getting a session.

 

[BlueSkiesHere]

@mendogal Thank you! Will do on the one session.

 

[Jamie]

I agree with mendogal’s suggestion. You definitely don’t need an hour of the therapy. In fact, a lot of my sessions were just 15-20 minutes. The pressure therapy doesn’t take a long time necessarily. Out of that long list, probably the main therapies you might need will be Myofascial Release and Lymphatic Massage. I like that she would also teach you how to do some of the therapies yourself at home. Since cost is a factor, be sure and ask about that. I wonder if she would consider 15 minutes sessions for you at a reduced cost.

 

[Cillacat]

Hi again @BlueSkiesHere I agree with all the recent advice about trying out this practitioner once and seeing how you go.... but only once you have the all clear from your scans. In answer to your question about difficulty walking: YES.... I had a lot of trouble. It was really difficult to walk very far at all as it was so painful in my groin and sitting for long was only do-able thanks to my trusty heat pad on my recliner. Your description of only being able to walk a few steps before the pain sets in is exactly my memory of me! I used to just despair sometimes and was so afraid I'd never get better, but I did. Your experience sounds to be so similar to mine which is why I feel so confident you will completely recover as I have, but it took months not weeks. Give your body the rest it needs, it's working very hard at the moment to heal for you

 

[BlueSkiesHere]

Thank you, @Jamie - I will ask her and thanks for pointing out the type of massage she offers that might work. I'll have that discussion with her.
@Cillacat you continue to be a God send. Seriously. You are such a support and offer me so much encouragement. (plus the dog licking the face cracked me up). Thank you for the reminder to give my body rest, it's working hard to heal.

 

[BlueSkiesHere]

@Jamie and @mendogal here are the test results from my CT scan this past Friday. These were just posted on my chart and have not been reviewed by my After Care PA yet. I see her next week and her reading of the results. This is the initial findings of whoever took the scan and reviewed:

TECHNIQUE:
CT LOWER EXTREMITY RIGHT WO CONTRAST. Bone 3D CT reformats were obtained
at the console and interpreted.

FINDINGS:
Bone: No acute fracture or subluxation. Right total hip arthroplasty
alignment is stable and hardware is intact. No complication identified.
No osteolysis or bridging heterotopic ossification.

Soft tissues: No drainable fluid collection or soft tissue gas.

No visible complete or retracted tendon tear.

IMPRESSION:
1. No acute osseous abnormality.
2. Right hip total arthroplasty hardware is intact without identifiable
complication.

So after looking up most of the "big words" I take this as good news because it seems to not indicate an occult fracture or tendon tear. I'll see what she says. I hope this scan takes in account the psoas muscle discomfort I've been talking about. The last conversation I had with the After Care PA is her thinking it is muscular and the abductor muscle.

 

[mendogal]

Yes @BlueSkiesHere once you rule out bone and implant issues, what remains is soft tissue.

It's good no tendon tears were found! Abductor and psoas could certainly both be creating problems.

Psoas is a tricky one to work on but a very experienced hands on practitioner can do it and can teach you stretches.

 

[benne68]

That's a very reassuring report, @BlueSkiesHere! So many of our members encounter soft tissue problems like this and it can be extremely frustrating when our surgeons dismiss the problem.

Hope you can find a therapist who can help you with this.

 

[BlueSkiesHere]

@benne68 and @mendogal Thank you, ladies! Yes, I thought the news was encouraging. At this point it is a process of elimination so I will be treating what "is". I will take @Jamie advice and just book the 1/2 hour and check the trigger point therapist out and see if I feel she is capable and if we are on the same page.

 

[Jamie]

I think you are 100% on the right track. Now the challenge will be to find a therapist who is experienced in this type of problem and know the ins and outs of trigger point treatments. Looking forward to hearing more from you.

 

[Cillacat]

That's all good news @BlueSkiesHere! So as @Jamie and @mendogal say, it's almost certainly a muscular issue....and that will definitely heal with time and some gentle coaxing from a good therapist. If the first person you see can't help you, keep looking. I think trigger point therapy or similar is definitely the way to go. You're definitely on the road forward now!

 

[BlueSkiesHere]

Thank ALL of you guys. Yes, I will check out this therapist after my follow up appointment next Tuesday. I have an appointment with the therapist on Thursday to see if we are a "fit". If that doesn't work...I definitely will keep looking. @Jamie also suggested Myofascial Release and Lymphatic Massage as an option if I can't find a trigger point therapist that fits. That would also be a path forward.

 

[benne68]

Checking in to see how you are doing this week, @BlueSkiesHere.

How was your follow-up appointment yesterday? Any luck finding a new therapist?

Give us an update when you have chance.

 

[BlueSkiesHere]

@benne68 Thank you for checking in. I had my follow up appointment yesterday and it is a mixed bag. It kind of left me "no where" in what this is. I mentioned to her the trigger therapy as an option and she said she would check with the surgeon (which happened to be available in his office that day). They are suggesting I hold off on the trigger point therapy for now and want to try a iliopsoas tendon shot to see if that alleviates the pain. She said it could be muscular and in that case it takes a long time for that muscle to heal. I think the plan is to eliminate procedures one by one. The cortisone shot is not until the end of April! She is aware of my pain and discomfort so I do have a sympathetic ear. So the plan for now is to continue no PT therapy and to do as I've been doing until the shot. Then I have an appointment with her two weeks later to see how that affected my discomfort and walking.
I must admit I feel this crushing depression again after the non-information yesterday. I thought a had a plan forward. I did ask about the mention of a total hip replacement after a year (from last appointment) is still a possibility. She said yes, it is not uncommon after a partial hip replacement if there is an impingement. So impingement is not off the table either. She said that no matter what you don't want to just have a total hip replacement until you are sure what it is. If it's muscular or something else - a person would have just gone through an operation for nothing. It would still hurt. She meant that well but that was not reassuring to me desperate ears.
I don't know whether to go ahead and try the trigger point therapy or to continue to follow their direction. I told her my life has come to a crashing halt. The inability to walk more that 5 or 10 minutes really limits one. I can't even go to a grocery store! UGh. At this point it has been 5 1/2 months.

 

[Jamie]

I’m not understanding why, if you have to wait a month for the injection, they would not allow you to see someone who could try the trigger point therapy. I would call and get an explanation of why they want you to wait and continue to be in severe pain. Trigger point therapy can aid in muscle healing since it relieves tension and spasm within a muscle and allows it to relax.

So sorry you’re having to go through this! But I don’t think it’s acceptable to force you to just hang out in pain for a month to wait on a shot that is just a “maybe” for a good diagnosis. Why can’t you get the shot sooner?

 

[BlueSkiesHere]

@Jamie That is a good question on why I can't at least go for the trigger point therapy. She said they use a specific person for that shot and the first available was April 23. I asked her if she was familiar with trigger point therapy and she said yes. She even shared that she occasionally has it for a hip abductor problem she has. HOWEVER, when she described how she felt during it, I inwardly questioned if we were talking about the same thing. Her experience is it is extremely painful as the person is "digging" into her tight areas but she feels relieved afterwards. That makes me think it is more deep massage or a myofascial massage. My understanding and short experience with it in PT was it was not painful at all. The areas were tender but I felt as more of a released feeling from the tightness for a day or so. She thought it might either help or further irritate the area.
I'm thinking I might go ahead and have that appointment with the therapist I found anyway. It just makes sense to me it would help alleviate some of this tightness which would surely cause pain! Just like a tight IT band or knots in your neck and shoulder. Common sense it helps to release the tightness. I might go with my gut on this. What do I have to lose by meeting this therapist and having a discussion and a short session. I know now - if it hurts don't do it or let anyone else do it!

 

[Morgan Le Fay]

Sending you hugs

 

[benne68]

I'm thinking I might go ahead and have that appointment with the therapist I found anyway. It just makes sense to me it would help alleviate some of this tightness

You have nothing to lose by trying it -- and, if it works, you can avoid an injection. You'll know after the first session whether it helps. I agree; go for it!

if it hurts don't do it or let anyone else do it!

Sometimes, it's okay to have a bit of pain -- as long as it is temporary. My experience with trigger point release was that it was painful when the therapist started, but as the tendon released, the pain dissipated. And, I felt much better afterwards.

Let us know how it goes.

 

[Jamie]

This is NOT deep massage that is extremely painful. As benne68 says, there can be a little discomfort from the pressure at first, but that dissipates after a few seconds and then it’s just relief when the release happens. If you’re comfortable with the therapist you talked to, go for it. And let us know how it goes.

People sometimes interchange the terms pressure point therapy, trigger point therapy, and myofascial massage. But they are not the same at all. The type of therapy I am referring to is officially called trigger point therapy and it focuses on small knotted areas in large muscles that are contracted and causing pain. These knots can be located and, with pressure, made to release. When the treatments begin, the muscle may relapse back into a contracted state after hours, days or weeks. But continued releases will eventually result in a permanent restoration of the ability to those muscle fibers to relax and contract correctly with movement.