THR Struggling with Recovery - THR

[jefro]

Thanks everyone for the encouragement! Does anyone have any tips for helping to relax my tight muscles?

-I'm doing daily stretches as prescribed by PT
-R.I.C.E.
-Short walks around the house every hour or two
-Gentle Massage yesterday
-Acupuncture scheduled tomorrow

 

[Jamie]

It usually just takes some time. The massage is really good. You might also try a heating pad in between the icing. Be sure your incision is completely healed before placing heat over that area, though. It can be placed around the incision on the muscles that are tight.

 

[Deni444]

I'm still pre-op but have experienced a lot of pain from tense thigh muscles in the past. In the end what worked really well for me was tense then release. It sounds overly simple but it worked. I had to keep repeating every few minutes at first over a period of time but eventually it seems I re-trained my leg muscles to relax.

 

[jefro]

Thanks Jamie. I confirmed with my Ortho office that its ok for me to put heat on my incision at this point.

 

[jefro]

I'm still pre-op but have experienced a lot of pain from tense thigh muscles in the past. In the end what worked really well for me was tense then release. It sounds overly simple but it worked. I had to keep repeating every few minutes at first over a period of time but eventually it seems I re-trained my leg muscles to relax.

Hi Deni. Thanks for the feedback. I'm restarting my home PT today. One of my exercises is to squeeze my glutes. I have in person PT on Friday, I'll ask if doing something similar with my quads would be helpful as well.

 

[jefro]

I'm still pre-op but have experienced a lot of pain from tense thigh muscles in the past. In the end what worked really well for me was tense then release. It sounds overly simple but it worked. I had to keep repeating every few minutes at first over a period of time but eventually it seems I re-trained my leg muscles to relax.

Hi Deni. Thanks for the feedback. I'm restarting my home PT today. One of my exercises is to squeeze my glutes. I have in person PT on Friday, I'll ask if doing something similar with my quads would be helpful as well.

One of my exercises is also to squeeze and release my quads. Maybe i should do it more than one set of 10 a day??

 

[Jamie]

More is not always better with exercises when you are in recovery. The “squeeze and release” exercises are pretty mild and you could do more of them in a day if you want to….like maybe a second set at a different time.
But don’t make the mistake of thinking that twice the exercises will get you there twice as fast. It just doesn’t work that way when you’re recovering from surgery. The exercises are designed more to keep your muscles and joints working and mobile rather than strength building. So, as long as you’re not experiencing any swelling or pain from the exercise, it’s okay to make gradual increases in the number you’re doing. With these more gentle exercises like glute and quad squeezes, eventually your walking and activities of daily living begin to take over to work the muscles and get them ready for the later strengthening.

 

[mendogal]

Quad sets, which these are, were my go to after knee surgeries.

In my experience you're much better off doing smaller number of reps a few times a day. Like six while relaxing and elevating, several times a day.

It's not for building muscle - you're too early for that - it's for reactivating the quads and getting the nerves and the muscle fibers communicating better for more effective coordinated contraction.

 

[benne68]

Checking in to see if you are feeling a bit better this week after modifying your routine, @jefro. Did the acupuncture session help?

Let us know how you're doing when you have a moment.

 

[jefro]

Checking in to see if you are feeling a bit better this week after modifying your routine, @jefro. Did the acupuncture session help?

Let us know how you're doing when you have a moment.

It's been about a week since I started back with the PT/stretching/acupuncture/massage. Things are gradually trending better. I'm down to .5 Oxy in the morning & my pain is improved overall. My stiffness is gradually improving as well. I have acupuncture today and massage tomorrow. Hopefully things keep trending right and I can get back on the cane and off the Oxy completely. Thanks for asking.

 

[mendogal]

Oh that's good news @jefro ! The regimen to promote relaxation will also abet ongoing healing of soft tissues.

 

[Morgan Le Fay]

Good news

 

[benne68]

So glad to read that you are already seeing improvement, @jefro! I'm a big fan of therapeutic massage and I'm really interested in knowing how the acupuncture helps.

Keep us posted.

 

[jefro]

Hi All,

I have had some improvement over the past 2 weeks in my pain levels but I'm still taking 1/2-1 oxy in the morning and my stiffness hasn't improved much even with the PT/Stretching/Massage/Acu routine. I'm also doing weekly Epsom Salt baths, taking Magnesium Glycinate nightly and added Magnesium lotion as well. I was better off a month ago, oxy free and walking around on a walker, instead of a cane.

It's been 1 month since my flare up and I'm still back to the walker, back to sleeping on my back, back to the Oxy. It's frustrating.

I asked my doctor to send in a referral to another Orthopedic surgeon to get a 2nd opinion.

Regards,

Jeff

 

[Jamie]

Jeff, if you’re going to get a second opinion, it is best to have it be totally independent. This means you’ll need to search out a surgeon and set up the appointment. Otherwise you run the risk of getting a biased second opinion from someone your current doctors know and socialize with. If you need assistance in finding a surgeon, I can help you. but, I must warn you that most surgeon will not see patients for consultations and second opinions for at least 6 months from surgery date. Be sure you’re not doing too much in terms of activity and exercise. You may just need to give things more time.

 

[jefro]

Jeff, if you’re going to get a second opinion, it is best to have it be totally independent. This means you’ll need to search out a surgeon and set up the appointment. Otherwise you run the risk of getting a biased second opinion from someone your current doctors know and socialize with. If you need assistance in finding a surgeon, I can help you. but, I must warn you that most surgeon will not see patients for consultations and second opinions for at least 6 months from surgery date. Be sure you’re not doing too much in terms of activity and exercise. You may just need to give things more time.

Yes, I have requested my personal physician send in a referral to a new Orthopedics group so I can get a 2nd opinion. We'll see what they say about the whole 6-month thing. I'm definitely not doing too much activity & exercise. Just the prescribed PT/stretching and some walking with a walker to help keep my muscles from stiffening up. You are right, I might just need more time, but I'd rather get a 2nd opinion to confirm that. This is my 2nd surgery and I've been on medical leave for a long time. I can't afford not to heal this time.

 

[Jamie]

Oh, good. I misunderstood what you were saying. Please be aware that sometimes even just “the prescribed PT/stretching” can be too much if your soft tissues are inflamed. With hips especially, you don’t usually need a lot of therapy exercises. Walking takes care of it. You’re correct, though, that regular stretching and movement is important. Good luck and I hope you are able to get in to see another surgeon.

 

[Deni444]

Hi there @jefro

Sorry been distracted getting my replacement and missed your question about reps on glutes/quads. Personally, I do 10 when I remember, this is probably about 4 times a day. You can over do them and that's not going to help. Think maintain not strengthening. The number is going to be personal to you. Find out how many you can do before you are fatigued. Going up to that number and beyond is strengthening. Doing less is maintaining. Don't underestimate the maintaining because the glutes are notorious for getting lazy and not working. When that happens secondary muscles jump in to compensate and that's when a lot of issues start. Same is true if you over do it. Compensation will jump in somewhere to support a glute that is suddenly underperforming.

I really don't think of it as physio anymore because I've been using it as a relaxation technique for a couple of years. Going through as many muscles, squeezing them for a couple of seconds and then relaxing will generally ease tension in the whole leg, in my experience. I've shared what I learnt along my journey. My glutes were hardly functioning at all at one time. I had to work on them.

 

[jefro]

Oh, good. I misunderstood what you were saying. Please be aware that sometimes even just “the prescribed PT/stretching” can be too much if your soft tissues are inflamed. With hips especially, you don’t usually need a lot of therapy exercises. Walking takes care of it. You’re correct, though, that regular stretching and movement is important. Good luck and I hope you are able to get in to see another surgeon.

My situation is different since mine was a conversion from a failed ORIF. My glutes, quads, etc are very weak. I'm upset because I was doing better at 7 weeks than I am now at 12 weeks. The doctor's office doesn't seem to care. If everything is ok, shouldn't I be making progress?

 

[Jamie]

You do have a more complex situation than a typical hip replacement, but this is all the more reason to realize that making progress may be a slower process for you. I do hope you can talk with another surgeon as this would be the best way to find out if everything is okay.

Have you mentioned your concerns to your therapist? I would be curious to know how they felt your progress was going. I do know from personal experience with weak glute muscles, it took many months of therapy to see progress and I’m still working on it even though I’m no longer in therapy.