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[THR] Stubborn pain- normal or PT induced?

Marls00

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Hello all! Glad to have found this site! My anterior hip replacement was done on Aug 19 in the U.S.
After a bumpy start due to a bad reaction to anesthesia and initial pain meds, I was discharged from the hospital after a 2 night stay. Starting around day 7, I began reducing my pain meds which weren't doing much anyway. (Tramadol). By day 9, the pain was very minimal most of the time while walking with a walker and almost non-existent while laying down and sitting (except for some butt muscle or butt nerve pinches that still comes and goes). But it continued to be painful to swing my leg up onto the bed or lift it up onto a footstool. I've been doing the PT exercises at home for about 5 days now-twice a day, though they recommend 3 times per day - and have been to the PT twice so far. (Most recently yesterday.) Today that muscle (adductor?) is quite sore and my range of motion which seemed to be improving ever so slightly, feels worse. I'm discouraged that swinging my leg up onto the bed or lifting it at all seems worse. I'm going to go very easy on the PT these next few days, hoping that will help. But just wondering if others who have had anterior hip replacement have trouble with that muscle - I believe adductor is the one - going into their 2nd week of recovery. It's really the last piece of the puzzle for me - once it heals up I will have virtually no pain, but it's a stubborn little thing that is quite painful when triggered. Of course, that little troublemaker voice in my head sometimes sneaks up on me and says ooooh, something is wrong, this is not normal!! I try to ignore it as I'm still in the early days of my recovery, but it's a challenge not to worry sometimes!
 

alexthecat

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Welcome to Bonesmart! I'm sorry you're having pain now. You're quite early in recovery and progress isn't always quite as linear as we might like.
I'm going to go very easy on the PT these next few days, hoping that will help.
I would suggest that you go one further and take a break from PT completely for a few days or even a week. Those exercises aren't really necessary for recovery and they can easily set you back.



Sent from my SM-S327VL using Tapatalk
 

Celle

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Hello @Marls00 - and :welome:

It's still very early days and your hip is still going to be sore. Try to treat it gently.

Here is the post-op reading we give to everyone with a new hip:
Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access these pages on the website

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it

Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 

mainegirl1

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I got a sheet of gentle exercises from the hospital PT and I do do them 3x a day as they are gentle stretches
I think its far too early for me to engage in outside PT
As a matter of fact until the six week checkup the OS forbids it
I have an uncemented hip where osteophytes must fuse to the implant
I am the same day post op as you
Yea lifting the leg onto the bed is difficult
I am using a sash. I tried once without and hurt more. That is my one potentially painful movement that needs assistance
As i know that two weeks ago I could get into bed I know that the ligament needs healing not training
PT could be useful later to retrain muscles that haven't been used properly in years, but not now
 

Mojo333

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:wave: and :welome: to the forum. Congrats on your new hip and allowing us to share your recovery journey.
I agree with the above members and staff advice. You just need to drop the PT for now.
Too often, new hippys engage in PT and attempt exercises too quickly without respect to pain. Allowing trauma to settle and healing to happen first will ultimately allow the neuromuscular control truly needed to progress.

Help that injured leg out for now...don't ask it to do more than it is ready to do and you will find that all will keep getting easier.
Early days and this is all temporary. :yes:

Hope today is a good day!:SUNsmile:
 

gertie

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Just to add another voice to this chorus! I had in-home PT in the first couple of weeks--she gave me a sheet of exercises but when doing them caused a slight increase in pain (mostly in the groin area) she said to stop. She underlined what is said on here--the best thing to do is walk--and not too much in early days. Let everything heal.
 

SurreyGirl

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I used a dressing gown cord for nearly three weeks to get in and out of bed. You can’t force this but logleg does go eventually! Like the advice re the gentle PT and if it hurts STOP
 

Jaycey

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Are you icing and elevating that op leg? Ice for 45-60 minutes several times per day. Try a bit of Tylenol if you are still having discomfort. Still very early days for you.
 

CricketHip

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Hello and welcome! You have already received the best of advice so I'm just here to say hi and hang in there, you really are still in the early days of recovery.

I had the anterior approach, too.
Hang around and do some reading, it's very helpful. :flwrysmile:
 
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Marls00

Marls00

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Thank you all. MaineGirl and SurreyGirl, using a sash is a great idea. Why didn't I think of that!??
OK, so based on everything I'm reading here and on this website, PT is not necessary - certainly not at the level that is suggested by some therapists and doctors. And, actually, my gut was telling me the same thing. I actually had decided that I was going to do less than what the therapists consider the bare minimum (aside from walking) but once I got to the PT office, I got swallowed up and pulled in and started pushing it a little harder than I had intended! (My surgeon is very good and has such good a good record with outcomes, that I felt conflicted because he believes in the PT.) In any event, I will not do PT for the next 3-4 days and after that, I will just do the simplest, most gentle exercises and will do them sparingly for about a week. We'll see where things stand after that.
On another note, I never realized how often I drop things! Those first few days I was leaving a trail everywhere in my house. Thankfully, I am now able to bend over and pick up after my butter-fingered self!

Thanks, all! This is a wonderful site ... very helpful. I've been reading the articles and will continue to check in.
 

Mojo333

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Post THR clumsiness...another shared trait.:sigh:

Hope you have grabbers, two pair are nice.
Grabbers to retrieve dropped grabbers:wink:
Great plan you have.
You know your body best.:yes:
 

mainegirl1

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Grabbers are great but frankly I am not using them post op aside from getting the remote for the electric recliner off the floor when I am stuck flat in the chair and no one around to help
I got a pair preop because I am tired of groceries on high shelves and deep cabinets
Safer than a ladder
The golfers pickup is very effective
Dropping stuff is normal in the post op fuzzy stage
 

Layla

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Hi, Welcome to BoneSmart! Thanks for joining us. Congrats on your new hip.
A couple things...

I will not do PT for the next 3-4 days and after that, I will just do the simplest, most gentle exercises and will do them sparingly for about a week. We'll see where things stand after that.
You really don't need to do any exercises right now. Your body just experienced a "controlled" trauma and needs to heal, not be put through workouts. The only exercise you need right now is walking, not to excess, but only about 15-20 minutes, once or twice daily at only 13 days post op.

Following is the BIG TIP and Activity Progression for THR from the Recovery Guidelines in case you haven't had the opportunity to read through all the info yet -

BIG TIP:
Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

http://bonesmart.org/forum/threads/activity-progression-for-thrs.13187/

Please consider our advice as we don't want to see you suffering setbacks as you're healing. Stop back often, we'll be here to offer support and encouragement as you move through recovery.
A great week to you!
 
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Marls00

Marls00

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The only exercise you need right now is walking, not to excess, but only about 15-20 minutes, once or twice daily at only 13 days post op.
.

I am now able to pick things up off the floor, carefully using golfer's bend -it's easy and no pain. I am very surprised to hear that 15 -20 minutes of walking a couple times a day is enough. Is that true also for anterior ?
I am walking or puttering about the kitchen, etc., about 10-15 min at a time almost every hour of the day. I get stiff and uncomfortable if I sit too long (and antsy!). Sometimes I feel stiffer and a bit more discomfort than other times (while walking), in which case I cut it short. But mostly there is no "pain" when I walk- just some bearable discomfort, and of course a limp. I still sometimes lean on my walker or cane for support while walking, but very slowly I am needing to lean less and less. What about sitting .... Does anyone else feel discomfort while sitting sometimes?
 

Calgal

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I was told to use walking aids (I was discharged with arm crutches) till I wasn't limping. It puts a lot of stress on the various muscles trying to compensate for the ones not healed yet, which causes pain and creates poor gait patterns hard to unlearn later. Just a thought. You're just a couple of weeks out. Regardless of approach, there are inevitable residual aches for quite a few weeks. Be gentle on yourself, take some Tylenol and don't forget to ice and elevate. This hip healing stuff does get better but not if you push things too fast. :ok:
 

Jaycey

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Is that true also for anterior ?
Activity levels have nothing to do with what approach was used. It's major surgery and the recovery is the same. At only days out of surgery you are doing too much. Let that hip heal and it will give you a lifetime of pain free living. Keep pushing and you will only lengthen your recovery.
What about sitting .... Does anyone else feel discomfort while sitting sometimes?
Nearly every new hippie has problems with sitting for any length of time. Use cushions if they help. Get up and move around frequently. This will all ease with time.
 

Calgal

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Does anyone else feel discomfort while sitting sometimes
Yes yes and yes! Sitting was actually the LEAST comfortable position for me from day 1. I ended up getting a sheepskin fleece for my recliner chair and a memory foam cushion off Amazon for all other chairs. I used that thing till almost 3 months out! Carried it, unashamedly, to restaurants and friends houses after enduring a miserable evening out on horrible wrought iron garden chairs. :yikes: You'll thank yourself if you get something like that. Ps it's much much better now, so there is light at the end of the tunnel. :SUNsmile:
 

Layla

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Good Morning and Happy Tuesday to you!
I agree with "sitting" being uncomfortable. For me the car was the worst, but hard dining chairs were a close second. Too soft or too low was an issue also. You often feel like Goldilocks seeking out the spot that's..aaah, just right. Thankfully it's only temporary.

The walking recommendations in the Activity Progression for THR are for all approaches, as Jaycey mentioned. http://bonesmart.org/forum/threads/activity-progression-for-thrs.13187/
It's a rough guideline, but one that's tried and true. Some excel, some lag behind, but if you don't want to run the risk of side lining your recovery in the ODIC (Over Did It Club) I'd try to stay within the perimeters in these early weeks of recovery.

Best wishes as you begin the journey!
 

ahipgma

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Hey @Marls00
Just popped on to your thread to say hi and offer encouragement. My first hip was 5/1 and the second 2 days after yours.
Lying and sitting cause no pain for me.
But every step I take does. I have muscle cramping, incisional pain, tightness, you name it.
My first hip recovery is different than this one, go figure. You would think I would know better from the last one. Go figure again.
I'm down to just Tramadol but not sure how much good it does.
I had a lot of fear about majorly ruining my surgery--- my OS told me if there was a dislocation, infection, or blood clot I would know something was wrong otherwise it's just the normal hip healing and not to fear the surgery went wrong.
I tried to watch a video of a hip replacement between my 2 hip surgeries to try and figure out why at 8 weeks out I still had stealth pain popping up everywhere. I couldn't finish watching it but I did realize were doing wonderfully well for what they do to us in order to fix us. A very long winded way of saying....its ok, dont worry. PS at 4 months out my new right hip is wonderful!!
 

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