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[THR] Stubborn pain- normal or PT induced?

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Marls00

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Thank you all, it's so helpful know that other people feel some of the same things I do. It's also good to be reminded that no 2 recoveries are the same. I know I shouldn't worry and I generally am keeping a positive attitude, but I stupidly have been watching videos of people who had anterior hip replacements and were literally walking absolutely fine 2 weeks out! No walker, no cane, no pain. What?? In the first half of the day I feel very comfortable, a little discomfort while walking but not bad at all. As the day progresses the discomfort picks up a bit - to be expected of course. Question: Most of the time when I walk, I feel the following: tightness in the thigh and kind of a pressure or pushing feeling in the hip. Almost like there's not enough room in there for whatever it is the surgeon added! As a result, I am unable to put all weight on the leg without modifying a bit with a limp to re-distribute the weight. I can't walk smoothly and evenly yet, even with a cane or walker. My surgery was 2 weeks ago. Would be interested in hearing how it felt to others to walk 2 weeks out!
 

Jamie

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That feeling of tightness is most likely a little swelling that can follow activity or even the surgery itself. Remember that your tissues are all getting acquainted with that new metal part that suddenly rocked their world and put your leg immediately into proper position. You have to expect that your soft tissues will take a while to adjust to your new normal. Some may not go willingly as they were quite happy, thank you, with their compensating position in life. But you'll get there with some time and gentle care.

This is why we tell people not to try too much too soon. It took months or most likely years for your muscles and ligaments to adjust to a deteriorating hip. It's going to take more than a few weeks or months for everything to right itself and create the new and improved you.
 
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Marls00

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Hello again, it' been awhile. After a rocky start with my anterior RHR, things are moving along. I'm in week 5. The hip feels good - I'm walking comfortably most of the time without a cane -but the some of muscles, tissue, etc. are taking their time. I did minimum PT until I felt ready, which was about 2 weeks ago. Question: at the end of the day the knee on my operated leg starts to act up. It's actually the top of the knee, or just very slightly above the knee. It's slightly painful and feels somewhat weak, to the point where I sometimes grab my cane for support. Sometimes I wake up with it and it sticks around all day or most of the day but it more frequently happens near the end of the day. Never had any problems with my knee before surgery. I'm wondering if my knee is acting up because it's picking up the slack for my weak quads, or if it's acting up because when I do PT on my quads, it's putting pressure on the knee. The PT I'm doing is not aggressive, if anything I'm being cautious. Is this unusual? Thoughts or suggestions on this would be appreciated.
 

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:hi:
Sorry your knee is causing you grief!
I'm wondering if my knee is acting up because it's picking up the slack for my weak quads, or if it's acting up because when I do PT on my quads, it's putting pressure on the knee. The PT I'm doing is not aggressive, if anything I'm being cautious.
What exercises are you doing for PT and how often?
Still lots of healing happening at a little over a month out.:yes:
 

CricketHip

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Actually your quadriceps attach in and around your knee and is the knee's primary extensor, which helps you to stride forward.. probably why you feel it by night time, after walking throughout your day.
Please bring this up to your PT, going slowly is the way to strengthen the quads, which it sounds like you're doing.
Maybe the PT will have some advice or suggestions on how to ease it.
 

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It is your quads. They are getting stronger but with getting there comes discomfort
Back off a little and see how it goes
I get the same feedback after climbing lots of stairs
The ache is your bodys way of saying its done
Google muscles around the knee and you will get a better understanding
But watch you dont overdo and inflame the quadriceps tendon that goes over the knee
 
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Marls00

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:hi:
What exercises are you doing for PT and how often?
Still lots of healing happening at a little over a month out.:yes:
Mojo, 2 weeks ago I did leg extensions on a machine with weights (10 lb) and a couple of days later my quads fell apart and I couldn't do anything for a few days. Since then they have felt weak. But I was having the knee issue a bit even before that. Now I'm doing easier leg extensions with a 2 lb weight (no machine), leg press (60 lb ... doesn't bother me at all), bridges, abductor and adductor exercises, step up and step downs (only about 5"), marching, heel slides, standing on operated leg with full weight for 10 seconds 10X. I do these exercises once or twice a day. Some are a little more challenging than others, but nothing feels painful. I'm walking around the house quite a bit but am trying to take rests if I'm on my feet for more than about 1/2 hour or so.... I am not always successful, though once my knee kicks in - I have no choice!

It is your quads. They are getting stronger but with getting there comes discomfort
mainegirl, that's what I'm hoping. I just don't want to do any damage ... that's alway my fear.

going slowly is the way to strengthen the quads, which it sounds like you're doing.
I am torn between pushing it a little with the quads to get them stronger and taking it slower, but I think your advice to keep it slow makes sense.

Thanks, ladies ... this forum has been so helpful for me and obviously many others out there!!
 

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Look at a picture of the muscle groups in your legs. You will see the large muscle group that runs down the outside of your thigh terminate at your knee. These are the muscles that had the greatest strain during surgery. The pain center for these muscles are at the top of your kneecap. if you strain them it will give you a burning and or pain in your knee area. Most likely not a knee problem but a muscle problem from muscles that aren't healed and now being strained.
 

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My OS said no PT save for walking
and carrying on with life. My surgery date was the same as yours and I am not doing any of that stuff.

Your surgeon thought different. To be blunt think. Is that working for you?. Seems you are trying to train healing muscles .
What I doing is hiking 3 miles a day on mild to moderate terrain and going up and down stairs because I have to. And that's it.
I had mysterious foot pain when waking two days ago but am pain free now. I did 12000 steps today outside.
Seems you might check with a doctor as it seems you are developing tendinitis .
You really do not want that
Have you had your 6 week checkup
and do you have an uncemented implant?
I too had trouble on my feet for more than half an hour but its worked up to over 90 minutes now and sometimes over two hours
I might go to PT but later for strengthening.
Right now I am trying to give the osteophytes a little time to firmly embed the prosthesis
 

Mojo333

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:unsure:Too much too soon, dear @Marls00
Often it doesnt hurt until we stop!
All that PT is keeping your healing muscles and soft tissue irritated.
Plenty of time for strengthening and toning after your injured leg heals.
Please give that poor leg a break.:beg:
 

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Using weights so early does not seem right - especially the leg press. My PT sanctioned the gym after 6 weeks but mainly crosstrainer/bike with low resistance and weights on upper body only to begin with.
 
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@Marls00
You shouldn't be using the leg press at all. It's a very bad machine for someone with new hips, as it could force your hips into a flexion of more than 90 degrees and increase the risk of dislocation. In any case, hips don't need a lot of exercise to recover and it's far too early in recovery to be doing any strength training.

Didn't you read this, in the recovery articles I left you on Page One of your thread?
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.

Heal first, then think about strengthening, if you still need it. You probably won't, because your muscles will gradually regain their strength naturally, as your hip heals.
If you really feel you need to do strengthening, leave it until at least 3 months post-surgery.
 

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Mojo, 2 weeks ago I did leg extensions on a machine with weights (10 lb) and a couple of days later my quads fell apart and I couldn't do anything for a few days. Since then they have felt weak. But I was having the knee issue a bit even before that. Now I'm doing easier leg extensions with a 2 lb weight (no machine), leg press (60 lb ... doesn't bother me
A consideration also is that your knee may be recovering from the dislocation process. The knee is manipulated rather aggressively during the dislocation process and mine didn't even begin bothering me until 17 days post op when some faded bruising surfaced. You mentioned above that yours bothered you earlier than two weeks ago, which would put you at less than three weeks post op when it began.

I agree that the leg press should be avoided. Also Bridges which are a core strengthening exercise and put a great amount of pressure on the hip joint where soft tissue and muscle has recently been traumatized. They can strain your back and lower back muscles also.

I'd give serious consideration to dropping the exercises for now and began walking instead. The choice is yours. Wishing you comfort and hoping you bounce back quickly.
Please stay in touch and have a great Thursday!
 

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@Marls00 just a thought - why are you engaging in all this training? These exercises are not addressing post op healing. They are training exercises. And at this point not what your hip needs. The choice is yours but you risk causing yourself a major setback and chronic pain.
 

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I have had knee pain since surgery. I can remember how painful it was to swing my op leg into bed the first few days because of my knee. My hip has felt good but I still have knee pain and my surgery was Aug. 20. The knee pain has gotten better each day. I have not been doing PT except for the few exercises that were recommended post op.

Basically, I have been walking with crutches. I can get around the house without them now but take them on a walk. I start by walking without them but when the pain is too much that it is causing me to limp then I get back on the crutches. I lean on them ever so slightly. Each day I can get a little further without them until I need them again.

I try to ice and elevate for an hour twice a day. I also started to use one of those topical ointments to get more warmth in the knee overnight. And last but not least I have been swimming and walking in the pool. I do 40 lengths of a 40' length pool in just freestyle with absolutely no kicking. Then I walk in the pool for about 10 minutes.

My knee pain is the worst when I stand up. There is pain sometimes on the inside but it is mostly on the outside. I have a basic check up on Monday so I'll know more then - I hope.

Didn't mean to go in depth but our surgeries were about the same time. I'd stay away from weights. I am just trying to keep it simple based on what I have learned here. And honestly, today is the best I have felt since surgery and feel encouraged that the knee pain will go away with patience and with what I am doing. I have no plans to run a marathon anytime soon.

I wish you the best of luck. You certainly didn't have hip replacement surgery just to end up with a bum knee. I think there can be a dangerous mindset that your recovery has to be that quick recovery(s) you read about. I had to change my own mindset and now find no shame in using my crutches even though I am six weeks out now. As long as I use them less and less I am content.
 
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Marls00

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Quick up date: The pain I was having in my knee is gone. It lasted about 2-3 weeks, but as I continued to walk with a cane and then without one, i believe my thigh muscles started picking up some of the slack so that my knee could go back to just operating normally. Just a note, I was really very careful with the PT the first 3-4 weeks. Some would say I was babying myself (my husband) but if something felt like it was a bit more than slightly uncomfortable, I wouldn't do it. I have heard stories of people who have done no PT and have had problems and poor recoveries and I have heard stories of people who have done PT as prescribed and had problems and poor recoveries. My husband did all the PT as prescribed and had a fantastic recovery. So it's hard to know what the heck to do ... all we can do is try to listen to our bodies, which isn't always easy. But I generally agree that the PT's tend to over-do it and push too hard, which is why I only followed their instructions at about 25-50% the first 3-4 weeks.

I am now 7 weeks post surgery (anterior) and have been walking well without a cane for about 10 days. My walking endurance (distance, duration) has increased a lot over these past 10 days. My remaining problem is my hip flexor muscle (iliopsoas?) which remains quite sore and tight. This has been an issue since right after my surgery. It hurts to lift up my leg from a seated position and getting in the car is better than it was, but still an effort and very painful if I don't take care in keeping my legs in a certain position. I have avoided any exercise that engage that muscle because it seems like it gets even worse if I do. I am concerned that I may have tendonitis or something. Also my thigh muscles are still terribly weak. Last week I started walking upstairs and downstairs foot over foot - but only 7 or 8 stairs at a time, once or twice a day. I haven't seen much improvement, especially walking downstairs. My thighs feel like wobbly jelly walking downstairs! My PT says "be patient" .... He said the hip flexor and thigh issues at this stage (week 7) aren't extremely common but they do occur and I just have to wait it out. Should I call my doctor? I'm not scheduled to see him until December.
 

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Ice and elevate for 45-60 min, then walk around, then smile, then walk, then ice and elevate.

Repeat

Maybe do some leg slides laying on the bed, then ice and elevate.

Walk, walk, walk.

You can exercise later
 

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:wave:
Happy Two Month Anniversary!
It's good to read your knee pain is gone.

it's hard to know what the heck to do ... all we can do is try to listen to our bodies, which isn't always easy.
It sounds like you've been very mindful in PT, not pushing yourself, which is wise. While your PT may be right given what you've described, there is nothing wrong in checking with your OS for the reassurance you're seeking. December is still a ways off and I'm sure a member of your surgeon's care team can easily advise whether you need to be concerned about anything through conversation with you. It sounds like you're doing well and on the right track. Stay in touch and enjoy the weekend!
@Marls00
 

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