THR Thigh Pain after 11 weeks

[readytogo]

Hello all....I have been reading these forums for the past month or so and it has given me much comfort. Had a RTHR anterior press fit on May 28, 2019 due to OA and expected I would be much farther along in recovery than I am!! Shocking I know!

When I started researching hip replacement, all I found was how great the anterior approach was and how fast everyone healed. Saw videos of people walking miles a few days after surgery....blah blah blah......So, my expectations were very high.

I think I am doing ok 11 weeks out but am concerned about my mid thigh pain. Only hurts when I walk but most days I can't go more than a couple of blocks and that is with pain. Seems to change from day to day....saw my OS 2 weeks ago and he said I have overdone it from the beginning! He is of the same mindset that Josephine is, and that is to heal....no PT just walk and rest. I don't think I've done anything horribly wrong but this has been a bit of a nightmare...Very bad pain, never got the pain meds right from the beginning and was so unprepared. This forum has been so helpful.

Of course my big worry is that the thigh pain is due to the stem having moved and the bone hasn't grown into it....Too much research!!

Anyway.....I guess I just want some assurance that all is well and NORMAL. Everytime I've asked the PA's and Doc is this pain normal they hem and haw....thanks for listening!!

 

[Trudijane]

You sound like me at 12 weeks! I had a RTH replacement (posterior). I was told in the beginning that in general, those who go to the anterior way, recuperate faster; but in order to get an appointment with the only surgeon that did it that way, I would have had to wait an additional 3 months; so I decided to go ahead with the posterior method and a Dr. that I liked.

I don't know how much whining I did on this forum, but every little ache I felt like I did something wrong, or I was regressing, doing research and watching videos simultaneously. This forum helped me a lot in realizing that this healing stuff was not competitive and everyone is different and the time it takes to heal is different.

It made sense that the posterior way took long because muscle has been cut into so the muscle has to heal as well. Every time I had a little jolt of pain, I wrote to my surgeon - this isn't working to the point that his PA got a bit irritated with me (she was having a bad day and apologized).

All I can say is eliminate the "should bes", "expectations by 4 weeks", etc. because it will get better. I can only say this now (recently) because I don't know exactly when but I was walking and beginning to feel normal again. At my 3-month post-op follow up the best thing my surgeon could have told me was that I was at the point in my recovery that the hip would not pop out of place (although a fall could that); so all the exercises that I was afraid to do, I can start doing, but slowly. That is the only reason I went to PT - for some mild stretching exercises. I am no longer afraid to put on my shoes and socks! without a prop.

I've finally reached a point where I can thank my Dr. for being able to walk without pain again. You will too, in your own time.

 

[readytogo]

Thanks Trudijane!! Sorry you had to worry about every little movement! With the anterior way I didn't have any hip precautions...not much chance of a dislocation....slept on my side from the get go....Guess it gave me a sense of invincibility and over did it....playing golf at 4 weeks....very gently...in a cart and only making half swings.

It is my profession and I so want to be able to play in a tourney in 2 weeks. I really do feel pretty good it's just the
thigh pain. It doesn't hurt at all to swing a golf club!

I guess I just need to be patient! so hard to do. I see my doc Aug 21st. hopefully he'll give me the all clear.

Thanks again for responding. These forums really have given my great solace. If you haven't been through this, it's difficult to understand all the things that run through your brain...so good to hear from someone who is experiencing the same think...

 

[Layla]

Hello, Welcome to BoneSmart and Recovery! Thanks for joining us.
I'm sorry you're struggling with some mid-thigh pain and concerns over it. Through your own admission, It sounds as though you may have overdid it early on. When you mention "very bad pain" I'm assuming that was early on, not currently? Since you're scheduled to meet with your OS again in ten days, I'd take it easy until then, icing, resting and taking some OTC meds when you feel the need, that's assuming you're off the heavy narcotics.

Below you will find the Recovery Guidelines. While you're past the timeline on the Activity Progression For THR, take a peek and see if you still feel you may have been a bit to ambitious early on. Hopefully with some rest and dedicated icing you'll be back on track quickly.

Stop by often, we'll be here to answer questions to the best of our ability offering advice, support and encouragement. I hope you have a great week and your discomfort eases soon.

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

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for THRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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 the at each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
@readytogo

 

[readytogo]

Hi Layla. Thank you for responding!! The really bad pain was early on as you said but I just can’t seem to shake this thigh pain. Hard to walk more than a few blocks. Hurts some with every step. The only thing that has felt good is riding my bike...a beach cruiser on flat surface with no wind so I’m not putting any pressure on my leg. But the doc doesn’t want me riding!!!! So, been taking it easy, been off narcotics for weeks. Taking Tylenol 650 mg and some ibuprofen. Stopped ibuprofen for a week or so as the doc said it could inhibit bone growth. It seems to be the only thing that stops the pain.

Guess my biggest worry is that the bone is not growing into the stem like it should. Last X-ray looked ok but hoping I didn’t do anything to inhibit bone growth!!

Am I being a baby? So many people have it much worse than me!!

Thanks for listening...,,

 

[readytogo]

Btw. Will try icing again. I did a lot of it at the beginning post op but lately heat felt better. Will go back to icing and see if it helps

Thank you

 

[Layla]

No you're not being a baby. Navigating recovery can produce anxiety not knowing what's normal and what may require medical attention. I'm not certain how often you're taking the 650 mg of Tylenol, but consider trying this dosage schedule - The forum nurse often recommends Extra Strength Tylenol at 1000 mg every six hours, not to exceed 4000 mg in any 24 hr period. You will need to calculate in any other medication you're taking that contains Acetaminophen making sure you don't exceed the 4000 mg per 24 hrs. Try that dosage and see if it works better for you.

See the diagram below which explains why this dosage is effective.
Most meds only remain fully effective in the system for 4-5 hours, no matter what the dose. So if you're taking a pain reliever every 8 hours, you're going at least 4 hours with no medication in your system at all. That gives the pain time to build up so the next dose takes longer to become effective.

So taking it every 6 hrs is more effective.

As for icing, try dedicating time several times per day and see if it helps. Ice for 40-60 minutes, no less, each session. Hopefully between rest, ice and the Tylenol, you'll bounce back quickly. Stay in touch and let us know how you're doing.
Wishing you comfort.

 

[readytogo]

I Thank you Layla. Yes that helps a lot. Was trying to wait the 8 hours before taking more Tylenol. I couldn’t find the 1000mg. Do you have to get it by prescription?
Feeling a little teary getting this help from youthank you so much!!

 

[Layla]

Here is another article that may be of interest to you -
http://bonesmart.org/forum/threads/...mol-and-nsaids-differences-and-dangers.12858/

 

[Layla]

Aww, don't feel teary, it's okay, we're here to help.
You will need to purchase the Extra Strength Tylenol which is 500 mg per tab, taking two at a time.
It's OTC, no prescription needed.

 

[readytogo]

Of course!!! Duh!! My husband said the same thing. Sheesh. Sad when your brain stops working. Thank you

 

[Eman85]

Never heard of no restrictions, generally anterior restricts of all the things the golfers bend! Pretty interesting they didn't tell you that. Thigh pain is pretty common as no matter what approach those muscles get a workout during THR. Then when we overdo it they don't like it. Ice is where it's at and you're still pretty early on to not be icing. Sounds like your OS understands THR, might want to follow their directions.

 

[readytogo]

Hi Eman85!

Shouldn’t have said “no restrictions”, meant no general hip precautions!!.
I could bend past 90 degrees and didn’t have to sleep on my back for 6 weeks because of the anterior method.

Thank you...will keep icing as Layla said.

 

[Small1014]

Hello all....I have been reading these forums for the past month or so and it has given me much comfort. Had a RTHR anterior press fit on May 28, 2019 due to OA and expected I would be much farther along in recovery than I am!! Shocking I know!

When I started researching hip replacement, all I found was how great the anterior approach was and how fast everyone healed. Saw videos of people walking miles a few days after surgery....blah blah blah......So, my expectations were very high.

I think I am doing ok 11 weeks out but am concerned about my mid thigh pain. Only hurts when I walk but most days I can't go more than a couple of blocks and that is with pain. Seems to change from day to day....saw my OS 2 weeks ago and he said I have overdone it from the beginning! He is of the same mindset that Josephine is, and that is to heal....no PT just walk and rest. I don't think I've done anything horribly wrong but this has been a bit of a nightmare...Very bad pain, never got the pain meds right from the beginning and was so unprepared. This forum has been so helpful.

Of course my big worry is that the thigh pain is due to the stem having moved and the bone hasn't grown into it....Too much research!!

Anyway.....I guess I just want some assurance that all is well and NORMAL. Everytime I've asked the PA's and Doc is this pain normal they hem and haw....thanks for listening!!

Hi @readytogo! Sorry to hear about your mid-thigh pain! Since the anterior approach incision is on top of the thigh, where there are some major nerves, that could explain it. But I can tell you each surgery is different and can have different timelines for healing. I’m 6 weeks post LTHR, (posterior), and am mostly pain free now. I will get some pain after extra activity, but just walking, sitting, standing don’t cause pain. However, after my RTHR a year ago, I still had some pain at 3 months when walking. I went snow skiing at 4 mos , and had no pain while skiing, but the day or two after I was pretty sore! So no worries at 11 weeks- you will get there, likely within a month or two. I know it’s frustrating when you hear all the hype about fast recovery with the anterior approach... but I really don’t think it matters which approach you use. One thing I have heard is that the longer you were in pain before having the surgery, the longer it will take to heal afterwards. Good luck, and keep us posted on your progress!

 

[zauberflöte]

@readytogo GOLF at 4 weeks? I couldn't have even gotten into the cart easily! I echo what @Eman85 said. I was specifically cautioned at my 2 week followup not to inwardly rotate, and the PA demonstrated a golf swing follow-through as what he meant. I am still cautioned, forever, about rear-ward extension while turned in with weight bearing (a particular yoga pose was the demonstration)

Welcome to the ODIC! (OverDid It Club). At 12 weeks on my first hip, I got cocky on vacation and gently trotted up a flight of 16 stairs. Bad choice. For months after that, walking was painful. I'd done my PT faithfully. Wrong choice! Because of a running-shoe shopping expedition at 9 weeks I gave myself a tendonitis. So my recovery/rehab was set back by that stairs incident. I remember walking half a mile, gazing longingly at the road ahead, and turning around to trudge back home.

Hip #2 I was smarter. No PT. Just a bit of walking, short walks getting longer. But at about 9 months I hoisted my share of both a very heavy marble statue, and the following weekend an even heavier treadmill, and still have the wraparound groin pain from that one. Do we never learn???!

However, your OS would be telling you if there was a problem with the stem. Anterior recovery is sometimes faster for about the first 5 days. And recovery DEFINITELY does not have "expectations", no matter what fairy stories we may be handed. (My OS was guilty as well) We can expect to have to practise "patience for the patient".

You will be fine! I'd say if asked that if you stay off that bike for awhile, things will go better faster. You've had major MAJOR surgery; take care of you!

 

[readytogo]

Thank you all for sharing your stories and encouraging my recovery. .I appreciate it all!!

Gonna follow Layla’s advice and ice and take more consistent meds. Just finished icing for 50 minutes. Haven’t iced for this long since the surgery!! Already feeling better about the future

 

[Calgal]

Sorry about the pains. I had some lingering thigh pain and stiffness too up until recently. Then I did some stretches lying (sideways) on the bed, legs off dangling 90 degrees from knees. Bring unop knee up towards your chest leaving op leg still hanging down. It stretches quads I think. A few days of those and my thigh pain disappeared.

Re bike, does your OS not want you to ride because he doesn't want you to fall? If so, is it possible to get one if those supports that makes real bike into a stationary indoor trainer? It props up the axel and you can pedal easily. I know not the same as wind in your face but it's exercise without much risk. Good luck!

 

[Jaycey]

Reset those expectations and don't push the activity. That hip will tell you when it is ready for more activity. For now it's telling you to slow down and let soft tissues settle. Icing is good - do it as often as you can throughout the day. Still very early days for you. Full recovery can take up to a year or more.

 

[readytogo]

@Jaycey am icing as I write! Started on the 1000mg Tylenol every 6 hours this morning....am taking it very easy! Expectations reset

@Calgal Yes, my OS was worried about a fall riding my bike. I have looked into turning my bike into a stationary trainer....Couldn't quite understand the position for your stretches for the quads.....

@Small1014 I was in really good shape right before my operation. Walked 6 miles a few days before the op. I didn't have horrible pain in my thigh as I didn't wait a long time after getting the diagnoses of end stage OA at the advice of my chiropractor I had an X-ray and it was obvious. My ROM was getting bad and I had off and on groin pain for years. Could still play golf and teach with no pain but I knew it wasn't going to get better.

Thanks again to all of you for your advice and encouragement and good luck to you too!!

 

[Calgal]

..Couldn't quite understand the position for your stretches for the quads..

Sorry, but maybe @Mojo333 can copy you the instructions for the exercise I'm talking about? I know she has suggested it on another post. I found it by googling but can't seem to find the site again to post the link for you. Mojo, it's the one you lay on your back on bed and bring non-op leg up towards chest. Cheers for your help.