THR Trailrunner's recovery

[trailrunner]

Hi @trailrunner! We had our surgery on the same day! I'm also apparently a member of the ODIC although I thought I was being pretty careful not to do that. Last week this time I was basically pain free and gradually upping my activity level. After walking outside for about 15 minutes on Sunday, I had been having pretty unremitting pain in my hip joint and down my thigh. So it's back to resting, even more icing, and fingers crossed that this improves soon. I am limping pretty much all the time, so I'm asking my husband to pick me up a cane today.

I'm a very active person and this forced inactivity is not fun!

Yes, last week I also had a bad day when I overdid it. Like you, it was my upper thigh and hip joint that was sore, and it was as bad as the pain I felt the first week. I rested for a day, iced it a lot, and took some extra anti inflammatories, and I felt better. Since then, any soreness I have has moved around to different parts of my leg. One day it was the back of my leg, one day it was my groin, and so on. I sort of take that as a positive sign that different muscles or tissue are healing or getting reactivated or whatever.

I have found that the cane is very useful and a great way to transition away from the walker. My next milestone will be to walk a mile today with my cane. If I'm not feeling it, I have a way to shorten my route. If that goes well, tomorrow I will try a very short walk outside without my cane. I'm trying to incrementally increase what I can do.

I was very active also, but my hip had really been limiting me over the past year or so. Now I'm just looking forward to all the things I'll be able to do once I'm fully recovered.

Good luck to you!

 

[raylo]

Good luck with your walk. I recall my first mile walk with cane in the first week which was probably far too soon, and I paid for it. You should be in a pretty good timeframe to take it on. The hardest thing for me with these recoveries for me is that I don't have sufficient pain or discomfort in the doing, but if I have overdone something it is only evident later or even the next day or 2. So, trying to decide what and how much to do is a challenge. It is still a challenge for me even at 5 weeks. I, too, have had the pain move around some, but not yet to the back of my leg. Maybe there is still time for that? ;-). Keep on truckin'...

 

[trailrunner]

Today is my four week anniversary from my surgery.

I had my first follow up yesterday with the surgeon's PA-C. The visit went well. She said the surgery went well, and the x-ray looked good. I had a page of questions for her, but she addressed about half of them before I asked, and she patiently answered the rest of my questions. She showed me the x-ray. Surprisingly they didn't screw the cup into my pelvis. She also gave me a copy of the surgery report. After reading that it's pretty clear why we are in so much pain after the surgery, but it's also very impressive they can do all of that work with a relatively small incision and without cutting through the muscles. Amazing!

I am now allowed to do low-impact exercises. No running or tennis yet, which is fine because I'm not ready for that. She said I could ride an exercise bike, but that I couldn't bike outdoors until my next follow up appointment, which will be four months after surgery in late August. When I heard that, I was a little disappointed because that means I'll miss biking during the summer. Now that I've gone through the surgery I'm anxious to get moving. But I have to look at the long term and I want this to heal correctly. I am a rule follower, so no outdoor biking for me until then. I have an indoor bike setup in my basement (with Zwift) but initially I will go to a gym and use the exercise bikes there. I can also swim. I used to swim on a masters team, but I haven't been in a pool in 10 years.

She also gave me a new set of exercises, and she said I could use weight machines at the gym as much as I wanted and within reason. I also got exercises from the surgery center when I was discharged, and I get exercises from the app that my doctor uses. The PA told me to ignore the ones from the surgery center. I'll look through the other exercises and come up with a plan. My hip flexor and my adductor are pretty weak, probably because before the surgery I couldn't bring my knee inwards, so maybe these muscles atrophied or something. I did ask for PT, which I will start in two weeks.

I think I have been pushing myself too much with the walking. I was able to walk just under a mile with a cane, so last week I decided to do that without a cane. I felt fine at first, but then got tired and very sore. I tried that same route several times, but after about 1/3 of a mile it starts getting sore, and then I struggle on the uphill home. I'm not making much progress. I think transitioning from cane to no cane is harder than I thought, so I'm going to reduce the distance of my walks without a cane, and maybe take some walks still using my cane.

I have another day or two of celebrex and aspirin, then I'll be off the medications.

The PA also said I could use Vitamin E or cocoa butter lotion on the incision. Does anybody have any recommendations?

I'm going to return to work in two weeks. I requested working from home for a while because the thought of walking around our big building wears me out. I am concerned that I will have to go from 0 to 100 as soon as I return. I had a trip I was supposed to go on at the end of June, but it's low priority so I will try not to go. I have another trip for early July that I will need to do.

ETA: One more thing - I told the PA that I wanted to be able to put my sock on. She said that I could start trying to bring my ankle up to the opposite knee to put my sock on. I told her that that wasn't how I put my sock on - I keep my feet on the floor and reach down to put my sock on. She seemed surprised that I did it this way. Even on my unoperated side, it's hard for me to bring my ankle up to the opposite knee. I asked my wife how she puts her sock on, and she does the ankle-on-knee method. So am I the oddball? How does everyone else put their socks on? Have I been doing it wrong all my life?

 

[AlanInAZ]

How does everyone else put their socks on?

Normally I would bring my ankle up to the knee but I still have some pain in the operated side when I try this. Also I have severe shoulder arthritis and this limits my reach. I now use a stepping stool as a foot rest and this elevation allows me to reach my toes.

 

[AlanInAZ]

After reading that it's pretty clear why we are in so much pain after the surgery

I also read my surgery report and my surprise is how little the pain was given the scale of the intervention. The temporary discomforts of the anesthesia were the worst pain I had and that subsided within hours. The surgery report indicated that the pericapsular tissues were irrigated with a bunch of pain killers, plus I had a nerve block and that combination worked well for me immediately post-op.

 

[mendogal]

Overall you're doing great!

I would suggest going back to using the cane on all your outdoor walks, focusing on good structure (hips over knees, shoulders over hips, heart and eyes aimed at the horizon) and gait (smooth heal to toe transition). Practice walking without it for now in the house.

Re socks... I draw my foot up to thigh height, sometimes using the opposite knee as a rest and sometimes not.
Having said that... decades ago I saw an article documenting a good half dozen normal hip x-rays. There's a lot of normal variation, and one person may do a maneuver totally automatically while another has just enough difference in their bony anatomy to where no amount of stretching will make that maneuver possible. So maybe you've always done it your way because it's THE natural way for you.
I agree with @AlanInAZ a small stepstool may be a help.

 

[myglasshalffull]

I'd avoid going uphill if possible at this early stage in your recovery. If you have an area (like a park) you can drive to and walk primarily on mostly flat surface that would be best. Save uphill for later.
Or grab a grocery cart in a big box store & walk.

 

[djklaugh]

@trailrunner Is that the way you have always put on socks .... even before the hip got bad? Then that's the way to put on your socks. On the other foot .... if you do it that way because the foot just won't go onto opposite knee because it hurts to do that or hip doesn't want to bend like that .... then get thee to a physical therapist.

My experience having 2 hips replaced at once after limping for several years was that it took PT quite a while to make it possible for me to get foot on to knee. About 3 months for left onto right and nearly 8 months to get right onto left (right hip was the worst of my 2 original equipment hips). It wasn't the hips them selves that needed the PT since walking and climbing stairs was doable very soon after the surgery, but the muscles and tendons around they hips --- they needed extra help.

 

[raylo]

I put socks on like you do. I was never flexible enough for the ankle-on-the-other-knee thing regardless of the hip! Flexible women probably don't understand! I am also with you on missing the bike riding. I am trying to follow the rules, too. My PA said 10-12 weeks but she didn't sound enthusiastic about it. But it is going to be very hard for me to wait that long. I may cave in and ride here on the towpath in a couple more weeks. There is no vehicle traffic and little bike traffic on weekdays, so the risk of crashing is minimal. Never had an incident there in decades of riding. If you want to hook up and do an easy hip rehab ride let me know.

As for climbing grades and steps, for me it was like a switch flipped and all of a sudden it just worked. And for overdoing it, that is how I am inclined... and IMO I will keep taking a Celebrex for a while longer necessary to keep the hip feeling better after the activities and keep on walking as much as I can. I am not talking about major ODIC soreness but just a little bit, of course.

 

[cold_brew]

Life hack, try lifting up your foot *behind* opposite knee to put on sock, doesn’t require as much hip rotation

 

[trailrunner]

@mendogal @myglasshalffull @djklaugh @raylo - Thanks for all your suggestions. Everything you say makes sense, and sometimes I just need to hear it from someone else. When I told the PA yesterday that I was walking almost a mile without a cane but that it hurt, she asked me "have you tried walking a shorter distance without a cane?" Well, that would make too much sense wouldn't it?

I think since I was doing so well with the cane, I figured it was time to move on to the next step, but I took a step too far (haha). I'm going to continue doing my walks with the cane for a while longer.

Thanks for the input on how you put your socks on. I hadn't really thought about it before. When I asked my wife how she did it, she said "don't say anything - let me not think about it and do it naturally." It might be a male-female thing, because like @raylo, I have trouble getting my ankle on my knee. Surprisingly, my good leg is more difficult. I also can't sit cross-legged very easily. I've always been fairly flexible, but just not that way.

@raylo - Thanks for the offer of riding on the towpath. Although it might be safe, I'm going to stick to my doctor's orders and wait until I get the all-clear. It looks like I have to wait four months (~16 weeks), but your wait is shorter. Oh well. BTW, my last ride on the C&O was about a year ago when I took my old cross bike out, starting from Carderock. Please make sure to post a picture when you do your first ride so I can live vicariously through you.

 

[raylo]

Wow, that is a pretty old cross bike. Even has old school cantilever brakes. My newish "gravel bike" really isn't all that different except for more modern components. I live up north so usually start at Monocacy Aqueduct or Point of Rocks and head west/north. But I have been down to Carderock on occasion, even did some road rides back in the day. Good hills on Brickyard Rd and McArthur up to Falls Rd.

[ BTW, my last ride on the C&O was about a year ago when I took my old cross bike out, starting from Carderock. Please make sure to post a picture when you do your first ride so I can live vicariously through yo

 

[Layla]

Happy One Month Anniversary!
I hope you have a nice holiday weekend, trailrunner!
@trailrunner

 

[trailrunner]

Thanks @Layla

It's hard to believe it's been a month. Since the surgery, it's all been a blur, even though my life has been so simple, with lots of rest, some walking, and some simple exercises. Seems like so, so long ago when I was wheeled from the surgery center outside to my car, where my wife was waiting to drive me home, but it's only been a short month. Walking up the steps and into my house, I felt fragile but I was also so relieved to be through the surgery. The first week sitting with the ice machine strapped to my hip. The first week of poor sleep. My birthday came and went just after the surgery. I kept telling everyone I felt great, which was mostly true. And then my first walk outside with my walker, which seemed like such an adventure. The first time I made it around the corner! Then taking off the bandage and seeing the scar. That first week seemed to go so slow, and it wasn't easy, but now it seems like no big deal.

Both my daughters and their families will be visiting tomorrow. Our house will be filled with family and grandkids. My almost-four-year-old granddaughter likes to play hide-and-seek with me in my yard, but I don't think I'll be able to do that. Hopefully she will understand. On Sunday, my wife and I are going to a nice restaurant that she really likes. It's my way of rewarding her for taking such good care of me over the past month. Things are getting back to normal.

 

[Layla]

Those first weeks can drag on, but then they do begin clicking on by. Sounds like you have a great weekend planned, trailrunner. Having your kids back home with the grands in tow makes for a lovely day! Maybe you can have someone hide some special treats, from you, for your granddaughter to look for instead of searching for you this time? You know kids love the challenge of the hunt, lol!

I hope you and your wife enjoy date night, as appreciation for her loving care toward you. Glad it feels as though things are slowly getting back to normal for you.
Have a great day / holiday weekend!
@trailrunner

 

[trailrunner]

Yesterday was my 5 week anniversary. I've been going to the gym every other day, doing the exercises I received from the doctor, riding the exercise bike, and doing a few other exercises (mostly upper body). I'm in a good rhythm now were I go to the gym, then take a shorter walk. The next day, no gym but a longer walk.

I had reached a plateau for a while, but I seem to have moved past that. Sort of two steps forward, one step back. I'm walking more and more outside without my cane, and walked for over a mile for the first time yesterday. Sometimes my hip gets stiff, and sometimes it's just a little stiff but hardly noticeable.

One day that I was in the gym, I met a friend of a friend who happens to be a physical therapist. She gave me some recommendations which I've been following. I'm looking forward to my first PT appointment next month.

I'm starting to walk up and down steps without my cane, but I usually have it handy just in case I need it.

When I ride the exercise bike, my hip clicks with every pedal stroke. I know some clicking is normal, but I was concerned that it was happening with every single rotation. I contacted the doctor, and they said that was normal and nothing to worry about.

I can feel that my hip flexor, adductor, and quads are pretty weak. Besides the surgery, I haven't been using those properly for a long time.

I might try to move from the exercise bike to my trainer set up in the basement. The position is less upright, and with clipless pedals I might engage my hip flexors and quads more. Plus, I just like that geometry more than the upright exercise bikes in gyms. I can also do programmed workouts, but for now I'll just set it on a low resistance and not do anything too fancy. I'm not sure if I can get on my bike, but it will be a huge accomplishment if I can. That was one of the biggest limitations before the surgery. My basement has a small gym setup so I can do my other exercises there.

My gym is at my tennis club, and I've been seeing a lot of my friends there. I'm still off work for one more week, so I've been watching a lot of tennis, including the French Open, which started this week. I'm hoping that all this watching will count for something when I get back on the court. The club is also starting an adult swim next week. I had planned on re-joining a masters swim team but I will try this first. I used to swim a lot, but I haven't been in the pool much in ten years.

 

[raylo]

Just another data point for you... I only did a couple of rides on my MTB... that is more upright than a road bike but not as much as those gym bikes... connected to a fluid trainer, before transitioning to my road bike on the smart trainer. The new hip was fine either way and I probably could have started on the road bike. Luckily my hip doesn't click (yet?). Wish I could say the same for my TKR knee. I walked 3 miles at the park this AM and will be back on the trainer this afternoon.

 

[trailrunner]

@raylo As I found out this morning, you were smart to start with your MTB before moving to your road bike. The bike I have on my trainer is a TT bike. I had made it more upright, but it's still more aggressive than an exercise bike or my MTBs. My surgical hip did fine, but my back wasn't used to leaning over so far. Plus, my tush wasn't used to sitting on a bike seat so I think I was putting more weight on the bars. I only rode for 15 minutes but my back was a little sore. Not a big deal - it will just take a few rides to get used to it.

It did feel good to get back on my trainer bike. I never thought I'd say that! I visited my other bikes and told them that soon I'd take them outside.

 

[Hessian]

woooo trailrunner going shrimp mode on the TT bike

 

[raylo]

LOL...I have aged out of doing TTs so gave my TT bike away to a charitable org. That thing would have been brutal on a trainer without some mods like trailrunner did. Besides, I needed the room in my bike workshop. And it is amazing how normal these new hips feel right out of the box. I honestly didn't lose any muscle tone in my THR leg having just one or 2 down days with almost no walking. But with full weight bearing and as much walking as I could stand meant preserving that muscle. And as both you guys know when you have done as many hard miles and years as we have no matter what is going on health wise you pretty much can always ride a bike. Like Hessian with that horrible hip doing fondos. And for years my no-ACL knee and troublesome hip. Bikes are magic.