THR Wonkyhipoy Recovery<<

[Layla]

Sounds like you're doing well!
I think you're wise in taking a rest day today after the walk back to the restaurant yesterday.
Rest and ice several times and hopefully you'll be back to where you were.
Have a great Sunday!
@wonkyhipoy

 

[luvsibes]

Pain in the hip bone was lessened as soon as I got in the car to go home after surgery. The pain from the muscles and would, however, were challenging for some time. The first couple of weeks home were painful as I could not get in and out of bed independently and move the op leg without assistance and then a strap. I couldn't even will the leg to lift! That went away by week 3 and I began getting out and about with the walker and was with the cane by the end of the 3rd week. I did identify with your walking too far as I had to go to a family dinner at a mall at about week 3. I took the cane and rode an escalator up. When leaving, the down el

 

[luvsibes]

oops....the down escalator was broken and I was already tired from the heat wave, walking and a long day. I looked around for the elevator and wondered how far I'd have to walk for it. I decided to make the long stairway down (the most stairs I'd encountered since surgery). Slowly with my cane, I recalled how to go down and made it while family patiently waited. It was a milestone and I wasn't too sore next day!

I am virtually pain free now and at about 6 weeks I began to realize I am not obsessed with the hip! I haven't had as much energy drain since then either. I still have to pace myself but took a 2 mile hike on dirt and hills this weekend with no bad effects. I later walked a total of 5 miles before the day was over.

The first 3 weeks are a blur of pain and sleep. The next 3 weeks were restful and I did get out for dining and short visits with friends. I began following my husband and husky on walks often turning back halfway. I quickly dumped the cane as I felt more balanced without it and it was creating arm pain. After those 6 weeks, I feel great but still cautious and am happy to be in pool rehab and sleeping in more comfortable positions - and sleeping through the night for the first time in a year!

It's a lost summer but I'm so pleased with my results! It does get better!

 

[wonkyhipoy]

Lol, your comment about stairs slays me. I wish I could have avoided stairs altogether the first couple of weeks. Alas, I live on a fairly steep hill. There are 20 stairs just to get from the driveway (and basement where I a sleeping presently) to the bathroom on the main floor. There are another to get the the upstairs to shower. I do a lot of stairs in a day... which takes forever when you are really only using the good leg.

 

[luvsibes]

That's a lot of stairs, wonkyhipoy - ! I'm impressed that you are doing that so soon!

 

[wonkyhipoy]

Hi @Josephine,

Could I ask you a few questions? I am going to assume you would say yes. I began experiencing groin pain a early last week (I am 3½ weeks out from my posterior THR) after walking up a hill by my house (I live on a hill sadly). The pain went away after backing off my activities. Basically rested and iced with very little walking for a few days.

I seemed to have aggravated something fierce on Saturday because it does not seem to be settling down with rest like it did before, and the pain is considerably worse. I have not done any PT exercises the last two days, not that I was doing much before, pretty much just icing and resting. Did some walking outside today... no hill though. The pain is around L3F and L2F, V and W. I have read many posts forum and certainly seems this pain is common.

My questions for you are these:
1. For me the pain occurs with stepping on my op leg and oddly more so when taking weight off the op leg but is not there otherwise, at least not yet. Also, the pain is a sharp burning pain. Most on this forum that I have read have described their groin pain as a constant ache. So could you comment on weather this pain pattern is normal or rather not uncommon in your experience?

2. This forum recommends against a lot of PT, which I have been following pretty rigorously. Can walking alone cause these symptoms, and if so, is it a sign that I am walking too far too soon ½ mile in 20 minutes?

3. Sometimes it feels like the pain come from my incision and wraps around to the groin. Should I be icing the groin, the swelling around the outside of the hip where the in incision is or both And is there some place I am missing?

If anyone else would like to comment, please feel free.

Cheers

 

[wonkyhipoy]

Oh, for clarity... the pain is felt on the back of the groin too L3B W

 

[Josephine]

The blue spot is probably Piriformis syndrome

The red, most likely Psoas pain

Both caused by all that exercising you were doing!

 

[luvsibes]

Thanks Josephine - The psoas info was helpful to me as I still have occasional mild pain in the inner thigh groin area. Per my restrictions (1 more week hopefully), I still have a pillow between the knees but I can feel tightness in the hip and IT when I do this with the op leg on top. This is where it all started 4 years ago with pain walking and as labrum tore. I was recommended to do clamshell leg lifts from this position. Your thoughts? Thanks for the info.

wonkyhipoy - pacing yourself (and your hill and steps challenges) is hard to do when you are used to being active but slow and steady and mindful of movements will win the race! I hope you are feeling better again soon!

 

[wonkyhipoy]

Hi all,

Time for an update. Okay, well let me first talk about the groin. Thanks to @Josephine for the response. In my case however, it was not the psoas causing the issue (though I imagine it will at some point ). In my case it was actually being caused by the adductors. Lift the leg is not painful at all, but pain was felt with weight bearing... or more specifically, bearing weight and pulling my body forward with the adductors and hamstrings (so right after the leg hits the ground and begins to pull you body forward while walking). Now, I know what you must be thinking... why are you using your adductors in this fashion... their main job is to pull you legs in, not pull your body forward... and you would be right!

So this is what was happening (and there is a little bit of theorizing going on here). For years I was walking with my leg slightly abducted, and rotated to the outside (so foot pointing out 15 degrees or so). So certain muscles became very week (specifically a couple of the adductors) while others got tight due to compensating for the weird walk (other adductors). Anyway, after surgery, the leg is no longer rotated outward... but, due to habit, swelling, and a fear of crossing the leg over the mid line of my body, I was still walking with my leg out to the side (my wife noticed this when she walked behind me a few days ago). So, I changed my walk to the I was walking with me leg directly underneath my body (you know... the way you are supposed to walk), and blammo... no pain. So, I rested and iced for the next few days (even did one day of very little walking), and I hear I am, feeling much better.

Also, I think the "areas of pain" I describe to Josephine were misleading. At the time, I felt pain all over my groin area, but in the morning, when things settled down a bit, I was able to feel the source of the pain... and it was more the inside middle to back of my groin. So I am willing to bet that had I describe the pain areas correctly, Josephine would have told me exactly what was causing the pain.

So, as advice to all of you out there who may be experiencing groin pain, certainly head Josephine's advice, because the psoas can certainly cause groin pain. But perhaps have someone look at how you are walking... it could be the culprit. Oh, and as a side note (and to further my despise of canes), walking with a cane reinforce walking with my leg out to the side... so now I have to focus on walking properly when using the cane.

Other than that, things are moving along. I am walking more... though more often and not as far... which is a good thing. Did a Costco run yesterday with almost no pain, and no next day issues (at least not yet). Spent the morning today on my feet for over an hour doing dishes, prepping my little ones lunch, feeding the dog... activities that should only take 20 minutes in total, but I was deliberately going slow. So far so good. some tightness, and a little pain here and there (mostly from the bruising around the surgical site and down the leg into the quads and hamstring... which is slowly going away).

Oh, and @dlp... thanks for the follow up to my question regarding your experiences. Much appreciated.

I have decided to take one more week off before going back to work on the advice of my GP. Sitting for long periods is still uncomfortable, and since I see the surgeon on the 17th, mind as well wait until after I see him. No sense in pushing myself back before I am ready... I have done that before . Will be doing a gradual return for 2-3 weeks before I am back full time (unless I am feeling stronger... in which case I have the option to increase or decrease the hours/days as needed).

Well, that's all for now.

Cheers

 

[Josephine]

In my case however, it was not the psoas causing the issue (though I imagine it will at some point ). In my case it was actually being caused by the adductors.

But wonkyhippy, the psoas IS an adductor! Its job is to move your leg towards the other leg and across across the mid-line of it to the far side

I have decided to take one more week off before going back to work on the advice of my GP.

Well you're only 4 weeks out now. Our recommendation is this Phased return to work.

 

[Lski]

Phased return to work is what I am in the process of. I worked 5 hr. days this week & barely got those hours in before being depleated of energy. I don't know if I'll be able to do 6 hr. days as planned for next week. I am 52 days into recovery and desire a full 8 hr. nights sleep , still only getting 5-6 each night.

I'm glad you figured out you just needed to change how you were walking to alleviate pain.

Good luck with your return to work.

 

[Layla]

Happy to read you're taking more time off before phasing back into work.
Isn't it a joy to be engaging in those mundane tasks once again?
Costco run, doing the dishes, prepping lunches, feeding the dog. You gain a new appreciation
for the simple things in life.
Hope you have a great weekend!
@wonkyhipoy

 

[Mojo333]

Glad things are getting better.
Good took see you spreading "cheers" across the forum, especially to newly recovering hippys.
Have a great day!

 

[wonkyhipoy]

Hi all, thanks for your comments.

@Josephine, sorry... I know I am not describing it well. For me, the pain (while walking) occurs when the leg is in front of my body while the adductors and hamstrings are contracting to move my body forward (the movement that eventually leads to hip extension). It only seems to occur if my leg is not directly under my mid-line.

Again, I am theorizing here (as I am no anatomy expert), but I believe the pain is coming from one of the muscles of the adductor group (brevis, longus, magnus, minimus, pectineus or gracilis). I have uploaded a picture for clarity... I am really horrible at describing things. Anyway, The reason I am thinking it is not the psoas, is because I have no pain with rising my leg (like when getting into a car), which seems to be a, indicator of the psoas.

My pain comes exclusively with walking, and only if my leg is slightly out to the side. All that said, at this point it could be anything... swelling (still have a ton in the thigh, groin, outer hip and hamstring), nerve compression (from the swelling), psoas, adductors... little aliens that are preparing to take me to another world (lol... just a little nerd humor... I am in IT after all). It may even be my SI joint... so I am certainly not ruling out the psoas... and you know way more than I do about hip anatomy. Just trying to figure things out. Would love more input though Josephine as I have a ton of respect for your knowledge and welcome your opinions.

Anyway, an update for everyone else... sadly, the groin pain returned last night... though not nearly as bad as before. I did not think I overdid it yesterday (a couple of small walks, dishes, walking around the house, etc.), but then I guess you don't really know until the next day.

I am hopeful that the pain is really a result of all the swelling and inflammation. I won't lie, I am a touch concerned that it is the psoas tendon rubbing on the cup... seems to be much more common nowadays... with recovery hit and miss (the prospect of revising the cup is gut wrenching). But, I think it is way to early days to suspect anything like that. Will rest and ice today, and then see how it goes. By the way... just another note about the ice therapy machine... I can effectively ice the groin... something that was challenging with ice packs for me.

On another note, I think I am at the point where I should be reducing my medication (which is just Tylenol at this point). I don't need it at night at all it seems, and the pain is not that bad. I also find that when I take it, and there is no pain (or at least not noticeable pain), then I have no pain to serve as a guide for what I can and can't do. My little book from the hospital says "take you medication before activity because there will be pain"... but, is it the pain medication that is causing me to overdo it. Would love to hear what everyone thinks about that.

Anyway, that's all for now.

Cheers

Forgot to upload the image. Here it is

 

[Josephine]

but I believe the pain is coming from one of the muscles of the adductor group

Well that's it - 'one of the adductor group'. I never cease to wonder why people insist on thinking such a pain is only from one muscle when there are several in that group. I've never seen anyone saying 'it's pain in 'that' group pf muscles! Inflammation and pain love to share themselves around. so mostly it's highly unlikely that a pain will be from just one muscular structure.

I have uploaded a picture for clarity

Why? Did you think I needed educating on it?

I am a touch concerned that it is the psoas tendon rubbing on the cup... seems to be much more common nowadays

That is also a very, very uncommon thing so you can safely disregard it.

then I have no pain to serve as a guide for what I can and can't do but, is it the pain medication that is causing me to overdo it.

I think you are overthinking all this. You don't use the pain to guide you on what you should or shouldn't be doing. Your brain should do that!

 

[wonkyhipoy]

You don't use the pain to guide you on what you should or shouldn't be doing. Your brain should do that!

Lol, that is asking a lot of my wee little brain .

Thank you so much for the feedback by the way. Most appreciated!

Cheers

 

[Layla]

Happy One Month Anniversary!
Hope you're doing well today and have a lovely Sunday.
Wishing you a great week as you continue healing.
@wonkyhipoy

 

[JoeKnows]

My little book from the hospital says "take you medication before activity because there will be pain"... but, is it the pain medication that is causing me to overdo it. Would love to hear what everyone thinks about that.

Back when I used to run long distance, this was always a big debate. I would take something before repeat (fast and short distance) days, and would often end up straining something (I had terrible sprinting form). I stopped taking meds preemptively, and found that helped me listen to my body more.

 

[wonkyhipoy]

Hi All,

Time for another update.

First, @Layla... thanks for the Happy Anniversary wishes. Can't wait for the 6 month wishes

So things appear to be going very well. My strength is increasing, as is the distance I can walk. My groin pain is almost non existent so long as I walk properly and don't to movements that aggravated. Said the patient to the doc: "doc, it hurts when I move my leg like this". Said the doc: "then don't move your leg like that". Who knew that joke had a basis in reality.

Anyway, I went to PT again on Monday. Raised the groin issue, and essentially got the advice in the joke from the PT. My PT indicated that it is really easy to strain the muscles in and around the hip (even though not cut or retracted) because there is a lot of deep swelling. He said it is a delicate balance between moving too much and moving not enough. He told me not to do movements or exercises that cause it to hurt (basically, don't aggravate it)... and it I do aggravate it, do next to nothing for the next day or to. Seems like sound advice.

While at PT, he showed me a couple of modified exercises, basically taking my groin out of the few exercises I already had. But mostly it was riding the bike (very slowly, no resistance, just light active movement), ultrasound treatment on the groin, and tense machine on the outside of the hip. Seems like PT will be mostly treatment (massage, ultrasound, tense, etc) rather than stretching and exercises at this point... which I am happy about because i didn't want to have to push back and say "I am not doing this or that"... I believe strongly at this phase in my recovery it, that stretching (other than passive stretching) and strengthening will only cause problems. I want to wait until all the structures of my hip have healed sufficiently before ramping up the PT. So, I was glad that his though process was aligned with my. That said, there is no question I will need a lot of PT after week 12 (or later depending on how well I have healed). Not from the perspective of recovery from surgery, but I need to get the ROM and strength back that I lost in the years leading up to my THR. While most of my muscles are quite strong, certain muscles have really atrophied, while others have become over developed from compensating. So I will need to correct this imbalance... otherwise I will have other issues.

Other than that, things are moving along. I am still getting verve pain down my leg. Will be talking to the OS about that on Monday. I still think this is due to inflammation. However, I now have pain in my good leg. I say this like it has never happened before when in fact it has, but it is somewhat concerning. It is likely coming from my lower back (sitting and lying so much), and I cannot rule out aggravation from the force applied to dislocate the hip. about 12 years ago I had a massage therapist work on my L4/L5 area. She got her elbow deep into the muscle. It felt good at the time, but 3 hours later I had bad sciatica in both legs. This lasted for three weeks. It is possible she compressed the nerves, but the muscles were quiet bruised and inflamed... so I am thinking the inflammation of the muscles were actually irritating the nerves. I think that is essentially what is happening now. Not bruising, but rather inflammation, cause by using back muscles that I have not used fully for years. If this seems confusing because it is on the other leg, then let me explain. When you walk, your body does a balancing act. So when step forward with your right foot, your body counter balances this by tightening you left lower back muscles (and you left abdominal muscles)... and when you step forward with you lift foot, the same thing happens on your right. So, limping for so many years, and putting most of my weight on my good leg while standing has caused my right lower back muscles to become very week (and now inflamed due to over use). My left side back muscles are also overdeveloped, something my massage therapist point out to me years ago. Anyway, it is just a theory at this point. I could have a slipped disk, or stenosis (unlikely), and it could even be my spondylolisthesis causing this issue (though this is unlikely as in is only a single degree, which is usually asymptomatic). It could even be inflammation in my good hip or piriformis from doing so much on my good leg. Who knows... but I am sticking with my theory for now.

Cheers