THR Worried about setback today

[FACmom]

Hello all, I am six weeks post op tomorrow for THR on my right hip. Had my follow up this past Monday and everything looked perfect. Been walking pain free without cane since middle of third week. Did two virtual PT sessions with hospital’s PT which was very gentle. Decided to do some in person PT on my own, which was, I now believe, too intense. So I’ve mainly stuck to moving around doing normal activities, and a few of the original “easy” exercises, and just whatever walking is required during the course of the day. I removed the risers and cushions from my chairs about a week and a half ago, also the toilet riser but the toilet is “comfort height”. So yesterday I had some discomfort in my glute, and on the upper outside of the operated hip. No big deal, only uncomfortable when walking. Felt kind of “tight”. This afternoon, as I was walking to my car after a quick errand, I felt a sensation like a tendon snapping into a new location...definitely not a tear or rip, but just a movement. I drove home, and have been icing ever since. I need my cane to walk around, which is very disheartening. It doesn’t hurt as much as it feels “tight” in that mid-glute area, and the outer upper thigh. Everything was progressing so beautifully and we are leaving for a week of vacation tomorrow (by car, no strenuous activity planned.) My gut tells me this is no big deal and rest and time will help, but I need some reassurance please!

 

[Celle]

Hello @FACmom - and

Please will you tell us the full date of your hip replacement, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately in the future.
Thank you.

Oh dear! You were trying so hard to do all the right things and it sounds as if you overdid them and now your hip needs a lot of rest, ice and elevation. It's a set back but, if you treat it right now, it won't have done any permanent harm.

Did you realise that joint replacement is surgery that you can't recover from in just a few weeks? Complete recovery can take as long as a full year. No matter how well you're doing, you simply can't bounce back in just a few weeks.

If you think of it in terms of a race, recovery from a THR is a marathon, not a sprint. Slow and steady should be your motto for recovery, not aiming to pass milestones as fast as you can.

Even though you've been doing so well, your hip is still in the early stages of recovery. It's still healing from all the trauma of surgery. It doesn't need a lot of exercise. It will get all the exercise it needs, just as you go about your normal activities of daily living. Trying to do too much, too soon, will cause inflammation and slow down your recovery.

For the next week, spend as much time as you can resting, icing and elevating you hip and leg. There are articles about icing and elevation in the recovery guidelines that I will give you in my next post.

Also, do try to follow as closely as possible the recommendations in this article:
Activity progression for THRs

You may need to reconsider taking a holiday so early in recovery, too. Unless you're only contemplating short car journeys, sitting in a car for hours is probably going to make your hip and leg very uncomfortable.

 

[Celle]

And here are the promised recovery guidelines:

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. Try to follow this

​

Activity progression for THRs​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[FACmom]

Thanks for your quick reply! My surgery was at the Hospital for Special Surgery in NYC on July 24. Tomorrow marks six weeks. It is my right hip.

I’m not overly concerned about the vacation. Our total drive will be broken up into smaller bits, with break for a lunch with friends. I’ve tolerated drives pretty well so far, and always make sure to get out and stretch my legs regularly. The trip involves visiting my son, and sitting (in an appropriate high chair!) on the beach. Nothing strenuous at all. Bringing my hospital-issue ice bags to fill from hotel ice machine, and bringing cane for sure.

 

[FACmom]

Also, I will add that everything you’ve said here echoes the words of my surgeon. Verbatim, his mantra is “recovery is a marathon, not a sprint”! The hospital PT protocol is extremely gentle, and I’m sorry I didn’t just stick with that. I had a bad feeling when I first met the in-person PT, but she had come highly recommended by a friend who I trust. At least I only did three sessions with her. She had me doing things like bridges (30!) and leg lifts with weights ( I declined to use the weights fortunately) and a wobble board, and step-ups ( too many). My gut told me this was not good. I was anxious to get my house back to “normal” so I removed the risers too soon. Bringing a set on our trip, and a cushion too.

 

[Maldugs]

Hi I have had a similar experience, at 4 weeks I was able to walk briefly without crutches, I went early to my OS and physio, they said that I was walking so well I could go down to one crutch, get rid of the toilet seat, foam wedge etc. and I could drive if I felt comfortable, so I kept up the home PT 30x10 reps 3 times a day, after 4 days I could not walk without a crutch, I am at 8 weeks next Tuesday, and still using one crutch, SO this obviously is the result of doing too much too soon, I have stopped the PT completely, and I have an x-ray appointment with my SO and staff on 9th October.

 

[FACmom]

Maldugs I had my follow-up on Monday and was literally flying around the hospital. Hadn’t touched the cane since 2.5 weeks. I can tell this is just some soft tissues pleading for mercy. Annoyed with myself but at least I’ve learned something. I can be way too competitive with myself. Going to rest and ice for the next week for sure.

 

[Celle]

I'm sure your hip is going to be all right again soon, with gentle care.

Enjoy your holiday - it will be good to see friends and family. That's good for the spirits.

You might like to forewarn them that you will need to rest more than you usually do.
''

 

[Celle]

Thank you for your surgery date. I've done your signature and I've also added your name to the July Sparklers monthly team thread.

I'm glad to hear that your surgeon agrees with the BoneSmart approach to recovery. I was fortunate that my surgeon do too, when I had my knees replaced.

 

[Layla]

Hi Happy Two Month Anniversary!
Hope you’re doing well. We’d love to hear from you when you have the time.
Have a lovely Thursday and weekend!
@FACmom

 

[FACmom]

Thank you Layla, I’m doing great. Pacing myself and sticking to just the activities of day to day living. We had a very nice week long trip to Maryland and Delaware; visited our son and got some beach time. Sand and ocean waves were interesting but sunshine was terrific. Headed to California in two weeks to visit daughter and son-in-law. My swelling and stiffness are gone; i do feel some aches and strains in my upper thigh/glute muscles if I overdo, so I’m trying to be mindful of that. Im taking one Meloxicam and two Tylenol daily; as much as Id like to be done with these, I think i will stick with them for a bit longer. How long do people usually need to use these meds?( I know we are all different but just wanting a sense of what’s “average “)

 

[Layla]

Hello @FACmom Thanks for the update!
It’s wonderful to hear you’re doing great. Your trip to Delaware and Maryland to visit your son and enjoy some fun in the sunshine sounds wonderful. Glad you enjoyed!

I don’t think taking something for pain and swelling at two months post op is uncommon. I think the length of time has to do with how your recovery is progressing and since we all go into THR in varying degrees of joint deterioration and have different tolerance to pain, it’s difficult to judge. Please don’t underestimate the power of icing for pain and swelling, even at two months post op. You can still ice several times per day for 30-45 minutes, if you’re not already.

Safe travels to Cali in a few weeks. I hope you have a wonderful time. Touch base
as time allows upon your return. We’d love to hear how you fared on the trip.

 

[FACmom]

Thanks, @Layla. One quick question: i really don't have any pain in the operated leg...but when i put weight on it to go up a step, if I dont have a handrail to take off some of the load, I do get a brief but sharp painful sensation in the soft tissue around the top of the thigh. Not in the joint at all, just like under the incision area, down the outer thigh a bit, and around to the glute area. If i have a haindrail, no problem. And this just started at six weeks. (Incision is healed beautifully; i had no staples or stitches on the outside, just glue and a mesh tape covering.) I have always “led” with this leg, as I have some minor issues with my other knee, and now Im trying to lead with the left leg to give the healing leg a break... which has caused the weak left knee to flare up! Ugh! Nothing tragic, just hoping it settles down soon...

 

[CricketHip]

Sounds like soft tissues that are still irritated at being disrupted in July. I think they can take longer to heal and forgive than bones!
Overall you sound like you are doing very well.

 

[FACmom]

Yes, for sure it’s soft tissues...and it started at six weeks, a few days after my surgeon had me discontinue the aspirin protocol for clot prevention. I wondered if that added bit of pain relief/anti-inflammatory was helping keep that tenderness at bay...in any case Im just trying to avoid steps without handrails for the time being...not too difficult!
Another odd sensation is this feeling along the incision area when Im sitting: it’s not at all painful but just feels like a thickened band of tissue under the skin. Im assuming this is normal, noting that it feels thicker if I do more during the day, and just wondering long that might last?

 

[Mojo333]

I just had to remind myself often -
Tightness (which might feel like thickness) is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing... If a long full step right now is causing pain and limping, don't take long full steps. Take smaller steps. Take a short walk several times a day, instead of longer walks. Use your cane. Use ice. lots, still, especially after activity.
Rest a lot.

This isn't the time to do anything to excess. Baby steps now, and lots of patience, pays off big time later. Recovering from self-induced tendinitis can end up taking weeks or months. Consider yourself as still recovering from surgery and structure your return to your life as a slow, gradual process where you introduce very small increments in activity, and then give yourself time to see how you react to it.
All temporary, and worth the patience. I am certainly glad I am able to get back to a full happy life

 

[FACmom]

@Mojo333 yes, I do try to keep reminding myself to be patient. I have no trouble at all with taking normal strides, and no limp whatsoever. Actually gave away the cane to my dad lol. I truly didn’t appreciate the magnitude of the “carpentry” that was done to me until afterwards, which was probably a good thing! Im in pretty good shape even though i didnt get around much for the few months leading up to my surgery; i did train weekly on Zoom with a personal trainer who is an exercise physiologist so that definitely helped me recover well. I try to mainly stick to just regular daily life activities around the house ( I dont work anymore) and take a walk or two around my big backyard every day. It’s not the most perfectly level terrain but it’s decent enough and it’s what I’ve got so I take it at a nice slow and steady pace. At some point Im thinking of returning to my gym to use the pool. Tried that once in our hotel on vacation two weeks ago. Walking in the water felt actually better than swimming; but I’ll get to that eventually.

 

[Mojo333]

You will get there, and you sound very mindful about your recovery.
I didn't over-educate myself about the carpentry presurgery either flabber and glad I didn't...but it is a good reminder of what we are tecovering from. Also, as you say we are also recovering from the months/years of bad hips.
Hope your weekend is easy breezy.

 

[Layla]

A belated Happy Three Month Anniversary!
Hope you’re progressing as you’d like. Please leave an update as time allows. We’d love to hear how you’ve been over the past month. Hope to hear from you soon.
A great week to you!
@FACmom

 

[FACmom]

Thanks @Layla, I am doing well. The hip is great. Been home for a week now after a 16-day trip to visit our daughter and son-in-law in California.
The hip feels pretty much 100% normal and like it’s always been there; I often sleep on that side, and it’s pretty comfortable other than feeling a bit “thicker” than the other side. My only problem is that this past Tuesday I decided to stop taking all my prescription and OTC pain meds cold turkey. I was taking 15mgs of Meloxicam and also two extra strength Tylenol once or twice a day. I really wanted to be free from all the pain meds and realize after a few days that I’m hurting all over. I have some moderate osteoarthritis in my left knee, and my left elbow (old bad fracture) and also in my lower back and Ive been taking the Advil fairly regularly for years. I am feeling really disappointed at how much I am hurting all over. I worry about the idea of taking the meds long term, even though doctors have said this was fine for me ( I have no other health concerns whatsoever) I am just being a perfectionist about the idea of taking no meds at all.
I eat a very healthy diet, but right now I dont get as much exercise as I would like because I am just hurting too much. Ugh. But yes the hip is actually great. Just the rest of me that hurts. Would love some reassurance that using some OTC stuff is ok...because right now I’m just too achy to appreciate my new hip as much as I’d like to...