THR 19 Months Out - Weak muscles causing problems

[danelady]

@Jamie I am right there with you Jamie! I stepped outside earlier to feel the temp and saw it was pouring rain and it will continue for a week or 2. Right now my body wants to do nothing more than curl up in a cocoon and hibernate till it gets warm but come spring you and I do a virtual jig together and celebrate our bodies' determination to improve!

Putting up my cane when I got home FORCED more of my core muscles to grudgingly continue to wake up and along with my knee getting drained I am so much stronger!

Polish up those virtual dancing shoes, Jamie!!!

 

[Jamie]

Sounds like a plan, @danelady. I haven’t danced on tabletops in decades!!!

 

[danelady]

@Jamie

​

 

[Jamie]

My therapist confirmed what I've been experiencing. My tight muscles are better. She still managed to find a couple of areas to push on today and got releases there. One of these days she won't find any and that will be great. It will mean I'll be walking completely with no pain.

I do recognize I need to build strength in my surgery leg, though. It's coming along, but not "normal" yet. I noticed I as able to do the side step exercise MUCH better today, though. My steps were longer and stronger and Katie said I was standing up straight the whole time. Yea for straight!!!

I also noticed that I was able to go up and down the outside deck stairs more easily today after my therapy session. I'm still taking an Aleve each morning and will continue to do that for at least another week or two. It is helping.

I cannot believe how slow this recovery seems to me. I guess when I had my knees done, it was longer, but somehow that has faded from my memory. I'm at just about 5 months out now with my hip and somehow I felt like I'd be good to go by now. Not so! But I still am glad I got the hip fixed and know all will be okay with some time.

 

[Mojo333]

I'm glad that things are still improving... I'm sure you are very tired of this Recovery Business...
I am getting far enough away from my surgery that my memory of ongoing issues in my timeline is fading.
I try to go back to My recovery thread when I want to refresh it... How was I at almost 6 months?

Small issues remain mostly at the end of extra active days. Stamina not quite there, but then again I'm not twenty though most days I feel like I am.
Legs get agitated and restless at night, scar tissue pulls and one hip has some more prominent lumps in places that sting when leg stretches out. Behind hurts when sitting too long and intermittent groin pain. None of these issues are excessive or anywhere near the scale of first months out. Healing still progressing, I remind myself.

Curious... where is your ongoing pain manifesting when walking?

 

[Jamie]

It moves around all the time, but centers in the quad muscle somewhat (mostly weakness) and in the tensor fasciae latae. The latter is where Katie focuses her pressure massage. But the tight spots she works on have moved all over that muscle during the past weeks. She’ll release one area and another tightens up. She has me doing exercises that work that muscle too. I actually have had some days that were totally pain free here lately, so I have hopes that everything will completely resolve with time. Katie thinks that will happen too.

 

[Jaycey]

I had the same experience with post op pressure massage. The area releases and then tightens again. The good news is there will come a day very soon when these areas behave. Just takes time. So glad you have a good PT!

 

[Jamie]

You're so right, @Jaycey. The one positive is that the released areas are getting fewer and smaller with every week. On Thursday my muscles were pretty loose all 'round.

This past week, Katie did a little more aggressive pressure on Tuesday. Wednesday I had increased pain in the tensor fasciae latae muscle (which seems to be the main problem area). It was a test and I guess I failed. On Thursday she went back to the more gentle pressure and got two small releases. Then she had me do a quad stretch and hold it for several minutes as the muscle was trying to spasm. Amazingly, the stretch with extended hold time worked and I left my session walking really well. The muscle was slightly sore yesterday, but is good today. So, I guess I'm definitely the "slow and steady" type of patient.

 

[spaniel]

I just saw this as I used the search button for "tensor fascia lata".I am 11 month post anterior hip replacement. I am having significant pain in the TFL area and probably gluteus medius. My PT says the muscles are still quite tight. And to add to this now my non operated knee feels like a ligament issue after finally getting custom made orthotics done by a certified person for a LLD that was just not resovling and giving me very bad back issues. Back feels better now. I do thank you @Jamie for the idea of PPT. I do wish we had more people who could address the concept of kinetic chain especially for seniors like me at 70 . OS visits of 5 minutes yield little. But for my followup i will ask for ultrasound. May I ask if you had an ultrasound to diagnose the TFL or was this an obvious clinical finding?

 

[Jamie]

@spaniel ... The muscle problems were completely discovered and evaluated by my physical therapist. You don't need an ultrasound and I'm not sure it would even yield this type of diagnosis. A trained therapist will be able to feel the tight areas when you are lying on the table. I didn't even see my surgeon to get this therapy. I asked my wonderful GP to order it for me and went hunting for a therapist who knew this treatment. Call around and see if you can find a couple of therapists who do it.

It continues to improve. My last session was 4 days ago and there was pretty much no tightness when I went to Katie today. She was able to do the small needed release in about 10 minutes. She also shared with me that she's treating two other hip replacement patients with this same tensor fascia latae problem and they are both making improvements just like I am. This tells me it may be a lot more common than surgeons realize. I intend to speak with my surgeon about it when I talk with him in March at my 6 month follow-up appointment.

Try calling physical therapy clinics in Albany and ask if they have any therapists on staff trained in Pressure Point Therapy or Trigger Point Therapy. If not, I saw a number of massage therapy businesses on a Google search that do this type of muscle release. You will have lots of choices to try out. You'll probably want to try the therapy clinics first as their sessions should be covered by your insurance. Massage therapy is not usually covered.

Your knee pain should get better with some time and could be the result of new alignment from your orthotics. The fact that your back feels better is a good sign and it likely just takes your knee soft tissues some time to readjust to the new you. This is common.

Good luck! I think this really would be good to try.

 

[spaniel]

I can’t thank you enough for your excellent reply. Yes I have an excellent DPT but I don’t believe she does PPT. As you said she certainly has indicated tightness. There are certainly a lot of massage places close to me. The main reason I asked about the ultrasound is some worry about glut medius tear and I do believe that ultrasound dies pick that up. But the TFL area dies hurt more than the flu medius. It’s my understanding that the TFL overcompensates for weak glutes but I am a novice here! Again thanks for your reply. I do appreciate it.

 

[Jamie]

@spaniel You are right about the tensor fascia latae compensating when glute muscles are weak. This happens sometimes and then the TFL muscle starts hurting from overuse. I hope you can find a place to give this treatment a try.

Yesterday I had a major accomplishment. My therapist was out of the office last Thursday, so I didn't see her. Then her daughter was sick on Tuesday and so I had to miss that appointment too. On Saturday, I had joined the ODIC (Over-Did It Club) when I went out with my granddaughter and her hubby to look at houses. I had been doing so well that I took my cane but didn't use it for the first two houses. Man, all that walking across rough ground, going up and down stairs, and standing during the tours really wore my hip out. Even starting to use the cane on houses 3, 4, and 5 didn't help. By Monday muscles had gone back into spasm and my leg hurt.

When I learned I wouldn't be able to see Katie again until (maybe) tomorrow (nine days since my last appointment), I decided to see if I could do the pressure point therapy on myself. After all, I had watched and felt what Katie was doing these past two months. Plus we had plenty of conversations about the "whys" and "hows" of the treatment, so I stretched myself out on the bed to give it a try.

I started exploring the muscle areas on the top and side of my leg with two fingers and, low and behold, I found some trigger points. They really could be felt with pressure as a small knot or firm area slightly below the skin. They were not painful, but definitely knotted and sensitive. So I did as Katie does and pressed on them for about 90 seconds each. Sometimes I'd do a small rotational massage along with the pressure. Sure enough, I felt the releases! As I pressed, the sensitivity would stop. Then when I let up and tried pressure to the area again, there was no knot and the muscle was smooth and loose. I'm telling you, this is all a miracle to me! I spent about 20 minutes exploring along the upper leg muscles to find little areas where the tissue was knotted in spasm and pushed until I got that release. Afterwards, I walked better but the muscles just felt tired. I went to bed and this morning I was walking normally again. Totally amazing!

I'm scheduled to see Katie again tomorrow (Thursday) and can't wait to discuss this with her. I actually think I might be able to continue this treatment myself. The benefit of doing it here at home would be that I could address any tightness that popped up immediately instead of having to wait for an appointment. It would seem that the faster you could get the spasm resolved, the better that would be.

I still wouldn't recommend anyone trying to be their own therapist with this treatment. But, once you experienced it and knew the process and how it feels when it's being done correctly (I have been seeing Katie for about 2 months now), I do think you might be able to do it at home with fewer (or maybe even no) official therapy sessions. That's what I'm hoping to be able to try, assuming Katie agrees. I like the thought that a person could learn to perform the pressure point massage on themselves when needed. But I do believe it is imperative that you be taught how to do it by a trained physical therapist first.

Stay tuned.....

 

[spaniel]

@Jamie Yea I was part of the ODIC until I Lost my membership so to speak! The scenario with house hunting-oh my-thank goodness it wasn’t in my neck of the woods with early 1900’s houses. My PT indicates several areas along with TFL. The gluts-the piriformis. Today she also used the word knots. Also the oblique. I never imagined all this involvement. But your suggestion is a very good one. I appreciate the time you took to explain this approach.

 

[Jamie]

I got the smiley-faced green light from my therapist, Katie, today. She was genuinely pleased that I was able to locate trigger points, press them, and send the pain and muscle knot packing. We’re going to try another week in between therapy visits next week. I hadn’t done my exploring today and she located a few spots on the quad muscles to release. And they did. Hopefully one of these days these muscles will realize who’s the boss and it ain’t them!

 

[Jamie]

So much for progress. I did just fine for a week or so and then suddenly some fairly extreme groin pain returned, even though I was doing the trigger point massage when I would check daily and find a spot that was either a bit sore or actually had a bump. I had to go back to using my cane as it was hurting to put any weight on my leg.

I tried taking one Extra Strength Tylenol and that helps significantly and lasts around 12 hours. But it concerns me that the pain and general stiffness in the groin are back. So, Monday I called to get an appointment with my surgeon, as my follow up appointment with him was not until April. I'll continue to take the Tylenol twice a day until then so I can at least walk correctly.

I'm worried about impingement and need his guidance as to what might be going on and what I should do now that I'm 5 1/2 months out from surgery. I was certainly not expecting this!

The stupid administrative system at the hospital where I go never seems to be able to return your call so you can get scheduled on the first try. So once again, I had to call them back a second time and complain that no one returned my call. Their current process is, you call and give the info to one person, then the information is forwarded to a scheduler who is supposed to call you back within 24 hours to give you a date and time. It just never seems to happen that way, and I'm always having to call a second time and complain before I get a very nice call back. (my vent of the day!)

So I called again today and did my complaining and, sure enough, in about 30 minutes I got a call. The good news is that the scheduler was able to get me an appointment for next Tuesday, so hopefully I'll have more information about what might be going on then.

 

[Layla]

I am sorry to read this, Jamie. I am sure this is discouraging after you were doing so well with the trigger point massage. I hope you learn it's something less involved than you are suspecting and you find comfort soon.

 

[Jamie]

Thanks....I'm hopeful too. It's been rather frustrating, but I sure have a better understanding of how our members feel when things don't go as planned. At least the Tylenol works to help with the pain and allow me to walk more normally.

 

[Jaycey]

The good news is that the Tylenol is working. Have you done anything different lately. Bending, twisting or lifting something heavier than usual?

Glad you can get in to see your surgeon so quickly!

 

[myglasshalffull]

Good luck with the visit and hopefully just a little tweak in the body letting you know it's still healing.
So you know the drill, rest and ice, I bet you are better in no time.
All my best.

 

[Constanze]

I'm sorry you've got groin pain @Jamie. I hope you'll no more after your appointment and that it'll resolve the problem. Alle the best.
Constanze