THR 19 Months Out - Weak muscles causing problems

[mendogal]

I am so heartened by your PT's very focused approach on your overall structure. It's wonderful you're feeling improvement.
Curious to see what the MRI shows.

 

[Jamie]

Yeah…..I’m curious too. I’m going to call the imaging center tomorrow and see if I can get it scheduled quickly. They are usually pretty prompt. I don’t know if they will do the bone scan at the same time or not, but I’m going to ask.

 

[myglasshalffull]

Last year around this time when I went back to work (silly woman that I am), after about 3 weeks I was pretty sure I had done something to my hip. I could barely walk, back to cane.
I did regular X-Ray & everything was still in place & that's when I followed up with new OS at Brigham who ordered MRI. Turned out it was my back & spinal stenosis. Took about 3 weeks of exercises, ice & heat to get back to normal but I did & thoughts of returning to my job as a server were quickly dismissed! (Although I love the job & people). Now I just dog sit to make some extra cash.
Keep us posted on your tests.

 

[Jamie]

Thanks for knowing that it is possible to come back from spine issues without surgery. I hope that’s the case for me if it is spinal stenosis, but the truth will be in the imaging.

 

[EalingGran]

Thanks for knowing that it is possible to come back from spine issues without surgery. I hope that’s the case for me if it is spinal stenosis, but the truth will be in the imaging.

I have spinal stenosis as well as facet joint disease and my MRI was pretty bad.
Straightening my leg from being very valgus pre my PKR helped- and now I can manage with back exercises/ pilates. My knee surgeon thought a steroid jab would also relieve my sciatica if the leg straightening hadn't worked.I think surgery is only if all else doesn't work. I also found naproxen and pregabalin were helpful.
I hope the MRI gives you answers and you can get relief without surgery.

 

[Jamie]

A major positive change happened with my hip (and to some degree my lower back) with today’s therapy session. Katie did pressure point treatments on the tendons in my groin for the quadraceps and psoas muscles. In probing around, she had found some areas that were tight and I could feel the tenderness in both when she pushed on the pressure points. She said both got some release and the psoas released so quickly that she felt it was a “secondary” problem. Then she had my bend my leg while lying down and she attached a belt around my leg at the hip level. I tried to find an image of what she did but couldn’t find one. If you can picture lying you your back with one leg extended and the other bent at the knee (foot flat on the table and heel as close as possible to the butt). The belt went over my bent knee and was then encircled my lower leg and upper thigh. She then strongly pulled on the belt to do what she called “traction.” I could feel it pulling my hip joint apart a bit. She increased the pressure until was pretty uncomfortable against my quadriceps. When I told her, she backed off a bit, but continued the pull for a while. She had me stand to see how things felt. The joint was looser.

Then she did what I image was pretty deep massage with the pulsating gun all up and down my quad. It was a bit uncomfortable, but no real pain. Then she had me turn on my tummy and did the same to the glute muscles. Less discomfort there.

When I stood up again, it was a miracle. My joint was loose. I could walk basically with a full normal gait. And pain was pretty much gone. I felt like I’d been through a real workout, though. I had to run a couple of errands on the way home and as I walked, things were noticeably better. I was shocked at the dramatic change and it definitely gives me hope that what I’ve been experiencing the past year actually can get resolved. Both my hip and my lower back are significantly better. I can only hope this holds or that she can do this same thing with each session until it is permanent. It certainly proves the point that a good therapist is pure gold. By giving her a lot of feedback as she was working on me, we may just have stumbled on the source of my problem.

 

[mendogal]

This is fantastic! And yes, in my experience a PT who has gone above and beyond the regular education based on their interests can seem to work magic at times!

 

[Jamie]

I’m still in awe this evening that I’m able to walk around the house with no pain and a new feeling that my hips and legs are somehow now “balanced.” I do have a little discomfort in my groin when walking sometimes, but it feels like a “tired” muscle more than actual pain. I’m still going to get the imaging done on my lower back.

 

[myglasshalffull]

That's great news, sounds like PT worked wonders. Yes, I'd still keep MRI appt, it's nice to have peace of mind after the test is done.

 

[Jamie]

New update: My hip continues to improve slowly. I’m seeing the therapist twice a week for a “traction” treatment that works to ensure the ball of the hip joint is in just the right place, followed by deep massage with a gun to the quads and glutes. Each time I have the treatment, my hip feels great and that lasts longer every week. I’m concentrating on walking correctly with a good gait and my shoulders back, head up. This is helping too because I notice it is just a bit easier to take steps up or pivot without using those little tiny steps to turn around.

I wish I had gone to the therapist much sooner. Lesson learned here!! I no longer need my brand new orthotics and no more lifts in my shoes. I’d love to get another x-ray to see what my hips look like. I feel like they are much more balanced now.

Even with this good news, I can tell that my body is going to require a lot more time to be normal again. I have a big trip planned for August and am hoping to be strong by then. But I’m certainly glad to see these improvements. I was beginning to wonder if I’d ever get my normal hip back again!

 

[mendogal]

This is just wonderful!!!! You should be in much better condition for your trip than expected.

 

[Jamie]

It sure seems promising. This really speaks to the importance of having a well-trained physical therapist. They are out there….we just have to find them.

 

[Jamie]

I am learning so much about how weakened muscles surrounding your hip can impact your ability to walk correctly following a hip replacement. It’s starting to make real sense why doctors have always said that walking is the best therapy after surgery. And the thing we always say about “everything being connected” really holds true for not only hip functionality, but weak glute muscles also can impact the knee functioning (patellar-femoral syndrome). Weak gluteus muscles (maximus, medius, and minimus … your “butt” muscles) can cause problems walking, as well as back pain and poor patellar tracking.

I learned today from Katie that my gluteus medius being weak was the cause of a recent discomfort and difficulty walking (this problem comes and goes as my muscles are trying to strengthen and normalize). I was suddenly having a little more difficulty walking in a balanced way after yesterday’s therapy session. So today, she located numerous trigger points in my gluteus medius that were tight and preventing proper functioning of the muscle. This can lead to a slight limp and a feeling that you cannot put full weight on your leg.…exactly what was happening. So, today, she focused on those trigger points to release the muscle tightness. And it worked! When I got up from the table, I could stand and walk in a more normal manner again. It may not last, but at least now we are both aware of the weakness of this muscle. She asked if I had done anything yesterday after our session that involved carrying heavy items. Bingo! I ran errands, carried a 15 pound bag of dog food around and a gardenia tree that I bought at the garden center. That is likely what triggered the muscle to tighten up.

I cannot believe the intricacies of our body’s muscles and the science of movement! Katie warned that I may experience a lot of these little problems in the coming months as my muscles begin to get proper strength and the balance among all of them changes. They don’t like change, and will try to stay the way they were. So, once again….patience is important as this all resolves.

 

[benne68]

It's always the glutes, isn't it?

Glad you have such a knowledgeable therapist working with you, @Jamie !