Total Hip Replacement and resulting post surgery difficulties
I am 54 years old and I had a THR on the right done almost 4 months ago. My surgery was such a success, I had virtually no pain at all, I recovered really fast and went back to work after almost three months. I walk a lot at work, take the elevator rather than stairs and bend to reach files in bottom shelves and drawers. This past week I have been experiencing some muscular pain in my mid to lower right outter front thigh area. I attribute this to a) the femur bonding to the prosthesis and b)the muscles healing and c) the fact that I am walking, bending, etc., a lot. With rest it feels fine, with my cane for support it feels fine. It does take time for muscles, soft tissue to heal and bone to bond. I too feel like my right leg is a little longer, but it doesn't feel like it all the time. My limp is usually when it is sore. I will just be patient. Best of luck to all my fellow THR recipients.
Hip replacement return to functional activity athletic
I am a 56 yo female (athletic), 7 months post THR thru the minimally invasive procedure. I was doing pretty well until I overdid it. Tightness in the joint seems to be common amongst the people who have reported here. The musculature sling around this joint is what holds it in place, just like the musculature joint around the bony joint held the femoral head in the acetabulem.
I have found it very important to stretch out my hamstrings, gluteal musculature (which externally rotate & extend the hip), quadriceps (flex the hip) and adductors (move hip into midline). The tighter these muscles are, the harder my hip flexors have to work, the more pain in the hip, and the weaker I become.
Also, I have gone backward with my rehab to the minimal straight leg raises in flexion, extension, sidelying, adduction, etc; quadricep sets (isometric), abduction to work the gluteals, etc. This has helped. I still have some instability which appears to be from the quadricep stabilizers when I go to walk & am back with a cane most of the time.
I too have been stiff when I stand & it takes me a minute to catch my balance before I can take a step. I am hoping this will be alleviated with stretching. I have found that my strength is gradually increasing & have to be careful to not overdo it.
I used to run, bike, swim & now can barely walk around the house, have gained 20 lbs, and am very frustrated. I feel as though I am 95, not 56.
I have worked with a DO (osteopathic doctor) which has helped release myofascia all over my body & some of the stiffness has decreased with this therapy.
I still have numbness over my anterior quadriceps proximal to the incision in the IT band. It has taken so much longer than I had hoped to "come back".
I believe that part of my delay came from the fact that I was on a steroid which rid my body of all pain so I did too much as well as the tightness in my hip.
I strongly urge all folks who have this surgery to have physical therapy, listen to your body; it is telling you what you need.
I have met people who have had this surgery w/no PT after and are very functional & active athletes. It is an enigma to me. Recently I met a woman who had both hips replaced, attended PT & is about 3 months post op, teaching Zumba. Amazing! I am not there yet.
Tena and a half months after thr the muscle half way down my right leg seems to be worse not better. I am tilting to one side most of the time now as it sends a sharp pain through my leg if I try to walk normally. Will this sort itself out in time I like to do a lot of gardening and look after my animals so am not sedentary but still can't take my dogs on the long walks I used to.
If you have not already done so, you should see your surgeon for an evaluation of your pain. By this time, you should be well on your way to full recovery, and getting better, not worse.
Thus it is important to figure out, exactly, what is causing your discomfort. Unfortunately, there are several things that can cause midthigh pain after a THR. Total joints are done for pain control, so continued pain after a replacement is not normal.
52 year old male. LTHR about 4 months ago and have been experiencing extreme pain upon waking up in morning. Can not lift or move bad leg. Immediately struggle to get out of bed with a tear in my eye. Pain seems to come from 1) groin area, 2) the muscle used to raise leg and 3) deep in the hip area, almost like a burning, sharp pain.
However about 10 steps down the hall and already starting to feel better. It's like I have to put weight on it to make it feel better. Have been doing all the PT and exercises. Doc and X-rays say nothing wrong. VERY VERY Frustrating as I have not seen any complaints quite like this. Pain is with me most all of the day but NOT nearly as bad as in the morning.
Some theories include the Muscles / Tendons etc contract during night and what I am actually experiencing is the first painful stretch. Have tried all the usual: (stretching just before bed / ice / heat / Anti-inflam all before bed. Stopped all exercise for a week. Overdid exercise for a week. NO significant change).
Finally went golfing (True Passion) yesterday. Took it easy and while on the course felt quite good. Minor pains, but tolerable. When I woke this morning, about the worse it's been ...errrrrgh!
One other funny oddity.... Even If I take a nap during the day, when I wake up that same pain is there. Just like after a night sleep.
Though I cannot offer you any other advice that what you have already been doing, the problem you describe is a hallmark of an inflammatory process.
Again, stiffness and pain after a period of inactivity is the hallmark of an inflammatory condition. This is why patients with inflammatory arthropathies (such as rheumatoid arthritis) prefer to keep moving than to rest. The get stiff and sore after resting for a while.
This is the opposite of the problems seen with noninflammatory conditions, such as osteoarthritis. In OA, patients usually feel better after resting and get worse with activity.
But, you have already tried all of the usual things that are recommended for the management of an inflammatory condition. The only suggestion may be to take the NSAID medication on a regular basis, rather than just at bedtime. By getting a good, steady blood level of the medicine, it may better treat the inflammation.
The other thing, if it is possible to determine that it is a tendonitis or bursitis, it may be possible to inject that with some corticosteroid medication. This could help to knock down the inflammation to a point, where the oral medicine could then manage it.
Anyways, hope you find a good solution to your frustrating problem. Good luck.
First, thank you for your reply. It sounds quite logical and your advice quite helpful.
If I can take a few more minutes to share what's happened since my original post:
Surgeon ordered an MRI which was read by 2 Radiologists concluded no indication of source of pain. What I found VERY interesting while laying perfectly still for 40 minutes in MRI tunnel, pain started to come on at 20 minute mark and by the end felt like typical morning pain....
Next a visit with my Rhumie. After explaining to her my symptoms' she performed a CT scan. and although there were some signs of epedimia(?) fluid in the sartorius muscle which appeared to get worse as I lay there. She too had no concrete answers. Suggested that I may have tendonitis of the Sartorius and if so, would be a long, PT process of minimal stretching etc with NO constrictive muscle movement (i.e. bike riding, elliptical machine etc.) but stretching-stretching-stretching - stopping before pain.
One other note: she mentioned that no one would risk Cortizone injection to site in fear of infection to new hip
So, 4 Docs, 1 nurse practitioner and 1 Physical Therapists and no hard evidence. Have appointment with PT tomorrow after a week off. Have a lot to discuss with him as to a new course of action.
Will keep the group posted and again if anyone has had similar experience, would love to hear from you...
You are correct about the cortisone injection. Being only a few months out from surgery, you are actually still in the healing process somewhat. It often takes many months for the scar tissue to mature and soften.
In patients who have had their total joints for a long period of time, and then develop a bursitis, which cannot be controlled with oral anti-inflammatories, a cortisone injection may be tried. But, again, not in the joint itself and not soon after the initial procedure. Cortisone can decrease the body's immune response.
It is interesting that you are developing edema within the substance of the sartorius muscle. (Also known as the "tailor's muscle". One of the actions of the sartorius is to cross the legs into a cross legged position. A common position that tailors used to work in, centuries ago.)
But, with the sartorius being very superficial on the anterior surface of the thigh, is it possible for PT to do some ultrasound over the area? They can also use some inotophoresis with the ultrasound (with a physician's order.) It might be something to ask about.
It is very difficult to stretch the sartorius, since it is very long, thin, and crosses both the hip and knee joints. You sort of have to stretch the quadriceps, adductors, tensor fascia lata, and hope that the sartorius gets stretched too.
Good luck. Hope you do find something to help with the discomfort. Wishing you the best.
Usually when patients have trouble climbing stairs, it is usually from not having enough strength in the legs and back to do that activity.
Most patients, before they have the total hip done, have significant pain that they are not able to do a lot of physical exercise. As such, their muscles atrophy and become weak. Thus, after the surgery, they have to really work on rebuilding their muscles. It won’t just happen. It has to be worked on.
However, if it is just pain that is keeping you from going up stairs, then that should be evaluated by your surgeon. Total joint replacements are done for pain control. So, if you are having continuing pain, it needs to be evaluated.
Your other hip may be bothering you due to a couple of reasons. One, it may have the same arthritic changes as the hip you had the replacement done on, just not as bad. When the replacement was done, the joint pain may have decreased enough to unmask the pain in the other hip. Or, you could be using the other hip more, after the surgery, causing it to hurt more.
But, again, if you cannot climb stairs because of strength issues, you just need to get to the gym. But, if you are having significant pain still in the hip, that needs to be evaluated by the surgeon.
Good luck. Hope you get to a good functional level with your new hip.
THR to left hip AUG 2012
I feel i am recovering really well! Off my crutches after 6 weeks thought i could go to the gym and swim Lol but was told to wait till 3months, I have had only 10 mins physio 2 days after my op and a booklet to explain exercises I needed to do. Everyone on the site appear to have received on going physio??? This i have found difficult as i am not sure when and how i should introduce things. However, i have became pain free from that crippling groin pain and found i could stop taking my pain killers after 2 weeks. Now i am walking around and about to return to work this week but i find i am having terrible pains in my feet some of this pain started in the opposite foot to my left hip, they felt that it was because i was unbalanced (walking awkwardly) and referred me to Physio which took 15 weeks but was just in time as now i am walking more i have very bad pains in my heel, side of my foot and top of foot. the physio seems to think the tendons are now inflammed and i should put ice on them and do some exercise, stretching and anti-inflammatries for 3 weeks. really hope it works as i feel my hip is fixed and now i can't walk properly because my feet hurt so much. In the morning when i first get up it is so bad but gets a bit better as i continue to walk but the pain is always there anti-inflammetries helping a bit and will get on with applying ice and exercise. It is good to read that others have this stiffness in the thigh and mucsel I have experience now i am doing more will do the stretching. I think it is easy to forget what a major operation this is and that it will take time.
Good luck to All x
Had my Left THR in 2005 very successful but long recovery back to work and heels in 3 months. Feb 2012 had my other hip done felt like a new person the next day, did my rehab, walking more and back to work in less then 3 months. For the past month I'm having the same pain as before. Since I'm back to work I stopped walking, stretching and exercizing. I don't know if this is causing my muscles to tighten up, but after sitting at my desk for a long period of time both hips hurt getting up and have to hold onto the desk to straighten up my body...I'm a young 61 year old who is always on the go..
You might want to take frequent breaks to stretch a little. These do not need to be very long and you do not really need to leave your desk area. Just standing up every half hour or so to do a little stretching routine may help tremendously: bending forward, sideways, backwards at the hips; rotating both to the left and right a little; picking up each leg to the chest (or at least get the foot off the floor about 12" or so); pace back and forth a few steps; and include any other exercise that you can basically do standing that you would like. This should not take more than a minute or so to do.
Again, do this about every half hour while you are sitting at your desk. Whenever you get the opportunity to walk down the hall or to somewhere else in the business, take it.
Just sitting at a desk for hours on end causes all types of musculoskeletal disorders. Patients with upper back or shoulder problems can do a similar type of program, but emphasizing the shoulder region: shoulder shrugs, rotations, neck schrunches, etc, all of which can be done sitting at the desk. This is also not bad for everyone to do, to reduce the chances of developing the problems in the first place.
Due to the way data is entered nowadays, we tend to just sit in front of the computer and hardly move, except the fingers. We do not have to get paper out of the desk drawer, or reach up to put it in the typewriter, or reach up to move the carriage on the typewriter back at the end of each sentence, nor do we get up and walk to the filing cabinet to put the document away. Now all we do is hit the send button and start the next document. No wonder we all get stiff and sore in the office environment. We need to move around a lot more than we do.
You might give something like this a try. Also make sure you are sitting with proper biomechanical posture and your desk/workstation is ergonomically suited to your body. If you are not sure, your employer is supposed to make sure that your desk/station has been properly evaluated and the proper type of desk, chair, supports, etc have been obtained for you.
If something similar to this does not help significantly, then you may need to see your surgeon once again, just to make sure there is nothing else going on.
I found this posting very helpful as I am 2 months post surgery and was rather frustrated about pain, limping, still using a cane when outdoors, and etc. From some things I read online I thought I should be healing more quickly. My physical therapist thinks I should be walking with no assistance at this time so I walk without the cane when at home and just endure the pain. In lots of ways I do feel stronger and more flexible but not anywhere near what I want. Reading that the recuperation can be a year long (or more) process has given me renewed hope and I will be more patient with myself. Thanks.
I am 52 and had THR March 28. I'm 4 months plus post op. I'm doing great. Feel great, and have very little pain any longer, if any, once in a while a little pain in inner groin. Started doing a workout at the gym and not hurting. Sleeping, is the thing, I'm so tired. I can sleep 11 hours straight. Hard to get out of bed, so tired...I'm hoping this is just my body healing. Has anyone else had that experience? It's kind of freaking me out how. Feeling like a bum for sleeping so late. LOL
Hope everybody is doing better since it would be a year plus for most of you after hip surgery. I had my hip replaced 9 months ago and I feel great. Riding my horse 5 to 6 times a week a week, playing tennis 3 times a week, walking 1 hour up hills 2 to 3 times a week, and working out at the gym at least 5 times a week. At home I stretch a lot. And, one thing I don't sit very much as I found that I get a bit sore still. But over all, I am doing great.
Hello. I see that this hip replacement forum is quite big and thought I should impart some wisdom for those who have had a THR, those who are thinking of one, or just generally anyone thinking of any type of orthopedic surgery. The way you respond to surgery is directly responsible to a whole host of things that are related to your internal healing abilities. One thing common theme among orthopedic recovery is that it can be a hit or miss. You have an athlete who injures a limb, gets surgery, then after little to no time they are back to a serious training regimen. Then there is the other person who finds themselves in constant pain, they can barely get around, their hip hurts all the time, and a doctor promises them that surgery is going to be the magic cure that gets them going again. Of course the doctor will say that because well they are a doctor and they thrive on your surgery. In reality though, we have two very different people with very different bodies. We have the athlete who is healthy, and the not so healthy person in constant pain who just wants relief. I am willing to bet on that there is a 99.99999% chance that if you took blood from both of these two extremes that the athlete is going to have higher serum testosterone levels than the chronic pain patient, their igf (insulin growth factor levels are going to be higher), and overall their hormones are going to be more balanced and in tip top shape. Now why is this important? lets say you enter a total hip replacement surgery and you are really low or deficient in testosterone, igf, or some other hormone is really messed up. Well guess what, when you have that surgery your body is either going to heal slowly or heal improperly to the point that you will be worse off. Now this is only taking hormones into account...it does not take into account nutritional deficiencies, antibody count, etc. However, generally speaking, a person who suffers from the above is not going to have healthy hormonal levels so I do believe hormonal levels are a good overall indicator of health. Needless to say, if you are thinking of undergoing surgery, get some blood work done, get educated on proper levels, and realize that you may be able save yourself/ or even help correct your pain and damage with this simple bit of wisdom.
I am 53 yr old female and am nearly 2 mos post surgical. this was my second thr. my first was in 2006. the surgeon left my first thr with that leg almost more than full inch longer than my left leg. I walked and did life for 8 years in ever increasing pain in my back from this. I had no insurance for most of those years after the 1st surgery so had no way to correct the problem. the surgeon denied my left being longer and tried to send me to a back surgeon. Now in 2014 I have good insurance and went back to the same guy. as I needed my left side replaced. He admitted post surgery to my husband that indeed the right had been significantly longer but that he lengthened my left leg to correct this. My PT say indeed that he did a great job and that both legs are so close in length as to be almost imperceptible. at about 7 weeks post op this 2nd time around I am progressing well according to my PT who i like and trust. The back pain is almost entirely gone but he tells me that it is too soon to tell if there is any permanent damage from having walked terribly to compensate for those 8 years. I still walk a bit odd. he says i look like i am stepping in a hole a little bit and that this is either due to a problem in my back OR just a habit. Once again too soon to tell. I have no natural stride or gait. i have forgotten how to just WALK forward naturally and normally and will have to concentrate on each step so that i do not develop a damaging gait due to having no natural one. Like a few others here I am a bit worried. I also have very high expectations since i have such phenomenal progress so far and was once almost a competition class body builder. I fell at work hurt my back pretty badly ( fell both legs out in front of me and shattered my tailbone impact going into my neck) in the late 80's and had to give it up before i was completely ready to compete.
I am desperate to walk NORMALLY. with a natural gait and stride now that my hips both pivot and move freely again.
Can anyone here say that they have achieved a place equal to where they were before their hip went bad? or do i have to modify my expectations to include a minimized version of the person i once was and try to just be glad that i can walk pain free even if it isn't unflawed.
Both my implants are metal on metal titanium bone ingrowth prosthetics. my right (older one) is a DePuy and my left is a zimmer if that makes any difference.There is one screw in the cup for of my new one on the left for stability i was tld since this left side was much more damaged than my right.
I have almost no pain but a great deal of odd pulling pinching spasm like stuff going on all over the place but nothing significant or consistent as far as type of twitch etc. My right hip has dropped almost 75% of the way back down to a more level length. Pain is in the seating area of the cup and for some odd reason I am hyper aware of my other hip again which most days i had forgotten i even have. it is like they both feel new for some reason? in my head? or should i be worried yet?
I have the hardest time lifting my leg out to the side and am limited with how far I can squat down when doing my PT exercises. I have such a hard time telling if something is wrong or even actually hurts since the pain I was in before was so devastating that my threshold is immense. i no longer have any gauge for what is normal anymore in so many ways. kind of scary.
A. L. Wilson