Leg Control?

[kwarendorf]

I'm 7 months post-op and for the most part doing great. Over the last week I have begun to experience lack of "fine" control of my operated leg. Since Day 1 I have noticed that my left (operated side) foot would lag when I turned to the right. I assumed that this was a muscle strength thing and would resolve as my leg strengthened. Things seem to have moved in the other direction. After walking 100 yards or so, it feels like I have to swing my leg to get my foot where I want it to go. I look almost drunk! It gets worse the longer I walk and short rest tends to reset, but not eliminate, the condition. There is no pain in my hip, but I do feel serious muscle fatigue in my thigh.

Has this happened to anyone else?

Any thoughts would be greatly appreciated.
Kyle

[JeanM]

Hi Kyle,
I definitely experienced the same thing.  However, it didn't get more pronounced over time.  If anything, it got less pronounced over time - but slowly.  It was definitely was one of the slowest things to come along.  I'm at 13 months right now.  As long as you don't feel pain, I wouldn't worry too much about it.  Just continue to focus on building strength.  I think the finer muscular coordination takes some time. 

Jean

[John C]

Are you continuing to do strengthening exercises? I am beginning to believe that our new hips require almost daily specific strengthening exercises. Daily life, and even vigorous sports, do not seem to be enough, without adding a period dedicated to keeping the hip area strong. My hip is definitely happier if I exercise it, than if I rest it.

[JeanM]

John,
I agree with you.  I'm finding that building complete strength in my operated hip is a slow process that truly does require very specific exercises.  For instance,  I can perform in a lot of my sports better than before the operation and most importantly I have no pain.  However, there are certain movements that are affected by a continued lack of strength in the hip.  Here are a few examples that come to mind.

1)  Moving from a standing lunge on the operated leg to a folded lunge on the operated leg is a slower movement on the operated side.  It seems that I'm lacking a certain strength required to help control the movement.  It feels a lot like a coordination issue on that side.  But, of course it's truly a strength issue

2)  Standing on operated leg only, reach for and touch the floor with unoperated leg behind (scale).  This is still pretty difficult on my operated side.  But, very easy on my unoperated side.  Again, I think it's a very specific weakness that affects my coordination.  This is one that I've decided I need to do every day.

3)  Stepping off of a very high step or bench with my unoperated leg supporting me, good leg stepping down.  I can do this.  But, with more awkwardness (and a little panic) when my operated leg is the supporting leg.

4)  When pivoting or turning quickly, my left leg still feels a little sluggish compared to my right. 

I've found a lot of exercises in the P90X workouts to be surprisingly good at targeting the specific weaknesses that still exist in my hip.    To your point, daily activities and even sports don't necessarily draw attention to these weaknesses.  I've been able to pinpoint most through my yoga practice and the P90X workouts.  But, my theory is that if I keep working on those specific weaknesses, I'll see even further improvement across the board in all my activities.  I would bet that some folks don't even recognize their more subtle weaknesses.  It takes some exploration to find them. 

Is this consistent with what you've experienced?

Jeanie

[John C]

Hi Jeanie,
Yes, absolutely. The exercises that you mentioned are exactly the ones that I still find challenging. The one legged squats to touch the floor have always been one of my favorites for ski conditioning, and I can easily do 30+ on my good leg. Before surgery, I could due about half as many on my bad leg, but with more pain and difficulty reaching the floor. At this point 15 months post surgery, I still cannot quite touch the floor on that side. The lunges you mentioned are another area of weakness. Lowering from a high step is another. As part of my training I do laps up and down six flights of stairs for 15 minutes, and I have no problem walking or running single steps, or two at a time. However, as soon as I step up or down off of something much higher than two steps, I feel the weakness and instability, so I am focusing more on that now. It is worth noting that two legged squats, even with substantial weights, are no problem, and therefore do not address these issues at all, nor does biking, since these do not involve the lateral and rotational stabilizers.
Keep up the good work!

[kwarendorf]

I have not been keeping up with my dedicated hip exercises. I have been doing a lot of walking and recently added a 20 minue pilates routine. I think you are all right, that I need to focus more narrowly on my hip. The leg control seems to have stabalized for now. To be safe I made an appointment with my doc on TUesday. Assuming he gives me the go ahead I will be more diligent about strengthening my hip!

Thanks,
Kyle

[Jed]

I am 7  months post op now and am pretty happy with my new ASR hip. I have no pain, just the very occasional twinge of discomfort when overdoing things. I have hiked 10 miles on several occassions without problems, have no limp, and, after 6 months started to push things a bit, doing light squats, walking with a 25pound pack etc. So I was feeling pretty pleased with myself. I did, however try to do what Jeannie suggested, balancing on my operated leg and bending over to touch the ground. Well I could barely get halfway down before the butt muscles started complaining.  I now see only too clearly the need to work on my ballance. On reflection I think the fine motor skills are equally as important as overall strength. So from now on I am incorporating bendng over to the ground on one leg as part of my exercise routine. Thanks Jeannie.

[stevel]

My physical therapist prescribed that exercise for my rehab up to the 5 1/2 month mark.  One leg is bent horizontal to the ground and resting on a bench.  Then I squatted to the ground on the other leg, maintaining my erect posture.  I alternated between the operated leg and the normal leg.  She also prescribed numerous other exercises (lunges, using the "Fitter," a ski conditioning cross training machine, etc.) to prepare for downhill skiing.  Needless to say, I have had no instability, weakness or aching in the operated hip when doing activities such as downhill skiing, hunting in mountainous terrain and jogging on the treadmill.

[kwarendorf]

I saw the doc on Tuesday and the xrays were good. Nothing has move and my right hip as not deteriorated significantly. I didn't connect the two at the time, but at the same time I was experiencing my leg control issue i started to have an itching/burning sensation around my left shoulder. It would itch but scratching provided no relief. It was like I couldn't find the itch. My dermatologist said it wasn't a skin thing and suggested maybe it was a pinched nerve in my neck. When I mentioned this to Dr. Mayman he said that a pinched cervical nerve could absolutely cause both the lack of leg control and the itching. I have an MRI on Saturday to see if they can find the culprit.