Range of motion expectations

[C.Busch]

I’ll be 5 weeks post-op tomorrow (35 y/o, very active, very fit). Over the past week I’ve been going back and forth between positive and negative thoughts. I’ll start with the TL;DR and continue reading for more detail.

TL;DR: I’m recovering nicely from the surgical trauma but my pain patterns, movement compensations and mobility are all VERY similar to what they were pre-surgery. Should I worry about this or be more patient?

It seems I’m almost back to my pre-op baseline in regards to pain patterns and mobility. Yes, I admit my glutes and hip rotators still having some healing and lots of strengthening to do. Maybe your thinking, “how could he complain about being nearly baseline at 5 weeks post-op”. Here me out or check out the TL;DR below.

I can flex my hip to about 90 degrees of flexion before feeling a pinchy ache and a “block”. External rotation is limited and provides the same sensation. Internal I haven’t tested because they said avoid IR until the 6 week follow up. But, I could tell you that is likely limited too. My pain patterns are also the same as pre-op… a dull ache and pinchy’ness in the hip flexor region and sometimes groin which comes and goes. My compensations are similar too… the way I have to position my body to pick something up or complete daily tasks.

I wouldn’t be as concerned with my limited mobility if I was feeling muscular tightness or stiffness when testing my range of motion. This ache and block is the same sensation I felt pre-surgery, and it feels like the joint has reached its end range and cannot possibly go any further. From my experience, there is no amount of strengthening and stretching that resolves a hard joint end-feel like this.

I’m happy with my progress since surgery but that’s just it…. It seems I’m recovering nicely from the trauma induced but (maybe) the core issue wasn’t solved. I always said “I can deal with the pain, what I want is my range of motion back”. And yes, I’m resting as needed, listening to my body as much as possible, rehabbing lightly, walking as tolerated, etc.

I’m trying to stay positive and telling myself “the arthritic joint is replaced with smooth functional hardware and the bone spurs and lesions are gone, there is nothing there to hold this joint back from being fully operational”, but it’s difficult when my pain patterns and sensations are similar to my pre-op self.

Please share your thoughts, advice, stories.


Thank you!

- Cole

[IRONMAN]

Cole I’m double the amount of time you are.

What you are feeling is so similar to what I was feeling at week 5/6. And I tell you one thing, I still feel the same but some of that pain you’re referring to has subsided but not completely.

Unfortunately something I’ve now noticed is the mobility and range of motion. My thinking. Going into surgery was that it would be solved and it’ll be like the Same as my good hip. That’s just not the case….. as how many can lift their knee to their chest….. so many can’t. There’s other positions also but some people just don’t mind this because their pain was sooooo bad going into surgery. Now you’re 35 and very similar in age to me and usually we have this done because we’re in the early stages and think this will be a Magic fix. Well sometimes it’s perfect and sometimes it’s not. If we were in crazy pain for years with really bad mobility then what we had before hand would bean ease trade off for what we have now.

Time will definitely make things better than they are now for sure so ask me again at 6 months. But one things for sure as the weeks pass the gains get smaller and I realise it’s not the best fix for those that are in the early stages wanting to return to high end sport etc. it’s a big risk worth the life you already have.

That being said it’s in the eye of the beholder but I do truly believe the worse off you are going in the better it feel coming out.

[BSarchet]

I’m on my second go round with this.  The first one I was very similar to you and maybe a little bit behind.  I really started to turn a corner at 10 weeks with pain and movement.  That’s when the hip flexor and groin pain really subsided.  I also began pushing more mobility and now at 6 months I can go knee to chest on that side.  My rotation still isn’t great. Crossing my leg is hard but I haven’t worked on that as much.

I’m at 5 weeks with my second one and am going through it all again. Although I’m ahead vs where I was last time.  I attribute that to this hip being in better shape to start.

My encouragement to you is don’t get discouraged.  This is a surgery that takes a lot of healing time.  I have continued to see progress all the way to where I am with six months and am able to do things I couldn’t do before.  I went swimming twice this weekend and was able to frog kick which I could not do before. 

This process is very non-linear.  Something will hurt next week that doesn’t hurt today.  There’s a lot of healing happening and your body is probably adjusting to a lot of changes with alignment and posture in addition to pure ability and healing.

[Caution Wide Load]

Hi Cole, thanks for posting this topic as its content has galvanised me into posting for the first time.
I’m 8 weeks post posterior LBHR, my first follow up with surgeon tomorrow ( Mr A Politis ROH Birmingham)

I have days when I wonder what I’ve let myself in for with regards to pain and recovery.  Each day week small improvements but I do have sharp pain upper quad when doing straight leg raises and Thera band hip flexion. So I’ve discontinued these for now. Just sticking with physio that doesn’t go above level 3 in pain.

Trying to keep positive as like yourself I am very active. Concept2 row erg daily up to 10k a day before my op.
last season I clocked up 3 million meters.

I hope you get better soon
Regards
Andrew.


Big thank you to Pat for Surfacehippy..

[demens13]

i'm 40 and was in good shape going into surgery. i'm 6 months in and just now starting to feel that range of motion is better than pre op.

it takes time.

[Caution Wide Load]

Hi to all,
I’ve just had my first post op assessment at 8 weeks. LBHR Smith &Nephew Head 50mm Socket 56mm.
My surgeon Mr A Politis Royal Orthopaedic Hospital Birmingham is very pleased with my progress. My x-Ray showed no sign of movement or anything untoward.

However leg raises in any shape or form especially straight causes quite a bit of discomfort. This is caused by Psoas tendonitis and I’m to leave these out of my physio for time being. I’m to revisit this exercise occasionally to see if things are settling down. If it persists there was talk about a cortisone injection. Had these twice in the hip and made zero difference. The numbing inj did tho… no pain at all
He said my ROM will improve as tissues heal and settle down. Be careful not to push yourself too hard and cause micro trauma to the healing tissue.

I can begin rowing again now hip precautions are lifted.( Concept2 erg)
This means a gradual build up of time and pace and not over do things.
Over all I’m pleased with my progress so far and I’m looking forward to a hip not being in the forefront of my mind.

As a side note I’m waiting to have a partial right knee replacement. I hope this will go just as well.

I had a hard paper round

We all want full ROM and be without pain.
We’re all the same boat just trying to keep active and vital.
Wishing everyone optimum recovery.
Thanks for reading.