Leg lift pain

[Salah]

Long time lurker here turned surface hippy. I had a right hip resurfacing a little over 6 weeks ago with Dr. Gross and am on his fast recovery plan.

Recovery has been going as expected mostly. Some set backs in weeks 2 and 4, but no “disaster”.

One lingering issue that I’ve had is occasional very sharp pain in the upper groin / psoas / quad region when lifting the operated leg. Now that I’m starting the 6 week+ exercises, the supine leg lifts on that side are initially accompanied by VERY sharp pain upon lifting and lower the leg in that psoas region.

Strangely the pain mostly subsides whiles holding the leg suspended in the air, but presents itself when lowering the leg and initiating the next rep to raise the leg.

Side leg lifts do not cause much pain at all (raising the leg laterally), just supine laying flat.

I was curious if others went through this experience? Did the pain eventually go away as part of recovery or did you need to do anything special?

[Domer]

Hi Salah, I had that experience as well.  Pretty much exactly as you describe.  For my 6 week check-up with the physical therapist I couldn't lift my operated leg at all without a lot of pain in the front of my leg near hip flexor area. I think it took another week or two (maybe more) before I was able to do the leg lift exercise.  I'm now almost 12 weeks out and have been doing the exercises for several weeks and don't have sharp pain in that area anymore.  My pre-surgery OA pain was mostly in that location as well, so I was wondering if the pain was due to that...but sounds like you are having a similar experience.

I've also found that doing the PSOAS stretch can lead to a clunk in the joint (assume this is a ligament sliding around) and it seems to make the joint looser and more clunky for a day or two after that.  So I've avoided that stretch as well...at least avoided pushing very hard with it.

[Salah]

Hi Salah, I had that experience as well.  Pretty much exactly as you describe.  For my 6 week check-up with the physical therapist I couldn't lift my operated leg at all without a lot of pain in the front of my leg near hip flexor area. I think it took another week or two (maybe more) before I was able to do the leg lift exercise.  I'm now almost 12 weeks out and have been doing the exercises for several weeks and don't have sharp pain in that area anymore.  My pre-surgery OA pain was mostly in that location as well, so I was wondering if the pain was due to that...but sounds like you are having a similar experience.

I've also found that doing the PSOAS stretch can lead to a clunk in the joint (assume this is a ligament sliding around) and it seems to make the joint looser and more clunky for a day or two after that.  So I've avoided that stretch as well...at least avoided pushing very hard with it.

Thanks Domer, appreciate the feedback.

I’m happy to hear that I’m not an isolated case. Similar to you, I’ve stopped doing the straight leg raises while lying down. In lieu, Lee Webb and the PT I saw for my check up suggested to do this standing, which is not painful and has seemed to help in strengthening whatever needed to be strengthened.

The PT in particular observed that while laying down my quad wasn’t firing when attempting to raise the leg, but was firing once the leg was risen (and hence when the pain went away) as the stress moved from the psoas / tendons to the quad.

I’ll report back on progress and happy that you overcame this.

[BBhip]

Hi Salah,

I am also a Dr. Gross patient. I had my surgery April 4. I also experienced similar pain when trying to do the exercise lying on my side. For me it improved around the 3 month mark. I no longer get the sharp pain.

[Hipchallengedone]

Greetings Salah,  I had bilateral surgery May 9th and 11th with Dr Gross. I too am on his fast protocol. (11 weeks out)  Prior to the surgery, I had sharp pain inside high on both sides along with stiffness.  After the surgery, (where the surgery was performed and it the same area), there still is stiffness, but no pain.  I never really had any pain issues with the leg lifts on either leg.  But I can say prior to the surgery, I was doing those exercises twice daily in anticipation of rehab.  Granted I couldn't lift either of my legs more than 8 inches off the ground.  I also now am able to do an elliptical for 30 minutes with no pain, but afterwards a little stiffness.  Not pushing it or anything, but just trying to get back into a solid exercise mode with all of the stretching and light weights.  I did noticed last week that the level of stiffness was substantially diminishing  and there is greater flexibility on both sides.   Keep at it, I am a believer that as you heal, that pain will go away.     

[Salah]

Thank you both for your replies and experiences. I agree that as the joint and musculature surrounding it heal, that movements and range of motion should “open up”.

Yesterday I was able to do a few reps of the lying leg lifts without much pain, but it set in after about 4 reps.

That’s an improvement from a few weeks ago whereby there was sharp pain on any sort of attempt.

With that said, the joint feels a little more “achy” today after trying them again. I imagine I irritated something, but that’s ok. Will keep “re-visiting” this exercise every so often until I’m comfortable doing enough reps to incorporate in to my PT routine fully again.

All other measures of progress are coming along well, including side leg lifts, walking speed / duration, ability to tie shoes / cut toe nails, and working the movements of a lower body workout 2x a week (body weight and assisted squats / lunges, glute bridges, body weight deadlifts, etc.).

Will report back with progress.

[Salah]

I’m now at week 9 and am happy to report that I can accomplish the supine leg lifts. It’s still “achy” and not the same as the unoperated side, but I don’t have the extremely sharp pain anymore.

Now my main issue is sharp flexion (think the bottom position of a “cat and dog”). There’s a pinch / groin pain there that is very similar to my OA pain.

As well, when standing on only my operated leg, everything is somewhat ok (albeit shaky and weak) until I put the unoperated leg down and transfer weight to it. I get that very sharp groin again on the operated side and I can almost feel a ligament “passing” by the front of the operated hip.

Will report on further progress as I go.

[Salah]

Update: I do the leg lifts now with relative ease. There’s still a difference, but that has gone from extreme pain, to pain, to “achy”, to uncomfortable to just noticing a slight difference.

The key in all of this has been quad engagement. My quad on the operated leg struggled to engage, and as a result the whole leg was being suspended by the psoas and tendons, not good. I found that focusing on forcefully contracting and maintaining a contraction in the quad to alleviate almost all of the pain.

Similarly, I focus on contracting the quad when needing to stand on one leg and that has meaningfully reduced the discomfort I had when doing that.

[Hipchallengedone]

Hang in there Salah.  Sounds like the healing process is taking hold the way it should.  If you have tightness, that will subside as well over time.  The repetition and dedication to doing the exercises will help.  I also do standing leg pushes, where I stand up and move the each leg back while squeezing the gluts.  I have been doing 40 a day, 20 in the AM and 20 in the PM when doing the other isometric exercises.  Starting doing them around week 6 or so.  Now that you are noticing just a slight difference it should be a piece of cake going forward.  Keep it up!! Really happy to hear things are improving.  It is a great thing to be pain free.  So wishing that it continues for you as you continue to get better.

[Boz]

Salah, any updates? I’m 8 weeks post op (Dr Gross) and have been dealing with the exact same situation since starting the leg lifts. I kept going with them and have gotten stronger with less pain but there’s still pain and I’m so much weaker in my op leg. Feels like it weighs 300 lbs. I’m curious how it’s worked out for you.

[Sal]

Am 4 weeks post op … recovery has been very slow… still can’t put full weight on the joint .. walking w one crutch .. can barely take few steps without the crutch with a significant limp … is that normal ?

[MarvinB]

Perfectly normal, Sal.  Don’t push too much, but do what you can.  It’ll strengthen up.  Everybody progresses differently and this surgery definitely falls into the category of “your mileage may vary”!