Smith & Nephew BHR Brimingham Hip Resurfacing

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Groin Pain / Re: Ongoing PSOAS tightness
« Last post by Slinkycarrot on Yesterday at 07:39:49 AM »
I have similar problems on one hip.

For relief I would recommend needling and possibly ultrasound/APS as well as your usual manual relief

It all comes down to getting your glutes  to fire and switching off the psoas or rebalancing. I'm really struggling with this even though I'm very aware of the problem.  You need to start with with basic functionality exercises and nail them before you progress.

Have you tried lying on your back with feet against the wall and a light thoroband around your knees. Then try and bring your knees apart without switching on your psoas and just using your butt? If you put your hand on your hip flexor you will feel it fire or not.  This is a good indicator of psoas overactivty.  A Physio I had a few years ago who wouldn't let me progress past that exercise until I could do it correctly as it means all my basic functions I'm gripping with my psoas.

Good luck
Thanks cat friend

I don't have a piriformis due to piriformis release surgery about eight years ago, when dr de Smet went in he said it had completely disappeared!

Hoping everything settles down soon
I'm sorry to hear that your recovery continues to be so difficult. It's different for everybody, and so disappointing when you're not the one walking a mile a week out.

I had to look up what the piriformis is. Is your lack of this muscle due to the surgery, or something else? I can't remember how long it took me to do a straight leg raise. I did do them in PT. However, straight leg raises set off my psoas, which is not uncommon. I would take a break from them, my psoas would feel better, and I would start them again, repeating the process. I work on strengthening in other ways now, and don't bother with. I don't see a reason to set it off, and even if I were to do them now I would. Psoas problems are commonly reported on this board. Don't know why they are such an issue for hip patients, or entirely how to resolve the problems. In my case I've just given up and moved onto exercises that don't set it off.

Not sure what to make of the pinching on the right side. I know that on occasion when I was healing I would move in such a way that made me think that something would break, and that I had screwed everything up. Groundless fears, as it turned out.

I have had issues with my knees due to weak lateral hip muscles. As they get stronger my knees do better (nothing wrong with the actual knee joints, just the muscles around them are weak because of the years of hip problems).

I hope your healing gets better.
Hi there,

Im 5.5 months post bilateral resurfacing with Dr De Smet, Ive been sticking off the board to try and remain positive and rehab (plus looking after an 8 month old baby!).

Progress is very slow as it seems I have to retrain my whole body with my new hips in a different position. I can walk but not more than half an hour without my back/knees/flexors giving me jip.  I was starting to get some strength back and do some cycling on a stationary bike but then Ive had to stop as developing some problems.  Im still unable to do single leg raises when lying on my back.

Anyway, each hip is a bit different;

The hip joint itself feels good, great ROM.  However, I have no piriformis on this hip and have very overactive hip flexors/psoas and my glute wont fire. Im fighting off psoas tendonitis at the moment so have had to completely stop rehab to hopefully let it heal.  I've been doing heaps of targeted glute strengthening exercises but am still unable to switch off my hip flexors/fire my glutes naturally.

Less issues with muscular balance, however my joint isn't functioning as well.  I get a pinching in the front whenever I test my range, get in the car and then occasional a sharp pinch that seems to happen sporadically when walking etc.  My physio thinks it may be scar tissue in the capsule or has suggested cup malpositining causing impingement?

My knees are causing me issues due to patella tracking dysfunction due to funky hips - im praying if and when I get strong they right themselves, but who knows.

So questions I have;

- Did it take anyone ages to be able to do a single leg raise (when lying on back)?
- Any idea what this catching is in my right hip? Does scar tissue or impingement sound right ? Has anyone else suffered this and does it subside?
- Can anyone recommend any psoas deactivation exercises or good web links?  Im really struggling to switch it off and my physio doesn't really get it.

Cheers all.

Groin Pain / Re: Ongoing PSOAS tightness
« Last post by Shotohips on March 25, 2017, 01:17:56 PM »
Stay strong, Larry. I understand your frustration. I am 35 with surgery on the horizon after 2 scopes in the last 1.5 years.

Find the best PT you can and do the best you can. You will get there for sure. Maybe at this point, and MRI would be helpful to see what's going on with the tissue. I have been told, minimum 3 months for psoas if I am disciplined. Tough..!

Another suggestion, take a vacation and go relax for a while, you deserve it :) You have had a tough year!!
Groin Pain / Re: Ongoing PSOAS tightness
« Last post by Ljpviper on March 25, 2017, 09:42:03 AM »
Hello all, thanks for all the comments. I went to have the one the year check with Dr. Gross this past week. The joint looks great on X-rays. It just stinks I got the feeling from him my job is done you deal with with psoas issues. Seeing all the people sit on the plane ride home comfortably, crossing there legs really hit home.

2 scopes and a hip resurfacing at 44 you think I would be at least close to normal. Not sitting in pain. Definately a bummer.

Groin Pain / Re: Ongoing PSOAS tightness
« Last post by Shotohips on March 24, 2017, 03:34:15 PM »
Hello - regarding the injection, give it time. I had an injection in my left hip about 3-4 weeks ago and it took a good seven days for me to feel the difference, about 40% improvement. I  just had another one done yesterday in the other lege and don't feel any improvement yet. Did you get one injection, and in the bursa?

I'm with Karlos on this one, give it time. I've been working with a physio for 4 weeks and I see slight improvements. Keep in mind, I haven't had a resurfacing yet, just having issues from the two scope surgeries I had in the the last 1.5 years. Every experience I have ever had with any kind of tendonits or tendinopathy took a very long time to calm down. Each time, it was with  PT and a very slow progression.

Psoas is especially tricky and frustrating. What helps me, is setting my expectations, and knowing it its going to be a long recovery. Easier said, then done..(it sucks)!! Not trying to sound like an expert here, but have your PT try the Thomas Test and see if it is really a flexibility issue. If it is not flexibility, over stretching can really irritate it and slow progression. I've been doing a slow progressing, eccentric excercise that has helped me see the improvements in the last couple of weeks. My PT recommended it and I do 4 sets of 20 and started with very small, slow movements. As soon as I felt pain, I would reduce the range of motion. Eventually this will lead to a full leg raise. Here is a video that will explain it better than I can (I don't use the ball), minute 4:47    .
Groin Pain / Re: Ongoing PSOAS tightness
« Last post by vonhouser on March 24, 2017, 01:11:08 AM »

That timeline is super helpful to hear. I am at almost four months, and my hips are very stiff. Still SO much less pain than before. Lately I especially have pain my upper quad, but my PT says it's not psoas because I can lift my left ok.

I've been strength training, but don't have external rotation back yet on my operated hip so we are mostly doing linear stuff. Focusing primarily on upper body and getting the glute and hamstrings to strengthen.

It's good to know that I can be patients as I have a few more months before the hip and tissues themselves are healed! How did you come up with those time estimates? I have heard that it take six months minimum for the bones and soft tissues to be solid.


Groin Pain / Hip Resurfacing check, now to deal with torn adductors
« Last post by a sensation on March 23, 2017, 01:47:20 AM »
I am 2 months post-op on my BHR right hip.  That is progressing, now onto the other related problem.

 During my the start of this injury, which the pain was in the groin,  I had an adductor (longus) lengthening procedure.  A few months post op, I had a tear in the area and it is shredded the tendon, you can feel it with you fingers and it feels like it has been split down the middle.  I still have pain in this area, and the trauma from the BHR has exacerbated it.  I will wait to see if it subsides, but I am pretty sure this is something I will have to deal with. 

Basically, anyone know a surgeon who repairs the adductor tendons and doesn't cut them off (tenetomy)?

If they can deal with patients form afar, that would be great.

I'm sure if they never messed around in there to begin with the hip resurfacing would have solved the problem from the start.

Hip Resurfacing Topics / Re: Resurfacing after failed FAI Surgery
« Last post by karlos.bell on March 21, 2017, 07:13:26 PM »
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Keep it simple.
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Rock on.... :)
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