I am at six weeks today. The big news is that the 90 degree restriction is removed. I have been waiting for this for some time now.
The problem is that my muscles are so tight that I can't reach my left foot. I was hoping to be able to put my sock and tie my shoes. I am frustrated because I didn't expect to be this tight!
I have started stretching but I am wondering.
1. Are there specific stretches that you did to work on getting your flexibility back?
2. How long was it that you got to the point of being able to tie your shoes?
Thanks.
Dan
Dan, you will get your movement back. Much more than you had before the operation. It will come partly from the stretching you do, and partly it will come anyway. Not all at one go, maybe you will continue to improve for a year, or longer.
D.
Hi Dan,
I was very tight as well from the 90 degree restriction. Now that you don't have to worry about that, the thing that I found most beneficial was getting on a spin bike or your bike at home on a trainer. That will really help loosen things up and you will see a difference after each session. In a week, you will be amazed at how much has changed.
June
Thanks for the responses.
June, I noticed this morning that my hip muscles seem to relax after a session on the cycle. I was pretty much 90 degrees to start the session but could slowly bend forward a little.
I will have my PT give me some good stretches. I am worried that I am stressing my back trying to stretch those muscles.
Dan
Before doing any static stretches, make sure you warm up or do dynamic stretching. While standing, you can swing the leg forward and back, then knee up towards chest and back, then what is called getting on and off of the horse, forward and backward. Do it on both legs to loosen up your back, hips, and legs. Hope that helps! But yes, the cycling really helps and same with swimming. You could probably even do flip turns now which will help. It seems like with every new thing you are allowed to do again, the more your range of motion as well as your strength comes back.
June
If you have access to one of these it really helps improve your flexion as well as building up strength with a no impact workout.
(http://www.concept2.com/us/images/products/rower_alex_anim.gif)
Before my two BHRs I could no longer reach far enough to strap my feet in or grab the pull bar. I'm on it up to five hours a week now.
What I need the most work on now is stretching the quads, flexors and hamstrings.
What has helped me is not only trying to increase my range of motion but my flexibility in my hams and glutes. The other key to my success in increasing my range of motion is not necessarily holding a stretch at the max position but holding a stretch at say 85% and slowing increasing the position over 3 or more minutes.
What helped me was putting my shoes and socks on every morning ::)
The hip capsule tissue is slow to change over, I think 100 to 300 days for the cells to regrow, so one stretch today won't get you much. Daily stretching, however, will get you a little bit in a few weeks or longer. I was very slow to gaining flex. I think you'll notice something in a week or two. I would notice a slight change every couple weeks after the 6 week mark. I think I was pretty much at about the same point. I think I even blamed Pritchett for sewing me up too tight. ??? Gotta make sure there are no dislocations, right? No, I think that's just how this goes with HR.
BTW - getting the shoes and socks on right now, is a pain in the butt, literally.
Oh I am seriously misinformed, I didn't think you had a 90 degree restriction with resurfacing for as long as six weeks. It this a standard amount of time? That will be tough for me. I somehow can still bend over and place my hands flat on the floor and do this frequently to stretch my hamstrings and open my lower back. I can easily bend over and put my shoes on with my legs straight. What I can not do is bend over flex my bad hip and put my shoe on my bad hip side (with the knee bent and pulled up). I can imagine there would be a lot of tightness after not bending over.....in fact it makes my back hurt thinking about it.
Hi Aerial,
Each surgeon follows his own protocol, and it probably depends on precisely how they approach the surgery. Some will give you a 90 degree flexion restriction and some won't. My surgeon put it at 120 degrees mostly, I think, because the PTs want to see some number. I couldn't get close to 120 right after my surgery anyway. His most important restrictions were outward rotation and crossing the midline above the knee, as these motions tend to rotate the ball out of the socket.
Aerial,
The 90 degree restriction depends on the surgeon. I had it for four weeks. I was like you, no problem bending over touching hands to floor, putting on and tying shoes etc.. But same thing with the rotation as yours. After the 4 week restriction was lifted, I was very tight, but it all came back quickly, including the rotation I had not had in a couple of years!
June
Does anyone know how Dr. Gross handles this? (what is his restriction)
Sorry, didn't mean to steal this thread?
Just to clarify something mentioned in an earlier post, I believe that it is inward rotation (toes turning toward the midline) that is often restricted for awhile. Outward rotation (toes pointing away from the midline) does not stress the head away from the socket, and is not a problem.
As far as Dr Gross, you should obviously check for your individual case since he has more than one protocol for different situations, but I believe that his normal protocol is still pretty conservative for the first 6 weeks; 90 degree restriction, avoid internal rotation, and a limit on how much weight you can lift.
Quote from: John C on September 15, 2011, 03:55:30 PM
Just to clarify something mentioned in an earlier post, I believe that it is inward rotation (toes turning toward the midline) that is often restricted for awhile. Outward rotation (toes pointing away from the midline) does not stress the head away from the socket, and is not a problem.
John, you are absolutely correct. I must be getting old...
John C,
Yes, you are correct about Dr. Gross. That is his protocol. Unless of course there is a patient with a different situation.
I was told no crossing center line and had the 90 degree restriction for 6 weeks.
Tin-
You just found out about not crossing the centerline? How have you not had a head-on collision before now?
And I have always been a big proponent of the 90 degree restriction. If it gets much hotter I just can't take it.
Hope your recovery is going great.
Dan
;D ;D ;D
That's my worst fear, crossing the centerline,..... when driving!. That would just downright suck, especially if you met a semi.
I have noticed early in recovery that when you rotate the knee inward a little, against doc's order's, hey sometimes it happens, there is a pretty sharp pain that tunes you up pretty quick. I'd like to think that the pain will be there to remind you that you shouldn't be doing that and it will come on strong way before the femur dislocates. I hope.
I can remember at one point fairly soon, probably 3 or 4 weeks, after my RBHR I was laying on my back on my bed. I had my left leg stretched out straight and my right knee up in the air with my foot pulled up toward my butt, a position that felt really good sometimes. As most can probably relate to, my hips felt a lot looser after surgery than before - that smooth ROM is really a great feeling. I must have started dozing off because suddenly my right knee started falling over across my left leg, just the thing you don't want to do. It must have startled me awake because it seems like I caught myself before my knee fell all the way over and twisted my hip out of its socket. It gave me a little twinge, and a big scare. Needless to say I was very careful after that not to fall asleep with one knee in the air.
Same experiences as both of you.
Tin, I think the same thing. The pain tells me when I have crossed the leg too far. It is definitely the warning light I need.
Mike, one of the first nights I was able to fall asleep on my side I woke up and the pillow had slipped from between my legs. My left operated leg was slightly crossed over my right. There was a little pain but more than anything it scared the crap out of me. I woke my girlfriend up and had her lift my left leg up so I could roll on my back.
Dan
Mike,
I also was afraid I would fall asleep with my knees at a 90 degree bend while lying on my back. I did the exact same thing you did only my leg started falling outward away from the other leg. I can't remember which leg it was, it doesn't matter since I had both done. I guess I woke up and caught it before it traveled very far. Really scary. I wasn't afraid so much of it dislocating as much as tearing an unhealed soft tissue or just experiencing terrible pain from stretching it to far.
I am at 8 months now. A few times recently I woke up on my back with both legs bent 90 degrees and flopped over and totally spread apart as far as they will go. I had no problem at all. It felt a little stiff when I moved them back together but no worse than back in the days before bad hips. It's amazing how far I can spread my legs apart now since surgery. I couldn't straddle anything before my hips were fixed.
Dan, I can't tie my "bad" shoe, either. I can, however, tie my "good" shoe.
Today is six weeks. Paul
good for u paul and welcome the the hip clan...
now for the toenail cutting to get some dignity back ... ;) ;)
Maxi (Paul)
The left foot is getting closer and closer.
It will be a glorious day when I can cut my own toenails on that foot. I could barely do it before my surgery.
Dan
You want hear about dignity? I was working on a job site the other day with my coveralls on and I had to ask a coworker (a manly man) to help me pull off the coveralls because I couldn't reach down to my shoes to do it.
LOL Tin! I can just picture it. "Hey, how 'bout them Bears? Did you watch the game?" ;D ;D
For restrictions, I think that it depends both on the surgeons' preferences/experiences/biases, but is largely dictated by the surgical approach, since one of the main concerns post-hip replacement is dislocation; this may help to understand why many of us have vastly different restrictions post-surgically. My surgery was a straight anterior, which has very little risk of dislocation. So, my restrictions were to avoid extension (leg behind) and external rotation (toe out). However, when I asked my surgeon he said I could stretch into those directions immediately as long as I stayed aware of how things were feeling/avoided pain and weird sensations. Post-surgically my hip flexion (bending forward) was very limited by swelling, but now at 3 weeks it allows me to just about reach my surgical-side toes....if I'd had a posterior surgical incision, my surgeon would have had me avoid flexion (bending forward) past 90 degrees for quite a while...