Leg Lifts?

[mountaingoat]

I am 6 weeks post this week. The Phase II exercises include both straight and side-lying leg lifts. The problem is, I cannot get comfortable enough on my side to do these yet. I really had no idea how weak I was until this morning when I tried to do a "clam" lift and literally the muscles just wouldn't turn on. After a little while I was able to do a few repetitions but I wonder about doing leg lifts. These seem to put so much torque on the hip. It is odd to me that Dr. Gross has his patients doing these at 6 weeks post-op but does not let patients begin the stationary bike or elliptical until 6 weeks.

Does anyone have any suggestions for other exercises which might be a more gentle lead up to leg lifts? I did about 10 and it felt kind of iffy. I clear need to do supervised PT although Dr. Gross does not require it.

Thanks.

[hernanu]

I found PT to be invaluable. I think you're running into a combination of things, which my home PT pointed out to me - muscle weakness, and muscle memory.

My first attempts at a side leg lift were pathetic, I could not do any at all. Then was able only do three assisted by my PT. This was at about 2 weeks in, but I think there is a relearning done by the muscles, which needs guidance at first. The side leg lifts progressed so that in about a month I was doing about thirty at outpatient PT with 5 lb weights on the ankles.

The physical therapists put me on a progressive regimen that let me strengthen / educate my muscles correctly. Very useful to me.

One exercise that may help is to stand holding a counter (I used the refrigerator) and lift your leg sideways until you feel any resistance. This is not for stretching, but for muscle memory and for strength, so bending into it does nothing. Just easily move it sideways while balancing on the other leg. Do it for both sides, to maintain a good muscle balance. Once that becomes easy, the side leg lifts may be easier.

[curt]

Agree with Hern (of course!)...standing up to do the abduction lifts to the side made it much easier to transition to the lying down versions.  Once you do progress to lying on your side concentrate on activating the muscles rather than worrying too much about lifting the foot up much.  It will come.  Those muscles were undoubtedly the weakest link in my recovery.  Concentrate on them.

Curt

[Neild5]

I also agree with Hern, supervised PT is invaluable.  They show you how to do the exercises and also how to make sure you are targeting a muscle and not letting other muscles do the task.  I could not imagine not having the amount of PT that I have done.  I was operated on a Monday afternoon,
I had PT twice on Tuesday, twice on Wednesday (both inpatient).  Thursday and Friday I had outpatient PT, starting the next week 3 times a week.  It is not only the exercises but she also does soft tissue massage.   Because of the OA there is muscle loss and muscle memory issues to be dealt with that I would not be able to work through on my own.

[imgetinold]

I was just about to post regarding the side leg lifts.  My six week follow up was last Thursday, and I find the side leg lifts the most difficult.  I am able to do them, but after four days they don't seem to be getting better as fast as everything else has during recovery. 

Oh, for the "clam" lift, it might help to put a pillow between the knees so you're beginning the lift from about 1/4 of the way up already.  That makes it a bit easier, I think.

[hernanu]

I think you'll find that most of us had trouble with them, Andy. Once you start being able to do them my outpatient PT had me do an exercise that was pretty helpful with both strength, balance and muscle memory for me:

• Use an exercise band like these : http://www.amazon.com/Thera-Band-6-Yard-Exercise-Band-Medium/dp/B0042PYGDQ/ref=sr_1_1?s=hpc&ie=UTF8&qid=1331141272&sr=1-1
• make a small loop with the band. About one foot when looped?
• Slip the loop under one leg of a chair that is under the seatback.
• Slip your foot into the loop, at the ankle
• with your hands resting on the seatback, move the leg in four directions, front, side, back and to the other side.. as many as you can with the goal being 30 (3 x 10). Obviously rotate your body or step over the loop to face in another direction.
• Don't press against it, this is not for extension or for weight lifting, just to give your smaller muscles the ability to move against light resistance.
• Repeat for the other leg, even if not operated - the balance part is also good for the operated leg.
• Again, go easy - this is not for power or ROM, just a good easy motion.

It gave me the feeling of nice smooth motion under good balance.

[imgetinold]

Thanks, Hernan.  I can do them, but they aren't getting easier yet.  I will do your suggested exercises, as that looks like a good way to work many of those small muscles.

[Neild5]

Also when there is any load on the exercise band move in slow controlled movements.  This will also work the smaller muscles.