6 weeks post op, abductor won't work

[Dessay]

Hi all-

I'm 6 weeks out from RHR with Dr Gross. I met with my PT to start Phase 2 exercises, and I can't do a side leg lift from lying down. My PT had to scale me back to a clamshell and even that was very difficult. There's pain in what feels like the glute med. I know these muscles get cut during surgery, but they're barely working at all.

On standing, I tested it again- same thing. Can barely lift my leg out to the side.

I'm on the slow protocol, but is this normal? Will it improve, or should I suspect an abductor detachment? Any advice is appreciated.

Thanks,
Cara

[blinky]

I had that problem on one side. My left leg struggled to lift sideways. (The right leg was killing it.) The ability to move came back over time. Two things that helped me: 1) low expectations. Don't laugh! Those leg lifts? I did five on each side to start, 5/30. Eventually I got to 30/30 with two pounds weights, but it took awhile. 2) walking sideways in the pool. It was an easy way to build lateral strength.

[Ljpviper]

Hi Cara,


  I am five weeks out of RHR with Dr. Gross. As Blinky suggested if you have access to a pool , sideways walking seems to wake up the adductors. I started doing 30 minutes of pool work on week 4. It took away the stiffness and just helped my entire recovery. I found any extended walking on land seems to aggravate my psoas, pool works better.


Good luck.


Larry

[LMS]

A quick question: did they mention if the abductor muscles were or got damaged/stressed before or during surgery?  If I remember correctly, that will affect the ability to do any abductor exercise during recovery.  The PT at the info session was giving us a heads up on this.

[Ljpviper]

Not sure but its either moved or deattached. Did you do your follow up with Dr.Gross?

Most of the muslces along the incision line are traumatized. The abductor and glute muscles are all in that area.

Larry

[Dessay]

Thanks, everyone. I got online last night and started reading about "abductor mechanism insufficiency" and scared the crap out of myself. I need to stop researching so much. Ugh!

It seems to be a little better this morning just from starting the clamshells- it hurt, but I could manage a couple of full straight leg lifts lying on my side. I'll check my surgical notes today, but yes, I think it says something like "the muscles were separated along their fibers." Something like that. So they were stretched and maybe even cut.

There is a health club pool in town- time to join. Thank you so much for all the helpful replies. Recovery really is a marathon and not a sprint. Cheers!

Cara

[jd]

Dessay, it sounds *very* normal. At least one of front and side leg lifts are usually very challenging post-op depending on your strength beforehand. Keep in mind that there's been a lot of muscle trauma in those areas and it takes time to heal. You'll get there!

[catfriend]

Congratulations, you're normal! :D There is no way I could have done a side leg lift at six weeks. I can do them now (I'm at 4 months), but they still hurt. The lateral muscles are weak, and they are hard to strengthen. I do the "monster walks" with a resistance band, plus something the PT calls the three way hip (I do it in the water more than the ground, but I've done it both ways). It was amazing to me how weak my muscles were after surgery, and how slowly they come back, but they do come back. This is nothing to worry about at all.

[hernanu]

They come back. On my first home physical therapy session, I could not move the leg at all. Very trying.

The therapist said that she sees it all of the time on THRs (I was her first resurfacing), so she helped me to move the leg. Eventually it would move, but it almost felt like my body was shifting to get it to go. After about three sessions, I started to move but could only do three before stopping.

Eventually (I did about six weeks of regular PT, at a clinic), I was doing side lifts with weights on.

I'm almost six years now, do 30 repetitions with an outer thigh machine with 120 lbs. You can get back, but as was mentioned, lowered expectations initially are your friends.

[Dessay]

Thank you jd, catfriend and hernanu! I'm so relieved to hear all these replies.


Dr. Gross is supposed to get back to me today regarding whether or not to keep trying the lifts while I'm in pain. From all of your feedback, it seems to me that I should keep doing them, even though it hurts.


Is that right? I'm not going to hurt the muscles as they heal, am I?

[hernanu]

I tried to change my behavior so I listened to my body first. Then the doctor, then (in my own experience) my own overachieving, Type A lying mind.

If it hurts, don't do it. Waiting is not a bad thing, maybe your muscles are tired and need to mend a bit before trying again. Patience and perseverance are key, so despite the fact that the exercises are positive and good things to do, it doesn't hurt to wait until your body is ready.

[Dessay]

Lol, I am a type A mind as well, as well as a "Worst-Case Scenario Wendy."


Point taken.

[Dessay]

Hi everybody!


UPDATE: Dr. Gross's office suggested that I try the side leg lifts while standing up for a while until the abductor got a little stronger. Just lifting the leg out to the side while standing. This worked very well, as I could manage about 5 or 6 of them with out as much pain. So I did that for a week and worked up to 10.


Last night, I tried some lying on my side again and got to 15!!! YAY ME!! It still hurt, but it wasn't nearly as painful as when I first tried a week ago.


Feeling much better about this- thank you all for the help and advice!


Cheers,
Cara 

[blinky]

Yay! Glad to hear it.


And the idea of standing to do them, glad you shared that.

[Dessay]

Hi blinky!


Yes, and it was actually kind of hard to do it without my standing hip popping over to the side to help. But because it didn't hurt, I could focus more on isolating the op leg. I kind of dug my crutches into the ground to keep myself stabilized.


Phew!

[jd]

Whether or not to continue through pain is tricky, because I think the answer really depends on how much pain and we're all different at interpreting that.

It's likely to be somewhat painful to use these muscles to begin with and I think it's fine or good to work through minor pain there or we'd be waiting forever to get better. On the other hand, significant pain really does indicate we're not ready, so it's a tough call.

Sounds like you've found a good plan of doing a lighter version of the exercise for a bit first (standing).

[Dessay]

Thanks jd-

I'm on the slow recovery protocol, and I'm just to the point where I'm supposed to put more weight on my leg. I think I may have to mix up the two choices depending on the kind of day that I've had. If I've been on my feet a lot, those lifts from a lying position are really tough.

[Dessay]

Hi all-


UPDATE: At 3.5 months, those side lying leg lifts are pretty easy. It does not feel like the muscles have recovered completely, and from posts here, it looks like that will be a while. I do get some "startup stiffness" when I first begin the lift itself. But I'm at 30 lifts with 2 lb ankle weights with no problem. I'm on my cane full time, and probably will be for a couple more weeks. But things are progressing nicely. Will probably see a PT at 6 months like Blinky did to address any residual muscle issues.


Thanks for the helpful posts!