Three weeks post-op right HR with de Smet

[vonhouser]

Well, I about about three weeks and three days out from my right hip resurfacing with de Smet. Things were moving along well until the last few days when I seem to have come to a stand still. I can walk quite comfortably with the one crutch, even outside and walking more than I would have been able to before surgery. But when I try to walk without it, everything gets inflamed and the limp is not pretty.


I know it's still early, but I'm wondering if people have suggestions for other ways to measure progress towards a crutch free existence when it's too early to actually be crutch free? It's quite amazing, people comment on how well I'm walking with the crutch, but now that I'm putting less weight on the crutch, I'm struggling to know that I'm making progress.


I still have some pain in the deepest part of the incision, but otherwise the pain is good, just taking a couple of tylenol here and there. Getting closer to putting on my right sock, too. And I started driving last week. But feeling a little bogged down this week. I'm also having significant pain in my front hip flexor/psoas, which I think is common for folks. I had a lot of trouble with that area before surgery so I'm not surprised.


I've also noticed that several people on here have mentioned that when they have had trouble after surgery and have emailed de Smet, he has not been responsive. What have others experiences been like? He was so responsive before surgery, but even when I emailed him for a simple receipt for my surgery so I could submit it to my insurance company, I heard nothing back. I'm a little nervous about being stateside without any reinforcement.


I know it's still early, and I don't consider myself to be in trouble at all, but I think maybe I could just use a little encourage and feedback from folks.

[John C]

I can share my experience with easing away from crutches at the three week mark. At around three to four weeks I could start on a walk without a crutch or cane, and then at a certain point my hip would just say enough, and I would start limping badly. The solution in my case was going on walks with my wife who would carry the crutches or cane until I hit the point where I needed it, and then I would use the crutches or cane for the rest of the walk. That worked out very well. At about four or five weeks I started feeling like I "should" be off crutches or cane by now, but my hip would complain bitterly if I forced it. By six weeks I got rid of all crutches and canes and walked as far as I wanted with no issues.
As is said often here, everyone is different, but hopefully my experience will help with where you are now.

[LMS]

I would assume that the approach for a HR is the same as a THR when you're getting to the joint?  So that being said, the sheath that they cut through needs the 6 weeks to repair itself & everything else that's been affected. 


So IMO, 3 weeks would still be early & easy to get to some sort of a plateau before more healing/progress occurs.


I too felt that I should have been off of... or at a certain stage by...  I wrote everything down.  And by the 4th month, it's everything was finally back to normal"ish", where the doc said I could start resuming what I used to do (start from step one & just pace myself) & then I would look back at my notes & realize that really, though things seemed like they were progressing slowly, they really weren't.  I was actually right on target at every step of healing & progress.


:)

[vonhouser]

So today was the first day to go without crutches. I feel really good, but I had someone video me and my limp is pretty noticeable. I have a feeling I just need to keep walking and strengthening the muscles. But in general I feel like I've made good progress.


Would love to know what others think...




https://youtu.be/mrMFXgbs8Lk

[John C]

If I am calculating correctly, you are about four weeks out now and walking very well. In my non-medical opinion, your lateral stabilizers including the gluteus medius and gluteus minimus are still a little weak as would be expected. As those get stronger over the next weeks, that slight side swaying limp should disappear. For only four weeks, you look like you are walking very well without your crutches. Congratulations!

[Quig]

You're doing great! It's still very early and you have LOTS of healing left to do but you're off to a very, very good start. The best part is that you're wearing a smile, and look to be enjoying your progress.


If I could offer some advice, and it's something I learned here, I'd suggest to just NOT LIMP. I know, that's a lot easier said than done but the point is to focus on walking 'properly' and teach your body how to walk they way you want to walk. I don't recall where I read it here but the poster was explaining that if you allow yourself to limp, that's how your body will learn to walk. There may be no truth to it but to me, just focusing on walking as correctly as possible during my recovery made good sense. It will not happen overnight but I think it's just something to think about a bit.


Best of luck and keep up the good work!

[blinky]

Your walking looks great! You are still very early in the healing process.


I was still on two crutches when outside the house at four weeks. Inside I did go assistance device free and I did limp (it was more of a lurch). Part of why I used the crutches outside was to walk limp free. I treated those outside walks as my official training walks and wanted them to look good. Inside, I was more interested in pragmatic concerns like getting the coffee to the table, for which I needed both hands.

[catfriend]

I also think you're walking quite well. I also agree with the advice that you should learn to walk correctly now, rather than walk incorrectly now and have to relearn proper walking later. I would suggest buying a cane, and using it to for assistance/support to improve your gait.

I, myself, was in a similar position at 4 weeks out. While I could walk without a cane, I had a limp; my gait wasn't correct. My PT advised me to continue to use the cane so that I could improve my gait. Otherwise, I would need to do so later. I did so, and dumped the gait completely after my gait improved. Below is an excerpt from my story that I wrote at the 4 week mark:

"While I’m quite capable of walking without an assistive device, the therapist wants me to use the cane anyway. He points out problems in my gait without a cane, and that I walk more correctly with one. This is true, and something I had been struggling with for the past four years. I haven’t walked correctly since my accident in 2012. His opinion is that I should walk with the cane for a while, and cut back some of my walking, so that I learn to walk correctly NOW instead of walking poorly now and having to relearn proper walking technique later. I agree to go along with this for a while. I’m interested in long term success, even if it means taking a baby step back."

[vonhouser]

Thanks to everyone! At the time of that video, I was doing walks indoors and from the car to work and such with nothing, but for longer walks I was using a trekking pole because of the limp. Also right after that I started doing more strength training.


I'm hoping to take a five week video on Thursday. Now I'm trying to build up strength with no crutch but sometimes carry or use the trekking pole if it's a longer walk.

[blinky]

Good luck.
That sounds familiar. I had periods when I would carry my cane/crutches just in case but would try not to use them. I liked to have them when I was in crowds, for example, to signal to other people not to bump into me.

[vonhouser]

Here's my week five video...

[catfriend]

I think the walk looks pretty good. However, you do still have gait issues. You will need to work on this, but that's normal. It takes a while for all the lateral muscles to get strong enough to support proper walking. Are you working with a physical therapist?

[vonhouser]

So, eight weeks today!


I went up to NYC to see Dr. Su. Dr. de Smet did not reply to my last email asking about when I could start cycling. I feel like once you are done with the surgery he is not as responsive. So I wanted to have someone who had me in their patient system I could also use in case I needed a revision.


He said I was doing great for 8 weeks. I asked him about the limp, he watched me walk, and said that's glute strength. The interesting part was, he said the glutes aren't really healed until three months, so you may not be able to get the strength you need until after that. This was very encouraging for me. The limp I have is like the one I had before on my very best day, and there's no pain at all, so I think it's just going to take a little time and I'm ok with that. I'm not going to worry too much about pushing glute strength for another month.


On another note, I did a one hour spin class yesterday and it was awesome! No problems at all!

[Quig]

Whoooo Hoooo! Congrats on getting back on the bike. Keep at it and it'll just keep getting better an better...


Have fun!

[blinky]

So glad to hear!


Hey, those glutes will change and grow for months to come. I am about fifteen months out and while I have been running and swimming, I have been hesitant to do a lot of squatting or vigorous lateral movements or one legged stuff. Hesitant until now. Finally I am doing movements that make my glutes really sore, the muscles sore. It has been amazing. I am astonished by what I can do (lunges! squat jumps! skating movements!) and by how sore I get afterwards. I have been walking normally for awhile and thought my hips were strong. 


I am glad you found someone local to follow your case, too.


My big caution would be don't do too much too soon now that you are feeling good. I had to wait six months to get all restrictions lifted and while it drove me crazy, it was a good precaution and let my soft tissue heal.

[vonhouser]

So I'm almost at three months. Things are going really well, I'm spinning, erging (rowing machine), and doing strength training with a trainer who is excellent at targeting just the muscles I need to build.


One question for others, my external rotation sucks! How long did it take for your external rotation on the operated side to match the other. Flexion is great, I can bring my knee up to my chest, but although external rotation (putting on socks and shoes) is better, it doesn't make much progress.


Is that something that just comes with time? Should I not worry about it or should I try to stretch more?

[blinky]

That all sounds great!


I think it will come with time. I didn't do a lot of stretching having been hyper mobile pre op, but I did test myself now and then to see what I could do. At six months I could almost sit cross legged, and then all of a sudden a few weeks later I could do it.


Maybe give it until six months? Then if you can't do some things you want to do, start working toward doing them?

[vonhouser]

Thanks Blinky, that's a good benchmark. I've read in some places that you just have to wait for healing, inflammation to go down, etc. I'm fine with how it is, as long as it will resolve eventually. Just didn't know if I should do active stretching at some point!