Pain with recovery month 7

[vivanova]

Hello,

I am hoping for some advice  about my recovery from my resurfacing operation just over 10 months ago. I am a 48 year old male. I have been having repeated painful episodes which normally last for a week or two and generally occur after I have done increased exercise or physio. The pain is generally a dull ache around the operated hip (on the outside of thigh) and posterially and is particularly bad whilst sitting - also making it impossible to sleep on that side. I require painkillers to sleep normally when the episode is at its worst, gradually it calms down but it is greatly affecting my ability to do physio and slowing down my recovery. I have returned to gentle, non competitive tennis and hiking small mountains but anything more strenuous is still remains out of reach (I was very sporty and active pre-op).
During the episodes I can walk fine with no pain but sitting is painful, particularly on low sofas etc. when I do my physio I do feel a small popping sensation especially when I am tired which I believe (from other posts on here) is the hip capsule rather than the prosthetic joint itself. I am considering an mri to see if there are any underlying abnormalities with the joint/soft tissue - X-rays at 3 and 6 months suggest the joint itself is in perfect position. Any advice greatly appreciated

[vivanova]

Hi everyone,

Update from me - I have now gotten an MRI back with the surgeon and been diagnosed with gluteal tendinopathy - minor generative changes in the attachment to the hip bone. Minor inflammatory changes in the perichondrial bursa.

I also got a PRP shot and so far (7 days later) I feel worse. I was told that it does take a bit to work and if it does, I should go get a second one. I am hoping this is just the initial inflammation from the shot. I have been told to do stretches and no activity like hiking or long walks but it's honestly even hard to sit on the couch, so I am sitting on my office chair when watching TV. I am really struggling with this - I did the surgery because I was hoping I'd go back to some type of activity and a year on, I am in pain a lot and even physio seems out of reach and aggravating. Has anyone else had experience with this? Has some words of advice /encouragement? Even sitting on the couch wit my girlfriend is a real struggle and I am starting to feel really down. Please help!

[sbrnecros]

Hi,
As with all recoveries you'll get different stories and perspectives but I can offer my experience which has similarities. I had bilateral resurfacing (phased, 10 weeks apart) and even factoring in the staggered recovery between left and right, my right hip (the second surgery) took longer to find a reasonable base level to work with.

Around 10 months on, I had what was determined as gluteal tendinopathy and bursa that wouldn't shift and was hampering the right hip's ability to recover and start taking more load. Working with my physio we tried a number of treatments and exercises before finally landing on a protocol that seemed to produce results.

We found that my outer quads, which for years had worked overtime to compensate for poor mechanics, were still trying to do all the work but now pulling at the tendon because they'd become so tight (a bit like tennis elbow I guess). In the gym, we worked on upper body, particularly core and Lats to try and relieve the quad. The exercise which really highlighted what was happening was the farmer carry, holding one dumbbell by my side, while holding another above my head, and then walking. The right hip would drop, the glute too weak to maintain a good neutral pelvic position and activate to push the leg through (the quad effectively pulling the leg through as before surgery). So, lots of Lat pulldowns, farmer carries, and dumbbell rows later we resolved a lot of the issues. We then worked on strengthening the inner quad muscles which had grown weak to get them in the game, along with glute strength. As for treatment, some (very painful) deep tissue massage into the quad to release the tightness was also a game-changer.

As I say, your issue may be different, and I would certainly say my pain was more acute than dull like yours, but something to perhaps discuss with your physio if not already.

All the best!