Hi Ruby,

You have taken steps to see Treacy and get an Xray. These should hopefully eliminate the the device as a problem.

Next step is getting the source of the pain. A therapist may help on this, try and see the physios at ROH.

Then figure out what is causing the pain, could be poor posture/ muscle imbalance.Then work out what excercises and stretches etc to remedy the problem.

If the device is in correctly which I am sure it is, the problem is soft tissue. Soft tissue can be extremely painful but in most cases can be rectified. To me it sounds like a flexor issue. Davo said stretching will probably not help much when a muscle/tendon is angry and that the opposing muscle needs working (antagonist). This is where to start I reckon if one muscle is tight and sore the antagonist is normally weak.

If you can excercise the glutes with out pain - then work on this it is a good place to start. The 'Bridge' for the glute max, 'clamshells', 'side leg lifts' for the glute med. This can only help and are all excercises lying down.

Next I remember you saying you had a tight psoas, this is a very important hip flexor. This muscle attaches to the lumbar (lower) spine and hinges over the hip capsule/pelvis and attaches to the inside top of the femur. If this is tight/tendonisis or bursa it can cause all sorts of problems with an anterior (forward) tilted pelvis and too much curvature of the lumbar spine leading to poor posture. All of this with time will have a knock on affect and strain other muscles. Psoas release excercise (lying down :) ) is probably where to start here eventually leading to flexor stretching.

TBH if you have suffered with a limp for a while, there is a good bet there are muscle imbalances and less than optimum posture which leads to over stressed musles. It can be difficult to address and this is where a good physio (I stess the good here) may help to identify issues. Probably working on posture lierally from head to toe.

One step at a time though, just IMO I would do the following:

1/ See Treacy

2/ possibly Physio or similar professional.

3/ Ice

4/ If you can glute excercises, psoas release etc.

5/ Then later Flexor stretches, Core muscles (Pilates), overall posture correction excercises.

Quote from: morph on October 13, 2012, 07:57:25 AM
Hi Ruby,

You have taken steps to see Treacy and get an Xray. These should hopefully eliminate the the device as a problem.

Next step is getting the source of the pain. A therapist may help on this, try and see the physios at ROH.

Then figure out what is causing the pain, could be poor posture/ muscle imbalance.Then work out what excercises and stretches etc to remedy the problem.

If the device is in correctly which I am sure it is, the problem is soft tissue. Soft tissue can be extremely painful but in most cases can be rectified. To me it sounds like a flexor issue. Davo said stretching will probably not help much when a muscle/tendon is angry and that the opposing muscle needs working (antagonist). This is where to start I reckon if one muscle is tight and sore the antagonist is normally weak.

If you can excercise the glutes with out pain - then work on this it is a good place to start. The 'Bridge' for the glute max, 'clamshells', 'side leg lifts' for the glute med. This can only help and are all excercises lying down.

Next I remember you saying you had a tight psoas, this is a very important hip flexor. This muscle attaches to the lumbar (lower) spine and hinges over the hip capsule/pelvis and attaches to the inside top of the femur. If this is tight/tendonisis or bursa it can cause all sorts of problems with an anterior (forward) tilted pelvis and too much curvature of the lumbar spine leading to poor posture. All of this with time will have a knock on affect and strain other muscles. Psoas release excercise (lying down :) ) is probably where to start here eventually leading to flexor stretching.

TBH if you have suffered with a limp for a while, there is a good bet there are muscle imbalances and less than optimum posture which leads to over stressed musles. It can be difficult to address and this is where a good physio (I stess the good here) may help to identify issues. Probably working on posture lierally from head to toe.

One step at a time though, just IMO I would do the following:

1/ See Treacy

2/ possibly Physio or similar professional.

3/ Ice

4/ If you can glute excercises, psoas release etc.

5/ Then later Flexor stretches, Core muscles (Pilates), overall posture correction excercises.

Thanks Morph :)

I had problems with my Psoas before the op, naively I thought this would right itself once I had the surgery... I think i've made it more angry! I've been limping too for about 3+ years... I can't seem to stop even though now I don't have pain when I walk!

I spent 5 hours in A&E last night, after 2 xrays, a set of blood tests and almost having to be admitted to the Post Op Ward, I got to speak with a very well informed Ortho doctor who worked at Stanmore Orthopaedic Hospital in London who knows all about resurfacing. He took a look at the xray and said the device was fine, in perfect position (not that I doubted Mr T, but it's nice to have the reassurance) and i'm looking at muscle damage and weakness.

In his opinion there has been a huge gap in my aftercare and that I was probably released from hospital too early. I need intense physio to get my thigh muscles strong seeing as I can't lift my leg at all, but they can't really do much down here with out Mr T's say so.

So, plan of action for the weekend is rest, back to basics with the exercises, ice, meds and get on the phone to the ROH Monday morning for an appointment with Mr T as soon as possible. The positive thing about all of this is at least I don't have to wait until 20th October for an xray!

I want to thank everyone that's taken the time to write me words of help and encouragement. You've no idea how much I appreciate you all.

Hey ruby, that's great news!

Don't forget that you are looking at correcting three years of dysfunction and faulty movement patterns, and I think morph is spot on with his post about the importance of core excersises for lumbo-pelvic stability as a starting point.  It is ball aching and hard work and often seems for little benefit, but over time you will notice the difference, which feels subtle but is in fact massive.

A GOOD physio is key - they are not all born equal - and there is a lot of hard work to be done, but you will get there!  I have to say that in my experience, the NHS ones are pretty clueless and generally new and inexperienced, though this sweeping statement might be a little unfair!


Take care,
dav0

Good news, ruby. Like dav0 says, good PT is what you're after. I think your steps are right, get back to the regular exercises, ice, etc. It's important to let Mr. T know where you are and what you can do next.

Hurrah, the device is ok! That is the very best news. Now to correct the muscle problems, which is a whole lot better than more surgery although still hard work. Plug away at it Ruby. X

Well ruby now you know that you will get there it will take time but thanks to your device being perfectly placed you will get there!

think you did best thing going to A&E as least now you have reassurance everything ok....waiting until 20/10 was crazy, take it easy now and give yourself time, we all heal at different rates x

Back to basics, way to go. I would not worry about not being ale to tie your shoelaces yet, that will come. I was still walking with a pain free limp at about 12 weeks, still do very very slightly when tired. This was down to a weak glute medius muscle which gets hit hard during surgey, maybe a mental thing too. My advice would be walk slow and steady, not overstriding and in all your excercises concentrating on form down to the smallest detail!!!! Enjoy your restfull weekend.

Great news Ruby. Back to basics is a good thing, better than me I had to go beyond that with non weight bearing so get in there girl do them excercises and when it plays up give it a couple of days to settle down then get going again.

Jas

You will get through this Ruby.  At least now you know that that the device is ok.  I think that's everyone's biggest concern.  It will take a bit longer than you want but you will get there.  Take care and hope you get targeted physio to help you strengthen and sort out the pain.

I had a psoas sprain at 22 weeks and I thought I'd broken it! (see my thread for details) It took a month or so to sort itself out but was absolutely fine in the end.
G

Hi Gary,

Just read your thread. That is interesting that you sprained it using the abduction machine. I never liked machines they always seem to have a restrictive forced movement.

Just out of interest, if you can remember what kind of pain and where exactly did your injury hurt? Did you get any pain in the lower back.

A while back I got a twinge/ping that seemed to be on the outside of my pelvis of my natural hip whilst lifting my daughter. The main pain was just to the right of my lower back and kind of went across the illiac crest and hurt when bending over and was tender to touch. Also there was a dull very uncomfortable ache deep in the inside groin area when just sitting or standing. No pain with hip flexion or abduction.

The first thing I thought was the psoas, it seems to be the culprit for so many issues. Still don't know but now I am fairly sure it was the SI joint/ligament that was damaged and the hip pain was just referred pain.

Did the hot cold thing, plenty of lying on the back and back stretches and hip stretches which helped.

Just wondered exactly what symptoms you got and what you did to relieve/cure them?

Like you Ruby before my op my psoas and my piriformis on my OA hip were tight. Also my lower back needed improved flexibilty among other things. Things have improved tremendously but there is still work to be done. Still do not have the flexibilty in my left leg to stretch the piriformis and glute, but getting there slowly but surely.

What did Mr T say Ruby?????

Thanks for your imput Gary, I will definately go and check out your thread!

I went back to see Mr Treacy today and thankfully I got to see him personally. He confirmed that the device is fine and it's my Psoas that's causing the bother, probably due to my wonky pelvis.
He's referring me for course of Hydrotherapy and he wants me to call his secretary in 4-6 weeks to update him and if i'm still having pain he will arrange for me to have an injection into the psoas muscle itself. If I still don't get any relief from that then he mentioned a surgery where he can cut away the tendons or something to relieve the pressure but he doesn't like performing that as it's better to keep as much strength in the leg as possible.

Oh, and i'm to go back onto the crutches for around 3 weeks as he doesn't like that i'm walking unaided whilst i'm still limping.

YIPPEEEE!!! Thats good news. Sounds like its all fixable which is great. It may be a little rubbish going back on your crutches but it will be all worth it in the end. Your recovery will just be a little slower .... but everyting will be fine eventually :)

Good news Ruby!   Muscle issues you can work out, as Gary pointed out; good that Mr. T is on the case.

Good news Ruby and 3 weeks back on crutches is nothing in the big scheme of things. At least you know it is  nothing major.

Jas

Great news Ruby. Hopefully you will get some relief from the hydrotherapy

That is fantastic news Ruby.  Now that your anxieties are over the next step is to put everything into getting that psoas sorted out with the help of all the physio exercises and the hydro-therapy.

In the article by Dr Su posted by John C, there is a bit about the Psoas and how it is stretched during surgery and to avoid striaght leg lifts for a while after surgery.