Leg Length Help

[kriyamon]

Day 8:   This is a running journal entry but I'm going to copy and paste in different categories to see if I get help.

I downshifted yesterday and even more today, trying to come to terms with movement in a pain level  of less than 4, as .  I think I was trying too hard.  It is not a race, it is a healing.

One observation that I've had since I was in the hospital and for which the continued refered pain in my knee and thigh (my hip and the incision area feel ok) may be responsible for is increased leg length on the operated side.

My operated side had been about 3/8-  1/2 inch shorter and I was wearing a lift in my shoe to compensate.  Interesting over all the years how different professionals would measure and come to conclusion about where the shortness was..some said leg, some said due to the deteriorated joint, some said pelvis structure.  Anyway, I had discussed this with Dr.  prior to surgery and it was apparent on my xray that the left hip socket was distinctly higher than the right.  Dr. Ure said he thought he could change that through the surgery, which I agreed to.

Now my operated left leg feels distinctly longer (seems like an inch) than the right when standing up.  If I stand up to what feels straight my right foot is actually off the flor or I'm standing on the ball of the right foot in a lifted position.  If I put all the weight on the right side, my left leg must stay bent.  This is not a good feeling, along with the pain.

Anyone else have a problem with this?   

[kriyamon]

I think my issue with leg length will resolve....seems to be common complaint that usually goes away...and I've noticed that posturally, my stance and balance are radically different than with the funky old joint.  So I think I just have a lot of unlearning and relearning to do.  Also, some people have said it is a physiological thing with surgical recovery, swelling, etc.
 

[whozethere]

I find this issue particularly interesting.  Like you, my hips have been uneven for 35 years.  By the time a lift was recommended, too much compensation had taken place in my back for me to adjust to one.  I am just curious since this affects musculature and curvature of the spine, how is your recover going?  I would think this particular issue could potentially make your recovery slower.  Perhaps using a lift, will even things out.  I asked this question on surfacehippy, but so far, no answers.

[Pat Walter]

Hi
I am sorry that you have not received any answers to your question either here or on the Yahoo Group.

I do know from reading for almost 3 years on the Yahoo Group that people with pre-existing problems like leg length do seem to have a longer and more difficult post op recovery.

Vicky had her leg lengthened and had a longer and a bit more painful recovery since all of her muscles had to adjust to the new length.  I know of several others who have posted the same thing.

I think if you have lived with a leg and back problem for a long time, it will make your recovery slower. 

Most of us have/had back problems just with the OA since it tends to shorten your leg a little.  I was always having back problems and almost lived at the chiropractors.  I have had fewer problems in the last 1 1/2 years with my back since I have my new BHR, but I still have problems. 

It will take some work on your part with probably a good PT to try to get your back to recover.  The stretches and exercises in the water for both my back and new hip helped me a lot. 

It took years to get your back curved and unbalanced - I think it will take much time to try to get it back to normal if possible.  At least your hip will be fixed with a resurfacing and you won't have hip pain.

Good Luck.

Pat

[whozethere]

Thank you Pat for answering.  I just think the other group has lost their focus amid personal disagreements that will never be solved.  Common sense told me that your answer was the logical one, I guess I just had to ask.  I know this orthopedist at least ask re: original injuries and care.  The first didn't.  He told me I would be off work for 3 months and could be 6 months before I really felt normal.

I am overweight.  He did tell me if would be a bit more difficult.  I am wondering how weight affects recovery as well.

[Vicky]

Hi,

Yes Pat is correct.  I had my leg lengthened by Dr. Bose by 6mm.  There was only one other patient of Dr. Bose that he also did this with and that was Sheila Feeney who I spoke with.  Interesting that our recoveries were almost identical and yes it did take a lot longer than most.  I believe my hips were always uneven, that is probably what caused my severe scoliiosis, I have a 37 degree curvature in my spine.  Once he evened me out, there were a lot of things that needed to settle down.  My back, my pelvis, so many muscles, etc. that needed to adjust to the new leg length and to my body walking correctly for the first time ever.  I had to deal with a lot of back pain, while this was all adjusting.  I found a chiropractor and a PT helped so much, but make sure you find an excellent one, one that has at least 10 years experience. and also clear it with your doctor first before going.

I had some really deep tissue muscle release done since my operated leg felt like it was pulling every time I took a step, like it didn't want to stretch back that far for the step.  It took me about 3 1/2 months before I started feeling somewhat normal again and it wasn't until 7 months post op that I finally could stop thinking about the hip.  All stiffness finally gone after sitting, etc.  It definitely takes work to get back to normal, it is like learning to walk all over again.  Here are some tips on proper gait that I saved from some prior posts on SH.

Walking correctly


Lead with a solid, pronounced heel contact...roll
through the foot, heel-arch-ball-toe. Critical to all this is to
remember to relax the toes. (That's the magical part that took me
the longest to figure out.) When the toes are relaxed, and able to
spread, you achieve the part that Marc was looking for. You can to
keep the foot on the ground longer. (I now find it useful to walk in
gym shoes on the wooden floor of a handball court...and just listen
to the sound of the footfall and steps. If I'm walking correctly, I
can even hear the "metronome effect" that Gordon mentioned.

Gordon's parts on levering at the knee and leg muscle flexion are
quite correct, and will be much more natural and comfortable if you
do let yourself roll heel-to-toe. Marc also emphasized with me the
need to hold the shoulders back and walk straight up. I had
unknowingly developed a forward-leaning motion over the years of
limping. This led to shorter, quicker steps.

In the beginning, I found myself trying to walk too fast, and I
dropped immediately back into limp-mode. As soon I concentrated on
slowing down and thinking about the step, it became easy...and the
limp went away.

Hope this helps.

Vicky

[Rayboy]

I put an item about this in the severe problem discussion.  I had perfectly good leg length and a perfectly sound back when I had my left hip resurfaced.  The surgeon, in some fashion, lost one inch of leg length.  I went through all the stuff about my body having to readjust but xrays confirmed that the left leg is shorter.  My surgeon said he had to pound down on the cap to get a firm grip on the hip ball and that I should get a lift in all my shoes.  One inch is a huge differential and I'm sure that something went wrong, but I'm not sure what, nor am I sure what options I have other than--as my surgeon said--wait until the other hip goes bad and get it fixed then.  I hope he was joking.  It seems to me that the resurfacing systems should make much more of a point about leg length differential.  In fact they say it is not an issue.  It is.

[takilasunrise]

I am 6 weeks post op.  I, too, felt that I have been "uneven" since the surgery.  I can actually say that in the past few days or so, I am leveling out.  Elaine pointed out to me in an email to be real conscientious about how I walk; to think about how I am walking.  I have been limping for the last 2 years, so no doubt my body has developed some bad habits.  When I really concentrate, I can feel my gait become more smooth.  Some of my co-workers have noticed that I'm walking much better than I was before my surgery.  I was kind of concerned at first at how I felt that I was uneven.  I asked my P.A. and she said it's pretty typical.  My muscles, etc. have to readjust. 

[Pat Walter]

You really have to concentrate on walking properly.  Using heal to toe with a full step for each step.  Marc the PT use to work with us in Belgium. 

It takes time to get back to normal.  Glad you are doing well.

It just gets better and better.  My hubby use to tell me I walked like John Wayne!

Pat

[SusieQ]

I'm at 8 weeks following RH resurfacing.  Have had many moments when I've felt alarmed how different my leg lengths feel.  Must wholeheartedly agree that you have to concentrate on how you take every step right now.  Heel/toe is something I constantly remind myself to do.  The feeling of length difference is diminished greatly at this point, but must keep up the work til it becomes more natural.  Also have a shoulder dropping problem that I have to always work on or I will limp again.

[Maggie]

Hi All,

I am now 16 weeks post op. I had been wearing a heel lift and insoles in my left shoe for a long time to even me out, as I had about 1cm shortening on the "bad" side. Once I started walking properly(ish) after my surgery I felt I had regained length on the operated side and felt much more balanced, despite the muscular twinges that went with it. Yesterday I went to see my orthotist and he confirmed that my hips are now perfectly level, and we were both delighted, the heel lift and the insoles are discarded and sometimes I can even wear "grown up" shoes (a little bit of a heel)! He said I should go and shake the surgeons hand for making such a good job of it, but I've already hugged him instead. I am aware that I still "dip" slightly to the left when walking, but I'm sure that is due to some continuing muscle weakness and the habit of limping for many years. I am probably not as conscientous with my exercises as I should be either because being pain free it is amazingly easy to forget to do them.

Best wishes

Maggie

[takilasunrise]

Today, as I was walking into work, I was noticing my toe (operated side) was slightly turned in when I walked (pigeon-toed) which it has never done before.  I'm hoping it's just my worn shoe.  Anyone else have this happen? 

[Scott35]

I'm interest to hear if your leg length problem ever worked itself out.  I'm 10 weeks post BHR surgery and my operated leg is 3/4 of an inch longer.  I walk with more of a limp today than prior to surgery and it is causing problems with my lower back and knee.  My doctor/hip surgeon explains it as a pelvis slant that will pull back into place over time.  Another doctor that I talked to questions whether it will even get back to even.

If your situation worked out I interested in how long it took and ifthere was any exercises you did to help it along?

[gmaestral]

I think my issue with leg length will resolve....seems to be common complaint that usually goes away...and I've noticed that posturally, my stance and balance are radically different than with the funky old joint.  So I think I just have a lot of unlearning and relearning to do.  Also, some people have said it is a physiological thing with surgical recovery, swelling, etc.
 

I had the same thing happen to me in California, and I could not touch the floor with me left foot. The Dr. did a revision on me just four days later, and I just had another revison this week because the liner was loose. I think that kind of leg lenth difference would have caused a problem in my back. It was way too uncomfortable, and too ungly to deal with. Before this second revision my pain was at about a level ten with that loose liner.