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Author Topic: Advice on mobilising after BHR Surgery  (Read 4897 times)

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gazza

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Advice on mobilising after BHR Surgery
« on: November 21, 2009, 06:48:35 PM »
Hi
I am from the UK and had my left hip resurfaced on 3 November. I have no PT sessions (NHS system for you) and don't see my consultant again until 6 Jan.  I have been given no exercise's to do, Called hospital and they said they would send something, but after 3 further calls I have given up. I have found the Phase 1 exercise program on this site, but was woundering how much additional bending and stretching I can safely do. I can walk about 1 mile with elbow crutches and manage around house unaided. But area around scar ared is still quite stiff.
I am 47 yrs old and was pretty active before OP. My consultant said I had to have this type of surgery before the joint got to the point of constant pain (because of risk of infection). But after reading posts on this site I think this is not quite so (I was fully mobile but just had a little difficulty tying my left shoe lace because of joint restriction). I have a scar that is about 13" long and is like an invirted letter J which extends round to my lower back area which is uncomfotable to sit on for more that 30mins at a time.
Sorry to go on a bit but just wanted to paint a full picture.
Thanks
Garry
LBHR 03 Nov 2009 Mr T.M. Abuzakuk  Derby, England

Pat Walter

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Re: Advice on mobilising after BHR Surgery
« Reply #1 on: November 21, 2009, 07:53:24 PM »
Hi

Some surgeons have people doing a lot of PT while others have them do nothing but walk, walk and walk.  You are still quite early in your recovery and would not normally be doing anything very strenuous.

The people that did nothing and just lived their normal lives and walked actually turned out to have about the same recovery as those that did a lot of PT. The athletes want to do a lot because that is what they are use to.  They do, however, have to be careful in the begining.  YOu can't force your body to do things it is not ready for.  If it hurts - don't do it.  You need to give your hip much time to heal.  People are pretty active at 6 weeks and are normally given the OK to do about anything at 6 months.  It takes almost a year to  completely heal.

Most people are very stiff after surgery.  I was very stiff at 4 - 6 weeks and did water therapy in the pool.  Lots of water walking and stretching.  That seemed to get my muscles back to working.  Others just walked while others worked out at the gym.  You need to get approval for anything strenuous from your doctor early on.  I would say be careful for the first 6 weeks.  YOu don't want a femur neck fracture or other problems.

You will have plenty of time to use that hip when you heal.

If your surgeon felt you need resurfacing, then you did.  Surgeons don't play games with major surgery as hip resurfacing.  Your pain level and inactivity is not a true indication of the problems in your hip.  Some people have a little pain, but very bad hips while others have a lot of pain and not as bad of a hip.  You are still very young.  If you waited, you could have missed the window of opportunity to have a resurfacing and ended up with a THR . Since you are in the UK, I don't think they very often suggest major surgery without a good cause. 

I would not be doing a lot of bending and stretching for now.  Most surgeons lift the 90 rule - if you have it, about the 6 week time.  Because you feel good, does not mean you are healed. There is no way to force healing and you should be cautious early on.  YOu don't want to have a revision to a THR because you were pushing too hard.  You will have plenty of time to do what you want when you heal.

I had a long scar too since I used Dr. De Smet of Belgium.  He believes in a large incision so he can get in and get out quickly.  The fast the surgery, the less post op problems.  My recovery was as fast as anyones. Walking with one crutch at 4 days post op, doing a over a mile a day by 10 days post op and no crutch at 3 -4 weeks.  No bruising and no swelling and no heavy meds after leaving the hospital.  So the incision size does not dictate the quickness of your recovery.  AFter about 6 weeks, you can rub vitamin e oil on it to help it smooth and heal. 

Take it easy and good luck.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

gazza

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Re: Advice on mobilising after BHR Surgery
« Reply #2 on: November 21, 2009, 08:09:28 PM »
Pat
Many thanks for the reply.  I will just continue with the phase 1 exercises.. For now..
 I just want to get back to work, I am getting pretty bored staying at home all week (wife and kids out all day during the week, and been told not to drive for 6 weeks so can't get out and about much except for a short walk of approx 1 mile). Just wanted to make sure I wasn't slacking.  Wish I had found this site earlier though.
I even have the clunking problem, but having read other peoples experience's this also seems to be normal .
Regards
Garry
LBHR 03 Nov 2009 Mr T.M. Abuzakuk  Derby, England

Pat Walter

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Re: Advice on mobilising after BHR Surgery
« Reply #3 on: November 21, 2009, 08:40:51 PM »
Glad you found the site too.  Clunking is normal for many people.  I clunked a lot.  Was told it was the muscles around the hip that had not tightened up yet due to the surgery.  I had it a long time, but it did not hurt.  It gradually went away for me.  Sometimes, even almost 4 years later, I get it when I am sitting or shift a certain way.  I am, however, much older than you so my muscles are not as tight as a younger persons even though I am pretty active.

I would walk as much as you wanted to unless your surgeon said to limit your walking.  It is the one thing most surgeons say - walk, walk and walk.  I was walking over a mile a day by 10 days post op and quickly lengthed it quite a bit. Try doing a walk several times a day if you feel like it.  Just don't push it to go fast or really long if your body is complaining.

Take some time and write a story for me about your resurfacing surgery and experince.  I would be happy to post it.

Good Luck.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

Tekka

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Re: Advice on mobilising after BHR Surgery
« Reply #4 on: November 21, 2009, 10:41:48 PM »
Hey Gary,

I am nearly ten months since my LBHR, those first six weeks are critical mate, be sure of the 90deg rule and crossing the legs.

It's easy for me to reflect now, but I was desperate to get back training and it was a real effort not to force my recovery...I'm really glad that for once I was sensible and took my time. It is a truly remarkable operation so why take any chances.

My PT was also useless but if you have a look at the mcminn website it is pretty helpful, Mr Mcminn is very conservative so its worth a look, but be careful mate.

If you want to have a chat, email and we can swap stories.

Best wishes

Terry
LBHR 23/01/2009 Mr Mcminn

pashley

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Re: Advice on mobilising after BHR Surgery
« Reply #5 on: November 22, 2009, 12:26:25 AM »
Hi Gary, I'm from UK and had a BHR done 27/10 in Birmingham where did you get yours done.
         I was mobilising really well until last fri day 25 when whilst out for a walk on 1 crutch started getting pain down front of leg to knee (was not getting this before) still getting it mobilising now and cannot walk a few steps without crutch, almost feels like its going to give way, any advice gratefully rec'd as really worried.
LBHR 27/10/09 Mr Mcminn

Tekka

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Re: Advice on mobilising after BHR Surgery
« Reply #6 on: November 22, 2009, 12:57:51 AM »
Hey Pashley,

I had a similar problem at six weeks, I rested and laid of my home PT and it improved over the following week. If it continues I would contact your surgeon just to be sure.

Who did your surgery mate.

I live in Brum now !!!

Regards

Terry
LBHR 23/01/2009 Mr Mcminn

pashley

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Re: Advice on mobilising after BHR Surgery
« Reply #7 on: November 22, 2009, 12:47:17 PM »
mr Mcminn did my BHR. I thought that the recent pain might be due to not doing my exercises regularly !
LBHR 27/10/09 Mr Mcminn

Tekka

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Re: Advice on mobilising after BHR Surgery
« Reply #8 on: November 22, 2009, 03:15:05 PM »
Best check with Mr Mcminn, Chandra or Joseph....

LBHR 23/01/2009 Mr Mcminn

gazza

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Re: Advice on mobilising after BHR Surgery
« Reply #9 on: November 22, 2009, 04:30:36 PM »
Hi Pashley
I had my Op done at Derby.  I have had a slight light burning sensation down front of my thigh and in my calf when walking, pretty much since I had the surgery.  It feels a little like the discomfort you gat the day after a hard session in the gym.  I assume this is from all the twisting and tugging that occurred during surgery..  Unfortunately I have arthritis problems in both knees as well, and I too get a sharp pain in my Operated side knee, although it goes if I rest for an hour or so.  I was walking with only one crutch after about 7 days, but my wife pointed out that I was probably doing more harm that good by limping and walking in a unnatural manner. I have since returned to using both crutchesí again. This seems to have stopped my knee pain as I walk in a more natural manner. 
Do you go to P.T sessions in Brum, or are you like me in the fact that no P.T was prescribed?
LBHR 03 Nov 2009 Mr T.M. Abuzakuk  Derby, England

pashley

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Re: Advice on mobilising after BHR Surgery
« Reply #10 on: November 22, 2009, 07:32:16 PM »
Hi, has it been as you expected Garry, I must admit thought I'd be a bit better than am, but that's probably just impatience on my part, just want to dump the crutch now but will have to be more patient  ::) did not realise anyone in Derby did the BHR, no not reccomended to get physio either just exercises at home! They say you should carry on with a stick until walking without a limp.
LBHR 27/10/09 Mr Mcminn

gazza

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Re: Advice on mobilising after BHR Surgery
« Reply #11 on: November 23, 2009, 02:03:00 PM »
I didn't know what to expect really.. I my mother in-law had a THR a few years ago and it seemed to take ages before she could walk again with out any type of aid. My Doctor told me that BHR is better but takes longer to get over due to the larger size of the incision and the resulting tissue damage. So Iím pretty pleased with my progress to date.  I am desperate to get out and about though, was contemplating going out on my bicycle (but having read some of the good advice on this forum Iím going to try and take it easy for a few more weeks). I am doing a couple of walks each day totaling approx 1.5 miles and doing most of the phase one exercises. I am not able to lift my leg straight up off the bed though (feels like my hip will explode when I try) but can do all the others quite easily. I am 47 bye the way, are you a similar age?
LBHR 03 Nov 2009 Mr T.M. Abuzakuk  Derby, England

Pat Walter

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Re: Advice on mobilising after BHR Surgery
« Reply #12 on: November 23, 2009, 02:16:37 PM »
Hi Gary

Abduction exercises and lifting the leg up are the most diffiuclt to accomplish early on.  I could not lift my leg straight up off the bed for about 3 - 4 weeks.  Also moving the leg out to the side is difficult.  It will - however - start to work again if you give it time.  Don't worry about it, it will all heal up and you won't even thing about your hip eventually.  You can't will your muscles to start working. Give them time to heal.

Personally, my experience of hip resurfacing and THRs is the opposite of what your doctor suggests.  I had a very large incision of 10" from Dr. De Smet in Belgium.  I was walking with one crutch at 4 days post op.  Sight seeing in Belgium at 5 days and dropped the crutch outside at 3-4 weeks.  Our PT people in the states sent me home since they had no clue what to do with me since I was healed so much faster than THR patients.  I thought I would try PT, but my doctor said I did not need it.  It turned out I did not need it.  I walked a lot.  The size of the incision does not mean you will have a slow recovery.  The surgical skill of your surgeon is what dictates your recovery.  I had no swelling or bruising at all.  That helps in recovery too.  Sometimes people that have the MIS surgery are more bruised and have more problems since the doctors have to push and pull around inside that very small incision. They can't see well.  Many surgeons theory is to make a large incison so you can see and get it done quickly.  My surgeons does the surgery in 45 minutes.  He says the less time you are under anasthesia - the quicker the recovery.  Also with a big incision, he can only cut and move what is needed without disrupting anything else near the incision area.  So there are many opinions about the size of incisions and recovery time.

Best advice - take it easy and be patient.  It will all be better and pretty soon this early post op recovery will just be a memory.

Pat
Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

Netta

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Re: Advice on mobilising after BHR Surgery
« Reply #13 on: November 23, 2009, 10:20:07 PM »
Hi, I had my op on 15 October in Brum by Mr Treacy and so am nearly 6 weeks post op and I too have been confused about how much I should be doing.  I'm walking with one stick fairly comfortably but I will still use 2 sticks if I'm going on a more lengthy walk - although not much chance of that with this rubbish weather!  I can relate completely with what has been written on this subject, I too wasn't offered any physio.  I get knee pain on the same side of my wound and over the knee cap and very often this starts off in bed at night when I'm doing nothing!  I use to get knee pain before my op and had it checked out as I thought I'd probably got arthritis in that too but I was glad to be told that I was clear in that area and the pain would more than likely disappear once the hip was sorted. 

I feel like I've reached a bit of a plateau with improvement in mobility at the moment but feel assured by comments on this site that patience is the key.

One thing that also bothers me is that although all swelling and bruising has gone the bottom of my shin and around my ankle is tender to touch and I wonder whether this is from the tugging and pulling during the op.

Left Hip, BHR, Mr Treacy
15 October 2009

Pat Walter

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Re: Advice on mobilising after BHR Surgery
« Reply #14 on: November 23, 2009, 11:01:15 PM »
Hi

It does take time to recovery.  You will find you reach a plateau, then all of a sudden leap forward a bit. Sometimes people go forward a bit, then backwards, then forwards again.  It is not a straight line healing.  Many people tend to feel better around 6 weeks post op.  I really felt much better at 6 months.  It took me that long to get all my energy back - but I was 61 and really out of shape.

It is an individual recovery.  And, yes there was a lot of tugging and pulling on your body and it will take time for all the tender spots to heal.  Usually many of the other knee, back and foot problems eventually will resolve too.  Not all of them if you have been on a bum hip for years and years, but most of us tend to have the knee and back problems get better.  Your body will be working more balanced when you are healed.  It will take 4 - 6 months to get your body working properly, yet the back and knee problems could take longer.  We are all different.  It is best to be patient and give yourself time to heal.

Walking is the one activity all the doctors usually suggest. 

Pat

Webmaster/Owner of Surface Hippy
3/15/06 LBHR De Smet

Geeod

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Re: Advice on mobilising after BHR Surgery
« Reply #15 on: November 24, 2009, 03:49:11 PM »
Hi Garry,
I see you've had quite a few replies and hopefully feel a little happier. I'm also from the UK and had a left BHR on 5th October this year, I'm 52 and its now 7 weeks post op. I had my surgery in London, privately and my surgeon was keen to get me walking full weight-bearing unaided asap. Your surgeon should have at least told you whether to be trying to get off the crutches or continue for a period of time.
I say this as usually if they are happy with what went on in sugery ie a good fitting with the acetabular cup then they are confident with the progression of walking / exercise. I feel that I'm going a little too quickly and I think its telling me to slow down occasionally. I honestly wouldnt worry too much about exercises yet unless you are pretty much pain free with walking unaided.
One can always strengthen or stretch at a later date but you cant make a loose prosthesis fit tightly by exercise.
Last night was pretty bad for me and today I am dosed up on diclofenac and di-hydrocodeine. I think I overdid it at the weekend. trying again to push things along a bit. Dont be tempted to go too quickly as its easy to do so - Good luck.
PS I am a Physio.

Garry

 

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