Stiffness and limping after sitting down - redux

[jackh]

Hello from a 1st time "poster":

As the Subject line indicates, this was addressed in an earlier posting; when I tried to reply there, it was suggested that I start a new post, so here goes:

I'm a 55 y/o male; very satisfied customer of Dr. Bose; RBHR 6 months ago and LBHR 2 months ago. The 2nd operation went even better than the first, with regard to recovery, and I was walking unassisted w/o pain at 4 weeks (even though I used a crutch for outside walks till almost 6 weeks).

After 1st BHR I can't say that I noticed this issue as much as I do now: namely the stiffness, soreness, and limping that occurs after getting up from a sitting position. Very embarrassing in a restaurant. My tactic sometime is to just stand up at the table and just move both legs a bit before walking away; otherwise I obviously "waddle" and limp for the first 20 steps or so. Not much pain, just a soreness and stiffness in the area around the joints. It always goes away after walking a bit, and I usually have very little or no limping after walking for a longer duration. One strange thing I've noticed is that I don't have this problem after getting out of bed in the morning.

Still doing the exercises and trying to increase ROM, but obviously having more luck with leg crossing on the earlier operated leg.

We're traveling outside the US on our sailboat now, and don't really have a good PT option. We do have access to pools (and open water) now and again, so I do water-walking, swimming, and leg kicks when I can. Sometimes we have access to gyms, and I wonder what exercises would help there. I go for the leg stretching equipment whenever possible, and go for the stationary bike for aerobics.

From the earlier posting, I see this is a common problem (?). I wonder what % of folks experience this? Is it just a ligament, tendon, etc. healing issue? Is it usually gone after one year post-op? It's really the only negative I have, other than the Frankenstein scars..

Thanks in advance,

Jack

[obxpelican]

I do not know what % of the people get it, but often it's called "startup stiffness" and it's pretty common, Dr. Gross said in some cases it can last up to a year or better.

Glad to hear you are doing well.

Chuck

[Luann]

Wow guys... this helps me a lot. What a great website!
 I am at 10 weeks now and this is really my only "hurdle", at least at this point in my healing. I can walk, without a limp or pain, for pretty long distances, do small chores, sit very comfortably, but those first few steps getting up... UGLY!!  My leg is painful, really weak, and feels like it would just about collapse if I put all my weight on it. I, too, take about 10 or so very limpy steps before it warms up. The last 3 days I have noticed it being a little better; more like 5 steps.
 Thought I'd weigh in. Good to know this is common and may take a long time to go away.
 Any idea why this happens, I mean, from a physiological perspective? I've seen people with THR do it too.  Thanks, Luann

[angelena99]

I don't know if this will be relevant, as I have not had HR yet.... but am working with a PT to help get muscles and strength in the right areas (and hopefully more symetrically) before I make more surgery decisions.

Anyway - I have this now, and it is mcuh worse after sitting than after laying down - the PT suggested it has to do with my super-shortened and tight hip flexor muscles.  I am working on strengthening my gluteus medius (inlcuding the clamshell exercise I've heard mentioned here) and stretching my flexors.

Best to you!
Angie

[moe]

I went through the same thing, lasted a few months. Now after a year I barely remember it, it gets better. All the best, moe......

[JDinHB]

I am about 3 months out now and - right hip - and have same issue(s). Sometimes worse than just a few steps. At times still very sore and what i would consider to be painful - especially after excercise. But after about 20 steps or so can get going pretty well. I like doing the elliptical, bike and swim plus some walking(maybe 2 to 3 miles max at this stage) for PT.   

[kdono1961]

Wouldn't it be nice if our doctors let us know this is common.  I am 4 months post-op and after sitting for supper or after a long ride in the car I have this "START UP" condition.  Hopefully it gets better.  This web site is great.  Everything I have read I can identify with. 
Kevin

[sfinrecovery]

Thank you for this trail of, hopefully, good news.  This has been one of my symptoms pre-op and the PT an doctors are learning from my lessons from this site.  How does this symptom improve, icing, stretching, a combination?  How about gluteus strenthening or ilopsoas strenthening?  Any suggestions are welcomed!

Juan

[Luann]

Hi Juan,
  I would love this question answered, too. At this point, looking at information from those more experienced that us, it sounds to me like you just have to give it time. Calling all hippies... is this assumption correct?
 I know that I, personally, stand up, and, without taking any steps, rock my weight back and forth on my HR leg until it no longer hurts as much. Then, I take a step. This assures I don't fall or limp so badly. I must say I'm at 11+ weeks now and just since I wrote my last post it is a little better. I maybe only take 3-5 "bad" steps now. It also seems to depend on how long I've been sitting. The longer, the more it takes to warm it up. 
 Luann

[resurface]

Hello -

So much of this is personal in so far as pre-surgery conditioning and how much effort is devoted post-op [perhaps most critical].  It is even personal from surgeon protocol: from weight bearing as tolerated to wait one-year.  I posted my exercise / rehab under stories May 6th surgery.  I am now just under 4 months post HR.  I cycle upwards of 120 miles a week with virtually no start-up issues.  I galloped down the hallway this week just to see if I could do it.  No issues.  I mention this as maybe what I am doing will help... no sure.

I still have ROM work to be done as well as strengthening.  I also think that a great deal has to do with "appropriate" progression: crutches to cane and then off-cane to strengthening / stretching.  If you are not ready to move to the next step the issues multiply and, I think, that rehab may be slower.  Just my opinion.  I was told to keep the cane until zero limping. 

For weeks I battled to stretch my piriformis and then all of the sudden it stopped being sore and my ROM improved. It also seemed to have made my IT band feel better.  So much is interrelated.  I now seem to be focusing on strengtening my hip flexors. 

A few notes that have helped with my stretching / ROM and hopefully has negated any start up:

(1) active passive resistance stretching with a PT.  Really improves stretching.  Basically, you stretch then push against someone to activate the muscles you are trying to stretch and then you relax and they are able to stretch you further.  This is fairly common technique I am told.
(2) daily stretching, if even for just 10 mins with icing.
(3) for several initial weeks with PT they did deep tissue messages over the scar [felt really great - ugh!] to ensure that there were few to no adhesions and that muscles were seperated.
(4) watching my gate, is my foot externally rotated or not. Getting back to a proper gate.  At times I stop walking and it is slightly rotated and I put it back.  Constant reminder.

I hope that this adds a bit...