6 week check up not as good as I thought

[marty004]

Hi folks,

I'm 36 yrs old 6'3" male and had LBHR in October.  Just had 6 week check up and all is looking good. ie X-Ray fine, incision healing well, not too much pain, off the crutches around house and short distances and on one crutch for longer walks, etc.  Great!

Problem is that during my check-up when the surgeon tried to bring (slightly force) my knee to my chest the hip didn't want to know and every muscle in my upper thigh/hip said "hey what the hells going on here!!" and weren't having any of it!!    There was also a dull pain in the hip(which went away immediately he lowered my leg).  Hopefully this was muscular and not the implant itself but in th eregion of my hip joint.

Anyway Good news (I hope) is that surgeon reckons everything is fine but that I need intensive physiotherapy (PT for you guys in the USA   over the next 6 weeks!!!  Ouch!

However if this is not successful (ie. flexibility still poor - like my Country!!!!  Cheers Mr Bank Managers and Govt  ) the surgeon said I may need to be put under General Anesthetic and have the hip manipulated!!  What the ..... .  He also said that he has never had to do this with any of his patients and that the PT work should really help and that this is last resort but I must return to him in 6 weeks to have this done if PT sessions have not been successful.

Anyway just wondering if anyone has had similar issues with flexibility (or none in my case) and did it all come good in the end.

Just to mention even though I am only 36 (and was very active in many sports) I have been unable tie my left shoe laces or lift my leg past 60 degrees (due to OA in hip) in about 12 years so I guess muscles around the hip don't know what has hit them recently with my new super duper hip (here's wishing!).  I'm still unable to drive a car (manual obviously!) and can just about sit in the passenger seat now but with cushions to raise my hip angle.

Any advice or positive stories would be appreciated!!

Ciao,
Martin

Ireland, LBHR, 13th Oct 2010

[Tekka]

Hello Martin,

I broke my femur 21 years prior to having my LBHR and my left leg had set outwards.

My ROM improved fairly quickly but I did have some very stiff areas within my hip and it did take a long time to improve these areas.

Wish you well mate

Terry

[obxpelican]

This is just my humble opinion but I think a 6 week checkup is WAY to early to start worrying about ROM, some people take up to a year or so to recover most of their ROM.  At 6 weeks you are still healing and again IMHO I would not allow PT to do anything really aggressive.  I'm not a surgeon, not even trained whatsoever but just from everyone else's experience has been this seems to be a lot over nothing.

At 6 weeks all Doctor Gross wanted was a few measurements of ROM, xrays and to have the incision checked.

Try a hot tub to loosen those tight muscles and go at it nice and slow to see if you can get some of that ROM back.


Chuck

Hi folks,

I'm 36 yrs old 6'3" male and had LBHR in October.  Just had 6 week check up and all is looking good. ie X-Ray fine, incision healing well, not too much pain, off the crutches around house and short distances and on one crutch for longer walks, etc.  Great!

Problem is that during my check-up when the surgeon tried to bring (slightly force) my knee to my chest the hip didn't want to know and every muscle in my upper thigh/hip said "hey what the hells going on here!!" and weren't having any of it!!    There was also a dull pain in the hip(which went away immediately he lowered my leg).  Hopefully this was muscular and not the implant itself but in th eregion of my hip joint.

Anyway Good news (I hope) is that surgeon reckons everything is fine but that I need intensive physiotherapy (PT for you guys in the USA   over the next 6 weeks!!!  Ouch!

However if this is not successful (ie. flexibility still poor - like my Country!!!!  Cheers Mr Bank Managers and Govt  ) the surgeon said I may need to be put under General Anesthetic and have the hip manipulated!!  What the ..... .  He also said that he has never had to do this with any of his patients and that the PT work should really help and that this is last resort but I must return to him in 6 weeks to have this done if PT sessions have not been successful.

Anyway just wondering if anyone has had similar issues with flexibility (or none in my case) and did it all come good in the end.

Just to mention even though I am only 36 (and was very active in many sports) I have been unable tie my left shoe laces or lift my leg past 60 degrees (due to OA in hip) in about 12 years so I guess muscles around the hip don't know what has hit them recently with my new super duper hip (here's wishing!).  I'm still unable to drive a car (manual obviously!) and can just about sit in the passenger seat now but with cushions to raise my hip angle.

Any advice or positive stories would be appreciated!!

Ciao,
Martin

Ireland, LBHR, 13th Oct 2010

[resurface]

Need to agree with Obxpelican.... way to early in your rehab journey.  Remember, you have been in all liklihood losing ROM for years.  It does not just come back after a few weeks.  I can tell you that I documented my recovery and program on this site and had a very fast recovery.  Even with that my ROM continues to be someting that I work on daily especially the piriformis.  My hip flexors just stopped giving me little "jabs" from time to time.

Stay with you PT program.  It will come back.  Just keep mental tabs of your progress when stretching.  I noticed significant differences at 4 months and now at 6 months.  Good luck.

[marty004]

Thanks for your responses guys.
I guess its way too early to start panicing just yet.

Just frustration being a sporty 36 year old and not being able to put on shoes, socks, etc and even drive my car.

One step at a time I guess.

I'll defo try the hot tub.  Sounds like a good idea.
Is it ok to hit the hot tub as soon as the incision as healed as those things are swamped with germs and the last thing is an infection.

Thanks,

Marty.

[obxpelican]

Follow your doctors advice in regard to hot tubs, most will allow once you are totally healed, no scab, just scar, an infection is very very bad.

The worst thing that could happen now is some PT perform some really aggressive work on you and you to have a large set back.  My doctor only prescribed PT if you asked for it, walking walking and later on stretching is what he wanted us to do.

Chuck

[marty004]

Cheers Chuck.
Yes, I have been doing as much walking as I can.  Average 3/4 miles per day and try and stretch as much as possible.
However because I had quite bad swelling aroung thigh, knee and ankle (which is now much better) I still feel severely tight so I'm going to need the additional push so to speak.
Hopefully the PT's know what their doing and can get soem of my flexibility back in the next 4 weeks.

Not being able to drive is a big issue for me so that's my no.2 priority (next to my wife and child of course!!  with no.2 baby on the way so I'm puting myself under a bit of pressure to get myself in shape.

Cheers,

Martin.

ps. anyone heard of having the hip manipulated under GA?? If so is it a success?

[gary2010]

Sounds like a really bad idea to me! Stretching, perhaps in water, with warm up first, sports massage etc. just keep at it.

[Pat Walter]

Martin

6 weeks post op is still early in recovery for many people.  I was very stiff at the 6 week point and started doing water therapy which helped a lot.  It simply takes time for the body to heal.  Some heal faster than others.  I would not do any kind of drastic PT at this point.  I would be conservative and let your body have time to heal.  It is telling you very clearly - I am not healed yet and don't force me.  It will heal if you give it time.  Stretching, walking and water walking is great, but don't push yourself too hard or you could cause damage and slow down your healing.

Good Luck.

Pat

[marty004]

Cheers Folks,
Had my first physio session yesterday and was told it was the worst hip flexibility she had ever seen (which made me feel great!!)

So she said she has plenty of work to do but woudl be confiednt in getting some of it back but that I probably will never get full flexinilty into that hip again.

It seems like my hip just doesn't want to budge and feels like something is catching in my hip when they try to bring hip to chest and I get alot of pain.  At the minute I am way off and still getting this catching impingement pain in my hip and buttock at 90 degrees which they say I shouldn't be getting at this stage.  Their (Surgeon and PT) words not mine.

PT was quite sore with digging into pressure points around hip and buttocks and this made a slight difference although I'm back to being stiff and sore today now.

I have another PT session later today, then the pool work starts tomorrow which I'm looking forward to.
Problem with the pool is that I'm so inflexible I can't get sockes, shoes and just about get my pants on by slipping foot into pants leg!!

Things just going very slowly and just slightly down as I thought I would have much more flexibility back after going through the operation.  I don't think I'll be tying my shoes laces for a long time if at all at this stage.

I'll keep at it I guess and see how the next 4 weeks go.

How much walking should I be doing at this stage.
I'm doing between 3-5 miles per day on one crutch with no pain so is this satisfactory or should I up the distance?

[gary2010]

It's duration that counts, not distance. I was doing about an hour a day at that point, over mixed terrain. Can you swap the crutch for a stick? Then maybe assist every other step. Try walking backwards and sideways as well. A good rule is if you can do it again tomorrow you haven't overdone it.

[Pat Walter]

Marty

You might be pleasantly surprised how much the water therapy will help.  It is very gentle and helpful to most people.  If there is someone around - ask them to help you with your socks.  Most people or staff are nice and understanding.  Probably not good to ask for help with the pants    Try sitting to put your pants on.  Don't know how you are trying to do it.

Best of luck and remember that it takes a lot of time for some people to get back to normal.  Be positive and keep working at it.  If it hurts a lot, perhaps you should back off.  Your body is talking to you.  Normally you don't want really agressive PT.  Hopefully your PT person knows about hip resurfacing.

Pat

[PaulC UK]

Hi Martin,

From close to you across the Irish Sea! Had LBHR 3 yrs almost to the day, still have ROM restrictions. Shoe laces remain a problem but flexible hamstrings help! Approaching 50yrs, after 10 months was able to referee rugby matches, motorbike, cricket and ski, despite only 90 degree hip flex when measured lifting knee to chest.  LIke you I suffered for 14 years before surgery, I suggest you modify lifestyle to enjoy new pain free environment particularly the sleeping! My physio hinted that any more ROM was unlikley, so adpated instead. Although not ideal the compromise is worth it, trust me. Techniques for pants etc will come second nature, just remember it might look strange in a gym changing room, eventually you will not notice it. Hope this cheers you up, I was gently jogging at 4 months. As stated earlier if it hurts then don't do it! I think we forget what damaged goods we were pre-surgery, the Drs even excellent ones can only do so much, unfortunately for the young recipients of BHR perhaps we expect too much, only time will tell, but I don't regret the lack of ROM for exchange of no pain!

Paul C

[Pat Walter]

Hi Paul

Thanks for your post.  It is good to hear real stories.  Sometimes those of us with lesser hip problems don't understand that you can suffer for many years.  Many of us were in pain only for a few years or less and decided it was time to do something.  So again, Thank You for the real story.  I try to tell people what you did  - if you have had problems for a long time, a hip replacement whether resurfacing or THR will not return the body to normal in a short time.  Your body has been in pain and out of balance for years and sometimes, as in your case, it never quite gets back to normal.  You statement that "being out of pain" is really more important than having full ROM is one of a very happy person that has made some adjustments in their life.

Good Luck and Thanks for your posts on the group.

Pat

[Terranova]

Hi Martin,
Snap....I am 36yrs old and had a RBHR on 3rd Nov in Cork. Ireland. 6 week check up due on Tuesday 14th Dec. I have had severe pain and restricted movement due to severe OA in right hip for last 3-4 years. During that time my movement has never been greater than 90 deg and I had trouble tying my shoelaces.

Roughly 4 years ago I finished a lifelong career of hurling (an Irish sport that I can only equate to Ice Hockey played on grass, but faster and more physical), (Martin you know what I'm trying to describe so please feel free to elaborate here) due to excrutiating pain  right through my right leg, that no one could diagnose.

I took up cycling after finally being diagnosed with OA in right hip and took up cycling to maintain fitness and got hooked. I cycled approx 5000km last year. Finally i decided to go for the op sooner rather than later. I saw Mr. Dave Mulcahy in Cork last March 2010 and he had no hesitation in recommending a BHR. I decided to postpone surgery till the winter months and scheduled surgery for 3rd November.

Now at 5 1/2 weeks I have the same ROM as pre-op but pain free. At this stage I didn't expect any better and I am hoping that I will get to 80-90% of text book movement. I could be wrong but I am prepared for hard PT over coming months.

I will keep you posted after my consult with Mr Mulcahy on Tuesday but I feel good and am comfortable walking unaided around the house and with one crutch on longer walks.

BR,
Vinnie

[BerkeleyGirl]

Martin, seems like the lack of flexibility has more to do with what the hip was like pre-surgery than a problem with the surgery itself. I'm only 8 days post-op, but I was extremely flexible before surgery (overdoing it in advanced yoga is what kicked off the osteoarthritis, I think), and already I can quite easily touch my big toe on my operated side. This is despite the hip being very stiff and the leg unable to lift itself or move to the right or left of its own accord... I am not having any kind of miraculous recovery, in other words, that's giving me this ROM. If my surgeon reattached the tendons etc. that I already had, they were flexible ones. Yours were shorter ones.

As someone who has suffered as a result of flexibility, I would advise being very careful about pushing it too much. This is hard enough without a setback!