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Author Topic: Mending Ligament Pain?  (Read 3022 times)

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morganedwards

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Mending Ligament Pain?
« on: October 01, 2011, 07:30:44 PM »
I'm a little over 3 weeks RBHR post-op.  At 1 week my hip was feeling so good that I walked up to our mailbox which is about a 2000' round trip using 1 forearm crutch.  As it turned out this was a bit too much because coming back my mending hip/butt area tightened up to almost becoming painful as I got back.  Later that evening I began having a periodic "stabbing" like pains which seemed to emanate from the new ball & socket area.  These would come & go without being triggered by any movement on my part. After checking with Dr's office I started taking Aleve to combat inflammation which definitely helped but did not eliminate this as a new source of soreness & pain which comes & goes but is exacerbated by excessive walking and/or anti-inflammatories having worn off.   So at this time I am still plagued off & on (mostly off) with pain which I am assuming comes from the mending ligaments that were cut & then repaired as part of my operation.  I have been taking minimum perscription pain meds -- mostly at night to allow sleeping but have switched to Ibuprofen on an as need basis.

I also discovered yesterday that when my hip flares up that if I stiffen my leg completely and swivel at the hip I can walk pretty much pain free while if I allow it to flex it can be painful enough to make walking difficult (this is without support).

My question is can I safely ignore this occasional flare-up pain?  I don't mind pushing the envelope a bit provided I don't do more harm than good.  I'm getting itchy to be more active but my walk to the mailbox and resulting setback is fresh in mind so I thought maybe this forum could provide some advice.

Can you damage the ligaments by walking too much (including stairs) or does this just aggravate the area and cause inflammation but no real harm?

I might add that I've been able to walk around the house and climb stairs foot over foot for almost a week without support.  The flexibility of my operated hip has improved significantly and I remind myself constantly not to violate the flexation limitations mandated by Dr. Pritchett.  Last night, without thinking, I rolled onto my operated hip side (I'm a side sleeper) for the first time.  I immediately rolled off but couldn't help but note that I am definitely not ready to attempt laying on this side.  I have been testing my non-operated side with a pillow between my legs for a week but my hip starts aching quickly so I still have to sleep on my back.  At night I wake up frequently and find myself constantly readjusting pillows, legs and hip positions throughout the night.  Last night, however, I managed to lay on my non-operated side for 15-20 minutes which is a new record by far. 

Another question, for anyone who might be in the know, is when will it be safe to start laying on the operated leg side?  Can it be sooner than the 6 weeks post-op mark which I believe is when I was told that I can forget about flexation restrictions.

Any feedback will be appreciate.
RBHR, Dr. Pritchett 9/13/11

Luanna

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Re: Mending Ligament Pain?
« Reply #1 on: October 01, 2011, 08:06:38 PM »
I'm a week ahead of you and I have muscle soreness and some tendon tenderness. It's getting better but recovery takes some time. If you are unsure contact Susan - your care coordinator and she'll give you a pep talk.

Dr. Pritchett told me to follow his restriction guidelines so that the ligaments And tendons heal well around the hip capsule. Everyone heals at their own rate. I was getting a little anxious around the 3 week mark but now at 4 1/2 weeks I can see some real progress.

Best wishes for a speedy recovery!

Luann

Are you working with a physical therapist yet?
RHR 8/30/2011 - Dr. Pritchett - Stryker Trident Shell /X3 Poly liner acetabular cup. BHR head.

morganedwards

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Re: Mending Ligament Pain?
« Reply #2 on: October 01, 2011, 11:44:29 PM »
I have a prescription but haven't looked into any PT that specializes in resurfacing.  Any suggestions?  I'm on the Eastside.
RBHR, Dr. Pritchett 9/13/11

Luanna

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Re: Mending Ligament Pain?
« Reply #3 on: October 02, 2011, 12:28:40 AM »
I'm on the Eastside too. I'm going to a PT who is fairly alternative and I'm still assessing. I don't have any other references but will search around and see what I think when I get my prescription renewed at 8 weeks. The clinic I go to right now is Alpha Physical Therapy in Woodinville and they do things like "nerve mobilization", and something they call "Feldenkris" and other manual manipulation techniques.

It is interesting - when I leave a session everything feels really good. She works with the nerves and opens them up somehow. She also does some other muscle stuff as well but we don't exercise during the session. I do the exercises at home and she provides input on technique if I have a question. I don't have an opinion on it yet, but it definitely does something positive. She used to be a regular PT type but has moved into and specializes in manual techniques that are very gentle and do not cause any discomfort. I'm for that right now.

I wonder if Susan can recommend some good standard traditional PTs for you on the Eastside.

Luanna
RHR 8/30/2011 - Dr. Pritchett - Stryker Trident Shell /X3 Poly liner acetabular cup. BHR head.

morganedwards

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Re: Mending Ligament Pain?
« Reply #4 on: October 02, 2011, 12:48:57 AM »
My plan is to ask Susan as well.  I had rehab on my knee about 5 years ago and felt it was a waste of time so I quit after a couple of sessions.  I had a real problem with my range of motion from having a bum knee for some years.  The trainer, however, focused on the measurements of my thighs finding that my "bad" leg was 1/2" smaller than my "good" leg.  She had me sit in a armless office chair on wheels and push myself around using only the bad leg while she worked with other people.  Figuring I could do that myself I quit going.  I later found out that the surgeons at the orthopedic clinic I used all owned the PT business together.  I found this to be a tad self serving and was annoyed that this wasn't disclosed to me when they gave me the perscripton and recommended that I use their business.  I'm going to make sure that this time around I find someone who specializes in hips, knows what they are doing, and will give me the time & attention I deserve as a paying client.  Keep in touch and we can compare notes  :)
RBHR, Dr. Pritchett 9/13/11

DGossack

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Re: Mending Ligament Pain?
« Reply #5 on: October 02, 2011, 05:11:35 PM »
Morgan-

You are at only three weeks so you will definitely have some pain.  I think it would be tough to do any serious damage to the ligaments without some quick and large movement which is difficult to do.  As Luanna said in another week or two I think you will notice a big improvement.  It is important to keep moving and keep icing.  You do want to stretch these muscles and ligaments so the scar tissue doesn't take hold and restrict range of motion later.

PT can definitely help if you find a good one and you ask for what you need.  Many of the ones that work with hip patients are used to working with older people.  So make sure they give you what you need.  I found one that specializes in athletes.  I asked them not to spend time having me do the exercises because I am very good at doing them on my own.  I use my sessions so they can evaluate my progress and give me new exercises and stretches.

I would ask Susan about the Aleve.  I though Pritchett didn't like the use of ibuprofen and similar NSAIDs.  I switched to acetaminophen after surgery for pain control.  But still ice is the best.

There are no restrictions on sleeping on your side, even the operated one, except for not letting your leg cross the centerline.  So putting the pillow between your legs is very important.  Sleep was one of the most difficult things for me because I am a side sleeper also.  I had very similar experience as you had about the same point. 

Best wishes.
Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

morganedwards

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Re: Mending Ligament Pain?
« Reply #6 on: October 02, 2011, 07:03:54 PM »
Hi Dan,

Thanks for the comments and advice.  I stopped taking Aleve in favor of ibuprofen on a need only basis. 

I went to Costco yesterday and spent close to 3 hours taking my time between the food court (I love Costco's polish dogs loaded up with condiments!) and walking the aisles.  I moved slow and leaned on the cart a bit and comparatively speaking, felt really good.  It wasn't until after I got home and foolishly carried some heavy items that I strained my hip a bit.  This caused some nighttime aching but this morning I'm walking the best yet!  Maybe I've been too cautious or I'm turning the corner on healing.  In any event, I plan on walking more today to see if yesterday was a fluke or not :)

Best regards -- Morgan
RBHR, Dr. Pritchett 9/13/11

morganedwards

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Re: Mending Ligament Pain?
« Reply #7 on: October 02, 2011, 07:08:00 PM »
Dan,

I forgot to ask who you are seeing for PT.  I was playing basketball 4-5 times a week up to my surgery so seeing a therapist who is more sports oriented would be of interest to me.

Morgan
RBHR, Dr. Pritchett 9/13/11

John C

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Re: Mending Ligament Pain?
« Reply #8 on: October 02, 2011, 07:44:45 PM »
Hi Morgan,
If Dr Pritchett is advising against NSAIDs, ibuprofen is considered to be an NSAID, just like Aleve. Acetaminophen (like Tylenol), is one of the few over the counter pain medications that it not an NSAID.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

morganedwards

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Re: Mending Ligament Pain?
« Reply #9 on: October 02, 2011, 07:56:00 PM »
I sent Susan from Dr. Pritchett's office an email asking if it was OK to take 2 Aleve at a time for inflammation and she replied that it was.  This was after my 14 day aspirin regime for clot prevention.  I had also minimized my use of Oxycotin and Oxycodone to the point where I had skipped a few days although I did resume taking 1 of each at bedtime.  Lately I've been taking 1 Oxycodone and 1 ibuprofen at night.  I hope to stop taking anything sooner rather than later...
RBHR, Dr. Pritchett 9/13/11

DGossack

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Re: Mending Ligament Pain?
« Reply #10 on: October 02, 2011, 10:18:54 PM »
Interesting regarding Susan's reply about Aleve.  I thought I had asked about taking NSAIDs and Dr. Pritchett said he would avoid it.  I have my follow-up on Monday and I will ask.

I am in Oregon so I am seeing a PT in Salem.  Probably not very convenient for you.  You should be able to call around or ask people to find a good PT with a sports background.  You may even want to ask one of the local high schools since they usually have a PT they use for their sports teams.

In my experience the vast majority of people tend to do too little and not too much.  The body is pretty amazing.  I learned long ago the difference between good pain and bad pain.

Best wishes.

Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

hernanu

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Re: Mending Ligament Pain?
« Reply #11 on: October 03, 2011, 01:39:49 AM »
Morgan, I used a traditional PT that I was referred to by my surgeon, and found that their exercise regimen worked really well in promoting both ROM and strength. I of course also walked and did my home PT exercises, following the whole thing with a personal trainer for about a month after the PT was done.

I think you can definitely overdo it, but I think a PT who is either knowledgeable about resurfacing or is willing to learn (like mine was) is important. Mine had handled THR patients before, but was both excited and very active in researching how to deal with a resurfacing patient. I was very pleased with the whole process.
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

morganedwards

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Re: Mending Ligament Pain?
« Reply #12 on: October 03, 2011, 03:13:23 PM »
Hernan, Thanks for sharing your positive PT experience.  I wish I could say I have been as regimented as you in doing my home PT.  I reread my initial blurb and realized that time has been moving very slowly for me because I mistated my post-op time -- it's 3 weeks tomorrow... 

At this point I'm very happy with my progress.  I can now walk pretty much limp-free if I concentrate which was impossible pre-surgery.  I went for my first real post-op stroll yesterday (at least a mile if not a bit more) in our neighborhood which included some up & down and didn't suffer any consequences.  My goal was some distance, not speed.

I did experience a couple of twinges in the ligament area but this was self induced by stepping over a low barrier.  My walk didn't impact me to any significant degree although afterwards I coughed a couple of times while walking around the house and got a sharp twinge in my hip.  My ligament tenderness isn't gone yet but it's definitely getting better by the day.

As of this morning, I'm excited about my progress for the first time!
RBHR, Dr. Pritchett 9/13/11

Luanna

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Re: Mending Ligament Pain?
« Reply #13 on: October 03, 2011, 03:44:33 PM »
Hi Morgan,
Good to hear that you are doing so well. That's Great!!!!

Cheers,

Luanna

P.S. Susan told me to "ice, elevate, and use ibuprofen" as needed.
RHR 8/30/2011 - Dr. Pritchett - Stryker Trident Shell /X3 Poly liner acetabular cup. BHR head.

hernanu

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Re: Mending Ligament Pain?
« Reply #14 on: October 03, 2011, 04:55:10 PM »
The twinges will continue as you challenge your system - I still get some every now and then, but keep an open line to your surgeon's office. I had absolutely no problem calling for anything that worried me, which kept my state of mind calmer. Having said that, remember that your body has been massively manipulated, and it will take time to heal and improve.

In my opinion, you are fixing the following:

1. Your muscles that were manipulated during your surgery, both large muscles and smaller, which IMO, require more work to restore since most traditional exercises deal with the larger muscles.
2. The muscles that have atrophied or become weaker during the years of impact with OA. With the reason for pain now gone, they are being called into service again, and will need time to become alive again.
3. Your mental state. I was frequently depressed and gave up on things that I did not want to give up. Restoring this to a positive state was a challenge for me, something I worked hard on before and after the surgeries. It drove me to be as proactive as possible; I think we're all doing this, as evidenced by being on this site and talking to each other.

Good luck, you sound like you're on the way.
« Last Edit: October 03, 2011, 04:56:39 PM by hernanu »
Hernan, LHR 8/24/2010, RHR 11/29/2010 - Cormet, Dr. Snyder

morganedwards

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Re: Mending Ligament Pain?
« Reply #15 on: October 03, 2011, 05:20:40 PM »
Hernan,

Appreciate your insights!

Morgan
RBHR, Dr. Pritchett 9/13/11

morganedwards

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Re: Mending Ligament Pain?
« Reply #16 on: October 03, 2011, 05:27:56 PM »
Hello Everyone,

I'm curious if others have experienced a ligament or tendon tightness directly behind the knee?  About a week after my surgery I started getting really sore around the knee area but particularly on the ligament/tendon bands directly behind it.  This has subsided considerably now but hasn't gone away yet.  I asked Dr. Pritchett about this last Tuesday on my 2 week post-op and he said this was normal along with substantial bruising.  Makes me wonder if this doesn't get strained during the surgery and then is made worse by immobility.  I did like his answer about bruising which is he prefers to NOT use a drain tube but rather allow the body to reabsorb the fluids.  My bruising is almost 100% gone now -- just a bit around my ankle.

It would be nice to be provided an in-depth "typical patient" post-op reference guide on what to expect over the first 2-3 weeks following surgery (e.g. swelling, immobility, tenderness, extensive bruising, ligament pain, etc.).  You'd think this could save doctors a lot of questions.
RBHR, Dr. Pritchett 9/13/11

DGossack

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Re: Mending Ligament Pain?
« Reply #17 on: October 04, 2011, 03:20:48 AM »
Morgan-

I definitely had the pain behind the knee.  It seemed the pain moved around my legs along with bruising.  I had outside thigh pain, knee pain, groin pain, hip flexor pain, high glute pain, lower back pain, etc.

The last couple of weeks it has really only been some occasional soreness in the hip socket.

Best wishes

Dan
LBHR, Dr. Pritchett, 8/1/2011
fullmetalhip.wordpress.com

Tin Soldier

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Re: Mending Ligament Pain?
« Reply #18 on: October 06, 2011, 09:00:42 PM »
I was told the same by Pritchett to stay away from NSAIDs for a year. 

I had pain in the leg as Dan mentioned and it moved around, but it was simply surgery pain.  It followed the bruising.  I do get some tightness here and there, but I think that is just muscles and tendons figuring things out again, as Hernanu points out.

I starting sleeping on my operated side at about 3 weeks, for short bits and with pillow betwen legs (I still do the pillow at 6 weeks and probabaly will for awhile).  The operated side is still pretty swollen and uncomfortable at 3 weeks.  It might not look that way, but as soo as you put your body weight on it, it hurts.  I think it'll take you another week or more to feel comfortable on your operated side. 

Definitely do PT and if you can find one that knows a thing or two about HR, or even THR. My PT is in Eugene, OR and so that won't do you much good.  I think he had to shut down early today because of the U of O football game wich consumes all the medical facility parking near the stadium.  He was wearing his duck shirt today and then I made a comment about being a Beaver fan when he was mobilizing the hip capsule.  Then he really gave it to me, Yousers.   :-\   
LBHR 2/22/11, RBHR 8/23/11 - Pritchett.

 

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