Need help with anatomy. Pain on outside of hip

[metoo]

I am a two week post op patient.  Things were (and perhaps still are) going well, but I have developed a tenderness/pain on the outside of my hip and I was searching the site to see if this was a common occurrence.  Things have been improving almost daily, so perhaps this tenderness has been there all along and now is just about the only thing to notice.

The problem is that I don't really know what keywords I should use when searching this site.  I have tried a couple of searches but did not find anything that matched.

This is a tenderness on the outside of the hip.  I would call it the point of the hip.  This is forward of the incision and I am pretty sure it is not connected/related to the incision itself.  If you were to bump something with the outside of your hip, this would be the point you would hit.  I started driving to work a couple of days ago and it could be the car seat irritating that area.

When I look at anatomy pictures, the thing that seems close is the "greater trochanter".  Does this sound familiar to anyone?  Any ideas on what to search for to see if others experienced something similar?

Thanks.

[hernanu]

I think that so much is in flux at the two week mark, that you're going to get some aches and pains that will pass, but will worry you as they come and go.

That area in particular is where a lot of manipulation was done during the surgery, so the muscles are offended, distended and just pi$$ed. That doesn't mean you don't pay attention to pain / discomfort, etc. Just that most likely, especially as early in the process as this, you're bound to have discomfort come and go.

No problem with calling your surgeon, though - I would call at the drop of a hat (especially since I couldn't pick it up  ) for anything large or small.

The area you describe is the top of the iliotibial band area. IT band for short, and many of us have dealt with either some discomfort or medium term soreness in that area. I did and still need to stretch that area to prevent any issues.

This image gives you and idea of the area and the muscles involved. There's a lot more muscles there than are shown, so all of those are involved, this is just so you can get an idea of where the soreness might be coming from.



Sounds pretty normal, though annoying. I'd call Dr. Gross just to get your mind clear on it.

[metoo]

Thanks hernanu.

Now that you mention the IT band....  Years ago I had an IT band problem and needed stretching to help it.

Things have been feeling better each day, and I am walking more each day as well.  I returned to work this week, and even though it is a desk job, I walk quite a bit just to get around (go to restroom, lunch, meetings, etc.)   It is a very large campus where I work.  Perhaps the additional walking is what is triggering the tenderness/inflammation.  I caught myself a couple of times hurrying to make an appointment.  Not good.

I have backed off on the walking  today and will be using ice (even here at work).   I suppose I am a little (hyper)sensitive to every development, but this recovery occupies probably 50%  of my attention every day.  If, come Sunday, this is still on my mind,  I will send an email to Dr Gross's office.

Thanks again.  I will do some searching based on your tips.

[jb46]

May just be incision pain. I felt that was only pain I had for longest time...not sure if I was right or not.
Good luck...jb

[John C]

Hello metoo,
What you are describing sounds exactly like something that I and others have run across. For me, it was a major issue for the first few weeks, and then would pop up periodically for the first year or so. Here is my amateur understanding of it from talking to my doctor and others.
That bump you are describing is in fact the greater trochanter. There is a bursa (small fluid filled sack that acts as a cushion where muscles or tendons rub across bones) that sits on the outside of the greater trochanter. When this gets inflamed, we have trochanteric bursitis. My doc prescribed gentle repetitive exercises. If that did not work, a cortisone injection into the bursa is sometimes done to knock out the inflammation.
For me, the real key was figuring out that the IT band runs across that bursa, and that is what was causing the bursa to become inflamed. Stretching out the IT band on a foam roller so that it has less tension across the bursa has led to very good relief for myself and others. I think that what may have started it in my case, is that my leg came out about 4 millimeters longer, so this stretched the IT band extra tight, putting pressure on the bursa where it crossed the greater trochanter. There are many other causes of tight IT bands after this surgery, and trochanteric bursitis is often the symptom. It always seems to go away through either time, PT, foam rollers, or cortisone injections.

[John C]

Oh yeah, and ice

[metoo]

I probed around and the tenderness does not seem like it is associated with the incision.  The incision actually feels pretty good to the touch. It is a little hard (scar tissue probably) but it is not tender.    There is even an area (maybe an inch) between the incision and the tenderness.

One can always use a little luck.
Thanks


 

May just be incision pain. I felt that was only pain I had for longest time...not sure if I was right or not.
Good luck...jb

[metoo]

I probably can't do much to stretch the IT band at this point in my recovery.  Certainly can't use the foam roller.    If I send an email to the Doctor on this, I can also ask whether a hand massage of IT band would be okay, or whether I should just let it rest and work on it later.

Thanks again everyone.

[David]

Metoo,
At two weeks lots of ice and rest is what you need.  Soft gentle massage and your basic pt exercises they gave you.  As time goes on you may continue to have discomfort in both the incision area and the trochanter area which is where many muscles and tendons are banding together.  Movement is best, find a good PT to work with you.
D.

[jb46]

Just reread your original message and took note of the driving part. That really irratates the leg/hip for several weeks, pressing and turning that leg. Put your seat back as far as you can, and lower the angle of the back...think "low rider" or "ghetto driving style". I had several times where I had to pull over cause I was almost seizing up with what I called spasms...which made the hip start "screaming". I'm coming up on six weeks post op and that still bothers me more than anything else...good luck with the healing...jb

[metoo]

Didn't want to be a hit and run poster, so I thought I would give an update on my status. 

I took it easy over the weekend by cutting way back on walking, and I was using an ice pack several times each day.  The tenderness was reduced after each ice treatment, but I could tell that walking around would still aggravate it a little bit.  Still, I was making progress.  On Monday I returned back to work, but cut way down on my walking.  I ate lunch at my desk and was able to use ice every hour or two (probably 45 minutes on ice and 1.5 hours off).  We have a great ice machine at work that dispenses crushed ice.  There was a huge improvement on Monday and now things feel okay.    There is still some tenderness on the outside of the hip, but that is probably normal for what it has just been through.  The pain did not involve the joint or the incision and felt almost like it was on the outside of the point of the femur.  Probably just a problem with the leg getting used to the new geometry as I increased my walking.

I think I will go ahead and email Lee Web to see if there is any specific advice for me.

thanks,

[hernanu]

All good steps in case of a setback. If you look at folks' stories, we all had setbacks of one sort or another, and scaled back enough to resume progress.

[23109VC]

You will have all minds of weird pains in the first several weeks of healing.....don't worry about them.  If something feels horrible...by all means go to the doctor...but I had a lot of pains and funny sensations that I was all paranoid over during recovery.....I would worry something was wrong....and they went away.  I overdid it with too uh walking around the six week mark and I was sore afterward for a couple weeks..lmaybe three weeks.... That too went away.

I'm Over a year post op and doing great.  You will too.

I was hypersensitive to those weird pains....but in retrospect....it's all part of the healing process.  You have to remember how traumatic the surgery is......it's amazing that we are up and walking the next day!  Those odd pai s will come and go.

I remember getting a really weird pain in my knee initially...gone now.
I had a strange pain in my butt / glutes....went away.
I also got that pain in the outside of the hip...it went away.  If I jog or push myself too far...so Eli's that bursitis type pain recurs...... But most of the time I am Painfree and just keep getting better.

You will get better and better very quickly...just don't overdo it.  Err on the side of caution and take it slow. 

Congrats on the new hip.  I love mine.  It changed my life.  Being pain free is wonderful!

[Programmer]

I am six weeks postop and get the same pain from driving.  If I pad up other areas and take the pressure off of the hurting area (while driving), it helps very much.