is this normal???

[Andyday101]

It's been 5 weeks since i had a resurface on my right hip but as of yet no physical therapy.Is this normal??

[hernanu]

Hi Andy, welcome to the site!

It is normal for some surgeons, some who are very good. It depends on their approach to recovery.

There's several different approaches that surgeons use, some don't want physical therapy for their patients, preferring to give them exercises to do, walking and more walking.

Others (like mine) arranged for me to have home PT and outpatient PT right out of the chute. We talked about it before the surgery, and they arranged with providers they knew for home and then a handoff to the outpatient.

So I started right after getting home and through until about three months out.

But there are plenty of very good surgeons who don't have PT involved. Have you talked to your surgeon about it? It's probably the place to start. They should have given you some exercises to do and a plan for walking, driving, etc.

Who is your surgeon?

[Miguelito]

There appears to be quite a variance in post-surgical protocols regarding physical therapy.

The big fear post-surgery is a fracture of the femur. Very small chance of that happening, but as that typically results in revision to THR, some doctors (including mine, Dr. Gross) restrict certain activities for the first six months after surgery. While I think many physical therapists would do, and do do (ha-ha) excellent work with HR patients, I think there is concern that a physical therapist who the surgeon doesn't know may not be up to speed on HR and could do something that might jeopardize the head of the femur. I was an out of state patient so Dr. Gross could hardly be expected to know anything about my local physical therapists. Also, regardless of what the PT does or doesn't know, the head of the femur is at-risk for a period after surgery, and many (I imagine most) surgeons recommend great caution concerning it.

So few people get HR in the U.S. (relatively) that I am sure there are even some physical therapists who are not familiar with the distinction between the two surgeries (though I bet most are). With THR there is no post-surgery risk of fracturing the head of the femur as there is no head of the femur.

I started with PT at six weeks and did once a week for two or three months. I really hadn't intended to, but I went to a PT practice for a diagnostic to report back to my surgeon, and they misunderstood, thought I was coming there for PT and I was just too much of a wuss to correct them... I made sure to discuss the surgery and my surgeon's restrictions with all of my therapists (there were three of them - they kept leaving the practice, so i finally gave up and did as well). They were all very capable and I thought PT was very worthwhile, though mainly to keep my nose to the grindstone about walking, light exercises, etc. I had been a real slug until that point.

To echo Hernanu's post, post-surgery protocol is really up to the surgeon. So check with him (or less likely, her) and proceed accordingly.

Mike

P.S. Sorry. Was a little flip. The proximate cause of my stopping PT was the birth of our third kid. Yeah, the PT's kept turning over, but it was really the kid.

[curt]

Lots of stories about other people getting PT, but Dr. Gross did not prescribe any for me either.  Basically, I got the order to walk, walk, walk and do the limited exercises that he provided to begin strengthening the hip muscles.
In the beginning I felt a little jipped by NOT having PT.  The idea of having someone else motiviate me and give me feedback was appealing.  Looking back, though, I feel that if you do the basics diligently, it is more than enough to get you on track for a good recovery.
Downside is that you have to be your own therapist and that kept me from being hard enough on myself in areas that were slow to respond or I was too lazy to push.
At 18 months, though, I am confident that the no PT approach has not left me behind and I'm doing just fine.

As a thought, a few sessions to show exercises and techniques from a PT experienced with HR would probably be beneficial.  I had to replace that with recommendations from people on this site like Hern (still appreciated greatly!).

Good luck, Curt

[imgetinold]

Andy,

I, too,  am a Gross hippy, given a list of at-home exercises only and told to walk.

I followed this religiously for about 3 1/2 to 4 months, then I requested the Dr. Gross give me a prescription for PT, which he did.  But, it was strengthening ONLY, no range-of-motion.  I'm not sure how great the PT was that I saw, but it really did help me quite a bit.  I went from a lot of "clunking" to very little, and did get noticeably stronger during that time.

I also liked doing the PT later, as I was able to identify some specific shortcomings and goals by then.  Like Curt, I don't think the lack of early PT set me back at all.  By the time six months came around, I was ready to go.

Good luck.  And....patience....

[Andyday101]

Thank you all for your replys.

Dr kim in Kennesaw was who did my BHR i have asked him and his staff but no one would take the question head on and went around it. I have a very good PT near me that i have been too after my last hip surgery . He is great works you as hard as he feels is good but never pushes too far.
     Dr kim gave me the very basic things to do at day one but that was it never told walking was good (got that from posts here).

  As for Dr kims work i think it's great i have had no problems i was walking with a stick after 3 weeks then at 4 weeks diched that and just trying to loose the limp just around the time Dr kim wanted me to drop the cruches(one stuben ass here).

  I just found it hard to beleave that after such major surgery not to have PT.

Thank you for all your help

[hernanu]

Does your PT have experience with hip patients (THR or HR)?

Mine had a lot of experience (the whole practice did) with THRs, but I was their first HR. They did a lot of research on it, were excited to have me there and were all learning as she treated me.

I think it helped me as long as the restrictions were taken seriously and no manipulations of the hip are done, as well as watching the load on the hip. I did no weights of any sort, the bulk of it was light massage, stationary bike and walking, strength by (my) raising the legs, balancing, core work on a pilates ball, squats (to 90 degrees) supported by the wall, using bands around the ankle, clamshells, walking on the track, etc. It was more than enough.

I did start doing very light weights (leg presses) at about three months, some stretches (light again) at that time, but always carefully supervised. No manipulation of the hip.

I was happy with it, but would have stopped them immediately if I felt something was even close to threatening my shiny new hip.

Again, though - many hippies have not had PT, just walked and did other things at home and have done very well  (I did the home PT exercises long past the point of needing them).

[luann again]

Hi - DO  ask your surgeon about it! Having said that, I did not receive any PT either and I am doing fantastic at 2 yrs 9 months post op! I WAS however, given exercises to do, totally on my own, at home.  I was also advised to walk as far as I could comfortably, every day. You will do fine. Call your Dr and follow whatever instructions that are given. Chin up! Lu