Balance

[Lauren Lee]

Tomorrow is four weeks for me. I am still using a cane and was supposed to return to work a week from tomorrow but since I drive a lot in my work, in and out of the car, uncertain terrain...I think I should wait til I get the restrictions lifted.
One thing is kind of troubling for me...when I stand on my operated leg and raise my unoperated leg off the floor, I am very unsteady and have no balance. If I am holding onto the counter I can do it, but as soon as I lift my hand I start swaying. Since this is one of my PT exercises I suspect that this may be a common thing but I have noticed no improvement since I started doing it a week ago. I walk well with a cane but when I try to walk without it I have a feeling like I am leaning to the right or that my legs are different lengths...it is hard to describe. On the treadmill or with the cane my gait is pretty normal until I get tired and then I get gimpy again. I waddle if I try to walk without the cane.
PT worked me over pretty well last week on my first outpatient session and I had muscle pain for a couple of days afterwards and laid pretty low.
When is it realistic to expect that waddle to go away? Thanks to all of you.

[Marco Polo]

Lauren:  I didn't have the exact symptoms you describe but I did initially have a harder time balancing on my operated leg than on my non-operated side.  I know I had some atrophy in my quad muscles on my operated side as a result of favoring the hip and I also needed to strengthen the muscles that stabilize the hip.  My situation resolved itself through exercise (walking and stationary bike) and PT.

[packman]

Smart move on not returning to work if it involves a fair bit of driving. Took me about 7-8 weeks post -op before I felt comfortable driving in a car more than 30 minutes. Found my operated side had a small annoying ache from being in one position on the gas pedal and inability to stretch (even if I faked moving to the brake or on limited cruise control).
As to standing on one leg and balance or walking extended lengths, you are continuing to build strength - I would advise just be careful on your expectations - when you get tired, suspect your muscles and mind are trying to protect you from further injury by shutting down a bit.
Look for progress in tiny increases 10 seconds longer, or several minutes further walking each couple of days.
I suspect weeks 6-8 you will have major break throughs

[Juno]

I can't wait to be 4 weeks out! Good for you!

Dr. Gross told me, before leaving the hospital, he expects his patients should be able to walk 1 mile at 6-7 weeks with a limp. He said at 3 months he expects you will be able to walk any distance without a limp. So, to me this means that at 4 weeks you are right where you should be -- the muscles get taxed and tired and the limp occurs. You are building up muscle strength and increasing muscle fibers -- it takes time.

Balance is all about core strength and muscle strength. The gluteus, quads, adductors and adductors are all considered core muscles. Once you build them back up, your balance will return. Thee is also just a sense of trusting your body as well -- I believe that comes with time too.

You're doing great!

I started with only one crutch this morning. 5 days post op. Today is my first day home alone....hubby got me all set up and went off to work for a few hours. So far, so good!

[hernanu]

All pretty normal, Lauren Lee - I began outpatient PT at four weeks both times and was, as expected, "challenged" in balancing exercises, which they launched on right away.

I was their first HR patient, but they had had many THR patients, and it was a common theme. They seemed to think I was ahead of the game, despite my initial inability to balance correctly.

My balancing exercises were:

• At four to six weeks, balancing on both the operated and unoperated leg for up to a minute. That was the goal - initially much less than that.
• At six to eight weeks, balance barefoot as above
• At eight to ten weeks, balance on a foam pad to force instability. A home small pillow works just as well
• At the end, all the above, but holding a ball and doing figure eights in front of you while balancing
• I do the above now, but while juggling.

It takes a while to overcome the muscle atrophy, relearning what were instinctual movements, etc.

I even took it to shaving while balancing on one foot after six months. Really keeps that focus. 

[Lauren Lee]

Thanks! I guess I won't get too wound up then....just keep plugging away. One foot at a time.
Yes Hermanu I guess holding a razor to your face would help you keep your focus. I won't be trying that. And the juggling LOL...I have always been challenged in the motor coordination area so I won't be trying that either. I'd bop myself in the head and wind up with a bigger problem.
I've done a lot of reading on this site and the docs all have such different protocols for restrictions and PT. As long as we all wind up where we want/need to be I guess how we get there isn't the issue. Thanks again.
Juno, a day all by yourself!!! Enjoy it!! I know the first day I spent alone was LOVELY!

[trgcfrg]

I also experienced some of the same things you experienced, Lauren. My first operated leg felt like it was longer than my non-operated leg for between 5-6 weeks. When I got my second BHR seven weeks after the first, I never had that sensation. I'm not sure if it's because I already had a BHR on the other side or because I did a better job icing in the beginning (I used MUCH bigger ice packs and was more aggressive about always icing) of the second surgery.

Balance and non-waddling took between 6-8 weeks to get better. I went off the cane at close to 5 weeks, but the difference between week 4 and 5 was significant. My PT said there was too much limping to go off the cane any earlier. Even after I went off the cane, I would say it took until week 7 or 8 until I've started walking with a more normal gait. At 8 weeks after my second surgery I'm still seeing improvements in strength and confidence in my gait, and walking is feeling less unpleasant (i.e. due to less muscle soreness, calf pain, or knee pain, etc.).

I would say you're in line with my experience and what I've read from others, so I would expect to see significant improvement in all these areas over the next 4 weeks or so. Good luck!

[bestbob]

Hi All,

Tomorrow is 4 weeks for me, 1 day later than Lauren. Anyway,within the past week I am now able to sleep on my non-operated side for a couple hours, and what a relief that was. As far as balancing and walking with/without a crutch or cane, I am still on 2 crutches as my doctor has a 6 week restriction and only allows 75% weight bearing so as not to risk a femur neck fracture. I have tried walking with one crutch, and can go a couple of steps, and even a couple without a crutch, I then get scared because I for one do not want a fracture. I did start to work 20 hrs a week from home last week (desk job), and my goal is to go to work Aug 1st. I am probably progressing slower than a lot, but I just feel that my body is saying to go slow, plus I still get that darn pain from the bottom of incision to the knee every now and then, which is why I am still on the narcotics. 

Juno, sounds like your moving right along in a positive manner.

Bob

[Tin Soldier]

Lauren - I think the balance thing has more to do with the brain's reconnection to those muscles in the hip than the actual physical strength of the muscles.  I base this on what my PT would talk about a lot at this stage of recovery.  Balance and full weight on the new hip should feel weird and uneasy at 3 to 4 weeks,  and I think it will take a few weeks of balance exercises to notice improvement.  Although I bet the change might be dramatic once the brain and muscles get back in sync.

I felt very uneasy at 4 weeks on the operated hip, the first time.  The second time I thought I had it all squared up at 4 weeks and did a bunch of walking in Salt Lake for a week with no aids.  That was not good though, ended up with a lot of soreness that I think lasted longer than it should have.   

[Lauren Lee]

What is kind of strange is that I can hold my balance (for a minute) if I do the yoga tree pose. (Shift weight to R operated leg, rest left foot on lower r leg). But as soon as I take that foot off the leg...I'm all wonky again. You would think that putting the additional weight of my foot on the r leg would make it even harder but it doesn't. I am very much a beginner ( I couldn't move beyond that   because..... my hip wouldn't move...soooo looking forward to seeing what I can do when I can).I hope I'll be able to advance after restrictions are lifted and I am recovered fully.
My therapist is allowing me (for now) to do this little cheater bracing thing until the muscles get stronger or...the brain muscle thing kicks in as Tin Soldier theorized. I still try to balance free standing though more than I do the "pose".
I am so glad I found this site and am not a lone ranger in recovery.

[Marco Polo]

Lauren - It's interesting that you bring up the idea of resting your leg on the one on which you are standing.  I was doing that to maintain my balance and my PT said that was too easy and she made me balance with the leg off the ground.  She also preferred that I hold lightly on to something rather than rest my leg on the other one.  I wasn't able to balance like this for very long at first but it got easier over time.

I am sure you will make progress as your muscles strengthen and help stabilize your hip.

[brianebanta]

Lauren,

I will echo what Hern was saying.  I am at 8 weeks right now and for the last 4 weeks in PT I have been working on three things, core, balancing, and stretching the hip flexor.  I have noticed a huge improvement in my balancing even just the last two weeks.  One other trick I used when coming off the cane and crutches was to do walks with my trekking poles nice and slow and using them for balance.  That combined with the uneven streets I think really helped my early on balance.


Sounds like you are right where you need to be.  Tree, pigeon, and king dancer pose can wait.  Or as my friend said... "The Ocean will still be there when you are ready."

I keep telling myself slow and steady.

-Brian