Physical Therapy / Recovery Training

[cgraves]

From this web site I have learned that there is a very broad band width of individual recovery experience and progress.

I am looking to share the physical therapy recommendations and rehabilitation experiences. 

The doctor has prioritized the standard hip precautions and hip stability with ROM secondary. 
Out-patient physical therapy 2 times per week.
I have been very disciplined to the prescriptions and comply with the recommendations of the doctor and physical therapist. 

Today is 30 days post operation to the right hip resurfacing.

At this stage I am walking with a cane, mostly for security, and occasional support.

Walks: 2 x per day about 1/2 mile each walk on sidewalks,
          I try to walk up an down a gentle grassy slope for 5 to 10 minutes while on the walk.

Exercises:  Half squats (less than  90 degrees of course) 3 sets 20 each, twice a day
                Various front, side and rear raises, sometimes with ankle weights of 1.5 pounds.

Stairs:  practice going up and down 10 steps,  2 x per day 4 / 5 times
           down is no problem
           up requires a slight toe off left foot.

ROM:  With best effort I can get to 75 or 80 degrees.

The resurfaced hip is pain free. Minor soreness end of PT.
The right knee is sore on the walks, the hip pain, decreased mobility and compensating gait over the years may have masked a knee problem.

What are others doing ?
Including a disciplined approach to all precautions.
How much PT ?
What strengthens recovery ?

[austin.m]

I'm glad this topic has been broken out, as I've been wondering about PT myself. I did PT twice a week for 4-5 weeks, but then stopped - partly because my insurance ran out and partly because it didn't seem demanding enough. I had both hips resurfaced at the same time (about 11 weeks ago) and have been really pleased with the result. Have been walking unassisted since week 3 and having no problem with long (5+ mile hikes) and indoor cycling (1-2 hours of spin class). I didn't have the 90 degree restriction - doctor said just to be guided by pain and no impact (running or jumping). No real pain whatsoever since surgery. I did have a bit of knee pain - as you mentioned, think the years of compensating for my hip may have caused problems elsewhere - but lots of walking and cycling seem to have taken care of it.

So strength seems fine - but I'm not so sure about my flexibility. I'm able to tie shoelaces, touch my toes and do squats easily, but I'm thinking of trying pilates and yoga to try to improve on this front. Maybe I should have stuck with PT longer to work more on flexibility? Pilates seems to make the most sense, as you can use the equipment to really control the stretching. Would love to hear what people have done - on their own and in PT sessions - for flexibility purposes.

[Pat Walter]

Hi

Don't forget that water walking, and exercises and stretches in the water are also very helpful.  Here is the set I used  http://www.surfacehippy.info/poolexercises.php I was lucky to have a large maybe 30 x 30 foot heated therapy pool availabe. It was 92 degrees and about chest deep.  I really enjoyed just the water walking the most - forward, backwards and to the sides.  I just did laps around the pool.

You don't have to be in a therapy pool to do some water walking.  I was really stiff at about 6 weeks when I did the pool therapy.  After a few weeks, I had no stiffness and it never came back.

Good Luck.

Pat

[xocy]

Austin M., I need to know more. Please provide as many details of your rehab as possible. How old are you? What is your height and weight? Were you an athlete prior to the hip problem?

I'm sitting in a hospital in Columbia, SC after having one hip done yesterday and will have the other tomorrow. I will answer anyone wanting to know more about the experience. Just send a personal email thru surfacehippy.info.
City2South was in the room across the hall. We had out picture made together and maybe we can post it on the website. She only had to do one hip, so she has goen home.

In addition to rehab, I am interested about a diet that will help in rapid healling. Any idea?

Mike

[Pat Walter]

Mike

Good Luck on your surgery tomorrow. 

Pat

[austin.m]

Mike - hope surgery goes well. I was very active (soccer, basketball, running) prior to the osteoarthritis hitting both hips - then was reduced to cycling, but was riding 250-300 miles a week and entering 100 and 200 mile rides pretty regularly, so my leg strength and cardio were good. I'm 52, 6' and 170 lbs and did both hips in the same procedure (Dr. Vail at UC San Francisco - excellent). Dr. Vail tries to go in around the muscle, and I felt almost as if no muscle strength had been lost (all surgeons may do this, I don't know). Did a few days on a walker post surgery, then crutches then cane - but was walking without any support by day 21. I had a set of PT exercises which I did (overdid) religiously, but progressively longer walks and indoor cycling have helped a lot. Now at 11 weeks, I'm walking further than I have for 10 years (find some hills, they seem to help) and I'm back to the 1-2 hour spinning classes at almost the intensity I was at pre-op. Not allowed any "impact" yet - so no jumping or running. Looking forward to soccer in the fall and skiing in the winter!

As I said, the strength part has come easy - but I think I need to focus more on flexibility - so I'm looking into Pilates as a nice, easy way to start stretching things that haven't been stretched in many years. Also thinking about getting back to a more athletically demanding style of PT. Just not sure what the best path is.

[cgraves]

Too tight to walk correctly

Age:55 5 ft 9 inches Active Lifesytle

Post-operation rt hip resurfacing 34 days

06-27-08 Physical Therapy visit

As I reported earlier I have been very diligent about following all activity movement and PT exercise prescriptions.
Overall the new rt hip is feeling better and stronger. 

New rt hip is pain free
Rt knee was sore, but better now because I got a shot in it on Tuesday
Rt upper butt is sore
Lower back is sore

The rt hip was tight before surgery, but not this tight.
The new rt hip does not move much without the pelvis. 
New rt hip bend angle maximum bend is less than 80 degrees.

Since I cannot move the new rt hip correctly, the Physical Therapist is suggesting that PT begin pushing
the new rt hip to increase the ROM.   

I will be seeing my doctor July 1 to discuss this.

Is this due to the new rt hip ?

Is this all due to soft tissue limitations ?

How can I find exactly what is wrong ?

What is recommended remedy ?

Any one else out there experience this ?

My best to all the surface hippy's.

[Pat Walter]

Hi I am sorry to hear you have such a tight hip.  You are still only 1 month post op so I think you may just be slow in healing and getting back to normal.  I am not a doctor, so I really can't tell you anything more than that.

If you are having muscle problems, I think your doctor needs to tell you what to do.  Hopefully, some more PT will help the hip.

I don't think any of us can answer your quesitons, unfortunately,  I would get good input from your doctor and go from there.  Some people have had long and difficult recoveries with a lot of muscle problems.  So your are not alone.  Most people don't have this type of problem, but some have and I have put together a page of people with difficult problems http://www.surfacehippy.info/groinpain.php   Maybe that will give you some idea of problems other people had and what they did about it.

I still would not be too upset this early on. YOu have a lot of healing to do yet and most people have quite a bit of stiffness and lack or ROM.  Maybe you are just going to be one of the turtles. 

I wish you the very best and hope you will keep in touch.

Pat

[cgraves]

Pat,

Hi back.
Thank you very for the response and feed back.
I am okay being a turtle. Don't some live to be 125 years old plus ?

Thanks again,

[CITY2SOUTH]

Hey Mike,

So you miss me huh? I can't get over how fast I am recovering. I still have tightness in the hip but no OA pain. My incision is super itchy and feels tight. I'm getting around the house with one crutch and at times none. My limp is bad when I don't use crutch. I ordered a funky pink cane and look forward to getting that in the mail tomorrow. Sorry I had to leave you up in Columbia but I am sure the nursing staff and Joe from PT took good care of you. What a Hottie! I barely use the ADL kit that Nancy talked me into purchasing. I use the grabber thingy when I can find it but my son has taken a liking to it as well. I can see why Dr. Gross doesn't require formal PT. It would be a waste of money. You can do all the exercises on your own and I think PT would push you harder then Dr. Gross would want. I do wish he allowed water therapy. (no submerging for 4 weeks) I've read plenty of posts including Pat's that say how wonderful it can be. We have a jacuzzi in yard and also access to indoor/outdoor pool. Not sure about a healing diet but I've been enjoying home baked cookies that friends bring over. I'll send you our picture to your aol email. How is Mary? I am sure you are driving her crazy. Keep up your exercises and get out and walk. I'm sure it is just as hot in GA as in SC so best time to walk is in the early evening. Take care buddy! Lisa (AKA CITY2SOUTH)

[xocy]

Hottie!! You are referring to me, of course. LOL

Mike

[CITY2SOUTH]

Ummmmmm Yeah Yeah!!!! Hottie!!!!!!!!!!!!

[xocy]

Now Mary is laughing, uncontrollable in the floor. I can't imagine why. LOL

[cgraves]

Physical Therapy / Recovery / Big Change

Up to 39 days post op
PT was not going well
hip mobility very low ROM 30-40
lower to upper back pain very tight
no walking and limping
getting depressed
maybe I was over doing things ?

Sunday June 29 went to ER
big shot of muscle relaxant
felt big "release"
pinched nerve ?
body realigning ?

Monday June 30 - Sat July 5
no pain
hip mobility increasing 70-95
slight lower back pain
walking better than ? perhaps 20 years
confident on the road to recovery

Doctor advised: walking and ride stationary bike, start with seat high, progressively lower seat to increase ROM
This makes some sense

Lesson: Even with a good surgeon and done right
           As Pat suggested, patience with your body healing
           Lots of stuff going on differently with each person
           More stuff wrong post op, may increase recovery time and issues
           It appears PT programs may be in need of catch up
           

[xocy]

I'm just reporting my progress from my bilat resurfacing, Left 6/23, Right 6/25 by Dr. Thomas Gross

From the time I got home I have had a urinary infection and altthough improving, I still have it. Also,my right hip has had a very different recovery, with a different type of pain than the left, much more severe, and much weaker.

Today was much better. I graduated to one crutch all day. I have reduced the pain meds and am hopeful for as much improvement tomorrow.

Mike

[Big Bill]

Well... Yesterday was my 1st post op visit ....resurfacing was on 7/9/08...all is good.    Was released to drive, start my own PT...been doing that already  and ready to see, with common sense and moderation,what else I can do !The  glued incision looks great, just can't get in the pool for another week or so.  ( I really miss the pool)   It needs to be totally healed and scab free. Don't want to risk ANY infection !  Thanks to all for your feedback and personal emails. Time to get out of the house and get moving!

                 Big Bill-- Cormet Anterior Surface Hippy, C.A.S.H.