Knee to chest stretch for operated leg very limited

[Drdan]

I am a 64 y/o male who had a bad labral tear about 2 years ago after kicking the heavy bag really hard in the gym.  The problem was misdiagnosed until I began having more and more symptoms.  A piece of cartilage lodged itself next to my femur head, and moved it superior and medially.  After 2 years, an MRI found deformation of the acetabulum.

I had a left hip resurfacing performed by Dr. Alessandro Calistri, who is Dr. De Smet's protege, and who works mostly in Rome Italy, but also in Belgium with Dr. De Smet.  Dr. Calistri began to perform resurfacing procedures under the guidance of Dr. De Smet in Belgium and in Rome, and has now personally performed over 800 resurfacing operations.

I was able to easily transition to one crutch after 10 days, but am still limping when I attempt to walk without any assistance.  I can walk very long distances with one crutch, but when I finish the walk, my leg is very stiff.  During the walk, I oftentimes walk with the crutch in hand, and I can go for a hundred feet nicely.  I am hoping that the severe tightness after the walk will be less and less with time.

I had problems touching my left knee to my chest before the operation due to the deformation of the acetabulum.  I still have the same problem, and it's probably due to very short muscles that were part of my biomechanical problems during the last 2 years.  Stretching is very painful, but I am doing a seated stretch in which I place my hands on my knee and pull my leg as far as I can toward my chest while keeping my back straight.

I must see Dr. Calistri in about a weeks' time, but wanted to hear from others if all is going well.  I am a bit concerned that I cannot walk without a crutch yet, and I cannot touch my knee to my chest.  I must add that I was at a very high level of fitness 2 years ago - pullups, situps, pushups, running, martial arts, etc.

Thanks for any help and input!

[Pat Walter]

Hi I was a De Smet patient 10 years ago and still going strong.  De Smet rule is use walking aid until you do NOT limp.  If you stop too soon, you could be slowing your progress down.  No one should be trying to force their knee against their chest, certainly not until they are well healed.  You can not force your body to heal, no matter what you do.  Your body has it's own time line of healing.  There was at least one patient that forced his knee to his chest and ended up dislocating it and having a revision.  Give your body time to heal.  Even the best athlete sometimes takes a very long time to heal.  Patience is your most important friend.  Please take it easy and ask the surgeon at what point you should even try to bring your knee to your chest.  Good Luck.   Pat

[Drdan]

Thanks for your input Pat!  I am definitely not going to get into the bad habit of limping.  I will use a cane or crutch until I can walk well.  As far as the knee to chest, I am doing simple exercises without going into the pain.  My ROM overall is improving daily, but the knee to chest is going a bit slower than expected.  Thanks again!

[Tri Hard Alan]

I would (and do) tread carefully where the knee to the chest exercise is concerned and would put that very much as a long term target. I am 9 months post op and can not do this. I am not convinced I ever will be and do not consider it important.


I regularly do that exercise to increase ROM, and it has done, but do not force it, especially in the early days.


There are other more important areas to work on and strengthen.


Good luck.

[rburns]

Hi all,
I am now at 12 months after Dr. DeSmet placed an uncemented Conserve Plus in my right hip. One day I'll post a longer diary of the experience, but for now wish to ask about ROM.
I was very active (55 yr old male) prior to my surgery (tennis, cycling, weights, etc...) and had a slight limitation in ROM (slightly decreased flexion/internal/external rotation). I am doing very well post op as far as activity and lack of pain, however the one thing I cannot do is flexion with my hip in external rotation. In other words, put my right heel on my left knee and bend forward (or lie on my back and cross my right ankle over my left knee and pull my knee to my chest (like a yoga or piriformis stretch - excuse the jargon, I'm a former physio). There is a pain in the groin and almost a mechanical block - it just won't go! I have close to full ROM in flexion and rotations if done in one plane. Is this true for all "hippy's"?
I've been very conservative in my rehab - no impact until this month at all, lots of pool in the first 6 months, consistent program 6 days a week.
Overall really can't complain.....thanks for any feedback.

[hernanu]

For both rburns and Drdan - I think more patience is called for.  It took me a while to get good flexibility back (I'm a black belt in tae kwon do), I figure it took me about five to six months after the surgery before I could touch my knee to my chest. I would just move it up until I felt resistance and that was that.

For hippies and non-hippies, having taught stretching and a long experience in doing stretching, the key is patience. Stretching should not hurt at any time. If you are feeling pain, you are not stretching any more, you are injuring.

My rule of thumb for any stretching is to:

• Do it when your muscles are warm. Do it after you've done some light activity, not before.
• Always do it lightly. If you feel resistance, hold at that point for a bit, then release.
• Never go past until it stings.
• Relax the muscle after the stretch, don't hold it for longer than a count of thirty.
• Drink fluids after the stretching session. I always get a bit thirsty.

Once, when I started at a new school (and I was young and somewhat dumb), I stretched when cold every time before working out. I got a groin pull that would NEVER go away.

I was talking about it with a friend and she noted that I was doing something that was not smart. In those words (wounded my heart) - she was a ballerina and said that she never would stretch before warmups.

I took those words to heart, have not pulled a muscle since due to stretching.

[rburns]

Thank you for the reply hernanu. I will be more patient and be thankful for what I have!