5.5 month update on bilateral with Dr De Smet and couple of questions

[Slinkycarrot]

Hi there,


Im 5.5 months post bilateral resurfacing with Dr De Smet, Ive been sticking off the board to try and remain positive and rehab (plus looking after an 8 month old baby!).


Progress is very slow as it seems I have to retrain my whole body with my new hips in a different position. I can walk but not more than half an hour without my back/knees/flexors giving me jip.  I was starting to get some strength back and do some cycling on a stationary bike but then Ive had to stop as developing some problems.  Im still unable to do single leg raises when lying on my back.


Anyway, each hip is a bit different;







Left
The hip joint itself feels good, great ROM.  However, I have no piriformis on this hip and have very overactive hip flexors/psoas and my glute wont fire. Im fighting off psoas tendonitis at the moment so have had to completely stop rehab to hopefully let it heal.  I've been doing heaps of targeted glute strengthening exercises but am still unable to switch off my hip flexors/fire my glutes naturally.


Right
Less issues with muscular balance, however my joint isn't functioning as well.  I get a pinching in the front whenever I test my range, get in the car and then occasional a sharp pinch that seems to happen sporadically when walking etc.  My physio thinks it may be scar tissue in the capsule or has suggested cup malpositining causing impingement?


Other
My knees are causing me issues due to patella tracking dysfunction due to funky hips - im praying if and when I get strong they right themselves, but who knows.

So questions I have;

- Did it take anyone ages to be able to do a single leg raise (when lying on back)?
- Any idea what this catching is in my right hip? Does scar tissue or impingement sound right ? Has anyone else suffered this and does it subside?
- Can anyone recommend any psoas deactivation exercises or good web links?  Im really struggling to switch it off and my physio doesn't really get it.


Cheers all.

[catfriend]

I'm sorry to hear that your recovery continues to be so difficult. It's different for everybody, and so disappointing when you're not the one walking a mile a week out.

I had to look up what the piriformis is. Is your lack of this muscle due to the surgery, or something else? I can't remember how long it took me to do a straight leg raise. I did do them in PT. However, straight leg raises set off my psoas, which is not uncommon. I would take a break from them, my psoas would feel better, and I would start them again, repeating the process. I work on strengthening in other ways now, and don't bother with. I don't see a reason to set it off, and even if I were to do them now I would. Psoas problems are commonly reported on this board. Don't know why they are such an issue for hip patients, or entirely how to resolve the problems. In my case I've just given up and moved onto exercises that don't set it off.

Not sure what to make of the pinching on the right side. I know that on occasion when I was healing I would move in such a way that made me think that something would break, and that I had screwed everything up. Groundless fears, as it turned out.

I have had issues with my knees due to weak lateral hip muscles. As they get stronger my knees do better (nothing wrong with the actual knee joints, just the muscles around them are weak because of the years of hip problems).

I hope your healing gets better.

[Slinkycarrot]

Thanks cat friend


I don't have a piriformis due to piriformis release surgery about eight years ago, when dr de Smet went in he said it had completely disappeared!


Hoping everything settles down soon

[karlos.bell]

  HI Slinky it takes time.
6 months your doing very well..
The knee issue normally are from the hips from my experience.
The sharp pinch may to do with tendons riding over structures in which the tendon is inflamed due to the rebuild - all the surgery......
A good surgeon will be able to tell you if the cup is mal-postioned.
I doubt it though De Smet is very good.

Sounds like your in the bracket of tissue repair - range of motion.
The next step hopefully will be stability and the strength.
The longer the issue the longer the recovery.

As I have said before 2 years and about the 18 month bracket should be able to see improvements week by week.

Keep at it. It does get better and you have improved.
Cheers K

[vonhouser]

I can relate, but I think we are doing fine. I'm at about four months, having only had one hip done.


It is taking me forever to do squats, but I'm making (very) slow progress. But still, it's progress. I've been working with a trainer for six weeks, and the PT there said I made good progress. But my right leg is still SO much weaker than my left.


Standing on one leg is a joke, but it's better. I still have a limp. I CANNOT do even ONE clamshell.


For about two weeks, BOTH hips were crazy tight and painful, and then it was gone.


I was having a pinching on the front of the hip, top of the thigh that I thought might be psaos, but the PT watched me and said it was actually the quad, which I guess is better.


Progress has been so slow, but it's progress. I went from only being able to do squats at the very top of the range (because I would shift to one side) with the assistance of the TRX band, to being able to do a pretty deep (for me) squat with no help, and not shift to either side.


My standing on one leg exercises are better, but it's still not pretty. My romanian deadlifts with handheld weight are getting closer to looking like actual deadlifts.


What I mean to say is, lots of random tightness, pinching, weird aching muscles, but a lot of it seems transitory, though some of it is hanging in there. (Four months and not one clamshell, really?)


I think improvement looks different after this kind of major surgery. I try to focus on the little improvements. They aren't the kind I would see if strength training and not recovering from surgery, but it's still progress.


My old PT told me two things to try for psoas release. Basically you do a bridge, with a pillow folded between you knees. Do 10, then do 10 with the band around the outside of your legs. In other words ten bridges pressing in on the ball, and 10 bridges pressing out against the band. That seems to be something you can try to get the psoas to calm down a little bit.


Also, make sure it's not your quad!


Hope this helps,


Taj

[Slinkycarrot]

Thanks taj and carlos.


I emailed dr de Smet and he told me to stop Physio for 2-3 weeks and load up the anti inflamms in case there is impingement. Subsequent to my post my right has flared up as I was trying some stuff which was aggrevating the catch. So now im doing nothing, so frustrating. I'm praying I can rely on his skill and that there's no long term impingement/issues with placement  and my tissues are just figuring things out still.


Taj, how did your surgery go? if it makes you feel any better I can't do clams yet either without seriously busting up my hip flexors, this is on both hips. Not ideal as a woman 😁


Anyway two steps forward ten backright now.

[blinky]

Slinkycarrot, remind me, how old is your baby? Has anyone explored the idea that part of your problem is that your ligaments are still lax from childbirth and/or nursing? That you are still making those hormones that make your ligaments extra stretchy?

[karlos.bell]

  Slink and Von Houser.
Yep it does take time and there is no calculation format for it.  6 months clam shells is a bit hard on yourself.
I can only just do those well and its 2 years now. Don't be so hard on your selves and take a break.
Cheers K

[Slinkycarrot]

My baby is eight months, I've stopped breastfeeding so my hormones are back to normal.


Both hips have flared the last three weeks which is pretty much when I stopped, wondering if now the ligaments  aren't stretchy that the are catching on the prosthetic? Could that even be possible?


Trying not to freak out right now but having hip pain like this kind of defeats the purpose of getting them resurfaced. I'm totally over it.


Is it possible for impingement to happen this far in? Surely it would have caused me problems already?  My hips had settled down last Friday and I went to the Physio and she got me to do five straight leg raises and try a couple other very gentle things, I've been in pain since.  I've been able to do those activities for the past few months no problem, any idea why I'm having issues now?


Thanks

[vonhouser]

I wonder if total rest might help. Both of my hips were really achey for awhile and a few days of rest and ibuprofen helped. If they are really jacked up they might just need a break. I have never gone to physio, just strength training, but if it feels wrong I tell him to find another way to accomplish that goals. Sometimes plank, standing on one leg, and other things just feel like a bad idea. Squats were always great but for a couple weeks even the hint of a single leg lunge would really bother the top of my quad. Both hips are sort of finicky right now, so if something hurts I just push on something else.


Hip is generally stiff and such, but I know that's to be expected.


Leg raises are given in the very first few weeks but I have never done them. Just doesn't feel right yet.


My surgery went really well. No problems, no complications, walking without a cane in a normal amount of time. I still have a limp, though, which I think I will until those lateral muscles are stronger.