Hip Flexor pain 8 weeks out

[byebye]

Had hip resurfacing done on 1/22/18 with Dr. Pritchett in seattle.  Things have been going well and i have been back in gym doing weights and cardio equipment (stair stepper, exercise bike).    I am having two issues that I could use advice on:

1) tightness down scar line (what a scar!) and some minimal pain. 

2) Sharp pain at hip flexor when knee is bent past 90 (sitting in chair putting shoe on, or at pt when he attempts to stretch flexor. This is a jolting pain -

are these normal?   How do I get my hip flexor to settle down (ive been icing nightly).


Thank you

[chuckm]

Nice job, Byebye.

Patience. The surgical process of resurfacing totally disrupts or destroys the bursa that acts as a cushion that allows the psoas tendon to glide over the femoral neck. That is why the pain is so strong when lifting the leg, it rubs right along the bone and new cup.
I discovered this early on in rehab after lots of research. I avoided all movements that reproduced that pain. Even getting out of bed I would assist the leg to avoid having that pain. I took about 4 weeks and one morning I forgot to assist my leg because the pain was 100% gone and it never came back. Do your own research and if there is a way to actively allow that area to heal then please share that with us. Working through that pain may prevent your body from creating new bursa-like tissue that you will need.

Chuckm

[byebye]

Thanks Chuckm.  Im curious if I should stop all PT- as honestly all the stretching and ROM is what seems to flair it up?   I don't want to create a long term issue by doing the "right thing". 

[imgetinold]

Hey there.

It's been a long time for me (1/12/12).  I think if you search "hip flexor" and "psoas" you'll find a lot.


There are going to be a lot of pains that ease with time.  My surgeon (Dr. Gross) doesn't even recommend PT.  He says to just walk.  However, he limits your walking to 1 mile for the fist six weeks, then says to walk as much as you want.  But, NO impact (running, jumping) for six months.

That said, I think SOME PT-type moves are helpful, but not to the point of pain.  Just give it time, and let it heal.  It took me a full year to never think about it or wonder if this pain or that pain was the hip.  Now, I never, ever think about it.


Good luck.  Be patient.

[Tri Hard Alan]

2) Sharp pain at hip flexor when knee is bent past 90 (sitting in chair putting shoe on, or at pt when he attempts to stretch flexor. This is a jolting pain -

This is why a lot of surgeons advise you to not have PT. But saying that I agree with the other posters that it is beneficial.


I would suggest listen to your body and if its painful tell the physio to stop doing it. Be firm with them. You have to judge yourself but stretching beyond a stiff point till it becomes an ache is probably OK but anything that you would describe as sharp, then no, tell them to stop.


It dos all get much better with time though so you will need some patience.

[John C]

I think that Tri Hard Alan nailed a key point. We have to take responsibility for our bodies when working with a PT. One potential problem is that many PTs are skilled at rehabbing THRs, but may not have had any specific training with resurfacings. They are very different surgeries with many different issues during recovery, and some PTs want to treat them the same; not good. If a patient is ever not sure, it is always good to insist that the PT consult with the surgeon about exactly what to do, and when.

[karlos.bell]

    Hi Bye bye 1/22/18 - 25-03-2018.  2 months...... Massive. But let the body heal first 2 months maybe way too soon. A lot of connective tissue will need to repair.
Cheers K

[byebye]

Had my 8 week follow up with Dr. Pritchet on friday.   He said the alignment is always a challenge and this may or may not go away.   Im sticking to the it will go away.  I honestly feel like there is progress every day and really am enjoying the journey to recovery.   For sure this was a major surgery. 

I have been always extremely active and yes, been known to work through whatever pain is in front of me.  So I will heed some of the advice (stubborn) back off anything that is agitating the tendon.   

Thanks to all for your responses.  As someone that has watched this board for 5 years from afar it is always reassuring to know your not alone in this experience

[byebye]

Meet with DR P as planned. Said it was my rectus femorus tendon that is rubbing against the implant. Said it may or may not settle down.   Said sometimes a cortizone shot would help.  Also said give a week or no exercise (so im doing that now).  The dog days of recovery....

[byebye]

thought I would provide a brief update.  13 weeks out today.  Still having pinching sensation at top of hip flexor (dr says its rectus femoris tendon).  Its slight when walking (slight burning sensation) which is no biggie. I notice it very intensely when laying on back and pulling knee to chest (anything past 90 degrees will give sharp pain) or when bent at waist and bringing knee up. 


Dr says time (usually by 7 months) these resolve (usually).  I am growing a bit frustrated- not that I can't function- just that I can't function without pain.  I am still stair stepping 30 min daily and walk a couple miles a night.  Also did 20 miles over 3 days this past weekend- so it works- just have the burn mainly.   I also have some pain at scar line/tightness.   


Did anyone have this sort of issue early on?   I noticed this pain/sensation very early on (like 2 weeks) as I started to move more. I don't know if this is tendonitis, or the tendon just rubbing on implant.   


Thank you

[karlos.bell]

  Yep psoas right side for over a year. Left It band for 3 years (finally subsiding). Depends also how long you had your crook hip. My experience was halve the time that it was crook that is the time it takes  to come right. Sooner your doing well. Take it easy its not a race.

[ArthriticHip]

Hey byebye - I'm not quite as far along as you are in your recovery. I'll be 9 weeks post op on Monday. My recovery through 6 weeks went very well. My surgeon required the first 6 weeks on crutches, 75% weight bearing rule, no exceptions. At the end of the 6 week mark I was feeling really well. No hip pain. Getting around very well on crutches. A little stiffness from time to time. After my x-ray was reviewed and everything looked good so I was permitted to get rid of the crutches. I must admit, losing the crutches was a little more difficult than I had hoped. 100% weight on that leg felt REALLY heavy. Felt like my joint was really straining, and my leg muscles just really didn't feel ready for it. The next couple of days I went to the local YMCA and tried to walk off the soreness and start building my muscles back up. After about a week, I wasn't seeing much improvement and I had developed some pain in the buttock (sciatic nerve?) that would pinch when I walked and send a shooting pain down the side of my leg. To this point, that was the worst week of my recovery including the first week, as I truly felt I wasn't making progress. I decided to just stop, and take it easy for a few days. For about 3 days I largely stayed off my leg, did the PT exercises my surgeon gave me, took some Aleve to try to help with any nerve inflammation, and iced at the end of the day. For me, this made a HUGE difference. For about the next week or so each day got better then the last and my muscles and ligaments seem to just settle down. Going into my 9th week, I'm not experiencing any pain and the joint feels "normal". I've decided that I'm going to just live life pain free for another month or so, then maybe start some light exercises that have been approved by my surgeon. Some walking, swimming, etc. I'm going to take it slow, and let me body heal. You mentioned you did 20 miles over 3 days. I'm keeping track of my steps, and at this point I'm walking 2-2.5 miles a day in my normal daily activities with zero pain. For now, that's all I'm going to do. It seemed when I tried to push through the soreness it was counter-productive and my muscles/ligaments rebelled.  Good luck.