physical therapy evaluation

[claudia]

Dr Gross is NOT a proponent of physical therapy early on.  From what I hear, physical therapists are too aggressive with hip resurfacing patients because they are not that familiar with hip resurfacing vs hip replacement. I'm not sure if it's urban legend or what but I have heard of patients going to PT's who don't know what they are doing and have dislocated the hip.  I understand Dr Gross's concern.  I am remotely supposed to get some xrays and an eval from a physical therapist to send to Dr Gross in the next week.  His instructions are very specific on the forms.  I called two physical therapists who said that there is no difference between hip resurfacing and hip replacement as far as the evaluation.  I don't want them to move my hip is such a manner where it will dislocate when they are evaluating and the PT that I talked to laughed when I was explaining the difference and didn't seem interested in the specific instructions on the form.  I also got the same response from a second PT.  There is no one in this area that does hip resurfacing so I doubt whether any PT's are familiar with it.  Any ideas?

[Pat Walter]

Hi Claudia

Many surgeons, like Dr. De Smet, just encourage walking, walking and walking.  I decided to try PT when I came home back in 2006 and they said I did not need it since I was so far better than a person with a THR.  I have also heard of PT folks really hurting hip resurfacing patients since they were more oriented to athletes.

So I would just stick with a lot of walking and not worry about it for awhile. 

Many of us just walked and it all turned out fine.

Good Luck.

Pat

[claudia]

Hi Pat,
I think I should have explained better.  I have to get a one time evaluation by a PT for Dr Gross before I go on any walking program or further my at home exercises.  SInce i am on the slow program I cant walk yet.  I'm not going to a physical therapist for "physical therapy". lolol  I do not live in South Carolina so I have to find someone at home to do a post surgery evaluation.  The problem is that I cannot find a physical therapist who understands the difference between a hip resurface and a hip replacement.  The eval is not the same and they think it is.  I don't want to risk a pt who is unaware of the differences.  just wanted to get some feedback on that. 
Thanks!

[Saf57]

An experienced therapist should be able to provide an evaluation for Dr. Gross' purposes. I wouldn't worry too much about dislocation. It's actually the opposite, as there's almost no risk of dislocation relative to THR, as resurfacings have a very large femoral component relative to cup size.

[John C]

The evaluation in the 6 week check-up is intended to look for unusual problems with range of motion or strength. The range of motion tests should be very gentle and are not intended to push your limits. This would be the key concept to get agreement with from the PT ahead of time. Any PT would be qualified to collect the information correctly, it is just a matter of finding one who agrees ahead of time not to push too hard in testing the range of motion. I would not worry about them needing to understand the differences in resurfacing, as long as they agree to your requests.  It is maybe more a matter of finding the right personality rather than with resurfacing knowledge is which somewhat rare.

[Quig]

Agree with all of the above Claudia. The measurements that are taken are pretty standard and all they need to know is to not push **hard** and I'm sure you can make that clear. Relax, it won't be a big deal at all. And, as was stated above, with our type of implants, the risk of dislocation is very, very, very low.