Weak and sore hip flexors.

[John C]

I have a quick question about a topic that has come up a lot before on the forum. I am now three months out from my second resurfacing, and things are generally going very well. I usually get in a few hours of pain free hiking every day, some time on the stationary bike, light weights, squats, stretching, etc. Most of the muscles and strength are coming back better than last time; except the hip flexors. They are not a problem most of the time, but straight leg lifts are still a major challenge in terms of strength and pain, and it has gotten worse over the past couple of weeks. I upped my stretching a lot last week after a knee injection required that I back off much of my usual activity for a week, and the issue seems to be getting worse. I emailed the surgeons office, and the nurse said to stop all rehab for 7 to 10 days, which is tough to swallow. I am certainly open to modifying my activities, but stopping all together seems too extreme for an isolated issue.
Anyone have any words of wisdom for dealing with sore and weak hip flexors?

[moe]

Hi John, did the nurse mean all activities? Like walking and stationary biking? I would keep those up and back off the on the weights and stretching for a while and see how that goes. I remember those leg lifts were really tough.


moe

[blinky]

I'll be the bad guy and say take a week off. Rest, ice, ibuprofen. Nip this thing in the bud. Then come back slowly.


An investment in the front end will pay off.


(Do as I say, not as I do...)

[John C]

Hi Moe and Blinky, thanks for the input.
Moe, yes she meant to back off from everything, only walk as absolutely necessary, and consider using a cane. Definitely no stationary bike.
Blinky; no NSIADs for the next few weeks since I just had a PRP injection in my knee.


I have decided to be guided by avoiding anything that hurts or strains the hip flexors. No leg lifts, sit ups, or anything that strains the hip flexors, and no stretching of the hip flexors. Still hiking, stationary bike, and any exercises and stretches that do not affect the hip flexors. Noticeable improvement already in the past 48 hours. Hope it continues.

[catfriend]

Straight leg lifts caused pain for me as well. I backed off doing them, but still did everything else. I had to go back and forth with them a few times, but everything worked out in the end.

[chuckm]

John, that is EXACTLY what I went through. I backed off on my own. I modified my activities to avoid any movement that I could feel discomfort in the flexors. Getting out of bed I supported my leg to avoid the pain. I even backed off walking because I felt it then too. I'd say it took about three weeks and it was gone forever. One morning I woke up and forgot about the flexor and it didn't hurt to lift out of bed. Now I play soccer like a madman and ski black diamond bumps like the old days.


Chuckm

[John C]

Thanks everyone; exactly what I wanted to hear.

[ArthriticHip]

Hi John - I'm familiar with many of your posts, and you were kind enough to reply to me with some questions I had prior to my surgery with Dr Books back in February. Your level of post surgery activity was also an inspiration as I considered having the surgery.  I know this is your second surgery and are extremely well versed in hip resurfacing so I'm definitely not going to offer you any advice on the topic. What I thought I might try and offer you is just some peace of mind. As I know you're aware, BHR surgeons have all types of recovery programs and recommendations. Dr Brooks' recovery process is the most conservative of any surgeon I've seen. He has you on a 75% weight bearing restriction for the first 6 weeks, no exceptions. After the 6 week check up if all is well you are able to return to most of everyday life, however ZERO high impact activities for an entire year. No running, jumping etc. Also, ZERO strength building exercises for the first year. None. I had 5 different sets of leg lifts that I did through the first 5 months. Then after that, nothing much more then walking, stationary bike, etc., but no strength building for the entire first year.  I'm happy to say, I'm thrilled with my recovery to this point. Zero pain, most of the time just feels like a completely normal hip. Couldn't be happier with my decision or the results at the 5 1/2 month mark. I'm looking forward to returning to full activity at my one year anniversary.


I know you're extremely active and your surgeon has different recovery recommendations. You seem concerned about some difficulty with some of your strength building exercises...I just thought I would mention that I'm not even permitted to attempt strength building exercises until my 1 year mark, and hope that context might offer you some peace of mind as you continue with recovery.


Wishing you a continued successful recovery and hope that you've got many pain-free, active years in front of you.


Donny

[John C]

Hi Donny. I am delighted to hear how well you are doing. I remember some of our discussions, so that makes me all the more excited by how well you are doing. I really appreciate the perspective you shared, thanks for that. Since Dr Gross does not want any lifting over 50 lbs for six months, any strengthening I am doing right now involves very light weights and light resistance training, so not too far off from Dr Brooks at this point.


For anyone following this hip flexor thread now or in the future, I thought that I would share my current approach and result. I stopped doing all leg lifts or anything that involved straining the hip flexors. However, I continued all of my other rehab activities like hiking, stationary bike, light weights, and pool work. After one week, my hip is very happy with this regimen. I also backed off on stretching the hip flexors for about five days, and am now back to a full stretching program with no problems. It is the classic rehab approach of "if it hurts, don't do it". I am not sure how long I am going to have to lay off the leg lifts, but at this point the plan is to not restart those until I can do them without pain, whenever that happens. At this point, I am just delighted with how well everything else is progressing, and that I did not have to back off on any other activities in order to get the hip flexors to calm down. Very happy about that.

[jimbone]

Hello John,

This thread is fairly old especially given your ability to overcome adversity.  I have been having a similar difficulty with the hip flexor during straight leg raises on my right [second, hip resurfacing 9/16/18].  The first resurfacing gave me difficulty as well but seemed to resolve itself by week 5.  I am at week 5 now on second and find straight leg raises on the right side limited to an inch or two and a couple of seconds.  Had an excellent PT session today and took this up with the therapist.  Did some bridge marching which I had held off from and noticed a micro but established strengthening/improvement.  Plan to have at this for several days to evaluate its effect.  First time through the leg raises on the left went form near atrophy and pain to function within a few days.  The marching bridges as I understand it exercise the illiacus and psoas which are the muscles responsible for the leg raises without placing the same leverage and stress on them.  Hope you've already worked this out but might give it a try if not.

[John C]

Hi Jimbone. I just hit the six month mark, and any hip flexor issues are long past. While doing all the hiking and other gym work, the hip muscles gradually strengthened, and by around four months they ceased to be an issue, and leg lifts etc became part of the gym workouts.
Today, being at around six months which is when Dr Gross allows full activity, I got back to playing tennis and surfing this morning. Both went well with no issues. Loving this new hip.

[jimbone]

John,

My sincerest congratulations.  It is so encouraging to hear another successful outcome.  I believe you are a few years older than my 63 so to read you are surfing not only fires up my envy but  encourages me to try something I've always wanted to give a shot.  There are those that surf in the waters of the PNW- I will not be one of them, but as soon as I can get to warm blue waters this winter I'd like to take a class or rent a board, always looked like a blast.  At day 36 yesterday I managed my first successful 4 leg lifts a result of good PT.  I knew they'd be there just needed some patience.  My PT guy is going to pleased to see it working as well.  Keep enjoying.