Weak leg

[captainahab]

Hello everyone:   Had a right BHR by Dr. Brooks on May 23, 2018.  The procedure went well and my recovery has been good.  So this is about 10 weeks from surgery now.  Off all crutches and support now, and walking or moving 5-7 miles per day.(FitBit)    The resurfacing was for OA that I'd had for 10 plus years and I'm now 67 years of age.  The Question?  How long till the leg feels strong again?  My good leg feels full of strength and balance.  The surgery leg feels weak.  I can walk fairly normal with out apparent dipping or wobbling.  Is there any exercise that others have tried that seemed to rebuild the strength in the affected leg.  Bicycling? elliptic treadmill, leg curls, walking  swimming?  Or am I just not being patient enough.  The pain is gone, so that is good and I have good range of motion.  There is still a "knot" in the hip on flexion, but my ROM is probably as good as it was before the surgery.  I continue to do the exercises.  Any suggestions?     

[Quig]

For the leg to truly feel STRONG takes some serious time. You're still relatively early in your recovery and it sounds like you're doing fantastic. I know it's not what you want to hear but I really believe at this point you're doing the right things and time is your friend. I would not hesitate to add some of the exercises you mention just do it slowly, overdoing it at this point is still pretty easy.


I'm a pretty avid cyclist and it took me at least 18 months until I felt truly strong on the bike again and now, at 2.5 years, I look back at that point and feel like I wasn't strong at all as I'm still getting stronger.


Good job, it sounds like you're doing great. Just be patient... and I know how hard that is.

[hernanu]

Ten weeks is a short amount of time. I'm a martial artist and I'd say it took a good 12 months to get my legs strong enough to do any serious workout. 


Patience is the key and to realize it takes time, but when it does come in it is here to stay. 

[captainahab]

Everyone:   Thanks for the reply.  Yes, I've got time- I'm RETIRED.  I'll take your advice and easy does it, enjoy every day.  Some therapists think sitting leg extensions and curls are OK, and others talk that puts excessive pressure on the hip joint.  Any opinions?  I have knee issues as well and want to keep the knee joint strong as possible.  Therapists basically just says walk as much as possible with in reason. Thanks again.   

[hernanu]

Everyone:   Thanks for the reply.  Yes, I've got time- I'm RETIRED.  I'll take your advice and easy does it, enjoy every day.  Some therapists think sitting leg extensions and curls are OK, and others talk that puts excessive pressure on the hip joint.  Any opinions?  I have knee issues as well and want to keep the knee joint strong as possible.  Therapists basically just says walk as much as possible with in reason. Thanks again.

I went through physical therapy both at home with a nurse initially and then with a physical therapist.

Both were prescribed by my surgeon and carried out by people who had dealt with THRs (no resurfacings) before.  I did two to three times per week at home, then the same outpatient.

I also had daily very light exercises mapped out by my nurse / therapist at home which I did several times per day.

Also, I walked around my apartment complex a good amount from the beginning. I started with about 100 feet at the start (you have to plan on walking about half of what you mean to walk, since you have to make it back), about three times per day. That walking grew to about a mile per walk with crutches , then eventually without.

After about two months, I started back in my gym and contracted a trainer to work with me on integrating the routine from my outpatient physical therapy with what I did before the surgery.

I knew I wanted to get back to where I thought I belonged, but did not want to have a relapse or (heavens forbid) to need a revision.

My surgeon had already put a limit on what I could lift to 50 lbs for six months, so that was a red line, but I wanted to know (with the trainer) about movement and stretching.

All of this put together gave me confidence about what I could do. I also put a real emphasis on listening to my body, which was missing before, since I was very hard nosed about athletics. I figure pain, instead of being an obstacle to overcome, is a canary in a mine, letting me know I'm beginning to push too much.

Walking is a great exercise, not just for recuperation, but for the long haul.

[ArthriticHip]

Hi Captain - I also had surgery with Dr Books. I had my left hip resurfaced on 2/26/18 so I'm about at the 6 month mark. I couldn't be happier with the recovery to date. No pain. Most of the time don't really think about my hip as it feels like a normal hip. I would say that while my operated hip/leg has gotten significantly stronger over the course of the 6 months, it's still not as strong as my non-operative hip.  For 12-18 months leading up to surgery my left hip had become so painful that I started using my other leg to compensate without even realizing it. Dr Brooks pointed out in my pre-op consultation how much my my left leg became atrophied and lost a lot of muscle tone. As a result after surgery I had a lot of ground to make up - which I think is probably the case for most of us that have this surgery. I would say at the 6 month mark I feel I've got about 80% of my strength back, and that's really just from walking and everyday living. As you know, Dr Brooks doesn't want any real strength training in the first year of recovery. If you're pain free at 10 weeks, you can feel good about you're strength returning over the coming months as you continue to use your operated leg more and more.

Good luck.

[karlos.bell]

Hi Captianahab.

At 67 tissue regeneration will be slower than a person at 37 or 47. But it also depends how long you were off that leg.

I would say just biking and walking hills - just walking is the best. I am 3.5 years 52 and still getting stronger at the 3.5 year mark.  I love running. I was on crutches for 8 years so its taking time due to the age and issues had. I also keep to a stricter deit for tissue regeneration.
My experience. Cheers K 

[John C]

Here are some of my favorites for getting leg strength back. My left resurfacing is 10 years old now, and these are some of the exercises that I am currently doing on my 3 month old right hip. It is far from full strength, but far better than it was at 10 weeks. 1. One legged partial squats. 2. One legged step ups onto a raised platform or box roughy 10 inches high to start. 3. Lots of laps up and down stairs. 3. Lots of steep hill climbs and hikes. 4. One legged balancing on a Bosu Ball. ( At ten weeks be sure to use something that you can use to stabilize yourself as you develop your balance. You do not want to fall off the ball onto your new hip at this early stage. I use ski poles.) 5. One and two legged squats with light weights. 6. Side walking with sports bands around your ankles to strengthen the abductors. 7. Pool work which allows you to strengthen the muscles in a 360 degree range of motion.
You mentioned leg extensions and curls. A leading knee surgeon that I follow just blogged about exercises that he hates, and leg extension machines were at the top of the list. I would have to agree with him. I think it is fine for very early rehab where you are just getting some movement without much resistance, but I avoid adding any weights to those machines. It puts a lot of load on the knees, and does not fire the stabilizing muscles that would be activated in any natural weight bearing movements.
I would not worry about where you are strength wise at 10 weeks. You are doing fantastic, so take your time to build back that strength, it will come. (By the way, I am your same age, so I can relate to the process.)

[jimbone]

This thread has been insightful learning the milestones and exercise routines of others.  Today marks 29 days since left hip resurfacing and I feel like I am somewhere between very pleased and questioning if I am making enough progress.  To date I have been walking with a cane since day 10 or so, 1/4 mile 3 times a day and doing home PT exercises provided by the hospital with daily improvements for the ones that were difficult.  I begin out patient PT on Thurs. will give it a chance to see if the therapist can really provide any depth of knowledge for recovery.  I definitely feel like I am ready to start challenging the operated hip a bit more under steady, cautious and controlled increments.  The real difficulty I have now is that the un operated hip which also needs resurfacing has degenerated so much and so quickly in the last 2-3 months before surgery that it is now the really painful leg I am favoring and it's hindering my progress.  I will be starting a thread to address the timing of a second surgery- don't want to derail this.  Ahab [funny that's who I reminded myself of the first week of nightly crawls to the bathroom room with my clonking crutches] 5 miles without aid at 10 weeks sounds pretty good.  I'm sure your continued efforts will make those miles easier and they'll feel stronger sooner rather than later.  John C.- some good advice and recommendations for strengthening.  I look forward to getting on with them after PT approval.