what is weight bearing or walking as tolerated?

[avilax777]

 I would start this topic to maybe help others and tell what i learned in this time and maybe others can post as well.  I feel that this topic is such an open ended question when we leave the doctors office most of us are so unsure of how much we can walk and if we hurting our hips and how to balance activity and non activity.   

So here is my story.   I had a pretty smooth surgery and that same night i was already doing walks around the hotel with my walker.  I continued to walk with the walker about every few hours for about 10 minutes.  I thought i needed to move plus it felt good.   When I left back to los angeles I used the airline wheelchair to get me to the gate but after that i walked with my crutches quite a distance to the lounge.  Then recovering at my parents i took walks two times a day covering about 1/2 mile each time.  The last big walk i took was 3/4 of a mile this was 9 days post of.   After that I started to bleed or drain so i had to slow down and my bleeding continued for about a week till it finally stopped.   That forced me to slow down.   Because i realized the movement was probably causing my wound to not close.  I moved back to my house and walked less but did do walks, one night i felt some pain and I still went on my walk very short one .2 miles when i got back my hip was swollen and felt very strange, i thought sure enough i fractured something.  So i slowed down again and kept icing and it was back to normal.   At 3 weeks I started PT she told me something that really hit me she said i walked to much and that if i walked a little less I would have even been in a better place.  Her thinking was that my muscles were weak and since they could not support the body it put more pressure on my hip which she said was good for bone growth but I over did it a bit. She told me to take it easy for a few days and to  just do day do day walking which i was already doing alot putting things away etc .   After two days of this all my pain went away and i was finally able to sleep pain free and I healed much faster rate. 

That got me thinking, that after surgery i was on pain meds which make you really not feel too much pain and be a little too confident.  I also read everywhere about people walking.  But what I didn't realize is that the walking caused my pain.  Also because i felt good and thought walking is good i kept doing it.   I can stay that there last two days of less walking and just rest i saw more progress then the days i was walking.  Before this i was doing post op exercises twice a day, going for walks twice a day and short walks around the house.  I felt good doing it but since we dont have limitations.   

I am healing quite well.  But I wanted to pass some lessons i would have done differently.  If before you go on your walks you feel pain don't go for a walk.  If you suddenly having to take more pain pills know you over doing it.   Learn to relax, which i have a hard time with.  Sleep is probably the most difficult thing to do.  For me having my leg still for more then an hour would cause pain, taking it easy at the beginning does not mean you are behind.  There is such a grey area here so better to under to it then over do it. 

I hope others can comment so that we have some advise for others because for me this was so difficult to understand "as tolerated"  I can tolerate a lot I been living with pain so its a little misleading.  I can tolerate more when i workout but this is not a workout its a healing totally different. 

11/7/18 Dr Pritchett Synvo and bioment cemented. 

[John C]

I the only thing I would say, is to repeat your last sentence, which sums the whole issue up brilliantly: "I can tolerate more when I workout, but this is not a workout; its a healing, totally different."
Every resurfacing patient should be given your quote as required reading. Thank you for sharing it, along with your story.

[jarheadwrstler]

Thank you for your post and topic.  I agree with John C - your last sentence is something everyone who has this surgery should read.  30 years ago I tore a ligament in my knee while wrestling.  The Ortho decided not to do surgery, put instead put on a removable cast.  He said if I followed his directions (which were to only remove the cast for a sponge bath) I would be able to ski when I recovered.  I did not ski at the time, but several years later I started down hill skiing and rarely had any problems with the knee.  Lesson learned - follow doctors instructions.  But how, when they are vague or don't cover all situations.  The only instructions/restrictions I had was not to put more than 50% of my weight on my surgery leg and not bend it past 90 degrees.

How do you judge when you are putting more than 50% of your body weight on your surgery leg?  For the first 10 days I used a walker and did not leave my house/property.  I also stopped taking narcotics after ten days.  I then started using crutches and went into town and did a little walking.  My problem was reading others post about walking a half mile or more during this same time period, etc.  I started thinking that maybe I should be doing more.  However, my recovery was going well and nothing really hurt and I had no leakage from the wound, so I kept with what I was doing.  I also started lifting weights using dumbbells, this at least made me feel good mentally.


I started driving at about 2 and a half weeks, and also started walking for about 20 minutes.  I started working at 3 and a half weeks and using only one crutch inside.  I am now walking every day for about 20 minutes.  I want to do more, but don't want to push things and injury my leg somehow.  My Dr. also will not release me for PT until I see him for my 6 week exam, although I am doing the exercises at home he said I can do. 


My point is, we all heal diffeently, and we should remember that and listen to our bodies.  As you said, this is healing, not a workout, so pushing through the pain is not always helpful, nor is comparing ourselves with others.

[avilax777]

thanks jhon c I was trying to find a way to help.   Jar my PT therapist told me to stop reading online its what gets me in trouble.  I think we focus on the superstars and not on the ones the are average.   The issue is that each one of us has different history.  Some of us were very immobile before surgery others were not.   Some of us were very athletic others were average.   For example, I was never a runner even before the AVN, so if i read about how someone is suddenly running at certain stage and think i should be able to do that but I never ran before I dont even have the muscles developed for that even with no surgery so you put surgery on top of that and its worse.  Last week i started working out with a my old trainer i saw it was difficult for use to find stuff that was not painful, but some how i was more aware and we did one exercise and i stopped it because it was painful in a way i felt was not good.  Still, that night my sleep was a little off because of minor pain.  So it think is such a balance, that now I can tell when i have over done it for the day and i back off and do no more.

It very tempting for us to look at  where other are at and think of this as a competition, there is a reason why they have age or weight groups in competitions we are not equal.  So it like me saying wow this guy ran this fast when he is 20 and I am 50 thinking i should have ran that fast.  So unless we know the entire story reading where someone is at is just that a reading.  The only thing we have in common is that we had hip resurfacing, but we must take into account we went to different doctors, we have different devices, we have different athletic abilities, we are different ages, body type etc.  Therefore instead of taking what we read as a goal we must connect to our body and it will tell us what our goal should be.   

[catfriend]

"thanks jhon c I was trying to find a way to help.   Jar my PT therapist told me to stop reading online its what gets me in trouble.  I think we focus on the superstars and not on the ones the are average.   The issue is that each one of us has different history.  Some of us were very immobile before surgery others were not.   Some of us were very athletic others were average.   For example, I was never a runner even before the AVN, so if i read about how someone is suddenly running at certain stage and think i should be able to do that but I never ran before I dont even have the muscles developed for that even with no surgery so you put surgery on top of that and its worse.  Last week i started working out with a my old trainer i saw it was difficult for use to find stuff that was not painful, but some how i was more aware and we did one exercise and i stopped it because it was painful in a way i felt was not good.  Still, that night my sleep was a little off because of minor pain.  So it think is such a balance, that now I can tell when i have over done it for the day and i back off and do no more.

It very tempting for us to look at  where other are at and think of this as a competition, there is a reason why they have age or weight groups in competitions we are not equal.  So it like me saying wow this guy ran this fast when he is 20 and I am 50 thinking i should have ran that fast.  So unless we know the entire story reading where someone is at is just that a reading.  The only thing we have in common is that we had hip resurfacing, but we must take into account we went to different doctors, we have different devices, we have different athletic abilities, we are different ages, body type etc.  Therefore instead of taking what we read as a goal we must connect to our body and it will tell us what our goal should be."

Yes! This is what I try and tell people. Everybody heals in their own time. There are a very limited number of superstar healers. There are also a group who have real difficulties after the procedure. The rest of us fall someplace in the middle. Yet everybody still thinks that they are going to be one of the superstars, and if they're not healing at superstar rate it's their fault, something is wrong, etc. No. Your body will heal on its own schedule. Push it, and you will actually slow your progress because you now have to heal from overdoing it. Your long term recovery is what is important. If you get rid of the cane at 2 weeks or 4 weeks or 6 weeks is immaterial a year out from surgery. Some people may heal up a little sooner, but over time nearly everybody heals.

[avilax777]

catsfriend  No. Your body will heal on its own schedule. Push it, and you will actually slow your progress because you now have to heal from overdoing it   well said that is something we all need to be aware of that pushing our bodies can come back and hurt us.  But its like human nature I guess we have to experience it to understand it.  Once you understand it its amazing how things move.  What  keeps me going and motivated is I look at things the I could not do the day before , the week before and that lets me know its all right.   Like last night was the first night i slept and didn't have to get out of bed because I could not find a position that was no uncomfortable, I did wake up in a little pain but didnt i have to get out of bed like the last month.  Or how i am suddenly noticing i walked somewhere in the house without a cane, or using the cane less, but the moment i feel something off i make sure i have my cane.  By doing that I notice each day I use it less not more.  My mindset in beging i would have probably tried to walk more without it, the results would be that the next day i would be in pain and using the cane all day.   This is one of the biggest things that i find I needs to be communicated.

I am a traveler I travel six months out of the year, before surgery i took a six week trip from kazakhstan to whales and people keep asking me where is your next trip and I respond i havent planned anything until i heal.  For a personality type like me its hard but to stay put, but we can find joy even in the healing and the time off.  What i been doing is spending more time with family and friends which i have not done because i travel.  We must find our balance and trust that we are gently moving forward. 

[karlos.bell]

Hi
Yes so true. I see a lot of comments of the rush to work out than "heal"
Depends on your pain threshold.
They need both from my experience. I am still healing 4 years later getting muscle imblances corrected after years and years of incorrection with FAI.
Good luck. Cheers