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Author Topic: 4 weeks Post Resurfacing Operation tomorrow - what is normal? Help please !  (Read 206 times)

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AJ2311

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Hello everyone, I am 4 weeks post bespoke resurfacing hip operation tomorrow.  I was doing very well, with little pain and good mobility until 10 days ago and on a faster than normal walk experienced groin twinging. It  went when I rested. However 2 days later it came and persisted and I was told to stop all exercise and walking outside for 4 days.  This definitely helped it. Physio has suggested 'virtually' it could be hip flexor/psoas especially as pre operation I was in agony and barely walking for 5 months as pain was so bad. She suggested psoas was contracted and I should try and stretch it out.  It's really difficult that Physio is virtual as feel quite alone and not sure if this is normal? can anyone help?

Good news is my chronic arthritic pain has gone so that makes me happy.   

I have moved myself down to one crutch in last week also    - it sort of happened naturally but is this too soon?  is there a rough guide from moving from 2 crutches to 1 crutch? and for how long should I be on a crutch?  I cannot imagine walking unaided anytime soon.

Is there a rough guideline anywhere although I know everyone is different.

Also another question I have is how far is 'normal' to be walking outside at 4 weeks?  I am currently doing about 0.5 mile plus my exercises?  how many miles do others do at 4weeks?

I sleep on my side with a knee cushion in between knees. Could this aggravate the hip flexor also?

Thanks
Any advice most welcome

jimbone

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HELLO AJ

There are just too many variables to hope for a definitive answer with your progress of current psoas discomfort.  One of the great things about this site is that nearly everyone here has undergone some kind of "oh oh" moment where either pain, or set back has them wondering if they'd botched it.  Most everyone turns out to the good with very very few revisions.  Consider this- you pushed hard and developed groin pain.  You laid of exercise a few days and felt better.  That's a good thing and how the body tends to repair itself- it needs to be stressed through movement and then given a time to recover, grow new muscles cells, let the nerves repair and renew the connections to tell the muscle what to do and to get strong enough the pain signals go away.  It's a whole lot of 1 foot forward and 1-2 back.  There is a general rule of thumb some surgeons use that a person should be able to walk 1 mile unaided by week 6.  It's a nice rule of thumb I strove for but my second hip needed 7 1/2 weeks and only barely handled it.  My first surgery on the right recovered faster in many ways.  It's HIGHLY unlikely you did anything irreparable like a femur neck fracture because you'd know it.  You may have some problematic issue with your psoas that will need further treatment but at 4 weeks it's really too soon to tell most likely.  The psoas takes a big hit with this procedure and can react quite unfavorably- sometimes because the OA we'd been locked up by was also affecting the psoas and now it needs to get back to being normal.  Go slow and gently.  Continue to ice against pain, don't push too fast, give your body whatever time it needs to heal, continue to be glad and grateful as you are the OA pain is gone [fantastic, right?] and see where you are in another 2 weeks.  Make an appointment with your surgeon as soon as you can if only for the reassurance that you are moving in the right direction.  Best wishes.

petemeads

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Hi AJ - a great response from Jimbone, take it steady, listen to your body and back off as necessary. I guess you have to overdo things to know when you have pushed too hard. It was certainly the case with my BHR in 2014. I was fit and light but had relatively poor bone quality so was told I could not be fully weight-bearing for a couple of weeks so I was on 2 crutches for about that time - but I walked a very slow couple of miles on day 7, repeated after a days rest, then managed 3 miles after another rest day.
By my physio appointment at 2 weeks I could just about walk unaided but was strongly dissuaded from doing so! Went to 1 crutch for a couple of weeks, then a trekking pole. I managed 3 consecutive days approaching 6 weeks walking 9k, 10k and 10k fast (with a bit of jogging) and found I couldn't walk without a crutch for the next week. It went away, I was jogging at 8 weeks and everything has been fine since but I was scared that I had done something serious. Live and learn. I guess I was very lucky not to break the head off my femur - my bone was not good enough for a BHR on my other hip, 2 years later. No way I would recommend being so aggressive to anyone else, but you did ask the question! Oh, and on the THR I was jogging at 6 weeks...
Good Luck,
Pete
Age 69, LBHR 48mm head 18th Nov 2014 and RTHR 36mm head Zimmer ceramic/ceramic 2nd May 2017 by Mr Christopher Kershaw, Spire hospital, Leicester UK.

AJ2311

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Hello JimBone and Pete, Thank you so much for your reassuring, informative and practical sound advice.  I really appreciate it so much. This forum is going to be my life saver as having made the decision to have a resurface instead of THR I hadn't realised as resurfacing is not routinely performed in the UK on females now that I would have minimum fellow female resurfacers to speak to.  I am so lucky to have a fantastic supportive and experienced surgeon and had my resurface at the BMI Priory Birmingham Uk.  I know I can text my surgeon at any time but don't wish to bother him too much!  I have a bespoke Cross Linked Polyethylene resurface that I am very proud of! I have been keen to speak to others and share experiences and so this forum is perfect.

Covid 19 doesn't help either as my Physio is by phone and I have no idea whether my mobility and strength is good or as should be at 4 weeks post op. This is why it was so helpful to get JimBone and Petes replies below.

I have realised that as per the advice below that slow and gentle is best. I think because it has been 6 months since I ran (Great North Run Half Marathon) or rode my road bike I was soooooo excited to try out my new resurface and began to walk too fast and exercise too much.

My Hip Flexor is still twinging but not persistently (like it did before my 4/5 days complete rest) and I am learning if I walk slowly and gently then it is less painful for sure. I just need to be patient.

A couple of other questions I have if anyone can help are:-

How long until I can bend down and try and put on my own socks and shoes on the bad leg?
Does anyone have any Psoas exercises to try and gently stretch it?
Does elevation, sitting or lying down help the hip flexor the most if I am resting it?

I am really looking forward to speaking via this forum with other surface hippies and happy to listen to any advice or guidance.

Having lived with chronic pain for 6 months I cannot tell you how petrified I am of the OA pain coming back although I don't think that is possible? is it? I'm hopefully still being paranoid as I cannot yet forget how much pain I was in post op and never want to experience that again (until my right hip needs doing! ;D).

Thanks everyone Have a good evening  AJ  :D :D

rday12

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I can't speak to activity within the first 6 weeks post-surgery, as I wasn't allowed to put any weight at all on my leg until the 6 week mark. But, what I can tell you is to not worry at all about "falling behind" a recovery schedule. I didn't even begin to walk unaided until week 7, and today (week 12) I'm exercising fairly aggressively, and walking 5 km without any trouble. 4 weeks is not 6 weeks, 6 weeks is not 8 weeks, 8 weeks is not 12 weeks, etc. Recovering to ~90% healed is a 3 month process. If you feel like you're "falling behind", think about the guy in Canada from the forum who didn't even put weight on the joint until the 6 week mark. You're ahead of that guy!

Listen to your body, as it sounds like you've done, and you'll be good.

jimbone

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AJ-

I also have a cross linked poly synovo HR- 2 actually- that I am very satisfied with now coming up on 2 years in July.  In reading your question on the timeline for bending over to tie your shoe I had to stifle a laugh- it's one of the goals everyone seems to anticipate and for many of us one of the simpler ones that can take months to achieve.  I'd have to look at my journal but I am certain it was at least 3-4 months before I could bend over to do that and a few more months to begin to do it naturally and without discomfort.  Standing up to put on my socks?  6 months at least.  Am I a slow healer? Ahdunno or care.  The satisfaction of those minor goalposts can't be diminished because they represent overcoming the OA that had crippled me and hung like a life sentence on my head.  As said I am almost 2 years out and still see strength, ROM and flexibility continue to improve.  The OA and associated pain will not and can not come back to the HR joint- the cartilage has been removed and the bone surfaces reconstructed with your prosthesis.  One thing I seem to notice anecdotally is the tendency for serious runners to overdo it.  They're a pretty intense group anyway IMHO which I suppose is a requirement for the pursuit.  A few I've read about here seem to have gotten themselves into some trouble going too hard but most managed to pull back in time to let things heal although it's true that some are running marathons practically months after discharge- that may be a small exaggeration but not an enormous one.  Age and physical conditioning plays a big factor- mine was done at 63, so as far as I was concerned my competition days were over.  I still intended to pursue vigorous activity weight lifting, swimming, trail hiking and sailing primarily but martial arts tournaments were a thing of the past.  Some manage to carry on and more power to them.  There are a few woman who participate here that lead very active, athletic lives and do it very well.  Hopefully they will pay a visit to your thread for more meaningful insights to the particular concerns of gender specific issues.  Meantime- try not to fret and start slow and gentle.  Best wishes.

jimbone

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Aj,

Forgot to mention- Dr, McMinn's website has an excellent series of post surgical exercises that although pretty basic and standard are well explained and very helpful.  Even if they seem too easy for you at this point it might not be a bad idea to do them while waiting for real time PT to re open.  The bridge is a good starting exercise to begin stretching the psoas as well as strengthening glutes and rotators, as are glute squeezes.  Another psoas stretch my PT instructed me in was to stand next to the edge of the bed [mine is at knee height approximately], put one bent knee leg on the bed and lean into the supporting leg going forward keeping the torso upright slowly.  You'll feel a deep stretch in the flexors and deeper in the psoas.  I also found standing on one leg in front of a counter for balance a good strengthening exercise to work on- eventually with no counter support and later on the bosu ball for balance and squats.  Best wishes.

AJ2311

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Thank you so much JimBone and rday12.  I really appreciate so much you taking the time to respond. This site is fantastic and huge thanks to Pat for it!  I really look forward to seeing the replies and am grateful to the support and feel much less alone.

After 5 days rest , then 3 days walking outside and exercising again my Groin pain returned again yesterday evening and persisted during the night. Keeping me awake.  It is definitely a sign that even the basic exercises and walking outside twice is perhaps too much. Still frustrated though cause at 2 weeks all this was fine. Yet at 4 weeks not so!  However I spoke Surgeon today and he said ' must listen to the message body is giving' so I will rest again and focus on small stretching and heat and ice.

Jimbone you are so right re. runners trying so hard and doing too much. I think I have fallen into that trap however I am now going to listen to my body and take it much more calmly and slowly.  I want more than anything to get out there on my road bike and need to keep that vision in my head.

This is certainly going to be a marathon not a sprint!

Thanks all, AJ  :D :D

AJ2311

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Will have a look at the McMinn website also Thanks AJ

 

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