PT after Surgery

[Pat Walter]

I have had a number of people write to me to ask what PT is best to use after hip resurfacing surgery.  I don't have an answer for that question.  Each doctor seems to have a different opinion on what is the best PT after surgery.  Some doctors don't recomend special PT after you have left their facility like Dr. De Smet of Belgium.  Once you leave Belgium, Dr. De Smet does not recommend any additional formal PT, or at least when I had my surgery in 2006 that was the case.  His suggestion was to walk, walk and walk.  Listen to you body and do what you want.

Other doctors seem to have formal programs of PT that they suggest.

This is a place to share what kind of PT your surgeon suggests after surgery.

Pat

[mtnhippy]

Pat,
I just left PT with a big feeling of accomplishment (had a LBHR on October 7, 2008).  I've had 10 sessions and they are now giving me exercises some of the trainers can't do!  I, too, met the basic requirements assigned by Dr. Hickman very quickly.  By the third session we started focusing on CORE exercises and re-building the muscle I lost.  I wanted to return to rock climbing and was told that when they shave the top of the femoral head, balance sensors are lost so the balance now must come from the surrounding (core) muscles.  I feel at 48 years old, I will have abs of steel for the first time!  A lot of the training is done with a bosu ball or balancing on one leg performing weights.  I can't believe the progress and when I did return to indoor climbing, it was amazing.  I actually think I'll be a better climber than I was prior to surgery.  I also do a lot of weight training to rebuild the muscle.  I feel, in my case, PT was extremely important to my recovery.  My therapist was Caime Hodlmair at The Orthopedic Specialty Hospital in Murray, Utah.  When I have my right hip done, I'll return to Caime as we've learned together what a hip surfacing patient requires!

[hawaiieric]

For my PT now that I am not doing formal and have been doing on my own for 2 weeks now being at 10 weeks post op.  I have been working on my stretching to gain range of motion.  Squats in knee-waist high water is great along with on the beach with something for support if needed, but more of a concentration on the stretching portion then the strength.  I then do walking lunges, and then side to side stretches using a twist into my lower back,and or just letting my leg muscles go to their limits and thinking of being on a surfboard and surfing or kitesurfing and how it should feel while standing stretching in the sand.  I finish off with single leg stands for balance and full weight strength to my hip, trying to bend the knee and lower my body or use my other leg and move it and hold in front, side and behind me.  I also work on just getting into postition to tie my shoes and hold it there, being I was tight before the surgery, I feel I am just slightly better then what I was before surgery, and knowing it will get better in the next few weeks as I continue to do what I do.  Looking forward toward hitting my 3 month mark and to see how much more I will be in 2 weeks.

I would like to think that PT is very important for your recovery, I like to also think that fine tuning to your specific needs is benificial.

Eric

[Bionic]

Regarding the preferred intensity of PT, I think it's important to keep in mind that the femoral neck is weakest approximately 3 months after surgery (according to something I read on Dr. Gross's site--I'll try to find the link).  This is due to the femur's delayed response to having its blood supply compromised during surgery.  Bone strength improves from the 3-month mark onward, with it being close to full strength at 6 months.

So, I guess good advice would be to be a little conservative with PT and other activites until the 6-month mark.  Even though we might feel better, and even capable of doing more, it's important to remember our bones are still healing.

[obxpelican]

Bionic,

You're correct about Dr. Gross, he will only allow phase I excercises and he rarely reccomends PT the first 6 weeks, he will however allow some PT after 6 weeks if you ask.  Personally I think I did fine w/o PT.  After 6 months Dr. Gross allows most activities, although from what I've read healing continues sometimes up to a year.

Dr. Gross feels the best PT is walking, a lot.  By 6 weeks Dr. Gross wants you doing a mile w/o assistance.

Chuck

[Mudpro]

5 weeks post-op yesterday and doing well, yea! 

Weeks 1 - 2:  In home physical therapist came three times a week; Ankle flexes, butt squeezes, quad flexes, heel slides, straight leg raises with assistance, toe raises, walking with crutches, mini squats focusing on equal action on both sides, not too deep.  Worked alone twice a day every day therapist didn't come in.  Ice down for 15 minutes after every session.  Pain medication (Oxicodone) about every 6 - 8 hours.

Weeks 3 - 4:  Outside phsical therapy three times a week added more standing work to above routine; deeper squats, anterior leg flex (side stretch), posterior leg flex (rear stretch), knee raises, unassisted straight leg raises, added recumbent bike at home and at therapy, each couple of days making the hip angle just a little cloer to 90 degrees, walking up to half mile my end of week 4 with a cane, physical therapist manipulates hip joint to keep down on scar tissue development and getting my closer and cloer to 90 degrees every session.  Worked once a day with stretches at home on days i didn't go to therapy, walking for 30 minutes a day and spending an additonal 40 - 60 minutes a day on the recumbent bike (over two sessions).  Pain mediation at bed time and an hour before therapy.

Week 5:  As i said, I'm at 5 weeks +1 day today.  Physical therapy today included all of the above but added one legged work on a tread mill (good leg on the side rail, hold onto hand rails, and let the bad leg "walk" with the tread concentrating on keeping it straight and letting as much weight on it as you can comfortably take, and started working on 4" steps with bad leg in the lead going up.  I am now able to walk short distances without the cane but will keep in in hand for a little while over, at least until after my 6 week check up with the OS next Tuesday.  Tylenol an hour before therapy.

[hawaiieric]

Here is a great PT for those who want to do something different, just came from a Tango class, just happened to be there, knew the teacher so I jumped in, my first lesson, but was way great for my hip!  You use weight shifts from leg to leg, and then the slides from left to right or forward and back...was really good..then we did a few other things that was just like PT.  I will go back for more when I can.

Eric

btw, guess I was meant to be there, met a lady who is going to get hip surgery.  Her doctor does THR.  I let her know about this site, and what her option is.  Mentioned second opinions but most of all, let her know that she will find out so much about hip surgery from this site.