Almost 6 months post op THR

Bones, joints and muscles
1

Its almost six months since my left THR. Although I had a few niggles to begin with, I thought I was doing really well. At six weeks I was riding my bicycle and walking without crutches or sticks. Then about three weeks ago I realized I was having to lift my operated leg in and out of the car, and the bed. Even getting dressed and undressed was becoming very painful. I decided perhaps I should start re-doing the exercises we do after the op, so I layed on the bed and discovered I couldn't even lift my operated leg up....it's as though it's paralyzed! The pain is excruciating, if I trip or try to sit up in bed the pain shoots down my thigh and groin area. I immediately went to the doctor who referred me to my consultant. On examination and an X-ray the consultant is confident my hip replacement has healed well and it's more likely to be a trapped nerve in my spinal chord.  I even suggested could it be 'Illiopsoas Impingement', (I'm sure people like me must be their worse nightmare, diagnosing ourselves)! Well he poo-pooed that suggestion and has arranged a MRI scan, which is next Monday. In the meantime I'm still unable to lift my leg and I'm in a lot of pain when walking. The cycling has had to stop too!  

Has anyone else had this problem or is the trapped nerve....if it is a trapped nerve, just a coincidence?

any feedback would be appreciated, thanks. 

Linda

2

I forgot to mention that I also now feel the new hip crunching and grinding when I do certain movements, which is quite off putting!

Linda

3

I've recently had something very similar. I was recovering amazingly well; walking without aids or limp at about 6 weeks. Post op review went great.

Then I started on more, different exercises from physiotherapist. I didn't make the link at the time, but several weeks after that I began to develop groin pain which became increasingly severe: to the point where I couldn't bear weight on it.

Someone suggested psoas muscle damage (on here), so we are probably talking similar.

I couldn't see surgeon as he's away for weeks and GP suggested I ask for an urgent physiotherapy appointment. They saw me immediately.

Different Physio - whole hour, one on one. After examining me he said it was a muscle problem, not nerve. He worked on points on my back; some were really painful, but he was very gentle. Twenty minutes later he asked me to stand and walk and I was stunned to realise the pain was completely gone.

Next half hour he spent more time on my back, or bum, on the gluteus maximus. Quite a few sore spots, then found what I felt and knew immediately to be the focal point of pain. Weird sensation.

I was told to stop all previous exercises and do only one - a bum clench, but in a particular standing pose. 100 x 4 per day.

Heartbroken to find, on leaving, that the pain seemed to have transferred to this newly found 'focal point'.

Have stuck with exercise for over a week now and pain is almost gone. Muscles are weird and magical things: this one of mine, poor thing, mustn't know what the hell has happened to it, as I haven't walked straight for 10 years: probably thought it was in retirement.

Hope you might glean something from this. I do know groin pain is common and it seems there are several causes. Do get it checked out and let us know how you do.

Elaine

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Hi Linda ----

So sorry to read that you are in so much pain  - bummer, is an understatement -

and at 6 months post up -- I would be upset and worried too ... at least the x-ray shows that the implants are in place, right? did you mention the clicking and grinding sound or is this new?

do you still have pain medication? 

I don't know what more to say ... take it easy ... don't force anything and be gentle with your self ...

sending healing rays and angel blessings

renee

 

5

Oh yes, I had Illiopsoas tendonitis. Takes about 3 to 4o weeks to heal.

Tendonities is little ripps/tears in your tendon so basicallly don't do anything that aggravates that INCLUDING exercises that cause you pain in that area. Exercizes only makes the rips deeper and adds more tears in the tendon.

 Let.It,Heal.

Think of it this way, say you banged your hed on a low hanging entry way, and you got  a big bump on your head. The next morning would you say, "Oh I should press his bump on my head with my hand, maybe even push it against the wall, that will help with the healing and it will go down if I bang it against the wall?"

No you wouldn't do that if you had a big bump on your head, you would baby it and make sure not to bang it again while it heals up and goes down. You should do the same exact think with you Illiopsoas tendon. Don't stretch it and hurt it more. let it heal up by babying it and not further injuting it.

The good news is, it will heal in about 3 1/2 to 4 weeks. All on it's own, you don't have to do anything other than avoid anything wich gives you pain in that area.

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Elain is very kind, in fact she said, "someone on here" without mentioning me by name but she is talking about me. Yes I really believed Elain had tendonitis of the Psoas Muscle or Illiopsoas tendonitis. Turns out she did not and BRAVO to her very higly talented physical therapist.

I HOPE to Hell Elaine never gets that groin pain back again, I am watching her posts and her comments that she is so generously sharing. I  am very surprised that her physical therapist diagnosed bad glutes rather than tendonitis of the Illiopsoas tendon, but that is what is so great about this forum, we all give different experiences. Read everything and seek professional help because ultimately we all see everything through our own lense of experience. Elaine is contributing to our knowledge base, and in the end, people on the internet can only guess, it is really the pros on the ground looking at your body who can give you the BEST Help.

7

Thank you for your kind words JF. Personally, I haven't actually ruled out the tendonitis, which is why I was careful to make that comment 'anecdotal'. True, the pain appears to have 'transferred' from groin to bum, but I've learned to be v cautious about this stuff, having been sent through a myriad wrong turns by professionals over the past 10 years. 

Healing hopes for everyone. 

Elaine 

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Many thanks to everyone who has replied here. I'm glad some of you have heard of this complaint, (illiopsoas impingement). I've been reading up on it and all the symptoms described  are what I  have..........I can't lift my leg when straight AT ALL when laying down, I have to physically lift my leg in and out of the car and bed, with great pain down my thigh and groin. Waking up and down stairs is painful too, as well as getting dressed.  Basically I can't do any of the things I had been doing post op.

Jodi-France....thanks for your advise, this happened four weeks ago and I've stopped all exercises, ie., cycling, swimming and long walks, but there is no improvement. As my husband keeps reminding me, it's a process of ilimination. I will have to be patient and have the MRI scan on my spine, even though I firmly believe it's this Iliopsoas impingement!  

Why don't our doctors recognize it?

I know I have to be patient but it's soooo frustrating not being able to do normal things and having to cope with this constant pain......we go on holiday in three weeks, I don't want to be a burden! (That's right, I should be 'put out of my misery&#39! lol

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Linda, how long was it after you had th groin pain did you stop exercizing, or I should say doing anything that hurts it?

Did it take you a while to stop? A lot of people get that pain and then think, "Oh this muscle is tight I'll exercize it more." You say it has been four weeks? IF you stopped everything that hurts it, if you stopped that right away I think in four weeks you should be better by now if it was going to heal up on it's own.  However if you jsut stopped doing anything that aggravates it, if you just stopped that last week, then no a week isn't long enough for the healing.

Do you get pain after standing up from sitting? Doesn't matter what type of chair, just after you have been sitting for a while do you get the groin pain for a little while upon standing?

Worst case scenerio if it is your illiopsoas tendon and it does not heal up and return to normal, your surgeon can do a small surgery to repair it.

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FWIW, for me, at 6 months I did not do strenous activities.

I wasn't out biclycing for example. I just did nromal everyday things.

Only after a year did I start to do more intense activities.

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Hi Jodi....sorry for not replying earlier, we've been pretty busy here!  I stopped doing ALL excesses as soon as I realized I couldn't lift my left leg up straight when laying on the bed. When standing I can lift it only slightly, with pain.   I keep hoping things will improve but each day I try to lift my leg and it's as if its paralyzed!  There is no way I could ride my bicycle, my leg just won't lift high enough to turn the pedals and the pain down my thigh and groin is excruciating. Even sitting up in bed from a lying position is blooming painful and I struggle a lot. I had my MRI scan last Friday so I'm waiting for the results. I'll keep you posted 😀

Thanks for your suggestions and help. 

Linda

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Thanks for your reply, but you didn't answeer the question in terms of weeks. You said, "I stopped doing ALL excesses as soon as I realized I couldn't lift my left leg up straight when laying on the bed" so how many weeks has it been since you stopped all exercizing?

I send you much support and am very interested in how you progress. Please do continue to update this thread, again thank you so much.

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By the way....it was meant to read 'excercises', not excesses! 😂

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Hi Jodi.....it must be six weeks now since I stopped all excercises.  I had my MRI scan last Friday, I haven't heard anything yet!  In the meantime, I saw a chiropractor yesterday. He was very thorough and said he was sure it isn't a trapped nerve in my spine but what I originally thought, illiopsoas impingement. He also said my left leg, same side as hip replacement, is at least 3cms longer than the other and this could have caused the problem because of the way I'm walking to compensate being uneven. (Does this make sense)?  When I layed down on my stomach on his couch, he said my spine was shaped like a banana, completely out of shape, (charming eh)! He did some aqua puncture and manulation and gave me a couple of light excercises to do every day, plus advised me to lay an ice pack on my groin area for 10-15 mins every two hours or so. I have to say, in the evening, last night, when I came to bed, I could lift my leg slightly off the bed......although this morning I can't!  I'm laying here now with an ice pack, lovely 😁. I'm seeing him again next week before I go on a weeks holiday to Crete....I was hoping to be more mobile by then!

any thoughts Jodi?

thanks, Linda

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I dunno Linda, IMHO 6 weeks is long enough, that should have healed up by now.  Will you be back seeeing your surgeon? Because orthopedic surgeons are the ones who also treat our tendons. You have done well by laying off of it giving it time to heal, but at 6 weeks I think your surgeon is going to have to do something. Do keep updating this thread so that you are able to help others. My illiopsoas tendonitis healed in about 3, 3/12 weeks and fully healed at 4 weeks. I call them the same thing because it is the same muscle, the psoas muscle or illiopsoas tendonitis. The good news is, your surgeon can perform a small surgery to rlease that illiopsoas tendon. Not what you want to hear I know, but I have never heard of anyone here who didn't eventually get the groin pain resolved one way or the other. I was lucky mine healed up.  

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Hi Jodi

since my last update I was advised to see a physiotherapist as they deal more with tendons and muscles as apposed to a chiropractor who deals with bones. So yesterday, (Monday 14th Sept), I had a 45 minute consultation with a private physiotherapist. She also said/confirmed it is Iliopsoas impingement and has given me a whole load of excercises for me to do to help stretch my tendons, they are very tight across my thigh and groin area. I'm going back this coming Friday and hopefully they may do a bit of 'hands on' and acupuncture......not Aqua puncture like in my last report! lol

we go on holiday on Saturday, I'm hoping they can relieve me of some of the pain.......I'm not expecting  miricals although it would be nice!

I'll keep you posted. 

17

I've now had six sessions with a Physiotherapist over a period of six weeks and I can't say there is any improvement. In fact I seem to be worse!  Today I saw my consultant who did the hip op. The results of my MRI scan didn't show a trapped nerve but did show signs of wear and tear at the base of the spine which has damaged the nerves, which explains the excruciating pain I'm now experiencing. The hip op and the bad knee and longer leg has most probably aggravated the damaged nerve because of the way I'm walking. The consultant is recommending a pain clinic.....probably a cortisone injection?😳  He has said Physiotherapy will not help but to continue doing the excercises. The orthopedic triage guy I also saw today regarding my knee has also said physiotherapy on my knee is not going to cure it as its wear and tear and you can't repair that, all I can do is continue with the excercises to keep muscles and tendons strong and get a new knee!  So that's where I am at the moment. On the NHS waiting list for goodness knows how long. I have to say though that everyone concerned with my problems has been very supportive and helpful. The one thing I would complain about though is the fact that I've never had any follow up physiotherapy following my total hip replacement. I've had to go private for the little I've received and I'm no better off. 

18

Hi

Sorry for being ignorant but what is llliopias tendinitis? I only ask as I'm a bit concerned it could be what I'm suffering from, my symptoms sound very similar to yours and I also get a almost unaudiable click in my hip? Is that also a symptom of it?

Thanks

Ella

Ps I'm sending you all healing thoughts!

19

Hi Linda,

I'm in a similar situation to you! I'm nearly 5 months on from my thr. And I was given just 1 physio assessment. My operated leg is 2cms longer than my other leg.

About 6 weeks after my op, my stick skidded on a damp slab and I jammed my operated leg down hard to stop myself falling. A pain shot through my thigh and I couldn't put any weight on my operated leg. Two days later, I woke up and couldn't move my leg and the pain was awful. I was taken to A and E and xrayed. There were no fractures so I was kept on the observation ward for the day until the pain gradually subsided. It was put down to muscle injury.

My gp said rest, so I did for a month. I then decided to see a private physiotherapist who has given me exercises to do. I've been to see her now for 3 sessions and although she says I'm improving I don't think I am! I still have to use one crutch and still waddle like a duck if I try to walk unaided.

So at the moment I'm so tired from exercising and just want to walk again.

But at least the awful pain from my arthritic hip joint has gone. So its not all bad!!

Love, Anna x

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Hi Anna lovely to hear from you again, you are improving, you were on 2 crutches now your only on 1 it is going to take a while longer for you but just think how you will be able to get into your lovely garden next year

Love Gillxxx