I am 9+ weeks post op THR and am experiencing a Trendelenburg Gait as the result of a severed gluteus medius (and minimus) from a lateral surgical approach. I'm getting blank stares from the surgeon and PT when I ask if it will ever go away if I exercise well. I have not spoken to anyone else who has had this problem but would love to know what prognosis to expect down the road. Can anyone relate to this? I am 71 years young (the new 51!) and otherwise have had a spectacular recovery. I still use a cane and sometimes a walker when I need to go faster without limping. The Trendelenburg Gait (without a cane/walker) will eventually damage my back, hips, pelvis. I'd like to correct it before it does damage.
Hi Dianne38189...I can relate.....I experienced a similar painful gate about 4 months after the opp. The Gluteus medius contracts to keep the hip level during the swing phase so that that leg can swing through......the Gluteus medius inserts on the Greater Trochanter and the action of contracting is very painfull....unfortunately , the stretches required for the GM is not recommended because it can cause dislocation. I am still active in athletics and this causes a delay in my preparation....a sonar scan of my GM shows multiple tears ...that is when the muscle heals it leaves scar tissue and without proper stretching this remains a bit tight and with sudden movement it tears again next to the scar tissue...so in fact a catch 22 situation....by the way I am " the new 50 "...I have been advised to use heat frequently....I use a bean bag heated in the mocrowave for 2 min. That seems to provide some relieve......My cowboy stride ( hehehe) is gone and apparently only time will correct it. My problem was as a result of the disecting the Maximus from the Medius to allow separation of the muscles to get to the Femoral head.I suppose this problem will test our patience.....
Hi Dianne
I'm 10+ weeks and have the same. My pt instructor has been really helpful, will not let me walk distances without the stick as that helps me walk straight. I'm working hard on glut exercises, am on the static bike for half an hour a day and have just started strength training. I use a step with a 4.5kg weight in one hand then the other and step up onto the step making sure my knee locks. I've been working really hard to ensure the motion is correct not just launching myself but it's very hard! This strength training I think is helping my progression.
It's frustrating, but you're right - if you walk with an odd gait, you will be compensating elsewhere. What exercises are you doing?
Oh and my gait is terrible first thing but gets better throughout the day
You need to strengthen the hip abductors and also get someone to check that your pelvis is sitting properly on your spine. To strengthen the abuctors first start by moving your leg outwards while lying flat on the bed. You can also move it outwards while standing but there is a tendency to 'recruit' other muscles to help if you aren't careful.
Then you can lie on your side and raise the leg to the side, again you need to take care to keep your leg in line with your body.
Finally you can build to one leg stance. Put one hand on your unoperated hip and the other on something solid. Raise your unoperated leg off the ground and keep your pelvis level. Put the leg down as soon as the pelvis starts to drop if you can't pull the pelvis back up using the muscles on the operated side.
I had Trendelenburg gait pre-op and pre-op exercises and these post-op ones mean that my gait is now almost normal but it took months of work and I still have to do some exercises each day to maintain it.
Good luck to you both because it is slow and to be honest tedious but the results are worth it.
My pelvis is rotated on the non op side which means my operated leg feels longer - this is making life really hard and my back really hurts. Getting osteopath to help with very gentle work. Some days my hips look straight, other days really wonky!!
Poor had a similar experience pre-op which sorted itself out during all the tugging during the op! The muscle imbalance was still there though and you need to get some expert advice on which muscles to work on and how so that your pelvis becomes stable once it is manipulated into position.
Good luck and I hope it sorts itself out even if you have to work at it for ages.
Hi Dianne, it has to do with your pelvis that needs to get pushed back into its normal place, that is the best way i can explain it. There is one particular exercise that i did and still do, that can help. Google it so that you get the picture on how to do it correctly. Very easy.
Should have also said this on my previous note: the two exercises i do most that i believe corrrected my gait are the one standing on the operated led while keeping the other leg bent and off the floor, i usually count to 50 in that position. Difficult to do at first but it gets easier as you improve. The other exercise is the clamshell, laying down on the bed.
Ok this is my last note on the subject i promise. For the standing on one leg exercise, you must not hold or lean on anything and you must try to stand as straight as possible, you will notice that the tendency for the body will be to lean towards the weak side (operative leg). I do not know abt other people but this has helped my gait tremendously. I do not understand why anyone in the medical field has not suggested this to you. Amen.
The first few steps in the morning are awkward, then my gait improves throughout the day until evening when I'm tired out. It gets slow and awkward again. The whole time I'm still doing the T-gait but minimizing it with the cane or, better yet with a walker. I can stride smoothly and almost tirelessly with the walker. Problem is I don't have long distances in my house and I live on an acreage with dirt, gravel and grass. I go to our local recreation center and use the walking pool which makes me feel like I have a normal stride!!!! Morning and night I "try" to do straight leg raises while laying on my good side. It is quite painful to raise my leg off the bed while in a straight body position. I can wiggle around a bit and get the leg a ways into the air and hold it for a bit which I figure is better than not doing it at all. I also do the "clam" exercise which is easy. Also easy is the abducter exercise where you move your affected leg forward, back and sideways while standing with a stretchy band around your ankles. I also walk on the treadmill at the rec center, walk in place at the kitchen counter plus do a few sieways stair steps. Oh, I can't forget that I use my spinning wheel every chance I get!!! <(~_~)>
It doesn't have to be your last note, Kalean! Your advice is helpful. I tried the standing on one leg thing and it helps. So far I am still wobbly but never have had great balance. I can do the one-legged stance for a few seconds so that's a start. I'll work on it.
Hi Dianne
First I heard about Trendelenburg was when I received a copy of my six week checkup when the physio had included the term "Trendelenburg Positive".
I thought I was too young to die then the panic passed and I researched it and found that I basically had a limp! He he
I was exactly like you but with the help of my Physio I am walking reasonably straight for short distances not (currently week 11). I am under strict orders to use a crutch or stick when walking outside to make sure I dont get back into the habit I had got into before the op. She also said that the leg muscles need to be woken up again onhow to walk properly.
So, if you are ever in Chester and you see someone walking while mumbling "heel......heel......heel" then that is me. I thought it was daft but she has been spot on. I will be back in work at the end of next week and feel ready for it too.
Th exercises she has given me are to strengthen the Gluteus and also the muscles around the knee but we are all different.
I would suggest you keep giving the physios hassle until you get some sense.
Good luck and take care.
Miracle of miracles happened today! I had a friend over to help me put a hook in one of the ceiling beams so I could attach a small pulley and rope above my bed thus do passive exercises with a sling around my ankle. I got into the correct position . . . bottom leg bent, top leg (operated leg) straight and my body in straight alignment. As Trina and I giggled at me trying to get my foot into the sling UP went my op leg all by itself!!!! I couldn't believe it. That's the first time my gluteus medius has cooperated. No I didn't kick Trina in the nose but probably can by next week. I'm so happy my GM is functional again. I don't care how good it is at this point. I'm just glad it shows potential which I was beginning to doubt.
I still limp when not using my cane but now I have a pulley installed so I can do passive exercises as well as attempt some active ones. YEAH!!!!
What are the Glut exercises your physio showed you?
ITs the straight leg lifts and Quadriceps sets mainly on top of the others to help mobility etc. Am actually suffering today as I think I over did it yesterday with quite a hard walk last night. I will learn one day!
I'm at the stage now when I forget at times and its either a pain or one of the family shouting that will remind me. Never knew I had a gluteus medius before the op. He he
Here's the link
Dear dianne, Like yu I have had a THP BUT UNLIKE YOU, MINE WAS NOW JUST ONE YEAR AGO ANDF ALSO, UNLIKE YO, i AM 82
Dear Dianne,
I was very interested to learn about your problem with Trendelenburg Gait. I had never heard of it until I saw it mentioned first in a letter in the SAGA mag and I am sure now I have it too. For me perhaps, unfortunately, I am 10 years olderthan you and have had my new hip for just a year now.Like you I have been delighted to cope without pain and move freely and it is only more recently when I have been walking either with or without a cane that I have realized this failing so much. Another problem I have, I wonder if you have experienced, is if when walking, I am hailed from behind I have to watch myself how I turn to address someone I have the sensation I could easily lose balance. I am about to start physiotherapy next week but I hope all is going very well for you and woould be very interedsted to hear of progress.
Hi, everybody!! It's Dianne and I'm back. It was interesting rereading all the posts in response to my original post of 7 months ago. Just want you to know my gait has improved considerably. If I concentrate on walking, I can do it without limping (Trendelenburg Gait). My muscles tire easily and I'm pooped by the end of the day. It will be 1 year on April 6 since the hip replacement. I was skeptical when people kept telling me that recovery will take up to a full year before you feel like your old self. Course I'd rather feel like my young self. I'll keep on truckin'.
That is good to know Dianne. I also have Trendelenburg Gait for the same reason as you. I am 5+ months post op and had thought around Christmas that I was well on the mend but am limping again. I think I am better when I can get out and exercise with walking more but with the colder and frontier days I am a little scared of slipping. I am in UK and having physio. I also walk outdoors with a stick (cane) and hobble about indoors without. My knees have become a bit painful. Roll on the better weather. My surgeon also said not to expect full recovery for 6-12 months. I also had the lateral approach. Keep on truckin'😊
frostier.
I have been so careful so I don't fall while walking, etc. However, I have fallen twice and both times it was stupid. I had the vet out to check one of my donkeys simply because I didn't want to take a chance being around him. Guess what? He jumped and I jumped back. Down I went . . . with the vet watching us. Best laid plans of mice and men . . . The second time I tripped over a length of twine and did a four-point landing avoiding a face plant by 1/2 cm. And I'm CAREFUL! Just thought I'd mention this as a reminder to all to be cautious. The good news is that I now know how healthy and strong my bones are. But no more tests, please. I'm in western Colorado, USA where it is cold, cold, cold.