Bilateral hip replacement

[MarkDeVries]

Hi all,

Just a week and a half ago, both my hips have been replaced (total hip arthroplasty) via the anterior approach. I am 53 years old and unfortunately, I had some sort of rapidly progressive arthrosis of both my hips. No apparent reason was found, apart from sports (marathons, (race)cycling) if that is a reason at all. Recovery is going great, much better and faster than anticipated by me. Walking around with two crutches (in house short distances even without). I am looking for some sort of program / control in order not to rush because I notice that tendency with me now I don't have any of the pains I experienced the last year. Obviously, I am using my fitbit (charge 4) both as a stimulator (to move/walk regularly) as well as a "brake" (to slow me down). Currently, I am at 7000 steps by walking around in house and three times outside. I will keep it at this level for the next couple of days before I progress to more steps. I noticed some posts about this subject but was wondering if there is any recent experience or tips-n-tricks ? I am thinking about adding a certain percentage every week to my daily steps (and distance) but not sure about that percentage.

Thanks !

Kind regards,

Mark

[alexthecat]

@MarkDeVries hello and welcome! 

I used my Fitbit to help in my recovery from a series of surgeries several years ago. I wrote about that experience here if you want to know more about that. 

My best advice is to listen to your body. It's great to have a schedule, but sometimes your body may want to overrule that and that's okay too. Rest days can be a really important part of getting stronger. 

[MarkDeVries]

Hello Amanda,

Thank you for your welcome and reply ! I have read your link: impressive and thanks for sharing. I have to agree on your advice, which is also my own experience, to listen to my body. I now use the fibtit just to keep track of what I have done.

Kind regards,

Mark

[emili]

@MarkDeVries kudos to you for the 7K you are doing. There are so many people with two perfect working hips who don't make the time or take the effort to do half those steps. Speedy recovery to you!

[MarkDeVries]

@emili thank you so much. Indeed, now time is progressing, I notice that it needed to become a habit to do my exercises and walking rounds. But I have been fortunate enough to incorporate habits pretty easily: so far so good. At present, I am at just a bit over 10k steps/day and yesterday I touched the 7km. Happy with that. As stated above, the funny thing is that in the past I merely used my fitbits to reach my limits/goals whereas now, by listening to my body (i.e. hips & legs....), I use it to slow me down ;-). And it really works ! Anyway, yet another way to use a fitbit.

[ReefShark]

good job mark.  i know EXACTLY what you are going through - been there, done that, got the same scars as you.  i'm 57.  i waited too long to get the surgeries and when i finally made the commitment to do so, covid was hot and heavy and the surgeons called it an elective surgery.  i had to wait another year.  bone on bone, 4" to 6" gait, and very painful.  I'm now 6 months out of surgery.  don't push it and let your body be your compass and just as i say that, i'll also say keep walking, walking walking.  i'm sure you notice improvement every day and its a very good feeling, but its not a race.  one thing i would recommend when you can / surgeon approves is to start working your hip abductors. it helped me greatly with stability.  everyone's recovery is different, so set your goals accordingly. i now fast walk 15k steps a day now.  i have a very basic cross country ski rig and that is helpful and i spend time on that 3x a week.  i get very good forward and backward stretches from it.  i do my total gym for 1+ hours a day.  the sliding bench is inclined at an angle that i choose.  i started that at 4 weeks out of surgery at very low incline and have increased it as i accomplished my goals.  As i said before, let your body be your compass.  you may want to do something, but your body knows whether it can be done.  good luck and keep walking.  - best

[MarkDeVries]

@ReefShark Thx !! Thank you for sharing your experiences ! And super to read that you are doing so well........there is hope for me 😉 How awefull that you need to wait another year ! Must have been unbearable...... In my case (Rapidly Progressive Hip Disease as they call it) I went from no symptoms to both hips replaced in two and a half year. Looking back, I waited to long too though: same story about bone-on-bone and due to the pain I walked like I don't know but it was far from ok. 

Thank you about the advice. As per now, I think I have found my modus to let my body guide me. The "pain" around the surgery area has gone but instead I experience a deeper uncomfortable feeling when I have done too much. Training my hip abductors is a good one: will check with my surgeon for sure ! I am not sure what a cross country ski rig is, do you have some info on that (probably if I see it I recognise it I think) ? I am now also at four weeks after surgery. I will keep walking ! Again, thank you for your perfect information ! Cheers

Edit: just found some info on the cross country rig. Will check if my gym nearby has one

[ReefShark]

keep us posted as you progress.  would like to hear about your successes as you meet your goals.

[MarkDeVries]

@ReefShark Will do! 

[Corney]

Hi Mark.  As a Physical Therapist with over 38 years experience, I have seen many clients after total hip arthroplasties.  At this stage it's important to observe the 2 most important precautions, that is avoid hip flexion over 90 degrees and avoid hip adduction.  Walking is your best rehab as long as you don't limp.  As you progress go from 2 crutches to one crutch as long as don't limp.  Progress to 2 canes then one cane as long as you don't limp.  When one limps you are developing a habit and you do not strengthen the Hip Abductors that strengthen the hip and keeps the hips level.  Good luck!!

[MarkDeVries]

@Corney Hi, thank you for your expert advice! Indeed, I avoid adduction by sleeping with a special cushion between my legs (which feels better also). Flexing over 90 is easily possible but I try to avoid it as much as I can. I am walking now without crutches in house, outside I still have one. I keep that one on the side which feels best that moment. Walking is what I do most indeed, as also stated by @ReefShark . I walk with my head so to say, paying attention to walk in the correct manner. I noticed by walking at a faster pace for instance that I tend to lean forward too much. In the meantime I started with physiotherapy and we have just started with some easy stabilization exercises. I am now at 5 weeks post op. 

Right after surgery I treated myself on the new Charge 5 (coming from the 4) with premium package. Now the readiness score has been tracking my activities I get a daily score now. It is much much better than it has ever before surgery....;-) As stated I am very happy with the charge5 as a companion device in order to slow me down a bit. Still, as I am feeling so good now but know this is a tricky period because doing too much too soon will have its consequences. 

I am concentrating now on walking correctly and at the right pace.

Most interesting journey I must admit.....

[MarkDeVries]

Just an update on my progress: I am now walking 10.000 steps/day and about 5-7km/day depending on how fast I am walking. This depends on how/what I feel. At present, most of the time I am walking without crutches as I noticed that walking with one is actually more "difficult" than without. With one I tend to limp a bit whereas without I am not. However, I almost never leave with them, just to be sure. Apart from that, I have my exercises. Starting next week I will begin with stabilization and strength exercises (6 weeks post op). 

[ReefShark]

AWESOME Mark!!!  I’m sure you are seeing noticeable improvement every day and that is rewarding.  I track everything on spreadsheets and its nice to see the improvement.  Instead of 2000 steps for a certain walking loop, its now 1800.  Once you start your hip abductor work, your progression will really start to move forward.  Those muscles have been on the bench and have gone through some trauma and it will take some time.  I didn’t enjoy the hip abductor work but am sure glad I continue to work through it.  I started by standing at the kitchen sink and worked one leg outward (only a few inches to start), hold it for a few seconds, and back down, a couple sets of that and switched legs.  Keep working the time longer as those muscles become stronger.  Continue looking months down the road with your training/recovery and when you get there, don’t forget to look back to today.  It will put a huge smile on your face.  Keep us posted and congrats on your progress.  -best

[MarkDeVries]

@ReefShark thx!!! I am very very happy with my progress indeed! Feel very lucky and fortunate. I guess my physiotherapist will start with those exercises next week. Will get busy with all the exercises 😉

I will get you posted. 

M

[Corney]

ReefShark: As a retired Physical Therapist with 38 years experience, I
have many clients post Total Hip Arthroplasty. The best and most effective
exercise to strengthen hip abductors is to work them functionally. Very
few individuals use their hip abductors to move the hip out to the side.
Hip abductors function to keep the hips level when stepping with the
opposite leg. People with weak hip abductors walk like a duck, they waddle
side to side. Stand next to a firm support(kitchen counter) with the
non-operated next to the counter. Lift the non-operated off the floor
maintaining just enough support with your hand so the operated side stays
level or the operated side does not move to that side. These are called
closed chain exercises. It's best to do functional exercise to strengthen
legs muscles how they are used, that is when the foot is on the floor.

[ReefShark]

Thanks for the input Corney.  All input is good and I appreciate your knowledge.  I'm just over 6 months out of surgery, both hips, and I still have work to do.  I've set 2-year goals.  Walking like a duck or as my wife said to me, "you look like a Weeble Wobble, but you aren't falling down".  Maybe you remember that toy/commercial?  My surgeon recommended the standing thing at the counter, so that is what I do.  Looking at my notes and videos my wife took of me early on, it was between weeks 7 and 8 that I stopped wobbling.   I've got enough strength now through squatting (no weights) and using my Total Gym that I can lay on my side and work the abductors pretty well.  Certainly not like 5 years ago, but far better than months before surgery.  It was very helpful for me, but as you know, every person is different, recovers at different rates and has their own challenges.  My left hip isn't quite to par with my right, yet, in some areas, but i work them just the same.  Right feels fantastic, left feels almost fantastic (some flexibility shortcomings at this time).  I'm on the Total Gym 6 days a week for an hour (all muscle groups), I use a basic cross country ski machine 3x a week and walk 15k steps a day.  Have had a few 25K days without realizing it.  My sister just moved houses, went to help her build a closet, hang shelves, put up sheetrock, plywood her shed, insulation, up and down stairs, squatting, kneeling, up and down, up and down, up and down, etc. and i certainly felt it, but 2 day later, everything was back to normal again for me.  1.5 years to go as a dedicated/focused effort and I guess I'll be as good as I can be by then, whatever level that is.  Thank you again for your input - very much appreciated.  -best

[MarkDeVries]

Hi all,

I am now at a bit over 3 months post-surgery and making great progress indeed! After I started doing stabilization exercises with my physiotherapist I am now training on strength with a cross-trainer at the gym and bike on my Tacx at home. Working full time again without any issues thus far. Actually, I am quite busy with all the exercises: 3 x per day I run a variety of muscle strength exercises (which takes about 20 minutes), twice per day on the Tacx/bike (15 minutes + 30 minutes) and three-time per week at the gym (on those days I skip some exercises and the bike sessions at home)....... And with all that taking great care not to overdo things so skipping sessions if needed. Driving my car and I ditched the crutches 5 weeks post-surgery. All in all, I am very, very pleased with my progress and the result of the surgery. Must admit I consider myself very privileged. Thx for all the support and response which have been most encouraging and helpful!

[alexthecat]

@MarkDeVries what an inspiring update! I'm glad that all your hard work is paying off. 

[ReefShark]

So glad to hear.  I can read the smile on your face.  It's nice feeling the improvement every day, generally.  I'm getting close to a year in and I still feel and notice the gains.  Keep working them and all that you are doing will payoff later.  Best. -Dave