For too long I had put off having another hip replacement. I’d had the left hip surgery five years ago and it had gone well, including the follow-up physical therapy. I thought I knew what to expect. Instead I had a surprise.
The years leading up to getting the right hip done were fraught with pain while walking and after sitting in a regular chair for a couple of hours. I couldn’t cross my feet at the ankles and angle them right or left in the demure pose my mom had taught me decades ago. A minor matter to some, perhaps, but it bothered me. Simple tasks such as putting groceries away left me aching. I finally, firmly told myself it was time to get the right hip replaced.
Dr. James Hartson, of the Franciscan Physician Network in Michigan City, replaced both hips in smooth operations.
By the time of the right hip replacement in 2018, patients could go home the same day or next. Back pain kept me hospitalized an extra day.
As instructed, I leaned on a walker at first, stepping gingerly. I wasn’t to use the stairs, so my comfy living room recliner on the first floor came in handy for a few weeks. And my husband, David, waited on me with meals and errands.
Per protocol, rehab began with a physical therapist at my home for a few weeks, guiding gentle exercises to extend the range of motion with my right leg. They were challenging at first — OK, they made me grunt with effort — but progress was steady and rewarding. I graduated to a cane and to physical therapy at a facility.
Then came the hiccup. I didn’t adequately communicate to my physical therapist how extremely tight my quads and hamstrings (front and back of thighs) had become. And foolishly, when asked what my goal was, my response was: “I want to be able to sit down and stand up gracefully again.”
So we focused on that, as well as on stretching and arduous step equipment. But I was increasingly in pain. I knew soreness is fine but pain is not.
I felt like a failure. A follow-up visit with Hartson that included an X-ray confirmed all was well with the hip post-surgery, but he was concerned about the lack of leg flexibility and ordered more physical therapy.
I switched to The Crossing in LaPorte, closer to my home and where I’d been for the first hip replacement.
The surprise? No exercise for at least six weeks.
After an evaluation, physical therapist Mary McHugh explained she’d be doing soft tissue treatment to loosen the tightness in my thighs before I’d start an exercise regimen.
“The soft tissues, the connective tissues, all affect our function more than simply being weak," McHugh said. "My approach is to see how the person is moving to find out where the complaint is coming from and addressing that before exercises or strengthening."
Pain like mine generally starts in the myofascial tissues that surround and support muscles. McHugh said she learned soft tissue treatment from the person who developed the myofascial techniques, though there are other approaches and variations of techniques.
It seemed too easy. I lay on my side while McHugh’s fingers searched for knots in the tissues from my hip to mid-thigh. She found them. The pressure from her fingers could be painful, from mild to enough to make me squirm. At each visit I lay on an opposite side and McHugh pressed on those hard, tense tissues. Gradually the discomfort lessened.
“My goal is to optimize a person’s movement, because if you’re not moving you’re taking away from your ability to maintain life and daily activities,” McHugh told me.
To my relief my stride became looser, longer and more confident and I could finally lie on my side comfortably again to sleep.
McHugh and I agreed it was time for me to exercise.
I started stretching with TheraBands, 3-inch-wide elastic bands that provide resistance to build muscle strength and improve balance. McHugh guided me through progressively more resistant bands. It was immensely satisfying to be able to work with more demanding effort for legs, arms, and back. Other exercises that included lifting small barbells and working out on a kind of stationary bike strengthened back muscles that had tightened while compensating for hip pain.
“Working with patients is an individual project each time, kind of like solving a puzzle," McHugh said.
I hadn’t heard of soft-tissue physical therapy but it turned out to be a very good surprise.
With my last physical therapy sessions in July, at home I’m doing McHugh's exercises, ensuring that movement, as well as overall health, will continue to improve. I’m working in my big deck garden, walking farther, and sitting comfortably for long, entertaining post-dinner conversations. After a slow start, that's the best surprise of all.