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90 degree angle

Posted , 13 users are following.

Soxy
Soxy

Does anyone know how long the 'don't bend 90 degree angle' is crucial for?  I am four months in after THR of left hip.  Bent down to put socks on and my husband said I was breaking g the 90 degree rule.  I wonder if this is still causing the low back pain i am getting.  Feel as though I should be better than I am. Feedback needed if possible please.

 

1 like, 33 replies

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  • AnnieK
    AnnieK Soxy

    Posted

    The rule is imposed by the surgeon, along with how long it is necessary to keep to it. So you should check with your surgeon for the rule for you. Unless you have an unusual situation, you are probably long overdue!

    I was released from restrictions at 6 weeks, and that is a common time for it. 

  • HollyHop9
    HollyHop9 Soxy

    Posted

    My understanding is... It kind of depends on the surgeon. At the hospital where my hubby had his done many of the hip surgeons don't give any precautions or restrictions at all (so allow complete bending, leg crossing etc etc)  some allow their patients to bend as long as they bend between their legs and don't allow leg crossing etc and some, lincluding his surgeon who is considered "old school", stick to the 90 degree rule. The most I've heard it enforced for is 3 months but again I would call your surgeon's office to check with them on your individual circumstances.

    For interest look at van der Weegan, Kornuijt and Das "Do lifestyle restrictions and precautions prevent dislocation after total hip arthroplasty? A systematic review and meta-analysis of the literature" Clin Rehabil 2015. I can only get the abstract but that's enough for us lay people.

  • Chris8968
    Chris8968 Soxy

    Posted

    I think it also has to do with wether you had the anterior or posterior approach. With the posterior approach I believe the chance of dislocation is higher for a longer period of time.
  • steve86482
    steve86482 Soxy

    Posted

    I had the LTHR back in mid Nov 2015 with the posterior method.  I can say in my case after my 6 week appointment I was off all restrictions. Now I forget I even had it done.
  • susyp
    susyp Soxy

    Posted

    Hi Soxi My surgeon has restrictions for 12 weeks but most of the other surgeons at the same hospital have a 6 week rule.

    Take care

    Sue x

  • Guest
    Guest Soxy

    Posted

    Hi Soxy, my hip restrictions are in place for 12 weeks, I have another 4 weeks to go.
  • Kate53CornUK
    Kate53CornUK Soxy

    Posted

    The first six weeks are the most vulnerable time, not enough healing has happened to prevent a dislocation should you provoke one.

    After six weeks the joint area is much more stable and although caution should be taken you can start to bend further than the rules.

    After two THR's I am 8 weeks from the second and have just started swimming again to build up strength. It takes months to heal fully and the first six months throw up all sorts of aches and pains as the body adjusts to a slightly different position.

    If your THR was due to OA then it is possible that other joints are moaning a bit as well. I think back ache is fairly common and I am still taking pain relief for this. 

    It takes a full year for complete recovery so be patient wink.

    I would suggest non-impact exercise, tai-chi, pilates and swimming all help with core strength and muscle tone which are essential to support the new joint.

    • Soxy
      Soxy Kate53CornUK

      Posted

      Thank you for your reply Kate. I am quite relieved that other people seem to be suffering from back pain, although I wouldn't wish it on anybody. I have recently seen the physio and she has had a good luck at me and said that she thinks, like you, that my body is adjusting to the op.  Other joints are moaning a bit as well, and I have back thigh pain which is coming from my back.  Unfortunately, I'm not allowed to swim, but will look at tai chi.  I think I'm in for a long haul which I didn't expect.  My hip joint appears to be OK, but it's definitely had a knock on effect on my back.

       

  • rose0000
    rose0000 Soxy

    Posted

    My surgeon said I should always avoid bending from the waist without a leg behind, it has been known to disclocate hips years later...but everything else was okay after 12 weeks - six weeks being the most important period. I am also four months post op, so same time as you. Horse riding, skiing etc after a year. Swimming, cycling all fine from six weeks. 

    I am still very careful when I pick things up, and if I am doing much too much I still have the familiar soreness...as long as I take it easy ish it is fine. 

    In what way do you feel you should be better than you are? Four months post op isn't very long at all in terms of a full recovery. 

    I have just started sleeping on both sides, I had a lateral incision, and even now I wake up to turn myself over in a controlled way. The sleep thing was the biggest surprise of all to me...that and the time it takes to feel human smile

    • Guest
      Guest rose0000

      Posted

      Rose, if the surgeon says to avoid bending from the waist, how will you do up the laces or buckles of shoes?  My restrictions are in place for 12 weeks, but I am hoping to eventually be able to bend to do up my shoes, put on socks and to trim my toenails.  

       

    • AnnieK
      AnnieK Guest

      Posted

      You don't! Unless someone else does it for you. I used a sock aid to get the socks on and off. And I wore sandals with velcro that I could push down and pull up with my grabber. I don't think I cut my toenails for 10 weeks, even though my restrictions were lifted at 6 weeks. Some people get pedicures or have a podiatrist or a partner cut their nails. There is always that spectre of dislocation or tearing of repaired tendons/muscles if you break the rule, so that keeps us honest.
    • Soxy
      Soxy rose0000

      Posted

      Thank you for your reply Rose. Have seen the physio and my hip joint is fine, but am having referred back pain which is also hurting my back thigh.  Hopefully this is my body readjusting to the op, but I am still taking painkillers and to answer your question nobody mentioned the knock on effects of this op, although to be fair I guess not everyone gets them.  I'm in for a long haul, which I didn't expect.  I'm definitely nowhere near as good as I thought, but we have to carry on don't we.
    • rose0000
      rose0000 Guest

      Posted

      I don't ever bend from waist to foot - I wear boots that I slip on, and only in the last few days have started managing socks, I am four months post op and I still don't do my operated hip side....I either go without or my children help or a use a sock aid. It is not that I can't, I am sure I could if I tried, but I choose not to, as I will not risk my hip. I am sure at some point we all come to do it, in time, but for now I am being cautious.

      My brother whom had a hip replacement a week before me, has now torn two muscles abandoning the 90 degree rule, and now needs an operation and will be off work for another six weeks. This has reinforced to me how important it is to take our time, and not rush the recovery. 

      Eventually I am sure we can do all the things you list, you will see when you get to 12 weeks how you feel about doing certain things....everyone is different some are more cautious, others more confident.

      I have just started shaving my own legs and that for me is complete bliss! smile 

    • rose0000
      rose0000 Soxy

      Posted

      I didn't know what long haul recovery really meant until now....so I completely understand. It is incredibly long, and we conquer one thing and then realise there is still so far to go....but we will get there. It just takes time. 

      It is a HUGE operation, HUGE and no one can prepare for it - I thought I would be completely perfect by now, but it is just our expectations that need adjusting our bodies are busy healing and recovering...and they are clearly doing it in their own sweet time! smile

    • rose0000
      rose0000 Guest

      Posted

      Wendy I would also add I have two young children and a husband whom works two hours away, and no close family anywhere near us. If I dislocate we have a MAOR problem on our hands. I am not even sure what we would do....so I may be super cautious and others much more relaxed. It might be my circumstances....but even without those circumstances I am not sure I would be things much differently. We have come so far with our new hips, the thought of starting again keeps me being careful smile
    • Soxy
      Soxy rose0000

      Posted

      Rose

      Totally agree with everything you have said. No one tells you the truth which is that it takes a long time to feel totally right.  Thank you for your posts.  I don't feel so much on my own now.

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