GROIN PAIN AFTER Total Hip Replacement- Hip Tightness after THR

IMHO this happens far more often than is recognized by the doctors and physical therapists. If you have groin pain after a THR investigate if it is your psoas muscle and Iliopsoas Tendinitis. Your physical therapist should be able to easily find your psoas muscle and push down and you will recognize that is where the pain is coming from.

AFTER TWO WEEKS- If you CAN do this,

Lay flat on your back on the bed with your shoes off

Keeping your heel in contact with the bed, bend your knee and drag your foot up towards your butt

But CAN'T do this

Lay flat on the bed with your shoes off

Keeping your leg straight (don't bend the knee)

Raise your foot up off the mattress (you are using your hip muscles for this)

AND your groin hurts like HELL in certain situations, but not all situations, you probably have iliopsoas tendonitis.

You need to pay attention and be VERY careful. Think of tendonitis as little small rips into the tendon. What you need to do is rest the tendon and don't do anything to make the tears bigger (deeper). You want to not aggravate it, let it rest and let those little rips heal up.

Most people think that they simply need to exercize or stretch more, and in fact this is the opposite of what you should do, doing that only makes it worse and can result in a permenet condition as scar tissue will form over the rips.  Trust me on this I had tendonitis in my IT Band that I ignored, kept on working, that tuned into a perment condition (Tendonosis). It actually disabled me, so I am rather an expert on Tendonitis.

During your hip replacement they have to manipulate your leg and move it into positions it is not used to, this can pull that psoas muscle/tendon. OR your prosthesis is to big, or placed wrong and you will have this conditon until they go in and fix that.

Since I previously had Tendonosis I recognized the pain and symptons immediately. It was confirmed by my physical therapist. What I did was not exercize at all for 3 - 4 weeks. That is the amount of time it took for that iliopsoas tendonitis to heal back up. Only after that was healed up did I take up exercizing again, my physical therapist simply gave me leg massages during this time.

I found I had to lay down on the sofa not sit in a chair, as sitting in a living room chair was just a bad position for that tendon, so I layed around until it healed. What was very odd is that sitting in the chair wasn't that much of a problem initially, but when I got up from the chair it hurt. The good news, it did heal up just fine and I have had no further issues with it.

Google -  iliopsoas tendonitis after hip replacement

There is one woman on here I was able to help. Her prosthesis was digging into the tendon, her doctors did a surgery and did something (not sure what) and that fixed it. I know she did not have to have her prosthesis removed or changed out, instead they did something with the tendon instead.

Another woman I was able to help, she was doing great after her THR, about a month/ 5 weeks after her THR she was stepping off a pier to get into a boat and that is where she injured her iliopsoas tendonitis. Of course she was "stretching" and exercizing thinking that would help, which it did not, she followed my advice, simply rested the tendon by not doing anything that aggravates it and in about 3 to 4 weeks she was fine also.

If you have pain in your groin it is either nerve damage or the iliopsoas tendonitis. Nerve damage will travel down to your foot, Iliopsoas Tendinitis will stay sore in your groin area.

I am not a big fan of rigerous exercize right after surgery anyway. Think about it, they cut off the top of your leg bone and shove a stick in it. It simply takes time for that stick to get knitted back into the leg bone. I was forced to not exercize because of the iliopsoas tendonitis and at 4 weeks I started. In a matter of one week I went from using a walker/trolly to walking completely on my own with nothing. I just focused on keeping my back very straight and not bending over, in other words being very attentive to keeping good posture. I am more of a fan of , don't push yourself, let the bones heal up, when the bones are good and strong you will be able to get back into the swing of things very quickly. Good Luck to you.

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Here is Shaye's reply to me---------------

Interesting that you say 'as sitting in a living room chair was just a bad position for that tendon' as I find sitting on an upright dining chair doesn't feel good after about 10 minutes. Driving is easier as I can tilt the seat back. In the article I read it said experiencing the pain getting out of a car was a sure sign this was the problem but so far I've only done the 'knees together and swivel' like we did when we wore mini skirts haha!! Next time I get in the car I'll try it the way I did it before I ever had a hipproblem.

Hi again Shayes

An update- I wentto my physio last week with info I'd printed off the internet re iliopsoas tendon weakness/inflammation. Now I know it's always difficult to see a 'medic' with info you've gleaned yourself but I've never been backwards in coming forwards - if you know what I mean! After a bit of discussion he got me on the couch and started prodding around the groin area - where I have most pain. he found a few very tender areas. he admitted it looked as if my iliac muscle was inflamed. One of the exercises he'd given me was all wrong for this and was making it worse!!!

He showed me how to massage it myself, which I've been doing for 5 minutes twice a day and it's soooo much better already.

According to the internet this is quite rare but it usually shows up later rather than sooner - I'm 15 weeks post op. However, when I talked to my brother about it he said he had the same thing 7 months post op!! One of the classic signs is pain getting into or out of a car- when you put one leg in/out first. I just can't do that, it's too painful.

And then my reply back-------

FWIW it will take about 3 to 4 weeks to have that Psoas muscle/tendons heal. IF after about 2 months it doesn't get any better you will most likely need a small surgery. I went from tendonitis to tendonosis (and you can look up tendonosis) of my IT band. Thankfully the THR totally fixed that, and that was a huge relief as my IT Band tendonosis caused me more pain than my bad hip. Please please take very good care of your psoas muscle so that it does nto beocme permenent. I didn't with my IT band and I suffered for 3 years, I was basically handicapped because of it.

My phyical therapist is the one who about 2 weeks in after my surgery told me it was my psoas muscle, he went and felt for it. He knew. When we had our THR they are moving that leg around in positions it never normally goes when they are dislocating the hip, this is what causes Iliopsoas Tendinitis. If you think of it this way it kind of makes sense doesn't it? Lay down rather than sit, lay around for a month and hope like Hell it heals.  If you have to get into and out of a car, wear pants and lift your leg by pulling up on your pants with your arms so as not to aggravate that muscle. Don't do anything that aggravates that muscle, pray that it heals. If after 2 months it never does heal go back to the orthopedic surgeon and ask for a small surgery to repair. Trust me you do NOT want to suffer with tendonosis all your life, it will handicap you. It is orthepedic surgeon who treat your tendons also. tendons and bones work together so that kind of makes sense to me.

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