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Physio, pros cons and evidence

Posted , 12 users are following.

Kikeena
Kikeena

Some people here swear by physio saying it really helps while others have stories saying physio pushed them too far and caused extra pain.

I'm wondering about other's experiences. What was physio like and what was the outcome for you? I'm also very curious about studies that may have been done into the effectiveness of physio following a hip replacement.

2 likes, 27 replies

27 Replies

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  • Tammy55
    Tammy55 Kikeena

    Posted

    Kikeena

    That's where I am right now. I had my THR on Sept 9th and have had in home PT since then. They released me to go to outpatient therapy but after reading some stories on here, I might not go. I'm looking forward to hearing responses to your question.

    • Kikeena
      Kikeena Tammy55

      Posted

      In home physio sounds like a great idea! I too have been harmed by over zealous physios so am reluctant to sign up.
  • mic71403
    mic71403 Kikeena

    Posted

    Hi Kikeena

    Nice to hear from you!

    A good question: I'm an ex nurse tutor and keen on evidence based health...and the lack of any clear lines on this are worrying for us patients. Also on the elasticated stockings...which I was told are 20 years out date of being good practice - yet others here have had to wear them!

    So...I was not given physio which was a shame...but I came into the hip op very fit and did do the prescient exercises regularly. All was well thankfully.

    I too look forward to other responses here. Kate say said she had a tough physio, but she enjoyed the challenge and never felt over stretched. So our personality may be a factor too perhaps.

    Enjoy the sunshine

    Mic

    X

    • Kikeena
      Kikeena mic71403

      Posted

      I too am very keen on evidence based treatments. Without evidence it's just someone's good, or bad, idea. It seem there's a whole industry built up around this with rehabilitation hospitals, but I'm concerned there isn't a standardised treatment.

      In the past I have been damaged by over zealous, but very lovely, physios. Surely there must be studies into the effectiveness of this with so many people doing it every year, and so many others needing PhD topics.

    • renee01952
      renee01952 Kikeena

      Posted

      good morning Kikeena -

      I think you are right here ... it depends on where you live, your surgeon, hospital, insurance coverage and therapist ...

      and of course your own personality ... 

      right now, 19 days post op from 2nd THR, I am taking it easier ... PT has come to my house twice now and at some point I will go to his gym and start working out there ... 

      Not much help here ... 

      big warm hug

      renee

    • cathie38426
      cathie38426 Kikeena

      Posted

      It was a physio who damaged my hip while pressing

      my piriformis muscle. Some have a theory that it can help

      back ache doing this. Two days later my leg collapsed.

      i know there must have been an underlying problem

      but she did have X-rays. She was over zealous.

      I managed alright without physios for my last hip and I will

      this time. My consultant says walking and hospital

      exercises are enough.

  • Guest
    Guest Kikeena

    Posted

    My physio was really well organised. I had 3 meetings with a one to one physio and then referred to the gym once a week for 6 weeks for more excersises, also referred for hydrotherapy once a week for 6 weeks. I love them both and they have been very very helpful. Also do a lot of walking at home and excersises inbetween too. Hope this helps Gillxx
    • Kikeena
      Kikeena Guest

      Posted

      Thanks Gillian. That sounds really organised and it fit what you needed to do. Glad you had such a positive experience.
  • Riley429
    Riley429 Kikeena

    Posted

    Was not given physio either.  I think a basic home assessment and initial physio instructions would alleviate the initial stress and discomfort of coming directly home.
    • Kikeena
      Kikeena Riley429

      Posted

      I'm wondering of that is all that is needed. Initial instructions to help speed healing, and then just getting up and doing whatever you can.
  • Kikeena
    Kikeena

    Posted

    It seems there have not been enough studies to be able to say which is better for rehab. Which I don't think is very helpful.

    "Currently, there is insufficient evidence (largely due to a lack of high-quality research) to suggest superiority of one particular type, location, timing or duration of available rehabilitation program after elective hip or knee replacement. The superiority of a group-based program, inpatient program or outpatient program is unable to be determined. Further research that specifies intensity of intervention and uses consistent measures would be beneficial."

    http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0020/172091/EJR-Evidence-Review.PDF

  • linda72833
    linda72833 Kikeena

    Posted

    My physical therapist was a great help and never pushed me beyond my limits.  I, on the other hand, pushed myself too far with one of my exercises and strained a muscle.  My advice: don't overdo physical therapy.  Be gentle with your body.
    • cathie38426
      cathie38426 linda72833

      Posted

      I agree, and each afternoon lie flat on the bed for

      an hour, which is the Royal College of Surgeons

      advice. Also get up out of your chair regularly in

      the early days. Rest and movement must be balanced.

    • Kikeena
      Kikeena linda72833

      Posted

      That's what I'm thinking too Linda. Do the exercises until your body starts to become tired. Then rest.
  • andy90315
    andy90315 Kikeena

    Posted

    IMO I reckon it depends on a person's situation and personality. Some possibly most people have modest physical activity in their lives, so need a little instruction in reminding their muscles of their job. Others like myself have always been very active and take an interest in how their body works and its limits.

    After the initial Physio at the hospital I knew what not to do e.g. twist the leg without moving the whole body and went from there. My surgeon is quite young and keeps up with what's happening, so no stockings, minimal blood thinners (timewise) no mention of antibiotics with future dental surgery etc.

    Yes it's a shame that there isn't more data/research on post hip replacements as there appears to be many differing theories like no sleeping on your side for many weeks and yet a simple pillow between the legs is all that's required....

    • Kikeena
      Kikeena andy90315

      Posted

      Two excellent points Andy. Different people have different personalities and varying interest in pushing their bodies to perform. I definitely fall into the latter and have many interesting conversations with my son in law who just loves to push his body to extremes. I suspect physios themselves are like this too.

      Your other point is that older surgeons stick to older ideas that have no evidence base, and may be fearful of moving on from their comfort zones. So true and so frustrating. Medicine is not just a science, it also seems to be a ritual.

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