Trendelenburg Gait after hip replacement
Posted , 38 users are following.
I am 9+ weeks post op THR and am experiencing a Trendelenburg Gait as the result of a severed gluteus medius (and minimus) from a lateral surgical approach. I'm getting blank stares from the surgeon and PT when I ask if it will ever go away if I exercise well. I have not spoken to anyone else who has had this problem but would love to know what prognosis to expect down the road. Can anyone relate to this? I am 71 years young (the new 51!) and otherwise have had a spectacular recovery. I still use a cane and sometimes a walker when I need to go faster without limping. The Trendelenburg Gait (without a cane/walker) will eventually damage my back, hips, pelvis. I'd like to correct it before it does damage.
10 likes, 76 replies
rcoa1998 diannemcgee
Posted
Did you mean 9+ months?
The lateral technique really breaks down the support on the operated side and all kinds of compensating things take over which cause the TG. PT is huge. I am 52 and almost a year post op. It took months to get the TG substantially reduced. My operated side is still weaker so I continure with PT.
It is scary!
adamjackman diannemcgee
Posted
It is gradually improving, but gets worse when I get tired, or if I over do it.
Suziemo diannemcgee
Posted
i had the trendelburgh gait before my op . I now am 7 weeks post right hip replaced and still definately have the gait without a stick.
I can walk around the house with 1 stick and have a bit of a rolling limp but as soon astray without it I have no balance at all.
Really feel it in my hip if I try to walk unaided and think I am actually doing more damage.
Would love to hear from anyone who has had a similar problem and if they have managed to loose the gait at all .
best wishes fellow hippies
patty6412 Suziemo
Posted
Prior to surgery when tired I would do the trendelenburg gait. After surgery, if I tried walking without the cane, I would do the trendelenburg gait. The operated hip side just would not hold my weight when I'd pick up the other foot to walk. It was very frustrating as I could bike an easy 10 miles, swim lengths and felt fine with no pain unless I tried to walk without the cane. At 4 weeks my doc said, just use the cane until you can walk regularly without the cane. At 8 weeks he said the same and encouraged PT with someone who worked on stretching my muscles. At 4 months it looked like I was losing strength in my right leg from not using it and doc said try walking with out the cane. At this point I was able to do some walking thinking heel/toe and strengthening exercises. In the last 2 weeks I'm strong enough to walk without the cane for about a mile. Still have to think about proper walking form or I slip into the trendelenburg gait, but I'm told it will get better. So I'm at 5 months and just getting close to normal. Really shocked at how long it took me but apparently everyone heals at a different rate. Good luck to you.
Suziemo patty6412
Posted
Many thanks for your reply. Interesting to hear your story. Yes like you I have to really think heel toe walk. Think I just plonk my foot down.
Definately need some physio after I see my specialist next week to help .
Out of interest which stretching exercises did they give you ?
Glad to hear your doing well now. Keep up the good walk .
With best wishes
suzie
patty6412 Suziemo
Posted
Hi Suzie. First off let me say I had an anterior approach, right, THR so this may effect what you do exercise wise. The stretching exercises were:
lying on back - all ten times holding 10 seconds
1) bringing knee of operated side toward same side shoulder (compare with unoperated side to see normal)
2) bringing knee of operated side to opposite shoulder
3) while lying on back, bend knees and cross right ankle over left knee. Push right knee away and then pull forward
4) on back legs down, bring up right knee over left leg (knee area)
PT also massaged my abductors and adductors as he said they were very "tight" compared to my unoperated leg.
In addition I had a number of strengthening exercises. Found going to a gym to do some gentle strengthening of abductors and adductors to be helpful.
Actually I was very frustrated with how long it took to heal and was trying all sorts of thing. Not sure what worked but finally it does seem to be better. I'll wish you the patience that I did not seem to have and a speedy recovery. Like your "keep up the good walk"! And best back to you! Patty
herse Suziemo
Posted
Hi there. I've just been told by my consultant that I have this trendenberg gait after my 6 weeks post op review. What are the very best exercises to do to improve my gait ? I use weights in my ankles and do the side lift with each leg . I'm in the same position as you walking with stick in house bur cannot walk unaided yet which is frustrating me. Any advice to share will be good .
sue1252 diannemcgee
Posted
I'm relieved to have found this discussion, as I'm into week 9 post op from THR (lateral approach). This was my 3rd op so far, had TKR and a resurfacing of the other hip (also lateral approach) 9 years ago, and I'm sure I was up and walking without a crutch last time, much faster, after the resurfacing. OTOH I still have an impingement of the ilio psoas tendon over that large socket of the resurfaced hip, which is painful when climbing stairs or getting into bed or into a car.
I'm doing exercises as proposed in the hospital booklet but also the clam and the abductor exercises for the muscles on the outside of the greater trochanter. I found I'd got a readymade "resistance band" in the form of a bum bag with a really thick elastic strap... it's also got a quick release buckle... so I can use it while working in the office at home and exercise those idle muscles, but I can get up to answer the door without killing myself cos my knees are tied together.
Thanks for the thread, it's useful.
emmajayne1973 diannemcgee
Posted
I type this with a very heavy heart. Nine months ago, I had a corrective femoral osteopathy. My surgeon said after 6 months I would be walking normally, but here I am "month 9" with a severe Trendelenburg Gait. I am a women in my 40's, have young children, work full time and a procedure that was supposed to improve my life (basically to extend the femur to match the other in length - the shortness originally the result of a RTA in my teens) has actually left me walking with a severe limp. The femur is still yet to fully repair (bone growth seems slow) and (having found my own physio) I do 3 x 30 mins sessions a week. I have done 3 months of physio to date with little if any improvement. My consultant is very much "lets wait and see" but I feel I cannot just sit back and do nothing. I'm worried I have ruined my life and will never walk or run with my kids again. I am based in the UK. Does anyone know of any amazing residential rehabilitation centres - I wonder if an intensive programme is what I need. I feel so helpless, frustrated and down. Any ideas gratefully received. X
donna52463 diannemcgee
Posted
Hello, I am glad to find a discussion on this. I am into my 5th week post-op of posterior right THR. Pre-op I was very active even though my leg dragged and I had a pronounced limp but without pain. I noticed about 3 weeks post-op that my gait was totally abnormal. I started doing research and to my horror have found I have the T-gate and was verified per my therapist. I am a bit worried. It seems like every step I take is so exhausting to try to keep my walk normal. Honestly, I go back and forth wondering if I made the right decision on getting this surgery.
My therapist, who I started with last week, is very good and informative and I have complete trust in him. I find that stretching and a hot shower is the best short term remedy to get me started in the morning but by the middle/end of the day I am so exhausted and tired that I just plop on the couch. I'm afraid this is going to be a long haul and I was not prepared for this at all. But then, I will fight and fight hard because this will not take me down... fingers crossed.
I was wondering how everyone else is making out with recovery from the T-gait?