Originally Posted by
meg55
I am a 56-year-old physiotherapist. Seven years ago I had a labral tear (hip) and OA developed secondary to this. By the time I got my THR, 10 days ago now, I had a fixed hip flexion deformity and my rectus femoris was consequently very shortened, despite my efforts to stretch it.
What I've discovered - through personal experience! - is that the usual post-THR regime of static quads plus Thomas stretches and gait-re-ed is a recipe for disaster in a relatively young, fit, motivated person, especially in the early days when significant analgaesia is on board. At 10 days I'm walking with one elbow crutch and have very little pain - EXCEPT for the grade 2 quads strain that developed one week post-op as a result of these exercises plus my attempts to regain a normal gait with full hip extension and push-off. My new hip joint gives me full extension - my rectus femoris hasn't stretched out enough yet. Especially damaging is hip and knee flexion in supine. I keep reinjuring myself trying this. When my rectus femoris contracts the tightness at the insertion with the knee flexed is agonising. The muscle goes into cramp with referred pain all the way to the ankle. I did not have this problem straight after the op. It only developed once I was back on my feet and progressing the exercises and strained the muscle. It's put my rehab back by ... I don't know how long yet. But it's very frustrating!
I hope someone can learn from my mistakes! These exercises and stretches are fine, but should be approached with moderation and caution in a young, fit patient.