Muscle atrophy from collapsed hip

Posted by Mamie @mamie, Sep 2, 2019

Hi. I’m back with an update and more questions. I have the “odd” — some docs have said “lucky” – problem of having a totally collapsed hip with NO pain in the hip. (I fell on concrete and not diagnosed until it had collapsed) However, the collapse has made one leg about 1.25 inches shorter than the other. I use an insert to bring the leg up a bit but too high and it brings on pain. I also have almost zero range of motion to the outside with that leg. My pain shows up in my knee on that side (the knee itself has no problems) and in my lower back on that side. Because I have no pain, two ortho docs would not replace my hip (it’s done mainly for pain, I was told). Three others said they did not want to replace the hip because they might injure my atrophied muscles (from years of not being able to full extend/work the muscles, etc.) and I could be in worse shape after. Now one doc said he thinks I would benefit from the posterior approach to the surgery that it would avoid my atrophied glute medius and minimus muscles. He thought I could exercise my atrophied muscles back into shape but it would just take longer. I am 68 with a BodyMassIndex of 35.

Have any of you dealt with atrophied muscles? I’ve had this problem for about 6 years but do floor stretching exercises and walk about a a half mile a day with two canes to keep me straighter. I would really like to not have to depend on a cane since I live up north and worry about the cane slipping on wet/frozen ground and I worry about falling since I can’t put that leg out to catch myself, etc. Plus I figure if I don’t take a chance now, I will never know if I could have gotten better.

Any thoughts on my situation?

Hi @mamie that is very interesting and must be frustrating.

I'd like to tag @lindyloo8 @katrine and @teemarie as they have similar experiences and may be able to offer you support.

@mamie, what are your thoughts about the option the lone doctor offered?

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Good evening. I know what it’s like to have atrophy muscles. I have in thigh and buttock atrophy. This was due to deformed hip that was not letting muscles be used correctly. I had hip replacement and it took a little over a year to get off the cane. Muscles were weak and there’s been pain because I was a almost 2 inches short so dr gave me back almost all my length. So muscles have been stretched. The muscles are stronger but was a long recovery. I also got nerve pain. The femoral cutaneous nerve was either damaged or injured because I did have to have a total hip revision 3 weeks after first hip replacement due to dislocation. I think it was because my hip muscles were weak and didn’t hold new hip in place. After revision I had to be non weight bearing and no hip flexión past 80 degrees for 6 weeks. Was a very hard and depressing time for me. It’s been a little over 3 years now. Still have nerve pain tho. But am walking with no assistance and go to gym 3/4 x a week. If it wasn’t for the nerve pain I’d be ok. I’m on gabapentin and have a spinal stimulator I planted for past year and a half now. I wish you all the best.

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@holybible

Good evening. I know what it’s like to have atrophy muscles. I have in thigh and buttock atrophy. This was due to deformed hip that was not letting muscles be used correctly. I had hip replacement and it took a little over a year to get off the cane. Muscles were weak and there’s been pain because I was a almost 2 inches short so dr gave me back almost all my length. So muscles have been stretched. The muscles are stronger but was a long recovery. I also got nerve pain. The femoral cutaneous nerve was either damaged or injured because I did have to have a total hip revision 3 weeks after first hip replacement due to dislocation. I think it was because my hip muscles were weak and didn’t hold new hip in place. After revision I had to be non weight bearing and no hip flexión past 80 degrees for 6 weeks. Was a very hard and depressing time for me. It’s been a little over 3 years now. Still have nerve pain tho. But am walking with no assistance and go to gym 3/4 x a week. If it wasn’t for the nerve pain I’d be ok. I’m on gabapentin and have a spinal stimulator I planted for past year and a half now. I wish you all the best.

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Hi, @holybible Thank you for your thoughts. First, it appears my computer "autocorrected" what I wrote. I do not have a shattered hip, I have a collapsed hip and that makes a big difference. Did you have an anterior or posterior approach for your first replacement? I had read that anterior apparently has a risk of femoral nerve damage. Can any type of neural manipulation (Barral Institute has some info) help your nerve pain or has that not worked? I worry, too, about a dislocation if I do undergo surgery. I've heard of two people this summer who had several repeat manipulations because their joint dislocated. Which buttock muscles were atrophied? Gluteus max? medius? minimus? That is great (and encouraging to me) that you can walk without a cane now and can go to the gym. I hope your nerve pain can be solved soon.

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@ethanmcconkey

Hi @mamie that is very interesting and must be frustrating.

I'd like to tag @lindyloo8 @katrine and @teemarie as they have similar experiences and may be able to offer you support.

@mamie, what are your thoughts about the option the lone doctor offered?

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Hi, @ethanmcconkey First, my subject line is wrong. It should be collapsed, not shattered, hip. My computer must have autocorrected the writing. Anyway, regarding my thoughts on the lone doctor's option: I am torn. I can get around now with one cane or two but am stressing the knee of the leg that is longer and causing arthritis in my back on the low side. I imagine that will only get worse. But I worry when I read here about all of the many things that can go wrong during these operations and after. If I don't do it, I might never know if I could have gotten "better." Is it best to just take a chance and deal with what comes when — or if — it comes?

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@mamie

Hi, @holybible Thank you for your thoughts. First, it appears my computer "autocorrected" what I wrote. I do not have a shattered hip, I have a collapsed hip and that makes a big difference. Did you have an anterior or posterior approach for your first replacement? I had read that anterior apparently has a risk of femoral nerve damage. Can any type of neural manipulation (Barral Institute has some info) help your nerve pain or has that not worked? I worry, too, about a dislocation if I do undergo surgery. I've heard of two people this summer who had several repeat manipulations because their joint dislocated. Which buttock muscles were atrophied? Gluteus max? medius? minimus? That is great (and encouraging to me) that you can walk without a cane now and can go to the gym. I hope your nerve pain can be solved soon.

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Good morning! It was both! I always walked with a limp, I felt like I would have to kind of force my leg to move forward. And my right butt always looked mis shaped. I was always self conscious about it. And When I wore pants the right side was always looser than the left. I had a hard time with pants fitting right. I have tried various injections into that nerve to help with pain & the sensitivity. currently I have numbness mainly on side of the thigh not whole thigh but in a certain area. I did have the anterior first then the second surgery was posterior. I believe that second surgery really left my butt muscle in bad shape according to my doctor he had to lift it up off the bone so I currently have some issues there. I’ve been working with a pain doctor and he is the one that did injections then suggested the spinal cord stimulator. I’m not sure just how much that really helps. currently the battery location has been my main problem, hurts when I lay on my back, when I lay on my side it has just literally been a pain in the ass!! I’ve not heard about this neural manipulation thanks for info I’ll be checking into that. I believe that again being short on that right side for so long has also affected the IT band. It has been stretched pretty good too, it’s been really tight and where I’m getting now my sensitivity is right down the side of the thigh by the knee so it starts like a little above the knee on the side all the way to mid thigh. It’s sensitive to touch. And side of thigh still sore. I can walk about a mile with inclines too. Pool is best to start with tho!

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@holybible

Good morning! It was both! I always walked with a limp, I felt like I would have to kind of force my leg to move forward. And my right butt always looked mis shaped. I was always self conscious about it. And When I wore pants the right side was always looser than the left. I had a hard time with pants fitting right. I have tried various injections into that nerve to help with pain & the sensitivity. currently I have numbness mainly on side of the thigh not whole thigh but in a certain area. I did have the anterior first then the second surgery was posterior. I believe that second surgery really left my butt muscle in bad shape according to my doctor he had to lift it up off the bone so I currently have some issues there. I’ve been working with a pain doctor and he is the one that did injections then suggested the spinal cord stimulator. I’m not sure just how much that really helps. currently the battery location has been my main problem, hurts when I lay on my back, when I lay on my side it has just literally been a pain in the ass!! I’ve not heard about this neural manipulation thanks for info I’ll be checking into that. I believe that again being short on that right side for so long has also affected the IT band. It has been stretched pretty good too, it’s been really tight and where I’m getting now my sensitivity is right down the side of the thigh by the knee so it starts like a little above the knee on the side all the way to mid thigh. It’s sensitive to touch. And side of thigh still sore. I can walk about a mile with inclines too. Pool is best to start with tho!

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Good morning. Thanks for the info. So the second surgery (posterior) was worse? That's the one recommended for me by the only surgeon who will do anything. Was the problem because of the deformed hip and the muscles were attached differently? I ask because the doc said my abductor muscles did not seem "disrupted" although atrophied — making it seem as though they were adequate for surgery. I was told that the posterior approach only cuts the gluteus max muscle and the tensor fascia latae – not the minimus and medius muscles. You mention pain on the side of the thigh between the hip and the knee. That's where I had pain initially — never any groin or front thigh pain. I got probably seven sessions of Class IV laser through a chiropractic office and that pain went away. Perhaps look into that. I also see that the one doc who proposed anterior and was ready to operate at the first meeting has removed his online notes from that meeting and instead put his "I would not recommend surgery" (a 180-degree turnaround) as the notes for the second meeting. I'm thinking that docs do not like to be questioned. Only the posterior doc says (in two meetings) that I should get better and more mobile after surgery (posterior) although it will take some time and work. I am so confused! Would you say that your surgeries were worth it now — even with the pains and soreness?

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@mamie

Good morning. Thanks for the info. So the second surgery (posterior) was worse? That's the one recommended for me by the only surgeon who will do anything. Was the problem because of the deformed hip and the muscles were attached differently? I ask because the doc said my abductor muscles did not seem "disrupted" although atrophied — making it seem as though they were adequate for surgery. I was told that the posterior approach only cuts the gluteus max muscle and the tensor fascia latae – not the minimus and medius muscles. You mention pain on the side of the thigh between the hip and the knee. That's where I had pain initially — never any groin or front thigh pain. I got probably seven sessions of Class IV laser through a chiropractic office and that pain went away. Perhaps look into that. I also see that the one doc who proposed anterior and was ready to operate at the first meeting has removed his online notes from that meeting and instead put his "I would not recommend surgery" (a 180-degree turnaround) as the notes for the second meeting. I'm thinking that docs do not like to be questioned. Only the posterior doc says (in two meetings) that I should get better and more mobile after surgery (posterior) although it will take some time and work. I am so confused! Would you say that your surgeries were worth it now — even with the pains and soreness?

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Sorry took so long to answer. Well in all honesty, either way was going to be with a life a pain. Before surgery I was always in pain. Outings became too much. And I’m only 56 years old…now I can go out, BUT, I take a Tramadol to ensure a pain free day. I can walk, for most part, without pain. The nerve pain can be a problem but with lidocaine patches and Tramadol I can endure it. Now I have to deal with my left knee!! Very bad arthritis and this too will be a major surgery due to what they drs did to it when I was 12. A whole other story of my life!! I just got an injection in my knee today cause I was having pain and walking was becoming difficult. Just a band aid for now! What I went through with my hip, makes more cautious scared to do another joint replacement!! It could be possible that the deformed butt muscle created a problem for surgeon, he never really said. It’s like he did his part in doing the replacement, nothing more he can do and has pushed me back to my pain management dr. 😞

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