hip pain causing tilt

[Yankeebstrd]

I have had avascular necrosis in my right hip for many years now and I'm putting off replacement surgery as long as possible. It affects my low back and right leg and something is causing my whole pelvis to tilt. It looks like I have a beer gut and my ass sticks out. It sucks, and it gets worse on leg day or if I work low back. My question is, is there excercises I can focus on to eliminate or minimize this? Is it caused by my low back muscles tightening up? Help!

[j4ever41]

How old are you? What is your range of motion like? How much rom have you lost?

[Yankeebstrd]

I'm 39. This is an injury from a car accident I was in 15 years ago. It has just progressed. Rom...good question. As many orthos that Ive been to that have checked my rom Ive never had one tell me. It also varies. If I'm on deca I gain quite a bit of rom. I made the mistake of running winny 8 months ago and could barely move. On a regular day, simple tasks like putting on a sock is a challenge.

[j4ever41]

is your pelvic tilt foreward and down? sounds like your hip flexor is tight, you can try some stretching to see if that will help you that is if your pain will allow it,you can do standing hip flexor stretchs and also one that might be a little harder for ya is to kneel on the knee of the effected leg ( like you are going down on 1 knee to ask your girl to marry you,lol ) keep everthing lined up the best you can including your pelvic area then reach back with hand on same side of effected leg grab your ankle and pull foot up,be gentle and take it slow. The bad thing is the more necrosis and arthiritis the rom you are going to lose and as you have already mentioned you will need a thr 1 day no way around that,if i were you bro yes i would put it off but not to the point where it is totally interfering with your daily life because if you put it off to long your rehab will be much more difficult and you will most likely not gain as much rom back,1 thing you need to do is search out a top notch doc that does nothing but hips and knees do not go to a general ortho also try to find someone that has a fair amount of replacement surgeries with a younger population,reason i tell you this is because i have been thru it, i had a thr when i was 37,there are few different types of articulating hips out there,metal/poly,metal/crosslink poly,ceramic/ceramic,metal/metal and hip resurfacing,i can tell you that after you the replacement you will think it is a miracle due to the fact that you will be pain free,can i walk in the gym and squat 500lbs nope those days are over now i do leg extensions,leg curls,light leg presses and calf work and i dont run for cardio i bike ride,if you want feel free to pm me be glad to discuss with you,it might help for you to do some stretching for your lower back but the rom lost it can make your lower back weak.

[Yankeebstrd]

Thanks for your advice/info.... I will attempt these stretches and let you know if they help. I do have a very competent expert in hip resurfacing chomping at the bit to get me in surgery. The reality is I need to stay working or my financial ship sinks. I dont have an office job so my conservative dr wont sign a release for 6 weeks at a minimum. As far as squatting 500. Well those days are long gone anyway.

[Yankeebstrd]

is your pelvic tilt foreward and down? sounds like your hip flexor is tight, you can try some stretching to see if that will help you that is if your pain will allow it,you can do standing hip flexor stretchs and also one that might be a little harder for ya is to kneel on the knee of the effected leg ( like you are going down on 1 knee to ask your girl to marry you,lol ) keep everthing lined up the best you can including your pelvic area then reach back with hand on same side of effected leg grab your ankle and pull foot up,be gentle and take it slow. The bad thing is the more necrosis and arthiritis the rom you are going to lose and as you have already mentioned you will need a thr 1 day no way around that,if i were you bro yes i would put it off but not to the point where it is totally interfering with your daily life because if you put it off to long your rehab will be much more difficult and you will most likely not gain as much rom back,1 thing you need to do is search out a top notch doc that does nothing but hips and knees do not go to a general ortho also try to find someone that has a fair amount of replacement surgeries with a younger population,reason i tell you this is because i have been thru it, i had a thr when i was 37,there are few different types of articulating hips out there,metal/poly,metal/crosslink poly,ceramic/ceramic,metal/metal and hip resurfacing,i can tell you that after you the replacement you will think it is a miracle due to the fact that you will be pain free,can i walk in the gym and squat 500lbs nope those days are over now i do leg extensions,leg curls,light leg presses and calf work and i dont run for cardio i bike ride,if you want feel free to pm me be glad to discuss with you,it might help for you to do some stretching for your lower back but the rom lost it can make your lower back weak.

Unbelievable! Just a few days of stretching my hip flexor, I am relieved of alot of pain in my hip and low back. It all makes sense to me why. After all the orthos Ive been to you'd think that one of them would clue me in to this. But I suppose it would make me that less inclined to get surgery. I'm gonna go to a rehab specialist. Any recommendations? PT, kinesio, sports med specialist??

[j4ever41]

good for you bro im glad it helped,you should be able to go to a good pt,i would just ask how old of a patient population does he/she work with just to make sure thay are not all 80 year olds also ask how many patients the pt handles at 1 time because you will want to get some good 1 on 1 time,keep working at it bro i hope it gets even better.

[Kratos]

Sounds great you get some relief from stretches!!!
That's the way to go before surgery for sure. Conservative treetment is always the first line. Surgeons are a hammer so everything looks like a nail to them, I find they just have it in their mind they have the right tool to fix you. It isn't really all about greed, rather they're a student of their own thinking more then anything. OK, some are greedy mo-fo's but most of them want to help people.
But, when the pain returns and the stretches aren't working anymore, don't put off surgery too too long. The technology is getting better all the time, but what we have now is pretty good, and you can expect to last a long time.
If it's messing up your alignment and quality of life, get it done.
No point giving yourself a degen scoli that leads to back surgery, SI joint problems, or damage to your knees or other hip to avoid surgery on the unhealthy one that will need replacing at some point.
At some point the time will come to get it done, so keep that in mind and make sure you aquire some decent health insurance in the mean time.

[Yankeebstrd]

I'm good insurance wise. Its paying bills while I sit home and recover that has kept me from getting this over with. My employer doesnt want to see me until I'm 100 percent. That could be several months. So this advice is awesome, as it gives me time to sock away cash and come up with a plan. Your right Kratos. It is a dance, navigating the advice of surgeons and running the clock on an injury that can cause other problems. I'll post my progress, if any, with a PT once I get one.

[j4ever41]

Yank how is everything working out for ya?

[Yankeebstrd]

Yank how is everything working out for ya?

Still no pt.Ive been too busy to call and get that going. other than that its tough to say. I just came off a few weeks ago so that means I'll be in alot of pain no matter what. It has beenmuch less than usual.

[j4ever41]

yank just a suggestion but when you get ready to have your surgery have you thought about resurfacing as opposed to a total hip?I take it that the avascular necrosis is of the femoral head, you would probably be a great candidate for a resurf,i was going to have resurf but my femoral neck was in to bad of shape and i had to get a total but thats been 6 years ago and im doing fine i just miss doing squats and deads.

[Yankeebstrd]

theres been no squats, deads, leg press or bench press for me for 3 or more years. I also have a torn pec and rotator cuff issues. Everyday is pain and my size and symetry have suffered. But anything I can still do is essential to keeping from spiraling down. Both mentally and physically. I am a good candidate for resurfacing and thats what I will do. I have a great ortho that I trust. Like Kratos said, if I wait too long I'll have to go full hip. I would rather not.

[j4ever41]

damn bro sorry to hear all that, it can be mentally and emotionally difficult to deal with injuries but we press on. Thats cool you be able to get a resurf i think you will be shocked after the surgery because you will be pain free,i think we get so used to dealing with everyday pain we forget how much it is,people do not know what toll having chronic pain can put on you,after my surgery and to be honest the surgical pain was not that bad,i went to rehab for 6 weeks and it was badd ass just to be able to walk pain free something as simple as being able to go on a vacation and enjoy myself was in my grasp again. Goodluck to you bro.

[Yankeebstrd]

Thanks j4, thats all good stuff to hear. And your absolutely right about becoming accustomed to everyday pain. Your not the first to say how suprising it is to be pain free after surgery. Some part of me thinks that even after surgery there must still be some nagging pain that lingers. Hopefully one day soon, I can find out for myself.