Hip feeling a bit sore or stiff?

[Donna Brown]

Perthes does tend to leave a legacy in the body - a femoral head that is mis-shapen (possibly mushroom-shaped, flattened, too large etc), femoral neck that has shortened and widened. If you had Perthes in one hip only, then you possibly have a LLD (Leg Length Discrepancy) too.

If you are starting to seize up or your hip is really making its presence known, then its time to get a referral to an orthopaedic specialist.

He or she will organise xrays and will check your ROM (range of movement). Most adults today, were treated by specialists who didn't explain what was happening and why when we were kids. Your specialist should be able to explain this all to you now. Its quite an eye-opener to go to the specialist as an adult and have him tell you what happened when you were a kid based on his examination and your xrays!!

Chances are that you aren't bad enough for a THR (total hip replacement) yet, so start researching your options. There are support groups and a lot of information available online about THR's and also hip resurfacing. Depending on your age, how bad your hip is, what is available treatment-wise in your area and a number of other factors, as to what you choose.

If you aren't already and are able to - get as fit as you can NOW!! If you are carrying extra weight, its a good time to drop as much as you can, to reduce the pressure going through your hip joint. Muscles will inevitably be weak, particularly the gluteus (bottom) and the adductor (down the outside of the hip). Ask your specialist or doctor for a referral to a physio to be shown some exercises that will help, if you can.

[greig]

G day Donna
I had Perthes and was encased in plaster from 1971- 1973 all was well and have had a full on life.
I am now 40 and I am getting pain in ankles and knees, I wake up every morning and it takes about 10mins before my ankles lossen off enough to walk properly.
If I have a very physical day they seem to seize up when I sit down to relax.
I this related to the Perthes, or maybe the length of time I was in plaster, and do others suffer like this, I am pretty fit, 14stone, the hips are ok, the odd occasional twinge but no where near as debilitating as the ankles and knees.
Any info greatly appreciated.

[Donna Brown]

Hi Grieg

I also had perthes as a child, but my treatment consisted of 3 months in traction, then over a year wearing a calliper/brace.

Through until my late 20's I did OK, although I have always carried extra weight. But about 18 years ago I ruptured my achilles tendon on my perthes leg. I have subsequently had 2 surgeries on that tendon and another on the peroneal tendon. Currently I am under a specialist and physio trying to avoid surgery #4! I feel, but can't prove, that the prolonged time with no weightbearing at an age where a lot of growth is happening in the body (I was 5-6 years old at the time), meant that the tendons, muscles and ligaments in that leg weren't stretched as they would have been otherwise. This has left me with very tight, inflexible tendons, I still have some muscle atrophy from the rupture and consequent castings, I am easily prone to tearing tendons, muscles & ligaments too. The ankle joint on that foot has been quite an issue too and the physio is working hard on that to loosen it up.

As part of the program she has me under, she is also working on strengthening my pelvic area, as a THR is definitely on the horizon for me, thanks Perthes! However, in the era we had Perthes, we weren't given exercises to do to recover muscle strength & flexibility like the kids nowdays are.

What is your doctor like? Does he/she know your history with Perthes? Can you organise some xrays of ankles, hips and knees so that you have a clear picture of what is happening?

I know that my knee hurts too, but I put that down to all the damage to my ankle & hip and that when either hurts, I take my weight differently through either (or both) joints, thus putting extra strain on my knee.

Donna

[ggjohn]

greig, any update on how you got or are getting on?

i had the op in the 70's was not as long as you in plaster though. i now have really painfull knees and was reffered to a specialist who blames the perthes but is only keen to watch the hip with a view to a replacement further on.
was sent to physio and built up the muscle and took some pain away as could hardly manage the stairs with the left knee - opposite to the problem hip.
now after building the muscle i get pain evenly in both knees and my right hip and sometimes in my left hip which had never ever been a problem before.
better add went to see about a problem with my knees 20 yrs ago and they suggested exploritory surgery which i refused as felt if they did not know what they were looking for on the xrays they we not going in.
i drastically reduced strain on knees and had a few trouble free yrs.

[catfaya]

May 6, 2007 21:17:06 GMT -5 Donna Brown said:

Perthes does tend to leave a legacy in the body - a femoral head that is mis-shapen (possibly mushroom-shaped, flattened, too large etc), femoral neck that has shortened and widened. If you had Perthes in one hip only, then you possibly have a LLD (Leg Length Discrepancy) too.

If you are starting to seize up or your hip is really making its presence known, then its time to get a referral to an orthopaedic specialist.

He or she will organise xrays and will check your ROM (range of movement). Most adults today, were treated by specialists who didn't explain what was happening and why when we were kids. Your specialist should be able to explain this all to you now. Its quite an eye-opener to go to the specialist as an adult and have him tell you what happened when you were a kid based on his examination and your xrays!!

Chances are that you aren't bad enough for a THR (total hip replacement) yet, so start researching your options. There are support groups and a lot of information available online about THR's and also hip resurfacing. Depending on your age, how bad your hip is, what is available treatment-wise in your area and a number of other factors, as to what you choose.

If you aren't already and are able to - get as fit as you can NOW!! If you are carrying extra weight, its a good time to drop as much as you can, to reduce the pressure going through your hip joint. Muscles will inevitably be weak, particularly the gluteus (bottom) and the adductor (down the outside of the hip). Ask your specialist or doctor for a referral to a physio to be shown some exercises that will help, if you can.

[catfaya]

Confused! I am. Thought that I had beaten it in my youth! Diagnosed at 11 yrs old. Right hip only. Treatment back then for me anyway was restricted exercise ( no trampoline,skiing ( don't fall over) restricted to swimming, cycling and walking " when possible" Got through my school years with a very bad hen toed walk and numerous 3 month x rays at hospital ( all to tell me I hadn't got any worse). Ceased at 16 and by then had fathomed out myself how to work with the pain and manage to have a much normal life. Went against my families worries and became a hairdresser. Standing for long periods! Although some days were tough most days I was tired but happy and just a normal teenager/ twenty something enjoying life. 9 years on and quit hairdressing and into Hospitality ... Reception/ Restaurant all physical activities. Doing good! ..... Last year around November I started with what i thought was the normal pain due to winter setting in and a busier time. By summer I am all out of ideas! I have been to DR ( seldom the same one) although next visit on 1st Oct will be ok. I feel that one leg ( right " perthes") is shorter than the other! I am in so much pain that I don't feel I can carry on much longer at work and can't get a good nights sleep. I'm medicated up to the full daily allowance ...and don't know where to turn! yours or anyones help would be appreciated! i have looked into shoe building etc, Can anyone help me with more ideas? thank you cx

[glennsten]

Well my hip's pretty dormant mostly so to speak, but with this (as with any medical issue) if one doctor doesn't seem to provide much help or commit much you should look for another one. Push them as much as you can to do detailed tests for diagnosis of the current state, and provide options for therapy. Maybe you have to look for a specialst in another area than where you live, could be worth a trip.

My dad used to have back pain for about 18 months that was countered with different painkillers mostly, until he finally got surgery, and it wasn't without drawbacks, sleeping disorder, stomach took a beating etc. Sadly he keeps having problems, but uses painkillers for shorter periods now and less quantity, not perfect but a better tradeoff.

Anyway, keep hunting the doctors as much as possible until you get some kind of answer!

Good luck.

[catfaya]

Thought I would update a little as off to see the Hospital Orthopedic next week. Iv'e had the physio ( once a week for an hour! yip yip the NHS.)...
Privately joined the gym ( for the swimming) helping I must say a little with mobility and sauna's are a good way to relax muscles, but costing more than I can afford long term in a big way... so just baring with is all you can do. As a full time worker in hotel ( active 10/12 hours a day) still need the pain relief from the ibrufen / diclofenic .... don't tell but much together/over dosing! Anyway also have put a heel cushion in my shoe ...this seemed to work a little also... and I would recommend anyone to try this... as gives an inclination to short leg problem due to femoral head injury ...only worked for a small time ..but haven't been measured correctly yet...and something they might look at.
anyhoo .. I'm hoping I can report some good news shortly.... for any of you that feel alone:-( you are not!!!! Please keep asking for help.... get the best information you can and get help!!! do not suffer in silence! I know a lot of people who will not be given a hip replacement ( or want it) in the early stages... but I believe .. we deserve the best possible outcome to be mobile for as long as possible... this means for most of us hip reshaping or full replacement...when we need it! ( not because it's not cost effective till 50) ... don't be scared!.. be active in starting the recovery to your full life with no pain... if we don't ask/ demand .... we don't get ! Please make aware our Dr and hospitals child perthse is here ...adult perthes is comming! thank