sit bone pain

by Ann
(UK)

I had a cemented total hip replacement in September 2017 and having quite bad pain in that I still can't put weight on my right leg and when I try I get the worse pain all around my hip, in my groin, thigh and knee; also I am now getting what I think is sit bone pain.

After reading your information I think it is from maybe the adductor muscle pulling on the pubic ramus, in between the legs on the right side at the top inside of my thigh. I hope you can gather where I am trying to say as it's what I think I am feeling.

I can't sit for very long at all and even partially lying down in bed is no better and I end up sitting half on a cushion and the right half of bum cheek on a pack of ice or place it sort of in between the top of my legs and under my bum cheek. I hope you can make head or tail of this. What I am asking is what is the best exercise or thing I can do as I can't cope with this on top of every thing else. My left hip isn't good either. Thanks.

Hello Ann, sorry about the misery you are experiencing.

I take it you've been back to the surgeon, he's re-examined you and taken a new x-ray of your pelvis. There's no sign of loosening of either the cup or the shaft in the femur? Are the hips level?

A vital question is whether there is a sacroiliac joint fixation; it may have been there before the operation, or subsequent, but we find it's often a big factor in failed hip surgery. In the test of Gillet, one thumb is placed on the sacrum, and the other on the PSIS, you raise your knee, and there should be movement in the SIJ.

Sitting in a kitchen chair, flex your head onto your chest and ask someone to straight first the left leg and then the painful leg parallel to the ground; are the equally tight?

This is complex stuff, Ann, and I wish I could be more helpful; start looking for a chiropractor who works with hips.

Dr B

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