Knee surgery is a major milestone in the life of any patient. Whether it is a simple arthroscopic procedure or a major open surgery, the knee joint is extremely sensitive and will need rehabilitation and therapy to regain its normal function. During this time, it is not uncommon for other parts of the body to experience pain or stiffness. One complaint that plagues many recovering knee patients is hip pain. Because the knee joint supports so much of the weight of the body and is so important for proper function and flexibility, when it is compromised, other parts of the body have to work overtime.
The function of the knee is one of the most complex in the human body. The knee is the largest joint, and it is made like no other. A series of tendons, ligaments and muscle essentially hold the joint together, while the kneecap, or patella, floats inside this ring of protective tissue and serves as a fulcrum for leverage between the upper and lower leg muscles. Because of its relative instability due to the soft nature of these tissues, the knee is notorious for injury and damage. Anyone who is active, especially athletes, are at high risk of hurting their knees at some point in their lifetimes. When this happens, despite the best of care and rehabilitation, surgery may be necessary. When this is the case, the quadriceps muscle, which is the main support system for the knee, "shuts down." It takes extensive rehab to get the quad back on track, and during this time, the stress of walking and other activity is shifted to other areas of the body, the hip being one of them.
When the knee does not bear the weight of the body as it usually does, the stress of walking, standing, sitting and bending is shifted. On the same side as the bad knee, the shift will be down to the upper shinbone and the muscles that run alongside it. This can cause pain along the shin and on the inside of the leg and kneecap. When a patient experiences hip pain, it is most often on the opposite side of the injured knee. This is because the body has shifted a majority of the weight and activity to the uninjured side, placing more stress on the hip and leg. Another reason for hip pain is that even when standing, the body shifts the weight to the healthy side, causing the hip to "slide" up on that side, which is a misalignment. After several days or even weeks of this shift, the patient is likely to suffer hip pain.
Generally, hip pain is not seen immediately after knee surgery. It usually shows up during the physical therapy process. When the patient is walking, whether with a crutch or other support, the unnatural shift of weight will be occurring, and this is when the stress on the hip, as well as other parts of the body, will happen. Most often, the patient will not notice the hip pain until several days have passed, and it is important to mention this to your physical therapist, as she will give you exercises to do to prevent this pain and may also provide manipulation to help with the alignment of your hips. In some cases, hip pain may be noticed after a particularly demanding physical therapy session. This is normal and should be no cause for alarm--again, just be sure to mention it to the therapist. Recovery from the hip pain usually goes hand in hand with recovery from the knee surgery, as the stronger the knee gets, the less stress will be placed on the hip.
When you are walking, which will be within 24 hours of your surgery, try to concentrate on keeping your hips even. Do not let your pelvis slide to one side as you rest your weight on your good leg. This will take effort, as it is the body's natural position to shift the hip upwards when one leg is "cocked." But if an effort it made to avoid this action, it can do much to allay the pain before it even begins. Also, take the time to recover properly. Too many patients rush through their recovery and try to do too much too soon. Listen to your physical therapist and try to adhere to his guidance. Another thing to consider is that if your knee surgery was a result of arthritis damage, it is very likely your hips are affected with arthritis as well, and the pain you are feeling in your hips is a result of the same disease affecting your knees.
In addition to the guidelines above, one way to prevent hip pain is to stay on anti-inflammatory medication while your knee is recovering from surgery. The medication will keep the stress in your hip joint from flaring into a swelling, which then causes pain. It is inevitable that your hip, as well as other areas of your body, will have to take up more of the load than they are used to, but it can greatly lower the pain level with a little preventative medicine. Take the medication on regular intervals, as advised by your doctor, while you are in rehab, then taper off as you are able to maintain more activity on the knee. Once you have regained strength in your joint, the medication will no longer be needed for the hip pain.
- Photo Credit Courtesy of Rebecca Boardman
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