Before and after hip xray: hip replacement to hip revision
So here is my new hip! With a handy before (hip replacement) and after (hip revision) comparison Xray. First thing that strikes me is that there’s a lot more metal than pelvis now. Due to my hip dysplasia, I’ve never had much pelvis on that side (which was the difficulty with getting my childhood reduction surgeries to stick). The challenge for the hip revision was to extend the socket and so that bit you can see on the right hand side of the Xray is the custom 3D printed metal socket doing just that job.
I was talking to a friend a few weeks ago about the fact that I was finding it difficult to visualise my new hip because I hadn’t yet seen an Xray. And in that conversation it became clear how much I understand my condition through the hip Xrays I’ve had through my life. I have never not had a mental image of what my pelvis and hips look like and I suspect that’s the same for anyone diagnosed with CDH at birth. And so I suddenly felt lost. Now, I ‘get it’. I can see what my orthopaedic surgeon has done and I can finally connect the image with how it feels. It’s reassuring to me.
The last few weeks have been very boring. I’ve been diligent and consistent with my physio exercises, and maintaining all the restrictions around precaution height and restricted movements. For the last 3 weeks I have at least been able to go for longer walks on my crutches, but I still can’t go anywhere where I need to sit.
I saw my Xray when I had my 6 weeks post-op check up this week with my orthopaedic consultant. He seemed pleased with my progress - wound is healed well, no infections, no thrombosis, nerves appear to be undamaged and the leg is “pointing in the right direction”. He was also happy that I’m taking things slow and steady - something he wants me to continue for the next 7 weeks. I am still to stay on crutches as by far the biggest risk is falling. As he said, in essence it’s like having a big fracture in my pelvis and that needs caution. I guess if I fall and damage this, there’s no more pelvis to play with, and now I’ve seen the Xray my brain gets that so much more.
So it’s more of mostly the same.
- I asked if I can swim yet, we compromised on me adding supervised hydrotherapy into the mix, as long as I take it carefully.
- Continue with the physio with the advice of take it slowly and carefully.
- I can however start to play with lowering the precaution height of chairs very gradually - eg removing one of the three cushion - as long as I never bend more than 90 degrees. As this progresses it will give me a little more freedom to at least walk further if I can sit on a bench or in a cafe to rest half way.
- Still no bending, twisting or climbing into the over-bath shower though….so still the strip wash regime continues into September. At least when I go for hydrotherapy I’ll be able to have a shower afterwards - can’t decide if I’m more excited about getting in the pool or having the shower!!
If I'm honest, I had mixed feelings after my appointment. Obviously the overriding positive feeling is that I’m progressing well in his expert eyes, and that surgically he is considering this a success. But I also had a feeling of dashed hopes. Hopes that I could start to do more, more quickly - particularly swimming or driving, which would give me more independence.
But this is not my first surgery and I know that by sticking to what I’m asked to do, the end result will be more positive. This too shall pass. And my independence day will come :-)
Meanwhile, stay tuned, thanks for following. Love to you all x
Jill Pringle was born with hip dysplasia in 1971, in Sheffield (then called congenital dysplasia of the hips). She's had many orthopaedic surgeries as a child and adult. Jill writes this blog to share her challenges with walking as a differently-abled person.
Post-Op recovery: 1 month milestone
It’s one month today since my hip revision surgery. I find this week 4-6 period of post-op recovery the most boring. The first week is mainly feeling ill and getting over the trauma. Weeks 2 and 3 are about getting more mobile as the swelling and pain subsides; balancing movement with rest. But the second three weeks can drag - I no longer feel ill, I’m not in a lot of pain, but I’m still really restricted in what I can and can’t do. My exercises are still quite restricted, I have to vary my sitting position too regularly to sit in one place for any length of time. And there's not much variety in the days. It's the boring phase!
For those who haven’t read a previous blog post, I had a full revision surgery of my 22 year old hip replacement, one month ago. I’ve had 13 surgeries all due to being born with bilateral hip dysplasia (CDH) with one hip socket missing along with a lot of my pelvis. You can listen to more of my history on this Steps Charity Podcast here.
So what am I up to every day?
Walking, always with crutches.
As well as continuing to march up and down the garden, I’m now also taking a walk around the block each day, on crutches. Walking is by far the best PT for post-op recovery. The surgeon was strict about using crutches for eight weeks, even indoors, and to date I’ve been using them together (ie both crutches go down together as I take weight on my operated leg). As of yesterday, my physio has added a small amount of walking in the garden using the crutches reciprocally, which means a bit more weight through each leg, and a bit more of a natural walking pattern. Sadly, I still can’t walk to the local cafe, as I can’t then sit down (chairs not high enough to meet the precaution height). Nor am I braving the local coop as there are too many ‘hazards’ like people, wet or uneven floors, baskets etc to feel safe. But the daily walk is enjoyable, and extends my bubble beyond the home.
Physio exercises, with some progression.
After a hip replacement you get one NHS physio appointment for post-op recovery and a pack to follow a standard progression plan. So I decided to use a private physio who has worked with me for the last 20 years. She knows my history (so we’re not starting from scratch with me having to explain how different my hips are). She also knows who my surgeon is and how he likes to work. And most importantly, she knows all the ways I can find to ‘cheat’ the movements I find most difficult! Over 50+ years I have become very creative in this regard, but that gets in the way of me exercising the muscles that actually need to learn to work properly. For someone like me, with a complex case, it’s important that the physio doesn’t expect to do much that’s standard, and can be bio-mechanically creative - ie find different positions or props that help me exercise the right muscles safely.
For the last two weeks exercises have been:
- Standing: Heel flexes, Hip abduction, Hip extension, and then standing on my operated leg (with crutches) and moving the other one into various positions (looks like an odd tap dance!) - so that I get comfortable with the left leg taking the weight and encouraging independent movement of each leg.
- Laying: knee/hip bends, hip abduction with knees bent, hip adduction with knees bent (pushing on a rolled towel) and pelvic tilts with knees bent (but still NO bridging allowed).
For the next 3 weeks this has progressed to:
- Laying: hip abduction and pelvic tilts
- Sitting (new position puts more weight through the hips): leg extensions and holds with ankle weights, hip adduction (squeezing a towel between my knees which works the glutes more sitting than laying, and standing from a perch position without using my arms (REALLY hard!)
Short bursts of reading, watching TV, writing, learning to paint :-)
It’s important to keep my brain busy. But I have to be super careful not to sit in one position for more than about 40 minutes. So things I can do in short bursts are good, where I can also switch position between my high seat chair vs. the bed with legs up. I was never an artist at school (I’m very literal, and my creative outlet was always music) but I’ve bought a small watercolour set and a book which is helping me learn to paint natural things like leaves and flowers. Don’t expect the gallery opening any time soon folks! But it’s a very relaxing thing to do.
Visits and calls from friends
I’m very grateful for everyone who has visited or arranged calls/zooms. It’s lovely to see people, hear about things other than my boring little daily routine, and just laugh and enjoy the company of people who I know well. It also adds some variety to my day and means I will still have some social skills by the time I go back to work or choir in the Autumn.
So these are the things, day-in, day-out, that stop me from getting too bored - which would lead to my doing too much, too soon. My surgeon has put the brakes during this initial period of post-op recovery for good reason. So I need to trust in that, until I see him in two weeks' time. Hopefully then I'll find out that everything is going OK and the new hip will have ‘set’ enough, with new bone forming to hold it in place securely. Then, hopefully, the handbrake will the released a bit to allow proper rehab to start - including hydrotherapy. And I'll be rewarded with a chance to see an Xray of my new hip for the first time - Xrays of my hips have always been how I understand and connect with my hip dysplasia.
So until then, thanks for reading this and for following my progress. Stay tuned for the next episode in a couple of weeks xx
Jill Pringle was born with bilateral hip dysplasia in 1971 in Sheffield, UK. She has had various childhood and adult surgeries on her hip and knee. She writes this blog to raise awareness of living with CDH/DDH and being a ‘differently-abled’ walker.
Post-surgery hip mobilisation and the get home checklist
Restoring independent mobility is a priority after hip surgery. Hip mobilisation reduces the risk of blood clots or chest infections and our joints and muscles were designed to move. But before you can get up it needs to be safe - the sensation needs to have fully returned to your legs, and you need to be strong enough to stand without the risk of falling. In short, being a Fainting Freda is a barrier to achieving this :-)
Fainting and sickness
The day I had my knee replacement 3 years ago I was using a walker the same afternoon. I wasn’t sick because I was awake with spinal pain blocker and very light sedation only.
But for my hip replacement 22 years ago, it took 3 days to get me out of bed due to the sickness and fainting I experienced post-general anaesthetic. My friends all know that where alcohol is concerned I’ve always been a total ‘shandy lightweight’. A couple of glasses of wine on a night out and I’d start puking, and my hangovers were fierce. My body just doesn’t tolerate toxins. So anaesthetics are not tolerated well either. All through childhood surgeries, a lot of vomit was an accepted part of the recovery.
So for my hip revision surgery nearly 2 weeks ago, I wasn’t sure what to expect. I wasn’t having a general, instead they used an epidural pain blocker, but unlike me knee replacement, I was fully sedated. What happened post-revision was more like the hip replacement, with the sickness and fainting, but nowhere near as bad on the sickness. For which I’m thankful.
I was sick twice in the early hours of first morning in PACU, but fast acting anti-emetic injections stopped that. The following morning they tried to sit me on the edge of the bed, but with the epidural still attached, and a catheter still in, I was quickly put back into bed for a bed bath. After breakfast at 930 the epidural was removed along with the arterial line, and by 10am I was wheeled down to the ward in my bed. My legs were not fully thawed, my non-operated lower leg taking the longest to return to full feeling. Hip mobilisation was going to take a while.
Meanwhile, I’m watching everyone else get up an about on crutches. My competitive side was not enjoying this! But I know from my first hip replacement I just need to go with it. My body takes longer. And my surgery was more complex and longer than average.
The first tentative steps on Day +1
At 3pm the physios decide it’s time to try and mobilise me. I move to the edge of the bed and then I’m up and walking a few steps on a walking frame. My new hip feels really heavy and stiff, because it’s swollen. But boy does it feel good to move - physically and psychologically. The physio moves me back to sit in a chair, at which point I start to feel dizzy, and I say “I’m going to faint”. The nursing staff were there fast, I was given oxygen, they kept me focused and conscious. They managed to get me to take the few steps back to the bed, where they could tip the bed back to get more blood to my brain. I didn’t actually faint… so this was progress, but my blood pressure had dropped. The 30 degree heatwave outside wasn’t helping, so they brought me a big fan which is now a static feature by my bedside even at home.
Despite all that, the first night on the ward was quite relaxing all things considered. A nice dinner, chatted to the two other ladies in my ward, and we all read our books until lights out.
Out of bed with some anxiety on Day +2
The nurse assistant got me out of bed and into a chair after breakfast, and I didn’t faint which was a good start. Sitting for the first time felt strange and uncomfortable, but then sitting is not that comfy for me generally. My pelvis is very crooked, and so I can never quite sit straight. But I managed to wash with the help of a long handled sponge, and put on my own nightshirt. Another step towards independence. At this stage in recovery, doing one new thing seriously feels being let out for a night out in Vegas. But I also felt vulnerable in the cubicle. What if I faint and break my new hip? What if they can’t get to me?
I waited for the physios whilst watching the 84 year-old who had her surgery last night get up onto crutches, go off and do the necessary hip mobilisation checklist, then she started packing to leave. It was my turn, first up on the walker again, and then onto crutches. Now, with my history, I’m a dab hand on the sticks, even if I do say so myself! All looking very impressive.
Later the physio came back and I was straight up onto crutches. Yay, look at me, so confident. Star pupil. This feels good. And then, yep, you guessed it, I say, “I’m feeling odd, I think I’m going to faint”. We get back to the bed, she takes my blood pressure which has tanked again, and so I was back in bed and on a drip of fluids. Which to me, was a backward step. I shed a few tears as the physio said no more PT today.
My partner came to visit and brought some lovely messages from colleagues and friends who he’d updated (thank you, they were well timed folks!).
After he left, I lay down and figured out the pay as you go TV. I needed a distraction. Then the nurse came with my blood thinner injection (which is the least painful needle ever really) and I got really anxious. All I could think was - oh no, the cannula made me faint. I got quite upset. He was very patient, let me have my mini-meltdown, then gave me the jab. I settled back to watch Speed (Keanu always helps right?!) whilst taking on the fluids and the breeze of the fan. Watching a movie felt normal and it was the distraction I needed.
This was the longest night. I didn’t sleep at all, the next patient to arrive in the bed opposite was struggling with pain and very vocal, and I almost fainted again when trying to use the loo. So back on the drip, the fan. Was I ever going to get home?
Day 3 - the checklist to get home
It was Friday and I wanted to get home for the weekend. I felt like crap but recognised I needed a plan, and I needed to feel in control. So I started asking the day staff - what do I need to do to get home now?
There were four things:
- Not faint/nearly faint
- Bowel movement and pee without the catheter
- Have an Xray
- Fully mobilised on crutches - on the flat, up a single step, and up and down a flight of stairs
So I had a goal and a plan. I’m good with that, and the fact I asked in itself showed I was ready. I focused on each with determination.
After washing myself in a chair the catheter came out, which made it easier to get up and mobile (dragging a catheter bag around on crutches adds something extra to think about)
The physio got me up and I walked down the corridor on crutches and up and down a single step. I found this easy - up: good leg, crutches, operated leg. Down crutches, operated leg, good leg. When we got back to the bed the physio asked if it was my goal to get home today? You bet it is!! The ward staff said OK, if I could toilet independently.
Shortly after I went to Xray in a wheelchair. I haven’t yet seen the image of my new hip joint, and I’m very curious to see it. I will have to wait until I see my consultant orthopaedic surgeon in 6 weeks.
After lunch, with a bit of extra medicinal help and focus, my bowels finally opened. Poo for victory!
Then the physio took me up and down a flight of stairs, which I already knew how to do. We did my standing, sitting and laying mobilisation exercises so I was clear on them. And proved I could get on and off a raised toilet seat on my own.
We don’t have a walk-in shower at home, so have to strip wash only for 6 weeks (the risk of bending or rotating the hip too far is to big). So I had a sneaky shower in their wet room. Such bliss. Clean hair, the feel of water on my skin. Post-surgery these little moments are so precious. I felt human again.
I then waited for the discharge papers, the sick note, the meds - with the hospital transport already waiting to take me home (we have a mini which won’t easily meet the precaution height of 18.5 ins). Then I was cleared to go. Yippee!!
I was soon cleared to leave, considered fully mobilised. We had to faff a bit with the wheelchair to get me downstairs as it didn’t meet the precaution height. Lots of pillows. It was hard to get into the ambulance, but we managed. It was a 40 min journey, which I shared with a lady who had just had her knee wound staples removed (ouch, remember that one). The ambulance had limited suspension to we felt every speed bump, and the air con couldn’t keep up with the heatwave. But at 5pm, I pulled up at home.
Thankful for home
My partner was there to meet me and with the help of the ambulance driver we got up the two steps. My partner set up a bed for me downstairs, so I have everything I need on one level and don’t need to climb the steep Victorian stairs. Dudley the cat was a bit unsure for a while, but soon came for a cuddle. Another very happy moment.
We ate dinner. We watched an episode of something on the TV (I could sit in a chair for about 30 mins before needing to move). Then got ready for bed. I have never been so thankful for home.
The NHS staff at SWLEOC are incredible. I will also always be thankful for them too.
We’re all differently-abled
As I reflect on this post-surgery mobilisation, I’m conscious that we are all diff-abled. No two people will mobilise the same post-surgery. Some of us just take a bit longer. But we get there.
Until next time, thanks for all the love and support folks xx
Jill Pringle is 54 and was born with bilateral hip dysplasia. You can read more about her experiences of living with this condition, and her various orthopaedic surgeries on this blog, or by following @WalkingJill on Facebook.
Hip Revision Surgery: my first day and night in hospital
I had my total hip revision surgery just over 1 week ago. It’s been a full-on week or so, as I start to recover from a major surgery.
This is not my first hip surgery. Born with bilateral hip dysplasia (DDH) in 1971, orthopaedic surgery has been a regular cadence throughout my life. As I child, I had several surgeries to finally get me walking by the age of 3 and a half, a femoral plate removed when I was 7, a leg lengthening surgery aged 16, a total hip replacement (THR) aged 32, a knee replacement at 50 and now this revision on my original THR.
I had my surgery at the elective orthopaedic centre (SWLEOC) at Epsom Hospital in June 2025.
The morning of surgery
I had to be at hospital for 7am and I’d been fasting since the night before. I had a big glass of water at 6am then nothing. I showered in the same special wash I’d been using for the last 3 days. Despite my hunger, the journey was calm and uneventful as my partner drove me there. Heading for major surgery is a weird feeling, not unfamiliar to me. I know it’s what I need, and have been waiting for it, yet it’s scary. All the what ifs and risks are bubbling under the surface, and just that feeling that I’m about to put myself through intentional pain and trauma is unnatural.
Along with 6 other patients, my partner and I were taken up to pre theatre. It was unexpected and reassuring he could come with me - my last surgery was just past covid so no visitors were allowed at all. It helped to have a friendly face there, someone who loves me. I gowned up, had the usual pre op checks to make sure I was fit enough, ensure no infections, scratches or bruises. They drew a big arrow on my leg and wrote LEFT on it for good measure!
The anaesthetist visited and explained it would be a spinal pain management with a sedative, rather than full general anaesthetic. For me this was good news - I have never reacted too well to the GA hangover. He inserted a cannula in my arm so they could take blood and to later administer the meds. He then listed all the side effects and risks, as they must for informed consent. And then something new happened. The room started spinning, I got dizzy and hot, and I fainted. Next I knew was my partner telling them I don’t like masks on my face, as I came round. It’s called a vasovagal response but to you and me, it’s fainting. It’s a common feature of my previous post-surgery journeys because my blood pressure is naturally low. But I’ve never done it pre-op before. First time for everything!
They put me back on the bed and I was quickly back to normal. The staff reassured me that it’s quite common and all good. My surgeon arrived, which was reassuring as he’s been my consultant since 2002. He explained the hip revision surgery again, showed me a diagram of the hip joint that’s been built, and said I was first up in theatre so not long to wait. It would be 4-5 hours and I might lose blood and need transfusions. He also reminded me it’s going to be a long recovery where I need to be slow and steady, not take any risks for the first six weeks, until the new hip sets in place. He confirmed I will be weight-bearing with crutches but need modified exercises due to the much higher risk of a revision dislocating and the need for the joint to set in place.
Before 9am I said goodbye to my partner, and was wheeled in a chair to theatre. The scene when I arrived was actually fascinating - like a scene from a movie, with lots of people in the background in blue hazmat style suits readying things! I recognised the anaesthetist team, who asked me to transfer to the operating table, undid my gown at the back, asked me to lay on my non operating side then hooked my cannula up to the drugs machine. “First anti sickness” says the anaesthetist. “OK now the sedative." I asked ‘should I be feeling sleepy?. He says yes. And that’s all I remember.
The afternoon - coming round in PACU
I think I remember them first bringing me round in theatre, I have an image of a few people in gowns/masks looking at me and saying hello, including the surgeon. The next thing I remember is being in PACU, with a two lovely smiley nurses, Pam and Suzy, telling me where I was and that they were looking after me. I was hooked up to fluids and they explained that I also had an arterial line on the other side so they can take bloods regularly to check my haemoglobin levels. They gave me my phone and I messaged my partner to say Hallo and sent a selfie, so he knew I was OK and could let my sister and colleagues know. This was at 2pm. The surgery had taken 4.5 hours.
Regular observations (obs) of my blood pressure, temperature, oxygen levels continued. I had some water, a cup of tea and some toast which was heaven. They asked me to wiggle my toes, see if I could lift my legs, and seemed happy. I had no pain, the epidural was still attached and would be all night. And then I almost, but didn’t fully faint, to add a bit of drama. Once again it was over quickly with some oxygen and a big fan (which has become a staple post-surgery friend for me).
The anaesthetist and my surgeon both visited me. They were un-fazed by my fainting - long surgery, lost some blood, I’m lightweight, and I’d been fasting.
My consultant orthopaedic surgeon explained that the surgery went to plan, so he was happy. He reminded me it remains very fragile in there - I have so little pelvis on that side in the first place to work with. And he reiterated no risks at all, slow and steady for 6 weeks, just focus on letting the bone and metal joint bond so it gets nice and secure. He reminded me only to walk with crutches, no twisting, carrying, crossing my legs or over rotating the hip, and be hyper-aware of my precaution height - the lowest furniture I’m allowed to sit on so I don’t end up bending to to 90 degrees or more. More on this in a future blog because, frankly, it’s quite limiting!!
My partner came to visit about 4pm. I heard him coming down the corridor, and it was the happiest thing to see his face and get a big kiss. It was lovely to chat, although I expect I made no sense whatsoever (nothing new there he’d say!!). He brought pics of Dudley, our cat, saying hello :-) I had sandwiches and a protein shake.
Obs continued throughout the evening, once my legs were better thawed they hooked pain meds into my epidural. Then I was sick so they gave me anti sickness injections and fluids. They had to keep spraying my legs, waist and trunk with an ice spray, to test what I could feel below and above my waist whilst the epidural was still in - to make sure that any spinal pain relief was not creeping up my body as that could impact my breathing. The regularity of my obs was a reassuring drumbeat.
The evening - a long night of intermittent sleep, pain, meds
As the evening progressed, many of the people who were in the waiting room with me that morning were mobilised up onto crutches and left either to go home, or down onto the ward. I remember this from my first hip replacement where as the youngest (but also the most complex) I had taken a few days to mobilise whilst all the 70+ patients were whizzing around on crutches on the same day!!
That first night I stayed in PACU. I had a new nurse called Andrew overnight who looked out for me and a couple of other patients all night. With regular obs, ice sprays, anti-sickness and other drugs, and the fan on all night to help keep my temperature stable. My legs slowly thawed - ironically it was the non-operated leg and ankle that was the last to regain all feeling some time the following day.
And just like that, hour by hour, me and my new hip made it into day 1 post op. I could not be more grateful for the care and good humour of all the staff at SWLEOC Epsom Hospital pre and post op that day. Friendly people, amazing professionals. Thank you all so much.
I made it through that first day. And now the post hip-revision journey begins.
More to follow in a few days…..thanks for reading the blog! Love to you all xx
Jill Pringle was born with bilateral hip dysplasia (DDH) in 1971. She writes this blog to share her experiences of walking and living with this common disability.
Time for a refit. Hip revision surgery and DDH
It’s 22 years since I had a total hip replacement, needed because I was born with hip dysplasia (DDH). Hip replacements of that time last about 15 years, so I feel lucky that I’ve had over 20 from mine. But over recent years, walking without sticks has become more difficult, and in December I learned it’s time for the hip revision surgery.
What is hip dysplasia?
Dysplasia means abnormality. In short, my hips didn’t form properly. When I was born, the socket was too shallow on one side, which means it doesn’t rotate properly. But on the other side, the socket and part of the pelvis were just missing. I spent my early years in and out of Sheffield Children’s Hospital, with open and closed reduction surgeries and in a hip spica between them. You can read more about that in some of my previous blog posts – from my early memories of surgery, to my leg lengthening, my hip replacement and a stabilising knee replacement in 2022. Like many people born with DDH, surgery is just part of my life.
Why does a hip replacement need revision?
Quite simply, the parts, and the fixings, start to wear. Just like a real hip. We humans take a lot of weight through our pelvis and hips, and they are made to move. Don’t know about you, but it’s quite for me to actually stand still. Should have been a jack-in-a-box!
The polyurethane lining in the socket starts to wear, just like with cartilage, and the tiny bits of plastic get into the bone tissue around the hip joint. This causes something called Lysis – which means the bone stops forming so well, and softens around the fixings. And so the socket starts to get looser and some of the parts need replacing.
I mean really, it’s a bit like a shelf. Nice and secure when you first put it up, 20 years later it’s come a bit loose and so needs taking down, some filler and new rawl plugs (if you’re lucky) or if not so lucky, you have to drill in slightly different places and plug the old holes. If anyone medical reads this I apologise for the massive oversimplification of your immense skill.
But it’s kinda what my hip revision surgery is going to be. So, the shaft into my femur is still secure, so my surgery will focus on replacing the ball, the socket and the polyurethane liner. And using bone filler to secure it in place and plug any holes.
A ‘3D printed’ bionic hip
Tech can be frustrating (someone changes the button you knew on Microsoft Teams LOL!). But it’s also amazing what it’s enabled in the medical field. So my new hip has essentially been ‘custom printed’ to fit my strange little pelvis perfectly. How amazing (again, if a little simplified). And how lucky to live in a country where I get to have that surgery.
Four days to go
So I’m now on the final prep journey, with 4 days to go until my hip revision surgery. I’ve had my pre op assessments, had the handover at work and I've been swimming as much as I can, and sorting out my home for what I’m told will be a “no picnic” kind of rehab. More on what’s involved in that, and some unusual places to get what I need, in my next post.
Until then, I’m hoping for as much sunshine as possible whilst I can still get out and about. Hope the weather is kind to you all too, wherever you are reading.
Until next time….
Jill Pringle was born with bilateral hip dysplasia in 1971. After an early childhood in a hip spica and various surgeries, she now writes about her experiences of living with her DDH, her surgeries and her walking challenges to raise money for Steps.
“Still on crutches?!” 9½ months post knee-replacement with hip dysplasia
Well, intermittently, the answer is “yes”. I’m still on crutches and yes, it’s annoying me! I find myself at the strange post-surgery stage where I’m more stable than I was before, but less mobile. I meet other people who’ve had a knee replacement after me, or know someone who has, and they’re off crutches and back to full fitness which is a little deflating.
It’s not pain that leaves me still in need of walking aids. It’s 50 years of weakness in my left hip and leg due to hip dysplasia; which of course is what caused my right knee to erode so much in the first place. My surgery has restabilised the knee but hasn’t fixed the root cause. Nor can it be fully fixed. As my physio said to me a few days ago “some muscles on the left side don’t work and never have, so we can’t rely on those like I might with other patients.” It will also take the full year to build up more functional movement.
So where does that leave me right now?
My new knee has less range (bend) but is much more stable (my own knee joints are hyper-mobile so move more than they should and wear more quickly). My orthotics mean I stand much straighter. I’m not in much pain but my muscles start to ache if I stand still for a long time, or walk for too long, and so that strength needs building. I’m weaning off the crutches based on each situation; the types of movement and duration for which it’s required.
- At home I don’t use the crutches at all. The stairs are OK as we have a rail on both sides and as long as I don’t have to hold anything in either hand, so I always have to wear clothes with pockets. If I have a mug of tea I have to place it on the step in front of me and work my way up the stairs 2-3 at a time following the cup. Over the last 6 weeks my physio prescribed an outdoor obstacle course to help me find my ‘centre’ and to move sideways, around or over them (see demo by my cat). So I’m able to walk around the garden with no sticks and do some gentle gardening but without bending or squatting.
- Around the local area I’ve now progressed off crutches and onto walking poles. This has two benefits; they take less weight, so it forces me to use my legs more whilst still allowing a natural rather than lurching gait. And they are also light enough to carry - my goal for the next six weeks is to alternate 1 minute with them, 1 minute off and then build up the time off the poles incrementally.
- To travel into London for my weekly choir rehearsal, I still have to take my crutches. The main reason for this is to get off a train. We still haven’t found a way of getting off a high step down to a platform whilst also traversing a horizontal gap. Next idea is to try stepping off backwards (I’ll let you know how that one goes!). The crutches also help at train stations or other places which for someone like me, is a huge moving obstacle course, every person a trip hazard. The crutches signal to them to avoid me. What I most long for is the chance to buy a coffee at the station and be able to carry it - target #freehandsday!
- I’m now back to working 3 days per week and on set days. I’m very grateful to have a six-month contract that allows me to work from home 99% of the time. Not only does this remove a commute or more trains but also it means I can swim every morning and still be at my desk for 9am (the pool is in walking distance). Sitting is not easy – with one hip 2.5cm higher than the other, a very crooked pelvis, and flat glutes - I lean to one side, balancing either on my hip bones or coccyx. So I try to adjust with my spine and upper body which leads to lots of shoulder and neck pain. The other advantage of WFH is that I can control the environment, desk and chair setup, no boxes, no trip hazards. Never has this been more important. And I don’t work on Mondays which means I have the energy and time to get into London for Choir – singing is my endorphine boost but getting there takes energy!
- The combination of orthotics and external shoe-raise is working well to address my leg length discrepancy. The sad thing is I have to wear something on my feet all the time (see adapted cosy shepherd slippers in the photo) so I can’t walk barefoot without one foot being on pointe! I’m also developing some pain in my left toes so the orthotic needs some adjustment (in progress). I do now have four pairs of shoes adapted so at least I can have some variety!
Don’t get me wrong. In many ways and overall life is good. I’m confident that my surgery will pay off. And I’m not in chronic pain which is not the case for so many people with DDH.
I’m just impatient. I want to progress more quickly. I want to get back out into the hills and do some walking, and that feels like a very distant goal.
Living with hip dysplasia is a ‘one step at a time’ challenge. Most steps forward, some backwards and all steps a little bit wonky! DDH is a lifelong challenge that many people like me face – 1-2 people in a 1000 to be exact. My story is just one of them.
Jill Pringle was born with bilateral hip dysplasia in Sheffield in 1971. She has had several surgeries including open reductions, leg lengthening and hip and knee replacements. She writes this blog to raise awareness of CDH/DDH and undertakes walking challenges to raise money for Steps Charity Worldwide who you can support here.
Taking Steps by talking DDH
Steps Charity recently asked me to do a podcast interview as part of their new series which tells the stories of people like me born with all sorts of lower leg conditions. Click here to have a listen - none of it was edited, it’s just me sharing off the cuff what I do and don’t remember about childhood surgery for hip dysplasia, about having a hip replacement aged 32, and about living life as a differently-abled person who can’t always take walking for granted but lives a very active and normal life.
What strikes me most about Steps is how grateful parents are to have them to turn to, and the wider community of other parents they facilitate online. I talk a lot in this podcast about how reliant I am now on what my parents could tell me years later, and how their only source of information was what the medical staff told them in an era pre-google or social media. Consequently, I feel like I know the gist of my early surgeries but not the full medical details. In some ways it doesn’t matter – what’s important is that the surgeons at Sheffield Children’s got me walking somehow despite how much of my pelvis and hip socket was missing.
This podcast also helped me share some of my earliest memories of being in a hip spica plaster cast - what that felt like and how often we had to re-plaster my knees! I remember my childhood as very happy one, I had a mindset to try and do as much as what other kids my age could do. Whilst I couldn’t excel in sports I did well at school and as a musician, and consequently I’ve lived a very full life so far. My life has been punctuated by surgeries at different points and as you know, I am now waiting for a knee replacement in January – this time on the right side which has borne too much of my weight for almost 50 years. More on that soon!
Hope you enjoy listening to the Podcast. Link again here.
And if you do enjoy it, maybe you could drop a fiver in the pot for Steps here - £5 would help them support more people like my mum and dad with an information pack that says “you’re not alone and your child can have a good life with hip dysplasia, here’s what you need to know and the support that’s here for you”
Thanks for listening! xx
Lockdown Walking Challenge: little and often on the virtual Pennine Way
I wholeheartedly support the need for another national lockdown until we are all covid-immunised and it’s safe to mingle again. My belief that it’s the right thing to do, didn’t however stop me from groaning as the local outdoor swimming pool closed last night and my next chance to unlock my joints swam away into the sunset! Well, maybe it’s my chance to set a lockdown walking challenge 2021.
I have been doing daily shorter walks around home – I usually take a walk at lunchtime or late afternoon for half an hour, to keep my joints moving and detach from tech for a while. In the first lockdown last year I used my hour a day outdoor exercise religiously.
This Saturday I walked with my trusty poles for 3.5 miles along the river. Caitlin has been doing her usual sterling job of keeping the BeaRCats community together virtually by getting us to pledge miles towards a team goal. This weekend we collectively smashed Lands’ End to John O’Groats by some distance and it was nice to play my part.
I’m definitely missing striding out in the open countryside. On New Years’ Eve I commented to my partner that I hadn’t recognised just how much walking the South Downs Way in 2019 had contributed to my mental health in that year. It gave me a big goal, a sense of purpose and helped me embrace @WalkingJill – the girl born with hip dysplasia – as a big part of my identity. It also helped me deal with my dad’s death that year and so when my mum died towards the end of 2020, I feel that I haven’t had the same outlet to process that she's gone.
The walking I’d done on the South Downs hadn’t just been about the physical action of one foot in front of the other. It was about connecting with nature, with my family childhood in the Peak District and ultimately with myself and my different ability. The national park was my own personal mindfulness app.
Since the lockdown state is likely to continue well into 2021, I feel the need to get more consistent about finding that walking rhythm and having that challenge to focus me.
In lieu of swimming I will have to use my wonky-yoga to try and manage the locked joints. And to do my lockdown walking miles this year in much smaller chunks without travelling.
Steps Worldwide’s work over the last 40 years reminds me that there are many people who can’t take walking for granted. 250,000 people are born with or develop a hip disorder every year. In 1971 I was one of them and I'm lucky that I can walk, just a bit differently.
I might not be able to use my right to roam the moors right now, but I can walk every day and I need to put that to some good.
So from tomorrow I’ll start logging my local daily walks towards a target of 268 miles – which is the length of The Pennine Way. It’s still my dream to walk it for real one day – the oldest and most challenging national trail from the Scottish Borders through Northumberland and Yorkshire down to the Derbyshire Peak District so close to where I grew up.
But in 2021 I’ll walk The Virtual Pennine Way.
And I’ll do it my own diff-abled way.
You can follow my progress on Facebook @WalkingJill and if you want to donate to Steps Worldwide you can do so here.
Unlocking my lockdown joints with a 5K walk.
This morning I just needed to get walking again. Whilst I have walked 30 minutes locally every day through lockdown, I can feel how tight my joints are and my unusual gait is more pronounced. Which means my muscles are working harder - and they ache. A lot.
I know there are two things which, in combination, help me manage my hip dysplasia and painful knee: Swimming and Striding. Since I still can’t get into the pool to do the laps I love, I decided to pack my poles, don my walking boots and drive to somewhere I could walk a bit further, and a bit faster with the help of the poles. My target was to walk 5K – to also support my friend Caitlin Limmer and the Bearcat Running Club as today was supposed to be the annual Turks Head 10K.
Just before lockdown I moved from Twickenham to Walton-on-Thames. So it took just 17 minutes to drive to Ockham Common, park up, and start walking through the woodland. It was just what I needed! As I got out of the car I could hear the birds and smell the trees (the recent rain really helped) and I immediately felt my body relax. And I was surprised how quickly, with the help of my trusty poles, I was able to get into my stride.
I love woodland walks. I’m always reminded of walking with my parents up to Lockerbrook Farm above Derwent Water in the Peak District. Thankfully today was much flatter but equally beautiful.
I’ve never been to this Surrey Wildlife Trust land and was struck me most was the variety of terrain. I took a path through the bracken, under the tall canopy of deciduous trees and quickly got to the edge of a lake. There I could see baby frogs hopping towards the water through the rushes. I made my way into the forest along wooden planks above the bog, and into the beautiful English woodland. Here amidst more bracken were beautiful rhododendrons in dappled light. Eventually I reached a small road, across which was the most amazing wild-flower meadow. I stood and watched the butterflies playing with the tall daisies in the morning sun. I made my way back through the woodland to the car but since I’d walked less than 4K I decided to take another path. And I’m so glad I did. Here I was amongst tall conifers and walking uphill on fine, chalky ground, to a clearing. And the landscape changed again. Suddenly I was amidst heather, birch saplings and small Christmas trees! And a big sky.
After a round loop I made it back to the car having walked over 5K. It was enough to stretch my joint, but not too much for a first outing. I have managed to book my first osteo appointment in 2 weeks’ time and hope to start swimming in July to really re-align my body.
Because now I have the walking bug again. Which feels simply wonderful.
The 'Wonky Dog'. Yoga and hip dysplasia.
So I got up this morning and decided that I was definitely going to seize up if I didn't take action to get more exercise during the collective lockdown. For the last few days I have gone out for a daily walk - at safe distance - but my body is so used to its morning swim, and monthly osteo visit, that it's starting to really object. The swimming pool has always been the one place where my body doesn't feel lopsided, and it totally relaxes. Rather than feeling like exercise it feels like giving my brain and my muscles a rest. Like everyone I've got to find a new way of doing things when what we would normally do isn't an option for very good reason.
My drawings for a pop-up olympic pool in our back garden quickly proved that I was missing most of what I needed - the space, the materials, the ability to build anything. And so I turned to my dusty yoga mat. I used to attend yoga classes in my late 20s and through my 30s, but have got out of practice in favour of swimming.
I remember my first ever Yoga class. Well actually I tried Pilates first but when I couldn't complete any of the warm up exercises I felt too awkward to return. But for some reason, in the Yoga class I could at least do something approximating the poses. And the class teacher was happy to let me get close to poses or do alternatives rather than try and push me into a pose.
And so my sun salutations this morning were my own 'hippy' version. And it was just what I needed. Achieving perfect balance between left and right when the two sides of my body aren't built the same would be a futile exercise. And so I work each side of my body as it needs, and I just skip the bits that aren't possible. The point is I'm doing it. And my muscles and mind felt the immediate benefit.
And I have invented three of my own Yoga poses. The wonky dog. The slanty plank. And it finishes off with the hippy shake (yep, sort of dancing it out).
What are you all doing to keep yourselves moving? I'd love to hear from you.
Stay safe, follow the guidelines, and do whatever exercise your hips need to keep mobile.