Severe Hip Arthritis - is my running career over??

I had a total hip replacement about three years ago. I'm running about 40 miles per week now, including speed work and tempo runs. I've had no problem with my hip, although I'm not nearly as fast as I was before surgery; I've just adjusted my running goals. A hip replacement is NOT necessarily the end of your running career. A lot depends on the type of replacement and method of surgery you would have and on whether your surgeon is current on long-term effects of running on the replacement.

Sorry to hear about that news. I'm on a similar path, arn't we all to some degree, but older and not as far gone.

I'm just starting to research it and certainly don't expect I do or will have all the answers.

At some level it is as simple as your hips are like tires and there is only so many miles you can get on them.

BUT, I wonder what we can do to increase the miles we can get on the tread that is left.

In your case, maybe start with an understanding of WHY your affected hip is wearing so "poorly' and with that understandinging determine what you can do to improve that. You have the MRIs, I would start researching and getting others' opinions. Maybe a Chiro (know I'll get flamed for that), just as one example/data point....maybe one leg is much shorter....EXAMPLE ONLY...

Maybe there are some "wear factors" that are partially within our control....

Best of luck!

When you look back at your life as a long walk along a beach , for the most part,you see two sets of footprints in the sand .

For the times when you saw only one set of footprints; That ,my friend, is when Chuck Norris carried you .

You should fail conservative treatment before you have hip surgery. Go to a physical therapist who understands that cartilage can self-repair. The therapist can assure you have full hip ROM and if not then restore it. Then you will need high repetitions of nearly full ROM with tolerable pain-free load. Run on an anti-gravity treadmill. Running in a swimming pool is not very effective and swimming will not be effective for restoring joint-loading tolerance. The therapist can also assess gait mechanics that have contributed to the abnormal degeneration.

Some good suggestions here. I'll make one - forget the dreadmill and start running everything you can on soft surfaces. Grass, namely. Every run I do I run on the softest surface available. If I'm on a bike path and the dirt/grass/weeds next to the asphalt is runnable I'll run there rather than the asphalt. Find some good long grass loops and run those regularly rather than the roads.

I've also been diagnosed with osteoarthritis in my left hip. Also in my right hip, both sacroiliac joints and lower lumbar area of the spine. All proven with x-rays. Arthritis in other areas, especially the knees also probable. But I'm 63 and had a life filled with trauma. You drew a bad hand of genetic cards apparently.

Prior injuries lead to arthritis. Much of mine was probably caused by climbing and weight lifting. You want to minimize impact and trauma. Keep your gym weights light and do more and slower reps. If you can't do 20 reps with the weight, it's too heavy. I've read that rowing leads to a lot of back problems, so I don't like that advice. I'd also be careful with skating, because you use the hip joint differently with that exercise and the motion gives me pain in my arthritic hip.

Replace one or two of your weekly runs with deep water running. I've used DWR during long injury recoveries and like to use it when healthy in place of Junk (i.e. recovery runs). It simulates regular running better than any other exercise, but is impact free. Road biking, or spinning in the gym, are also good alternatives. Hiking and walking are also good cross training substitutes. Hiking briskly up hills will give you a good workout.

I'm hoping to continue running, but it will be off road and probably limited to two or three times per week. Hopefully I can do 2 quality runs per week. My long run mileage will be cut back and the run supersized with hiking (no pounding).

In training avoid running down steep hills. On gentle downhills keep it slow, but with a quick turnover and short stride to avoid pounding. Land on your forefoot and flick quickly off the foot. Don't heel strike!!!!!!!!!. Also, avoid gnarly single track as it places too much demand on the hip (that's how I finished myself off~~long trail races). Stick to dirt roads if possible. Maintaining your form is of foremost importance, as is shoe selection.

I hope you didn't love running as much as me. I've at least had 30 years more than you. Good luck.

Some of this advice is fantastic.

What is your running form like? Do you have a history of injuries to the hip? Leg-length discrepancy? Does it only hurt when you run?

G wrote:

Prior injuries lead to arthritis. Much of mine was probably caused by climbing and weight lifting. You want to minimize impact and trauma. Keep your gym weights light and do more and slower reps. If you can't do 20 reps with the weight, it's too heavy.

How much and what kind of climbing and weight lifting were you doing? What are the numbers?

To "I also..."

Example weights: Into my late 40's and early 50's I'd load 750 to 800 lbs in plates on the leg press and come all the way down, like a full squat for 12 to 15 reps. Not a good idea. Hard on shorts too~~I split the butt open on several pairs! Don't ever go more than 90 degrees at the knees. A bit less is better.

For any young guys out there, keep your weights light. Instead of going for max weight, do more reps with slower more precise movements. My doctor (who's been the physician for Olympic teams in two sports) believes that the weight is too heavy if you can't do 20 reps with it. Everyone to their own opinion, but I know a lot of baby boomer (late 50's and 60's) gym rats like myself and they all have joint issues now, especially to their shoulders.

Climbing: Mainly Alpine and bouldering. Alpine climbing was toughest in terms of traveling over loose rock (shifting forces on the joints) and through boulder fields (high steps). Sometimes joints would be stressed in abnormal ways.

With bouldering, every fall is a ground out and I took some big ones. Don't remember any hip/leg trauma while climbing roped, although I had one good friend shatter his ankle and another broke her ankle grounding out on a ledge on the east face of Mt. Whitney when a flake pulled out rendering her pro useless.

Yes to soft surfaces. I'd do the same thing on training runs---run on the soft border next to the paved trail. Even when training for road marathons, I'd do 40% to 95% of my long runs (20+ miles) on dirt, depending on my opportunity to get off the pavement. I don't think it makes much difference on race day. Perhaps your feet get sore a couple of miles earlier than if you trained solely on pavement, but you are more likely to get to the race uninjured. And since the soft surfaces offered more resistance and slippage pushing off, you are probably a bit stronger after training on them versus pavement.

caveman wrote:

Before you try surgery or drugs, try a change in diet to a plant based one while also eliminating dairy. Here are some books to read:

http://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1932100660/ref=sr_1_1?ie=UTF8&s=books&qid=1274386846&sr=8-1http://www.amazon.com/Mcdougall-Program-Dynamic-Health-Plume/dp/0452266394/ref=sr_1_1?ie=UTF8&s=books&qid=1274386943&sr=1-1

1) Use only pure water for drinking and cooking. Fluoride in the water causes arthritic, degeneration of bone, and cancer in the bones. Do not soak in fluoridated water, and limit the time of showers as it is also absorbed through the skin.

2) Avoid sitting in chairs, especially for long periods of time. Stay on your feet as much as possible, or else do exercises while you're sitting on the floor. Do not ever sit in a lazy boy chair! Use it or lose it. Inactivity is the bane of living a long life.

3) Exercise as much as possible. Especially vigorous exercise will help you to be stronger and live longer.

4) Find out what it takes to be healthy and do it. Do not have any surgery on your hip! Stay away from physicians and surgeons. Be healthy. Take control of your destiny.

Caveman

Your advice on exercise is generally good. Some of your other advice is debatable and I don't want to go there.

However, this thread is about osteoarthritis (aka degenerative joint disease) of the hip and in the case of some, including the originator of the thread, resulting joint replacement surgery. I'm sure you'll agree that no diet in the world is going to reverse joint replacement. And no one has proven any dietary change can reverse to any significant degree osteoarthritic degeneration.

Hope springs eternal however, and some believe glucosamine chondroitin and MSM supplements (I use them religiously now), possibly combined with other substances like Turmeric and Bromelain, can reduce pain and perhaps partially repair damaged cartilege. Nothing we shove down are blowholes is going to remove the bony deposition including spurs that occur with osteoarthritis.

I have no idea whether this problem is manageable, but doctors are not knowledgeable about physical therapy and its benefits for training, so I would say that before you quit or go under the knife, explore the range of exercises that might strengthen the muscles around the hips and possibly ameliorate your problem.

Oh, ..., they're trying to poison our precious bodily fluids.

G wrote:

I'm sure you'll agree that no diet in the world is going to reverse joint replacement. And no one has proven any dietary change can reverse to any significant degree osteoarthritic degeneration.

Actually diet and exercise are both the prevention and the cure.

You have no f***ing clue what you're talking about.

OP, is there any history of early arthritis in your family? Or possibly your hip's just not aligned correctly? 35 is really, really young to need a hip replacement.

Thanks jjjjjjjjjjjjjj. My doctor wants me to do P.T. despite my buns of steel. It might help a bit, but I don't see it preventing further damage if I continue to run. Perhaps I'm wrong.

Who is trying to poison our body fluids and why are they precious? :)

This is the OP (changed from Sore Leg to Sore Hip once my tibia stress fracture healed and then the hip problem surfaced). No history of very early OA in the family but have had some older relatives need hip replacements in their mid-50s which is still pretty young. They wouldn't have been as active as me though when they were younger, which is probably how they lasted 20 years longer.

Hip has probably been getting sore for the last 12 years. Did a lot of taekwondo when I was younger, which the docs say was probably the wrong sport for someone with hips like mine, as they weren't naturally the most flexible.

Skating while playing hockey has definitely been hard on the hip; swimming is okay but the wall push-offs cause some pain. Haven't run in 1 year now and even with walking around I have a noticable limp. I think OA in smaller joints like the toes or feet might be something I could run through, but I've been strongly cautioned about trying to run where the OA is in the hip. Having it in a major weight bearing joint and doing impact activity such as running will definitely speed the progression of the OA. The fact that walking is difficult makes it obvious to me, as I definitely tried to run with the pain for a long time and I do think that wasn't a great thing to do.

Don't know if I could actually run now even though I want too, think it might simply be too difficult. I've been working with physio for the last couple of years. Our current goal is to maintain the range of motion that I have and try to slow it's regression. Don't think I'm going to be able to improve the range, it hits a hard endpoint and simply won't go any further.

Surgery is going to be my last resort. I would love to think I'll be running again after I have it, but I worry it will cause my replacement to wear too fast. My Ortho says he'll probably let me run on the replacement (whenever I decide to go ahead with it) because I'm not very big but it's still a concern to me.

Anyone who gets a hip replacement is an idiot.

Please read OP:

I just finished up a degree in Biomedical engineering, I am by NO means an expert but I did learn a fair amount about hip replacement. If/when you need a hip replacement and since you are a younger guy, who will presumably want to continue doing some athletics (be it running or biking) I'd really recommend looking into ceramic hip replacements.

Ceramic hip replacements are gaining popularity for young people as they are very hard and can last much longer then conventional metal plastic combos. They also have less risk of debris rubbing off and becoming lodged in the joint (this can lead to loosening of the implant and actually some pretty nasty wear on the bone).

Here's a link to some really basic info:

http://orthopedics.about.com/od/hipkneereplacement/i/ceramic.htm

Ceramic hips aren't all good a major problem they have is the joint squeaking...loudly (see link below)

http://www.youtube.com/watch?v=qWerMkRAAWg

This isn't necessarily 'bad' in that the joint could be operating well and pain free. One of my professors worked with an athlete with a ceramic hip (cyclist I believe) and the hip was squeaky as hell but the guy was happy because he was able to exercise freely.

If you do have to get a replacement obviously you'll want to do your own research and talk to people more qualified than myself, but at least you know this option is available.