Nearly 9 weeks post-op and have just started jogging again

So on Christmas Day I did my first walk/run, having seen my surgeon a couple of days before who said that was OK. He’s a runner himself and knows there is no point telling me not to run!

I have a question though. What is the risk of running on roads as opposed to trails/grass? Is it merely wear and tear on the prosthesis or is there some other danger? I don’t anticipate doing very much in the way of road running but I would like to do my favourite10k race next year, which is all on tarmac. I’m just a little confused about the advice and the basis for it. I’m light and I try to run mid-foot rather than heel striking – does that make a difference too? Also, what about track running? My running club does a track session that is for all-comers (i.e. very mixed ability) and I’d love to go back to that again at some point, but not sure if track running is OK? I wouldn’t be trying to sprint, but the intervals sessions are really useful for building up a bit more speed/stamina.

Thoughts?

New member, here’s some 10 week post surgery details before I forget.

Surgery:

50 year old male, ceramic / poly hip, anterior approach.  Got my left hip replacement April 4th 2016 (the right is still original and fine).  Surgery was in the morning, could stand about 4 hours later but VERY weak.  Should have eaten more that evening but stopped at 7pm, should have grabbed something before my 12 hour window expired (highly recommend Gatorade).  No problem walking the next day.  Used a walker for 4 more days, then a cane for 2 more weeks.  Still “sort of” limped for 6 weeks, partly out of habit.

Hip history:

Had been slowing down for about 2 years now, although I have been running with a limp for 6 or so years.  X-rays over the years showed that the cartilage in my left hip had been declining over the past 10 plus years.  Doctor said that my labrum was torn, which I think I did several years ago riding dirt bikes.  That all I can attribute my cartilage loss to, doc says that it’s not possible.

Running history:

Been running regularly for a dozen or so years, mostly to stay in shape for dirt bike riding, and I consider myself a middle distance runner.  I really do like going 8 to 14 miles.  Did my first full marathon 6 years ago (3:58), preparation held me back but even then my hip was hurting.  My hip really didn’t stop me from running until last October (8 months ago), that’s when I knew it was time.  Too bad it took 6 months to get it replaced.

Getting back into running:

10 weeks since my surgery date and I haven’t run yet.  Been biking for 4 weeks and walking 2 plus miles 4 times a week for 6 weeks.  Surgeon doesn’t want me to run for 16 weeks (possibly never), but I do have a 10 mile race in September and I’m using my biking and walking to at least keep me somewhat conditioned for that.  So the 16 week “delay” isn’t great but won’t stop me.

Dentist??

So what’s this about needing to take an antibiotic after “every” dentist visit ~ for life??

Rusty – How To Get Back In The Game

It’s been a while since I posted, mainly because I’ve had a lot of ups and downs. I’ve experienced two recoveries; one was 25 month ago, the other 13 months.  I thought the first recovery was easier, but that may be jaded by the failing of my other hip. Many ask how to get back to running form.  I think I have a good handle on what to do and what NOT to do.

Where to Start:

– Stationary Bike / Spinning after two weeks (Min) Slowly Build up time and resistance.

– Elliptical after 4 weeks (Min) Slowly build time and resistance.

– Walking.  Lots of walking!  I was walking up to 8 miles 6 weeks after my first procedure.

 

Running:

– When?  8 weeks for some, 6 months for others, everyone is different.

– Cross Train.  Continue bike & elliptical, Try Yoga, Dance, Swim, etc.

– Develop a 10-15 minute core routine and do it religiously. (more on that later)

– PUT THE GARMIN ON A SHELF!!!

– Start real slow and slowly build distance.

– Concentrate on form.

– Develop the base distance and maintain that for a few months

– After base is developed, start building speed WITHOUT the Garmin

– Reintroduce the Garmin

That’s the skinny basics.  I’ve had some great triumphs this past year and some even greater let downs.  I built my weekly mileage to over 50 miles in 8 months.  I ran an 11 miler with the final mile at 7:30.  Why, because I COULD. Then I spent the next 4 – 6 weeks NOT running.  Just because I COULD doesn’t mean I SHOULD.  That’s when I put the Garmin away.

I realized my body wasn’t ready for my new hips.  I had spent years running wrong.  The medical professionals said I had a high pain tolerance.  No, my body adjusted and found a way to work around those deteriorating hips.  That’s why some of us have those funny gaits that our fellow runners make fun of.  Many of us have spent years slowly adjusting and then bam, new hips and our bodies aren’t ready for the new smooth action.  Some muscles are too strong, and some are too weak.  I really believe many of us need to concentrate on returning to good form.

That’s how I believe I got so many darned many injuries.  I was pushing hard, but everything was out of whack.  Lots of over-compensating going on!

My everyday Core Exercise routine.  Start with a few and add more along with increasing repetitions:

– 30 Push-ups

– 120 Bicycle Sit ups (for stomach and Flexors)

– 20 forward lunges each leg (For lots of core muscles)

– 20 Kneeling Leg Raise (For the Glutes)

– 20 Side lying Scissor Lift ( Abductor and Adductor)

– 20 Air Squats (Lots of Core Muscles)

– 20 Bench Dips (Tri-Ceps and Core)

Lastly, for Cross Training, I am very fortunate to have a stationary bike, elliptical, treadmill and Concept rower at home.   Along with NETFLIX and an addiction to binge-watching various season long shows.  Cross Training is a little more convenient for me.

My biggest recommendations:

– Start slow and listen to your body

– Develop core – Cross Train

– PUT THE GARMIN ON A SHELF

– Work on good form

That’s it for now.  I’d love it for others to comment and maybe we can all develop a “what to do and what NOT to do” list.

Big THANKS to Tom for helping and encouraging us all.  Merry X-mas and Happy New Year!!!!

Dave – A summary of various hip pains over my last 5 years

After my last race report I was asked about my pain before and after so thought rather than replying as a comment, I would try to document my pain over the last 5 years from prior to my replacement to my operation, starting to race, my post operation injury and now my comeback. I’m not sure it will help all of you but if you can see similarities hopefully you know that you need to give your body time to recover, cross train to build up your core, glutes and upper body, and listen to your body and slow down when you feel discomfort.

 

Before THR:

I was lucky in that I didn’t have significant pain before my THR, what I did experience was almost like a trapped nerve. I would be sitting or lying down and then all of a sudden my left leg would jump as if the nerve got pinched. Some nights it was very annoying as it would interfere with me trying to get to sleep lying in bed. As far as walking, towards the end I could only walk about half a mile before I started limping, prior to that I could walk without a limp. I think what eventually led me to decide to have it replaced was that just standing on the beach fishing, walking in and out of the water watching my lines, changing bait, my hip would start hurting. I had delayed this decision for 10 years after being diagnosed as bone on bone after being told for 10 years prior to that I had hip dysplasia. Once I decided to have it replaced I decided to start running so I would be stronger when I had the operation. At first I could run every week, a few miles with some walks every half mile or so. Towards the end I could only run every other week as it took longer and longer to recover from a run, if you could even call it that. It was like having a plank tied to my left leg, I ran about 25 yards then had to stop and walk 25 yards and repeat that. The week before my operation I did that for 6 miles, I can’t tell you how many people stopped at the side of the road and asked if I needed a ride.

 

After THR Operation:

The day after my operation I lay in bed and was in some pain but nowhere near as much as I thought I would and by the second day was feeling fairly comfortable. I couldn’t walk the first day because I got dizzy when I stood up but the second day was fine and I was able to leave on the third day. From then I didn’t use a walker, just a cane for a month but was back in week after 2 weeks. My limp had gone and apart from the hip area being tender didn’t suffer any pain and stopped taking any medication apart from to help me to sleep once I left the hospital.

 

After THR:

For the next 18 months I really didn’t have many issues at all. I started running after 3 months and I had a 5K race scheduled for 1 month after that. I did experience a lot of numbness in my lower left leg, calf area and a pin size sensitive area that was painful in the middle of the calf. On the day of my first race with my nephew and niece visiting from England I didn’t think I could run as my calf was so tight. Luckily after some light massage I decided to run and was able to finish in 26:30, the same time as one year earlier when I started training for my THR. There were several other times when I had similar pains and calf tightness but eventually it went away. Then over the next year I started to run a little further and more frequent until I started to race about 20 months after my operation. For the next 6 months I ran several 5K’s, increased quickly to 10K’s, then my first half and the week before I ran that signed up for my first marathon just 7 weeks later. It was after my marathon that I started feeling more pain again in my hip. I had crossed the line in a Boston qualifying time of 3:19:12, was given a bottle of water and had a medal placed over my head and then as I tried to walk my hip had stopped working. It felt like it did when I was training for the THR, painful, severe limp and pain down the side of my leg. After walking it off for about 15 minutes the pain eased and 2 days later started training for my next half about 3 weeks later and another 4 weeks after that. Not being an experienced runner I continued to run 6 days a week and race and very 3 or 4 days my hip would get bad again but if I walked it off it was fine and the next day I would train again. The pain then started at the very top of my leg, more in my front groin region before it started heading to the outside when my operation scar was and then down to the inside of my left knee and then down to my ankle, at the top was more of a pain but from there down it was my leg becoming very numb. After continuing this process for 3 months the pain would occur every day I ran, but if I paused, walked I could then resume running. I did this for a couple more months before my hip gave up completely in a 5K race around mile 2 and then I wasn’t able to run a mile before the pain intensified in the groin and quickly moved down as described above. At first I tried not running for a couple for days and then tried again with the same result, then I took a week off but the same on my return and then a month off and exactly the same before I reached a mile. I went back to my surgeon and he took x-rays but said everything was fine, several doctors later and a couple of thousand dollars on a chiropractor, masseuse and physical therapist no one had any remedy and I still could run a mile. Eventually I decided to take 6 months off with no running at all and just focused on swimming, biking, boot camp and yoga which I had taken up over the previous 6 months trying to recover.

 

Post Injury:

After a year of not racing and 6 months on not running I resumed a very light training on a treadmill one day a week, 3 miles at a very slow pace. I changed my run style, significantly increasing my cadence and concentrating on a mid to fore foot strike and a couple of other slight modifications. I continued this for about 3 months only increasing my distance and frequency a little until I felt I was ready to start running outside. I was lucky that I had started a job in Miami and therefore was away from all my running friends in the Tampa area and not under any pressure to run, a pressure I always put on myself as I find it hard to say no and not run fast. I found a run club and started running with them, just 3.5 miles each week and gradually picked up the pace to where I felt I was ready to race again, 18 months since my last race. There were certainly some times when I felt like my left like wasn’t quite right, almost as if it was half an inch shorter than my right leg or that it wasn’t quite screwed on correctly, not painful but it just didn’t feel right. Last December I ran my first comeback 5K in a time of 20:42 and was very pleased and without any pain and in January ran a 5 mile race at a very similar pace. After watching my friends run the Miami half marathon in Miami I decided I was ready to try that distance and set a race date of March 22nd and started training more frequently and longer distances. I would feel a little discomfort on the outside of my left leg near the incision area, more of an aching pain, nothing severe. I started to ice the area every evening and morning for 20 minutes to help manage this. I didn’t do any fast speed/sprint work as a couple of times I did my hip would start to sing and I would feel discomfort and would then limp a little.

 

Long Race:

So March 22nd came and started to warm up. For the first time not sprinting the inside groin area was a little tight and sore, I hadn’t felt any pain in that area for the 10 weeks or so I trained and had ran a 1:37 practice half the week before with no issue. If anything I did feel a little tightening of my muscle in my calf area at times but nothing like when I started my THR recovery. I tried a few moderate stride runs but didn’t feel like I could plant my left leg down and push off easily. I wasn’t sure how well I would be able to race and was doubtful of hitting my revised goal time of 1:35 after the previous weekends practice half. However when the race started it felt fine and I ran fast and strong with no pain for the first 10 miles or so. I did start to feel a little soreness in my hip but nothing more than in my training and continued to push and amazed myself finishing just 5 seconds of my PR time of 1:31:21. Again though similar to the marathon my hip reacted badly and I was unable to walk easily being asked by the medics to go to the tent, which I didn’t. Again this was more on the outside near the incision area. I took 3 days off and then started with a light run, albeit 10 miles but again could feel a pain in my groin area, numbness moving down my leg and soreness on the outside of my hip area. I also still didn’t feel like I could push off strong on that leg juts kept the pace slow. At my next couple of runs I backed of my speed and distance and also reduced my training to 4 days a week. I’m still feeling some discomfort and it only feels 80% right but have started to up my training a little but continuing to ice frequently. On my last 10 mile easy run, it almost felt like my leg was twisted as I ran, from the top, down to the knee and then continuing down to my ankle. It didn’t last all the run but did for the first 5 miles or so. I don’t take any medication for the pain or anything, but I do take glucosamine chondroitin tablets each day.

 

Right now I haven’t set any more race dates and will continue to monitor my pain as I try to recover. I hate missing races but having had to take a year off I’ve learnt how to be patient and better educated myself.

Steve – information/opinion for new or potential members

Dear All,

I am no more (and no less!) qualified to offer advice than many others, including Hip brother Tom. But I know that I was desperate for hope when I found this site and therefore I offer a few things in response to questions posed by new visitors.

As a matter of responsibility, I suppose I must offer the typical disclaimer: Every case is different and my comments/advice may not apply to all situations. There – that’s out of the way.

After my own research, and lengthy conversations with my surgeon at Hospital for Special Surgery in NYC, I believe most of the conservative restrictions post surgery are nonsense and old-fashioned. This field, like most other human endeavors, has advanced dramatically over the years.

1. The notion that the implant will somehow shake loose with impact or repetitive activity is false, according to my doctor. When the bone knits to the pores in the implant, it makes a solid bond. My doctor implied that the new femur is as strong or stronger than my natural leg. His only precaution was to resist running for 12 weeks post-surgery to allow the bone to grow properly into the implant. If too much motion occurs too early at the interface, fibrous tissue can develop, which is not a good thing. Thereafter, it’s good to go.

2. The idea of the parts “wearing out” seems equally nonsensical. Many, perhaps most, of the folks on this site have a ceramic “ball” and a polyethylene socket liner. Both of these materials have evolved so as to have nearly indefinite life. One study I read of the newest highly-crossed polyethylene showed virtually no wear at all after many years of activity. My impression is that they really don’t know the longevity because it simply hasn’t been in use long enough. But at least my doctor was quite certain that it will outlive me. I’m 67, but still as active as several decades ago. It seems silly to restrict activities at all, considering that the life of these things may well be 30 years or more. If I’m wrong – if he’s wrong – I’d still rather do everything I want to do.

3. The final piece may not sit well with everyone, but . . . Although my doc may have some professional interest in what follows, he certainly made a powerful case for me. There are several computerized systems available for guiding hip replacement surgery. The process, over-simply stated is: A CT scan is taken. Using this image, the surgical team designs a digital model of the precise hip the patient will receive. This includes implant size, angles of implant, etc. The digital model is perfectly symmetrical, balanced and aligned. Then, during surgery, the computerized system essentially requires the surgeon to create what has been designed. There are, of course, many human checks and balances through the process. The result is an accuracy rate that is much higher than with traditional human measurement and surgeon experience. It may not be a relevant factor, but I believe my fast recovery and current completely normal function is partially because of this. Also, referring back to #2, one cause of premature wear would be any small error in alignment of the parts, which is less likely with a computerized procedure.

So, there’s my two cents. Or maybe it is more like a quarter. Sorry for going on so long. I would have liked to read this when I was investigating hip replacement. Perhaps only I like it!

Cheers and good luck,

Steve

Stan’s Pre Op…

Just had my Pre-Op Dr. appointment. 5 days till surgery date. I have been
dreading all this surgery stuff. But what are you going to do? Hip won’t get any
better without surgery! I was a bit bothered in that I didn’t even have appointment with my Doctor, but instead with his PA. I really needed to hear the words from the Surgeon. I expressed that running has been a huge part of my life for as long as I can remember and wanted to build back my fitness post surgery by cycling but still wanted to be able to run 5k’s occasionally. PA’s response of course was “we don’t believe you should ever run on a prosthetic hip. That it will just not last! And that if a revision is needed later the surgery is
harder”.
I’m supposed to be getting ceramic/ceramic and I was curious if maybe I should be getting ceramic/plastic because of my goals.
I left the appointment wondering if 1) I have the right doctor, 2) If I still even want to go through this! Guess I have some real soul searching to do!

MRS – one week post-op

I’m not able to tell stories of minimal pain or no need to medicate or “hold me back” regarding PT.

I had my anterior approach right THR on Tuesday, April 1 at 5 pm. It was done and I was in recovery by 6:11. They said I did great and all had gone amazingly well. I got to see pictures of my femur head…flat on the top. Very delineated where the cartilage ended and the bare, eroded bone began. They said it was a really good thing that I got the surgery done. The joint was beyond shot.

I FELT great at that point. By 9 o’clock, I started feeling some inkling of pain. My teeth started chattering uncontrollably. Having decided to not be a “tough guy” and to follow directions and advice of those who had gone before me, I buzzed for meds. Fifteen minutes later, when the pain was actual pain and no one had shown up with any relief (or anything, for that matter) I buzzed again. “O, right! She’ll be right there!” Twenty minutes after that when I was in excruciating pain, I buzzed again and was pretty rude and nasty and pretty much experiencing pain worse than any I’d ever had before. The nurse came scurrying in, apologizing profusely, and administered dilaudid through the IV. While the pain melted away, I suddenly vomited the small amount of fruit they had given me once I was in my room. Thus began an 18-hour alleviate pain/empty stomach pattern until they figured out when to dose and what to use regarding the anti-nausea meds. Then it was much better.

My first round of PT was so painful. I was somehow able to get out of bed with my Thigh Of Fire and stand using the walker. I got about 20 feet from my room and said I was light-headed. Back to the room I went. Blood pressure 65/32 or something like that. And thus continued my PT pattern for the next 4 sessions before being discharged.

Last night as I was feeling frustrated I decided to see what really happened to my leg and I found this video…

I also posted this in a comment on Sarah’s thread. For those of you who had anterior approach and are experiencing IT issues…they cut through your TFL. Just sayin’…

So I felt better seeing evidence of what I already knew…that it was a very very invasive procedure and to be gentle to myself in terms of recovery.

Every day the Thigh Of Fire burns a little less. I’m looking forward to the day when the swelling subsides for good…because Blimpleg is no fun!

A question for you: did you ice pretty constantly? can you over-ice provided you aren’t giving yourself frostbite? I’ve a message in for my surgeon but no answer yet.

For now I only need the pain meds at night…maybe once during the day…but not yesterday or today.

I’m still able to make meals for my 4 kids (not because I want to but because there’s no one else to do it). They do help a little bit. Still able to help the youngest get dressed and undressed and brush her hair, etc. Self-care is pretty good, too…except for putting my foot down when I’m spent and really want to lay in bed! Where’s my housekeeper? lol

I’m not feeling as negative as this all probably sounds. In fact, I’m feeling really ‘up’ about the whole thing…just my story isn’t sunshine and roses 🙂

Hope all of you Hiprunners are doing well!

The hip bone’s connected to the……..jaw bone???

Antibiotics are now required before every dentist appointment.

I remember when I was speaking with Dr. Tim prior to the surgery.  He mentioned matter-of-factly that from now on whenever I go to the dentist I would need to take antibiotics one hour prior to the appointment. “Really?” I said, “For the rest of my life?”.   “Yep!”, he said.  “What about cleanings?”  “Even Cleanings.”  So today, I had a cleaning appointment clear on the other side of town and guess what I forgot?  I COMPLETELY forgot about the antibiotics.    But this dentist remembered me from my last visit.  I had been there just prior to the surgery to get a confirmation that I had no infections in any teeth – a requirement for hip surgery.  When I got there today, the first question they asked when I sat in the chair was, “Have you taken your antibiotics?”.  So I have to try again next week.  And you can bet that I won’t forget the antibiotics.  Who’d a thunk the hip bone was connected to the jaw bone?

TAKE…..IT…..EASY……BE….PATIENT.

Greg offering advice to take it easy. He can relate to the impatience that comes during recovery.

So I met up with a friend who I met through The Flying Irish Running Club.   Greg is an all-around nice guy.  The people who run at the Flying Irish Running Club are all that way.   During the spring, summer and fall, the club meets at O’Doherty’s Irish Grille in downtown Spokane.  It’s a fun club and its gotten incredibly popular.  So popular in fact that you have to bring a DTH(designated table holder) if you plan to have a seat in the bar after the weekly run.  Otherwise, it is standing room only.   Greg contacted me a few days ago asking if I wanted to meet up so that he could impart wisdom from his own experience on the whole recovery process.  His advice was simple and to the point.  Take it easy and be patient.  He had knee surgery several years ago and he too was antsy to get out and moving again.  From what he told me,  he tried to get back into his workout routine too soon and paid the price for it later.  It also sounds like his surgery didn’t go as well as it should have.  I need the constant reminders to be patient and wait.  I too am getting antsy to return to my regular routine, especially with the old hip pain gone and the hip healing and improving each day.  He leads a group of people every Saturday through “crossfit like” exercises and invited me to come along.  I may have to take him up on it at least while my running has been curtailed for the next 2 1/2 months.

The Post Surgery Exercise Routine

Now that I’m home, I’ve been put on a physical therapy regimen that I must do 3 times each day.  These exercises are such a far cry from old me….but it’s a start.  This is the routine:

Ankle Pumps: Sitting or lying position, point your feet down and pull your feet up.  (10 Times)

Quad Sets (Thigh Tightening):  Lie on your back.  With hip and knee straight, tighten the muscles on top of the thigh, pushing the back of the knee into the bed.  Hold at least 5 counts, then relax. (10 Times)

Buttock Squeeze:  Squeeze your buttocks together.  Hold at least 5 counts, then relax.  (10 Times)

Heel Slides:  Lie on your back.  Slide your heel up toward your buttocks, then slide it back down.  Do not lift you heel from the bed.  (10 Times)

Hip Abduction:  Lie on your back.  Place a pillow or folded towel between your knees to rmind you to not cross midline.  Slide your entire leg out to one side and back to the pillow, keeping the knee straight. (10 Times)