When you say hip surgery are you talking about total hip replacement due to osteoarthritis, or are you referring to some other intervention.

Thanks

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Graham Wilson
USAT Level III Elite Coach
http://www.thewilsongroup.biz

I am most likely talking hip replacement, but the doctor will determine what level of deterioration I have.

Go to the website sufacehippy.com and do some research. I have had my right hip resurfaced due to a few crashes over the years and now my bionic hip will allow me to participate in Ironman Arizona this November. If you're in Arizona I can recommend an amazing Dr. but the website will tell you of the people in your area or close by that do resurfacing!

I had a full replacement of my right hip in 2009 at age 39. I broke it when I was 14 and over the years the arthritis ruined the joint.

Took over a year after surgery before I could run and it was slow coming back but I've since done a full IM, 4 HIMs and a number of half marathons. I've done quite well in a number of local running races and tris, entirely due to the bike and run as I suck at swimming.

I won't say it's been pain-free and there have been a few setbacks along the way that required a few weeks of little to no running but all in all it was a great decision for me. I'm in much less pain than I was prior to the surgery.

As long is you manage it properly you can definitely have an active and even aggressive lifestyle. My surgeon's advice has worked well - use pain as your guide.

If you are a good candidate for resurfacing, I highly recommend it over the full replacement. It's much less invasive and you could be up and around much faster.

One caution for the years post-surgery. Continue to maintain hip strengthening routines - i.e., flexors, glutes. I didn't and it caused a bad IT band issue over this past winter.

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Loud pawls save lives

Good tip on surfacehippy.com. Lots of good info there.

http://bonesmart.org/...s/hip-replacement.3/ is another forum that really helped me.

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Loud pawls save lives

Pain is being my guide now. I have done 7 IM's since the accident when I was hit by a truck. But as I grow older, so does the pain and most troublesome is my lack of flexibility in that hip. For years, I had ART done which helps a lot. By I no longer live by my ART Guru, Doctor John Asthalter, who gave me back as much flexibility as I could as for. But those sessions were far from pain free. They were worth the results though.

But I have found even now, that weight training helps somewhat. It helps to keep me lose. Especially either squats or leg presses and dead lifts.
Even if my right knee points out 45 degrees because of my hip.

As an orthopedic surgeon, if I ever need a hip or knee replacement, I plan for my running days to be done and to concentrate on low-impact activites (e.g. biking, hiking, cross country skiing, swimming, etc). The concern about a joint replacement and running is premature wear on the prosthesis. Revisions are more complicated, high risks on complications, bone loss and frequently have a lower life span than the primary. I know there are a lot of people on this forum who run with their total hip replacements, but I wouldn't recommend it. Some may be fine for years, others may pay for it sooner than they would like.

Resurfacing has been shown to have a higher risk of complications compared to a conventional replacement, but is appealing given the less amount of bone loss which can help for future revisions. As a result of the high complications, a excitement about resurfacing has definitely leveled off in the last 3-5 years. The complication rate with resurfacing (as with many other surgeries) is directly related to the amount of resurfacing a surgeons does. Basically, you need to do your research and NEED to find a surgeon who does a high volume of these, not someone who does it occasionally.

At the point I had the replacement my cartilage was gone. The bone on bone grinding was horribly painful and my flexibility was extremely limited. Even if I can never run again the flexibility I've gained makes it all worthwhile.

I doubt you will find a surgeon who will recommend running after the surgery. Mine doesn't like it but he's okay as long as I stop when something is off. Having had this problem for nearly 30 years, I know when something is wrong or going to be wrong if I don't stop or slow down. That said, everyone is different. Just giving my experience.

I don't do heavy squats or leg presses. I do some un-weighted squats and low-weight leg presses at times. Also take Pilates and yoga classes one day a week. I don't play basketball, tennis, racquetball, etc. With running I can really control the impact. My stride is short and I try to land softly and with feet under my hips. Those other sports, especially lateral movements, are difficult to control how you land.

CrossFit and any other program with plyometric activities are also out for me. Also Tough Mudder and the like. Not worth the risk.

I realize I will probably need a revision at some point and that's a risk I'm willing to take. I had larger hardware installed, which my surgeon felt was a better fit given my desire to be active. I hope it lasts a long time yet.

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Loud pawls save lives

I will have to remember to mention other activitied to the surgeon as well. Last winter I skied and snow boarded for two months everyday. Down big steep slopes in the Alps, so I will have to factor that in as well.

You want to find the best doctor for this type of surgery. Not just a doc who does these- but a doc who is the "go to guy" for this type of surgery.
Be as fit as you can be pre-surgery. Follow his recovery protocol post surgery.
I know a guy who has been multi time masters world champ in road, tt, and mtb. He had a re-surfacing done at age 57. He is riding better than ever.
Before his surgery his left leg stuck out like you mentioned- he was essentially riding on one leg.

Ahhhh, some encouraging news! I new that would be hard to find. But I suspect that it will help my bike big time, but the run.....not so sure.

Problem with running is the longevity of the hardware. Running will accelerate wear and tear.

I had total hip replacement three years ago and did a huge amount of research and consulted with a number of surgeons before undertaking the procedure. The consensus is the running in general is NOT recommended - simply because running causes the prosthesis to wear our much more quickly and the a revision is much more complicated and never as successful.

I know a number of posters have talked about resurfacing - also known as The Birmingham Hip, my only advice on this is to be very careful about undergoing this procedure. Their is much documented evidence about the side effects - such as cobaltism- and now many surgeons will not do this procedure. For example, I met with one of the most respected surgeons for the Illinois Bone and Joint Institute and he refuses to do the procedure any more, and as of when I spoke to him, only one surgeon in the practice was still doing resurfacing.

Finally, for conventional hip replacement, it can either be done - either posterior (back) or anterior (front). Mine was posterior, and whilst very successful this procedure is normally conducted by more mature surgeons!! :-) The newer approach is anterior and is less uncomfortable post op and does not come with some of the movement restrictions that the posterior method does - such as no bending more that 90 degrees etc.

So I consider my IM days long over, but am racing bikes and my biking has never been stronger. So as a case study of one - my endurance running days are over. Hope this help and good luck.

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Graham Wilson
USAT Level III Elite Coach
http://www.thewilsongroup.biz

X2 what feman said. I had a hip replaced 18 months ago. Everything went very well for me. No pain at all post operation, good range of movement and no issue whatsoever... I had to give up running and playing goal on ice hockey. Small price to pay to be pain free! I did inquired about the resurfacing but opted for replacement as there is a better and longer track record. The way I look at it is not what I can't do anymore but what I can still do instead... JC

On Nov 15, 2011 I had bilateral hip resurfacings with Dr Scott Marwin at NYU Hospital for Joint Disease. Please go to SurfaceHippy and the sister sight for total Hip replacement. Post your questions and do your research. Although it sounds like is should be, hip resurfacing is not a less invasive surgery. They can do Minimally Invasive Total Hip Replacements with just two little cuts and they slip the old bone out and the new unit in through the cuts. My friend was out tramping through the woods, hunting, less than a week later. For a hip resurfacing, they will give you an 8 to 11 inch cut, most likely on your but and if they use a posterior approach, they will detach your glute muscles. Then, here's the best part; they yank the femur out of the socket and flap your leg up over your back while they work on your hip. This is a hard surgery on the patient and a difficult surgery for the doctor. As has been said above, you need a very experienced surgeon. This is a steel ball bearing. I don't know if you know anything about bearings but alignment is everything. In a power plant there is a bearing between the motor and the turbine. If it's not lined up properly it will blow the balls out of the bearing. It's the same with a metal on metal hip. The very experienced hip resurfacing surgeons know what they are doing and don't have problems. Most of the non specialists have turned away from HR because it was too technically challenging for them. Recovery from HR is a serious rehab. I was bilateral so I stayed in the hospital three days then got moved to the rehab wing for 6 more days with PT three times a day. I was an all-star; on the stationary bike at 6 days, kicking the soccer ball in the hallway with both legs and no holding on at 8 days. And I walked out of there using just one cane on the 9th day.

For my 6 month check up, I had my running clothes on, Dr Marwin sent me across the street for my first 3 mile run in years. First I walked and ran but then I found my stride and I felt like my old self, just not as fast. I'm at 2 years, 8 months and I don't even know I have HR's. I race sprints and Olympics and 5 and 10 k running races. I did do American Zofingen short course last year and I'm going back for middle distance next year. HR's were designed for athletes. If it is installed by the right doc, you can go out and do anything you could do before the original hip went bad.

Some doctors don't believe in PT for hip resurfacing. I don't know how you can recover without good PT.

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''Sweeney - you can both crush your AG *and* cruise in dead last!! 😂 '' Murphy's Law

Also, I run 3 or 4 times a week, running 3 to 8 miles. By spring I'll have my long run up to 10 to 12 miles. Dr Marwin and Dr Su at Hosp for Special Surgery are both top HR surgeons and they both support and encourage their patients returning to running.

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''Sweeney - you can both crush your AG *and* cruise in dead last!! 😂 '' Murphy's Law

I've been fortunate enough to go through the three biggest joint replacement "factories" in the world - I call them factories but they are enormously high volume and their core business is elective ortho procedures - looking at the process flows and procedure times and outcomes compared to general ortho undertaken in more general facilities. There was enormous commonality between the super specialised centres in terms of patient flows, rapid mobilisation, intensive PT etc

Irrespective of what you choose - there's no question at all you want to look at the surgeons volume and the surgeons outcomes as well as the facilities as you want post operative support for your specific procedure and generalists MAY not offer the level of support you would want

I would, as a preference, look for a surgeon and a facility that has a specific interest in the procedure you're looking at.

Thank you for all of this information, it is much appreciated.

BionicMan, what kind of prosthesis did you get? Was in ceramic on ceramic, or ceramic on plastic? And how many miles a week do you run? I had a total hip replacement 2 months ago for pretty much the same reason as you. Arthritis, no cartilage, bones grinding, bone spurs. After 2 months, I'm walking 4 miles at 15 minutes per mile. I'd like to be able to run at least twice a week, but I'm afraid the prosthetic will wear out much quicker and I'll have to go back for a revision (is that where they just replace the plastic cup lining?) in just a few years. I'm looking for real life info from runners who have had a total hip replacement. Please tell me as much as you can about running with a THR.

Metal on metal. Cobalt chromium, I think. It's on the larger side. My surgeon said it would wear better with my activity.

I think the revisions can vary depending on the prosthesis and what is worn or damaged. I saw one on YouTube where they replaced everything, including the stake in the femur. It hurt just seeing them hammer that out. I know I'll have a revision or two or three but it's a risk I'm willing to deal with so I can stay active.

With running, I took a little over year with no running at all. It took a good six months to build the muscle support where it felt good. I was fit through cycling, though, which helped. I've had a couple setbacks where the pain got unbearable and I thought I had done some damage. Luckily a few weeks off cleared the pain. It's been a year and a half since I've had any real pain in the hip. My plantar fascia on both feet is another story, but I digress.

I had a great surgeon who knew what I had planned with running. His advice all along was just to use pain as a guide. He certainly didn't encourage me but he wasn't totally against it like some are.

Oh, one of the reasons he wanted me to wait a year was because my surgery was pretty invasive with regard to the incisions he had to make. I had two prior surgeries and there was a lot of scar tissue. Your situation may be much better. I know people who have had minimally invasive procedure with much less downtime.

I don't do things like weighted squats, basketball, racquetball, box jumps or other plyometrics. I know it sounds funny to some people but I feel like with running I can really control how soft my feet land so the impact is lessened.

If I had to start over I would add soft surface running. I didn't do any of that. I started slow. 5 minutes. Do that a few times and then slowly add minutes each week.

Stretching and keeping the flexor muscles and glute medius strong is something I didn't do well. I paid for it last year with IT band problems. My hip support structure got really weakened even though it wasn't obvious on my running.

Yoga helped tremendously the first year after surgery.

Sorry this is so long. Just trying to throw everything out I can think of.

Let me know if you have specific questions.

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Loud pawls save lives

Thanks BionicMan. I'm trying to take it slow, but I'm very eager to get back to running. I've been walking, stationary biking, and elliptical. I tried the stairmaster for 25 floors yesterday, and it felt good. I think I could have gone longer, but I wanted to feel the after-effects of a short one before I start going longer. I also ran a quarter-mile at the end of my 4 mile walk on Sunday, and that too felt good. I think I might be good to run further, but am still a bit apprehensive due to all of the "specialists" warnings. My new hip is ceramic on plastic, so I'm not sure how that compares to your metal on metal hip. I feel great, but will continue to build up very gradually. Thanks again for the info.

I know that you are determined to run and race again. I hope I can help you to keep that hip in good shape and avoid a revision.

First thing, get Hoka shoes. No other shoes will protect your joints as well.

Never train on pavement. Run only on trails, grass, a running track or a treadmill, and run outside only once a week like your doctor asked. Other "running" days use the elyptical or pool run.

And keep your distances short. No more IM's for you. Think speed not distance.

You need this hip for the rest of your life. Take care of it, and enjoy yourself.

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''Sweeney - you can both crush your AG *and* cruise in dead last!! 😂 '' Murphy's Law

Hello Iron..

I had THR 2 years ago on R hip (anterior lateral)...Zimmer ceramic and poly replacement. I researched and talked to a few Ortho Dr's and settled with what felt right for me. I rehabbed longer and harder to help myself get into competitive racing shape sooner with PT's help. Dr. doesn't want me to do longer tri's or runs but was ok with me doing sprints/international distance tri's and shorter running races. I will include doing some longer Half and full Ironman) aqua bikes.

This is what I found to work for me...

1) As stated in another post...Hoka running shoes are a must...been using them since prior to surgery and they are a great shoes for "hippies".
2) I went to more of a Chi-running style using fore/mid foot strikes and shorter/quicker stride..this really helped reduce my force/foot strike
3) 95% of my running is in hills 2x's/week seems to work best for me...in addition to 3-4 cycling workouts/week. Pre and in-season for Tri's I add a short 20 minute or so brick run
4) I found regular rolling and some specific stretching routines were really helpful in recovery for getting and keeping good range of motion..I found that my hip capsule was very tight post operation and I needed some extra specific rehabbing in getting that loosened up... the book, "Becoming a supple leopard" was of great help in that area and for other self-diagnosing/rehabbing.
5) I wasn't overweight but decided to go on more of a higher fat/moderate carb diet and lose some weight (160 to 150) and will drop a few more as training and racing ramps up next spring summer. I found that this diet change had a few more pluses to it but that goes beyond the scope of this post. The decrease in weight helped my running and also takes extra force off of hip when running.
6) I weight lift and do some supplementary exercising and found that I'm not really limited. I have good lateral movement and strength as well as coordination

Ortho Dr. wants to X ray hip again in 1-2 years to look at wear and tear of my training. I literally ran into him running in hills about a month ago and he asked about my hip/training and was ok with what I have been doing. He really liked the Hoka shoes...

So, we'll see how it all plays out in few years or decade or two. I'm 62, have done tri's since early 80's. I train/run with much younger athletes and do quite well holding my own. I also have no problem backpacking for several days when the opportunity arises.

Best of luck to you...

TriKona (anokirt)

''Metal on metal. Cobalt chromium, I think. It's on the larger side. My surgeon said it would wear better with my activity.''


Bionic, do you know which implant you have, exactly, name brand? I'm asking for someone who wants to return to running but was told that he doesn't have enough bone left on the femoral head for hip resurfacing?

Thanks

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''Sweeney - you can both crush your AG *and* cruise in dead last!! 😂 '' Murphy's Law

Hi, just joined this group as looking for advise as due a right ceramic hip replacement in the next 8 weeks after months of pain with worn joint, years of football and very hard tri training have had there effect, but was pleased to hear that I may be able to run again after op in some form as I have an outstanding half iron to complete after bike accident last year, any basic advice after op very welcome Thanks Steve