A couple months ago, I had a hip MRI which showed a degenerative labral tear, full thickness cartiledge loss, and muscle tears all probably there for well over a year. I completed B2B full in Oct so I was doing OK just a short while ago. Recently, my hip has flared up not allowing me to run nearly as much or long as I like. I try to do 3 times a week ranging from 30 min to 75+ with 4/1 plan in my new Hokas:) I have lost 10 pounds and have about 7-9 to go to be under 140 at 5"6’(female). I strength train as I can-a bit of a struggle due to weakness from pain and the tears. I ice, stretch, kinesiotape etc. I discovered I have much more night time pain if I run two days in a row.
I gave up my spring races including Raleigh 70.3. I did get into the Army 10-miler in Oct, and I want to at least do an oly tri a few weeks before. My question is how do I keep running(my emotional self needs to run)? I would be thrilled to keep doing HIM-no more IM, I know. I am a fan of 4/1. I realize most folks state to run less distance but more frequently-I have night pain(wakes me up and keeps me up) even after 30 min. I can ride with no pain so I have really been keeping my fitness that way. I won’t get the same emotional stuff running in the pool. Can I just keep with 3 days a week with 1-2 runs over 1 hour and work up to 10 miles once a week? I know it is not ideal.
I figure I have to keep my hip on life support until surgery which I am sure is in my future. Once that happens, at my age(54), it can be tricky. I also have cartiledge loss on my knee but has been very stable, my back has stenosis which I control. So I am hopeful I can find the right combo to keep me up and running slow for another couple years.
FYI, I take glucosamine, omega 3s, Mobic, etc. I don’t eat dairy, grains, sugar, beans, etc for joint inflammation.
Thanks for all opinions. I know running on this joint is not beneficial, but I don’t want to give up yet. Always, you guys have given me suggestions(Hokas) that have been life savers!
C
In the same boat as you but due to a bad knee. No cartilage left in the joint after 4 surgeries over the past few years. I’m only 35 and have been struggling with being told not to run by the Dr. I have been just biking and swimming for a very long time but my mental health needs running.
I don’t think there is an easy answer but you probably need to cut the running down to deal with the pain. You will need surgery because the hip will get worse. I’d suggest trying to cut the running in half and see how you feel. If that’s OK, add a little more week by week until you get to your pain threshold.
Good luck.
Cayenne, much of what we’re told about joints is true. The problem is figuring out which parts apply to us. As everyone says, you’re an experiment of one. Many folks on this forum with bad knees / hips / ankles / backs / brain injuries etc love to run and have made informed and balanced decisions to continue despite the potential consequences. There’s nothing wrong with that as a good friend of mine always says “you’re dead a long time”. So you have to think about worst case scenario which is accelerating the replacement of your hip. And even it that happens, there are some hip replacements these days which folks will run on. It does strike me that you can have your cake and eat it too. Maybe instead of running two days in a row and then suffering, you run one day and then ride the next. Every ortho I’ve ever talked to has always told me that riding is far less harmful to joints than running. I can burn far more calories riding than running and maintain my cardio just as effectively. So maybe you rejig your schedule to run 3 x per week and learn to love suffer fests on the bike.
Hi Graham,
That is a good saying about being dead a long time-very true. We all have issues we have to work around and adjust to and this is just another one for me. I am hopeful I can cont to do HIM on 3 runs a week wit hone long run only. Today, I did 1 h,15 min with the first hour 4/1 and the last 15min 3/2. I don’t mind making these adjustments so I can keep moving.
I know most active/competitive people at one time or another will come face to face with being unable to do what they need or want to do physically. We all need to figure out how to handle it when it comes. I know I have not handled this very well. A bit anxious, moody and more than a bit pissed off.
Thanks all!
GrahamK I asssume you are not an orthopod. There are no hip replacements that you should run on. Can you run, yes, but you will almost certainly decrease the longevity of the replacement regardless of company or material. As an orthopod who does hip and knee replacements it is somewhat annoying to get opinions on Slowtwitch suggesting there is no consequence to running on a replacement whether it be a resurfacing, minimally invasive, ceramic etc. The OP is a young person for a joint replacement. In an ideal world you have one replacement, treat it right (no running or jumping) and it may last your lifetime. Revisions are no joke, the complications are significantly higher and the results not as good as the initial surgery in most cases. I know some orthopods let their pts do anything they want because they are looking to please a demanding population like the Slowtwitch crowd. In my opinion this is a disservice to the pt. If I recommend no running and you run, compromising your surgery I will sleep at night. If I do not inform you of the risk and you need an early revision I am complicit in your problem.
To the OP there is little that will allow you to run comfortably. Judicious use of NSAIDS, limiting mileage, walk/run and maybe even a cortisone injection will help to some degree. I would recomend you run until the pain is unbearable (assuming no significant bone loss on XR) and then get your replacement and stick to low impact exercise.
I had a Dx of labral tear, hip OA, cysts, etc in summer 2009. Raced 2 x HIM that summer, 1x IM in 2010, a full Mary in 2011, and am mid-training cycle for an IM this year.
A few keys for me have been:
if it hurts, don’t do it. This is not the sort of thing you want to ‘tough it out’ through. Something is wrong if you’re in pain.Don’t try to stretch it out. Even though it feels like the sort of pain that desperately needs to be stretched, you’re more than likely just aggravating the tear.For me, my hip is hugely sensitive to whether my knee is tracking straight up and down, or if it’s tracking medially, both running and cycling. In running, I find using shoes with a slightly lower heel (Zoot OVWA’s or Asics DS-trainers) that have some stability helped, and have since combined that with custom orthotics that really help keep my knee from collapsing inward. On the bike, a good varus wedge or two has made a huge difference.Need to sacrifice aero. The more closed my hip angle gets, the more I pinch the labrum and aggravate it. So, I’ve had to increase the stack on my bike (hate to do it, always rode with a much flatter back). Also bought 165mm cranks, which helped a lot.I seldom, if ever, run back-to-back days. It just doesn’t work out well for me.
Bottom line is that there are some people (like me) who can figure out the modifications to allow them to continue activity without pain. If you can devote some time to finding out what works for you, you may be able to do the same. But if you can’t, it’s an awful cycle of train, train, have a bad day, limp home crying, take a bunch of NSAIDS, feel better, start training again, repeat. I don’t recommend that at all.
Kurt and Al at Pursuit Athletic Performance (www.pursuitathleticperformance.com) were huge in helping me understand everything I was going through with the challenges of my hip. I’ve learned a ton from them, and would recommend them in a heartbeat if you’re looking to accelerate your learning process through a gait analysis.
C, I went to an orthopod with my lower lumbar issues a couple of weeks ago. He looked at me, took my history, and actually said he couldn’t in good conscience treat me because he’d violate his oath. Told me that I’d be a paraplegic if I sneezed wrong.
Told him to turn his head so I could get dressed & leave.
Would have loved to tell him more, but I was so pissed I would have lost it. Attorney with fingernails in doctor’s carotids would not have looked good.
Bottom line: do whatever the hey YOU want to do till you can’t. Then get it fixed.
Works for me.
Cheers!
~~ kate
GrahamK I asssume you are not an orthopod. There are no hip replacements that you should run on. Can you run, yes, but you will almost certainly decrease the longevity of the replacement regardless of company or material. As an orthopod who does hip and knee replacements it is somewhat annoying to get opinions on Slowtwitch suggesting there is no consequence to running on a replacement whether it be a resurfacing, minimally invasive, ceramic etc. The OP is a young person for a joint replacement. In an ideal world you have one replacement, treat it right (no running or jumping) and it may last your lifetime. Revisions are no joke, the complications are significantly higher and the results not as good as the initial surgery in most cases. I know some orthopods let their pts do anything they want because they are looking to please a demanding population like the Slowtwitch crowd. In my opinion this is a disservice to the pt. If I recommend no running and you run, compromising your surgery I will sleep at night. If I do not inform you of the risk and you need an early revision I am complicit in your problem.
To the OP there is little that will allow you to run comfortably. Judicious use of NSAIDS, limiting mileage, walk/run and maybe even a cortisone injection will help to some degree. I would recomend you run until the pain is unbearable (assuming no significant bone loss on XR) and then get your replacement and stick to low impact exercise.
Anything else you recommend other than NSAIDS, limiting mileage, walk/run and maybe even a cortisone injection? My issue is not hip relate but knee related. Two ACL’s and three mensicus repairs/removal and my Dr (whom I trust very much) told me at my last visit that I’m out of options given my age (35) and 50% of my meniscus removed. It was pretty tough to hear but I appreciated the honesty. I had a recent Synvisc injection but that doesn’t seem to help. I’ve look into PRP but it seems kind of gimmicky. I’ve also looked at options like Regennex but the cost is prohibitive and not sure if it will really work. Meniscal replacement or microfracture seems like the same diagnosis as a knee replacement - stay off it and it will last but can’t take impact. I’d like to be able to run just enough to do sprints. I ran 2.5 miles outside last night and it was the first time outside in 15 months. Hurts like hell today so like the op I’m a little discouraged. My next steps are trying to change my running style to a more forefoot strike and looking at Hoka’s as an option.
Three years ago at age 37 an x-ray showed fairly advanced osteoarthritis in both of my hips (as the radiologist advised that I stop all running and that it was only a question of when my hips would need to be replaced). It was crushing and unexpected news given my age and weekly running mileage (about 25 miles per week in addition to either ultimate frisbee, basketball, or flag football another three times per week). So, I sought out the opinion of a local orthopedist with a background in running. He thought the arthritis was not as bad as initially diagnosed, and that I could likely continue running moderate distances 4-5 times per week if I gave up the other sports that required more explosive movement. In the end, I decided to compromise between the two doctors’ viewpoints, and just run once per week (and take one Aleve after doing so). To replace the running and other sports I was doing, I began biking and swimming a little more, but I also added 1-2 pool running sessions per week. Not the most exciting activity, but with a friend or digital music player, not awful either. I also occasionally hop on the treadmill in some Vibrams, put the incline on 15%, and walk at 3.5mph (after reading somewhere that the physiology of walking at a steep incline closely mimics the running motion but with less impact).
The result of all of this is that I have been able to largely maintain my previous fitness. At 37, my open 5Ks were usually in the high 16s/low 17s. Now at age 40, they are usually in the high 17s. As noted above, I’ve changed too many things in my training to definitively point to one thing that has helped the most, but if I had to guess, it would be the fact that I make the one time that I run a quality session (i.e., either a race or interval/tempo workout, never exceeding 8 miles). Probably because I’m only running once per week, my muscles do get a bit more sore than they used to and recovery takes longer, but my hips seem to tolerate this reasonably well. I would be crushed if I couldn’t run at all (which may happen eventually), but at the same time, I’m in no rush to get hip replacements either.
I certainly wish I could run more simply because I love to do it, but I am also very grateful for being able to run at all. The fact that I have been able to keep most of my fitness has been a surprise bonus. Best wishes in figuring out what will be best for you!
Unfortunately it is difficult to prognosticate about arthritis without examining the patient and seeing the x-rays. Having said that your history suggest significant cartilage loss throughout your knee. As such you would be beyond meniscal tranplantation or microfracture. PRP and stem cell treatment is difficult to asess because most of the data is anecdotal or derived by researchers affiliated with the company. In addition there is little FDA oversight since these treatments have not yet fallen under FDA jurisdiction. (there is a lawsuit filed by the FDA)
It sounds like your doctor is spot on. I am a Hoka advocate, I use them myself. But other then limiting your impact (pool running, trail running etc) there is little medical intervention that will have a great impact. As one of the previous posters suggested gait analysis, orthotic wedges may help somewhat but not likely in avery significant fashion.
It all started for me with pain in my right groin. It was diagnosed as severe arthritis in my right hip and starting on the left. It progressed though cortisone injections that helped at first but finally did nothing. November 15, 2011, I had bilateral hip resurfacing with Dr Scott Marwin at NYU Hospital for Joint Disease. Worked hard on my rehab and on May 15, 2012 I started to run again and ran my first 5k race in November. Did American Zoffingen last week with no problems. Where it ends I don’t know, but I think these hips will last me a long time.
Thanks for the response - it seems like the opinions I have received come to generally the same conclusions. My next step is to give Hoka’s a try and look at gait analysis. I have a brace that is supposed to help unload pressure on the medial side of my knee which has helped slightly. However, it’s designed more to help ensure I don’t do anymore major ligament damage if I do run again. I’ll consider everything successful if I can race the couple of sprints later this summer. Even if I have to run/walk at least I’m out there competing.
Wow! Bilateral! I’m impressed. Your recovery must have been a beast.
~~ kate
It actually went very well. I was in the hospital for seven days; three on the surgical floor and four on the rehab floor, with two or three PT sessions every day. They had me up and walking the next day after surgery, one the exercycle on day five and kicking a soccer ball without holding on day six. On the seventh day I walked out of there using just one cane. The first best thing was when I got back to the pool, ah did it feel good. The next best thing was running again at the six month mark. The best thing of all was racing American Zoffingen last week after waiting 8 years for a chance.
It actually went very well. I was in the hospital for seven days; three on the surgical floor and four on the rehab floor, with two or three PT sessions every day. They had me up and walking the next day after surgery, one the exercycle on day five and kicking a soccer ball without holding on day six. On the seventh day I walked out of there using just one cane. The first best thing was when I got back to the pool, ah did it feel good. The next best thing was running again at the six month mark. The best thing of all was racing American Zoffingen last week after waiting 8 years for a chance.
Sweeney - you are a BAMF. Wow.
Thanks, these new hips kick @ss!
cayenne, check out www.surfacehippy.com If you want to keep running, you are going to need surgery at some point. Get all the information you can, then make your decision.
Sweeney congratulations on your succesful surgery but a couple of points
- You should read the FDA communication re: metal on metal implants, suffice to say you are at high risk for failure
- Many if not most surgeons are moving away from resurfacing because of the early failures in fact some surgeons have a practice almost entirely devoted to revising failed metal on metal implants
- If that is your XR, your left hip has marginal acetabular bone stock and is at high risk for protrusio. I do not know your surgeon but I can’t imagine that today he would condone your running.
Caveat Emptor
I too had end stage OA…before I had my total hip replacement done, I was training for Kona and was getting cortico steroid shots into the hip joint itself. I would
try these first. Also, try to be diligent with your shoe upkeep, and the surfaces you’re running on (no sidewalk!!) And don’t have surgery until your pain really gets to you.
Manage the nsaids as well…
Love my Hokas…they have let me run more than just a regular shoe…
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That’s not my xray. I just go find pics from google. I used to use one where the guy had a huge c@ck but I can’t find that one anymore.
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I am aware of the J&J Dapuy unit that has a total recall. I have the Birmingham units form Smith and Nephew. This is the original HR unit that has lasted up to 20 years in patients. My doctor told it to me this way. A lot of doctors jumped into th HR business without taking the time to learn the technique. It’s a technically dificult surgery and if the units are not aligned properly, it could lead to failure or other problems; metal ions, infections. My first hip doctor is like that. He’s the one who told me about HR, but when my pain was getting too bad and cortesone no longer worked he had turned against HR and said that I should have hip replacements and learn to relax. Turns out that his HR surgeries didn’t work out so well. I also met one of his hip replacement pateint at PT and he was also having a tough time. I’m confident that Dr Marwin knows his stuff and did everything right.
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I don’t care. I was having trouble walking, I couldn’t stand because it was like my glutes were on fire, I couldn’t ride the bike, and I couldn’t even swim without a pull bouy. And I was told to learn how to relax!
Now, if I get a few more years of racing and then need a revision to a hip replacement, I’m only back to where I would have been if I followed my first doctor’s advice.
The top doctors who are doing HR have a failure rate that is better than the hip replacement average and that is with a bunch of patients like me who just want to keep moving forward a little longer.
sincerely, thank you.