Total Hip Replacement?

Bob Irwin

The nagging groin injury that has kept me from running for the last eighteen months turned out to be hip arthritis.  I guess I shouldn't be surprised since my sister has it, and several people of the last generations of my family also were so afflicted.  I'm scheduled for a THR (anterior approach) in a couple of weeks.  My surgeon said that biking an swimming are fine - any distance I want.  He recommended that I no longer run.  Said that if I really want to do triathlons, I should walk the run - although he did realize that it would be tedious for longer races.  I know that we have some medical professionals here, and wondered if there was any way that I could safely run after my surgery, and whether it was actually reasonable to walk the run in an IM.

Bridget Pichette

Hi, this is not Bridget but her husband Don. I had THR in 2012. Best thing I ever did. I was 42 at the time. I raced LP the next year and will be doing it this year as well. I run better now than ever. I stay very lean and never run fast unless racing. Run 35 miles a week. As of my last X-ray I have zero signs of premature wear. I'm not recommending that you run or disobey doctors orders just letting you know it's possible.

Good luck and find an excellent surgeon.

Don Pichette

Coach Patrick

Bob, anything is possible and the quality of life is the most important benefit. And being able to ride (and ride hard) and swim, no pain, is amazing. The run will be what it is...where you draw that line is up to you. Please keep us posted!

thekidduxc

Bob - +1 to Coach P's quality of life statement.

How many docs have you seen? Always a great approach to see multiple doctors if possible (being sensitive to what insurance will and will not cover).

I have a ton of running mileage on my legs from HS/University). At 33 my ortho told me it was time for a THR now or I wouldn't walk when I was 35. Went to a different doctor whom Rx a wait/see/monitor approach. I'm 37 now (shhhhhh!) and have two IM's under my belt after my first ortho's assessment. My last IM run leg was sub 3:50 with not a ton of training.

Bob Irwin

Thanks for the replies.
@Bridget - Your experience is encouraging. Congratulations on your IM success! I'm not sure if I'll be able to do IM's again, but I'm sure going to try even if I have to walk the run.

@Patrick - I think your right, quality of life is key. My plan is to try a HIM next year and see if I still feel like doing an IM the following year. I guess I'll just wait and see how I feel. If I can't do IM, I'm thinking a thru hike on the John Muir Trail.

@David - I've seen three doctors - my primary care doctor and two orthopedic surgeons. I've seen my x-rays several times, and there really isn't any room for disagreement. The last orthopod said he was surprised I could still walk. I thought that was an unusual statement when he made it two months ago, but now I can't walk without two canes, and even then only to the corner and back. I would urge you not to wait until you're in the condition I'm in, it's pretty bad. Keep an eye on it with x-rays. I was fine until December of last year. It really progressed quickly.

robin sarner

how old are you ?    be careful with your new hip.     it is a significant surgery and you do not want to have to repeat the surgery too many times.  

rlh2000

I'll chime in as a PT. First, this will SIGNIFICANTLY help your quality of life. Almost every patient I see after a total hip says they wish they hadn't waited so long. Anterior approaches especially do amazing! I have no doubt you will love your new hip. Probably every doctor and therapist will tell you not to run, the impact is just tough of it and revisions of total hips are a much harder surgery, and getting back to a quality of life after that is not as guarenteed. That said, the decision is yours as to how important running is, and the risk/reward thing.

Bob Irwin

Robin

I'm 65, and I don't want to do this ever again.  The implants are such that, if I'm reasonably careful, it's likely that this may be my only time.  That said, I do want to stay active.  My doctor did say I could do an IM if I was willing to walk on the run.  A lot of people walk a good portion of the run, but I'm not sure that I'm ready to go in with that plan.  We'll see.

Bob Irwin

Rachel

Thank you for the response.  I think PT's probably get the best look at people as the heal, and you'd see them again if they come back a second time.  I think you're correct, I doubt that I could find a doctor that would recommend that I run.  I read a book about how to run with a hip replacement.  Basically his whole premise is that mid/forefront running reduces the impact to just about the same as walking.  Having transformed myself into a mid foot runner, my knees can testify to the benefits.  But I'm not sure it reduces the impact that much.  (He hasn't been running on his new hip for all that long)  My primary card doctor is a sports medicine guy.  I haven't spoken to him yet, but I will talk to him and see what he know or can find out.  Ultimately, I'll probably go with the recommendation of my surgeon.  I don't want to risk a revision.  I can't envision how they do that procedure, but I'm sure it isn't pretty.  I still have a lot of things I want to do with my grandchildren, including a thru hike on the John Muir Trail.  I don't want to risk all those plans for what has always been a pretty slow marathon anyway.

Douglas Sutherland

In general the answer is no, but hip surgeon I know recently told me about a 68 yr old ironman triathlete patient who received ceramic on ceramic bearing and he is doing 1/2 marathon training distances in prep for his annual ironman event. He cycles and swims more than he runs, but the implant and bearing is holding up great as it was designed for more demanding activity.

Douglas Sutherland

My personal opinion on matters like these, particularly as a surgeon who seems to attract difficult procedures (knowing full well the bad things that can happen after revision type work) - do what will make you happy and prevent regrets. If you replace the hip, and the lack of running puts you in a bad place, then run (assuming you can - that the hip allows for that functionality). Yes, you might need a revision. Yes, that might be a real bitch of a surgery to do and a difficult recovery that might not allow you to do as much afterward, however, life is short man, and we all are going to end up the same - best to use that body the way that makes you happy and not worry so much about it. I would try all kinds of other things that do not jeopardize the hip first, but again, if lack of run puts you in a funk, do what you need to do to be happy first. In triathlon we seem to be obsessed with "saving matches" to allow going long. Just make sure you burn all your matches before the end of the race...

Bob Irwin

Doug - thanks for your insight. I guess I won't know where I draw the line until after my surgery.

Bob Irwin

Cheryl - thank you for the input on my Coach's thread.

An update to the discussion of two years ago.  I had my THR two years ago, and am getting ready to try to make a comeback.  My surgery was quite involved.  I had congenital hip dysplasia, which I had never known about.  By the time I got to surgery, I had virtually no socket left, and the surgeon rebuilt part of the socket with a piece of bone from my femur.  I was not allowed to bear weight for two months after the surgery.  I am now able to walk without a cane for most of the day, but need to use my trekking poles for long walks.  I have been able to go on several backpacking trips of up to six miles a day for 3-4 days.  I am riding my bike, and swimming.  I have not tried to run.  My surgeon told me that I could run if I wanted, but that a revision would probably be necessary in 10-15 years if I did.  

I haven't decided for sure what I am going to do.  I am going to try walking the run on a couple of short races to see how I feel about it.  I have gotten clearance from USA Triathlon to use my trekking poles, but have been unable to get a response from WTC.  

I have lost a lot of fitness over the past two years.  Any ideas about how a 67 year old comes back from where I am would be appreciated.  I’m sure that Patrick will have some great ideas, but any other input would be great.  Thanks

Al Truscott

Bob - Not THR stories, but might be relevant nonetheless. Two tales from my personal IM lore, about over-65 athletes with significant challenges to their athletic aspirations, and amazing results.

A guy I know in Portland (Even Evensen) was a top tier AGer a year older than me - multiple KQ, AG wins, etc. 12 years or so ago, he had a bad encounter with a car while biking. Ended up with rods in his spine among other things, couldn't run at all. Two years later, I met up with him while biking IM CDA 2009, and then he finished 4th in the AG while mostly shuffling/fast walking. He got a roll down spot from me to Kona that year, and he REALLY wanted to go back, but could not run. So he walked the whole damn thing on the island, over 7 hours. Fast Forward to this year - he did IM Canada yesterday, first out of 3 in 70-74. He averaged 14:30 min miles the whole way on the run, still with his fast walk/shuffle run.

In AZ in 2014 at the awards ceremony, I met the lady (Karen Aydelott) who won our 65-69 AG that year. Her story is similar. She had been multiple KQer, even won there once. Again, had a bad encounter with a car, multiple lower limb surgeries, told she would lose her leg, etc, etc. WTC said she could race in the PC category, but she wanted to go back to Kona as a "real" athlete. After 8-10 years of work, she made it, with a 7 hour, 56 minute marathon there in Tempe.

Whenever I bemoan whatever recent injury or surgery is keeping me from full training and racing speed, I think of Even and Karen, and keep on going.

Just sayin' like Coach P - anything is possible, and if competition and the long stuff is calling you, you really should respond with whatever you've got. *Keep doin' it 'til ya can't*

Bob Irwin

Al - Thank you very much.  Those are inspiring stories.  I'm just going to keep trying and see if I can make it back.