Staying Active Despite Arthritis And Two Hip Replacements

I’ve been very active in endurance sports, like biking, running, and hiking, all my adult life. Then I began to develop some pain in my right hip, which was diagnosed as arthritis at age 49, back in 2002. So I had to give up running, my main activity at the time. You may think, as some people have actually suggested to me, “of course you got arthritis with all that running”. But statistically runners actually are less likely to get arthritis than sedentary people. And it turns out I had a condition discussed below that predisposed me to arthritis.

I thrashed around quite a bit trying to find an enjoyable activity after the diagnosis. I really did not want to just go the gym, I wanted something outdoorsy and fun. I found walking outside to be pleasant, but if I went too briskly it still bugged my hip. I tried both roller blading and roller skiing, which I enjoyed, but I’m clumsy enough that I did a few faceplants. Finally I decided to retry biking, which I had done a lot before I got so heavily into running.

That worked for me, I found some beautiful places to ride in my area and joined a cycling club. I also started participating in the Bay Area Senior Games cycling time trial (5K), which takes about 10 hard minutes. I competed virtually against local cycling hill climbing challenges on Strava, again choosing ones that take 10 minutes or less. I find I prefer either longer and easier rides or shorter hard ones. I also did kayaking in Monterey bay and participated in races with an outrigger canoe club in San Jose.

All in all I appeared to be aging gracefully and staying in decent shape, but friends kept nagging me that I was starting to limp. I also was having back pain. I kept insisting the problem was not my hip, because part of my yoga routine was a hip stretch, which I could do just fine. What I didn’t realize was that my hip was actually almost locked, and when I thought I was stretching it I was actually torqueing my back. By this time it had been about 10 years since my arthritis diagnosis and, unbeknownst to me, the hip had continued to degenerate. By 2012 my arthritis had progressed to needing a hip replacement.

Fortunately I had read (on Clarence Bass’s excellent fitness site about the advantages of the anterior approach to surgery, and found a great surgeon who did it that way. In the anterior approach, the surgeon comes in through the front of the leg, sneaking in between two of the quadriceps muscles. The Surgeon removes the femoral neck and head, and a metal insert is shoved down the femur. The surgeon cleans the surface of the socket and inserts a metal cup. There is a low-friction wear resistant plastic lining between the new ball on the insert and the new cup. In my case the cup was cobalt-chrome, the insert titanium, and the lining ultra-high molecular weight polyethylene.

My right hip was replaced in May 2012. This was my first experience with major surgery (actually with any surgery at all except removing wisdom teeth). It was overall a very positive experience, if a bit scary going in. Not everything was great. There were the “itchies”, a side effect of my anesthesia that kept me awake at night. These were helped a bit by a Benadryl IV. And getting your catheter removed does not make my top ten list of fun things. But I received great care from competent and compassionate people. I made sure to always express my gratitude to all of them. After two nights my wife and I went home, and it was great to be sleeping in my own bed. And it helped to have continued care from my wonderful spouse.

Rehab was amazingly fast: I started out at home with a walker that I only needed for a few days, after which I graduated to a cane for a few weeks. Even after the first few days, I noticed how great walking felt. No more back pain, and it felt like I was gliding on air without having a stiff hip in the way. To this day walking still feels great to me.

I did my PT exercises faithfully. You lose some strength in your glutes and abductors during the long period when your hip movement is impaired due to severe arthritis, and diligent work is required to get the strength back with exercises like “the clamshell”. These may not be fun but are important. My doc told me lots of his patients don’t bother with this and never get a proper gait back! I don’t understand why you’d go to all this trouble to get the hip fixed then not do your homework to make sure you can walk right.

Though I was walking just fine, the hip is vulnerable in this period because the femur has not yet grabbed on tightly to the implant. So falling is not a good idea. For this reason I also had to avoid biking for about a month, although I was able to stationary cycle. After about a month I was back full tilt on all my activities, feeling great. I’m still not supposed to run or do other high impact activities, in order to maximize the life of the wear resistant plastic lining mentioned above.

I found out from the pathology report of my removed hip that I had a condition called “avascular necrosis”: there is insufficient blood supply to the “ball” of the hip joint, which causes the cartilage to prematurely degenerate, leading to arthritis. This meant the left hip was not far behind the right, as my surgeon had already noticed on my x-ray. I probably could have waited as much as a year or so, but decided to go ahead and do the left as soon as it was a good idea, which turned out to be four months after the first operation. This one went even smoother since my wife and I were now experienced at it.

My x-ray had showed the left hip was not far behind the right, so I got it replaced in September 2012 when I was 59. Again rehab to where I could resume my full activities took about 4 weeks.

After rehabbing the 2nd hip, I got extra-enthused about my training and managed to tear my Achilles tendon. Fortunately a partial tear can heal itself without surgery if you immobilize it, so now I was stuck in a boot for a few months and had to do more P.T. I stubbornly kept riding my bike. I thought I looked like an idiot but I got compliments for my tenacity. My wife was very supportive of my riding- I’d tell her “I’m committed to biking”, and she’d say “Yes, you should be committed”.

After a few months in the boot I was good to go and got back into working out full blast and felt things were going well. Things went well for a few years, until my heart adventure, which is another story…

86 thoughts on “Staying Active Despite Arthritis And Two Hip Replacements

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