The Saratogian (Saratoga, NY)

Consider low-impact exercise after double hip replacemen­t

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Before I had a double hip replacemen­t at 47, I was an avid daily runner, participat­ing in several marathons per year and any charity event possible. Everything I’ve read says not to run with hip replacemen­ts. Do I really have to cut running out of my life?

The advice regarding running and hip replacemen­ts relies on basic physics. The more stress you put on the new prosthetic joint, the more wear-and-tear can occur, and the sooner you may be a candidate for revision surgery to replace the device. And although the current wisdom is that a modest, even moderate, amount of running can be OK in some cases, the life you have described, with as many races as possible (and, we imagine, plenty of training in between) is not a good fit for someone with artificial hip joints.

In a total hip replacemen­t, the surgeon removes the damaged or diseased bone and cartilage and replaces them with a prosthetic joint. People consider the surgery when medication, lifestyle changes or walking supports fail to have an effect on pain or impaired mobility. From its introducti­on in 1960, hip replacemen­t has undergone a sustained evolution in surgical techniques, as well as the materials and technologi­es that go into making the artificial ball-and-socket joint.

However, the data regarding the effects of regular running after a total hip replacemen­t haven’t kept pace.

A few studies have looked into what happens when individual­s with a total hip replacemen­t continue their running regimens. The results suggested that running could be OK, but there is disagreeme­nt among scientists as to whether the sample sizes in those studies were adequate, and whether the subjects were followed for a long enough period of time.

A larger study published several years ago, in which hip replacemen­t patients took part in a diverse range of physical activities, including running, uncovered some potential problems. Though not widespread among the participan­ts, these included fractures, dislocatio­n, loosening of the prosthesis and mechanical wear that resulted in the production of metal ions, which passed into the bloodstrea­m. The long-term effects of this type of exposure are not yet understood.

But here’s the good news. Although running isn’t recommende­d for people with total hip replacemen­ts who would be new to the sport, it’s a different story for experience­d runners. Those individual­s who had been regular runners before the surgery and who have completed their rehab period can take part in a moderate amount of running. Needless to say, there are some caveats.

• Before you run a single step, get the OK from your surgeon and your physical therapist. This is non-negotiable. You’ve put a lot of effort, time and money into your new hips.

• Take your time and get back into shape with low-impact exercises like swimming and stationary cycling.

• Be aware of your stride. Twisting of any kind can cause the ball of the prosthesis to separate from the hip bone. Choose flat, straight surfaces that won’t tax the joints.

• Stick to the distance and frequency that your medical team allows.

 ?? Eve Glazier + Elizabeth Ko Ask the Doctors ??
Eve Glazier + Elizabeth Ko Ask the Doctors

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