Hello everyone, I'm new to the discussion group so apologies if this has already been covered elsewhere.
To give some background - I am 31 and had a BHR 2 1/2 years ago following a diagnosis of osteoarthritis when I was 16 which became too much to withstand. I am athletic, 6' 1" and weigh a fairly lean 220lbs. I currently train at a functional strength gym and cycle often without any pain or discomfort.
I'm preparing for a 10km assault course run; and whilst gym work (cross-fit style training 3 times/week) is going well and also cycling without any pain - following any running I'm experiencing extreme pain in hip. My conditioning is good so I have no problem doing the run (currently around 4-5kms) despite discomfort - but as soon as I stop the pain is intense
To describe the pain, I would liken it to the pain I experienced when my arthritis was at its worst or post-surgery pain. The only way to alleviate this is to take a lot of pain relief, have a bath then rest up. The following day the pain is gone.
The discussion group is full of success stories and positive messages but I wondered whether anyone else experiences this level of extreme discomfort following exercise and whether this could potentially be damaging in the long term?
Thanks kindly ahead of time for any responses
Best wishes,
Kev.
We've had lots of people who worked themselves back into running and found themselves where you are.
Take a couple of weeks off and work yourself back up to where you are now and see what happens. Sounds like you have a major inflammation problem going on.
Chuck
Thanks Chuck, some good practical advice.
Best wishes,
Kev.
go to the doc, make a x-ray. better be safe than sorry. we can talk, but nobody knows for sure. I hope everything will be right!
Assuming all is well with the implant, x-ray wise, consider getting your soft tissues worked on. I personally prefer Active Release Technique, but deep tissue massages can help as well. The scar tissue from the surgery is very real and builds up - you have to get rid of it by breaking it up.
Good luck!
It's really disappointing that there hasn't been much research in this area.
When I run, my left hip becomes painful after about a mile. My right hip (newer than the left) is fine when I run. I've been trying to build up, but haven't seen any progress. What I feel is a an intense, but dull ache. It subsides fairly quickly after I run, and within a few hours, resolves entirely.
I recently had my annual checkup with Dr. Pritchett and discussed this with him. All of my xrays are normal, and excluding the running, the hip is performing well. So what's the problem? He says there is a fair percentage of people who experience this, caused by effusion in the hip capsule (fluid swelling). He says it's due to a localized tissue reaction to the increased cobalt level in the joint, which spikes when we run (for obvious reasons). The body can't keep up with processing and excreting it.
Now you may be asking, "why doesn't your other hip hurt then when you run?" I asked the same question. Dr. Pritchett says (as I think all of us bi-lats know) that no two hips are alike. One may have a greater tolerance for the cobalt. It may also (for reasons no clear to doctors) be able to more readily prepare it for export to the bloodstream, and onto your kidneys.
All of this to say, there's not a great answer. And your problem may be unrelated to this. I keep hoping I'll turn the corner. I'd love to be able to crank out 3-5 miles pain free. Good luck.
Hi folks, I'm 15 months post op for my left BHR. I too have experienced a strong ache that comes on during intense physical activity. Right now it is directly related to the intensity and duration. I don't think it is related to ions at all.
When I first began a walking regimen at the three month mark, going up hills used to bring on an intense ache. A few minutes of rest would resolve it but if I continued right away the ache would occur even sooner. Over time that ache diminished during my walks as my endurance improved.
As my athletic abilities improve, I am able to increase the time and intensity before that ache creeps in. Right now it happens playing soccer (only when it is a competitive match) after about 70 to 80 minutes. It used to happen sooner.
If I compare the most recent ache to the ache I had at the three month mark, it is not any different. That ache just the same will have me limping and if I continue the limp becomes very marked. One time that ache lasted 2-1/2 hours after I stopped. But once it was gone that was it. The most recent onset(yesterday) it came on after 70 minutes of intense soccer but the ache went away after about 30 minutes of rest - not hours. That is a definite improvement.
Does the body improve its ability to handle a spike in ion release or is this ache really a muscular endurance issue? I think it is the latter.
If I can work my endurance so the ache never occurs I'll post on that.
Chuckm
I believe a 30 min non impact or low impact warm up is important to us hippies prior to running. I think this will suck in more synovial fluid and really separate the 2 components. This will cushion the device more and lower wear associated with impact. Only a theory but I think it has merit.
Have you read this writeup?
http://www.hipresurfacingsite.com/Patient-Articles/20090405422/Patients/Running-Cory-Foulk/menu-id-62.html
I suspect everyone is different. I limit my running to 3-5 miles and don't have any significant issues 3 years post op. However, I don't run that often... I bike a lot though
Nope I'll have a read mate :)
Well Corey puts it better than me!! ;)
Einreb, very interesting article and very convincing too. I am certainly going to rethink what causes this pain. Mr. Foulk admits it is his own theory but I am going to try his advice on warm-up and see if I improve.
Thanks for posting that.
Chuckm
It does make sense. Hence why I thought of the same thing. The bhr only has contact at rest. Movement sucks synovial fluid into the clearance space like it was designed. A good warm up gets your joints to produce more fluid and it will get sucked in and clear the components giving some cushioning and lower wear.
I found this article. It says two studies show that metal ion shedding has little relation to activity level. That is counter to Dr. Pritchett and Cory Foulk who say that activity increases metal ion shedding. Well, Cory Foulk says increase in metal ions and Dr. Pritchett (according to Baby Barista) says increase in cobalt level. Maybe that is the same thing.
The fact is I am leaning toward Cory Foulk and Dr. Pritchett, but who do you believe with this stuff.
http://www.healio.com/orthopedics/journals/ortho/%7Bfa95d324-0e22-4667-b99e-bfdbbaadcfd1%7D/shedding-ions
Chuckm
I'm 10 months post op and have been struggling with increased pain and discomfort over the last 3 - 4 weeks after feeling pain free just before that. I went back to most activities in March but was still taking it easy and have gradually (or not so gradually) ratcheted it up since then. It seems like the regression came with the higher level of activity, 2 things come to mind;
i) going full out at my weekly soccer game
ii) taking a heavier weight at the weekly kettlebells class. This week I went down to a lighter weight and while still a bit sore I don't think it's as bad as it was.
For now I'm attributing it to not respecting the difference between "can" and "should" and hoping that this will improve over time as most symptoms have. I've tried the foam roller but think I didn't get the technique right and maybe aggravated the situation.
Like everyone I'd really like to know the cause and make the necessary adjustments.
Oldsoccerplayer, playing soccer never bothered my hip except for the late deep ache that we are posting about here. All my other joints and muscles were hurting, never the hip. But the kettle bell class sounds like that could really be the culprit. I think you are on the right track that you should back off from that until you are pain free.
Chuckm
In the past when I over did it with kettlebells it hurt my soft tissues around my hip.
I know this is an old thread...but I haven't been here in a while..was reading this section, and thought I'd add my thoughts....
I am 4 years post op. I pretty much can do anything I want..but the ONLY activity that has bothered my new hip is running. I can RUN... and I can run fast if I need to, but I cannot run for a long distance that well. If I go for a job... at about the 3/4 to 1 mile mark, I start to notice pain in my hip area... it doesn't really feel like the joint.. but it's in the overal general area.
the second I stop running.the pain quickly goes away completely. If I start up runnning again... the pain doesn't come on immediatly, but it comes on again within a short distance.
I don't really like to run a lot..but if I do..I usually run like 1/4 or 1/2 mile and stop to stretch out for 30 seconds at a time..then resume running.. I can go further like this. i once did a 5k....but at the end og hte 5k my hiop was kind of aching... but once I quit runing it pretty quickly went back to feeling normal. next day, not a thing is felt.
I can bicycle no problem. I have done "long" rides..long for me.. like 20-25 miles of going fast..like 15-16mph the entire time... fast for me... and no hip pain at all. I've played baseketball, racquetball, no pain.
just the sustained runin bothers me.
any idea what it really is and is there a way to get byond it or is this just a permanent limitation of our hips?
Quote from: 23109VC on February 24, 2015, 11:53:12 PM
just the sustained runin bothers me.
any idea what it really is and is there a way to get byond it or is this just a permanent limitation of our hips?
I've sure you have read through some of the previous posts. There has been discussion on this. I had posted previously on this topic an article about a study that claimed that cobalt levels in marathon runners with resurfacing did not change with activity. That article no longer exists on that site so I'm doubting its veracity.
The leading theory in my opinion comes from Baby Barista who quoted his surgeon, Dr. Pritchett. He said that the pain is due to increased cobalt levels that spike right in the fluid around the hip during activity. This can cause a local tissue reaction in some people. The body works to excrete the high levels of cobalt and the pain subsides as the levels drop.
I have the same issue with pain as well - but only sometimes. In 2013 I ran in a 5K pain free at 11 months post op. A year later in 2014 I ran in the same 5K coming into the race more fit. But the pain began at about the one mile mark and I had to walk several times just to finish the event. My time was much worse than the previous year. That defied explanation.
Cory Foulk, a well known Iron Man competitor explains he had problems with pain during running due to ions shedding (increased cobalt levels). He says he found a way to fix the problem in that a proper warm-up is the key to running pain free. See earlier post for a link to that. I tried many different variations of warm ups as he describes. Warming up had no effect for me on my pain during running.
Aside from my one 5K-a-year endeavor, my activities include competitive soccer which I returned to six months after my resurfacing. Invariably if I were in a match more than 60 minutes, I would start to get that deep ache and I was in pain for up to a couple of hours after. But this year I started watching my hydration in the days before a match. The more consistent I stayed properly hydrated, the better my hip remained pain free during soccer (regardless of whether I used the Cory Foulk warm-up or not).
Just recently, playing pickup indoor soccer, the pain started creeping in at about the one hour mark. I immediately left the pitch and grabbed some water - a lot of water. I quickly drank at least a 16 oz bottle and then a little more from a second bottle. I waited a few minutes, stretched a bit and then returned to the pitch. The pain was gone and did not return.
So maybe there is a correlation between fitness, proper hydration, and personal tolerances to spikes in the cobalt levels that play a role in pain during running. If you have no idea what your hydration has been the days before you try and run you could find yourself in pain.
Chuckm
Hi chuckm,
Your Post was well written , informative and concise. I am very interested in it , as soon-[July this year], I will return to full on Run training , for my sport of Triathlon . Its interesting to see the correlation between water /hydration and pain. Im sure its a very, very valid point and one that holds alot of substance and truth . I keep well hydrated , and also use a set of TANITA SCALES , MODEL BC 545N,.to monitor Water %. :P . These scales give, amongst alot of other info, your hydration %.
Thanks , Cheers, :)
Ultimately I think everyone is going to have to find their own solution that works best for themselves. If you are the hardy type who could spend the night in the quaff house the night before, gobble down some water the next morning and win that day, things might change after resurfacing. Might have to down a water every other round from now on!
Chuckm
i am going to try and watch my hydration levels to see if that could play a role.
i'll load up on water before a run to see what happens and will post back!! thanks for hte suggestion.
I also recently bought a pair of Hoka Bondi 3 running shoes..they helped a little.. not game changing..but i htink I can run a bit longer than before... they certainly are comfortable. i like them a lot. just having them makes me want to go run more! :)
Thanks for your observations chuckm. I'm a former competitive runner who hasn't run in a few years but I'm getting an itch to get back into some light running. I will be cognizant of drinking water enough water to stay hydrated prior to and during my attempts to run.
I just did an experiment today to test my own theory because I don't really support the one about cobalt levels around the hip.
One common theme that stands out with the onset of running pain is that everyone has to just take it. Once it comes on, there is not much you can do. You can't seem to find any relief. And then it finally goes on its own and all is fine.
So, as I posted before, the leading theory (backed by at least one top surgeon) is that there is a spike in the cobalt level in the fluid around the resurfaced hip that irritates the tissues temporarily. And once the body flushes out enough the pain subsides. But this does not happen in everyone.
It does make some sense but I do not believe this theory.
It has been so cold and snow covered for so long this winter I wasn't in the best of shape. And I was coming off a bad cold that lasted for several weeks. Today however, I was finally feeling good and it was not below freezing so I got out and pushed myself a bit by getting some exercise. I stayed very close to home at a nearby school ground. I did a combination of jogging with mixed in sprinting.
At about two miles in with this type of activity, I began to feel the onset of that ache creeping in. Once I felt it, I headed straight home which was only a quarter mile away.
I had my FOAM ROLLER ready. I hopped on it with the glut in full stretch and rolled away. Within a minute the pain was gone. I could feel it massage the pain as though it is a very very deep tissue cramp.
So here is my theory. The tissues around the hip after resurfacing are traumatized. Muscles and tendons have been spit, stretched, cut, and sewn back together. It is a long process for the body to restore a high level of blood supply to those areas in addition to the healing of nerves. Does the tissue fully vascularized at those small inner muscles with everyone? If not, during running some of those small inner muscles can become oxygen deprived and ache. They are so deep in I think that is why everyone just has to wait around with the pain. Regular palpation doesn't really find a sore spot.
But, get on the foam roller with all your body weight on your glut and you suddenly find that spot where the ache is.
This theory goes hand in hand with being better hydrated. The better hydrated you are the more efficiently your body is able to sustain supplying your muscles with nutrients before the pain sets in. It also would explain why as my conditioning after resurfacing improved, the ache would take longer and longer to set in and since all people heal differently, it is not a problem for everyone. And surgical technique could affect this too.
I'll keep experimenting and posting. Next I think I'll try rolling after the pain and then try to get back out there and see how long before it comes back in. But how long would it be to recharge those starved muscles. Perhaps rolling and sports drink combination.
Chuckm
Hi Chuck,
Very interesting post- I feel like you about the cobalt theory and your smaller muscle oxygen deprivation theory provides a highly valuable consideration for further research, expert consulation and discussion. Hopefully, if this is the case with training these muscles can be developed and their vascularisation improved to fully overcome the problem.
My situation is slightly different as I didn't experience a significant problem when building up the running after my HR but now have experienced the discomfort since building up post my complex Achilles reconstruction.
Apologies but I've copied my previous post below(under the Hoka thread) as it fully describes my situation but put in some updates. Also, Chuck I find that it's strange but if I'm once I'm running and feel the ache, if I start walking it goes away-then I can run again. So as I said before like you- I'm 'experimenting' with my running at the moment as I've had some ups and downs. Quick resume -after my resurf Jan 2010 I waited a year and picked up the running-initially had some discomfort but through gradual steps building up walk/runs combined with stretching and strengthening eventually managed 3 mile runs at 8 min mile pace without discomfort and could also break into a sprint without a problem. Although several years before my severe OA and resurface I ran half marathons at 1.18 mins (6 min mile pace), I was delighted to be able to run again and with my improving pace-I never had ambitions to do distance runs again anyway-but wanted to complete a Triathlon. But as some may remember 20 months post resurface hip was so brilliant I returned to squash after long lay off and then DISASTER! Ruptured my achilles tendon. Then following surgery had deep wound infection-NIGHTMARE-section of tendon eaten away-fighting to save life/leg etc long story short-had surgeries to reconstruct tendon (7 surgeries in total). Hence, I do not have a proper tendon-mine is constructed from scar tissue. OK so I'm lucky to even walk but my last year once again with gradual steps I completed a Sprint Triathlon- in the build up got the hip discomfort but worked with a physio and this was definitely due to the stress going up the hip from biochemical issues caused by not having the spring from a proper tendon. So now once again after a few month lay off (work/calf tear/severe flu) I'm experimenting with what helped before to build up to sprint tri in May/June.
1.Learning from Chi Running technique.
2.Building slowly and gradually increasing the speed and distance.
3. Walking to warm up and combining running and fast walking-even stretching out hip flexors-half way-currently I'm out for 50 min in total. Starting with 4x5 min runs-2 min walking (previously experienced discomfort on 2nd run now later part of 3rd run) *also more recently 3 times 8 min runs with 2 min walking in between.
4.Playing around with speed to see how it effects discomfort
5. Now up to 2 runs a week as above and one treadmill 4x4 with 1 min walking in between.
6.Tried out different shoes (Asics Gel Nimbus-heavily cushioned and Nike Vomero-lighter shoes) and keeping a log of which prove most comfortable-now prefer the less cushioned Nike's.
7. Getting back to a more disciplined stretching and strengthening routine and a bit of foam roller.
Sorry again for such a lengthy post-just trying to share ideas.
Best
Toby
I am with you on the Achilles tendon issue. I have been battling tendonitis for awhile now. It is the Achilles on the same side as my BHR. Before resurfacing I had lost so much extension in the hip that the Achilles and calf muscle below had shortened and atrophied.
Surgeon pops in a BHR and now the leg can extend back and suddenly the ankle is being put to use in an angle it hasn't been in for years. The calf strength came back quickly but the tendon and the transition where the tendon and the calf connect are so slow in adapting and healing that it is quite susceptible to injury.
Chuckm