Running/Pain question

[MaryEllen]

Ok, I think I know what all you runners will say, but... at 15 weeks I started running and was doing really well. (I'm now 18 weeks post-op). This week, I upped my mileage just a tiny bit (still not doing big miles, just a couple a day, now 3). I find that running days are really painful by days end--like I can barely walk!  My question is... do you all think I need an xray along with backing off the running? Or should I just back off for a bit, and start again in a couple of weeks? Thanks for any advice.
Mary Ellen
11/2/11 LBHR

[johnd_emd]

I'm surprised your doctor would clear you to run that soon.  I think the ave. time to run is a year.  I'd definitely stop for awhile and see if the pain subsides before going in for an xray. Try riding a stationary bike, or vertical running in a pool and see if that helps.  Have you been icing after your runs?  Where is the pain?

[MaryEllen]

Thanks John, my doc said 4 months. Pain is at the hip, like the "start up" pain I had immediately after surgery. I knew the answer-- back off-- I guess I was starting to worry about maybe having damaged something. Thanks for writing.

[David]

MaryEllen,

I started picking it up a bit at 4 months and I'm now a bit over 6 months.
It certainly has not been a straight line of progression for me.
I am getting stronger for sure but there have been many days when I have overdone it and have not realized until after the fact.  My device and strength are feeling good, but when I break down I feel soreness/bursitis in the Trochanter area.
What has worked best for me is the run/walk routine.  Started off 2minutes running/1 minute walking.  I'm now up to 4-5 minutes running/1 minute walking.  I've been doing all of my runs on trails.  Up to 6 miles seems to be my comfort zone.  Body is not ready for more than that (although I have explored it).
My opinion is that you surely should not be running everyday.  At this early point I need at least 2-3 days of active rest in between (walk, cycle, swim, pool run, elliptical, yoga, whatever).  Your body tells you it's sore for a reason...too much too fast.
Even though my Dr. said it's not necessary for another xray until the 1 year mark, I scheduled for one in a few weeks just to assure myself that I'm not more of a dumbass than I already know to be.
Be safe...
David

[MaryEllen]

David,
You don't know how much I appreciate your response! I, too, have been doing the run/walk method. I have been doing every-other-day runs, but want to run so badly that lately I've been doing some back-to-back runs. I will go back to every other day, and not be in such a hurry. Again, I thank you for taking the time to write!

[jon]

This is obviously a personal call at the end of the day, but the inventor of the BHR procedure/device says NO running until the 10th or 11th month, and then only on a treadmill.  No actual running until at least one year. Why not let it heal...?

[David]

We are healing...
I have not done anything without the guidance of my Doctor.
I don't desire to screw things up...
Just a desire to get back doing all the things I love.
If my Doctor told me not to run for a year I would listen.
Probably why I chose Dr. Su, I got the answers I wanted to hear prior to my surgery.

[MaryEllen]

Hi Jon,
I appreciate your response. I am healing, and quickly, too. I never used a crutch or cane and at my 6 week post-op visit my OS said I was ahead of schedule. He then cleared me to start running (slowly starting) at 12 weeks. I waited for 14 and am on a treadmill. I have pushed it, admittedly, and will back off some. My doctor has done over 1000 resurfs and I trust him implicitly. I am going to do a better job of listening to my body. My original goal was to run my annual 1/2 marathon at 6 months and I know I have to wait to be able to do that.
Thanks for taking the time to post.

[Dannywayoflife]

I also echo Jon. I had my BHR installed by Mr Mcminns friend and co designer of the BHR and he said no running or heavy impact for 12 months. I couldnt possibly tell you all the reasons behind it but i know that bone density doesn't return to normal levels for 12 months or more. Also the new bone that grows into the BHR is still remodelling for a very long time up to 2 years I believe. It's like putting something in concrete, if you keep wiggling it before the concrete is fully set then it will eventually come loose. If you let the concrete fully set then apply force it will not go anywhere and will be there for life.
I see this as a life long investment and personally I wouldn't be going avaunt what the 2 designers of the device say as they both know the device inside and out and between them have done over 10,000 bhr's I believe.
It's up to you but I would think twice.
All the best Danny 

[Dannywayoflife]

Oh I forgot I have read somewhere that Mcminn believes that a premature return to activity has been responsible for several revisions at around 9-12 years. It would suck for these to only last 10 years if just holding out for a few months extra could mean another decade on top o that!

[sroberts]

I agree with Danny and Jon. Can't add anything else except this:

[MaryEllen]

Thank you for your input.

[Dannywayoflife]

Your welcome Mary.

[jon]

I also echo Jon. I had my BHR installed by Mr Mcminns friend and co designer of the BHR and he said no running or heavy impact for 12 months. I couldnt possibly tell you all the reasons behind it but i know that bone density doesn't return to normal levels for 12 months or more. Also the new bone that grows into the BHR is still remodelling for a very long time up to 2 years I believe. It's like putting something in concrete, if you keep wiggling it before the concrete is fully set then it will eventually come loose. If you let the concrete fully set then apply force it will not go anywhere and will be there for life.
I see this as a life long investment and personally I wouldn't be going avaunt what the 2 designers of the device say as they both know the device inside and out and between them have done over 10,000 bhr's I believe.
It's up to you but I would think twice.
All the best Danny

Agreed.

McMinn tells a story (roughly along these lines) of a guy that foolhardily went skiing at seven weeks post-op and basically blew the thing up...

[mountaingoat]

MaryEllen,
Its great that you are feeling so good and that your recovery has been smooth but I must say I would really, really advise you to hold off on the running for a few more months. It just does not make sense to push it this early - you could potentially have the rest of your life to run on this device or you could fracture your femoral neck at 4 months post op and be done with running.

I have been a trail runner for more than 15 years and I am definitely not going to even think about running until 10 months. I will hike, bike, mtn bike a little swim, do yoga and even backpack this summer when I get to 6,7,8 months but I am absolutely going to wait until 10-11 months to return to running.

Here is a story that has given me a bit of pause. Have you heard of Robyn Benincasa? She is a world-reknown adventure racer. She does ultras and multi-sport adventure races. She had both hips resurfaced in 2008 and 2009. The 2nd hip was done by Dr. Su so it is highly unlikely that surgeon experience had anything to do with her failure at least on that hip. Her resurfacings BOTH failed within a year or so because she had stress fractures of the femoral neck which eventually fractured all the way through. She started running at 3 or 4 months...not exactly sure - you can find it on the internet somewhere. She was doing marathons again within 6 months. Well, now she has two THRs. Obviously THRs aren't the end of the world by any matter of means but I'm sure as an ultra-runner and distance athlete she is not too happy that her resurfaced hips failed b/c of her own lack of self-control.

I am honestly not telling you this to judge or to scare you. I mention it because I am that person who has been unable to hold myself back and has pushed it recovering from past surgeries way too fast...and it has caused a lot of problems.

If your body is telling you to slow down (soreness, pain, etc) than it is not ready for the stress you are putting on it by running at 18 weeks post-op.

Good luck,
Amy

[MaryEllen]

I really appreciate your response, Amy. I ran again this morning, "just to see", and again, today I can hardly walk. I guess I really needed to see that polar bear picture (see a couple of posts above) and take heed. I am done running for awhile. I really want to get back to running, and I will... in time. Again, Thank you.

[stevel]

MaryEllen,

I also struggled with the timeline to return to downhill skiing at 6 months vs 12 months.
Dr. Su allows skiing at 6 months whereas Dr. McMinn advises 12 months.
I found two articles which document the increase in bone density of the femoral neck until 2 years post-op.
At 3 months the bone density actually decreases.
At 12 months the bone density returns to pre-op density but if you have been inactive due to a bad hip(s) then your pre-op density is lower than normal.
There is little risk of femoral neck fracture after 6 months but the long term effects of impact loading from 6 to 12 months are unknown.
So it is prudent to wait until 12 months to do heavy impact sports.
The two articles about bone density are "Preservation of the bone mineral density of the femur after surface replacement of the hip" by Kishida, et al and "Bone density of the femoral neck following Birmingham hip resurfacing" by Cooke, et al.
Check out the articles.  They may be on this website.

[ScubaDuck]

Wow, this discussion has given me pause.

I was a runner from about 14 to 38 years old.  I had to stop after a car accident and then ultimately the pain of OA.

Once I was diagnosed with OA and found HR (thanks to this site among others), I dreamed I could run again.  After a very successful HR surgery and great recovery and rehab I started running at six months.  Prior to starting I did as much aqua jogging, elliptical, strengthening, and stretching as I could manage.

I have been starting very conservatively because of the years of not running and the surgery.  I run six days a week.  The first week I alternated 10 minutes/15 minutes.  The next week 12 min/18 min.  The next week 14 min/ 21 min.  Then 10 min/ 15 min.  Then 14 min/21 min.  And this week 16 min/24 min.  All of this done at around 10 min/mile pace on either treadmill or rubberized track surface.

I am using the Good Form Running technique to minimize pounding.  I have had a little soreness in the muscles of the hip socket.  The most pronounced is high on the glute on the operated side.  This goes away quickly once I stop running and massage it a bit.  I continue to do roller and sitting on a ball to help.

I am taking it slow and easy but I wonder if I should back off.  I am certainly taking the long term view which is easier now that I am older and wiser.

Dan

[sroberts]

Sorry to be so harsh. Overachievers sometimes need a wake up call. I received the "Polar Bear"
as well, so I'm just passing it forward.


best,

spencer

[hernanu]

Sorry to be so harsh. Overachievers sometimes need a wake up call. I received the "Polar Bear"
as well, so I'm just passing it forward.


best,

spencer

Spencer, the polar bear is classic. It's a tradition worth maintaining given the overweening number of type A's that are hippies   :o .