start running

[garskoci]

Hello everyone!

I had my LBHR done on March 31st and RBHR on June 28th. Recovery is moving along with therapy etc. About how long should I wait before I attempt to run? I have read that at six months everything is about 90% healed. I don't plan on trying before that. What are your experiences? I was an ultrarunner before all of this. But, the past five years have been nothing but slowing down and pain. I have the same question for cycling. Both road and mountain. My thought is to try cycling before running to build up strength. Any advice is welcome.

Thank you!

[Danlalane]

Hey Garskoci - Do yo have BHR or non-cemented? I ask cause I am BHR and think they probably differ slightly. My surgeon said that technically speaking at the 6 week mark the device is healed enough that it won't move. The question at that point is the surrounding muscle and soft tissue capable of doing what it needs to do to support load, launch, etc. With this knowledge my PT had me start jogging on grass for 5 minutes 2-3 weeks ago (my hip was 3/16/2023). I have gradually increased it to 8 minutes. The hip felt sore/weird sensation near the incision a bit and in the groin a couple of times I jogged and other times no issue at all. If I am sore I hit the hip with the hip hook and things feel fine after. Which means it is soft tissue issue and not the joint itself.

Cycling I resumed at the 4 months mark, been doing a nice 10 mile bike ride a couple times a week now and the hip feels great. Much less of an issue than before surgery.

Good luck and keep us posted!

[garskoci]

BHR. The cup is a press fit and cap over the femur head is cemented into place. At 6 weeks on my left hip, I received the all clear/no restrictions. From what I understand, it really takes six months for the bone to grow into the prosthesis. That was my reason for waiting minimum of six months. I really don't want to go through surgery again to fix any of this. But, for running, it sounds like you started fairly soon after your surgery. That's awesome! I'll have to see how PT goes for a few weeks. Then I'll bring it up.

[ScubaDuck]

I don't think the device or bone are going to be the limiting factor.  After my first one, I was pushing to do a triathlon at around 10 months.  I think I started running too early and my hip flexor area would get very painful.  After the triathlon I tried to keep running but it ran into pain after extending the times.

Now I am about 10 months from my second hip resurfacing.  This time I am taking my time and doing other exercises.  A lot of walking (10 km), swimming, aqua jogging, and some stationary cycling.  I just started to introduce some running and it is going much better.  I think my issues now are the long period of time that I didn't run.

I really think it is the healing around the joint that is the limiting factor.

[BilateralRecerf]

Hi, i can share my experience in running so far. Now 3months 1 week post op. Background few years ago sub 3h marathoner.

Firstly, never skip the rehab exercises, that will make your body ready for running. For example I started squatting from 7 days post op and progressively moved into harder exercises once feeling too easy: increase weights etc. Focusing on the operated area is the key: clamshells etc. Also cycling made legs stronger before running. And lots of walking every day, also now.

I got slowly and progressively back to running. Doctor said running is ok after 3 months op if feeling ok. As felt good, started 2.5months post op very slowly with 500m run / 1km walk x2-3. Next week 1km run / 1 km walk 2-3x.  After that to continuous running, first 3km, now 4km. All runs just super easy pace. Wearing new soft shoes, running on soft surface to have less impact.   Never ran on consecutive day: that makes it max 3-4 runs in a week. Could be just one or two as well.

Listen to your body all the time. If feeling sore afterwards, you did too much. Stop running if feeling any pain, its a sign that soft tissues or muscles are not ready yet. Continuing all the time with strengthening exercises.

Plan from here is progressively increase mileage but not too fast, maybe 4-6km per run for the next month. Then if feeling ready could do hill sprinting once a week to get the running strength back. At 5 or 6 months could try faster 1km intervals, if all feels good. Patience is the key here anyway. To be able to run again feels amazing, but not ruining this possibility because of doing too much too soon.

[spartykus]

LBHR 8/9/22. Saw surgeon at 6 weeks and said I could start gentle jogging. I did this while walking, so a hybrid fartlek, which was wonderful.

The first time I tried running all the way down a fairly significant hill I had a few pains in the soft tissue around the joint. But they went away and never returned. This was at + 1 year (I also have taken my time, my leg leg was seriously wasted by the time of operation so my main issue was been musclular/ soft tissue).

Same first time skiing, in an indoor slope, I had a signifcant tight pull the very first run down the slope, I thought “oh no, is this the end of skiing” but again it went away immediately, it was just soft tissue complaining about the new movement!

So I would be guided by the surgeon? Tbh I was astonished he allowed me to jog at 6 weeks, but I guess once the joints in, its…in and gentle jogging is only going to encourage bone growth, probably better than anything else. Plus I had alot of bone (almost too much) which maybe a factor.

As others have said, walking was my friend for a year. Lots of it.

[BilateralRecerf]

I guess running will make the device last longer, as your bones stay strong from the impact and device dont loosen up. This will be seen maybe when hitting the senior years and bone deteriorstion starts more. I just wonder can one run too much? Perhaps nobody have experienced that yet? At least it should be impossible to break the ceramic implant just by running.

[BilateralRecerf]

got confirmed from De Smet (doctor), that running cant break the implant. Therefore pushing it forward.

Made some changes to warm up routine and foot strike. That helped a lot and had my longest run since OP without pain (11km). Can share my experience here, hopefully it helps others too.

Most important thing: change the warm up routine. I Walked 1km, then changing between slow run and walk. This lubricates the joint and brings the synovial fluid between implants so that head and cup parts are not touching and creating pain. Before did not have this long walking session, just standard running warmup with short walk, some plyometrics, squats etc whatever anyone feels important.

Foot strike: paid attention that footstrike is just forefoot/midfoot, not heel striking even on downhills. This creates less impact for the device and joint.

If starting to feel pain while running, just stop running and walk minute or so to lubricate the joint again. Pain goes away and can continue running.

[MattFL]

Thanks for posting your experience.  I'm wondering if the pain you're referring to isn't from the joint being dry, but the muscles for some reason?  Since the joint is all artificial there are no nerves, so I'm not sure what could cause pain just from the joint being dry. 

My Dr. said 1 year before running, apparently the biggest risk is the femur breaking where it goes into the implant, and it takes about a year for that bone to build density after they shaved it down during surgery.  Good luck, let us know how it goes!

[BilateralRecerf]

Because there is no cushion from the cartilage anymore, fluid is the only thing that cushions the joint. Impact would move to bones without it.

Also my stronger side(stronger glutes and piriformis) gives the pain, weaker side feels perfect. Thats why would also say it does not relate to muscle strenght.

But of course its not 100% sure to say where the pain actually is coming from. Just need to continue with good experimenting. I always stop running if feeling pain so no need to worry about broken femur. Impact also makes bones strong, just till some point for now. But thats good to hear that bone density is still improving! And have felt it, it can now take more impact than few months ago, so looking very promising

https://www.hipresurfacingsite.com/patient-articles-pl505/running---post-op-performance-running-by-cory-foulk-p10971.html

[MattFL]

Just trying to think through this out loud in hopes of finding the source of the discomfort (I hope to run again some day too!); fluid is non-compressible and the layer that would be inside the BHR would be so thin that it would not squeeze in and out rapidly, so I don't think it gives any cushion.  The clearance between the parts, according to chatgpt search, is 2-6 thousandths of an inch, which is about the same as the thickness of a hair.  So I think it would be more or less a hydraulic lock situation for short sharp movements like impacts from running.  I'm not at all debating what you feel, just trying to figure out the cause.  When I first got off of crutches, on longer walks I was having muscle fatigue pain on my strong side (natural hip) because it was having to work in odd ways to make up for the instability in my new hip.  That is now gone since my new hip is getting stronger.  Could it be your strong side is having a little pain because it's working extra to make up for the other side? 

Regarding breakage; the recommendations from my Dr. seem to be the most conservative of any that I've read on here, so with that in mind: he says you won't feel anything wrong with the femur before it breaks, it will break without warning.  He compared it to bending a paperclip; it may break on the 1st bend or the 20th bend, but at some point it will just break.  Until the bone is back to full density, it can flex with impact movements like running causing microfractures, which is what he compared to the bending paperclip.  Too many of those microfractures in a short time span (too fast to heal) and it will just break without warning. 

Here is some interesting reading.  An older study, but this one showed bone density decreasing at 6 weeks and 3 months, but back to pre-op density by 1 year:  https://pmc.ncbi.nlm.nih.gov/articles/PMC2823310/

I read something somewhere that the femur can reach 110% density beyond one year post-op, but I can't seem to find that article now.  But the general idea is, the bone density drops after surgery increasing risk of fracture, but by 1 year it's back to normal.  So be extra careful with impact movements the first year.