Skiing with a THR

[Anna]

Hi,
I know a lot of people out there have returned to skiing and boarding after resurfacing, but is there anyone who has done so after having a THR? If so, how long after did you go?

My surgeon said he is positive I will be able to ski again but said to wait at least 6 months. I am only 4 1/2 months post op and will definitely be listening to my surgeon but I have been speaking to others with THR's and they have said no way would they go .... EVER! That worries me a bit. Am I being stupid thinking I can return to skiing? Will I be taking huge risks? I know I will take it steady and stay away from jumps and off piste to reduce my risks, but I cannot wait to get back in the mountains!

Any thoughts?

Thanks, Anna

[John C]

Hi Anna,
I have been following your story, and am so happy that you are at last on the happy road to recovery that allows you start thinking about skiing. As you probably read, I have a resurfaced hip that I ski hard on; 6-8 hours a day seven days a week all winter, and I am very happy with it. I know your question was about THRs, and though I do not have one, I know and teach many people who do. Where I ski, there are at least 5 or 6 full time ski instructors with one or two THRs, and at least the same number of full time ski patrollers. I have had at least half a dozen ski students with THRs, many bi-laterals. Of all those people, I know of two that are going in for revisions this year, but that is after about 15 years each of skiing and other high level activities. I have seen a couple of dislocations on the hill, but these have always been with small heads; probably 28s. Having conferred with a number of hip surgeons about how to advise my ski students who have THRs, here is the consensus they have passed on to me: People can ski safely with a THR. Avoid racing because of the possible vibration crossing chatter marks. Avoid hard landings. Moguls can be skied only if you have the skills to ski them smooth as silk with no impacts. Same with skiing off piste; it is all about the skill that a person has to deal with the conditions. One friend of mine owns a heli skiing operation up in Canada, and he guided in deep powder for years with a THR while carrying a heavy pack.
One minor thing to watch out for. Be careful of reaching down and buckling your boots if you are on your skis. Because of their flexibility, many women do this by rotating their knee far to the inside so that they can sink down to get leverage to tighten their boot buckles. A friend who is a strong racer dislocated her hip by doing this. Better to sit down on a bench somewhere to buckle the boots so that it does not involve any contortions.
I hope that you are able to enjoy getting back into the mountains with your THR, I know lots of people who have.
John

[Mike D]

Hi Anna,
I think its a huge dilemma for so many of us about how hard we can push after surgery.
If you're desperate to get back to pre surgery activity, even slightly scaled down, then go for it.
Wait the 6 months, then ease back into it slowly and enjoy it.
I got back to motorcycling after months of pondering the risks and I've altered my riding style to suit the perceived risks as I see it- I don't go out in bad weather, don't get involved in racing-which can be hard to resist to anyone who knows the roads to Squires café bar on a Sunday!
My thoughts are that motorcycling is a risk at all times and should the worst happen, I may well do damage to many other body parts, THR or not- so that's how I deal with the risk.
You'll know if it feels wrong when you give it a go and should that happen, it won't be a problem to give it a miss-but I can't see that happening, you're too positive for that!

[Anna]

Thanks guys!!!

John, you have made my day! Its sounds like many people with THR's ski. Mine has a large ceramic head so I should be fine. I will probably just stick to the piste where I am pretty confident in my ability. I just want to be able to get up in the mountains again. Mike is right, we have to weigh up how much we love to do things against the risks. I'm definitely going to be skiing again at some point now, just more carefully! Thanks for the boot tip ... and Mike, I know Squires café well, my dad used to take me on his motorbike!

John, how long after your resurfacing did you start to ski again?

Thanks again, Anna

[John C]

Hi Anna. Sorry to be late in getting back to you, but the holidays have been pretty hectic. Dr
Gross okays getting back into skiing gradually at six months, and full throttle by one year. I got back on skis at exactly six months to the day (I had scheduled my surgery so that six months would be the start of the ski season). I was definitely pretty tentative for the first few runs, but was skiing powder and chopped powder by the end of the first day. I felt pretty confident by the time spring skiing rolled around a few months later.
The six month wait is partly because of the risk of femoral neck fracture with resurfacings. A fellow ski instructor here just started skiing and teaching a couple of weeks ago with his surgeons permission 3 months after a THR.

[Anna]

Thanks John, that's great to hear! 

I'm hoping to go out for a week at the 7 month mark and just take it steady. Fingers crossed I get the ok from Mr surgeon!

Anna

[mountaingoat]

Really great to hear all this. I've been skiing hard on my resurfaced hips for the last two seasons but I fear that a revision is in my future and that I will probably be skiing on a THR with a large head next season. (I have no real pain but am having problems with my metal levels and clunking). I wondered about skiing with a THR - I have heard of many folks here in CO who do it but I wasn't quite sure. I don't ski fast or particularly hard anymore but I do telemark ski which is more torque on the hip. I ski moguls on occasion but super slowly and I do a lot of skiing in powder in the backcountry which I think is probably more forgiving and safe than flying down groomers at a resort.

Anna - good luck to you. I may be soon behind you.

Amy
Bilateral, Dr. Gross, Jan. 2012

[mountaingoat]

Btw, John,
 Thank you for the great post on all the THR skiers there in Sun Valley (I think that is where you are located?). It's really reassuring to hear that there are even ski patrollers and instructors skiing on fake hips. I've been skiing since I was 6 years old and am 38 now so I hope to have another 20 at least on skis We'll see.

[Anna]

Thanks Amy, good luck to you too. I will let you know how I get on 

[Anna]

Yesterday I went skiing on the indoor slope!!!!    It went absolutely fine except for the huge lack of confidence. I guess it will come back after a bit of practice

... best get that practice in before my holiday to the Alps in 4 weeks time 

Anna

[Dannywayoflife]

You go girl!

[hernanu]

A lot of it is confidence. I think it's great Anna, just build up your skills and confidence again.

[John C]

Good for you Anna! I am sure that you will be ripping up the slopes in no time. As far as confidence, let me share part of my story so that you will not feel alone. I started skiing when I was about 7, raced throughout my youth, competed successfully in freestyle at a national level, skied in numerous films, and have been teaching 8 hours a day 7 days a week for forty years. Now after all that, I had no confidence my first hour on skis after my resurfacing. The first turn that I tried to make failed, and I went all the way across the run and into the trees. However, after giving myself a serious pep talk, I built my confidence back over the next hour by skiing off the beginner lift; and then I spent the rest of the day having a blast in deep powder and chopped crud on the expert slopes.
Give yourself a little time to build your confidence, and soon you will be back as good or better than before. You go girl!

[Anna]

Thanks everyone

I expected pain or weakness in my legs but everything just seemed fine. I only had a little gentle go for an hour though. I cant wait to get out to the Alps ... it's going to be a gentle week and I'm not going to be attempting anything daring, I will just be happy to be out ... crawling slowly down the mountain My only issue is that I do not have the ROM to get my right boot on and off. I think I will just have to rely on friends for that.

In other news, I had my (a few weeks early) 6 month check up. Apparently everything is looking pretty good and I am now free to do what I want. My physio, however strongly disagrees with this!! Although I don't really get any pain anymore unless I over do things, my muscles are in a bit of a mess and my right glutes just don't seem to be firing up again properly. Everything is tight and I'm still having ROM issues so still have a long way to go.

... I cant complain, I feel fantastic!!!! 

Anna

[Reno]

Hi Anna-

Congrats on your upcoming six month anniversary. I know you were really missing the slopes, so I am very happy for you to be getting back out there! In the Spring, if it ever comes and moves this Artic Freeze out, I plan to get back on the Links again. 

Oh. How did it go with your tooth extraction? Ouch, just thinking about it. I have several that need crowns and I am not looking forward... 

It is great to hear that you are feeling fantastic, Anna! I too, have some of the same little complaints as you, but we are just two weeks apart in our recovery, so it makes sense... But, like you I am so very grateful for how far I have come.

As always, it is nice to hear from you.
Take care.
Reno

[Anna]

Hi Reno, I'm going to the Alps a week today. I'm so excited!!  There is so much snow out there at the minute. A great soft landing for my hip! 

The tooth extraction was awful. They couldn't get it out. I did my full course of antibiotics so fingers crossed everything is fine. I was nearly 2 months ago now so I can only presume no infection!!

Have you any current issues Reno? My main problem is my ROM. I just cant get my leg past 90 still. I struggle to put my sock on. It's my psoas that is getting in the way and stopping it. I'm not sure if it will ever get better now ... but that's my only complaint. I'm still so very happy.

Anna

[chuckm]

Hi Anna, I think you might have the best recovery story on this forum. I am very happy for you.
You were so low and now so high.
I am not giving you advice about trying to regain range of motion, only telling you what I had to do.
Early on I couldn't put on my socks. To do so hurt bad, really bad. But I have been through five knee surgeries and I could recognize that particular pain. It was just stiffness and the onset of scar tissue. Every day I would reach to put on a sock and endure a fair amount of pain.
Then I would pull my knee up to 90 degrees and hold it there - with discomfort. I found if I could just hold it long enough, I could make better gains, but it was so exhausting trying to hold the leg for 30 seconds. So I sat in the front seat of my wife's car and put my knee against the dashboard and used the electric control to push me past the 90 degrees and just hold it there. I know that was a little crazy so I don't recommend it but it worked. Even a year post op, about once a week I will pull my knee up as far as it will go until it hurts a bit and then just hold it there. My knee will go to my chest now but it's still not exactly like the other hip - but close.

I don't recall any of my range of motion returning on its own. I had to endure little discomforts all along. I might be different than others and maybe you are too. My surgeon told me that it was going to be sore to bring back ROM.

I went skiing a couple of months ago. As good as my ROM was I still felt some twinges when absorbing some of the rougher terrain - so please be careful if you are still near the 90 degree range.

Have fun in the Alps and at the après ski too.

Chuckm

[hernanu]

Hi Reno, I'm going to the Alps a week today. I'm so excited!!  There is so much snow out there at the minute. A great soft landing for my hip! 

The tooth extraction was awful. They couldn't get it out. I did my full course of antibiotics so fingers crossed everything is fine. I was nearly 2 months ago now so I can only presume no infection!!

Have you any current issues Reno? My main problem is my ROM. I just cant get my leg past 90 still. I struggle to put my sock on. It's my psoas that is getting in the way and stopping it. I'm not sure if it will ever get better now ... but that's my only complaint. I'm still so very happy.

Anna

Hey Anna! For ROM in that direction, one thing helped me:

Use a chair, with the back to your right or left, for your hand to use for support. Stand at the chair, then put one foot flat up on the seat. Hold that position for 30 seconds. Once that's comfortable, just rock forward slightly until if feels tight. Rock back to relieve the tension, then repeat several times.

Repeat with the other foot.

As to the psoas, do you have a foam roller? Nothing better for me.

[Debcoco]

Hernanu.....I just got up and tried that...I could really feel the stretch....that is a good one!

[hernanu]

Hernanu.....I just got up and tried that...I could really feel the stretch....that is a good one!

I'm glad - I had good physical therapists, that was one of theirs.