Anybody Ever Experience Significant Improvement after OA Diagnosis?

[TotalWus]

I joined this forum a couple months ago thinking that I was destined for BHR in the next few months. Let me say in advance that, if anything, I'm inclined to pessimism about the value of PT for OA, especially for someone who's already active in fitness and sports. I made the following changes, just hoping they might let me get through the hockey season before going in for the surgery:

-Cut down from skating 4 or 5 hours/week to less than 2/week.
-Stopped lifting my leg over the boards to get on/off...always try to use the door to the bench.
-Cut way down on slap shots in practice (really torques the left hip as a right-handed shooter).
-Added OTC NSAIDs before and after skating.
-Purchased PT bands and added 2 movements to my usual leg training: standing front knee lifts and standing one-leg lateral scissor movement.
-Doing those same 2 movements as a warm up at home before skating.
-Added a (very) little bit of hip stretching at home.
-Maintained the same leg workout as always.
-Spend more time on the elliptical in between workouts and before skating.

Before, I was at the point where I couldn't walk without significant sharp anterior pain striding out for 5+ days after skating, it was interfering with my skating, I couldn't tie my shoe on one side, and my hip was at least a little painful pretty much all the time.

Now, I don't feel it skating (except for an instant if I shift weight unexpectedly or awkwardly) and there's only minimal soreness afterwards, almost none while walking, and tying shoes is no problem...just a mild reminder if I do it too quickly right after skating. Remember, if there's any placebo effect, it would probably be negative rather than positive in my case, because I'm skeptical about PT for this to start with and I've read this 2014 JAMA article concluding that sham PT was no less effective than real PT: http://jama.jamanetwork.com/article.aspx?articleid=1872817

Just curious how many others have experienced this, how much time it ended up buying you, and maybe which changes you imagine might be the most likely to have made a difference. Thanks in advance for your responses, as always.

[Quig]

Sounds to me like you're really going about things wisely and listening to your body. Good job.


In my experience I've had to adjust many, many activities over the years as a result of my OA. Some of those adjustments helped immensely, others helped just a little. I did have to quit a few things I really loved including roadracing motorcycles and running. I've always been very active and fit but over time it's become significantly more difficult to stay that way. At one point a few years ago I discovered mountain biking and, for a time, that motion really seemed to help. I still ride a lot but lately I'm really paying for it. Over the course of the last year, things have gone downhill fast and as a result I'm scheduled for Bi-Lateral resurfacing in April with Dr Gross.


Like you, I tried HARD to to adjust my activity type and level to preserve my hips but, in my case, it didn't work. I'm of the opinion that once the joint starts wearing out it's just a matter of time before repairs will need to be made. That amount of time is dependent on many variables and none of the Drs I've seen were able to accurately predict it.

My struggles with my hips started about 8 years ago so during that time I've made constant adjustments and concessions to my hips. I've had a couple cortisone shots, one was very, very helpful and the second wasn't helpful at all. There's been good times and bad, it's been a helluva roller coaster.


Keep fighting the good fight and good luck!

[MattJersey]

I agree it sounds like a wise approach and if you aren't in pain and still leading a happy lifestyle you are content with then good for you.


I think the only point I would note is the NSAIDs, as taking these for long term can have unwanted effects. And in period leading up to surgery my surgeon advises against using them as they can cause more bleeding intra-op. "The smallest dose that works" is what I was advised.


If you're having fun as things are, stick with it, and long may it continue. If and when surgery beckons then your disciplined approach to this pre-hab will serve you well in getting a fantastic outcome like so many on this forum.

[Tri Hard Alan]

I think it depends who you are and your experience. Looking at your post its clear you are an experienced athlete and were able to device the effective program probably from previous PT (whether that was conscious or not). For others, I would suggest PT is essential.


For me, I saw my physio to try and reduce the pain levels and keep running and have one more season in Triathlon in case the op went wrong (morbid I know) and that worked a treat. I wouldnt say the pain got better but I managed 14 triathlons and various other races and even did a duathlon 2 days before surgery.


Good luck and hope all goes well.

[blinky]

I bought a year by training carefully and getting massage, ART, etc. Dropped long runs, worked on strength with an ex Green Beret, stretched, swam. I didn't get better, in fact my abilities were shrinking, but I managed the pain.


Then we remodeled the kitchen, my schedule went to hell (couldn't do all the strengthening I had been doing), and my OA came roaring back.

[Ljpviper]

blinky you make a good point manage, being the key word. If you stop you revert back. I was trying to battle the OA with hip strengthening excersises, it helped for sure. Like you if I would stop my back, knees and hips would start hurting.


It just makes no sense staying like this anymore, you start dreading excercises, just to get a minor benefit. The hip joint is just so complex if it's not functioning correctly it effects too many other muscles. That was my tipping point to go forward with Dr. Gross, it felt like I am fighting a loosing battle.


Larry