Process check - running prep

[OneHipDude]

THIS SECTION IS FOR CONTEXT AND BACKGROUND, SKIP TO THE QUESTION SECTION IF DESIRED

I had my right hip BHR in August of 2018. (After ~9 years of trying for one) No unexpected issues in surgery or recovery. I waited 6 months for anything even slightly impact related, aside from whatever my PT deemed prudent. Then from 6-12 I gradually increased activities until my doc cleared me for "anything I felt comfortable doing" at 12 months.

Something I had never really done before is running, but I would like to. During the COVID lockdown I bought a NordicTrack treadmill. It has very cool digital programs which will guide you day by day through the process of going from not-running to running. I've been doing the 6 week program and honestly I've been loving it. Which is a new sensation for me in the context of running.

The program alternates between walking and running to gradually introduce your body to the changes. However, on week 3 as the running times increased, I started experiencing an achy, throbbing in the BHR hip. I stupidly pushed through and the intensity of the pain increased each day. Finally I listened to my body and took a break.

-- QUESTIONS HERE --

I have been scouring these forums for other people's advice and experience and I think I have an approach figured out. Please help me to make sure I have this correct:

• Warm Up - Several posts talk about Cory Foulk's recommendation for a 30 minute warm up to get the BHR implant lubricated and floating. My understanding is that this is a slow ramp up of the kind of activity to be done (walking and then running) which must include the full range of motion? Does anyone suggest any additional warm-up? How about any stretches to specifically avoid?
• Running stride - I am a complete n00b at running. I really, really don't know what I'm doing. I went and did a bunch of research on this, too, and I'm sure I have been doing this wrong; putting my weight on my heel and landing my forward step out in front of me. From what I've read I should be landing that step almost directly below my hips, or maybe a few inches forward? Any lengthening of stride should be done behind me? Other sites I read agree that avoiding the heel is ideal, but the opinion is split on whether to land on the center of my foot, or more towards the ball of my foot. Is this just personal preference?
• Diet - Foulk briefly touches on eating in such a way to encourage increased fluids in, and available to, the joints. However, I can't actually find the diet to promote this. Does anyone have a success story with this they could share? I like high protein diets with limited processed carbohydrates, but I'm willing to modify if it means I can run.

Thank you for any help or advice you are willing to share!

[petemeads]

Hi OneHipDude, interesting situation you find yourself in!

Most hippies who run were runners, and I vaguely remember reading a couple of surgeons advising that runners could go back to running but non-runners should not contemplate starting... I started running age 30 and am still running age 70 despite a BHR and a THR, in both cases I was jogging again within 8 weeks, and I never really warmed up to speak of although I have recently started adding a 20 minute jog/sprint warmup before 5km races and think it helps a bit. Corey's article is pretty good,  I just re-read it,  and advice like landing on your mid-foot placed directly below your COG is correct - lean forward slightly from the ankle - and shorter steps with a higher cadence will minimise stress on your hips. I tended to return to running using unpadded racing shoes to stop me heel-striking, it seemed to work to focus me on quick pattering steps.
You don't say how much the treadmill plan has you doing, or how quickly the effort ramps up, but quitting when pain starts is the correct response. Do you have a history of long, fast walking on your new hip or is the walk/jog/run experience completely new to you? If the plan is too ambitious in increasing effort then adding more rest days or repeating weeks might be a solution. The pain you have had will almost certainly be scar tissue rather than device related at this time from your op.
Diet-wise I have no advice other than limit processed food and seed oils, no idea if synovial fluid production is related to diet, decent hydration is important though.

Good luck!

[OneHipDude]

Thank you for all the advice. It is especially nice to get both new information and also confirmation from someone else about things I thought I understood, but had begun to doubt.

In regards to not having run before, I did have some concerns about that. Most of the literature does pretty consistently state, "a RETURN to previous activities". My sports background pre-revision is mostly martial arts, casual hiking, swimming, and a little parkour. I'd avoided a return to martial arts because I was concerned I could not adequately control hip-related movement while interacting with another person. The other person creates too much uncertainty, and I'm not that good to always ensure no undesired stress is put on the hip.

For running, I think the additional rest and backing off to a cadence that does not exacerbate the hip pain is the way to go. (I'm a little jealous of my wife who is progressing well through the running program.) The first week of the program is a one minute walk alternating with a 30 second run. The second week is alternating one minute walk, one minute run. These didn't bother my hip, so they're probably worth repeating. Especially as I learn to run properly!!