Riding after total hip replacement

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Riding after total hip replacement
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Posted: Oct 25, 2016 at 12:05 Quote
Since I have have some considerable down time as I recover from my concussion I was able to have my THR surgery bumped up to the end of November. I am really worried that my surgeon will put an end to mountain biking but was hoping to find some help here. I currently ride a 26er full suspension XC race bike with 100mm travel front and back, but was thinking of going to 29 because of its ease in rolling over obstacles. Would that be a good choice, and if so would 100-120 mm travel be enough or should I increase it to 140-160mm? Any thoughts would be greatly appreciated.

Posted: Nov 3, 2016 at 13:59 Quote
with the new total hips, you should have no limit to your riding. that said i wouldnt put myself in crazy most likely to crash situations.

if you surgeon says to quit riding, ask him for his clinical reasoning and facts. i have seen too many a surgeon say stupid stuff to patients. just saw a 19 yr old competitive soccer player with acl reconstruction and her surgeon told her she will never play again. pure garbage

Posted: Nov 7, 2016 at 6:17 Quote
Thanks for the reply. Another pb member was kind enough to share their experiences after a THR, and after meeting with the surgeon again, it looks riding is back on the menu. I think I may repost this in the 29er section to get some thoughts on a different bike. I was thinking a 29er, with its better roll over abilities, may put less stress on the hip after surgery. Thanks again.

Posted: Nov 9, 2016 at 19:30 Quote
There is a post at MTBR about a woman riding whistler after THR!

Posted: Mar 18, 2017 at 10:14 Quote
I'm to this thread but I like to add my THR experience for others that might read my post. To start, I'm 6'1" (was 201lb, now 185lb after my surgery). I'm super athletic, sports is a big part of my life. I play golf, tennis, ski, basketball and mtn bike most of my life. After fighting my hip arthritis for almost 10 years I pulled the trigger and had my left hip replaced (like most, I wished had done years earlier). After months of research I decided a THR was better than resurfaced type. My surgeon used this device http://www.djoglobal.com/products/djo-surgical/taperfill-hip-system. The device uses a LARGE head, the size of your femoral head, reduces the chance of a hip dislocation. Similar attribute associates with a resurfaced femoral head.

I was in good physical shape going into surgery but I started "prehabbing" 12 weeks before my surgical date. I was lucky in the fact I could spin a stationary bike without much pain ( But I couldn't walk the mail box and back). I rode 6 days a week for 90 minutes, lost 20 lbs down to 181lb.

After surgery, I thought I made a mistake. The first 7 days was a kick in the pants! But after that point the healing process kicked in. I started out patient rehab 2 weeks after surgery, 3 times a week for 4 straight weeks then cut it back to 2 times a week for another 4 weeks. I played my first round of golf after 8 weeks, got on my mtn bike in 10 weeks (road the streets and fire roads or wider single track avoiding rough terrain. 4 months later I went on 7 day ski trip to SteamBoat. At this point I was riding 6 times a month, typically 3 hours a ride, up and down hills (6-12 minute climbs).

I wear a protect hip pad with a plastic pad (like a football or hockey pad), will distribute the force in case I take a major fall. I'm definitely more cautious going down hill and no longer bomb it (want to ride another day).

I had my THR done in Oct 2014 (56 years old), it's now 2 1/2 years later. I'm going to have my other hip done in 3 months. Is it a risky, absolutely (I have taken my share of falls, a few over the handlebars), is it possible that my hip may need a revision on 10-15 years, sure, but I rather have another THR than sit around for 20 years. I want to take advantage of the time I have left to do the things I love!

Trust me on this one, the patient has much do about the outcome of your THR as does the surgeon. You put in the time and effort, you will never even know you had it done. Warning, do not over do it in the first 6 weeks of recovery, you will have a setback. It happens to most and to me. I decided I was ready to walk a mile 3 weeks post op. I was sore for almost a week. Push yourself in short increments. If you want a great outcome rehab is a requirement. There are different types of rehab facilities. I didn't want to use an "old folks home" but in stead found a place that rehabs "athletes", from pros to high school athletes. More progressive in their training and exercises.

Will

Posted: Dec 21, 2017 at 0:15 Quote
tennisco11 wrote:
I'm to this thread but I like to add my THR experience for others that might read my post.

Will

Hey Guys,

Late to chime in here, but I'm posting in the hope that PB's forum will notify all of you that this thread has been updated. Given the time-span b/w posts, I'd love to hear an update from everyone now that it's several months down the road.

Something that we all likely share is that the years leading to a THR are pretty shit; painful, mentally exhausting, etc.

It's also probably safe to generalize that any mountain biker facing a THR has had an active life; however, unfortunately, it's unrealistic to discover that you're a candidate living with the THR preconditions until it's too late.

Some backstory...

I started mountain biking when I was about 13- or 14-years-old; now, at 38-years-old, I have spent the past 8 years actively battling a steadily worsening hip condition.

I have been a competitive athlete since I was about 5-years-old, jumping between the "traditional", seasonal, school-based team sports of soccer, football, volleyball...and spending my free-time skiing, mountain biking (and bikepacking), rock climbing, mountaineering,..etc...

Those activities are literally where I spent every second when I wasn't studying--I went to CU, Boulder, simply so that I could study Mon, Wed, Fri...ski the other 4 days ... and work / study at night. Oh...and drinking some damn good beer.

Life was radical...

Then I found out that I had destroyed my hips...years of hip flexor problems weren't just from all those flat landings...if only I'd known!

I have spent the past 7 years recovering from 4 hip surgeries (two preventative "osteonomies", and two THRs)...which included those same sports, only with the added "luxury" of painkillers......medicine taken to buy me time between surgeries, and a ton of time rehabbing my legs in hydrotherapy and with my physio.

3 weeks ago, I had my 2nd THR (right leg); this guy was added as a buddy to the lonely THR inside my LEFT leg, which went down at the end of 2015.

For whatever it's worth......in hindsight, if I were given a do-over of this OH-SO-FUN experience, I would jump immediately to a THR, thereby bypassing the bilateral osteonomies...simply because of the stress and strain of recovery from those surgeries--they each independently require about double the time it takes to rehab back to "normal" when compared to a THR.

So...

Since around the time of my first surgery (the osteonomy), some buddies and I began doing one or two week-long mountain bike trips every year--one to enjoy the summer together, as the lot of us live all over these days, and one to escape our respective cold winter climates.

Since my THR exactly 2 years ago, I've ridden in Whistler and all over BC and Alberta, Canada; I spent this past summer riding all over my birthplace in Southern California. I've taken numerous weekend trips around my current location in the UK; so, all over England, Wales and Scotland. AND...I've taken a couple of short trips across the English Channel to ride the French Alps, and the Austrian Alps.

Now, other stuff since my THR...

I have been a bit more cautious; e.g., when I'm riding "DH" terrain (ski-resort or uplift stuff on the "big bikes"), akin to @tennisco11, I add some POC hip pads to my riding kit. I try to avoid features with gnarly consequence(s), where a big crash / leg injury would almost certainly result in a life in a wheelchair; e.g., massive gaps, etc.

As my buddies hardly hesitate to comment, the POC pads make my already large ass look delicious... and we all know that mountain biking is, and always has been, a fashion show!

In all seriousness, the kind of fall that could yield a break to your femur(s) is simply not worth the risk sans specialized padding, though especially if you're in rocky / technical terrain...or if you're riding Mach 10 on hard-packed bikepark trails. I think it just makes sense to be humble with your riding; get off and walk the second that you doubt yourself.

And really, every time you hop on your bike, you assume a degree of risk where breaking your leg could be a super-ugly outcome.

With that said...

No surgeon with a desire for a long career is going to sign off on an activity like mountain biking.

Understand though, that MOST surgeons also don't understand the wide variety of terrain accessible to mountain bikes, nor do they have any idea how that terrain is ridden ...... nor do they have knowledge about protective equipment, nor...nor...nor...

My surgeon, and other surgeons with whom I consulted, confirmed that risk with a THR does NOT lie with the mechanics of mountain biking; i.e., you'll do no damage to your THR while mashing down on your pedals; you won't harm the implant by bouncing along on plush suspension, etc.

As well, the estimates of 15-ish years before needing a replacement-for-your-replacement is based on current 2nd-replacement surgeries; i.e., the technology for current implants will last longer...likely beyond our bodies, which is a good thing.

Instead, though, the risk isn't IF you crash ... let's be honest ... as it goes with mountain biking, it's a matter of 'WHEN' you crash. You're going to fall at some point, so prepare as much as you can.

My surgeon confirmed with me that the dangers of mountain biking are relatively straightforward; your hip replacement is more-or-less as strong as your "natural" leg / femur; however, if you crash (or, as it goes with mountain biking, you should say that WHEN you crash), and break your leg, the reconstruction of your implant is very difficult AT BEST ... and what is the point of dwelling on the potential worst-case situation(s).

If you dwell on that sh1t, you're going to spend all of your rides wondering why you're not having as much fun as you could...or that you used to...or that your buddies are, etc.

All that MOST surgeons know is that mountain bikes ride on and around rocks...they know that falls on rocks can break bones AND that a femur with a THR is, by nature, a compromised structure.

For whatever it's worth, I've had a few crashes now, on both my road AND my mountain bikes, where I've come down directly on the implant. The first time, I was scared shitless as I came down on icy pavement on a rehab ride for my first THR ... got an X-Ray just to be safe. I haven't been quite as worried since, and as I said, I take precautions on the more hazardous (i.e., not XC-type rides) rides, in the form of protective hip chamois (yes, they exist by most big padding manufacturers).

Importantly, as you guys likely know, you're going to come across situations while mountain biking where your relative safety is actually bolstered by, or even totally dependent on, your confidence level; i.e., stiffening up during a technical move or while hauling the mail can and will make you more likely to fly out the windshield.

If you made it this far...I'm sorry. I started the post intending to leave only a couple of paragraphs. Confused

Please post a response--it's difficult to find information on individuals w/ our unique condition...mainly b/c people who have a successful operation just get on with their lives...by nature, most outdoor-types are averse to spending their days in front of a screen anyway, so I guess that it's hardly a surprise.

I will say, though, that one killer thing about recovery / rehabilitation is there's really no better time to catch up on missed TV series. I've banged through the entirety of Game of Thrones...all 7 seasons!

Game of Thrones + pain killers + muscle relaxants = I am Jon Snow!

Hope you're all well...

- Jason

Posted: Mar 20, 2018 at 15:53 Quote
Just had my right hip done. Thanks for sharing your story, Jason!

Posted: Apr 30, 2018 at 15:36 Quote
Just hard my right hip replaced April 4th by a very well know and proficient surgeon. I made him well aware of my riding style and he said that after 6 months I could return to exactly what I was doing but use a more cautious common sense. I am not a hard core rider anyways and already walk high consequence sections so I should be OK. Besides....when I crash I land on my head anyways so my Hip should be safe....tup

Posted: Aug 5, 2018 at 6:47 Quote
I know a guy who is an avid mountain biker, which i have ridden with several times. A few weeks ago we met up while riding and he asked me how my broke hip was recovering...he then mentioned his hip replacement, which he had 7 years ago.I was was stunned. I would have never known, how would you know anyway? He said he has zero issues with his riding.

Passing along info.

Posted: Jul 4, 2019 at 5:09 Quote
had THR 2 weeks ago (anterior). I'm 55 and I cant wait to get back out. I was able to pre-hab like Jason and walked out of the hospital 5 hrs after surgery. Dr said I can go 20 min low resistance on a SPIN bike until 6 weeks and then I can get back out. I plan on riding non technical stuff for a few months and I will wear a pad for sure. I appreciate these posts because people outside our sport dont really get MTB riders and our will to move forward fast. I will try to track my recovery and post for others as a reference. I would love to hear follow ups from other THR riders further down the trail then me to help get a real timeline for return. Ride on my brothers!

Posted: Jul 20, 2019 at 9:12 Quote
I had a THR May 2019. With following the doctors and physical therapists direction, I was able to fully recover to be able to ride road and MTB again without any problems.

My PT started 5 hrs after surgery at the hospital, with walking, motion activities and doing some small stairs in the hospital PT area. I was discharged the following day. At home, my PT included strength training with resistance bands at home, plus motion and flexibility training at the PT office. I was on a recumbent cycling machine for 3 weeks, before transitioning to a regular spin bike under the direction of my Dr. He said as long as I don't have any issues or excessive pain on the spin bike, then I could start riding my road bike indoors on a trainer. 5 weeks after surgery, still doing PT and getting clearance from my Dr., I did my first road ride of about 7 miles. Spent lots of time on the trainer and the road. First MTB ride was 4 months after surgery just to make sure.

So from the 2nd week of June till November, I put over 700 miles on the road and the mountain bike.

My advice is take it slow, listen to your body, listen to your physical therapist(s) and doctor and you'll be back on the bike in no time.

Posted: Jul 23, 2019 at 12:47 Quote
@ frdfandc - so you had it in May 2018? Sounds like we are having similar results. I am just back from a vacation in Marin and used my uncles RadRover e-bike with pedal assist to get some saddle time in. All in all I ended week 4 with 44 miles of E-hab! Uncle is 80 years old and still rides the Mt Tam fire roads albeit on an E-bike, but he's ridin! He had his hip replaced 3 years ago. Listening to your body is all I can go by. My PT defers to the surgeon on how much to do...he said he doesnt want me to be the first to loosen a new joint so he hasnt cleared me to ride yet, but I see him next week and expect to be riding gravel (5.5 weeks post OP). Jason I would love to hear how your hip is these days...Peace

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