Riding after total hip replacement

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Riding after total hip replacement
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flag bilbs99
Posted: Dec 3, 2020 at 23:17 Quote
Hi all,
I had a left THR May 2018 anteria (so about 2.5 years now).... I got back on the MTB at 3 months (just on road) and then back on dirt in the middle of the 4th month ... I was very careful and did all the things my surgeon asked of me. I use clipins and always have. My riding is both heavy trail and XC now ... no crashes.
About 3 months ago I did get some pain mid thigh, so that along with Covid shutting down our office somewhat, I decided to have a break for a bit a do some walking. I thought nothing of this pain in my thigh, and then finally thought I best get an Xray ... long story cut short, my prosthetic has developed a small gap on the underside near the top of the bone and as a result is causing the pain. We (surgeon and I) compared xrays from the year prior to new xrays and found there was no gap previously.
Anyhoo ... my surgeon wonders if using clipins might have caused it (the push pull effect of course and being relatively locked to one position), and perhaps using flats might be more sensible (so push only with no pull).
My question .... is anyone else in this thread experiencing any pain 2+ years in ? and ... are peeps using flats and/or clipins ? .... i am interested to hear others thoughts
flag kwcpinkbike
Posted: Apr 5, 2021 at 10:09 Quote
emsley wrote:
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

Thanks for posting this. If you're still on this site, can you provide an update. I find you particular story of most interest because you were just 38 at time of your 2nd THR and I'm curious how you do over time. It would be about 4 yrs since you posted.
flag Miketene
Posted: May 6, 2022 at 17:07 Quote
I’m almost 59 yr old male, 10 weeks out from my left THR. I’m leaving for a trip to Italy in 4 weeks with family, and my daughter wants to buy a mountain biking trip up Mt Vesuvius (an active volcano) for her boyfriend. I’m the only other Moutain biker on the trip and i desperately want to go. My PT is advising against it. At the same time I have need riding a spin bike with good resistance for weeks now. Riding hard for 45 minutes every day with almost no discomfort. I don’t think the ride is all that technical. The tour company that provides the bikes recommends riders be intermediate level. I have not yet been on my bike outside or any trails. I’m thinking to go start some climbs up fire road this weekend to start to get a feel for it. I will not use my clip in pedals as I’m afraid of the twist motion to release. I’m curious if anyone has any thoughts either way on whether this is stupid to attempt? Also, I’m curious what the pads are that people are talking about on here? I’d be happy to buy whatever necessary to make it a safer venture. I’d really hate to miss this opportunity! Any input would be appreciated.
flag Norcal23
Posted: Jun 3, 2022 at 16:26 Quote
Just wanted to add my name to the list. Diagnosed with severe arthritis a couple years ago, had my THR 8 weeks ago at 42. Always been active but haven’t been able to walk or run comfortably for the past few years. Was very nervous but ready to address the problem. Recovery has its ups and downs but heading in the right direction. I’ve been rowing and using the stationary bike. Arthritis pain is gone, just a little sore from surgery still. I Can’t wait to get out there again. I’ll definitely be changing how hard I push the DH but that’s to be expected. I love reading about peoples recovery and getting back to an active lifestyle… I’m ready to do the same
flag karlos84
Posted: Dec 11, 2022 at 13:30 Quote
Hi guys
So glad i found this thread, im 38 and in need of a THR on my right hip
I suffered from perthes as a kid which led to 2 hip operations and has left me with really bad arthritis and a crumbling hip
My surgeon told me years back my hip was ready for a replacement but i was to scared to go ahead incase i couldn't do all the things i love , mountain biking being the main one.
After reading all the positive threads on here i feel alot happier going ahead with it as its got to the point where i have trouble sleeping, sitting and can barely drive any distance
So thanks for posting guys and hope you are all still going strong
Alls left for me to do now is make that call to my surgeon
flag thebikingviking
Posted: Feb 2, 2023 at 7:04 Quote
I'm a 36 year old male, and I've been dealing with severe hip pain for the past 7 years due to a torn labrum in my right hip (it took almost 5 years to get a clear diagnosis). I finally had surgery in March 2021, but still haven't been able to ride a bike, with the exception of some light riding after my first cortisone injection. The surgeon is talking about the possibility of a replacement due to possible arthritis.

I'm hearing that it's not possible to bend an artificial hip past 90 degrees, plus a bunch of other very restrictive movements. Can anyone confirm that this is the case? I'd like to get back to mountain biking/BMXing, but not sure if it'll be possible. I'm primarily an XC rider, nothing too intense or high impact.
flag Jgarbarino
Posted: Mar 12, 2023 at 7:05 Quote
I believe the restricted flexion tighter than 90-degrees is just for a rehab time post surgery. I am currently investigating getting THR after years of arthritic pain.
Jay
flag gonzula
Posted: Mar 24, 2023 at 22:30 Quote
tennisco11 wrote:
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
thank you.
flag mtb-luchador
Posted: May 15, 2023 at 7:12 Quote
thebikingviking wrote:
I'm a 36 year old male, and I've been dealing with severe hip pain for the past 7 years due to a torn labrum in my right hip (it took almost 5 years to get a clear diagnosis). I finally had surgery in March 2021, but still haven't been able to ride a bike, with the exception of some light riding after my first cortisone injection. The surgeon is talking about the possibility of a replacement due to possible arthritis.

I'm hearing that it's not possible to bend an artificial hip past 90 degrees, plus a bunch of other very restrictive movements. Can anyone confirm that this is the case? I'd like to get back to mountain biking/BMXing, but not sure if it'll be possible. I'm primarily an XC rider, nothing too intense or high impact.
I just had my 10 year check up on my THR, best thing I ever did, I ride mainly xc and do a little bike packing. I have no issues with getting past 90 degrees about the only thing holding me back is my current state of fitness.
flag JohnNj8wSE
O+
Posted: Dec 5, 2023 at 12:24 Quote
I'm just seeing this post. I had total right hip replacement in 2015, (posterior approach) and can honestly say It has not hindered my mountain biking, gravel or road cycling any. Since the hip replacement, I've raced quite a few Gravel, XCO and 3 hr. endurance MTB events. I also lift weights. I was advised not to run due to it wearing out the replacement sooner (I don't enjoy running, so not big deal for me) But I also know of a couple of runners who still run after their THP.
As far as restrictive movements, I was told not to raise my knee above my waist and across the centerline of my body at the same time, that is was they insert the hip into the hip joint and the way it can come out, but that is an un-natural movement anyway. I guess, if you got in some crazy crash, you could possible get in that position but I think the odds are small (but still possible). Now as far as my MTB riding, I'm not one who rides crazy technical stuff, or big jumps, but I do ride lots of rooty, tight single track w/ a few rock gardens thrown in, typical XC stuff and our local "flow trail" w/ small jumps..Also, I still ride a XCO MTB ( 100mm front, 90mm back). If any of ya'll have any more questions, ask..
flag gpsmapper
Posted: Feb 26, 2024 at 7:44 Quote
Thanks for this thread. I had an anterior THR six days ago and am nervous about mountain biking again, but this definitely helps.

I'm an active 68. I aim for 10,000+ feet of elevation gain per month, usually a couple of rides a week. I'm blessed to live in Asheville, NC, so Bent Creek, Dupont and places like that are my favorite haunts. I tend towards intermediate single track, although I like advanced when its rated that for elevation gain more than it is for technical difficulty.

I'll probably pickup some shorts with hip pads, just in case. I expect to be back on the bike within another month or so, progressing from greenways to gravel to flowy single track before getting back to more typical trails.
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