Member Case Study: Osteoarthritis in Both Hips and My Triathlon Career

author : AMSSM
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Member Question from L. Hablas

I'm a 45-year-young male. I've been involved in sports pretty much my entire life, golf and soccer being the primary pursuits from young age to adulthood, but snow/water skiing, mountain biking, etc., have also been present quite a bit too.

Here's the issue: I've got osteoarthritis in both hips. The left doesn't bother me at all. The right hip only bothers me in that it became very bound up after I had surgery to repair a torn ACL and medial/lateral meniscus (yes, soccer-related) in January of 2002. In addition to the ACL being completely repaired (via hamstring autograft), the medial meniscus was sewn up, which meant four weeks of non-weight bearing on the right leg. The subsequent loss of muscle mass and physiological changes ultimately led to the arthritis really manifesting itself and causing the socket to really bind up. Unfortunately for me, I took the binding to simply be a by-product of the loss of strength in the leg and figured it would work itself out over time.

Well, after a number of years of living with the binding (really not much pain at all) and enjoying my first year of tri last year. I found myself with a window of opportunity in April and visited a local sports med clinic, where osteoarthritis was confirmed as the culprit. As you're well aware, options include PT, shots, hip resurfacing, and THR. I've gone the most conservative route and also incorporated yoga and additional stretching into my routine as well as glucosamine/chondroitin. All of it has worked well and to my PT's (and my) delight the hip is much more mobile.

I'm still cycling and swimming, though I've pretty much stopped running for the time being, only running short distances (1.5-1.75 miles) from time to time after cycling. I'm planning to start running again in November - low volume, low pace - and see how things go. If things go well, I plan to keep building from there. Ideally, I'll be tri-ing again in 2009, culminating with a HIM in September. As noted above, the actual act of running doesn't bother me (I ran the ING half-marathon in March and had a great time); It's only the binding in the right hip that has been a pain (more figurative than literal).

Am I crazy to want to still pursue tri, or is it fair to assume that my body will tell me when enough is enough and enjoy it/use it until such time comes to pass? Thanks!

Answer by Dr. Chris Miars, DO
Member AMSSM

I think it is reasonable for you to pursue resuming triathlon activity for the 2009 season. The medical literature is currently mixed on arthritis and running. Some studies have shown a correlation between high impact activity and development/progression of arthritis while other studies have shown there is no correlation. Typical medical recommendations for individuals with arthritis of the hips (or knees) is to avoid high impact activity (running) and replace it with low impact activity (cycling and swimming) as you are doing at this time.

 

In your situation, I feel it is reasonable to resume running this fall and listen to your body. Make sure you continue the exercises you were doing in PT to maintain good core strength and flexibility.

 

As for anyone resuming running activity, make sure to gradually increase your running volume, try to run on soft surfaces, and wear appropriate running shoes that are replaced every 6 months or 300-400 miles (whichever comes first). If you find that the hip is not going to allow you to run, consider an aquabike. Like triathlons, aquabike events are growing in popularity and offer triathletes that can not run an opportunity to still compete. In summary, listen to your body and do not keep running through the pain, as this type of pain is there to tell you to stop tri-ing and choose another activity.
 

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date: November 12, 2008

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AMSSM

The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR

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