Young Active Patient: Back To Sports
Sports Recommended By The Hip Society
| RECOMMENDED / ALLOWED SPORTS |
NOT RECOMMENDED |
stationary bicycling
croquet
ballroom dancing
golf
horseshoes
shooting
swimming
doubles
tennis
walking
low-impact aerobics(*)
road cycling(*)
bowling(*)
canoeing(*)
hiking(*)
horseback
riding(*)
cross-country skiing(*) |
high-impact aerobics
baseball/softball
football
gymnastics
handball
hockey
jogging
lacrosse
racquetball
squash
rock
climbing
soccer
singles tennis
volleyball |
(*) Recommended only to experienced patients
No conclusion was reached among the members
of The Hip Society as to the following sports:
| NO CONCLUSION |
Jazz dancing
square dancing
fencing
ice skating
roller / inline skating
rowing
speed
walking
downhill skiing
weight lifting |
American Academy of Orthopedic Surgeons Post-Op
Exercises
A comprehensive assortment of early post-op exercises including illustrations.
Exercise Prescriptions
Hip muscle anatomy and articulations described with video demonstrations
Post-op Hip Exercises
A comprehensive list of early post-op exercises
Klein GR et al.: J Arthroplasty. 2007 Feb;22(2):171-5 "Return to athletic activity after total hip arthroplasty" Consensus guildelines based on a survey of the Hip Society and American Association of Hip and Knee Surgeons.
Kuster
MS et al.: Am J Sports Med 2002; 32(7): 433-45 “Exercise
recommendations after total joint replacement: a review of the current
literature and proposal of scientifically based guidelines”
“ Patients should be encouraged to remain physically active for general
health and also for the quality of their bone. There is evidence that
increased bone quality will improve prosthesis fixation and decrease
the incidence of early loosening. To recommend a certain activity after
total knee or hip replacement, factors such as wear, joint load, intensity
and the type of prosthesis must be taken into account for each patient
and sport. To maintain physical fitness an endurance activity will be
performed several times per week with high intensity. Since load will
influence the amount of wear exponentially, only activities with low
joint loads such as swimming, cycling or possibly power walking should
be recommended. If an activity is carried out on a low intensity and
therefore recreational base, activities with higher joint loads such
as skiing or hiking can also be performed.”
BOOKS
“Exercise beats arthritis”, by
Valerie Sayce et al
“Healing Hip, Joint and Knee Pain” by Kate S. O’Shea
“Heal Your Hips” by Robert Klapper
et al
“The Complete Waterpower Workout Book” by
Linda Huey, et al
“The Egoscue Method of Health Through Motion: Revolutionary Program
That Lets You Rediscover the Body’s Power to Rejuvenate It” by
Pete Egoscue
CLIMBING
There are many people who resume climbing after hip replacement with
a few modifications. Once post-op hip precautions are lifted you could
safely follow just about anything, since you'll have a top rope. Avoid
taking a long fall on the lead by placing lots of protection and avoiding
run outs. In new areas, climb at grades lower than you usually do until
you familiarize yourself with the area and their grading standards.
Get information in advance about how run out a climb is before getting
on the sharp end of the rope. Climb routes that have plenty of gear
opportunities. If you're sport climbing, especially overhanging routes,
it's probably a good idea to make sure your belayer doesn't short rope
you by taking in rope when belaying a short lead fall. This results
in slamming the leader into the rock, and the hips are very vulnerable
to trauma in this situation. As with all activities, when the thigh
is at less than a 90 degree angle to the chest, make sure you can see
the inside of the thigh.
DANCING
Dancerships.com
A dancer chronicles her experience with a hip replacement, lists other
dancers who have had hip replacement and offers guidelines for recovery
and returning to dance.
Tips for Returning to Dance
EXERCISE EQUIPMENT
Hipprotector.com Hip protection pads
Walkaerobics.com In home walking video
Kangoojumps.com Low impact rebound shoes
Study of Impact Shock during Jogging
GOLF
Rothman
Institute “Playing Golf and
Hip Replacement Surgery”
“ Fortunately, hip replacement surgery not only restores patients' quality
of life but of equal importance allows them to return to golf. Recognizing
that golf is a primary recreational and social activity for many of our
patients, we have offered the following advice about when and how to
resume golfing after total hip replacement.”
HORSEBACK RIDING
Horseback Riding with Hip OA
Guidelines for riding with arthritis and with a hip replacement.
SKIING
You Can Ski After Hip Replacement Surgery
A recent article in WebMD reports, “It's fine to participate in
active sports after hip replacement surgery, including even vigorous
sports like skiing according to recent research from Switzerland and
Canada. Just use common sense.” “Our findings, combined with
previously published biomechanical studies, do not provide any evidence
that controlled alpine and/or cross-country skiing has a negative effect,” write
the authors in the journal Acta Orthopaedica Scandinavica. Earlier biomechanical
studies conducted by Benno Nigg, a physicist who serves on the International
Olympic Committee's Subcommission on Biomechanics and Sport Physiology,
measured the stress on the hip replacement during skiing-like movements. “We
put force-measuring devices on skis and bindings, to gather data from
different people skiing different terrain. Using that information, we
could calculate back to the forces on the hip joint. Cross-country skiing
and long-radius turns on a flat slope put little stress on the hip joint,
somewhere between walking and running. Skiing on a flat slope with short-radius
turns or on a steep slope with long-radius turns exerts a little more
stress than running. Short-radius turns on a steep slope and moguls exert
the greatest stress. The results of the biomechanical studies indicate,
that it is advantageous to avoid short radius turns on steep slopes or
moguls." Click on the link to read the complete article.
SPORTS MEDICINE
The American Journal of Sports Medicine
American Physical Therapy Association
TENNIS
Mont
MA et al.: Am J Sports Med 1999;27: 60-4 “Tennis
after Total Hip Arthroplasty”
A questionnaire was sent to all United States Tennis Association member
associations in a tri-state area to identify players who had undergone
a hip arthroplasty. The study group had 50 men and 8 women with a mean
age of 70 years (range, 47 to 89). Only 14% of the patients’ surgeons
approved this tennis activity, with 34% of the surgeons recommending
only doubles. Three patients required revision surgery after a mean of
8 years. Until future studies are performed, the authors recommend that
physicians advise caution in tennis activities.
Disclaimer:The
information provided here is intended to educate the reader about certain
medical conditions and certain possible treatment. It is not a substitute
for examination, diagnosis, and medical care provided by a licensed
and qualified health professional. If you believe you, your child,
or someone you know, suffer from the conditions described herein, please
see your health care provider immediately. Do not attempt to treat
yourself, your child or anyone else without proper medical supervision.
©2008 Todd Swanson, M.D.
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The minimally invasive total
hip replacement was developed by Dr. Swanson after being introduced
to the concept in early
1997. Dr. Swanson began using the technique in May of 1997 and has continued
to make improvements that now allow reliable surgery and reproducibly
good results in most patients. Standardization of the technique has allowed
teaching to other surgeons. Numerous physicians and orthopedic companies
have shown interest in promoting “minimally invasive surgery” for
total hip replacements.
The minimally invasive technique utilizes a 3-4
inch incision, much smaller than the 8-10 inch approach historically
used for hip replacement. Patients require less anesthesia and pain medication,
and mobilize more quickly. This results in both quicker recovery for
the patient and a lower incidence of complications.
Patients typically recover from minimally
invasive surgery in about half the time it takes to recover from standard
incision surgery (6 weeks vs. 12 weeks).
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