Young Active Patient: Back To Sports

Sports Recommended By The Hip Society

(*) Recommended only to experienced patients

No conclusion was reached among the members of The Hip Society as to the following sports:

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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