By David Ward – It was when I could no longer ski the groomers without too much pain to have any fun that I finally decided to have my left hip replaced. Still, as I hobbled into the hospital the morning of June 3rd, I wondered how my life would change. Little could I know it was one of the better decisions I will have made in my life.
[Editor’s Note: This article, along with its companion piece, was originally published in the September 2013 issue of Cycling Utah.]
I had heard that if you have good fitness, it really helps with your recovery. So in the two months leading up to the surgery, I was riding quite a lot. That may sound odd, given the condition of my hip, but interestingly cycling was one of the least painful things I could do. It hurt less than walking, actually, though I could not ride in the drops because of my restricted range of motion.
Surgery itself was an interesting experience. I went into the operating room at 1:30 p.m. The anesthesiologist came up to me and said he had just started the anesthetic. In the time it took me to say, “I am beginning to feel it . . .”, I was out cold.
The next thing I remember was someone telling me that if I needed something for the pain, to push the button on a little handle they had placed in my hand. I couldn’t even hold on to the handle, much less push the button. My wife told me later that she would push the button for me when I would start to moan, but was then sharply reprimanded. Fortunately, it was not too long before I could do it myself.
When I came out of surgery, my doctor, G. Lynn Rasmussen (a great guy and excellent surgeon) told my wife that I had one of the most developed TFL (tensor fasciae latae) muscles he has had to deal with. My years of cycling and my training right up to the day of surgery are to be thanked for that. However, this apparently caused some difficulty for Dr. Rasmussen as it made it hard to work past the TFL to get into the hip to do his carpentry work. (They no longer cut the muscle. They basically push it aside enough to have room to get into the hip and do their work.)
At any rate, first thing the next morning, a therapist came in and told me she was supposed to get me out of bed. “Are you kidding me?” I thought? But she did. We slowly worked my legs over the edge of the bed, then she had me grab round her shoulders and she literally lifted me up on my feet. We stood there for a few minutes while another nurse changed the sheets on my bed, and then I sat back down and she lifted my legs back on the bed.
In the afternoon, another therapist came in. He got me up, and with the aid of a walker, I walked over to the door and back. When he came the next morning, we walked down the hall, back to the other end of the hall, and back to my room, and that afternoon I even went up and down stairs.
The fact is, the hip no longer hurt, and the drug I kept pushing the button for was taking care of the rest of the pain from the incision and surgery. With the hospital staff taking care of me and bringing me meals, and painkillers keeping me happy, life was good. All I had to do was eat, sleep, read and take an occasional stroll.
Three days after surgery, I was released from the hospital. At that point, I became serious about recovery and rehab. I received in-home physical therapy for about three weeks, and was fortunate to have Shane Dunleavy, a cyclist and racer, as my therapist. In addition to understanding my needs better, we talked cycling while I did my therapy.
Naturally, there were exercises to strengthen the muscles and loosen the tissue surrounding the hip, and some of these were quite challenging. But, I could literally sense improvement each day. I took my exercise assignments seriously as I wanted to not only recover, but recover well and be better than ever.
I went outside the day I arrived home and, with the aid of a walker, started out toward the end of our driveway. I quickly realized that, now on ground less smooth than a hospital floor, crutches would work better than a walker. And that was the end of the walker.
Within two days, I was walking (with crutches) a half mile each day. Then, about three weeks after my surgery, Shane had me on an exercise bike for 15 minutes a day. That felt great. And again, walking and sitting down on the commode hurt far more than my time on the exercise bike.
I did have a setback that arose from walking. First, the sole of my right foot became painful, to the point I had to stop my walking routine. With a new hip, the bio-dynamics of my body had changed, and it led to a flare up of a some plantar fasciitis in my right foot. Because of the surgery to my left hip, the right foot had been taking a lot of the weight and pressure of my body, and in new ways.
After three weeks with Shane, home therapy was no longer allowed, and so I started going to Red Butte Clinic for physical therapy. There I managed to hook up with Jason, also a fellow cyclist, who added more exercises and refined my routine to the progress I had made to that point. I am now finished with physical therapy, but continue with the exercises I learned.
Looking back, I can define a few things that made my surgery and recovery a success. First, fitness. By my own experience, and anecdotal evidence from others, this makes a huge difference. The body deals much better with the trauma of surgery if it is fit. Plus, it makes it so much easier to get into the exercise and stretching routine of therapy. Finally, recovery becomes a process of bringing the hip to the same level as the rest of your body rather than trying to rehab your hip and get into shape at the same time in order to do so.
Second, being serious about therapy. I was told to do my exercises two times a day, and I did. Even after getting back to work, I did them religiously. Now that I am three months post-surgery, I have scaled that back to once a day, and about 3-4 times a week. But the initial couple of months are of prime importance, and the therapy is key. Even now, I can tell there are some things that need attention. I can’t imagine how much more difficult it would have been if I had not been committed to therapy.
Finally, a good doctor. Dr. Rasmussen who practices at TOSH (The Orthopedic Specialty Hosptial) met with me the first time I went in, unlike the doctor to whom I was referred at the University of Utah Orthopaedic Center where I was seen by a physician’s assistant. I have nothing against physician’s assistants. Indeed, my daughter is one, and I know they are good. But Dr. Rasmussen personally spent about a half hour with me, explained the condition of my hip, the history of the development of artificial hips and the one he now uses, and what I could expect of surgery. There really is something about meeting personally with the doctor who is going to be cutting into you, sawing off your bones and installing a new hip. I felt confidant after meeting with him, and even excited about getting it done. He really made me feel comfortable with him and what he was going to do.
Hip replacement is major surgery and very invasive. But, it is also a very well developed procedure and, of the three main joint replacement procedures, hip, knee and shoulder, it is the most successful. In my case, it has restored me to a level of life enjoyment that I had feared might be permanently past. Indeed, it has been one of the best decisions I have made.
Great article. I am 6 years post-hip replacement surgery and am much stronger than pre-surgery. Going in, I kept thinking “are my cycling days over?” I, too, cycled until the day before my surgery, and was only off the bike 10 weeks. I kept seeing bruising on my hip for almost a year after surgery. Other than the bruising, I’ve had no side effects. I’m very fortunate to have great healthcare.
I shuffled around and couldn’t ski.. I wore hips out running so took up cycling. Cycling did not hurt at all though my legs stuck out at an angle whilst on the bike. I too had both hips replaced 6 months apart in 2004/05. Been cycling ever since with no pain or problems and backpack yearly (even did LOTOJA in 2017), but no more running nor skiing. I’m 77 and not all that fast but will keep it up as long as possible, except, no more LOTOJA..
And I third the response! As a result of a broken hip more than 30 years prior, I had to have hip replacement shortly after 73rd BD. Did 65 mi ride 3 days before surgery no problem – in fact at no time did failing hip give me any riding problems. For 1st 2-3 days after surgery I thought friends who said only regrets after surgery would be that I didn’t get it sooner were pulling a cruel joke but by golly they were 117% correct. 8 years have passed – still biking up to 70 mi (and could go farther) with no problems. Very occasionally hip has bothered me in bed. Tip: if you are getting your replacement because you have broken your hip sometime in the past, be sure to ask your surgeon for the old parts (bolts, etc) as a souvenir – there is no extra charge!
Good to read this-I just this week got three PRP injections into my R hip, TFL and SI joint. Like you, cycling was never painful but walking was so painful. I’m hoping the PRP calms everything down so I can resume running and hiking but I know a replacement is on the horizon. Having had bilateral ACL repairs and a shoulder reconstruction I agree with your assessment of the importance of pre op fitness and a good PT routine. When the surgeon leaves the room your job to rehab begins.
I had a hip replacement October 8, 2018. The importance of pre-operative conditioning cannot be overstated. I was able to walk without crutches within a week, and began walking 6-7 miles per day within 3 weeks. Although the surgery delayed my offseason workouts by 3 months, I still had a strong season (2nd and 5th in my age group at USA Triathlon Nationals), and am doing everything I was able to do before my hip pain started. The most important issue that is often overlooked is reprogramming the neural pathways to return your gait to normal. You learn to walk with a limp when you have hip issues, and you have to re-learn to walk (and run) with a normal gait. The strengthening component of PT is important, but lots of clamshells and hip bridges are equally, if not more important. I had tried PRP a year before surgery, and it didn’t help much. Once you have had the surgery, you wonder why you waited so long…
Hi David. Thanks for a great post. I’m 60 and had a left hip replacement on 17 Dec 2019. Similar experience so far. Could do a little cycling pre op as it hurt much less than anything else. Not big distance but 3 months of 100km per week. Made a huge difference compared to others in my rehab group. Four weeks on and I can cycle an hour on the indoor trainer. Looking forward to getting on the bike outdoors but will wait for clearance. Want the joint to be strong enough in case I crash. Echo Neal’s thoughts. The specific exercises are important and for me I’ve had to relearn how to walk. Still have a few range of motion issues but will keep working on it. Last thing is I had the superpath technique. No cutting of muscles or hip dislocation. Also no restrictions post op. Brilliant for improving your recovery time.
I am about to have a double hip replacement. Can anyone recommend a good stationary bike? I figure I’ll only be using it for a few months. Did you do upright or recumbent? Thank you!
If possible please email me: [email protected] as i don’t know if I’ll see responses here.
Thanks for this article. I am in my early 50’s and need a left hip replacement due to a hip injury 40 years ago – developed arthritis. As an avid cyclist and skier, my greatest concern is having the ability post-surgery to continue doing the things I love to do. I am wondering why some who have commented stopper skiing. Curious as to why?
I’ve just had my second hip replaced in November Had my first one replaced 2014 and knee replacement 9 month later , I’ve always been able to cycle when struggled to walk , can’t wait for the better weather to get back on the bike , if you keep the muscles strong helps with recovery , and I am 77 yrs young
John, I had both hips done at the same time on 3/1/2020 and skied 12-15-20, like a teenager! Anterior approach speeds recovery dramatically. I was on a stationary bike in 3 weeks. On way to Aspen Friday. I’ll only ski about 15 days this year, but I lost 7 weeks to a broken rib from a ski fall hitting something under the snow coming out of the woods. First fall out of the way! Don’t hesitate. It’s the best thing I’ve ever done.
I was hit by a vehicle when riding my bike (time trial). Preparing for cycling time trial race. I fractured my pelvis, recovered to a degree, now cycling again. However, I have been told by the orthopaedic consultant that I need a full left hip replacement. I have been worried about recovery and cycle racing again. Reading al, the comments posted has really given me upliftment, and now I am mentally focused to the surgery. Until then I will keep cycling with the view to prepare. Happy days, thank you everyone.
I just had a Total Hip Replacement March 29th, 2021.
35 days ago, and new I am cycling using Zwift indoor trainer platform.
Doctor won’t let me get out on the road until first week of June.
But for the past two weeks, I have been logging 140 miles per week on the trainer.
I also had the Anterior Approach.
Hope this helps.
Regarding anterior surgery speeding recovery. From my experience, this is nonsense.
I am mid-70’s, had posterior right hip replacement on June 15. Was walking unassisted two weeks after surgery, and started riding my road bike two and a half weeks after surgery. Not sure it is possible to heal up much more rapidly via either approach.
Had a lengthy discussion with my surgeon about pros and cons of anterior vs posterior, as he does both procedures. He recommended posterior due to lower pelvic damage complication rate in older adults. I go with the doc’s recommendation, as I have not been to medical school.
What I think is way more important than posterior vs anterior is being in shape prior to the surgery. I was hiking two miles per day up to the day before surgery, and back country skiing several times per month.
Surgery was mid-June, plan on being back on skis by this November.
Thanks for this article, while no two people’s recovery is the same, I am yet to have my hip done. At 39 I need full replacement and I actually find cycling espically uphill makes it hurt the most. I have backed off racing espically time trial because the leg can’t do full range of motion anymore.
I put it off for a year because of the fear of being off the bike so long after the op.
But after reading all the responses and article I have alot more faith getting back on the bike sooner then I thought.
Thank you so much for this – the writer and the commenters alike. I have an arthritic right hip scheduled for replacement Jan 17, 2022 – anterior approach. I’m extremely nervous about it, but have a great doc and the combination of the science and testimonials like this are keeping me on the path to the 17th, all fears aside. My wife is beside herself with worry.
I’m 59, avid cyclist, and I think I’m going in a bit early. I still have good days, sometimes even 2-3 weeks. Then, I’ll have days-weeks where that hip stabs on every walking step, and my balance will occasionally falter as the body doesn’t want to put weight on it. Sleep is always still good. Cycling is still good (125-150 mi/wk) – coming off my best season ever, results wise – but the thing starts to stab and grind at 45-60 minutes; just enough where I can feel the inhibition of power. Cycling is still joy, but not quite as much. Outdoor riding is worse; indoor still smooth. Running is out of the question, golf died about 5 years ago, and my yard days are a lot shorter now.
I know we all an individual situation and path we follow, but I really appreciate your sharing – it’s really important for me to hear from serious cyclists and athletes on this. Cheers..
Jan 3 2022 had left THR anterior, 10 days post op walking mile, back on bike trainer rouvy 20 miles zone 2 now. TIP – Easy to get leg on and off road bike on smart trainer by removing front wheel step over then remount front wheel. 69 yoa
I am emailing from England, long way from the great state of Utah! Any thoughts on best saddle shape for hip replacements; and whether the smaller wheeled bikes are better? I write as an amateur cyclists compared with you guys!
Had my right hip replaced in 2019 (I was 59) and skied that season as a mountain guide. No PT protocol was prescribed by my ortho; went with the “Your activity level will be dictated by your pain/flexibility level”. Big muscles held my hip joint in place and, as David stated in the article, pre-surgery fitness played a big part (maybe the largest part) in my recovery back to unrestricted activity and a high-performance scenario. FYI, had my right knee replaced in December 2020 and skied within 90 days. Technology is amazing now and would highly recommend joint replacement to anyone that is pondering that option.
59 year old female here with an anterior right hip replacement scheduled for tomorrow. I am so encourage by your responses. I haven’t been able to get my leg over the bike or ride up any hill at all for six months. I still walk every day, but my pace and distance have been cut nearly in half. Zwift is ready when I am and I’m looking forward to those 60 birthday miles in October!
March 28 2022, total right hip replacement, anterior approach. All costs plus rehabilitation & physio courtesy of the Government of Ontario. 80 year old male, endurance cyclist, lifetime of tough workouts — maybe too tough. Not much to add to the above comments since I’m not into impressing with specific mileages in skiing, running and cycling. However, two helpful notes: I postponed surgery as long as possible, until two things persuaded me to take the plunge; first, I couldn’t get my leg over the top tube without standing on a bench and second, pre-surgical imaging stated “end-stage” OA. As for home rehab,in addition to a two-wheeled walker, I have a four-wheeler in the basement for walking (which began two days after surgery). It really helps! Ciao
Hi peeps, I’m 39 years young and have had arthritis for over 10 years. I’m a keen cyclist doing anything sportive around the country where it’s got a challenge! I love hill and scenery!
A week today I’ve had a full hip replacement and rebuild on my right hip, they was more damage than expected when they were doing the op, all removed and and healing well, doing the physio as required.
I’m hoping to get on a stationary bike next week, just a steady spin to get the legs going again. It’s so refreshing to listen to these inspirational stories.
Wayne c
I am 53 years old and had my left hip replaced with a ceramic on ceramic prothesis back in 2014. I have been an avid amateur nordic ski racer and bike racer since I was in my late twenties. All the falls during road races definitely jump started the OA in my hip joints. That and the fact that I never took a break between sports. When my left hip was replaced in 2014, my doctor told me my right hip didn’t look good either. Well, I waited eight years before the amount of recovery time from training eclipsed the actual time spent training. So here I am, one week post op with a right new hip. Things have drastically changed since the last time I had total hip arthroplasty. I was sent home the day of the surgery, and saw my PT 3 days after surgery. Things are going well, with the exception that my body has aged and I am slower to recover than last time. I am walking with a cane after a week and get stronger every day. I used my walker for seven days before feeling comfortable enough to use just a cane. I Probably won’t be on a bicycle for another six weeks, but I am ok with that. Sometimes you have to be greatful to just walk. Planning to be on skinny skis again in December so long as we have snow. In my experience, healing from a THR is a marathon, not a sprint and I have lots of strength and mobility issues to iron out moving forward. I did tons of testing the waters before resuming activities even 6 months out from my surgery. Hoping for zero pain and lots of restful sleep in the year to come.
Having right hip replacement surgery on 18th of August. Previously had both knees replaced 15 and 9 years ago as well as my right ankle rebuilt over 40 years ago. Unable to walk without a cane for about 2 months and have had almost constant pain for years. I’m sure most of my injuries had something to do with terrible training methods in “the old days”. I was a basketball/football player and the method back then was “no pain no gain”. Over the years I eventually became unable to play any competitive sports; not even golf. So for the past number of years been restricted to weight trading and stationary bike riding at the gym; which I attended religiously.
It is really great to have so many positive reports about this surgery as at age 74 I was starting to get a little down emotionally. However as a result of reading these comments I am now recharged and highly motivated to get on with it!
Thanks again to everyone for taking the time to comment on your own experiences it was both educational and motivating.
Inspiring stuff, David. I’m an obsessive road cyclist and same as many above and you, cycling causes less pain than anything else, though in the past few months I’ve had more pain on the bike than before. But hip op (right hip) tomorrow, so very apprehensive. This blog is just what I needed to read. I will adhere to the exercises and aim to get on the trainer I’ve bought in but Christmas. Thank you!
In 2012, my cleated shoe failed to disengage from my bike pedal & I fell over. As a former competitive cyclist, it was not not the first time this occurred. However, rather than the normal scraped ankle & bruised ego, this fall caused two complete fractures. My femur completely fractured from the hip bone & the ball of the hip completely fractured from the lower section of the hip bone.
Unbeknownst to me, I had developed severe osteoporosis in my R hip thanks to a breast cancer drug, Exemestane. Although my bone density scans (Dexa scan) showed no evidence of any bone deterioration, my orthopedic surgeon, a cyclist, informed me Dexa Scans are not reliable. He informed me my hip bone looked like “a sponge.” After speaking with him, I believe women need to question their docs about the accuracy of & need for a Dexa Scan.
I was 58 at the time of my accident. I did my own PT and was back on my road bike in 11 weeks. I began walking more than cycling at my onco’s recommendation & began weight lifting again in my early 60’s. I have had no problems doing any of these activities. I have not resumed XC & downhill skiing for fear of falling. If you are in good shape, don’t put off a hip replacement. The earlier it’s done, the more likely you are to have a full & rapid recovery & be back on your bike within a few months.
I had right hip resurfacing about 3 1/2 weeks ago (Posterior) at Sunnybrook Hospital in Toronto. I, too, was cycling the day before my surgery. In fact, just like the author, I had zero pain in my right and lower back when cycling or playing hockey. Standing and walking were the issues which made life very difficult to manage. Year prior I had an injury doing yoga in May 2022. My lower back and glutes made it impossible to stand without a sharp intense shocking pain. Had an epidural spinal injection. Helped. But, pain persisted. MRI confirmed disc herniation L4/5. But hips also saw severe OA on right hip joint. Left lesser extent. That was in August 2022. Chiro, acupuncture, PT did nothing. Saw a hip surgeon. Looked at both X-rays. Hip and back. Said it’s not your back. It’s your right hip. So, after what I believe is so far a successful surgery, I’ve been walking, single cane three times a day for about 3 kms each time. Walking was an activity that caused so so much pain. Hip flexors are still a bit ‘tight’; but, getting better. Yes, I do the rehab exercises 3 times a day. Can’t wait to get on the road and bike. For now I’ll watch the Tour de France and dream!
Gary.
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