I trace the timeline of my hip-replacements to the revised me of present time. The new-and-improved me offers some tips on how I got here.
“I have OA? Old age? What, at 30?” I asked my physician.
“Osteo-arthritis,” he replied.
Doing ‘fun-runs’ and playing field hockey had been my sports-of-choice when I was a physical education student, teacher and coach. After a foot fracture in the 1980s, I over-compensated. A ‘domino effect’ of injuries impacted musculoskeletal movement. Five years later, in training for a half marathon, a sports-medicine doctor counseled me:
“Imagine your hip-cartilage injury like a golf divot,” he said. “Bone grows into the gap. Over time, the joint erodes.”
Hips and knees are weight-bearing (or load-bearing) joints. During activity, they tolerate a force greater than our body weight. A brisk walk places a hip-joint load at just under five times the body’s weight (jogging, at six times). Healthy joints (and joint replacements) withstand ‘load.’ High-impact sports (especially on hard surfaces) put more stress on joints. I put a halt to jogging and stop-and-go sports to postpone surgery.
I learned that an active life was possible post-running. From early triathlon participation (swim-bike-run), I re-focused on the swim-bike. From hiking to ocean kayaking. ‘In-the-tracks’ cross-country skiing is a low-impact, lifetime sport (as is downhill skiing, skating, doubles tennis, rowing, Pilates and many more). Weekly Iyengar Yoga sessions, with a pile of props, an experienced instructor’s guidance, and my own body-barometer, were possible pre-and-post op.
“Find your healthy edge,” my yoga instructors have always said.
Physiotherapist Dawn Siegel says, “The more variety, the better. Life is meant to be lived fully and a joint replacement can help to return you to a full and active lifestyle.”
My first total hip replacement came at the age of 40 — the other one at 46. Twenty years ago, this major surgery required several days in hospital and weeks off-the-feet for an un-cemented prosthesis. The surgery then, as now, replaces the damaged joint: both the head of the femur, or ball, along with its stem (the prosthesis) and the socket. Between the metal ball and socket is a plastic liner, which is now made of more resilient materials.
Joint replacement patients receive an exercise booklet. A skilled physiotherapist’s guidance is essential, especially at the three, six and nine-week intervals.
Listen to an expert like Dawn: “The goal of physiotherapy is to motivate and guide the patient to achieve their full post-operative potential… Patients that get the most benefit from their surgery are those that are diligent with their exercises, follow the guidelines from their surgeon, and work closely with their physiotherapist to set goals for their recovery.”
She continues. “Over the many years of treating joint replacements, I have been impressed by the positive changes this surgical procedure has made in the lives of my patients. Not only does a new knee, hip or shoulder take away their pain, but it gives the recipient a chance to regain their fitness and return to an active lifestyle and sporting activities. With the modern joint replacements available, there is very little downtime post operatively and a return to most activities of daily living is possible in just a few weeks after surgery.”
The pre-2000 plastic liner of my first hip replacement might have lasted 15 years, if not for my transition to low-impact activities. I lost function after 26 years. New liners may last up to 30 years.
“Joint replacement patients will commonly have many years of pain and de-conditioning prior to getting their new joint and many will be surprised at the opportunities for sport that are possible post-op,” says Dawn. “Often they need to be inspired and encouraged as they return to activities that they once abandoned due to pain… even to try some new ones. Building and maintaining bone as we age will help protect us from the effects of osteoporosis.”
My 2021 revision surgery saw the liner and the ball replaced without implicating the metal parts. My surgeon, Dr. M. Neufeld, endorsed weight-bearing with assists.
For the first month, steps were tentative with two-wheel walker, crutch and cane support: gel packs at the ready.
At the six-week mark, Dr. Neufeld said, “The reason you are doing so well is that, yes, the hip replacements were done very well, but just as, and if not more important, that you kept active, which increased your range of motion and kept your muscles strong, which would help you pre-operatively and help your recovery. And then even your own cardiovascular helped things. And mental health. There are no limits to what low impact and strengthening exercises can do for you.”
The components of fitness that Dr. Neufeld referenced were what I had practiced as a young physical educator. Fitness is loosely defined as one’s ability to do daily tasks without undue fatigue. But it is so much more.
- Cardiovascular or cardiorespiratory fitness (aerobic exercise) works the lungs, heart and blood vessels for an extended period, supplying oxygen to the working muscles.
- Muscle endurance is muscular work (repeated contractions) for an extended period.
- Strength training powers low repetitions of maximal force.
- Flexibility counters muscle stiffness and improves range of motion with dynamic and static stretches.
- Body Composition is the fat to fat-free mass ratio. Lean muscle mass lends itself to a lower percentage of body fat. Diet and exercise work together (via activities #1-4) to stabilize body-mass index (BMI).
Here’s to moving ahead with healthy lifestyles: our newly-revised editions.
Joan Boxall is the author of DrawBridge: Drawing Alongside My Brother’s Schizophrenia (Caitlin Press, 2019).
More Info:
For more info: www.orthoconnect.org and http://vch.eduhealth.ca/PDFs/FB/FB.130.B393.pdf or the Canadian Orthopedic Foundation: www.canorth.org to ‘get-moving’:
The Arthritis Society has ‘arthritis-friendly’ programs: info@bcarthritis.ca
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Great information, Joan!