When is the right time for THR?

Not all surgeries are 100%. You won’t hear about them, because this site is for people who run again after THR; it is not a representative sample. I ran multiple times after my bilateral, but it didn’t work to my favor. When you can no longer work 40 hours, or walk 5 miles, then get your surgery. Running is very, very important, but at some point, we all must give it up. Sadly.

Hi Brent,

I had mine when I could no longer walk for exercise. I had to conserve steps to have enough left to do routine things like grocery shopping. Walking more than a short distance provoked horrible muscle spasms. It also hurt to lift my leg to get on a bicycle and the amount of riding I could do every week was declining rapidly.

-Hoppie

Brent-your story IS LITERALLY MINE!!! SO MANY OF THE IDENTICAL SYMPTOMS AND THOUGHTS!! I’m 49 y.o. I had the exact same questions as of December 20 for my December 22 procedure!
How did I know??? MANY of the same reasons you gave but cemented in my mind this fall when a 10-mile race (that I was prepared for) left me barely able to walk the next day due to hip pain and when older heavier non-athletic parents can move faster than me during a parents-kids soccer game 😉 I don’t know that I’ll answer “for sure the right decision?for another 6 months but I can tell you today-22 days post-op, I’ve hit 2 big milestones: I can walk up stairs pretty normally with just a slight muscle stiffness at the incision and can walk briskly with ZERO JOINT PAIN. I hiked a hilly 3 miles on day 20 post-op (avg. 3.6 mph) and biked 8 miles easy on a road bike at 15mph on day 21! THERE IS BRIGHT HOPE and I plan on running again; God willing by May.

Hi Brent – have you researched resurfacing (Birmingham hip and variants)? The sort of procedure that Andy Murray chose that allows full activity including impact. Only a few surgeons specialize in the procedure, those that don’t will probably not even mention it as an option, but it offers a younger athlete a more conservative option than a TFR which is easily converted to a TFR later in life if necessary. A well-fitted BHR or its equivalent will last at least 20 years. That said, a modern ceramic THR seems a pretty good alternative and my surgeon was happy for me to carry on running and climbing, saying “you will not be able to break it” when I expressed my disappointment that my second BHR op resulted in my femoral head snapping off,thus requiring THR as second best.
Whichever you get you should be able to get running again within a few months, I have had a good year despite lockdowns, over 900 miles of running, up to 13 miles, and long days in the hills up to 42 miles. I have just turned 70, my hips are 6 and 3.5 years old.

Hey Brent in reading your last post you once again confirm my experiences pre – surgery. I live in FL so water skiing (for me at a very recreational level) had become painful. And yes with OA, one day is tolerable and the next is real painful. Tempering your expectations is great because the reality of your future is unknown… in addition to what I said previously, I posed this reality to myself: “with OA and the decline in stability, strength, and mobility (all eventually inevitable but in my late 40’s, OA was the main cause), AM I WILLING TO ROLL THE DICE – knowing I may not run again – in order to gain the CHANCE to run like I did 15 years ago?” What’s the chance of NOT running again due to having a THC? For “runners” our age, I estimated that at 20%, so I am rolling the dice. For me, I’d rather take the risk at having a shot at running a 3-hr. marathon (that’s the best version of myself) than “shuffling off into the sunset”. 20 min. before the surgery I’m standing in the pre-op room practicing deep breathing, fighting back fear-tears and praying that I was doing the right thing (for more reasons than stated above I.e. please God no complications”…
So I made the decision…. and some of the best advice I’ve ever heard… “make the decision, then WORK TO MAKE IT THE RIGHT DECISION!” So here I go out the door, practicing proper form in how to fast hike!

Hey Brent not trying to play psychologist here but I had an additional thought in evaluating your last post… it seems you really want to get back to running “soon“ or “quickly“… totally understand this and sympathize, and also don’t think there is anything wrong with having a “calendar goal“ to start running again… But I believe we should plan in our minds first that the return to running schedule is certainly not up to our wants and wishes. Nature, healing, the orthopedic surgeon, physical therapy, stress, nutrition, fate, etc. all will play into determining when this can happen. Put any races or “need to be training by to race“ dates on the shelf for now… and this was another reason I decided to have mine done when I did, three weeks ago. Osteoarthritis progressively gets worse, I turn 50 in six months, racing and the best endurance events are certainly paused and many of them for this year will be open only to those that didn’t get to race last year… and most importantly, I chose the Christmas holiday weeks because it would have the least amount of impact on my work, income, and providing for my family. From about April 2 2020 to December 2021 will undoubtedly be the “darkest“ time for endurance events in my lifetime so no better time to try the replacement, recover, and see if I can come back stronger 💪🏽
Again, not trying to tell you what to do, just giving you the best background for my decision and I was struggling with so many of the same things that you are currently… once I made the decision, there is no turning back… Only moving forward and making the most of my present situation. Regardless of my long-term outcome, I have made a promise to myself to not be negative and never dwell if things don’t turn out as I realistically expected!

Hi Brent. I don’t think anyone can really tell you when the time is right for your THR. But I do think that each of us know when the time is right for us, though we may rationalize against that knowledge. In my case I fought hard against it and felt that I could endure whatever pain and discomfort was necessary to keep my old hip and keep running. The deal breaker for me was when the pain affected my sleep. When the pain prevented all but a few hours of sleep at night it was too much. AND it went drastically downhill in a couple of months. When I first scheduled surgery I was unsure, but when the time arrived I couldn’t imagine waiting longer. Now I’m more than thrilled with my new hip. It’s been three years now. I am running again though not to the degree I was before, mainly because the rest of my body resists. Strength has been slow to return but my range of motion is as good as it has EVER been. Speaking for myself, it now seems irrational to try to delay the inevitable a few more months, while enduring the pain of the deteriorating hip. I’m confident you will do what is right for you, when it’s right for you.

One other confirmation cue as to when I needed THR…this past summer when attempting to mount a horse for introductory horseback riding. Myself (49 y.o. and 150 lbs.) and a heavier woman in her 60’s were the only people in a group of 20 that required the roughly 2’ tall step-stool to mount our horses! And yes the 2-hr. ride was painful!

Hi Brent, I ran through most of 2019 and 2020 with pain in my hip. It began as a discomfort over the years and then in the last year and a half became debilitating. I went from running 60-80 miles a week on average to 25-40 if I was lucky. Last year I could still manage runs of up to 100k but by the end of them I was done, my hip would be unbearable and I would have to take a few days off after any High intensity or long run. By the end of September last year I couldn’t run a step without severe pain in my hip and I stopped running. By November I finally went in and had my hip looked at. I have FAI (Femoroacetabular Impingement) bone growths on the femur ball have completely worn down the cartilage in the hip socket and now the socket and femur head are bone on bone. The pain is constant and I can’t walk half a mile without sitting down form the pain. Some days the pain is manageable, then I step wrong, stub a toe, the hip locks up and I’m done. Some days I get the pain radiating down to the knee or ankle, those days really suck. I can still cross country ski (classic only, skate skiing is way to painful) so I can still get my cardio in and still feel somewhat normal, but even then after a hard or long ski over 10 miles I have to take a day or two off afterwards for my hip to calm down. I’m scheduled for surgery February 15th, I’m so sick of the pain now I’m counting down the minutes until surgery. If I knew how bad the pain would get, how fast my hip would degrade over the last 8 months I would have scheduled the surgery back in July when it really was impacting my life.
I guess what I’m saying is if your hip has caused you to not have the life that makes you happy, that is no longer the life you live, get the surgery. The sooner you’re pain free the sooner you’ll be back to doing the sports that you love. I have wasted 8 months of my life because I wasn’t sure it was the right thing to do. I’m 56 years old and now I’ll have to wait until the end of summer possibly before I can actually begin returning to running. I’m pretty pissed at myself for waiting this long and now my life is on hold.

Get it done!I got my first at 49. Just like you, I wanted to hold off. I was scared. Less that a year later I was darn right giddy to get the other hip replaced. The added benefit….. I sleep so much better, No more waking up all night. And I still run! Only advice, find a surgeon that encourages you to continue your running. Don’t wait.

Hi Brent – lots of great advice above for you. I am a long time endurance athlete/triathlete and plan on continuing that lifestyle until they put me away:-). I was training for the half in Atlanta last spring and just couldn’t deal with the painfully slow miles any longer. I had dealt with it for nine years since I twist broke my leg. The tipping point was I wasn’t living the lifestyle I really wanted….couldn’t compete…hard time sleeping so recovery wasn’t good, couldn’t play with my grandkids. Though I was still running 45 miles per week, biking and swimming it was just too painful.

Now 6 months post op, I am back to riding and swimming well….but because I ran on a bad hip so long….I am dealing with imbalances while running. I run 3/4 days per week now pain free 15 to 20 miles….but realize that I am having to do lots of single leg squats and other types of exercises to correct and use the proper muscles.

My suggestion as you try to decide when to have your THR and continue to do repetitive exercises….are you also creating these imbalances and what is the long term effect?

Good luck with it and hope to hear all about your recovery.

Hi Brent

I’m 55 now and had a THR in January 2019. Like you I knew that it was only a matter of time before I would need a replacement, but it took me well over a year to make a decision to get it done. The decision was quite an easy one in the end and I made it when I realised that without having an operation my running was only going to get less enjoyable, more painful and my times were only going to get slower The words of Morgan Freeman then came into my head, “you either get busy living or get busy dying”. Once I had made the decision I became very excited about having the operation and got busy planning my road back to running.

Prior to the operation I had regularly competed on the World Age Group stage in Triathlon. I enjoy racing triathlon and wished to carry on after the operation.I had qualified for the Triathlon Sprint World Championships in July 2019 by competing in a race, on my bad hip, in 2018. I went under the knife at the end of January 2019 and raced in the World Championships in July. I didn’t set any records with my 5k run time, but what was pleasing was that I was faster than my qualifying race in 2018.

2 years on and, COVID permitting, I am still competing in triathlons, but have also taking up Aquabiking. I compete in aquabike not directly because of my hip replacment, but because I was never a great runner anyway 😉

You will know when the time is right for you, but like many on this site, I saw my THR as a beginning and not an end to my running.

Good luck!

Hi Brent, like many have stated, we all have to make our own decision. I’m 47 and 3 months post THR. I wasn’t a hardcore long distance runner, but did have a minimum mile/day streak for 1391 days until surgery ended it. The last couple of months before surgery were pretty much a survival shuffle to make it through my mile. What put me over the top was I couldn’t coach my 5th son’s football team the way I normally do, demonstrating techniques, showing them how to run routes, etc. That and I couldn’t sleep through the night. Not being able to live my life the way I wanted is what convinced me it was the right thing to do. I received the go-ahead from my surgeon to start the slow process back to running today. 7 minutes of walking, 30 seconds of jogging x 2 a couple of days/week. I’m listening to the other advice I’ve read on this site and am going to take it slow and listen to body. Good luck with your decision, that first week post-op sucks, there’s no other way to put it. But it does get better and sharing your story here provides some great support!

Brian

Hey! I had a THR just 2 days ago and am 1 week shy of my 42nd bday. It was a long hard decision. I’m also a PT. I would say sooner rather than later. I kept justifying putting it off because I could still work, walk, and do my Peloton. I was occasionally run/walking but it wasn’t great. I also could no longer row or do pretty much any lower body lifting. At some point, you have to look at what you’re giving up not what you can still do. I’m not sure if anyone follows Kelly Starret on IG but he is a PT who owns a CF. He just had a TKR. He really talks about making the decision sooner rather than later. I wouldn’t wait until things are so bad you have no other choice. Your recovery will suffer. My surgeon said my hip looked significantly worse than they had thought.
He was happy I didnt wait any longer. Go for it. Work hard. Put it behind you. Good luck. Hope to be back to running in 6-8 weeks. Grateful for this site.

Hi Brent – sorry to take so long to get back to you. I was able to run only til late April when I started getting sharp stabbing pains that stopped me in my tracks. I had my surgery on June 30th. I could no longer walk more than 2 miles, no running….but I was biking and swimming at a high level up until surgery.

I am now seven months post op and can tell when doing one legged mobility and strength I am really not balanced yet. Since running is a one legged sport….it is very important to work that out. My swimming is great and I am back to about 70% of my potential on the bike. Since it is only February…..I am sure I will be ready to compete in duathlons and sprint triathlons this spring.

And oh BTW….I have no hip pain and am so glad I had it done.