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Post Hip op do's and dont's

 Poster: A snowHead
Poster: A snowHead
In June 2019, Mrs SHAP had a total hip replacement after several years of pain. She's never been the best or most confident skier, but now she is refusing to go at all. She seems to think that only people who were good before the op should ski after it.

My concern for her is that since she left the hospital, there has been zero follow up, no physio, so suggestion of exercises for her to do, so she hasn't done anything... she is still sore, but more from the op site itself rather than the 'bone' pain that she used to get.

Has she messed up by not doing any kind of physio for the last 6 months, or is it normal to do very little post op? For ref, she has been doing light yoga and little gym cardio for a around 6-8 weeks, but nothing directly recommended by the surgery team.

Cheers
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
My father had both his replaced in his 60's. He was an ok week a year holiday skier but not a good skier. He was active after the ops but didn't do any specific exercises and wasn't supplied any from what I remember. After the ops he skied sixth months later to much the same standard as before but with a lot less pain. So from his experience it was business as usual. He still skis but as he in his 80's only an hour or so a day.
What did/do the doctors say about skiing. My father's consultant was fine about it.
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I should add that she was just 49 when this was done.

@pieman666, I'll be delighted to be skiing in my 80's. I'll check what the Dr said.

I think I'm more surprised that there was no post op plan...
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Me too @SHAP I will be very happy to be skiing at 80.

The difference between pre op and post op was amazing for my father. He was in extreme pain before the op post op it had gone. One thing that was more difficult afterwards is putting on ski boots. I help him or he gets one of the boot room attendants to help.
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@SHAP, as related in one or more other threads here, I had a hip resurfacing nearly 5 years ago now (at 55) and was skiing 3 months later - albeit indoors. Last October I sustained multiple fractures to the same hip, which amongst other things resulted in the resurfacing being removed and a full replacement inserted.
I was given limited exercises by the inpatient Physios and referred on to the local Physios who I am seeing once a fortnight. Together we are building up the exercises that I do every day, which currently includes a 2 mile walk (with a walking stick at the moment) and 30 mins on a static bike as well as some very limited weights. I also apparently get 6 weeks free gym membership curtesy of the local Health Board.
It is my hope that I might be able to do some skiing right at the end of the season.
Now I do, under normal circumstances, ski around 8 weeks a year as well as skiing indoors most weeks; hill walking; mountain biking etc.
Perhaps worth noting that in the case of both incidents I have not had anything I would describe as pain after a couple of days after the operations.
Now my experience of all this is that you have to be very pushy. Emphasise that your wife does not lead a sedentary life style; that skiing (and whatever other activities) are essential parts of her life (and yours) and not being able to participate is likely to have a hugely detrimental impact on physical and mental health. I’m afraid that with tight budgets the authorities won’t do anything unless you ask and ask again.
Before my leg was operated on in October Mrs SL (normally a woman of few words) spoke to the consultant making it very clear that the most important outcome was that I needed to be able to ski when it was all over.
Good luck to both of you and do not give up or take no for an answer.
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I had a full hip replaced just under 3 yrs ago at 55. Straight away I was put on Walking every hour and exercises 5 times a day. I skied 11 months later and was stunned howgood the hip was.
I would get her to see the best physio you can afford and get some work in. After 9 months I hit the gym hard and the hip really benefitted.
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Mrs NBT had a hip replacement after an accident and has resumed skiing with no issue whatsoever. However she was given a programme of exercises to do as part of physio following the op, and continues to swim regularly some 3 years later in order to help build the muscle. No physio and no follow-up sounds like awful patient managment from the hospital, I'd be straight onto them to get something sorted
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Thanks all.

I think we need to head to a decent physio, and go from there. It's definitely a massive improvement from pre op, but I think we were expecting to be in a better place by now, 6/7 months post op.

I'm skiing with son this year, and wife and daughter are having a beach hol, but I'd love her to want to come back to the mountains.

Edit for typo...


Last edited by After all it is free Go on u know u want to! on Tue 21-01-20 15:34; edited 1 time in total
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My french neighbour is in his mid 80s. Not a local but has skied here most of his life, they've owned their apartment since 1969. He knows all those of a similar age here and went heli skiing in Canada with a group of mainly instructors when younger. He had both hips replaced last year in 2 ops. He skied a bit between the 2 but is now back in full swing on both. Not just pootling around, still skiing anything, to a good standard.

My mum fell and broke her hip on Christmas Eve 4 years ago at 80 and had an emergency replacement. They sent a physio very soon after she got home to get her moving, getting upstairs, etc. She hasn't skied since, but she didn't before either wink Laughing
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Quote:

I would get her to see the best physio you can afford and get some work in

This. There is a shortage of physio capacity in the NHS but I'm surprised she wasn't even given a sheet of exercises to do. Better late than never, get on to the physio now. I have a friend in his mid 80s who had a replacement hip the winter before last. He did his exercises religiously from the first post-op hours, and is a new man! He's not a skier, but a keen sailor, and can now get about the boat much better than before.

However, I have some sympathy with your wife's feeling that if she wasn't a good, or keen, skier before the op, starting back after such a long period of pretty total inactivity might not be the best idea. The Snowheads who describe their successful return (and my sailing friend) were all mad keen to get back. Not the same as being cajoled by somebody else, though I sympathise with your wish to get her back in the mountains.
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Thanks again all.

@pam w, just to add a little - she has always been very keen, just not overly confident. Shame really, as I think she could be pretty good if she trusted herself to go a little faster (but that's another thread altogether...)

She loves the mountains, and we had considered her coming as a non skier, but the more she has thought about this, it seems that she feels it would frustrating for her to be there, but not ski IYSWIM.

Physio it will be....
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
I had heard somewhere that after a hip replacement you can only do the cross county as opposed to Alpine Skiing. Does it have any negative effect on your Alpine Skiing?
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@GarryC, I’m afraid you heard wrong. It is possible to do both. I will personally be returning to alpine before XC (as I did after resurfacing) not least as in my case a fall is more likely on XC skis than alpine.
As long as you can get muscle strength back, should not be a problem.
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 You know it makes sense.
You know it makes sense.
Hi, @SHAP,

My wife had a hip resurfacing in Jan 2008 having only being able to ski a little immediately prior due to the pain from her arthritis. Due to the metal ion issue with resurfacings that was replaced with a total hip replacement in May 2014. In both cases she returned to skiing the following January and was skiing just as well as before the operations. The two issues to overcome are firstly the phsyio after needs to be done as a major muscle group has been cut and needs to recover. The second is the mental aspect of "What happens if I have a bad fall, will I damage the replacement?" which is countered by "Isn't it nice to ski and not be in pain."
Hope your wife gets back to fully enjoying skiing.
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 Otherwise you'll just go on seeing the one name:
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@Ski lots, can I ask why you had a resurface over a replacement (if you were offered one?) I've just been diagnosed with osteoarthritis and have been told I needed a replacement without a discussion on why resurfacing was not available/suitable. At 45 I'm keen to try and avoid a hip replacement for as long as possible, but I'm starting to not be able to do things I enjoy such as cycling and running. I'm hoping skiing in 3 weeks will be ok Shocked

Seeing the reply's on here has given me confidence that I should be able to ski again if I have a replacement.
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 Poster: A snowHead
Poster: A snowHead
@C Holt, When you get to needing a replacement/resurface do research on femoral head size. When my wife had her resurfacing she made it very clear to the surgeon that she skied and wanted to continue. That led him towards resurfacing which at the time had much larger femoral heads than the traditional THR which had a tendency to dislocate in falls. Since then the trend in THRs has been towards larger heads which give a much more stable joint. Lots of info on THR websites and discussion groups. DO the physio your joint will be better than ever, it's the muscles around it that have been cut that need to recover.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Timc wrote:
it's the muscles around it that have been cut that need to recover.


This is bit Mrs SHAP is working on. The pain she had before is gone, it's just been replaced by another, albeit temporary, one for now.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
@C Holt,

Hip resurfacing has had a bad press recently (mainly around the DePuy ASR device which was recalled). Total replacement has improved over the years and now offers options with larger heads as @Timc says. The original hip replacement was small metal head in polythene socket which could dislocate, hence advice not to to ski on those. For these reasons surgeons appear to be favouring total replacement even in younger patients.

That said, resurfacing is still an option, some surgeons will offer it. My surgeon still does them but last time I met him he said it was the exception these days, whereas it was the default choice 11 years ago when I had mine done.

I would go back to your consultant with some questions - 1) why no resurface option 2) what does he/she recommend and 3) what are the implications for exercise. If you are not happy with the answers seek a second opinion.

As for skiing in three weeks' time, I advise doing as much exercise as you can now (squats, lunges, weight machine) to build up really good stability in your hip. Do a lot of stretching after skiing too, that won't do a thing for the hip but a side effect of arthritis is pain in the quads, knee and lower back that can be helped by stretching. Also pack industrial quantities of ibuprofen, or diclofenac if you have been prescribed it. I kept on skiing to the point where I could barely walk afterwards; I'm not advising that, it's not clever but so long as you ski in control and keep focused on good technique it is possible to enjoy the skiing. If you are doing a full week also consider a day off mid week.

Regarding post-op physio, I think most surgeons recommend it but some do not insist. I *think* Sarah Muirhead-Allwood is one who does not require on it for example. I heard that second hand so may be wrong, I've never met her myself. I think it helped me, but physio (and hydro therapy) before surgery was even more important in keeping me mobile and ensured the muscles stayed in reasonable shape. With severe arthritis there's obviously a good chance you won't do a lot of exercise and you can lose a lot of muscle tone, which in turn just make the pain worse.
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Thanks for the comments. I've got another appointment in a couple of weeks and will go armed with questions and also what I want to be able to to after the operation. The pain isn't too bad at the moment and I managed to get my ski boots on and off unaided at the weekend, I thought trying to open and shut the buckles might be a problem.

Recent experience is the local hospital recommend physio after surgery. I only realised I might have arthritis after my Mum was in having her hip replaced in the autumn and she was telling me the symptoms she had, and I was thinking, sounds just like me........
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@C Holt, I originally had my resurfacing done due to a laboral tear, which was itself caused by some bone damage in the joint. The resurfacing was superb, from my point of view. No pain and easy to mobilise.

I only had the full replacement as I managed to smash up the whole of the femur and as I understand it there was not enough stable bone to support the rather smaller metal work of the resurfacing.
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I had my hip replaced in June 2017, went sailing in the October and skiing in Feb 2018.

After the op I was on crutches for 6 weeks, and then did gentle walking. I have to admit I didn't keep up the exercises. I did diet and I went swimming 2 or 3 times for a few weeks before we went for the first time; but I am basically not very fit.

I now get intermittent pain in the other hip, but nothing on the false one. I skied again in Feb 2019 and at New Year this year. I have put some weight back on and am much less fit - but my "new" hip didn't hurt at all.

I used to be a better skier - but that isn't because of my hip - I have lost my confidence. At New Year my own hip was playing up while walking, but was fine on the slopes. Weird.

I stick to cruisy blues and reds and prefer quiet pistes - my biggest worry is someone crashing into me. I also tell the ski shop that I want the bindings set so that the skis fall off long before I would twist my hip/knee.

At the end of the day though - if you pay for a new hip its a waste of money if you don't then use it.
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Encouraging message from Mrs Pralognan! I am a rubbish skier, in my 70s, and had both hips replaced, the first in Sept 2016 and the second in Feb 2017. Our medic son said very firmly to me when back in Pralo in Feb 18, that if I didnt ski that hol, I probably never would again... So I wobbled off down the nearest green run in fear and trembling. No problems, but I am still a happy cruiser on blues and reds, so no dramatic improvement! On the advice side, our NHS hospital was very clear on exercises and that my recovery was dependent on my own efforts. I like exercise, and weigh less than 50 kilos, which helps. My bindings are set very light, and I ditched my old rather too long and soft skis, and bought a modestly priced shorter, meatier pair. Good luck, hippy hoppy skiers!
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Had my left hip replaced 18 months ago (aged 52). Part of a study into a new approach (AMIS - anterior minimally invasive surgery): they go in the front and separate quads to access the joint so no cut muscles to repair therefore much quicker recovery and less risk of post-op dislocation. I was off crutches in 2 weeks and walking (tentatively) without aids. Back teaching PE in 6 weeks (but carefully!). Skied again 9 months post-op and it was a revelation: no pain and much freer movement after 4 years of constant pain. I suppose I had a big advantage being fit with already well developed leg muscles for recovery, and thick strong bones (my surgeon swore and said I'd made him work a lot harder than he ever usually does!); but I had excellent physio aftercare and followed the exercises religiously to get back to full fitness asap. Personally I don't think Mrs SHAP need have any worries about returning to skiing, especially if you insist on decent physio (or bite the bullet and have to pay for it yourself). Good luck!
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Another thumbs up for skiing post THR.
I broke my left hip in an accident and had a new unit installed. Quite a shock at the time but I skied 8months later and now 2yrs in I hardly notice it. Unless I run far !
Had no proper physio but back to biking after a month which nicely stretches things out and increases mobility .
Hope all goes well for everyone.
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scarbski wrote:

Had no proper physio but back to biking after a month which nicely stretches things out and increases mobility .
Hope all goes well for everyone.


Thanks - she used to love her bike, I'll get her back on it!
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I got Skippy (my titanium hip) on 31/7/19. I’m now on my way back from a successful week in St Anton.

I would definitely recommend physio to any who have hip surgery (whether hip scope or replacement) if you want to get back to your favourite activities. The muscles they separate or slice through need a lot of healing and pretty much all muscles around the hips and glutes need retraining as you develop compensation issues before surgery. I saw a great physio couple from 2 weeks post op until last week!

I’m a keen skier and it has only been the prospect of the next ski trip that has kept me from sinking into a black pit of depression post each hip surgery (2 hip scopes and 1 replacement in the past 4.5 years)!

Find a great physio, one who does the same activiities as you, and they will get you ready to get back on that horse!

My surgeon was fine with me skier because I’m an experienced skier. He would not recommend a hippy to start skiing post THR at 48. He did say to say of the black runs, anything steep and moguls. Ha!! Good luck with that in St Anton! Even blue runs turn into mogul fields by 11am! Oh well! I had fun! New hip did great! The other hip is on its way out but as long as it’s still fine for my end of March trip, I’ll be happy Smile
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Wayne Watson, one of the guides working in Alpine Experience in Val d'Isere, has had a hip resurfacing operation but it certainly hasn't stopped him skiing. He skis off-piste pretty much every day of the season and has been doing so for years after the operation. His exploits appear every day in his blog https://alpineexperience.com/en/waynes-diary/

So anything is possible!
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
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Are replacement hips like replacements knees?
Ie they delay it as long as possible so you dont need a 2nd?
Just curious, as I have a degenerative knee condition and was told 10 years ago it needs replacing at some point.
I have alread lost the ability to run, or twist, turn, etc. As my knee wont take the impact.
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 You know it makes sense.
You know it makes sense.
Bone on bone is very painful. Once you’re at that stage, you are begging for the replacement. I delayed mine a couple of months (a bit of denial going on) but once I faced the situation, it was sorted I think a month. If you wait too long, it can cause other issues (for pelvis, other hip, knees).

I will know when the other hip needs doing. It was a bit painful yesterday so I did not ski as much on the last day. Shame as the conditions were great. Oh well... I’m no masochist!
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@Mr.Egg, get it done now.
Who cares what its like when yr 85.
New Joints last longer these days
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