Hip Replacement, Cycling, and Recovery: My Experience

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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.

David Ward with teammates during the 2004 Lotoja
David Ward with teammates during the 2004 Lotoja. Photo by Marinda Ward

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.

 

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7 COMMENTS

  1. 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.

  2. 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..

  3. 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!

  4. 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.

  5. 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…

  6. 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.

  7. 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.

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