Should You Run After A Hip Resurfacing?

Osteoarthritis is the gradual degradation of a joint. It can lead to pain, stiffness and swelling. One of the most common joints to be affected is the hip. In 1940 Dr Austin Moore performed the first total hip replacement (THR) and the technique was later refined by Dr John Charnley. Modern replacements consist of a metal stem and head that is inserted into the top of the femur. It fits into a plastic cup which is cemented into the pelvis. Post surgery, patients usually experience less pain and enjoy greater range of motion. However, several studies have shown that the prosthesis wears and loosens prematurely if excessive running and impact activities are undertaken. This can lead to another operation to revise the THR with the associated risk of complications.

More recently, hip resurfacing was developed by Dr Derek McMinn as an alternative to THRs. It requires less of the femur to be removed. A metal cap is placed over the head of the femur and a metal cup is placed in the socket. The advantages of a hip resurfacing compared to a THR are numerous: bone preservation, less chance of dislocation, less leg length inequality, better lower limb alignment and easier revision to a THR if necessary.

A recent article in Reuters has quoted work done by Dr Julien Girard in France. Hip resurfacings were performed on 40 physically active patients. Their average age was 51 years. After surgery, 90% of the patients returned to running. Three years later 33 out of 40 were still running albeit they had decreased their mileage from 24 miles per week to 16 miles per week. The study didn’t look at the long-term effects of running on the implant.

An article in today’s Medical News Today summarises research presented at the 2012 Annual Meeting of the Academy of Orthopaedic Surgeons.  Over 10 years, 445 patients (average age of 49 years) who had undergone a hip resurfacing were monitored. A correlation between higher activity scores and revision of surgery was found and it was concluded that impact activities such as running and tennis were harmful to long-term success.

In conclusion, although a return to running and impact sports is possible after a hip resurfacing…even to high level competitive sport…it does bear risks…such as the untimely wear and deterioration of the prosthesis. This would require further surgery…and possibly a total hip replacement. With that in mind, my advice for anyone with a hip resurfacing, wondering how much they can or can’t do…would be to stick to non-impact exercise such as cycling, rowing, cross-training, etc. That doesn’t mean that you shouldn’t run at all…I wouldn’t want you to miss that train…but it should remain occasional.

Tai Chi Improves Balance In People With Parkinson’s

Parkinson’s disease is a degenerative disorder that affects dopamine-generating cells in the central nervous system. The physical symptoms are the classic triad: shaking, rigidity and slowness of movement. Posture, walking and balance are also impaired. Dr Fuzhong Li and colleagues studied the effects of Tai Chi on patient’s with Parkinson’s. Amongst other benefits, they found that Tai Chi improved posture, walking ability and decreased the number of falls.

Previous research has already found that Tai Chi reduces falls among the elderly. In fact it’s slow, fluid movements over a firm, balanced stance seem like an ideal form of exercise for aging populations.

Exercise Promotes Cellular Housecleaning

Aging, infections and diseases such as cancer, neurodegenerative disorders, inflammatory diseases and insulin resistance can all be caused by a buildup of waste products and debris within cells. It’s by a process called autophagy, an intracellular recycling system, that cells maintain their ideal environment. A group of researchers have found that exercise helps boost autophagy.

For a more in-depth analysis of the research, have a look at “Exercise as Housecleaning for the Body” in The New York Times.

“In health there are neither rewards nor punishments,

There are only consequences”.

Robert G Ingersoll

Hypermobile Sportsmen Are More Injury Prone

Hypermobility can simply be described as joints bending and stretching further than normal. For instance, knees or elbows that bend backwards, a little finger that can bend backwards past 90 degrees, a thumb that can be bent to touch the forearm, etc.

An article in Reuters has summarised research that proves that hypermobile sportsmen are more prone to injury. Not only are they more likely to get injured but the injuries they sustain tend to be more serious. This could be due to a mix of factors such as weaker ligaments and soft tissue, and to poor joint positioning.

The likelihood of injury could be remedied by working on joint positional awareness and by muscle strengthening and coordination exercises to support the joints.

“Grant me the courage to change that which can be changed,

The serenity to accept that which cannot be changed,

And the wisdom to know one from the other”.

Reinhold Niebuhr

Exercises As Effective As Manipulation For Neck Pain

A recent study has found that spinal manipulation therapy is more effective than medication in both the short and long-term. The most interesting part of the study was that home exercises and advice were as effective as manipulation. It just goes to show that the benefits of self-help should not be underestimated. It would have been interesting to compare a combination of spinal manipulation therapy and home exercises…which in my opinion would have yielded the best results.

More Proof That Exercise Improves Health

A team of researchers have identified a new hormone named irisin. It’s produced by exercise and increases the metabolism and the sensitivity to blood sugar levels. This in turn may make us less susceptible to obesity and diabetes.

Yet more proof that exercise is beneficial…if we needed any more!

Can Yoga Wreck Your Body?

Can yoga wreck your body? According to a recent article in The New York Times it definitely can! The article mentions a number of serious injuries that are thought to have resulted from yoga. Although it’s slightly dramatic and perhaps a little biased, it may contain a valid lesson…

Surprisingly, it’s a stark contrast to a previous article I posted about the benefits of yoga for back pain. How can yoga be both good for health and hazardous at the same time? By the way, this doesn’t just apply to yoga but can be extended to almost anything in life…and the answer is summed up in one word…moderation! The overwhelming majority of injuries that were cited resulted from forcing the body past its anatomical limits i.e. extreme postures…

If you practice yoga or are thinking about starting…how can you make sure this doesn’t happen to you? There are two parts to this…your teacher…and…you…

Your instructor should:

• be properly qualified and experienced
• have relatively small class sizes to allow for more personalised tuition (particularly for beginners)
• ask students about any existing injuries
• focus on technique and alignment during instruction
• offer a variety of exercise options to allow for differing skill levels
• correct students that are doing movements incorrectly
• not try to push students past their limitations

You should:

• wear clothing to allow free and easy movement
• ask questions if unsure of any posture or movement
• know your limitations…we’re all built differently and have our own strengths and weaknesses
• be cautious with any existing injuries and perhaps even consult your doctor or therapist before starting yoga
• avoid competition with others and with yourself
• take the time to progress from beginner moves to more advanced moves
• listen to your bodies…particularly when it comes to more vulnerable areas like the neck, low back and knees

Lastly, remember to have fun!

Happy New Year 2012!

The New Year is usually synonymous with resolutions…and the resolutions are often linked to health…eating a more healthy diet, exercising more often, losing weight, etc. This may have something to do with the guilt following the hedonistic excesses of the Christmas period! Ask any gym manager, January and February are probably their busiest months of the year. People abounding with good intentions flock into gyms and ardently throw themselves into strenuous exercise routines…only to run out of steam 4 to 6 weeks later upon which they mysteriously disappear…never to be seen again…until the following year of course!

So if you happen to have set yourself some goals this year make sure they’re SMART.

Specific

Measurable

Achievable

Rewarding

Timed

Specific

If you don’t know where you want to go, you’re unlikely to ever get there.

Clearly define what you want to achieve

Eg. “I want to run 30 mins twice a week”.

Measurable

If you can’t measure it, how will you know how close you are to it or even if you’ve reached it?

Use an objective unit of measurement

Eg. “I can time how long I have run”.

Achievable

Setting unattainable goals will decrease your confidence and motivation and setting goals that are too easy will not give any sense of accomplishment.

Set challenging but realistic goals

Eg. “I know I can run 30 mins twice a week if I work hard at it”.

Rewarding

Letting others set your goals or setting yourself uninteresting goals will sap your motivation and enthusiasm.

Set goals that will enhance your life and about which you are passionate

Eg. “Running 30 mins twice a week will help me lose weight and decrease stress”.

Timed

Not setting a deadline is the best way to fall prey to procrastination.

Set a definite starting and ending point

Eg. “I will start today and aim to reach my goal in 3 months time”.

Sometimes, your desires can only be accomplished after a long time. These long-term goals are best broken down into medium and short-term goals. You’ll experience a frequent sense of achievement as you reach your short-term targets and this will be instrumental in elevating your self-confidence and bolstering your motivation. Keep in mind that life is about the journey not just the destination and that health is not a transient goal but a way of life. Good luck!

May 2012 bring you health, vitality and happiness!