UKC

Not sure this is the right place to post but i'm looking for other who might have a similar issue.

I was diagnosed with osteoarthritis in both hip joints about 4 years ago, not consistent with someone my age (just turned 38). I'm reasonably active and sought a diagnosis and quit running after a super painful half marathon. I turned to climbing about 2.5 years ago as a low impact alternative and have really fallen in love with the sport, but as i've progressed the pain and stiffness has increased (both during and after a good sesh). Now i'm past the steep learning phase of a new sport I'm noticing more and more how much it's limiting me, and at times I think I'm actually regressing as it gets worse.

I've continued going through the NHS diagnosis process, more recently being referred for possible surgery for suspected FAI (impingement as an MRI showed a bone cyst/spur on one joint), but ultimately the consultant decided the pain/stiffness is due to the osteoarthritis alone and so not a good case for surgery. The next step is to try steroid injections, although ultimately it's a degenerative process both helped and exacerbated by being active. Although I'm relieved I don't need to go under the knife, the advice seems to be just live with it. 

There are definitely other things I can do to train and improve my overall climbing, and I see a physio privately and try hard to stick with the exercises - foam rolling helps somewhat, i've been advised not to stretch hips at all - but I wondered if anyone else has found anything that works/helps with this issue?

My only regret about the T.H.R. that I got is that I didn't do it sooner. All the other stuff that I did for my painful hip (also osteoarthritis) was pretty much useless and just delayed the inevitable.

Hi I have similar issues along with hip impingement and a bone spur in my right hip which has been there for years.  I also have some balance issues.

I don't want to provide contrary advice to your physio but I actually find yoga extremely helpful, along with pilates.  I have historically tried strength training but found a conservative yoga practice to be more beneficial. 

Best of luck

That's interesting - I've been told conflicting things. The referring physio and in initial surgeon appt it was suggested I'd be more resilient at this age so likely to recover quicker and better after surgery. But in the more recent app the surgeon said I was too young to take the risk. They were looking at arthroscopy for FAI too but decided not necessary. This is the crux really - If THR is inevitable anyway...

Did you get it done on the NHS or privately?

Yes!! I used to do a lot of pilates I do bits and pieces on my own but can't afford reformer classes right now. It's pretty amazing for everything though! Going to look for a matt class locally as i've just moved.

In my case, I suspect too much work on hip opening when I did yoga regularly has contributed. My physio really warned me off stretching around the hip joint (and I do notice pain afterwards) hence why I've been foam rolling instead, which definitely improves mobility and reduces pain (but doesn't fix the issue). I find movements rotating the hip joint when flexed painful so I stopped going to classes as following a routine was ouchy (admittedly I prefer vinyasa flow) - I guess that's why you say 'conservative' yoga though!

I do a short routine before/after bouldering sessions that avoids too much hip stuff instead. Are there any particular moves/poses you'd recommend?

I live in the US.
Ist Doctor said to wait, 2nd doctor said to get it done. 
I believe improvements in the prosthetics (and also surgical techniques) have made most of the precautions, that were previously directed at younger patients, obsolete.

I feel for you. I was diagnosed in my mid forties about 20 years ago. Like you I was advised to live with it as long as I could rather than having surgery at a young age - lessening the need for a revision later in life was the reason given. I was told to stay active and take pain/inflammation relief as and when required. Finally though, when I was 49 the pain and restricted mobility (especially for climbing) meant that it was impinging on my quality of life so my GP was persuaded to refer me for replacement. I had one done privately ( a resurfacing, not done nowadays but very robust and stable) and one on the NHS ( an experimental mini-hip, developed for younger active people) in the space of 18 months. It was truely life changing and has allowed me to climb, cycle, walk and run without any discomfort for 12 years now. No sign of them wearing out yet either

I don't know what the feeling is now about fitting replacements in younger people  but the quality of life (and negative health effects of restricted activity) argument is one to try. With a sympathetic GP/Consultant you might get lucky. Certainly the improved technology around the implants (like the mini hip I had) has meant more robust, successful and longer lasting  treatment which lends itself to operating on younger people.

I would keep going with the stretching/flexibility exercises in the meantime, it was climbing that kept me fit and mobile (and sane) until I was in the right age range for intervention. I hope it works out for you.

I'll be watching this thread with interest having also been recently diagnosed with osteoarthritis in both hip joints at age 46. Advanced in left hip and moderate in the right. Pretty much had to give up running for the time being, which I really didn't expect at this age and certainly didn't want.

More than willing to entertain the prospect of surgery. It's got to be better than hobbling around like an 80 something. 😁

I've been joking for years about my granny hips, turns out it's true 🤣

(I'm 38 now so was diagnosed at 34 which is quite young, I think)

Not true that metal on metal resurfacing is not done any more,  just more difficult to find a surgeon who is keen and experienced as the operation is more difficult than a total replacement. I had mine done at BUPA expense nearly 7 years ago and local to me - best choice for a young active sports-person (like Andy Murray), and me by the skin of my teeth - aged 64 with mild osteopenia. Other hip failed to withstand the operation 2 years later so I have a ceramic THR as well. Jogging (carefully) within 6 weeks with both of them, and long mountain days within 4 months or so. Bouldering to easy V4 on a good day and HVS/E1 on grit. Welsh 3000s in 2019, Derwent Watershed last year...

Only downside to resurfacing is that a small minority can be allergic to the chrome/cobalt metal alloy - the procedure got a bad name from one poor design poorly fitted which allowed excess wear in the bearing edges and hence metal ions ending up in tissue, causing pseudotumours to show up under x-ray and requiring revision to a THR. This was worse in the smaller sizes suitable for women and the manufacturer of the Birmingham hip (Smith & Nephew) has withdrawn them from this usage. Professor Cobb at Charing Cross/Imperial college is trialling a ceramic resurfacing, as is Koen de Smet in Johannesburg. Try Surfacehippy website (US) for more information.

Good luck to the OP,  try speaking to the McMinn centre in Birmingham, and check out their website - resurfacing is not dead. 

This is exactly what I was afraid of - I was diagnosed mid 30s which is quite young I think. I'm an active person and it really is impacting on my quality of life, and mental health. I got quite irritated with the write up of the first consultation describing "pain after strenuous exercise" Cycling is my main mode of transport, I climb 3-4 times a week, so that's all the time basically. And I also suffer if I sit at a desk for too long or a long drive. Which is better for my health? The recent consultant suggested steroid injections instead but only after I really pushed the point, and after I mentioned it impacts on my love life too 🤣

I don't really want to lose 20 active years waiting for surgery, by which time other bits of me will inevitably also be injured and might actually feel like slowing down a bit!

Maybe I'll seek a private 2nd opinion...

Interesting thanks, I didn't know they were still done. There was such a fuss about them not long after I had mine done  that i believed there had been a moratorium. I was monitored closely for 5 years when that happened, with regular Xrays and blood tests. Thankfully no problem detected and it has worked perfectly for 12 years.

Do the injections for the time being until things deteriorate enough for you to need surgery. Strengthen your glute max/min and don't forget medius...use band walks and band squats for this for weight bearing functionality. strengthen psoas carefully if pain free but definitely stretch it and the quads.. Work your core. Use Pilates or a good PT if you don't have enough motivation to self train or finances restrict you, or at least use them on and off which which keeps you going and saves money.

Ceramic hips are the choice and is probably what you will be offered. they work well and last a long time just don't go running or have a heavy fall as the ceramic can shatter. Resurfacing is good for younger patients because you get very good function and will delay full hip replacement for a good while. Prof Justin Cobb is one of the best guys for hips (previously mentioned in a post). The anterior approach for hip replacement avoids cutting through any muscle so you get a much faster recovery. Justin does these.

I will have my second hip replacement in August.

Good luck

I have 2 hip replacements- one a metal on metal resurfacing (subject to a worldwide recall)! and one full ceramic replacements- first one done in my mid forties, the other a few years later.

The first is 15 years old. Before it was done I couldn't walk more than 150 metres without sticks, had less than 8 per cent rotation and was in constant pain, though I was still climbing and skiing.

My replacements have been brilliant. I am climbing and skiing harder than ever. I run cross country. I don't worry about falling off, whether outdoors or at the wall. Surprisingly annual X rays show the bone has actually thickened and strengthened around the new joints. The surgeons assume it's due to the amount of exercising that I am doing.

My experience suggests that hip surgery can be very successful.

I had a left hip resurfacing op' in 2003, aged 55 or so, and a right one in 2005. Both due to osteoarthritis and both working well for climbing (E1-ish) and mountaineering. I wouldn't hesitate to recommend the operation. Any steroid treatment, physio, dietary supplement, etc. is just delaying the invitable as far as I can see. MIllstone climb image is after first operation.

Hello Jessmess,  

I was diagnosed with osteoarthritis at the age of 38.  I was doing a fair bit of running at the time and was getting pain and locking up of the joint.  I left it for way too long and had a had a resurfacing in February 2020 around 14 years later!  Now pretty much pain free and did a fair bit of bouldering and running a bit.  Just wish I'd had it done sooner but the thought of an op. terrified me!  I still haven't got any better flexion in that joint probably from leaving it too long.

It was carried out on the NHS by Mark Norton  in Cornwall  who specialises in hip surgery in younger folk.  He is also part of a national clinical trial for a ceramic resurfacing that might still be ongoing.

Looks like they were getting good results and I was on the list but the trial kept getting delayed so I opted for a standard Titanium jobbie, the same as Andy Murray.  

Hope this is useful.  

Titanium?

Try a combination of vitamin D and vitamin K2.  The K2 (probably the mk4 form, although there is some debate about this) is what regulates how calcium gets to the bones and builds them up.  Taking lots of calcium and vitamin D without K2 runs the risk that the calcium ends up in your arteries instead of in your bones (bad!).  This all assumed you’re getting enough calcium in the first place but this is almost certainly the case unless you’re on a particularly niche diet.

This won’t be a quick fix (because building bones is a relatively slow process) but in your case this is what I would be doing.

To be clear though, I’m not advocating this as an alternative to any intervention/surgery, that’s a separate decision.  I’m just saying that given you are susceptible to this condition, then I’d give your body the best chance long term of building strong healthy bones irrespective of what other treatment you decide on.

Sorry, yes it's Cobalt Chrome alloy apparently.

I had the Birmingham Hip resurfacing when I was 53 (now 64). My problems began when I was 32 causing me to eventually avoid running. My surgeon was Mr Ronan Treacy. I've never looked back. Being a Pilates instructor/Personal Trainer and Ex-RAF  PTI has helped. I do loads of mobilising. The bottom line is seek out the best surgeon and unfortunately this can mean going private. Take a look at John Alcock's post on this subject. He's a top end climber who had his hips done and he gave me sound advice on this subject. Nice bloke too, I'm sure he'll give you the 'skinny' on this.

Thabk you for all your advice. I'm pretty good at keeling up with the physio. Adding in bandwalks has been good, but pilates I find harderto self motivate for, a PT/class is a wise idea.

Yes I'm fairly terrified of such a major sounding opp at my age but then every single person I've asked unanimously says they wish they'd got it done sooner 😬

Thank you, I'll check it out. I already take Vit d but K2 new to me. I've had people recommend glucisamine which I'm unfortunately allergic to. I can't seem to. Find chondroitine in a preparation on it's own but that seems to come uo frequently. Also turmeric extract and cbd but a bit dubious haha. 

it’s interesting that maybe ‘criteria tests’  to identify free or further intervention on nhs are the place where the gatekeepers can manipulate and stop further intervention/surgery thereby reducing size if waiting lists etc. You need a second opinion if you believe it is having an effect  seek further investigation. This is how one political party is intent on wrecking the NHS through a lack of funding. You get to feel dissatisfied with service and go private. They get to stop funding 1/2 nhs and we all get psycho’ed into believing that to get anything done ‘we might as well go private!’ As the guarantee. it’s despicable what that political party has done to nhs making it appear a shambles. As to your condition keep seeking support in a ‘worsening situation’ allied to the diet alternatives. Keep climbing. Keep doing core work and anything to stabilise the joints. 
 

it’s interesting that maybe ‘criteria tests’  to identify free or further intervention on nhs are the place where the gatekeepers can manipulate and stop further intervention/surgery thereby reducing size if waiting lists etc. You need a second opinion if you believe it is having an effect  seek further investigation. This is how one political party is intent on wrecking the NHS through a lack of funding. You get to feel dissatisfied with service and go private. They get to stop funding 1/2 nhs and we all get psycho’ed into believing that to get anything done ‘we might as well go private!’ As the guarantee. it’s despicable what that political party has done to nhs making it appear a shambles. As to your condition keep seeking support in a ‘worsening situation’ allied to the diet alternatives. Keep climbing. 
 

Can these be found naturally food rich rather than supplements. 
Any recommendations for dietary examples.