Rowing With an Artificial Hip

[Ron Ginsberg]

I'm looking for recent information concerning how to safely row with an artificial hip. I received an replacement hip in mid December. Currently I'm biking regularly on a racing style bicycle without any problems at distances up to 50 miles. My Dr. told me cycling would be ok. But the Dr. told me that the erg would not be acceptable because it would cause my knees to be above my waist. I tried placing a stop on the slide to prevent excess forward motion, but the result is that the seat will only move about two inches before I reach the point where my knees would move to where they would be above my waist. How do rowers with replacement hips row? Do any of you have videos that you can share? Do people spread their knees apart so that they can slide forward more? I do not have trouble getting on or off the machine. It feels like I should be able to row without difficulty. I can tie my shoes easily by turning my knees outward. I'd like some hints. I'm desperate to get back on my erg. I do not want to disobey my Dr., but it seems like I should be able to row.

[jamesg]

After mine (October) I started by pulling fast and short (30 -35, 100W, which means arms and swing only) then gradually increased length. Now at 140-150W rating 20 for 30 minutes, more or or less where I was before the op. I still can't bring that thigh up against my chest, but get hands to within about six inches of the chainguard. Mtb no problems at all apart from too much sweat.

The risk is dislocation, and early rules said avoid crossing legs and keep trunk-thigh angle <90°. Now I stop when it won't go any further, with knee about 10" from my shoulder.

[joe80]

It would be very irresponsible to encourage you to ignore your doctor's advice. Nobody on this board can be aware of any specific difficulties relating to your case.

That said, Georgina Price, #1 in the Nonathlon for 2011 and holder of many records for distance rowing has done all her erg training and racing since having a hip replacement some five years ago. She rows with a short stroke at high cadence but is a very effective performer at all distances.

Her blog describing the most recent 24 hour record, set last October, may be found here:

http://concept2.co.uk/forum/blog.php?u=9306&b=90373

I had the pleasure of rowing a 100km tandem record with Georgina two years ago; we hope for a repeat performance this September over 24 hours.

I hope your recovery has progressed well and you can find a way to regain and maintain fitness.

Regards,

Joe

[wsmith]

i am an orthopaedic surgeon, 54 yo, with a hip replacement for 5 years. i rowed quite hard the past year on the pete plan: 6x per week, all out, weights etc. in general, if a large diameter head was used (32mm or greater) most of our patients can do anything they want after the first 6-8 weeks. here in colorado they ski, race bikes etc.. if you had a posterior approach, the first 6-8 weeks you will be advised to limit hip flexion and so the exercise bike is better. after that, with modern hips, there are usually no restrictions. if you have an anterior approach, you will have no restrictions from day 1. you may have some special circumstances such as DDH, other types of dysplasia and then modification might be in order. in general however, rowing is a great and safe exercise for hip replacement and knee replacement patients. we encourage rowing as well as spinning etc for our patients. my personal experience is that rowing allows me to train very hard, achieve a high fitness level, without problems. as with anything you should move into things gradually and with some sanity. Check with your surgeon regarding the details of your replacement a you may have special circumstnaces such as a small diameter head repalcement, revision surgery, complications etc. if your surgeon feels strongly, best to have a careful discussion as opposed to neglecting his/her advicein favor of an anonymous online doc...however not all docs are that familiar with the rowing motion.. ..best of luck..wsmithmd

[Cyclingman1]

Up until, really, three months ago I never would have thought I'd be posting in such a topic. I vaguely knew I had a bad hip but it really flared up in Dec and Jan. [Really screwed up my season. I had planned on being at Crash-B, competing in HWt 65+] Had an anterior THR on Feb 4. Now, for anyone who thinks anterior means piece-o-cake - wrong. The swelling and trauma is significant. Even the knee is affected. Think about it: the other end of the femur is at the knee. When the sugeon is yanking around the femur at the hip end, trauma is occurring around the knee. But I've been walking (hobbling) and rowing for days. The hobbling is mostly due to the trauma, sorenes, and swelling in the hip. Not due to anything wrong with the THR. I get better every day, but I probably have a good 2 weeks before most of the limp is gone.

I started off easy the first couple of rows. The forward motion is definitely restricted due to swelling at the hip flexors. But today, 12 days post-op, I wanted to see if there was any possibility of getting back sometime in the near future to where I have been the last year. After a slow start (2:03) for 5 min, I pulled 1:57.7 for the last 15 min. Ended up with a 19:50 for 5K. Did not feel too bad. I'm not discouraged and maybe slightly encouraged. It will be quite a while before I'm doing 1:46 for 5K, but 1:59 looks mighty fine for now.

Anyone want to weigh in and tell me: watch out, you're over doing it? I might be. I'm not trying to be foolish about the entire matter. Won't be doing any 500m intervals for a very long time - probably in the fall after a summer of cycling. In any event, this is my input at this point to "Can I row with a THR?".

[Bob S.]

Anyone want to weigh in and tell me: watch out, you're over doing it? I might be. I'm not trying to be foolish about the entire matter. Won't be doing any 500m intervals for a very long time - probably in the fall after a summer of cycling. In any event, this is my input at this point to "Can I row with a THR?".

Patience and persistence, Jim. Just take it gradually, adding steady increases of either time, intensity, or both. Don't try to push it and, in case of adverse reactions, be prepared to back off a bit. I believe you know my own story on this. It was open heart surgery rather than a joint replacement, but the principles of recovery are the same. It takes a lot of time. Overdoing it just sets you back and slows down the overall progress. To repeat, it requires the patience to go at it gradually (not pushing it) and the persistence to keep at it, even at those times when there doesn't seem to any progress.

And good luck on your recovery.

Bob S.

[Cyclingman1]

Bob, thanks for the comment. I suppose one cannot be reminded too much that healing takes time. I'm probably a good 6 weeks away from basic healing to be over, let alone the more subtle, complete aspects.

But you know the feeling. Once one is fairly decent at something, one hates to see it slip away. I was supposed to be record hunting this weekend at Boston. Maybe my hubris got me. I just have to back off and come back strong when and if I can. Again, thanks for the words of encouragement.

[hjs]

Thats a sudden move, hopefully the new hip will hold up well, if so your muscle can do the same work. Have passience, let it heal up well.

[Cyclingman1]

Continuing with my recent experience in resuming rowing after a THR. Progress has been slow and not necessarily steady. There is still swelling and discomfort. Getting going in the mornings is a little tough. Ice and heat help. I'm now 5 wks, 3 dys post surgery. I offer this experience because I know many users of this forum are older. I suspect some may face THR.

As far as rowing, I started slowly after a week - no push at all. Increased effort over the next 2 weeks. The last 2 weeks has seen a little more intensity and longer distances. Have not really had any adverse reactions from rowing. Tried a couple of relatively harder 2K's. Just trying to get breathing back.

Today was my most ambitious day. Rowed 16K at 1:59.5 pace (C2Log) including a 1:15 break at 8K. SPM 32, DF 130. A little fatiguing. Probably will be a bit sore in the morning.

I think there is light at the end of the tunnel. But I would not say to anyone that having a THR is a piece-o-cake experience. It is not.

[Dano]

i am an orthopaedic surgeon, 54 yo, with a hip replacement for 5 years. i rowed quite hard the past year on the pete plan: 6x per week, all out, weights etc. in general, if a large diameter head was used (32mm or greater) most of our patients can do anything they want after the first 6-8 weeks. here in colorado they ski, race bikes etc.. if you had a posterior approach, the first 6-8 weeks you will be advised to limit hip flexion and so the exercise bike is better. after that, with modern hips, there are usually no restrictions. if you have an anterior approach, you will have no restrictions from day 1. you may have some special circumstances such as DDH, other types of dysplasia and then modification might be in order. in general however, rowing is a great and safe exercise for hip replacement and knee replacement patients. we encourage rowing as well as spinning etc for our patients. my personal experience is that rowing allows me to train very hard, achieve a high fitness level, without problems. as with anything you should move into things gradually and with some sanity. Check with your surgeon regarding the details of your replacement a you may have special circumstnaces such as a small diameter head repalcement, revision surgery, complications etc. if your surgeon feels strongly, best to have a careful discussion as opposed to neglecting his/her advicein favor of an anonymous online doc...however not all docs are that familiar with the rowing motion.. ..best of luck..wsmithmd

I realize this is an old thread but I want to add my 2 cents worth.

I have had two THR's, and one revision (due to press fit cup moving after implant). My revision was done middle of last April. I have been rowing again the past several weeks pretty regularly. The only issue I have is my muscles are not completely healed from my posterior revsision, so they can hurt and get a little stiff, but usually off the macine, not on it.

At present I still have one "big ball metal on metal hip" and one smaller one with the plastic bushing style. The ball on that one is I believe 32mm or greater -- biggest one they have as far as i know.

I am working down my gut, so realistically I cannot roll up like a teen or competitor, but I can tell you I am approaching maybe 10-25 degrees short of that with no problem. Rowing again has been a wonderful rehab and weight loss 'sport'. Like the doc says above, if you have larger femoral head balls, this is all very doable.

Oddly, every replacement I have been thru has gotten easier and easier. The first one, where they pulled pins out of me from when i was 15 yrs old totally wiped me out. The 2nd one I was driving in less than a week (AMA of course!), and walking a half mile a day on crutches in less than two weeks. With the revision (being the least damaging), I was on a cane for about a week after I left the hospital, and then walking without it. Used crutches for like 1 day at home.

Medical technology is amazing.

[wsmith]

very interesting feedback about rowing after total hips. since my own experience is only a series of one, it is very helpful to hear from others. the info on this thread is particularly helpful for advising our patients. in general, rowing is probably one of the very best motions for a total hip patient. biomechanically, a stable, well placed total hip should not "wear out" from rowing. whether anterior or posterior approach, the climb back to a high level of fitness likely averages about 6 months for a previously fit individual. however, lots of total hip patients spent several to many years in pain, favoring the hip and perhaps not training so much. in those cases, extra patience is needed with a strong empahsis on gently rebuilding an aerobic base before getting crazy. no reason to just be getting your hip muscles in shape and have to deal with back issues or overtraining effects (especially since most of us receiving hips are over 50). while all this sounds good, if someone had a difficult or non routine replacement, revision (redo surgery), or has a prosthesis in place older than 10 years, they should check in with their ortho surgeon before they get going just to make sure they are safe...after that: once in shape- no need to hold back! wsmith md

[slick]

I am now post op 9 weeks after my resurfacing op. I havent rowed for about 2 years now due to my injury and thought that I had seen the last of rowing. I am now a little more optimistic and although I am not yet rowing due to restrictions with the 90 degree rule I feel that there is light at the end of the tunnel. I think it'll be a while before I'm rowing at any decent rate but i have something to aim for. It's nice to know there are people out there with similar issues who are succeeding.

[janinamid]

I am shortly to have a THR and was researching just what I will and will not be able to do, rowing wise. Getting back on a horse will probably be out, being high impact, but I have rowed regularly, particularly when unable to get to a yoga or Pilates class. Now I read that the porcelain and metal "socket" makes life easier as far as getting back into activities involving more hip rotation. But my surgeon showed me the alternative, the plastic smaller socket which was a myriad of little mosaic lozenges and it looked very lightweight. I think he won't know until he cuts in (from behind) as I am only 52kg and size 4 US. The X-ray looks as though the femur has ground right through and bone is being laid down in the wrong place. It is astonishing I can still stand.

Can anyone elucidate the differences between the metal and plastic sockets; they looked so completely different. And since many posts here have mentioned that the thigh shouldn't be raised too near to the chest, I wonder what benefits I will still get from rowing, especially the glutes which have become very flaccid over time with my limited mobility. Can I request the metal one, or is it just a question of size? They surely are manufactured in many sizes, being more crucial than a shoe size for example?
That little plastic thing looked like a piece of LEGO!

Thanks anyone.....

[Cyclingman1]

But my surgeon showed me the alternative, the plastic smaller socket which was a myriad of little mosaic lozenges and it looked very lightweight.

The ortho Dr who posted here spoke of using a larger head, 32mm, for more stability of the joint. I wonder how that squares with what you were shown.

I have a ceramic ball inserted into a plastic socket. Can't say long term, but nine months after surgery, the joint is fine.

Regarding training and restricted motion. In the first place, most hip surgeries produce a good bit of swelling that takes quite a while to go down, which alone restricts motion. That is a good coincidence. I had anterior approach THR. There is a good bit of propaganda floating around about ant THR taking only a few weeks to recover from. It took me about 6 months to get rid of all hip discomfort and the limp. I have absolutely no restrictions on rowing. I row as hard as ever using the full slide. By the end of the yr, I hope to equal all of my rowing times pre-THR.

[wsmith]

i agree with cyclingman: all THAs take time, no matter what you are told. i also had an anterior THAwhich has early advantage of no positional restrictions, but long term, both post and ant approaches permit full rowing motion wihtout restriction. as far as the types of components, the standards vary a bit depending upon country and healthcare systems. overall, as a previous department chairman in the US who does a lot of research, i would advise to not have something that is the "newest " or in any way experimental. THA is a great quality of life operation with 97% patient satisfaction 10 years after operation (which is good). Current data and evidence supports using a ceramic or metal ball in a ceramic or polyethlene ("plastic") socket with a metal shell. IN the USA the implants are usually uncemented and in other OECD countries, sometimes cementing is favored. All of these apporaches should provide excellent results. One of the key predictors of low complications worldwide has been that the operating surgeon does more than 25 per year. my rec is to have your hip done by someone who does lots of them at a hospital that is well orgnaized for hip replacement. Its your hip and life and its fair to ask. best wishes. wsmith md