If you’re an avid runner, there are probably few things your doctor can tell you that would scare you more than hearing you need a hip replacement.
But, can you run after a hip replacement?
In this article, we will discuss running after a hip replacement and will share expert advice from Dr. Carlos M. Alvarado, MD, FAAOS, the Director of Robotic Hip and Knee Surgery and Adult Hip and Knee Reconstruction at Montefiore Medical Center and an Assistant Professor of Orthopedic Surgery at the University Hospital for Albert Einstein College of Medicine.
We will cover:
- Can You Run After a Hip Replacement?
- When Can You Start Running After a Hip Replacement?
- What Should Runners Expect to Feel When Running After a Hip Replacement?
- Does Running After a Hip Replacement Increase Your Risk of Injuries?
- Risks Associated With Running After a Hip Replacement
- 3 Tips for Returning to Running After a Hip Replacement
Let’s get started!
Can You Run After a Hip Replacement?
A hip replacement, known as hip arthroplasty, is a major surgery that can take you out of running for quite some time. But is it possible to run afterward? Can you run after a hip replacement?
The good news is that, in most cases, you can run after a hip replacement.
In fact, as much as it can be a daunting endeavor to bear the news that you have to get a hip replacement, it can equally be the amazing solution you need to start running pain-free again.
A hip replacement gives you a newly-surfaced hip that can make it feel like you’ve rewound the clock a couple of decades in terms of how your body feels when you run.
Now that we’ve answered can you run after a hip replacement, let’s see when you can actually start!
When Can You Start Running After a Hip Replacement?
It’s important to establish that everyone’s recovery trajectory from hip replacement surgery can be different.
It might take you much longer than average to return to running if you had complications or other running injuries prior to your surgery.
However, Dr. Alvarado says that runners can typically begin introducing running back into their fitness routine about 3-6 months after a hip replacement.
If you were previously running before your surgery, you will probably be able to resume running earlier in the course of your recovery (closer to the 3-4 month post-op range) than a former non-runner who had hip replacement surgery and wants to now take up running as a new runner.
But how do you know when you’re ready to run? Is it enough to just wait until you turn the calendar page to a 3-6 months post-op date?
According to Dr. Alvarado, you can begin running once the pain associated with surgical recovery has resolved and the hip’s supporting muscles have regained their strength.
“The muscles that must regain strength after a total hip replacement are the abductor muscles and the hip flexor muscles,” he explains.
“You will know these muscles are ready for higher-level exercise if you can perform a straight-leg raise without pain with some resistance. This is an indication of the return of hip flexor strength. You will know that the abductor muscle strength has returned if you can stand on one leg without pain or imbalance.”
In addition to the impact of your pre-surgery fitness level and running status, the specific type of hip replacement surgery you had can affect how soon you can return to running after a hip replacement.
The newer anterior (front) approach to hip arthroplasties is associated with a quicker functional recovery than the older posterior (back) or posterolateral (back/side) approaches.
It’s important to speak with your surgeon or physical therapist to get medical clearance to run after a hip replacement.
What Should Runners Expect to Feel When Running After a Hip Replacement?
The good news is that most runners can return to running after a hip replacement with very little issue.
As long as you listen to your body and progress slowly, you should be able to run pain-free and potentially return to prior levels of training in time.
Dr. Alvarado says that the most common complaint after hip replacement in runners is groin pain during running.
“If this does occur, the runner should stop and be evaluated by their doctor as sometimes this can be a sign of tendonitis and may require specific muscle stretching and strengthening prior to returning to more intense training,” he advises.
It is also normal to have some generalized muscle soreness when you return to running after a joint replacement, simply because your body has to get used to running again.
However, soreness is okay; pain is not.
If you’re feeling sharp or lingering pain, you need to stop running immediately and consult your surgeon or physical therapist.
Pain when running after a hip replacement is not normal.
Does Running After a Hip Replacement Increase Your Risk of Injuries?
Obviously, if you’ve been sidelined from running for quite a while before your surgery due to pain, or even just for the several months after your surgery during the recovery period, the last thing you want when you start running after your hip replacement is to get injured again.
For this reason, it’s vitally important to progress slowly and be honest with yourself about what you’re feeling, not only in your post-operative hip but also in the rest of your body.
If you are feeling any sort of unusual pain, particularly if it lingers after your run, it is always best to err on the side of caution and cut back your training, rest completely, or try low-impact cross-training instead of running until the pain resolves.
According to Dr. Alvarado, running after a hip replacement doesn’t necessarily predispose you to additional injuries relative to runners who have not had surgery, but he does say that you have to be particularly mindful of overuse injuries such as stress fractures and tendinitis.
“In patients that have undergone joint replacement, it is important that bone density testing is done to help avoid stress fractures, especially in women, as they are more commonly affected. In addition, stretching and appropriate rest in between training sessions can help to avoid stress-related injuries.”
He also notes that some runners who return to running after a hip replacement experience thigh pain while running or performing some other form of vigorous physical activity.
This is called end-of-stem pain and can be self-limiting and [will] go away usually within a year of the surgery,” explains Dr. Alvarado. “If it continues, then this should be discussed with your doctor.”
The good news here is that Dr. Alvarado says that stem pain during running has become less of a problem with modern implants because the updated designs have improved to eliminate this phenomenon.
Risks Associated With Running After a Hip Replacement
For most runners, running after a hip replacement can be totally safe and workable as long as you work with a physical therapist during your recovery and progress slowly and mindfully with your training.
Even if you are a beginner starting running after a hip replacement for the first time, running can be a safe and healthy form of exercise if you take the long approach by building up very gradually.
The biggest concern most runners have with running after hip replacement is that high-impact exercise will damage the implants used in the hip replacement.
While this is a valid concern, according to Dr. Alvarado, “To date, there are no studies indicating that runners are at higher risk of damage to the implants; however, this remains a theoretical risk and something that is debated among hip and knee replacement surgeons.”
He recommends getting regular evaluations by your surgeon with x-rays once every 1-5 years to evaluate for any ongoing wear of the implant.
Most importantly, to mitigate any potential risks of running after a hip replacement, no amount of running should begin until you have fully recovered from your surgery and are truly ready to run.
If you still feel any sort of pain or weakness, you should not begin running.
Work with a physical therapist to strengthen the hip and surrounding musculature. Slowly increase your range of motion and strength through isolated resistance exercises and low-impact aerobic activities such as cycling, walking, or swimming.
Once you are ready to run, the distance and intensity of your workouts should be progressed very slowly in a stepwise manner, under the guidance of a physical therapist or the surgeon who performed your hip replacement surgery.
3 Tips for Returning to Running After a Hip Replacement
Any time that you return to running after an injury or extended time off, it can be difficult to get back into the groove.
Running is very taxing on the body, and depending on how long it has been since you were able to consistently train, running after a hip replacement can feel really challenging and defeating.
Here are some tips for returning to running after a hip replacement:
#1: Do Prehab
One of the most important questions runners should consider before their planned hip replacement surgery is, “What exercises can runners do before a hip replacement to help return to running faster?”
Clinical evidence has consistently shown that the best way to improve postoperative outcomes is to try to maintain strength and range of motion in the affected limb before the surgery.
This can be difficult for runners getting a hip replacement because it may be too painful to run if your arthritis is too advanced. However, it should be noted that there’s evidence to suggest that running may actually reduce the risk of hip osteoarthritis and the need for hip replacements.
He says that these types of cross-training exercises can maintain strength and range of motion and potentially allow a faster return to normal once the reconstructive procedure is complete.
This routine should consist of single-leg, multi-joint strengthening exercises such as lunges, single leg-mini squats, single-leg Romanian deadlift, and single-leg leg press, so long as you can perform them without pain.
You can also do bilateral exercises such as squats and hamstring curls.
Hip abduction exercises, such as side-lying leg raises and clam shells, are great if you can perform them pain-free.
In addition to strengthening the muscles controlling the hip, it’s also important to stretch. This will ensure you can regain your range of motion as quickly as possible after the hip replacement.
#2: Cross Train
When you start running after a hip replacement, you essentially need to think of yourself as a beginner.
Running is a high-impact activity, so it stresses your bones, joints, muscles, and connective tissues.
It’s a good idea to only run 2 to 3 days a week at most to begin, supplementing with low-impact cross-training on alternate days if you are up for it.
This will improve your aerobic fitness so that running feels easier from a cardiovascular standpoint while simultaneously minimizing the stress on your body.
#3: Work With a Physical Therapist
A physical therapist who has experience working with runners after a hip replacement can be a vital cog in getting you back into gear with running.
The physical therapist can give you specific strengthening exercises to reduce the risk of injury and expedite how quickly and seamlessly your body can handle running again.
Be patient, stay positive, and listen to your body. You’ll hopefully be enjoying miles and miles of pain-free running soon.
If you have hip pain from running and are still trying to figure out what is causing it, we have some potential causes in our guide: Hip Pain After Running.