Should you run with Hip Arthritis?
The incidence of hip arthritis in runners is common. In fact, according to the Journal of Medicine and Science in Sports and Exercise, 18.1 percent of 74,752 runners were diagnosed with hip osteoarthritis.
What is osteoarthritis ?
By definition, arthritis is “Joint inflammation” which can cause pain and swelling in the body’s joints. Although there are several types of arthritis, osteoarthritis (OA) is the most common and is a degenerative joint disease or age related arthritis, meaning it is more likely to develop as people get older.
The most common symptom of hip arthritis and usually the first to develop is groin pain, while pain in the front of the thigh and/or buttock pain may follow. Suffers find pain from hip arthritis is usually worsened with weight bearing activities such as running and prolonged walking and by rotation or twisting of the hip joint. The hip joint may also feel stiff on walking for the first couple of hours in the morning.
Diagnosing hip osteoarthritis:
If you think you may be suffering from symptoms of hip OA, a proper diagnosis is essential. This should include an x-ray of the hip in combination with a clinical examination from an experienced physio, who will be able to decide if the changes on the hip x-ray are responsible for your pain.
Getting the correct diagnosis for your pain is essential. Over the years at Apex Clinic we have witnessed a proportion of patients with groin pain who had been told that it was due to hip OA, when in fact their groin pain was due to referred pain from their lower back, which cleared completely with manual physio treatment to their back!
To run or not to run?
Following a diagnosis of hip OA, many runners will be left to face the question of whether to run again or not. While this remains a controversial subject in sports medicine literature, the fact that a degree of hip osteoarthritis is considered part of the normal ageing process should be kept in mind.
From the literature in combination with years of experience of treating runners with hip OA, I believe that passionate runners with mild to moderate hip OA should continue a modified running regime.
For those with moderate to severe hip OA, the effects of running could be damaging and so an active alternative to running is highly recommended. Choose low impact activities which don’t load the hip joints as much, such as cycling, using a cross trainer, swimming, aquajogging and low impact aerobics.
If you have been diagnosed with mild to moderate hip OA, Apex Clinic recommends the following tips to help prolong your running life:
1) Reduce your land based running frequency to two or three times weekly and reduce the distance.
2) Substitute road running with running on a softer surface such as grass, bark, sand or treadmill where possible. The higher shock absorption of these surfaces is kinder to joints.
3) Change your running style to a forefoot to midfoot strike, to reduce the load coming upwards to the hip and reduce your stride length to reduce load.
4) Change to a maximally shock absorbing shoe and consider a shock absorbing insole. Whether shock absorbing insoles are effective or not is debatable, but we hear from runners that they appear to help.
5) Consider jogging in a pool (aquajogging) once or twice a week to maintain running fitness, which is kind and unloaded for all your lower limb joints.
6) Do not run through significant or moderate pain.
7) Add low load forms of exercise to your training regime such as cycling, using a cross trainer, swimming and low impact aerobics.
8) Get expert help from a physio who is experienced in treating runners. Following your assessment, they will manually work on your hip joint in order to regain any lost range of movement which should provide pain relief and slow down the progression of the OA. They should also provide you with a specific strengthening/endurance program to improve hip and trunk stability as well as specific stretches to target any tight muscles. Your foot biomechanics will also be assessed to determine whether a consultation with a podiatrist is warranted or not and whether shock absorbing insoles are appropriate.
Passionate runners may be delighted to hear that a diagnosis of mild to moderate hip OA may not be the end of the road of their running career if it ismanaged correctly.