Diving with osteoarthritis of hips

[Orchid]

i saw a post about this but it is over 9 years old so it recommended starting another.
I am 34 and have osteoarthritis of the hips recently diagnosed due to a birth defect. I have been trying to find an exercise I like for around 5 years and diving is the first thing I think I can get stuck into!
The thing is that the arthritis in my right hip is quite bad and there is also a labral tear. I do shore dives as boat dives are very expensive so after each dive my right hip is quite sore.
I don't want to stop! I need to do some exercise I like, but I don't want to bring on a hip replacement sooner due to my age ( I was given 10 years 7 years ago).
Any ideas on what I can do to make this Do able?

 

[Cali_diver]

I have been actively diving (averaging 200 dives+ a year) with a labral tear for almost 4 years. Diving is one of the few things that does not hurt my hip and when I am on diving trips it doesn't hurt at all. It hurts almost all of the time when at home and not diving. I would swim if you can and yoga is wonderful as long as you do it with modifications. I never do frog etc. Trick is to not let your bad hip side lose too much of its muscle tone. Squats and bridges help too.

 

[mi000ke]

I have osteoarthritis of the hips and try to get on the elliptical for 50-60 minutes every morning, and that seems to help. I also do some torso stretches each morning (lie on back legs pulled up toward chin and rotate legs together to right, then to left to where they touch the floor - hold each side for about 30 seconds, and do as many reps as you need - for me about 3 or 4; plus I do a piriformis stretch and a hamstring stretch) that also put some stretch in my hips, but that does not seem to help as much as the elliptical. Also have some serious back and shoulder issues, but they all seem to disappear when diving.

 

[DocVikingo]

I need to do some exercise I like, but I don't want to bring on a hip replacement sooner due to my age. Any ideas on what I can do to make this Do able?

Hi Orchid,

If you have not yet consulted with a rheumatologist or an orthopedist who specializes in arthritis, it would be prudent to do so.

Below is a list of exercises that may provide some relief*. Best results will likely come from doing as many of these as is comfortable, not just one or two. Any exercise that causes significant discomfort should be discontinued.

In addition, pain management is among the first-line treatment methods for hip arthritis. For those with mild symptoms, over-the-counter ibuprofen, acetaminophen, or naproxen may control the pain, and there is a variety of prescription oral pain relievers and anti-arthritis meds intended for those with moderate to severe OA. The divers treating doctor should approve use of any such substances. Hyaluronic acid and corticosteroid injection can reduce inflammation and pain, but relief may be only temporary and the substances can have problematic side effects with repeated use.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.


* Flexibility exercises for hip osteoarthritis

Single/or bilateral knee hugging

Lying on your back, grab your right knee and pull it toward your chest until you feel a stretch. Hold for 20 seconds. Repeat on the left side/or lying on your back, grab both knees and pull them toward your chest. Hold for 20 seconds

"Cobra pose"

Lie face-down on the floor, hands parallel to your shoulders. Straighten your arms, lifting your upper torso off the floor.

Your lower back should be arched, with your pelvis making contact with the floor.

Hold for 20 seconds, then lower yourself back down

Hip flexion with abduction/adduction

Lying on your back, bring one knee up toward your chest.

Holding your knee with both hands, roll your knee from one side to the other for 20 seconds.

Repeat on the other side

External hip rotation

Lying on your back, pull your right knee toward your chest. Place your right hand on the knee and your left hand on the ankle.

Gently pull your right ankle in the direction of your head. Hold for 30 seconds, then repeat on your left leg

Internal hip rotation

Lying face-down, bend your knees 90 degrees, and let your feet fall outward. Hold for 30 seconds

Strengthening exercises for hip osteoarthritis
"The Clam"

Lie on your side, feet together, and knees slightly bent. Raise your top knee as far as you can, then lower back down.

Repeat 15 times, then switch to the other side

Bridging

Lying on your back, with your feet flat on the floor, raise your hips toward the ceiling.

Pause for a few seconds before lowering back down. Repeat five times

Knee pivots

Lie on your side, feet together, and knees slightly bent. Raise your top knee and foot.

Holding your knee in a raised position, pivot your foot up and down. Repeat 15 times, then switch to the other side

Heel pivots

Lie on your side, feet together, and knees slightly bent. Raise your top knee and foot.

Holding your foot in a stationary position in the air, pivot your knee up and down.

Repeat 15 times, then switch to the other side.

 

[Orchid]

Thank you for all your input! It is interesting that the elliptical doesn't hurt mi0000ke, as it hurts me so it must be the tear! That is good because I stopped doing elliptical and walking around the block due to pain. If it is just the tear then I'll start up again ( within reason)
I went to a sports physician and have been going to a physio since. Been told to stay away from orthopedists until I need a replacement. I thought rheumatologists are more for rheumatoid arthritis? I don't need any regular pain meds, just a little rest after shore diving. I used to do clinical Pilates but find it hard now around work ( I work 6 days a week) and an active 18mo.
Thinking that maybe daily walks around the block may be good along with exercises. Thanks!

 

[Eric Sedletzky]

I just had a full hip replacement on my left side.
I'm in my 50's and wish now I would have had it done 5 or more years ago.
The problem with waiting too long is that one side gets so far behind and the muscle wastes away so much that it makes rehab even more of a challenge. Too much Naproxen isn't good and getting on the narcs can be even more problematic. I lived on naproxen but never got on the narcotics thank god.
I had three hip shots before I finally went in for a replacement. My advice is to not do them at all, or maybe just one. It seemed to me that they accelerated the wear. The last one I got lasted 6 weeks and wore off leaving me in utter agony. Then I was told I had to wait 5 months from the date of my last shot to be able to have the surgery. One of the few things in life I truelly regret was to overdue the shots.
A lot of it depends on how much cartilage wear you have. In my case there was nothing left and I was bone to bone.
If you are eligible and get the surgery when you're young and then need a revision later like maybe 15 to 25 or even 30 years onto the future, you'll still be young enough to sail through your second rehab no problem. The older you get the harder it is to do phys therapy.
Do yourself a favor and get your life back, that's if you qualify. I lived in denial for a long time. Finally the pain and subsequent cramping of my lifestyle became undeniable.
It's the best thing I ever did.

 

[DocVikingo]

I went to a sports physician and have been going to a physio since. Been told to stay away from orthopedists until I need a replacement. I thought rheumatologists are more for rheumatoid arthritis?

Hi Orchid,

Rheumatologists specialize in OA as well as RA & related conditions.

Sports medicine physicians primarily diagnose & treat musculoskeletal & non-musculoskeletal aspects of sports health. While they certainly would be expected to know something about OA, OA "due to a birth defect (not otherwise specified)" well could be a bit different situation than OA due to conditions that generally fall within their baliwick, i.e., sports-related issues.

Regards,

DocVikingo

“Make things as simple as possible, but not simpler.”--Einstein

 

[Orchid]

Eric, a replacement would be a good option if I was older but hips only last 10-15 years and subsequent ones are never as good so I'm doing what I can to minimise any damage. I don't go down stairs, stand for long periods, run/ jump or do anything to load my hip at all, except the walk from the car to the surf when I scuba. With any luck I wont be in a position that I rely on ibuprofen for a while.
DocVinko - sorry It is due to DDH ( something that I thought was easier to simplify) so my hips are shallow and the labrum is the only thing keeping them in ( which is torn on the right side). I showed my MRI to a paediatric orthopedist ( orthopedic surgeon in Australia) and he is the one who said I had 10 years until I needed a replacement. He told me that there was nothing an ortho could do except refer for radiologically guided steroid injection. I agree and was taught previously that steroid injections increase wear on the joint so I would never have one done in a joint that I wanted to use in the long term. Maybe as a last resort. I had stem cells injected into it 2 years ago ( not evidence based but hey what do I have to lose? ) but it is hard to tell whether that has made any difference as the pain from the labral tear overlaps with the OA symptoms. The guy who injected the stem cells wanted to do a scan at 1 or 2 years down the track, but what's the point? If it did work, great, if it didn't there is nothing else to be done anyway. I am against investigations where it doesn't change management ( especially one that is $1000 and not covered).
I will ask around to see if there is a rheumatologist here who has an interest in OA because it would be useful to know if there was anyone who kept up with the latest in the field (well someone who doesn't just keep trying to push surgery).
Thanks !

 

[KevinNM]

I don't know about hips, but I severely messed up my shoulder in an accident about 15 years ago and the two shots I've had over the last 10 years have broken a pain/inflammation/no-use cycle and allowed me to get better. The hospital shoulder replacement surgeon I saw last year said now is not the time, but he expects that time will eventually come some year in the future, hopefully many years.