About ten years ago I was speed hiking up a steep trail when I noticed a strange sensation in my right hip. I didn’t give the end-of-stride stiffness more than a moment’s thought, figuring that I had tweaked something or just wasn’t fully warmed up. Little did I realize that this tiny little twinge would turn into something much more ominous down the road.
Besides the occasional stiffness, not much happened with my hip until the end of 2005 when I had a bout of off-and-on sharp pain that caused me to see an orthopedist. My X-ray and MRI were normal and it was obvious to the doctor that I had good bone density. The doctor was at a loss to explain my symptoms based on the X-ray chart, and he felt that the most likely explanation was very low grade (two on the scale of ten) early-stage arthritis in my hip. It turns out that all I had to do was wear fleece bib-tights while cycling on chilly days to prevent the intermittent pain from returning.
While I seem to be blessed with a cardiovascular “age” much lower than my chronological age, I have never been so lucky orthopedically. I’ve suffered through much more than my fair share of over-use injuries since I was in my early thirties. I’ve had elbow and shoulder problems from throwing baseballs, hitting a million golf balls, and smashing a few tennis balls.
I went back to the orthopedist this week because recently the stiffness and pain has gotten quite a bit worse in my hip. With the right hip, for the first time in my life I have an injury that was caused primarily by the aging process—with some genetic and lifestyle components thrown in for good measure. While the orthopedist I saw earlier in the week felt that my level of activity was a major contributor, it was little consolation when he told me I likely would not be experiencing the hip issue (at least at my current age) if all I did was drive a car to work and then sit at a desk.
Doctors like to talk about outcomes, and I asked for the best possible prognosis for my right hip. The doctor started off by using the words “progressive” and “degenerative.” I said, “Progressive? Degenerative? Exactly what are you talking about? I can’t fix this?” He said that I could hope to stabilize the hip through targeted exercises, and limit the progression of the arthritis. Worst case scenario is a full hip replacement in 5-10 years. For someone who, knock on wood, has been healthy their entire life, this news came as somewhat of a shock. I’ve gone years at a time without taking any kind of pain reliever. I guess it’s foreboding that I just added a column titled “Advil” to my training log. Keeping tabs on this trend seems like a good way to monitor the situation.
Next the doctor started using words like “limitations” and “results” in reference to a possible surgery. He also told me that recreational cycling was actually good for my hip, and that I should be able to walk without compromise. Rather than discuss limitations, I wanted to talk about the effects of a hip surgery on athletic performance. Yes, there are stories of elite athletes who wind up with hip replacements, but are there stories of these athletes coming back and performing at the same level? I know that some people in their twenties have a hip replaced due to rheumatoid arthritis and do well. There are people my age who have had both hips replaced and get around just fine.
But how many of these people cycle 12-14+ hours a week, ride a mountain bike like a kid, hike, snowshoe, and are considering learning how to paraglide? How many people with a hip replacement are trying to do a climb on a bicycle faster than someone twenty five years younger than them? I guess when I get around to returning to alpine skiing I won’t be searching out the mogul runs. In fact, I’m not supposed to do jumping jacks, so I guess jumping off of Poo Poo Point in a paraglider is out of the question.
Yesterday, I went to see a physical therapist, not only regarding my right hip, but also for lingering soreness from an ankle sprain almost two months ago. Just to “get my money’s worth,” I threw in an elbow issue, so we went through that as well. The PT was a lot more optimistic than the doctor who had told me that a lot of muscle has to be cut into during hip surgery, and that the cut muscle would not be as strong or possess the same endurance or time to fatigue. The PT didn’t say this was rubbish, but he feels like people who are willing to work hard on rehabbing post-surgery can do extremely well and come back just as strong as ever.
Really, the best I can hope for is that by the time I need to have something done, the technology of the surgery has improved dramatically. Maybe there will be a less invasive procedure developed. In any case, I now have the Fear of God in me, and I intend to get down to business and start the extensive exercise program the PT outlined.
I sometimes ride with several “heroes,” people older than me who are racking up incredible athletic accomplishments and performing at a high level for an athlete of any age. My friend Reg N just competed one of the most arduous trips on a bike that I am aware of:
If you visit that site, be sure to scroll down the page for some pretty incredible daily mileage and climbing numbers. Keep in mind that a lot of the hard riding was at higher altitudes, and that there were 18 straight days of riding. Even Tour de France riders get rest days! As a result of preparing for and completing this tour in style, I expect that Reg will have the best fitness of his life, and will once again kick the aging process in the teeth. I’ll find out about his trip—and how strong he is riding—when we get together to ride on Monday. I aspire to such feats of greatness a few years down the road.
Since 2003, I have led a hard group ride called the Hills of the West Coast. Sometimes in the back of my mind, I wonder when declining aerobic capacity will catch up with me and I no longer will be able to ride (and yes, be competitive) with strong riders much younger than me. With the proper lifestyle and training, I know that I can delay the aging process and extend the time before I see a dramatic drop off physiologically. Certainly I expect to win fewer of those battles as I get older, but it’s kind of ironic that the very training designed to help me keep my aerobic capacity from dropping might be costing me in other ways. Most of the cyclists that I coach are younger than me. Maybe that’s a good thing, because I will have experience with issues that may eventually affect them as well.
It’s a real eye opener that my first major decline due to the aging process may result from an orthopedic condition of my right hip, rather than a decline in max heart rate or stroke volume. I am seriously pondering the fact that I might not just be getting older, but that I actually might be getting “old.”
This is the first time I have had this feeling, but it certainly won’t be the last. I guess I could just resolve to get used to it. Bullshit! No, I am not going to get used it, and no, I am not going to ignore the feeling. As I always have, I am going to do my best to fight against getting older, and now I am also going to wage war against actually getting “old.”
By the way, the doctor thinks that I now have a moderate arthritic condition that is a five on the scale of ten. I think he just can’t count.