Gas station without pumps

2019 June 30

Hip osteoarthritis is a pain in the butt

Filed under: Uncategorized — gasstationwithoutpumps @ 13:44
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As many of you know I stopped running in April after getting a diagnosis of hip osteoarthritis.  This week I went to see a physical therapist to see what I could do

  • to prevent further deterioration of the hip joint and
  • to learn to run without doing further damage.

The half-hour appointment cost me $503, which counts toward my insurance deductible, but no fraction of which is otherwise covered.  I was prescribed five stretching exercises to do daily to prevent further deterioration, but not given even a hint about whether I could run without doing further damage.  I’ll do the stretching exercises, but I’m considering not bothering with the followup appointments (one of which is already scheduled)—the price seems a bit too high for the small amount of information gained.

If I were on the UC Care health plan, rather than the UC Health Savings Plan, some of the physical therapy would probably be covered, but that plan would cost me an extra $337 a month (an extra $1101 a month while on leave without pay), so I’m still better off with the low-price plan that lets me save money in an HSA account.

So far, the best advice on running with hip osteoarthritis seems to be from https://nirunning.co.uk/should-you-run-with-hip-arthritis/:

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.

(They have eight points to their recommendations—go to their site for the whole story.)

The big questions are

  • whether I can change my running style to a shorter stride and a forefoot strike and
  • whether that is enough to avoid further damage.

I suppose I can practice changing running style on a treadmill at OPERS, since I want to learn how to run on treadmill anyway—the only treadmill running I’ve done is a few minutes for my stress electrocardiogram test last December, and I felt unsteady on the treadmill, even when I had not gotten up to full speed.  I’d like to get more familiar with treadmill running so that the next stress electrocardiogram I get will be one where I can put out full effort without worrying so much about balance.

2019 April 17

Running hiatus

Filed under: Uncategorized — gasstationwithoutpumps @ 10:48
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I am going to stop running for a few weeks and reassess my goals.  What triggered this change was my annual physical, where I got some of my various aches diagnosed.  There were three main outcomes:

  • It is worth trying ezetimibe in addition to my current rosuvastatin to see if that controls my cholesterol better—it is probably less of a risk than increasing the statin dose.  Interestingly, my insurance requires prior authorization for ezetimibe (a $9/month generic), which makes no sense at all.  I’ll probably be paying for the prescription without insurance, since the full price will be less than the insurance co-pay would be.  (They don’t pay for the $6/month rosuvastatin either.)
  • My elbow injury is probably tennis elbow (lateral epicondylitis), for which I’ve been prescribed stretching and strengthening exercises.  I’ll also start wearing one of the tennis-elbow braces that wraps around the forearm.  I’ve had elbow inflammation before (due mainly to bad keyboarding posture), so I know more or less what to do about it.
  • The ache in my hip that I’ve had since last August is osteoarthritis, as I suspected (confirmed by X-ray). This is bad luck, but not unusually bad luck—the incidence of hip arthritis among men my age is about 12%, if I’m reading the literature correctly.  Experts seem to disagree about whether running is safe for people with hip arthritis, but even those who recommend running agree that one needs to change to low-impact running styles and do other exercises to stretch and strengthen muscles to avoid further injury to the joint.  Almost all recommend working with a sports medicine specialist and physical therapist trained in running and arthritis to determine exactly what is reasonable.  I’ll probably be doing that when I have some spare time (this summer?).

I was just feeling good about having done a 5km run last weekend, albeit at a slow pace (8:35 mile pace), and now it looks like I won’t be increasing my distance to 15km this summer as I had planned.  I may never run a marathon—I should have tried 20 years ago, when my body was better able to tolerate abuse and recover from it.

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