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  1. #1
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    Default Thoughts on Hip Problems & Martial Arts

    I was reading a post on another site that had nothing to do with hip related problems, at least not on the surface, but it got me thinking about the whole issue of hip problems and the martial arts, so I thought I would share some thoughts with everyone and maybe keep them from going through with needing their own total hip replacement (THR) surgery.

    One of the things I noticed as I started researching hip related problems and martial arts, was that a LOT of martial arts seem to have screwed up hips as they get older. Most are aware that a number of notable martial artists have had THR with Chuck Norris, Bill Wallace, Nasty Anderson being the more famous. I have also run into a number of others over the past year or so that have problems with their hips. The strains and stresses our arts place on the hip is apparently very high relative to other physical activities. Maybe some sports medicine researcher out there can do a serious study on these stresses and we can take some means to avoid them in future generations of students. Until then, we are sorta on our own. Here are some things to keep in mind that will maybe help you and your students.

    When I first started having problems with my hip, it did not feel like I was having problems with my hip. It started out with what felt like a groin pull that just would not go away. Like most MA's, I ignored it, knowing that groin pulls take a while to heal any way, and I could still tough it out. Later, then pain started in the lower back/upper leg, kind of like you get with a sciatic nerve acting up. So I treated it as such, lots of motrin, heat packs, etc. and just continued to deal with it. Anyway, by the time I got smart enough to go to the doctor and have it properly diagnosed, I learned my hip was totally shot and my only treatment option was a THR. So I put it off for almost five more years and finally I am on the road to recovery. I guess the bottom line I would like for everyone to take away from this is; just because something feels like a groin pull, or a sciatic nerve that is acting up, doesn't mean that it is. If the pain persists, for heaven's sake, go to a orthopedic doctor and get a proper diagnosis. Better safe than sorry.
    Robert M. Carver
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  2. #2
    Moderator Emeritus TonyU's Avatar
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    Default

    Thanks
    Great post, that's good to know. I know as a martial artist most of us do tend to "tough it out" thinking that we'll get over it or that we are weak to have a doctor take a look at. I waited almost a year before I got the nerve to see a doctor and wound up having knee surgery. Best thing I did.
    Professionals talk about tactics and concepts while amateurs talk about gear and equipment.

  3. #3
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    Glad you liked my mindless ramblings. However, I hope that it will be informative to others that may be going through the same thing. I think that the important point to be made, whether it be about hips or knees, would be to encourage folks to get a problem diagnosed early and corrected sooner. That way they are not left with the least desireable alternative.

    Glad to hear that your knee surgery has been a blessing for you. I have a student that had his knee replaced about 18 months ago and it has been a good thing for him. I have also communicated with a number of martial artists and athletes who have had their hip(s) replaced, and they all say the same thing you did, "Best thing I did". Still too early in my recovery to say this yet, but I am hopeful that in a few months I will be saying the same thing.
    Robert M. Carver
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    "We are fast approaching the stage of the ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission; which is the stage of the darkest periods of human history, the stage of rule by brute force." – Ayn Rand

    “In a time of universal deceit – telling the truth is a revolutionary act.” - George Orwell

    "A man with a gun is a citizen. A man without a gun is a subject."

    "A government big enough to give you everything you want is a government big enough to take from you everything you have." Gerald Ford in a Presidential address to a joint session of Congress (12 August 1974)

  4. #4

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    For the last couple of weeks I have had mild groin ache/stiffness on the right side that is triggered especially when I go into what in the Gung Fu style I learn is called 'Po Bu' - i.e. one leg fully squatting, knee turned outwards, the other extended straight out. It is in the squatting leg that I feel mild pain. I don't know whether to stop training altogether, or to continue training and just cut out any agravating movements (mainly Po Bo). Should I follow your lead, Robert, and see a doctor?

    Simon Bacsich

  5. #5
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    Simon:

    The fact that I was so hardheaded and waited so long is proof that I certainly am not a doctor, but knowing what I know now, I would definately go and see a doctor as early as possible. There are newer treatments that are available or on the horizon that probably could have saved my original equipment if I had acted early. So based on what you are describing, I would definately go and see a doctor. Try and see a sports medicine or orthopedic doctor. They will do an x-ray at the least, or an MRI at the best and get a very good look at what is going on with your hip. You will get a much more definative diagnosis than going to a GP, who will just give you some drugs and send you on you way.

    Good luck and let us know if you take this course of action and what the results are.
    Robert M. Carver
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    "We are fast approaching the stage of the ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission; which is the stage of the darkest periods of human history, the stage of rule by brute force." – Ayn Rand

    “In a time of universal deceit – telling the truth is a revolutionary act.” - George Orwell

    "A man with a gun is a citizen. A man without a gun is a subject."

    "A government big enough to give you everything you want is a government big enough to take from you everything you have." Gerald Ford in a Presidential address to a joint session of Congress (12 August 1974)

  6. #6
    Senior Member tkdcanada's Avatar
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    Interesting thread. I was just reading the other thread about Robert's hip replacement and it got me thinking that there seem to be so many active people who end up needing new hips or knees. I was about to start a thread asking if this was an unavoidable pitfall of constant physical activity (certain kinds anyway) until I found this one. It seems quite disenheartening that so many people end up with such uncomfortable and seemingly permanent problems at such a young age. I really thought that using your body strengthened it, but in the case of joints, it seems to be the complete opposite. Even mere walking, when done too much, seems to be a hazard. My dad was a letter carrier for years(now works inside instead) and has terribly screwed up knees due to his job, and others of his colleagues suffer similar complaints. Are there measures that can be taken to avoid future joint problems (besides not doing anything too physical) or is it just a matter of time?
    Mich

    "Do not go where the path may lead, go instead where there is no path, and leave a trail."
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  7. #7
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    Hey Michleine:

    One of the things that goes along with educating yourself about joint related problems, is that I have learned a heck of a lot about some preventative measures that may help with joing health. There are a number of very good supplements that have shown great promise in this field. For instance, supplements of Chondroitin Sulfate/Glucosamine Sulfate have shown to be very effective. I have started taking it again for no other reason than to help protect my other hip! Supplements of EPA/DHA Omega-3 seem to protect joints, and I read an incredible article about chicken collagen that shows it to be very effective. I have that article at work, otherwise I would post it for you to read. I will try to remember to do so once I get back to work.

    Overall, I think that normal everyday use of a joint will cause wear and tear and possibly lead to osteoarthritis. However, I my case it was "extreme" use of the joints that did me in. Also, it is likely that at some point, I injured the left hip and that lead to osteoarthritis in that hip and not the other (the doctor looked at my right hip and said I have plenty of mileage left on it). So with that in mind, if you get injured, don't try and tough it out. Let it heal and if you don't see improvement after whatever time you give yourself, go see a doctor.
    Robert M. Carver
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    "We are fast approaching the stage of the ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission; which is the stage of the darkest periods of human history, the stage of rule by brute force." – Ayn Rand

    “In a time of universal deceit – telling the truth is a revolutionary act.” - George Orwell

    "A man with a gun is a citizen. A man without a gun is a subject."

    "A government big enough to give you everything you want is a government big enough to take from you everything you have." Gerald Ford in a Presidential address to a joint session of Congress (12 August 1974)

  8. #8
    Senior Member tkdcanada's Avatar
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    Thank you, Robert. I'd be very interested in reading that article, both for myself and my husband (who has recently began weight lifting and is experiencing shoulder pain). Myself, I have been lucky enough to suffer very minimally, despite my tendency to go full speed ahead at everything I try - but then again, I've been at it a very short time. However, I do experience stiffness when I get out of bed the day after a particularly demanding class, which is likely more the effects of age creeping up on me than anyting.

    Anyway, I look forward to the additional info when you get a chance. Take care and heal well!
    Mich

    "Do not go where the path may lead, go instead where there is no path, and leave a trail."
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  9. #9
    Super Moderator Jeff Burger's Avatar
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    I had mentioned this awhile back....

    One of my CMA teachers had said that some of the Karate alignments maybe good for getting power in a short period of time but were not kind to the body over time.
    Specifically to the hip was side kick.
    I didnt really think much of it at the time. I thought he was just biased to CMA.
    But it made me start to notice injuries common in different styles.
    Wallace, Norris and Anderson are sideways fighters.

    Jeff

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    Some SKA guys I know tell me than several years ago Tsutomu Ohshima eliminated the side snap kick (yoko geri keage). Sure enough, when I watch the SKA people perform kata and a side snap kick comes up they rotate slightly to face the target and use a front snap kick (mae geri keage) instead. The reason I am told is that Ohshima sensei was haviing lower back pain and felt the side snap was just flat bad on our bodies.

  11. #11

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    Just to say that I went to my GP about my groin ache recently. He was very helpful and said that it was a case of my adductors not settling - so he booked me in for physio which he said should sort it out. Fortunately I'm able to train at pretty much peak rate as long as I watch myself on certain exercises.

    Simon Bacsich

  12. #12
    Member kmtsd's Avatar
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    I'm a little late on this thread... but I am a family practice doc and have been perusing this forum today... here a few more thoughts-because I have often wondered about this myself and read about the subject

    As far as arthritis goes... research on runners and knee arthritis showed that the incidence of arthritis(how often it occurred) was not higher in runners than nonrunners. Once arthritis occurred it progressed faster in the runners compared to nonrunners. There was also a small study on martial arts masters- the indicence of hip arthritis was not higher compared to the general population. Another interesting point is that both runners and martial artists were found to have a lower incidence of osteoporosis(fragile bones) compared to the general population -suggesting that impact sports help build bone density.
    So the take home point is -martial arts will not "give" you arthritis, but if you already have it, it will make it worse, faster. On the other hand you will have stronger bones.
    Anyhow-I guess I fall into the "hardheaded" category... I tend to have right hip aches and pains which I believe are muscular because it gets worse whenever I go crazy with continuous frontleg round kicks. I wonder if I should get an xray to make sure its not arthritis...but I concluded (as your common "hardhead" will) that I'm not gonna stop training or competing anyway so I'd rather not know.
    But-(just in case I end up with a hip replacement at 40)
    Robert: I am curious to know- are you still training with your new hip? What has the surgeon advised? You are very young for a THR and will likely need another in 10 years? Did he tell you to stop training to extend the life of the new hip? I am hoping- if I ever need one that they will create a hip replacement that will last 50 years.
    Candace Hill

  13. #13
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    Quote Originally Posted by kmtsd
    Robert: I am curious to know- are you still training with your new hip? What has the surgeon advised? You are very young for a THR and will likely need another in 10 years? Did he tell you to stop training to extend the life of the new hip? I am hoping- if I ever need one that they will create a hip replacement that will last 50 years.
    Candace Hill
    Hey Candace:

    It has only been six weeks since my surgery, so I am just getting back into the swing of things. I have been hitting the physical therapy really hard and it is paying off. My surgeon just told me I can lose the normal hip restrictions. So at least now I can actually bend past 90 degrees! Yoo-hoo! However, I have a lot of healing still ahead of me.

    For the most part, I will be able to do everything that I did before the surgery, except it will be pain free. That is a big plus! About the only restriction I will have is taking hard falls on the left side. I do Jujutsu, and getting thrown is part of the equation. Once I get a bit more comfortable, I should be able to take falls on the right side, but I need to not take them on the left. Impact to the hip and the possibility of fracturing the femur (with the stem of the prosthesis) is the big concern here. Taking rolls is OK and I should be able to do them on either side.

    Dislocation is always a possibility at this early stage, but will be less of a concern as I continue to heal. I am able to move and rotate the hip in just about every direction. For instance, I am allowed external flexation (like crossing the left leg over the right and pulling the foot toward the groin...or higher) is OK. But internal flexation (like doing hurtlers stretches with the left leg tucked behind me) is totally out...forever. I think I can live with that restriction! I can also bear enough weight to throw someone else. Right now, I am still a little hesitant to do any sharp pivots, but that is more a confidence thing right now.

    Overall, my surgeon is not too thrilled about my starting back to training and teaching, but I think he realizes that after 30 plus years, I am not about to stop. So he is dealing with it. My physical therapist on the other hand is a lot more positive about the whole thing and she believes that I can easily get back to almost 100%. I know I will always have some restrictions, but I can live with them.

    Yep, 42 is definately a bit young for a hip replacement, but on the other hand, it is better than living with the pain. One of the nice things about some of the newer prosthetic hips is their durability. The new ceramic and metal-on-metal devices have an estimated lifespan of 20 plus years. In fact, the metal-on-metal ones have been approved for use in Europe for like 30 years. There are many that are still going strong with them 30 years later, and that is not even with the more modern metals that are being used. The one I have is very high tech and actually has a higher range of motion than the original. I should get at least 20 years use out of it.

    One of the things I have learned about the durability of hip implants is that it is not the wear and tear of the ball rubbing against the cup that causes the need for a revision. Instead, it is the loosening of the stem in the femur. With the older metal on plastic hips, particles of the plastic cup would wear off and settle down near the top of the stem. This would cause an immune response, and as the body was going to work on the foreign stuff near the stem, it would cause the stem to become loose. With a non-cemented stem (which I have) where the bone grows into the stem, and the high tech metal of the ball and cup, loosening is far less of a problem in my case. The metal on both the ball and cup is machined so that they are super smooth and the metal used (chromium something) is durable enough that I will not get particles of metal settling down near the stem. I do have a concern over metal ions that are released into the body, because there is no definative studies to show their effect on the body. So they really don't know how that will effect me in the long term. The studies conducted to this point are very inconclusive. Another concern for all hip replacement patients is the problem with infections. If for instance, I get a sinus infection and blow off going to the doctor for treatment, then there is a possibility of the infection settling into the femur around the stem and causing it to become loose. So now I have to take that a bit more seriously. I was also told that anytime I have ANY dental work, to advise the dentist that I have a prosthetic hip and I should be prescribed a round of antibiotics to prevent any possibility of an infection.
    Robert M. Carver
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    "We are fast approaching the stage of the ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission; which is the stage of the darkest periods of human history, the stage of rule by brute force." – Ayn Rand

    “In a time of universal deceit – telling the truth is a revolutionary act.” - George Orwell

    "A man with a gun is a citizen. A man without a gun is a subject."

    "A government big enough to give you everything you want is a government big enough to take from you everything you have." Gerald Ford in a Presidential address to a joint session of Congress (12 August 1974)

  14. #14
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    Quote Originally Posted by Jeff Burger
    I had mentioned this awhile back....

    One of my CMA teachers had said that some of the Karate alignments maybe good for getting power in a short period of time but were not kind to the body over time.
    Specifically to the hip was side kick.
    I didnt really think much of it at the time. I thought he was just biased to CMA.
    But it made me start to notice injuries common in different styles.
    Wallace, Norris and Anderson are sideways fighters.

    Jeff
    Has anyone carried out a survey of martial arts injuries across various styles? I remember reading one about Canadian Tae Kwon Do students a while ago, and they seemed to suffer a lot more fractures and broken bones than I'd realised possible given the number of respondants. The sample may have been self-selecting, of course.

    If a survey like this doesn't exist, do you think it would be interesting to set one up?
    Simon Fraser

  15. #15
    Member kmtsd's Avatar
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    big grin That's great news!

    Well Robert I am very happy to hear that the new hips are lasting so long! That's great!(hmm... maybe I will get my xray now and stop being so hard headed).
    Jujitsu is a different type of stress on the hip than Tang So Do... I can understand why the surgeon's main concern would be dislocation-not so much wear and tear. Now that I understand you are a jujitsu artist I would tend to agree with your PT(Physical Therapist)--you should be able to do nearly %100 of the stuff you did before... assuming you are a "good boy" and really do your best to get the range of motion and strength back in your hip to keep it as strong and stable as possible. Therapy is hard, but your therapist has probably realized that you are strongly motivated (unlike your typical nonactive patient)
    The Glucosamine and Chondroitin have been suggested to help slow arthritis and they certainly don't hurt... the "chicken cartilage" are you talking about Synvisc injections? made from the red crown on roosters heads? Synvisc is used to prolong the time before knee replacement...at best Synvisc will usually work for a year or two. then you have to get the knee replace anyway. I don't know if they are using it in the hip.

    Simon:
    As far as studies on martial arts injuries across the styles..I do have information but I will have to look it up and get back to you... most studies on injuries were done through tournament records...most focused on head injuries and safety equipment- I do remember that the only "deadly kick" was the spinning back hook kick which resulted in one death-immediately. The spinning back hook kick was actually banned from many tournaments after that incident....by the way did anyone else see the heavy weight gold medal fight for Tae Kwon Do? Chinese Tai Pei guy beat Greece by a knock out! Guess what kick? Spinning back hook kick!!! (in the first round) I have it on tape. It was a good fight.

    Talk to you guys later...
    Candace Hill

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