Training in your 40's after having both hips replaced

I am 45 and had both hips replaced last year (June and October 2019). My father had his first hip replaced at 47, so the doctor believes my issue is genetic. I started LP in January before COVID halted my progress. I started over with LP once gyms reopened. I have worked up to a 200# squat (from 95#), 275# DL (from 135#), 175# press, and 235# bench. The Ortho said that I should do sets of 10 and squat (maybe even DL) no more than 250#. I am well aware of your thoughts and feelings on most doctors. I agree with you and see the flaws in his reasoning, but I would like some guidance as to how to proceed with my training. I have read other threads regarding training and hip replacements but see no specifics on a long-term plan of progress. I would like to make training progress for the rest of my life after having done all of the wrong things (strength coaches playing football until college and after, playing catcher in baseball, Crossfit, my own stupidity, etc.) until now. I found The Barbell Prescription helpful, but would like to get more details on a plan for those with hip replacements.

Any wisodm you can offer will be greatly appreciated.

Thanks!

Post the specifics of the procedure, so we can see what actually was done to your hips.

I had the anterior approach done on both hips. Both were outpatient procedures, and I was walking down the street that afternoon/evening. I ditched the walker after one day and used a cane for 2 additional days. I have a plastic socket liner and a ceramic head to the hip prosthesis.

There is no long-term plan. There is only the linear progression approach to your own situation, that evolves into more complex weekly training when it becomes necessary. The plastic socket liner will be the problem eventually.

What type pf problems have you seen?
Is this a matter of normal wear and tear or does training cause these issues?
Can I still progress to have weights on the lifts?
Are there any considerations I need to make in programming long term? I assume you would recommend a coach to help me.

Hi Daniel,

I am a PT and as Rip alluded to, there isn't a specific long-term plan that someone can lay out for you about training after hip replacement as there isn't any research on the topic that I am aware of. As far as your doctor's advice goes, as is typical, they are just giving you conservative advice to protect themselves if you hurt yourself training. How hard you push yourself in your training is up to you. The implants used today are very durable, but you are a young guy and will most likely need revision surgery down the road regardless of whether you train hard or spend your time lounging on the couch. As long as your programming is sensible in terms of volume, frequency, load progression, etc. then you will be fine. Also, make sure you follow your surgeon's advice about your follow-up schedule with him as those scans will pick up any problems with the implants that will eventually occur with time.

I am sorry that I am not being more specific than that. If you want to speak more about your training privately, feel free to DM me.

Good luck with your recovery,

John

Thank you for responding. I appreciate what you had to say regarding my questions. Do you have any insights as it pertains to volume, load progression, and frequency? Since May, I started all over again with LP. I started LP in January after my second surgery. I have an athletic background that includes baseball, basketball, and football up to college and a little beyond. I also had about a 7 year run of Crossfit until the hip issues started. I have spent a lot of time in the weight room most of my life from 7th grade on. That being said, a lot of that time was spent under cousins who played SEC football training me with their college programs, strength coaches in high school and college, and under my own tutelage (trying too many different programs in search of the "best" way to train).

I had both hips replaced 8 months ago. I have just started squatting again and boy does that feel good and my progress has been slow. I mean recovering from the surgery, as squatting -wise my progress is good and I add about 5 lbs. each time I squat. There was even a time when I thought I would never squat again.It feels great to squat without icepicks stabbing into my hips.

Anyway, Dr. pain and soreness have been my primary physicians. I use them to guide me. My actual doctor said my prosthesis is solid and has green lighted me. They no longer do hip precautions because they found that people who were told a bunch of "no's" recovered slower and never fully recovered. They have found that the average person will shy away from things that cause excruciating pain and things that cause excruciating pain are usually good to stay away from. However, some pain and soreness is expected and as an athlete you already know that.

I have found this to be a good guide.I have learned to be patient and not overdo it either, as the real soreness pain doesn't fully hit me until 48-72 hours later.

This general guide might become more complicated if you have a very high pain tolerance or some other reason like pain meds, but even then you're post- exercise soreness will let you know that you need more time to heal so even if you do overdo it , it just means you will need more time to heal.

"The Ortho said that I should do sets of 10 and squat (maybe even DL) no more than 250#. "

I would have a conversation with the ortho about why 10 sets and why 250# limit. Find out what is their concern. See if it's really the joint will fail or they have some other concern like you doing the lift safely or who knows what.

I had an interesting experience a month or two ago, I had eye surgery and the doctor told me no strenuous exercise. This was during the shut down so I was swinging heavy kettlebells. I abided by her rules for two weeks. At the re exam I asked why no exercise and it turns out her reason was blood settling in the eye. I asked if 30 minutes three times a week would would really create a problem over me sitting on the couch and letting my general health deteriorate. She agreed to lift her exercise ban based on overall health and asked me not to stand on my head, hahaha. So talking to your doctor and asking the whys can get you valuable information and many times permission to things they wouldn't normally do.

Find the ortho's reason for the restrictions and likely you can work out a better set of guidelines.

Quote:

---

Originally Posted by John Petrizzo

... feel free to DM me.

---

Can you DM on this board? I haven't been able to find an direct messaging feature.

Quote:

---

Originally Posted by danielk

Thank you for responding. I appreciate what you had to say regarding my questions. Do you have any insights as it pertains to volume, load progression, and frequency? Since May, I started all over again with LP. I started LP in January after my second surgery. I have an athletic background that includes baseball, basketball, and football up to college and a little beyond. I also had about a 7 year run of Crossfit until the hip issues started. I have spent a lot of time in the weight room most of my life from 7th grade on. That being said, a lot of that time was spent under cousins who played SEC football training me with their college programs, strength coaches in high school and college, and under my own tutelage (trying too many different programs in search of the "best" way to train).

---

No problem, Daniel. The amount of volume, frequency, etc. that a person will be able to tolerate after a procedure like this is really individualized. Most of the people I have worked with who have had total hip replacements are older than you, so I usually start them back ramping sets of five to one moderately heavy, but submaximal work set on the squat and deadlift and titrate volume up from there. Similarly, most of the people I work with are generally training twice per week. However, given your background, age, and training history, I don't see why you could not just perform the standard LP as written.

I hope that helps!

I started out on regular LP, but by the third session in the week, my lower body did not feel recovered. I have since moved to a 4-day template swapping an intensity lift and volume lift each time. That seems to feel better. My issues before could have been from form. I went to see Alex Beasley when she was in the Nashville area a year before my first surgery. I was too far gone to really get what I needed to out of that. I could use some coaching, but Alex is not here anymore. Do you know of anyone close?

Hi Daniel,

I apologize for my delayed response. I am happy to hear that the 4 day split is working for you. I am not sure if we have any coaches in that area at the moment, but I would suggest checking out the Coaching Directory:

SSCA : Coaching

If there aren't any coaches in your area, I would suggest seeking out a coach who offers online services. Many SSCs offer online coaching. They can be found here:

Starting Strength Online Coaching:

I hope that helps!

John

If I follow a 3-day or 4-day LP and progress from there, is there a point of too much weight for the hips and surrounding structures? I have worked up to 1X5 at 285# on DL and 3X5 at 215# on the squat so far. I am also pressing and benching. I haven't experienced any issues so far other than elbow pain from a football injury and surgery in college. I just don't know how far to go before I create possible issues for myself. I need to keep these hips as long as possible.

Quote:

---

Originally Posted by danielk

If I follow a 3-day or 4-day LP and progress from there, is there a point of too much weight for the hips and surrounding structures? I have worked up to 1X5 at 285# on DL and 3X5 at 215# on the squat so far. I am also pressing and benching. I haven't experienced any issues so far other than elbow pain from a football injury and surgery in college. I just don't know how far to go before I create possible issues for myself. I need to keep these hips as long as possible.

---

I don't think so provided you progressively load yourself in an incremental fashion, but ultimately, how far you push things will be up to you.

Thank you. I appreciate you taking the time to give some good information. I'll just keep going and see what happens.