sore hip advice?

Hi Jim: Gosh, by now I should have a PHD in hip pain...both before and after replacement. So, my advise it this: 1. NO BREASTSTROKE KICKING. THAT IS BAD STUFF FOR THE HIP WHEN IT IS SORE. 2. Stay away from pull buoys until it feels better. Pull buoys made mine worse...and your right, the effort to hold the buoy between your legs can aggravate the hip. 3. Without knowing what is going on inside the hip you are guessing on your recovery or severity of the injury. I do know that some hip injuries can get much worse with exercise...and some get better with rest. So, my strong suggestion is to see a qualified Dr. and have it looked at. Again, stay away from the breaststroke kicking until it gets better. Fly kicking never bothered my hip, but other guys with bad hips told me fly kicking hurt theirs. Dott Donnley (bless her heart) told me fly kicking bothered hers for a short time..then it quit. Get well soon. Tom

Tom and Anna and Greg (who sent me an e-mail directly): thanks to one and all. I've taken a couple days off, i.e., no swimming, or exercising, or even much in the way of substantial walking, and the hip does seem to be getting better. I have also taken ibus and ice regularly until today--Anna's advice about weaning myself off the ice seems to be worth heeding. (I stopped the ibus after we ran out, and I didn't want to walk over to the store to buy extras.) Anna, I haven't noticed any popping sounds or sensations and don't think the joint is coming apart, even momentarily. I suspect that I inflamed a muscle or tendon or ligament or some combination thereof, and that with enough rest the inflammation should begin to die back. In any event, it's very encouraging to hear that with the right rehab, you have successfully bounced back from your kick-boxing injury (which sounds similar to what I did on the Nautilus machine.) My big dilemma as always with injuries and/or colds is that I get such stress relief from swimming that I am going stir crazy "taking it easy"! Hopefully, I will be able to return to the pool soon, and the hip will continue its slow slouch back to normalcy... Here's a credo I propose for those of us in the neighborhood of 50 or over: Any form of exercise you haven't done a lot of lately, DON'T DO A LOT OF NOW!!! Start very, very slow and gradually build your way up. I think I get tricked into doing more than I should because I feel like I'm able to swim similar times to college--and hence my body must generally be in the same kind of shape. Perhaps this is arguably a little true for swimming, but it is definitely not true for kick boxing, Nautilus adductor exercises, etc. i.e., anything I haven't done much of lately. (Last summer, I played soccer for the first time in 25 years and had trouble walking for a week.) Any tips on how to handle the psychodynamics of being out of the water? I know there must be other swimming addicts whose heads say "rest" but whose hearts long to be back in the water. And remember, all those out there who have not recently injured yourselves: Any form of exercise you haven't done a lot of lately, DON'T DO A LOT OF NOW!!!

Does your hip "pop" at all, particularily when doing exercises like the abductor/adductor and breaststroke kick that use a wide range of motion for your hip? Do you think it may have dislocated, even partially, and gone back into place? I had problems with this about a year ago when I was doing kickboxing (I've noticed my hip "pop" occassionally while doing breaststroke). I finally went to the doctor because it was getting so sore I could barely walk. He sent me to a physical therapist (DON'T go to a chiropractor if your hip is "popping" or dislocating, it'll only make it worse and wear at the ligaments to keep readjusting it). The physical therapist said one hip was considerably weaker than the other and did ultrasound therapy (to lessen the pain) and gave me floor exercises to strengthen my hip. Since I started doing that, I have had almost no problems . . . or pain. If you did strain the muscle, most doctors would say to quit icing it after a while, it slow the circulation in the area and slows healing. Hope this helps, if not you, someone else! :-) Anna

I'd like to second Greg's statement regarding chiropractors vs. orthopedic surgeons and other specialists. I think what you want in any kind of healer is someone who understands the injury, the psychology of the injured, and the best "first, do no harm" remedies for the condition. I interview lots of doctors for various articles I write for GQ, Modern Maturity, etc., and I've come to believe that sports injuries in particular need to be treated by someone who understands how important sports participation is to the injured athlete. I'm convinced that a good physical trainer, for instance, with expertise in specific sports, and who really understands how to rehab a wounded part, is likely going to do a much better job than a "top" orthopedic surgeon who makes the lion's share of his/her money from wielding the knife. I don't mean to be stereotyping here--plenty of orthopedic surgeons are athletes themselves, understand how important getting back in the pool is to us swimmers, and send their patients to rehab without knee-jerk surgery. Conversely, I suspect there are chiropractors out there who have not kept up with current trends in sports medicine/rehab, and apply a cookie cutter "manipulation" approach to all their patients. Greg has e-mailed me advice, and I am extremely grateful for this. If I lived in Knoxville, I wouldn't hesitate to consult with him about this injury because it is obvious that he understands swimming and could help me rehab my hip and return as quickly as possible to active participation. His academic credentials, in my opinion, are not the critical factor but rather his wholistic approach that emphasizes stretching and rehab.

Anna, I resent your statement that going to a chiropractor can make the situation worse. Whoever told you that, doesn't understand chiropractic (which is just about everybody). It is very tiresome to continue fighting the medical opinions about our profession that have been going on for over a hundred years. With the overload of criticism heaped on us over the years, if one percent of it was true, chiropractic would have disappeared long before now. I can't do anything about the few bad Doctors out there, but there are incompetent people in every profession. Perhaps you've heard that surgeries occasionally get botched? Does that mean that nobody should ever have a surgical procedure done, because you can die? In reality, that is more true than your original statement about chiropractic. My apologies to the rest of you. I would have replied directly to Anna, but her profile didn't allow for her to receive e-mails in that manner. Dr. G

I'm neither an MD nor a chiropractor. But I have loads of observational experience with swimmers who've been to one, the other or both. From that experience I can confidently state that chiropractors do NOT have the market cornered on ineffective, detrimental or inappropriate treatment. By and large, the experiences my swimmers have had with chiropractors has been very positive. In addition, the general consensus is that they seem to be better "tuned-in" to the needs of athletes than is your average MD - though certainly there are many exceptions, on both sides. I also perceive that the incidence of MDs giving poor advice or treatment (at least from the athlete's, coach's or PT's viewpoint) isn't any less than that of chiropractor's giving poor advice or treatment How all this relates to the specific topic of hip replacement I cannot say, as I've no knowledge or experience in that area. But I'd be no more inclined to dismiss chiropractor care or advice in this area than I would that of an MD.

Apparently some people either mistook what I said before or read more into it than was actually there. I never said anything negative about chiropractic care. I stated that for the injury I had, it would not be a good idea. Emphasis on the injury I had. Many of my friends suggested I go to a chiropractor to have him/her re-adjust my hip and put it back in place after it had dislocated (which I was able to do myself anyway). If I had done that, the problem would have re-occurred a couple of hours later (just as it did when I adjusted it myself) or the next day if I was lucky. Everytime it dislocated and had to be adjusted, it wore at the ligaments and bone in my hip. I needed the care of someone who would help me rehabilitate my hip, not bandage the problem with a quick fix. My friends go to some of the best chiropractors in the area, but none of them have ever been given advice for rehabilitation of their injuries and therefore, they keep going back for adjustments and will have to do this forever since they aren't healing the root of their problems. If they are content with that, it's their choice. Here's another way to look at. If every time you raised your arm to wave at someone, your shoulder became dislocated, what would you do? You'd realize immediately that something was wrong and you wouldn't be satisfied to adjust it and wait for it to happen again and again. Most people would probably go to a physician, maybe get an x-ray. Well, that's what happened to me. Just walking across the room, my hip would become dislocated, it was very evident and very painful. Greg, There was no need to get so defensive about my remarks. I did not attack you personally, or your profession. I simply stated that chiropractic care was not the appropriate approach for my injury. If you truly do focus on rehabilitation, then you are way ahead of your colleagues in my area. I have never known anyone to have received long term results, or even advice for long term results, for their injuries from a chiropractor around here. They all have to keep going back, years later, and their problems are just as bad as when the injuries occurred. All the criticism out there comes from somewhere, much of it from people who've had bad, or simply worthless, experiences with chiropractors. Many professions get a bad reputation because of a few underqualified and careless people, you have to prove yourself and overcome those things. I'm sure it does get tiring, but unfortunately, it comes with the territory when you work in a profession that is still trying to prove itself, even after all these years. I would have much more respect for, and faith in, chiropractors if more of them took a whollistic approach to healing, not just bandaging, and even one person I knew saw long term results from chiropractic care.

I have gained many long-term benefits from my chiropractor. He has helped me rehab through both a shoulder and a hip injury ... to the point where these bother me no longer. He suggested various muscle-strengthening exercises, in and out of the pool, appropriate supplements of magnesium both at critical times and for ongoing muscle maintenance. He did adjust my hip back into place with that injury ... ONCE. And it has stayed there. With the shoulder discomfort he repeatedly adjusted my neck ... but the adjustments became less dramatic and my range of motion continually increased and is sustained. Anytime I visit him now is for some new problem ... unless I decide to go for a muscle relaxing tune-up ... about twice a year ... also to make sure I haven't unaligned something that could lead to injury. My chiropractor comes with a couple other benefits. He always does alot of deep muscle massage before any adjustment. Also, he used to be a competitive swimmer and coach ... so he knows what I'm doing with my body and often has great ideas for small ailments. I HIGHLY recommend a good chiropractor ... especially for those of us pushing our older bodies. It really helps to stay injury free ... and can greatly help any aggravation!

I think Anna is correct that she said nothing negative about chiropractors in her first post. Her second post, however, is a significant criticism of the profession, at least in her geographic area. Unfortunately, there are many professions and 'sciences' that have existed for hundreds, or thousands, of years, and still are not effective in what they claim to do. While some of you may disagree, I put in this category astrology (of all traditions), acupuncture, and homeopathy, among others. And dousing, and . . . Chiropracty has at least plausibility going for it. It will have to submit *all* of its practices to scientific study, much as western medicine is (trying) to do before I become a complete believer, however. My own limited experience with *both* chiropracters and orthopedic surgeons has been poor. I went to both trying to solve a sore lower back, and both took extensive xrays and identified a front-to-back misalignment in the lumbar vertebrae. One (the best surgeon in a large midwest teaching hospital) said it was congenital and may or may not be the cause of the bad back, but weakly recommended significant and debilitating surgery. Thank god I did not follow that advice. The other said the misalignment was definitely the cause of the problem, and proceded to make me so sore that I had another spasm the next day and was in bed (painfully) for several days afterword. Neither did the obvious and responsible thing and take a personal history, with the intent to identify behaviors that could have been aggravating my back. It was only six years later, while wondering why I had not had a sore back in all that time, that I realized what the problem had been. I'm sure there are both chiropractors and orthopedic surgeons that could have and can have identified the cause and suggested a simple solution, but the title to this post is the lesson for everyone to pay attention to.

Hi Jim, your post wound up generating a lot of heated discussion around the merits of chiropractic medicine...I'm a teacher, so I know first hand about trying to validate a profession... But about your comment: Any tips on how to handle the psychodynamics of being out of the water? I know there must be other swimming addicts whose heads say "rest" but whose hearts long to be back in the water. Yup, it's a bummer, but listen to your head...make yourself better, not more injured...here's some thoughts passed on to me by my coach when I've been laid up: 1. accept it. use the time to get caught up on other areas of your life (bills, writing Christmas thank yous, time with your friends, etc.) 2. know that an injury or illness is not a reflection of you as a swimmer, athlete, person, etc....you just got tagged by some bad luck. Better luck is bound to be around the corner. 3. can't swim? exercise what you can...arms, lats, abs...do some weight training. Also, focus on daily stretching. I mean, just how streamline is the average master coming off the wall? We could all use a bit more flexibility. (Laura Val not included, obviously...) 4. Volunteer on deck, if you can...if not coaching stroke technique, how about videotaping people's stokes, or recording splits in long distance swims...besides being a nice helpful guy, you'll get to breathe in that nice chlorine smell... Anyway, hope this helps and that you get well soon. Lexa