Diving After Hip Replacement Surgery

A long-time, off-and-on, 68-year old diving buddy of mine has had hip replacement surgery on both sides. He is strictly an Openwater and Cavern diver. The last time that he went diving with me was in July 2004. Other than him being rusty and my desire to feel like a babysitter to him, is there any real concern about him having circulation problems or bubble trouble while diving? His orthopedic doctor has cleared him for diving. He has no known heart problems, but does have to monitor his blood-sugar every day.

How long ago was the surgery? Has he had any hip dislocations after surgery?

Mark

I agree,when was the surgery? When a hip replacement procedure is done the stabilization of the jont capsule is weakened and hip precautions of flexion beyond 90,crossing the legs (adduction beyond midline) are the main precautions,plus excessive rotation. If the physician has released the person to dive then the precautions are not an issue,but forceful movement could be a concern, I remember reading a case study of a diver on a boat in a high seas being rocked side to side,and a rogue wave caused him to double over with force,this caused a hip dislocation even though he was 5 years post-op. New studies have indicated greater muscle loss in some key hip muscles than orginally thought,and these muscles would play a role in frog kicking. Therefore a post-op strengthing program would be ideal beyond what is done in the first 6-8 weeks of hip surgery.

There is a good article in this months DAN magazine.

He definitely has some hip rotation problem and still walks with a limp. He had the surgery just before the Christmas holidays. Personally, I think his diving days are over, but he won't admit to that. He and I usually dive places such as Blue Grotto(Williston) and Paradise Spring(Belleview), which involves climbing up and down several steps.

From the DAN Medical FAQ's:

"The greatest concern for any type of exercise after hip replacement surgery is for the surgical site and bone to be completely healed. When your doctor releases you for full activity, and you are able to perform your exercise and daily living activities with full weight bearing and no difficulties, such as pain, swelling or stiffness, diving would probably be allowed.
There isn't much difference between the physical demand placed on your hip during a workout in the gym and during scuba diving. As long as the area has an adequate blood flow to help with the off-gassing of nitrogen, a problem is unlikely.

As with any type of injury and returning to diving, there is no guarantee that you will not have an injury to your hip. However, the greatest risk divers run is the amount of exposure (depth and time) they have to nitrogen. It might be wise to dive conservatively by not diving as deep, as long or as often when you return to diving. "

I would encourage him to go ahead and make the phone call to the DAN Medical Information Line, he may even get a local MD name to have his PMD consult with in regards to diving.

Dive safe,

Celia

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Originally Posted by CaptainSpeleo

He definitely has some hip rotation problem and still walks with a limp. He had the surgery just before the Christmas holidays. Personally, I think his diving days are over, but he won't admit to that. He and I usually dive places such as Blue Grotto(Williston) and Paradise Spring(Belleview), which involves climbing up and down several steps.

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If he walks with a limp chances is there is a lot of weakness in the gluteus medius muscles which is a hip abductor (movement out to the side),but it plays a role in trunk stabilization. Following hip replacement surgery there is a 40% muscle loss,and gaining as much strength as possible is important.

Had mine replaced at age 45, both sides one in 2000 and the other in 2001. No post op problems, I lost the needed 60 lbs and still have a few more to do. At age 50 I am very cautious about carrying my doubles but since surgery have made over 250 dives and over 125 of them are in the caves. I ride my bike at least three - five times a week and concentrate on keeping my glut medius muscle group in great shape as I think Kelly mentioned above. I am an old hockey player, always had a big butt and thighs so they were in good shape prior to surgery. I did quit teaching scuba as I did not want to be on a boat and have it pitch one way and me go the other and then not be able to dive. I very seldom do deco dives any longer than about a 30 min hang time and and usually only do one deco dive in any 24 hour period now. On a great note I still love to dive and have found that I see more now than before. I also don't do the deeper dives I used to. My replacements became necessary from nercrosis on one side and just plane wearing it out on the other. could be hockey related and also deco related. It was a toss up. Doing great now! Robohips

He's a real couch potato and king of his castle and is used to barking orders and having everything done for him. I've told him many times before that he needs to exercise and keep his stamina up, but it's like talking to a brick wall. Personally, I don't believe that he can't handle any kind of diving anymore, but he's going to have to find that out for himself.

I go in for mine a week from tomorrow, not sure when he is planning to do the second one as they are both shot. The doc told me the big thing I would have to be mindful of is the artificial joint is going to be a lot easier to dislocate, so I will need to be mindful of my flexion patterns. In talking to Kelly this past weekend he has me thinking I may want to look into altering my finning technique when I return to avoid problerms like I encountered while trying to kick out oF the flow Saturday (tearful ouch on that one.) I asked about depth limitations when we discussed the surgery and the ortho did not think it would be a major problem provided everything healed satisfactorily. Looks like everything is going to hing on a good rehab program following the surgery.

DeWayne:

Good luck with your surgery. If it's anything like my buddy went through, you'll be in the hospital for a few days, then you'll have a few weeks of physical therapy. He had them done one at a time a few months apart, so it laid him up for almost a year. Hopefully, it won't keep you from diving for more than 2 - 3 months.

Frank

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Originally Posted by CaptainSpeleo

DeWayne:

Good luck with your surgery. If it's anything like my buddy went through, you'll be in the hospital for a few days, then you'll have a few weeks of physical therapy. He had them done one at a time a few months apart, so it laid him up for almost a year. Hopefully, it won't keep you from diving for more than 2 - 3 months.

Frank

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Thanks Frank, I like your outlook better than the doc's as he was targeting 5-6 months (he has not had the chance to get to know me yet though.) Hospitals and rehab have become second nature to me since '97, so I am just viewing it as a minor set back and know that it will be worth the trouble once I have healed and returned to a much improved version of life. I hope your friend can renew his interest in diving as well, 68 is much to young these days to have to pack it in.

If my back and knees and eyes can hold out, I'll be cave diving for several more years, although I'll need to cut back on the more brutal dives. I just made my 60th birthday celebration dives in November. Now, I'm working towards my 65th. :-D

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Originally Posted by CaptainSpeleo

If my back and knees and eyes can hold out, I'll be cave diving for several more years, although I'll need to cut back on the more brutal dives. I just made my 60th birthday celebration dives in November. Now, I'm working towards my 65th. :-D

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That is great news,I'd like to know your secrets. Maybe Ginnie will offer senior discounts when I reach that point.

I haven't made a dive at Ginnie in about 3 years. There's too many other less brutal places to dive, and without having to use a stage bottle and scooter.