Recently there has been some mention of sore hips, knees, aging joints etc.  and what follows is nothing more than my opinion based on my own experiences.

I had a massive medial meniscus cartilage tear at age 21 from simply stepping up onto a table. No scope procedures were being done yet, so they opened it up and removed what they felt was needed. Mistake #1   Hospitalized for 5 days and walked with a noticeable limp for the next 30 years. Mistake #2

In those days you typically had to be 70 plus years old to have a replacement because the life of the mechanical joint was either short or unknown.  They always worried about how many “revisions” could be done within the patient’s lifespan.

That has all changed.  I had the knee with previously torn cartilage replaced at age 52, mostly because the Doc pointed out the ongoing damage occurring to both hips from the fouled up gait I had developed over 3 decades.  Now they can replace the sacrificial polyethylene puck within the new joint and complete revisions can be done several times, so they are willing to do them at much younger ages.  Now at 60 my hips no longer bother me unless I have really abused them.

Most of us are inclined to wait as long as we can and keep using the original equipment until utter failure occurs.  I believe that is a mistake because of the collateral damage to other joints involved in walking.  I also had two joints replaced in my feet because I was too stubborn to have a lesser preventative surgery at an earlier date. Mistake #3

Steroid injections twice per year 2 weeks out from canoe trips  bought me some time for several years and Hyaluronic Acid injections work well for some people, but all are just stop-gap measures.

As to the use of exercise to help the joint pain, it absolutely does help because if the attending muscles are strong the joint is more stable and less likely to “give out” unexpectedly.  The joint replacement physicians will always recommend months of exercise to build the muscles up prior to surgery to shorten rehab.  The majority of rehab is nothing more than forcing flexibility back in the joint AHEAD of the scar tissue that WILL develop. It is always unpleasant, more so if you do not get right after it.

Standard disclaimer here.  My opinions are for entertainment purposes only and not to be construed as medical advice.

Consult your own physician, but do it sooner rather than later.

MossBack

  Good stuff MB and if you do some research you'll find your "entertainment" advice is what many experts tell you.

  I have a good friend that treats these type injuries with "alternative/non-invasive" means for those who don't want surgery/lengthy rehab or had surgery one limb and are not pleased with the outcome?

Everyone is different and it's important to hear about the NEGATIVE experinces as well as the positive one's before you undergo ELECTIVE surgery.

My friend told me that his patients that don't want to do another replacement type surgery said the RE-HAB after surgery was what turned them off, all saying the pain involved was more than they could handle to get the optimum results.

He has one patient a lady on her 50's who's a competitive marathon runner. She had one knee replacement and they told her she needed the other one done too.

  She balked, found my friend and now her REAL knee feels better than the new one.

In any case, the key is to get yourself looked at by an expert, see your options before surgery IS your only option.

Thanks for the good info Mossback.  I stay in relatively good shape bc of the job I do.  Over the winter I don't work nearly as much and get out of shape very easily.  It's then very painful to build the muscles back up and my goal now is to never let myself go more than 2 days without some kind of workout.  A week off and doing nothing and I am toast.

MossBack wrote on Jul 7^th, 2017 at 7:34pm:

Most of us are inclined to wait as long as we can and keep using the original equipment until utter failure occurs.  I believe that is a mistake because of the collateral damage to other joints involved in walking.  MossBack

This is probably a valid observation... and an issue I struggle with right now.  I don't believe it is just "happenstance" that I started having hip issues shortly after coming off of back fusion surgery.

So I have one doctor saying I can move forward with hip replacement because I am bone-on-bone and it's not going to get any better.  Yet another doctor recommends I wait until I can stand the pain no longer before having surgery.  His reasoning?  My active lifestyle (in gym everyday, 2-3 wilderness canoe trips each year) would probably result in ANOTHER hip surgery within 10 years (ie. the NEW equipment will fail, predictably).  He suggests I avoid surgery until my appetite for rigorous activity diminishes.  He likened me to a "beat up Dodge Caravan."  "Why not just keep driving the danged thing into the ground?  You can't hurt it."

Well, maybe he's wrong.  My fear is that Mossback may be right-on-the-money with his notion of "collateral damage."

Here's what I know: 1) aging sucks, and 2) my appetite for this stuff is unlikely to diminish anytime soon.

So, while I ponder the "collateral damage" theory, my strategy will likely remain: a) exercise greater care about my routing AND b) recruit more strong, young backs for my more aggressive planned trips.

Jimbo   8-)

Jimbo wrote on Jul 8^th, 2017 at 10:15am:

MossBack wrote on Jul 7th, 2017 at 7:34pm: Most of us are inclined to wait as long as we can and keep using the original equipment until utter failure occurs.  I believe that is a mistake because of the collateral damage to other joints involved in walking.  MossBack This is probably a valid observation... and an issue I struggle with right now.  I don't believe it is just "happenstance" that I started having hip issues shortly after coming off of back fusion surgery. So I have one doctor saying I can move forward with hip replacement because I am bone-on-bone and it's not going to get any better.  Yet another doctor recommends I wait until I can stand the pain no longer before having surgery.  His reasoning?  My active lifestyle (in gym everyday, 2-3 wilderness canoe trips each year) would probably result in ANOTHER hip surgery within 10 years (ie. the NEW equipment will fail, predictably).  He suggests I avoid surgery until my appetite for rigorous activity diminishes.  He likened me to a "beat up Dodge Caravan."  "Why not just keep driving the danged thing into the ground?  You can't hurt it." Well, maybe he's wrong.  My fear is that Mossback may be right-on-the-money with his notion of "collateral damage." Here's what I know: 1) aging sucks, and 2) my appetite for this stuff is unlikely to diminish anytime soon. So, while I ponder the "collateral damage" theory, my strategy will likely remain: a) exercise greater care about my routing AND b) recruit more strong, young backs for my more aggressive planned trips. Jimbo   8-)

JIM I AM OVER 70 AND YOU’RE PLANNING A TRIP WITH ME!! There ant no young strong back here.

Quote:

There ant no young strong back here.

Being over 70 and doing the kind of trips you do means you have something that's even MORE important than a strong back, you have a STRONG mind/will.

I'll take THAT over a strong back without the will to use it.  ;) ;D ;D

Hey MB, I have to second your opinion and also add that that is mostly because of my own experience.  I had very serious congenital hip problems that began manifesting in earnest when I was a mere pup (35.)  From that time until I was 47 things got so bad that I could barely get my socks on by myself.  Needless to say there was no canoeing or tripping, something I had done and loved from the time I was 9 years old.  The added shame of it was that my wife had also been very much into canoeing and backcountry tripping and in our first 20 years together we never even talked about it much less shared the experience.  When I was 55 I had my second hip replaced.  Three months later my wife and I were out hiking in Algonquin Park and realized we could paddled together.  We spent the next 4 years regaining our chops by renting a small ranger cabin in Algonquin, getting our equipment together and going on a few 4 and 5 day trips from the cabin.  The rest, as they say, is history.  We'll be heading out August 1st for our 7th, month long jaunt in the remote Ontario Northwest.  I feel younger, fitter and happier now at 66 than ever I did when I was 40.  Degrading joints not only affect and limit us physically, they also have a huge emotional impact.  Speaking for myself, I was becoming increasingly irritable and bitter without even realizing it.  I have not been a big fan of Western medicine but when it comes to joint replacement surgery it can perform miracles.  I am told that one of these years, maybe sooner or later, I will have to have my aortal valve replaced (again, a congenital malformation.)  Forty years ago that would have been a 50-50 proposition.  Now ... well it's still open heart surgery but the success rate is phenomenal.  I feel blessed to live at a time when this is true.  My advice to anyone over 50 - go get your hips replaced. Whether you need it or not, you'll feel like a million bucks ... just kidding!!

I haven't tripped in three years with back/hip issues. I feel like I need to re-think this and get back out there and do the best I can. I do miss it.

The intent of my original posting was to encourage those with “Arthur” problems to not make the same mistakes  I did.  Postponing the inevitable to the point of causing more damage to other joints.

Joint replacement surgery, or any surgery for that matter, is a very personal decision and I do not intend to mettle in other’s affairs.  Only to relate what I believe my own mistakes were.

Looking forward to a yearly canoe trip or two is what keeps me walking stairs, being conscious of my weight and what I eat, and a myriad of other bad habits I would rather be enjoying.

When I cross paths in the woods with someone 10 or 20 years older than I am, still there and doing it in style, I am in awe and inspired.  Last year, on the upper end of Kawnipi I found a 3 generation family walking the portage.  The elder was 86 and his stride would make anyone proud.  I hope to be him someday.

Jimbo,  you mentioned conflicting opinions from your Dr.’s.  That is all too common.  They are human and often driven by different desires.  Some to heal and help and some by cash flow. They are capable of encouraging unreasonable caution with their handiwork so their outcome statistics look better, even if it is at the cost of lifestyle to the patient.

I decided some time ago that many Dr.’s form an opinion of the patient’s ailment within the first 30 seconds of discussion and never hear anything else you say beyond that point.  Before I had my knee replaced I got two opinions, just like most people do.  But to short circuit the 30 second opinion habit, I took visual aids.  A single page with 12 smaller photos of things I explained to the Dr.’s I had to be able to do after the replacement.  A firewood pile, stiff clutches in vintage vehicles and farm equipment (left leg), my knees folded up and legs crossed in the stern of a canoe, a steep rock garden portage’ trail with a heavy pack, and so on.  One Dr. said no to 4 or 5 of the photos.  The other asked if I did any of those 12 things as my daily occupation for 8 hours per day. When I replied “no” he said I should be able to enjoy all those activities for the rest of my life. 

He got the job. 

My only lifelong restriction was not to use a treadmill, stairclimber or any other daily exercise machine that loads and unloads the joint.  He recommends an elliptical machine.  Hips may be different?

All of us who are a bit long in the tooth will hit that wall at some point in the not too distant future.  Ceasing to do what we love and need before we simply can’t do it anymore seems akin to giving up and sitting around waiting for the grim reaper to have his way with us without a fight.

Standard apologies if I ricocheted off into the weeds to far on this one.

Regards,

MossBack   

I have had my joint problems also. 25 years ago I had a noticeable limp most of the time because of knee pain.  I was taking antihistamines for chronic hives.  I found that after being off the antihistamines for a year my knee pain went away. 2 years ago I took Mucines for a sinus infection.  It worked great on clearing the congestion and the infection went away BUT it took 6 months for the knee problems to go almost away.

MP,
You bring up a point that many people overlook and that is the side effects of taking medicine.

Everything you take, especially artificial medicines have a side effect. Some minor and some not so much.

There is a reason they print those "possible" side effects in lettering you need a magnifying class to read and most people don't bother too.

  Often the "cure" has worse long-term effects than the initial problem.

  One of the great things about GOOGLE is you can by-pass the doctors who may or may not be driven by what's best for you and get info about ANYTHING on-line.

I've been lucky and with some effort on my part, I don't take ANY prescription medicine and have zero physical/joint ailments.

Most people I know are not so lucky. I have friends and family that are on the prescription medicine/surgery lotto wheel and it seems like they get one problem medicated/surgery and another one pops up to take its place.

I advise everyone before they start a prescription drug ( long term especially or have elective surgery) to GOOGLE the NEGATIVE SIDE EFFECTS and long-term outcomes compared to NOT taking prescription meds/surgery compared to alternative ones.

Often, more than people know the difference is very small. If you factor in the quality of life, sometimes depending on the individual it's not worth it.

Not knocking prescription medicine/surgery, just saying KNOW the NEGATIVE side of them so you can ask your Doctor the RIGHT questions before you start down that road.

Hip pain has been mentioned.  I can make it worse. That has made it possible to make it better. If my pack touches my rump mussel my hips will hurt. Last month near the end of the 2 mile bushwhack from the beaver dam to the Wawiag my hips started to hurt.  I put my hand between my pack and the small of my back and after a while it relived the hip pain.  If I use a hip belt it pulls the pack against my rump and the hip pain soon comes on strong.  A good framed back pack does not do this but portage packs are NOT good framed packs. 
The more expensive portage packs have load lifter straps.  As you tighten them they make the pack load slide down on your rump. I call them discomfort straps.  If your pack is too comfortable just pull them a little tighter. They are meant to keep the pack against your back when you have the load supported from the bottom with a good hip belt which requires a good frame which a portage pack does not have.
If your hips hurt on portages while carrying a pack and not the canoe something is wrong with your pack.
I carry a old Woods Mason pack (one of the cheapest pack on the market) and I sold my Copia bought high dollar pack because the Woods mason pack carries better. 

I guess I'm becoming more of an expert on the subject than I ever wanted to but...

Just finished my first trip in 3 years a couple days ago and did so with one new knee (replaced in February) and one knee that's scheduled for replacement 1 month from today. Might as well send the original equipment out in a blaze of glory, amirite?

Once you hit bone on bone, all the non-traditional treatments are going to fail to provide long-term relief. I know; I tried.  Over the past 3 years my weight has ballooned by 30 lbs. Most of it is due to exercise simply being too painful to do on a regular basis. 1 session of moderate exercise (on an elliptical, no less) followed by 3+ days of pain. I won't lay *all* the blame on my knee...life got pretty busy too, but weight gain plus arthritic knees is a pretty crappy combo platter.

I've taken off a few pounds now that one knee works well. I'm eager for the 2nd surgery and the rehab is not overly difficult to accomplish. I feel I can start getting back down to a much better weight as soon as I get a couple months past the 2nd knee replacement. At least I'll know that if I don't, it's my fault and not my knees fault.

My replaced knee passed the canoe trip test with flying colors.  It really felt good the entire time, no matter the load or the stress.  The other knee is still attached to my body which is about the nicest thing I can say about it.

I'll echo what others have said:  I found myself wasting 3 years of my life by trying to avoid what needed to be done and I was in nearly constant pain and it severely limited my activity level. I'm much happier since I got on a plan to fix the problem and my appetite for physical activity is returning. I'm eager to be able to go full-bore once again in just a couple months and I regret having stalled on getting the problem fixed.

I will add my two cents.  In 1975, at age 24, I blew out my right knee trying to do a 360 while down hill skiing.  I never sought any treatment, but after my skiing accident, my right knee would pop out when I played football, basketball, racket ball.  When MRIs were invented I found out that my ACL was gone.  I opted to stop doing the sports I used to love because my knee just wouldn't take it.  I kept my weight off and rode bike to keep my muscles strong.  Keeping my muscles strong worked as far as keeping my knee from dislocating, but eventually I got bone on bone in my right knee.  Favoring my right knee eventually made my LEFT Achilles Tendon very sore.  I had p.t. for my tendon, but was advised until your right knee is fixed your tendon will continue to be inflamed.  Eventually just walking became painful and difficult.  In March 2013, at age 62 I had a total right knee replacement.  The rehab took several months and had some pain and discomfort associated with it.  During peak rehab I was spending 5 hours plus per day.  In four months I was better than before knee surgery.  I don't recall rehab being all that painful, but it was time consuming.  While rehab was unpleasant, my life was already affected because of my knee pain.  Four plus years later my right knee is great and I don't have any regrets at all relative to my decision.  If anything, I should have had the knee replacement sooner.

this is a good thread. i've have had reoccurring issues with L5-L6/hip pain down thru the years and esp lately. without regular stretching i'm toast and an inversion table also has helped.
by all appearances my new-ish granite gear pack is nearly identical to my old superior one packs but the gg isn't nearly as comfortable. cinching the load lifters on the superior one seems to help a lot.

After reading this thread, I'm thinking that instead of a Bushwacker's Jamboree, we should have a Jamboree of everyone with repaired, refurbished or replaced parts!

I suggest the south end of Louisa, so we can take frequent advantage of the healing waters of the Louisa Falls jacuzzi  ;D  8-)

But seriously, this has been an excellent thread with some good solid advice.
ml

My Dad had a total knee about 2 years ago. He checked with all his buddies that had the surgery as he knew a few did not do that well...although all said they were better. The one's that didn't have as good of an outcome stressed doing the PT and to take it seriously unlike what they did, a few months of work results in the rest of a lifetime of a better knee. So he hit the rehab running, he was walking normal at 2 weeks and could hike 4 miles at a fast pace within a year.

I just went fishing with him and he was squatting and kneeling in the boat with no pain. He moves like he is 15 years younger. His only regret is he thinks he waited 3 years too many---should have done it sooner.

He worked extremely hard and I think he had some luck as he didn't really have much swelling so not everyone will have that fast of a result. He does need to do light exercise daily like walking or squats or else the knee stiffens up but before surgery he couldn't even do those things so that is a positive in his book.

Before my Dad did the surgery I looked at the statistics and they continue to improve. 95% of patients in the US are satisfied with their result, of course that means nothing to you if you are in the 5% but I'd take those odds especially if nothing else is working.

Based on my own experience, my ortho and pt person, the main thing for a good result is that the patient takes rehab very seriously and starts as soon as he can and works as hard as he can.  Also, the better shape you can be in prior to the surgery will help a lot.