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Before the hip went bad

I was an active martial artist. I was living in Heidelberg, Germany (a truly lovely) place and yes the German song has it right that you can lose your heart there. I was working as a contractor for the military during the evenings which financed my pursuing a Doctorate in Pure Mathematics.

I was training in my favorite martial art, jujutsu and doing lots of conditioning. This consisted mostly of running in the lovely mountains around the city (especially on the mountain called the Heiligenberg). About 1995 - 1996 I noticed some pain in the right hip. I was hale and hearty and chalked it up to a common ailment of mountain runners, iliopsoas bursitis. Ominously, my sports medicine book stated that the symptoms were the same as for hip arthritis and only a trained physician could tell them apart.

The root cause of this was congenital hip dysplasia (CHD). Dysplasia refers to any developmental abnormality and really most folks have tiny ones. This is effectively random, rather than inherited and there is no clear cut understanding of its causes, just that people of northern European extraction have a slightly higher incidence of this. There are other types of dysplasia more prevalent in other ethnic groups. In my case, the ball of the right hip was very slightly flattened, so that it rubbed. I knew the hip was a bit 'stiff' and noticed when I was very young that crossing my right leg over my left meant I couldn't quite get my thighs to touch completely. There was really never pain when I was younger and maybe if they'd known they could have taken some x-rays and detected it.

As the ball moved in the socket, it rubbed off the cartilage. Once that was gone I had bone on bone articulation (fancy word meaning the bones touch when they shouldn't). Arthritis is primarily a disease of inflammation. When bones grind on each other, there is only one way for the body to stabilize that; it makes the bones grow together into a single solid mass. If it cannot move, there can be no inflammation. Bone on bone articulation is astonishingly painful, and the growth of the bones is not orderly but based on what is inflammed. This is why people with untreated OA gradually twist into grotesque shapes.

As a martial artist, my performance was not really affected for the longest time. I mean I could do what I needed to. This made me far less inclined to get checked out than I should have been. If I can whack you in the head I'm ok, er, right? By the way, now I watch my martial arts students for alignment problems closely. If I encounter anyone who has potential structual problems, I always urge them to get a checkup. Yes, running accelerated this drastically, rather than my other activities. There is a real possibility that had I not been so avid, I might have made it to my 60's before knowing there was an issue. A lot of people end up in the same boat as I do. Finally, I made sure both my kids got really well checked out as babies for this, and there is no sign in either of them.

Back to the onset of the disease. I did notice that there was a lot of pain after running and that I limped badly most of the time, although if I concentrated I could walk fairly normally. One thing that sneaked up on me was that I was tending to be very inactive most of the time I was not training. Now I can look at that as pretty abnormal, but my life was slowly but surely shutting down before my eyes. I just had no frame of reference for something like this.

Always one to play rough, I injured my shoulder and went to a doctor for him to check it out. As I was lying on the examination table, he casually asked me if my hip was holding steady. Now, I'd never seen this doctor before, so I muttered that I really didn't understand the question. He repeated it and sure enough, my German was not at fault. He pointed out that I could not lay flat on the table, with my toes pointing at the ceiling. Try as I might, I just could not do it. I got it x-rayed right there and then. I could see the arthritic changes in the hip and the complete lack of cartilage. He told me I had to quit running. I did that week.

There is a quip that if a doctor tells a runner to quit, he gets a new doctor. Running was a very important part of my life and had been. I always ran on the mountain there and could count on being the first one in the mornings. One of may favorite runs was right after the first snowfall. I like to do cross country running, so I stayed on few paths. This allowed me to find various denizens of the forest. Most Germans were non-plused when I told them I'd seen foxes, boar (hate those, they're nasty), deer, marder (don't what they are called in English or even if we have a word for them), beaver and a whole slew of other things. Having my running days end, especially with an unrelentingly ghastly future was very difficult to deal with. I was no longer truly in control of my fate, but beset by something that was sweeping me along.

Here is something I found that I will pass along. It's just a philosophical aside. One should always strive for tragedy. A tragedy, in the classical sense, is not just a story with a sad ending, but one in which the outcome is certain from the beginning and the main character is better than what destroys him or her. Always strive to be greater than your foe. At the least, it bugs the Hell out of them, Seriously though, I found that all I could control was a bit of dignity.

The next couple of years saw me switching to swimming as my major activity. This is a fine thing to do, but it takes a good solid year of practice before you can get a workout that is anything remotely as taxing as running. If you are serious about swimming, take lessons. I also concentrated on my degree and got it cum laude and yes I'm proud of it. My dissertation was on complete minimal surfaces of genus 1.