A Karateka’s Life After Double Hip Replacement Surgery

Karate After Double Hip Replacement

2006

In the Japanese language, there is a term known as “gaman” which loosely translates as “to endure, no matter what” or “to work at your best potential even if you don’t enjoy your work.” These are just two examples of gaman’s many interpretations but in karate, it refers to the training attitude of “never quit.” Those who train for a long time in the martial arts and truely love it, will suffer through the jammed fingers, pulled muscles, broken toes and continue to train regardless of injury or pain. It is what we do, it is the path we have chosen and the one that we love to travel.

Demonstrating kata at a Christmas tournament December 2002. Notice the knee position in this shiko dachi due to collapsed hips

When I began karate as a teenager, I was a soccer player and my leg muscles were not the most flexible to begin with. I struggled with flexiblity but through the years, I wrestled my way through stretching and acheived above average range of motion. In 1994, I began to notice increasing pain in my hip flexors, lower back and a decrease in flexibility. As the pain progressed, I started visiting chiropractic clinics and physical therapists who all told me that I was pulling muscles and because of my busy schedule teaching karate, not allowing them time to heal. So, through stupidity or ‘gaman”, I rested(a little) and went right back to training, dealing with the pain as training had taught me.

The pain continued to grow and my frustration level grew as my stances, kicks and kata began to suffer from my condition. Not only was the pain a hurdle, but my emotional state was equally hard. Karate was my life and training below a certain level was not an option. I was no longer able to demonstrate kicking techniques and I could not perform kata at a level that would be expected.

Advice from seniors

As pain worsened, I asked the advise of Kyoshi Chris Estes, nanadan/7th dan Shorin-Ryu Shorinkan who is a well-known surgeon in North Carolina. After many conversations, he became quite concerned about the progression of pain and lack of flexibility and suggested to get MRI or x-rays and find out the true problem.

The second nudge came from karate legend Bill Wallace. Mr. Wallace was staying with Lorie and I for the weekend while we were hosting him for one of his great seminars on kicking and stretching. On Sunday morning, the two of us sat on our living room floor going through his daily stretching routine and after we were finished, I asked him to give me his thought on my condition. Like Dr. Estes, Bill believed that there was something very wrong with the position of my hips and the amount of pain that I experienced in certain movements.

Bill himself had both of his hips replaced and still can land jodan mawashi geri before most of us can blink and he told me that he was not asking me, he was telling me to go to an orthopedic surgeon in order to get right to the problem. Two weeks after Bill left us, I went to one of the more well-known names in Williamsburg for orthopedic surgery to find out what was wrong.

Bill Wallace with John, Emily and Madison Spence 2002 – Bill “Superfoot” Wallace- a double hip replacement recipient

After my inital x-ray, this particular surgeon told me my worst fears as a martial artist. Both of my hips had severe necrosis and that both hips would eventually have to be replaced. To make matters worse, his words were:

“Karate is over. You will never be able to do it again. Take pride in knowing that you can still teach others but your “career” is over in the martial arts.”

After almost 18 years of Shorin-Ryu karate, this was news that I would never forget and never get over. One of my close friends Scott Cormier worked at the Medical College of Virginia in Richmond and urged me not to make decisions on this diagnosis and told me to seek a second opinion at MCV, where incredible steps were being made in knee and hip surgery.

Dr. John Cardea, the Superman of Orthopedics

Lorie and I loved Dr. John Cardea the moment we met him. Aside from being one of the leading experts in hip replacement surgery, Dr. Cardea is also a Marine and a Shotokan Karateka. With one look at my x-rays, he determined that I had severe necrosis of my femur heads, no cartilage left in my hip joints, collapsed femur heads and that I had been training for around two to three years like this based on the scar tissue.

After a short discussion, Dr. Cardea became enraged when I told him the diagnosis from the first doctors’s visit in Williamsburg. He assured me that I would get right back to training and my hips would not be 100% but 80% which was still great. Dr. Cardea has worked with instructors from the New York Chamber Ballet and I felt a great deal of comfort knowing that he makes great efforts to get people back into their activities rather than putting a band aid on things. “I know what your hips need to do, so just trust me.” Said Dr. Cardea. After a little prodding, Dr. Cardea honored my request to have both hips replaced at the same time because of my age and health. (I did not want to go through this operation twice.)

MCV is the “best of the best” and every person from Dr. Cardea to the nurses took my surgery and recovery so seriously that you would have thought that I was a relative of going through this.

Long Story- Short

1) I was up walking on crutches the day after surgery and spend a month in Tokyo three months after surgery.

2) I am just now(three years later) starting to feel the muscles lock in and I am more flexible than I have ever been in my life. I was instantly more flexible after surgery but it has taken hours of performing movements, kicks and kata SLOWLY to build muscles back.

3) The hips that I received are titanium and only the liner of the hip socket will have to be replaced in around 15 to 20 years.

4) I am training like I was a teenager however the days of kicking a makiwara or heavy bag are over.

5) Dr. Cardea designed the hips so that my flexiblilty and range of motion would be extraordinary.

6) I had a tremendous amount of atrophy to my stomach and leg muscles but constant training and work have built them back up. It has to be a daily routine.To any karateka, this is not a problem.

7) I had 100% bone growth one year after surgery. (I took Okinawan Coral Calcium religiously after surgery)

8) I owe half of my thanks to my incredible surgeon but the other half goes to my beautiful wife, Lorie, who helped me daily through recovery and gave me the strength to push on.

Conclusion

If any martial artists or athletes are reading this, life is great after hip replacement. Despite the ugly picture this surgery paints, I am able to do things that I couldn’t in my teenage years. I am more flexible than most of my students and I am more happy than ever. Don’t give up hope. For those of you that have this as a looming possiblity in your future, the words “hip replacement” sounds a lot worse than it really is. However, going through airport security can be difficult!

John Spence after double hip replacement surgery