Your hips do not come with a set number of miles

Feel-good Friday

Two summers ago, a man at the hardware store in Camden told me I only had so many miles left in my hips.

I was there to buy a heating pad. My back had just given out on the dock, and I walked like a man with a pane of glass on his head. He meant it kindly. Joints, he said, are like tires. Each one has so much tread, and every mile you walk wears a bit of it off. So save them.

I believed him. It made sense to a man who spent thirty years thinking about things that wear out. For a few weeks I cut my walk on the harbor road in half. My back got stiffer. So did my hips. Carol saw it before I did.

So this week, with the whole issue given over to hips, I went to look for the tire. I wanted to know if anyone had ever counted the miles. Someone had… quite a lot of someones.

The tire idea

The idea has an old name. Doctors used to call hip arthritis "wear and tear." The kind they mean is osteoarthritis. That is when the smooth pad on the ends of the bones thins and gets rough. The pad is called cartilage. It is the slick, rubbery layer that lets the ball of your hip glide in its socket.

If cartilage wears like tread, then every step should cost you some. And the people who take the most steps should have the worst hips. That is a fair test. It is also one you can check. Runners pound their hips far harder than walkers do. If miles wear out hips, runners should be first in line for new ones.

Then somebody counted

In 2017, a team of surgeons and researchers pooled the results of 17 studies. Together they took in 114,829 people. The work came out in the Journal of Orthopaedic and Sports Physical Therapy, a journal for the people who treat joints. The team split people into three groups. Casual runners. Elite runners, the ones who raced at the top level. And people who did not run at all.

Here is what they found. Of the casual runners, 3.5 in 100 had arthritis of the hip or knee. For people who did not run, it was 10.2 in 100. And for the elite runners… 13.3 in 100. In other words, the casual runners had about a third as much arthritis as the people who sat still.

The elite runners did worst. So there may be a limit. Years of hard racing at the top is not the same as a jog round the block. But few of us are at risk of that. I am not.

A second study looked at walkers too. Paul Williams, a scientist at a US government lab in Berkeley, followed 74,752 runners for about seven years. He also followed 14,625 walkers for close to six. The results came out in 2013, in a journal of the American College of Sports Medicine. Those who ran or walked more were less likely to report arthritis. They were less likely to report a new hip, too. And the walkers gained about as much as the runners.

The honest half

Bear in mind what these studies are. No one was told by chance to run or to sit. The teams just looked at people who already did one or the other. So they can show a link. They cannot prove the running did the good. The 2017 team said so plainly. They could not rule out other things… an old injury, say, that might keep some people off their feet.

Weight is part of it too. Runners and walkers tend to weigh less, and extra pounds are hard on a hip. In the 2013 study, much of the gap shrank once weight was taken into account. Or put another way, part of what walking does for your hips may be what it does for your belt.

So I won't tell you that walking will guard your hips. I can't prove that. What I can tell you is the thing I went to find. No one found the tire. The people who used their hips the most did not wear them out first.

Versus Arthritis, the big British arthritis charity, puts it this way. Osteoarthritis is not simply wear and tear. When cartilage gets hurt, the whole joint gets busy trying to fix it. That repair can change the shape of the joint and still leave it working well, with no pain. They add that too much rest can make a joint stiffer.

That last part I can vouch for. When I went back to the full harbor road, my hips loosened up in a week or two. My back took longer… but it went the same way.

That was the week

Monday, the side leg raise. It works the glute med, the muscle on the side of your hip that keeps your pelvis level as you walk. A 2025 Cochrane review found exercise eases hip arthritis pain by about 7 points out of 100. Small. But real.

Tuesday, where your hip joint sits. It is deep in the front crease of your groin, not at the bony knob on the side. Pain on the outside is most often a sore tendon, not a worn joint. And it is not usually bursitis, whatever the old name says.

Wednesday, the cane. Held in the hand on the other side from the sore hip, it cut walking pain from 42 to 26 out of 100 in a small study of 27 people. Thursday, a pillow between the knees for side sleepers with pain on the outside of the hip. That came from the LEAP trial of 204 people.

Here is how the week adds up. Move your hips, and move them often. Use a cane if it helps, and a pillow at night. And the next time someone tells you to save your hips, you can tell him that no one ever found the tire.

I still walk the harbor road. Most mornings, both ways. Carol comes too when it isn't raining… and she walks faster than I do.

Here is to a few more miles on the harbor road,
Walt

The Health Brief is for education only. It is not medical advice. Always check with your own doctor about your own situation.