FITNESS : Dear Doc; YOUR HEALTH AND FITNESS MAILBAG.

GOT a sports injury or general fitness problem? Don't suffer in silence. Drop John a line at: Dr John MacLean, Hampden Park, Glasgow G42 9ED or e-mail him at info@ sportsmedicinecentre.org Q. I am a 50-year-old male who has ran four half-marathons each year for the last 20 years and played a lot of squash. After an X-ray I have been told I have excessive wear and tear in my right hip and, although I need a hip replacement, was told I am too young!

What are your views on hip replacement for someone my age and what are the do's and dont's for exercise now (pre-op) and the future (post-op)?

ALAN BAIRD, MIDLOTHIAN

A. You have Osteoarthritis (OA) of your hip. There has been much debate about whether exercise causes OA but the consensus is that in general it does not despite your high weight-bearing activities like road running.

Hip replacement is one of modern medicine's major advances and has dramatically improved the quality of life of those with the pain and immobility of a damaged hip.

In general a new hip will last at least 10 years, possibly quite a bit longer. So surgeons are reluctant to replace hips in younger patients because repeated surgery is more complicated and possibly less successful.

Like you, many people with arthritis ask about the role of exercise. Though certain forms may be painful it can offer many benefits including an improved range of movement, increased stability and muscle strength. Exercise also increases general well being, both physical and mental.

So what type of exercise? You should plan to maintain or improve your muscle strength, balance and flexibility. Non-weight bearing exercise such as cycling and swimming are recommended but continued running on hard surfaces is not. However, remember to be as active as you can.

After hip replacement remember to exercise slowly at first, following your physiotherapist's advice plan. But there is no reason why you can't get back to more energetic exercise in time.

Q. Whenever I try to run any distance I get a sharp pain at the top of my leg in the groin. This becomes worse if I try to kick the ball with any power.

Any ideas? Could it be a hernia? WILLIE MELVILLE, FOOTBALLER

A. Injuries to the groin make up about five per cent of all sports injuries and are particularly common in football players (up to 25 per cent will report groin pain at some stage). This is due to the nature of the game which involves twisting and turning at speed.

The most common cause of groin pain is a strain which will produce discomfort as you describe but also be painful when you lie on your back, bend your knee up and try to let it fall sideways towards the ground.

You are correct to suspect a hernia, especially if the pain has persisted for a number of weeks. This is commonly known as a Sports Hernia.

This type of hernia is over the groin and discomfort may spread to the testicles. It is usually aggravated by sudden movement and coughing or sneezing. It is often worse first thing in the morning, making getting out of bed painful.

An experienced sports physio or doctor will confirm the diagnosis.

If local therapy is unsuccessful, surgery is needed.

# The Sports Health and Injury Clinic is backed by the SFA and Glasgow's three main universities.

It is open seven days to people who take part in competitive sport, exercise for fun or who just need advice or physiotherapy. Contact them on: 0141 616 6161.