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Ankur Warikoo gets six-pack abs at 44: How he ran marathons, got back from hip injury

Any rehab plan involves muscle-strengthening, says orthopaedic surgeon

Ankur Warikoo details his fitness journey (Photo/AnkurWarikoo.com)Ankur Warikoo details his fitness journey (Photo/AnkurWarikoo.com)

Entrepreneur and content creator Ankur Warikoo has taken to Instagram to document a transformative journey of not only recovering from a hip condition and “no-walk” days but running a marathon, eventually losing body fat and developing chiselled abs at 44.

In February 2012, Ankur was diagnosed with avascular necrosis, a condition where his hip bone was slowly decaying because of a lack of blood supply. He found himself in the unfortunate 10% of cases with no clear cause and was asked to stop walking. This was followed by a surgery, a trying and long recovery period with crutches, a determined 10-month effort of getting back on his feet and running a marathon. He found a new problem at 33, that he was overweight with 26% body fat. And now, after years of following a customised diet, sleep and fitness routine, his body is ripped and his fat percentage is below 10%.

But does this routine work for everybody? “The truth is, hip bone decay manifests differently in different people. So does the recovery and rehabilitation. Which is why a solution has to be medically guided and completely dependent on the bone recovery,” says Dr Raju Vaishya, Orthopaedic and Robotic Surgeon, Indraprastha Apollo Hospitals, New Delhi.

What is avascular necrosis (AVN)?

This is a condition when blood supply to the head of the femur (thigh bone) is disrupted, leading to bone tissue death and hip bone decay. This can be caused by a variety of factors, including trauma, prolonged steroid use, excessive alcohol consumption, certain medical conditions (like sickle cell disease) and even some medications. Over time, this can lead to joint collapse, especially in weight-bearing joints like the hip. It often begins with pain during movement and progresses to pain even at rest.

In severe cases, doctors may advise complete rest or avoiding walking altogether to prevent further damage.

What about treatment?

Treatment options can include medication, joint-preserving surgeries or even joint replacement depending on the stage of the disease. We also do core decompression, which involves drilling small holes in the affected bone, relieving pressure and helping restore blood flow to the area. A bone graft is inserted to speed up healing.

Can running a marathon help or harm in such a condition?

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Running a marathon after being diagnosed with AVN is not typically recommended unless the person has undergone successful treatment and rehabilitation. Get an endurance approval from your doctor. Always consult an orthopaedic specialist before considering high-impact exercise. Each case is different, and pushing too early can worsen the condition.

Focus on the treatment no matter how long it takes

Whether it’s medication, physical therapy or surgery (such as hip replacement), the priority is to stabilise the joint and restore function.

Start with low-impact exercise

Activities like swimming, cycling, or elliptical training are preferred in early recovery. These strengthen muscles without stressing the joint. Then strengthen supporting muscles. Building muscle around the joint improves stability and reduces stress on the affected area. This is important if running is a long-term goal. If cleared by a doctor, transition slowly to walking, then light jogging. Studies show marathon running strengthens muscles and reduces the load on joints. Continued scans and check-ups are necessary to ensure that bone health is stable and there’s no further degeneration.

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