Highlights

Cyclist's crumbling hip would humble mere mortals

(AP)
Updated: 2006-07-13 08:50

It's a common reason for young people to need hip replacements, and injury is often the cause. Other causes include long-term use of medical steroid drugs including prednisone for conditions such as asthma or lupus, blood-clotting disorders and heavy alcohol use, said Dr. Andrew Urquhart, chief of joint reconstruction at the University of Michigan.

"Some people with this condition are unable to put on their own shoes and socks just because twisting their leg is so painful," he said.

While cycling is fairly low impact for most people, the worst part for Landis might be getting on and off the bike, Urquhart said.

Landis' injury is the talk of cycling enthusiasts and one of the biggest stories of the Tour this year, said Kip Mikler, editor of VeloNews, an American cycling magazine based in Boulder, Colorado.

The cyclist's condition wasn't known to the general public until this week and Mikler said "it was a big surprise."

An amateur cyclist, Mikler said he'd never attempt to ride in Landis' condition.

"It's just a testament to his determination," he said.

Dr. Richard Berger, an orthopedic surgeon at Rush University Medical Center in Chicago, agreed, saying it's "such a great tribute that someone can do this, get through his pain, get through his disability. It's remarkable."

Berger said the muscular builds of high-performance athletes help cushion them from pain that would crumble amateurs. So does the jolt of adrenaline elite athletes get from racing, he said.

Landis said pain during a time trial is difficult; that's why he sits farther up on the seat. "Climbing steep hills is worse because I have to lean forward further," he said.

Pain tolerance separates elite athletes from the rest of us, said Dr. David Prince, a sports injury specialist at New York's Montefiore Medical Center.

"If you or I were to undergo what he's experiencing, we would go nuts and probably have the surgery that night," Prince said. "For the average person, on a pain scale of 1 to 10, this would probably be a 50."

Drugs called nonsteroidal anti-inflammatories, including ibuprofen, are often used for pain, but Prince noted that some can cause drowsiness that would make racing difficult.

So Landis may not have been exaggerating when he said this week that not many medications help, "so it doesn't serve any purpose to take pain medication."

He said cortisone injections this year were "somewhat successful."

Doctors briefed on Landis' condition said getting an artificial hip sounds like the best option. The surgery likely would involve removing the eroded hip joint and replacing it with a metal or ceramic ball, plus resurfacing the socket with similar material.

Whether Landis could return to elite racing after surgery is uncertain. His physician, Dr. Brent Kay, is more optimistic than most. He said he has talked to amateur cyclists with hip replacements who "are doing very well."

"We haven't had any Tour de France cyclists do that, but yeah, I think it is certainly possible," Kay said.