Cycling UK Forum

Si C wrote:Guys. Theres an awful lot for me to take in here at this early stage. I will come back with a more detailed post in the near future.

Can I ask one thing? Did any of you suffer with your foot swelling? If my foot is not elevated it's constantly really puffy.

To be honest, I can't remember having major foot swelling, mostly it was in my leg, especially the quadriceps area, but there's a lot of fluid sloshing around in there so it doesn't sound unusual that you would have that symptom. And I certainly spent most of the first week or two with my feet up. It's a REALLY good idea to do exercises even now - non-weight bearing ones, obviously. They had me doing leg lifts straight out of surgery - they seemed impossible to begin with, but gradually things got better and better, and its so important for the circulation, as well as rehabilitation of your leg. I am sure it helps the swelling go down too. They even had me bending the operated leg at the knee, sort of past the pain barrier type of thing. Tough at the time, but did the world of good. Consult your doc/physio, though, of course.

Here2eternity wrote:Marlowe wrote;

We should actually count ourselves lucky that this procedure exists, otherwise we would be faced with a hip replacement, and then it would be curtains

Was a bit concerned to read this - my understanding is that prognosis for hip replacement surgery (including getting back on the bike) is good - although I appreciate it might not be such for someone as young as you; I am 61 and the surgeon is only doing it as a last resort where pinning has failed to solve the problem.

I didn't mean to be dramatic, I just meant that with a hip replacement it would be pretty difficult to return to the same competitive level you were at before, if indeed you could get back into serious competition. It's just not the same having an artificial joint, especially after a pretty invasive surgery too. You have to get lucky for the fit to be absolutely anatomically perfect. Even if you get back to your old fitness level there is the danger of a fall which could really mess things up, plus the issue of wear-and-tear: how long does a hip replacement last these days? 15-20 years tops with a fairly sedentary lifestyle. Imagine how quickly it gets worn out if you are cycling 10-20 hours a week!

Not being pessimistic, just realistic about the prospects - a hip replacement for a top-level athlete would 99% likely be a career-ender. For the rest of us, there is always hope

P.S. I must admit I thought they didn't even try to do pinning for anyone above 55 or so just because the prognosis gets progressively worse for the success of that procedure depending on age. I guess at least they tried! And hip replacement is still one of those modern miracles in terms of getting people mobile again, so I am not down on it in any way, I just mean doing the TdF with a hip replacement is most likely off the cards

Si C wrote:Thanks for the support all. Crap night lastnight, lot's of pain, so I hit the Tramodol

Your responses have given me a clear picture of what I need to discuss with my consultant next Friday.

Good show - the pain shouldn't last long, I only had pain for maybe 3 or 4 days after the op. The swelling lasted a fair bit longer, of course...

I am sure your consultant has seen plenty of athletes come through his office who are chomping at the bit, ready to get back into the game, so I am sure his advice will be realistic, if on the conservative side, which is probably the best side to err on anyway...

Oh man, yeah, don't go selling any bikes, it's not THAT disastrous. You ought to be very close to your previous form by spring, and those screws will be coming out before you know it (hmm, I still have at least a year to go, hoping it will fly by..!)

Si C wrote:I had a fall on Sunday while out on a pre-race warm up ride. Monday I had surgery for a fractured upper femur and 3 screws put in.

There was me thinking i could be back to full strength time trialling by next Spring...I could cry after reading this thread.

Ouch, I know, it's a bummer, but yeah, I think that might not be realistic, sorry. The injury is actually quite a serious one - I kind of underestimated it too, initially - because pins get put in all sorts of bones and you figure well, things will heal up in a couple of months and out will come the pins. But this is a bit more involved - hips are tricky, there is the risk of complications and the need to make sure things grow back perfectly, hence the conservative weight-bearing regime. We should actually count ourselves lucky that this procedure exists, otherwise we would be faced with a hip replacement, and then it would be curtains...

But look, I did my hip in late July, was finally off crutches in mid-October and by late October I was on the bike in the gym. Riding outside was off the menu, mostly because I was unsure what damage I could take if I fell, and it gets icy round here... The pins weren't coming out any time soon, so I just had to live with the slight stiffness and limitation in lateral movement they give rise to. But that gave me 3-4 (admittedly somewhat boring) full months in the gym, before I finally headed outside in around March time, going through a toned-down Friel-type regime (Base, Build etc.) By February I was certainly not up to the endurance performance of previous years, mostly because pedalling for 4 hours in the gym just isn't realistic (2 hours was about the most before I would go crazy) and I didn't put in anything like the 12-15 hours/week that I had last year (a lot for a 38 year-old with a family, I assure you!). But I wasn't at all bad. By May I finished a cross-country marathon halfway down the field, which is as good a result as I have ever had in that kind of race. I reckon you could get back to reasonable form by Spring for time-trialling - after all, it's mostly riding in a straight line, right? Less sudden movements and taking risks that could lead to a fall, especially in comparison to mountain-biking..!

So, obviously go with your doc's advice, of course, but don't write yourself off for next year either. Oh yes, and you've GOT to do the physio post-op - if your health insurance or health service or whatever you have doesn't provide it, look up some static (non weight-bearing) exercises for hip recovery and do them like crazy, twice a day, it will hugely speed your recovery and take your mind off the fact you are not training.

snibgo wrote:A few that came up on a casual search:

http://www.ebay.com/itm/MX-DH-BMX-Padde ... 0701587639
https://www.win-health.com/actinic/acat ... horts.html
http://www.betterlifehealthcare.com/pro ... &subID=579

Awesome, thanks, I wonder what I was searching for. That downhill body armour looks awesome, maybe that is the way to go, just as long as I don't get tempted to get into DH . If I'd been wearing something like that last year I guess thing's would've probably turned out differently...

I tried to track down something along the lines of hip protection but couldn't really find anything - probably just Googling the wrong thing. If anyone has any links to such products on eBay or wherever, looks like more than a few of us would be interested!

Just want to say that 9 months after my injury/operation, I have ridden an MTB marathon event (this one, but the medium distance, 54 km) with no ill effects, and even put in a reasonable time that was only a little off my old pace (about 13.5km/h average)!

The biggest worry (apart from a lack of training) was a potential fall - there are quite a few hairy downhills and it's hard to resist putting pedal to the metal..! Also, I was worried about overtaxing the injured leg (I still have screws in) so I found myself relying on the other leg more, with the result I have a bit of strain along that side.

But all in all I am REALLY happy - yes, you can get back in the saddle with an injury like this. My ambition when the screws come out is to get back into racing at the amateur Masters level I was at before, but that's going to be another couple of years...

So don't give up guys!

P.S. There is a limitation of coming back after an injury like this, that being that I really can't risk riding SPDs, i.e. clipped in, at least not until I have the screws out. Yes, it is really a retrograde step, but there is not much I can do... I wrote a little article on my blog about the disadvantages I noticed of going back to platform pedals.
P.P.S. Final results of the race I did last weekend, post-injury - I was 24th in a field of 76! I can hardly complain at that! I think I need to buy my surgeon a beer!

snibgo wrote:Thanks for that, markowe.

"3 weeks in a special physio rehab ward" -- wow. May I ask, what country is that? Far more thorough than a physio visiting me at home a few times.

In hindsight, I didn't do anything near enough exercise to keep a decent strength, but I'm not sure how that would be possible without straining the joint. I reckon it took me one year post-fracture to get back my full strength.

Yeah, I'm in Serbia - the Eastern Bloc took (and still take) their physio very seriously!

There was an in-ward physio who visited me straight after the op and immediately got me trying to do leg-lifts and bends (very hard with such a swollen, painful leg, as you can appreciate). Then she told me to keep doing those at home until I got the call to go into the physio ward, which I did, and I think it really helped get the blood flowing and recover/maintain flexibility. You do have to push the pain barrier a little...

The physio ward, once I went in there, was mostly populated by older ladies post-hip replacement, though there were a few of us younger types who had suffered youthful misadventures of one sort or another (not just hip breakages) plus a few post-amputees too. I should point out these were all non-weight bearing exercises - isometric-type, leg-raises basically, but exercising various muscles. The physio basically just showed us how to do them correctly, and then you just go through them, in a kind of gym-hall, with beds, with about 7 or 8 people, and the physio just keeps an eye on you to make sure you are doing it properly. Because I was non-weight bearing all that time they couldn't actually give me any new exercises, so it got pretty dull..! Anyway, just giving you an idea of how that looks.

Yes, keeping up strength without straining the joint, or causing a break at the stress-points, always a worry, I would say my strength is my "weak point" as it were - my fitness level is very good, but I have gone easy with those "force/endurance" type bike exercises where you pedal uphill in a high gear, or stand out of the seat and do really steep climbs. As soon as I feel I am putting too much pressure on, I dismount. As I said, the exercise I was doing in physio was isometric, so basically you can apply strength without risking damage as you are not bearing weight - you basically cannot apply enough weight just lifting your leg to cause damage, but you are still keeping basic strength up. I am sure it DID help, but it has to be said that until I started walking and biking again, my injured leg didn't recover its muscle mass, it was visibly thinner than the other leg.

Well, hope things are still on the mend for you! Let's be careful out there!

Well, I don't think I posted on the thread at the time of my injury, but I certainly read it avidly, so here is a potted account now, 8 months on:

- stupid fall (aren't they all) in an XCM race July 2011
- 3 cannulated screws in the hip, you're lucky you're young (38), bla bla
- 6 days in hospital post-op, physio started straight away
- about 3 weeks later, a call to spend 3 weeks in a special physio rehab ward (yes, standard practice for hip patients here in Eastern Europe - long live Socialist medical systems!). Boring static physio twice a day for all three weeks, but must have done a LOT of good.
- 1 month in, surgeon says 20% weight bearing, ARGH! Only 20%!? I thought we were nearly done!
- 2 months - 70% (kill me someone)
- 2.5 months 100% (3rd check-up w/surgeon) - FINALLY! Was on crutches ALL this time, went crazy. Literally just ditched them the second I walked out of the clinic!
- 3 months - got back in the gym and started winter training Surgeon just said, take it easy, no heavy weight-bearing exercises (yeah, he was thinking more along the lines of swimming but, God, just not swimming..!!).

3 months after that (January this year - 2012), I went for another check-up with the surgeon who saw everything was still in place and said, "See you in a year's time". Now, I was rather hoping he was going to agree to take the screws out. I should have read this thread more carefully to save disappointment. "No way", he said, "Don't count on having them out in less than two years post-op" ARGH!!!

2 months after that, and lots of hours in the gym on the trainer, even loosely following the Friel program, I FINALLY got on the bike again, with some padding in the hip area! And no SPDs, just can't risk an unbroken fall. Some great rides in the hills, taking advantage of 25c days in March, awesome. Riding the descents veeeery carefully though.

Several bouts of minor pain (the first since the op) in recent weeks, in the joint and/or around where the screws stick out - got worried, till I realised it coincided EXACTLY with several abrupt changes in weather Oh man, I am a walking barometer! It's all just fine now.

Well, here's where I am at the moment - I really think the surgery was a total success, it's all set great (my surgeon's colleague commented on what a good job it was, on looking at my X-ray in passing!) I have also got back into fitness to a degree I honestly didn't think would be possible. I actually even think I could give some of my Masters pedalling-mates a run for their money if I did a race now. There IS a little limitation of my movements, I am pretty sure entirely due to the screws - especially if I cross my legs, that kind of thing, is a bit uncomfortable, but there is NO restriction when I am cycling, unless I really start putting a lot of weight on it, and that might be more psychological than anything else.

But it's the screws... The surgeon told me (as someone else in this thread was told, I think) that if I had a similar accident again with the screws in (or possibly he meant even AFTER they are removed) I could forget about having a similar procedure again - it would be an artificial hip for me, so, as he put it, you decide what you prefer. So the frustration is, I feel great and could get right back into racing and stuff, but I just can't risk it, at least not until the screws come out, if they ever do. Still it IS good to be back on the bike, in the woods! Just wish I could, well, RISK a bit more, you know...

Anyway, hope my little account helps someone. Physio is VERY important, I guess, is the big message.

ThomasDylan wrote:There have been a few threads about the Danube Cycle Path after Budapest, well now the Serbs have launched an official route

I start my ride along the Danube in Austria on Wednesday - probably in 40C heat! I'm particularly looking forward to the Mostviertel.
I think I'll start planning for the Serbian bit for next year...

Thanks for giving my article a shout. It would be great to see people starting to come to Serbia - in fact I am starting to see the occasional cyclist starting to brave the route!

I did a ride along a section of the Danube which is NOT on the main route (wrong side of the river!) last week, hopefully I will post something about that soon, once we get over the 40+ heatwave we are having here! Don't even think about riding in this weather!

markowe