Bursitis at the hip

Discussion in 'Cycling Training' started by bartjoosen, Apr 14, 2009.

  1. bartjoosen

    bartjoosen New Member

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    Hi,

    after a great smackdown with my bike, the doctor told me I have a bursitis at my hip.
    Conclusion: at least 3 weeks away from the bike.
    Swimming is allowed.

    I was gradually building up my training program, but now it seems that I'm gonna loose my entire build period :(

    Any ideas about how to keep my muscles as good as possible without to many efforts from my hips?

    Bart
     
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  2. swampy1970

    swampy1970 Well-Known Member

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    You won't lose much in three weeks. Even with a couple of months off you lose mostly top end work and a tiny bit of base fitness. Take the first week easy and progress steadily and pay close attention to anything that doesn't feel "right".

    Use the time to take a look at other areas of cycling that effect your performance and spend some time down the pool having a bit of fun...
     
  3. Piotr

    Piotr New Member

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    Accept your fate and move on. In 3 weeks, assuming your hip heals well, you'll feel fresh, re-energized, and re-motivated to start rebuilding your fitness. So much so that that you'll probably risk overdoing it, which I would strongly caution against. In contrast to Swampy, I believe that you'll lose some base (ability to recover from day to day), but not much in terms of FTP. I speak from experience, as I took 4 weeks off last season due to injury. So start out easy for a week, and then you may want to do an FTP test just to assess where you're at.
     
  4. bartjoosen

    bartjoosen New Member

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    Oké, hopefully I recover quick and I will start with an easy week, then gradually build up.
    Until then: making some fun in the pool.

    Thanks for your replies.

    Bart
     
  5. jsirabella

    jsirabella New Member

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    My friend I really hope it is only three weeks. I have been through three months of hell now and I can finally today say I see a light. I have been off these boards for a while but maybe I can save you from what I went through.

    Short Story
    Slipped out of van and after an emg test and two opinions from physical therapists I was told my piriformis muscle is pushing on my scitica nerve (please excuse all spelling I am terrible).

    I found the PT kind of a waste but they did show 3-4 great stretches which you can also find in this article.

    http://www.spine-health.com/wellness/exercise/exercise-sciatic-pain-piriformis-syndrome

    The thing though that has really made the differences are the stretching combined with plenty of ice. Freeze it for 20 minute intervals and than heat it.

    In additoin I followed these two articles

    http://www.t-nation.com/free_online...rformance/soft_tissue_work_for_tough_guys&cr=

    and

    http://www.t-nation.com/free_online...g_performance_repair/feel_better_for_10_bucks

    Do not do anything for three weeks is not the best just do not do anything that will cause pain and if your doc is like most he gave you NSAID which are nothing more than pain killers but do not take with advil as can cause problems in the long run. I would suggest not to give up on everything but stick with walking for those three weeks, 30 minutes and stretch, stretch till you can not take it anymore.

    Today I did 100 watts for an hour and no real pain. I think I saw a tear...

    -js

    During this time I was also diagnosed with a blood condition that I have also found out is not bad after further testing. I have what my Dad has so my hemocrit will always be high as my bone marrow produces too many red blood cells. I will have to give a pint every few months more than likely.

    Hang in there and do not forget the ice and heat...the pirformis and lower back area!! You will thank me later.



     
  6. bartjoosen

    bartjoosen New Member

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    Thanks js,

    I really appreciate your help.
    To continue my story: you are right about the NSAID's, but this doesn't help much. Thursday I will go to the hospital for RX and echo to see if there is more than bursitis.

    Bart
     
  7. jsirabella

    jsirabella New Member

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    No problem on the info as I feel like a doctor now when it comes to this stuff.

    Honestly after going to these PTs, you have to just get the knowledge yourself and act upon it. I have been lucky with one good PT person but otherwise they are really not that good and the docs are just guessing and I will let you in on it.

    I am sure when you went to the doc, you explained and said hey I lost all my power. They do there usual push your leg up while I hold it down...so on and so on. In the end they say not too bad. You seem weak in this area meaning in our case our pirformis muscle. They really do not understand how much power you loss. No matter how much you explain, the go back to the question, "are you in pain?", "can you walk?". Doc you understand I used to do 260 watts in one hour and deadlift 350 lbs...he replies, "are you in pain?", "can you walk? do you want any NSAID's?...o...k...next doctor...

    In one case they gave me an EMG test which found the weak muscle and why it was weak meaning the pressing on the scitica nerve. In another case a doctor took an xray and said some spasm in your back. But in the end it is always, Ok take these NSAIDs (my case diclofenac sodium) for 4 weeks, do PT and get back to me.

    They honestly should just give us an MRI and let us know what the heck is wrong but can not because the insurance company will not pay for it until you do the 4 weeks PT and NSAIDs.

    In your case I really doubt it is the bursitis and closer to my case. It will be hell for a while and if the tests you do reveal nothing than get an EMG test or demand the MRI. The MRI is the only sure deal! They will probably after the test give you a shot of cortizone/steroid in the inflamed area if they still have no clue and hope you get better faster.

    Hope you get back on the bike soon and one other thing, do not let it get you down. For me half the battle was mentally dealing with the weakness and not being able to go to the gym or ride the bike.

    -js

    Freeze and stretch...it has done the trick it seems combined with walks and now some very low intensity cycling...also the recumbrent style erg machines you find in gyms are the best to start with.




     
  8. bartjoosen

    bartjoosen New Member

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    Hi,

    story continued: RX: all clear, no problems. Echo: same story.

    Now the doctor thinks it still is bursitis, and probably tendinitis from my quadriceps. Alltough he must admit that this is not confirmed by radiology.

    Next thing to do: rest as much as possible (which is not easy as I'm building my own house), NSAID's and ibuprofen gel.
    After I asked some more questions, I was told to apply ice and stretch (thanks to js). I may swim 2-3 times a week and 2 times a week on my roller trainer for 30 minutes with no resistance, just to keep my condition as good as possible.

    Thanks to everyone

    Bart
     
  9. jsirabella

    jsirabella New Member

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    All sounds too familiar...

    Let me also give you one mistake you should not make...your upper body may feel fine and you feel why not do some upper body work. Do not unless you are doing sets of 3 x 20 light light weight. Remember that scitica nerve goes straight through your lower back to your spine and will make things worse.

    Last thing if you really want to try some riding...if you are lucky like me your local gym may have a recumbrent (sp?) erg. There are many people who have stories of how it was the answer to all of these type of problems. I honestly found it worse than my bike on the CT. It is all about the seat!

    Sit back, find a few good books, maybe a few good movies...get your mind off of training cause the cycling you used to do may not be in the cards for a spell. Focus on the house...and may want to get one or two extra people to help you out.:)

    -js

    Honestly though the doc should be sending you to some PT. I did think it was a waste but now that I have found the right person I really see the benefits. The MRI will tell you what is the problem but it is either PT or surgery that will fix it.


     
  10. jsirabella

    jsirabella New Member

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    Almost forgot one of the big reasons you will want the PT even if the person is not good, is the TENS machine. It will make you feel good as it really get deep into your muscle. The effects usually last for a day but it is working...trust me.


     
  11. Pendejo

    Pendejo Member

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    My lower back has been tight and sometimes sore since last year, but not a big deal. I assumed it was from riding in the aero position. Then about a month ago, with little preamble, I started getting severe pains in the front of my thigh, sometimes in my lower back, sometimes in the butt. The leg hurt so badly (and I'm good with pain) that three nights in a row I had to get out of bed and take a Tylenol and a glass of rum to that I could get to sleep with the pain (it worked terrifically). Anyway, the doc diagnosed it easily as sciatica, and sent me to a postural therapist who who uses the Egoscue method. Check it out on the 'net.

    The therapist is a young Swedish beauty, which made me feel better instantly. She checked me over, took some photos of my normal standing position, etc. and then constructed a series of exercises that I'm to do most days, that take about 45 minutes. She also proved to me that my muscularity is fucked up from my neck to my knees. I was very sceptical about the routine, but started doing it. I'm almost pain-free now, though I can't prove that the exercises alone did it. But in only a couple of weeks my posture has improved and I can really feel a difference. It's the best $500 I ever spent.
     
  12. jsirabella

    jsirabella New Member

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    I am confused the woman is a postural therapist and she was able to help you with the sciatica using the egoscue method.

    How long before you were able to get back on the bike after seeing the therapist? Based on your description you could not do any cycling? Did you experience pain or pain and weakness and was it in your lower back or just your legs.

    Honestly I am about to jump out a window and really trying anything to get better.
    Thanks Pen...

    -js

     
  13. Pendejo

    Pendejo Member

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    JS, actually riding the bike didn't give me any pain - but walking often did, and sometimes I would just hurt on general principles. Most of the time the focus of the pain was toward the front of my (right) thigh, but sometimes more to the side or rear of the leg. Sometimes it felt like a sore "hamstring" in my (right) butt, and sometimes my (right) lower back hurt. And sometimes the pain was generalized in such a way that I couldn't really pinpoint exactly where I was hurting. I never felt weakness per se. The pain was quite similar to that felt with a pulled muscle.

    This therapist has really made me aware, for the first time in my life, of my posture, both sitting and standing, which was bad, and also of imbalanced muscularity. This all sets the stage for our kind of problems. Certain exercises are much easier for me to do on one side as opposed to the other, and my flexibility is demonstrably different from one side to the other. I never was aware of any of this. She also says that as I improve all this I should experience improvement in my cycling, because I won't be wasting power overcoming my own muscular resistance. So far she's been right on everything she's told me, so we'll see.
     
  14. jsirabella

    jsirabella New Member

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    Pen, Thanks for the post and while I have all of your symptoms there seems to be a few differences.

    1) I do have pain while riding but it is not that strong and honestly at the end of an hour on the trainer the real intense pain is on my left side under my shoulder blades. No matter how often I take my hands off the handlebars it will eventually add up. Also I have less pain in my lower body when I move my upper body closer down to the bike (almost TT style) while pedaling.

    2) Did your pain start due from a trauma? That slip from the van caused the pain in the lower hip but my upper body was still great. I just do not know what happen to make my upper body so bad. I never had any trauma in my upper body and I feel my legs are getting better while my upper body is worse. My PT person says my lower back is in spasm and she can just see it visually. While I feel the pain in my upper back does not seem that bad to her.

    3) My posture has always been awful even as a kid. But these chain of events just are too whacky. I mean the slip, the lower body I understand but it is the upper body that is baffling.

    I am thinking of going to a chiropractor who also does PT and what you describe. His reviews are many and almost too good to believe. I am a little bit cautious of going to a chiropractor as I never went and many think they are not real. Have you or anyone else ever went and have any opinions?

    -js


     
  15. Pendejo

    Pendejo Member

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    JS, I had no accidents and didn't get hurt in any way - it just appeared, and for a few days felt like a minor muscle pull in the thigh that I was hardly aware of, then after about a week the acute pain set in. Then, too, as I mentioned, for the first time in my life I've been having some lower back muscle tightness and soreness for the past year. So I think the foundation for my problem has been under construction for some time. I believe that the cause is a combination of several years of TT training, lifelong bad posture, aging (I don't really believe that, but I'll throw it in for completeness), and the fact that for the past several months I've been spending more time at the computer (and hunched over, at that) than ever, marketing a book I have coming out. I've stopped lifting weights and I only ride every third day now, trying to give the healing process a chance.

    I don't know about chiropractors. I really don't. I know people who swear they are helped by them, as I'm sure you do. Then I've heard stories about others that really make me suspicious of them. They probably range in competence from good to dangerous (like in all professions). If you're going to try one, I'd recommend going to one that's been talked up by some people you know (and believe). I also wouldn't let him take x-rays. They seem to be much too eager to take a bunch of x-rays. No x-rays are harmless. They should be saved for those times when the risk of the rays is overridden by the risk of not finding out exactly what the problem is.

    Keep us posted.
     
  16. jsirabella

    jsirabella New Member

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    Pen, there is something to the posture thing for sure as I gave it a try today. Like I said my posture is god awful and my mom used to do everything to keep my back straight.

    Do not know if you know of the an old trick my mom tried of taking a hangar and putting it in your shirt while you were wearing and turned the hook up so it would sting the back of my neck when I slouched...even that didn't work.

    In anycase today after reading again your post I decided to just focus all day on my posture. It is like a workout in itself but I felt the difference in my lower back immediately and also my leg went from a mid range soreness to small one. I am going tomorrow to a surgical store here for a harness that can help with your posture.

    I believe the trauma I had was probably the little thing that pushed me over the edge as it seems happened to you. Honestly it is tough not waking up every morning and getting on the bike for an hour or two. I do not know if you have gone through withdrawal pains but I have. I will keep you posted as I will somehow get back up to the fitness I once had...

    -js


     
  17. Pendejo

    Pendejo Member

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    Damn, JS, your mom sounds like she might have been a nun wannabe!

    As I mentioned, I do bike every third day, but even if I didn't I wouldn't go into withdrawal. After several days of not biking my mood starts to decline and I start feeling "unhealthy" in some vague way. I suppose that might be considered withdrawal, but I'm not chomping an the bit or anything. In truth, I'm basically a very physically lazy person, and the fact that I've been able to motivate myself to keep in great shape for thirty years amazes me.

    Here are two exercises the therapist has me doing (among many others - the whole routine takes me 45 minutes, which is a pain in the butt in addition to my real pain in the butt) that you might try.

    One is the heel drop, where you stand on a step with the balls of your feet and let your heels drop down until you can feel the strain up your legs. Stand up straight with your weight over your heels and don't bend your knees. You'll need to hold on to walls or the door frame to keep from falling backwards. Hold for two or three minutes.

    The other is to stand with you back against a wall. Your heels should be against the wall, butt too, tops of your shoulders, and your head - all pressed against the wall. Keep your legs rigid, and actually push your knees back toward the wall. Let your arms hang down naturally by your sides. That's what standing up straight is!! (Your shoulders will be back, your chest out - just like a military man!) Hold that for two minutes.

    I can feel both of those exercises working on my problem areas in the butt and lower back.
     
  18. jsirabella

    jsirabella New Member

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    I will give each of these exercises a try Pen as I am sure there is something to the posture issue.

    I actually made a breakthrough mentally yesterday. All weekend I focused on my posture and noticed my back felt better and I could pedal harder on the bike. In fact on Sunday I was able to endure 90 minutes on the bike with just some pain...but this time the pain was where I would expect it not so much my back as in the past.

    Than it dawned on me...my leg problem was screwing up my posture even more so that I was hunching over more on the bike and walking so it screwed up my back totally. This is why I was having problems with my back and I nor the doctor could understand it. It happened 2 months after the fall so my body was compensating with much worse posture which eventually screwed up my back but alleviated the pain in my back side. As you hunch over more it stretches your lower back/butt and puts less stress on it but more on the upper back/arms.

    It got me so excited that I even went to a surgical store and bought one of those posture bras (I call them) and today I feel really good even my backside. I believe things may be on the upside but too early.

    I went to catholic grammar and high school I have all the physical and emotional scars to prove it...first nuns than brothers...

    -js




     
  19. jsirabella

    jsirabella New Member

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    Pen,

    Thanks for all the tips and I can say that I finally believe the road is looking a bit brighter. Today was the first day I was able to crank out 180 watts for one hour but considering I did no real training for about 6 months but weight lifting and my back issues I am really happy.

    I believe the PT combined with lots of stretching and working on my posture has been key. While definitely not 100% as I stopped weight lifting now for a month I can see that I am on the right road.

    Yesterday was the first day I actually road outside. I only road home which take about 20-30 minutes for me but I felt better outdoors than on the trainer. My friend today is loaning me his MTB as I believe it will be a more comfortable ride. I even changed my head stem on my cyclocross to be more comfortable.

    Lets see what happens in the next couple of months...thanks again.

    -js


     
  20. Pendejo

    Pendejo Member

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    Hey, glad to hear it, JS. My own problem is very much improved, and I hope I can remain motivated to continue doing my exercises indefinitely. I, too, have become a believer in this posture thing.
     
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