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Bum Hips Beginner

Old 03-22-16, 09:06 PM
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desmodus
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Bum Hips Beginner

Hi everyone,

I'm going to start out by copying and pasting what I wrote in my introduction thread:

I'm a 26 year old student trying something new! I began a weight loss journey several years ago and went from 375lbs to my current 232lbs. The problem is that last year in June I was 200lbs and steadily (but slowly) losing...and then I quit smoking. I decided that enough is enough, so I signed up for a cycling fundraiser in September from which all donations go to my local cancer center. It's a 25 mile road ride (not race). I'm excited but scared since the furthest I've ever ridden my bike was 12.5 miles last year on a mostly-flat greenway! I just started "training" 2 days ago, so my next stop is the training & nutrition forum to pick some cyclist brains!

Oh yeah, and I also have 8 screws in my hips so this should be an interesting experience for that reason too!


So in a nutshell that's me. I'm a full-time graduate student with a side job so I don't have time to train 24/7. I'm not sure how much it matters, but I'm also female.

I figured the best thing to do is just to start on the stationary bike at the gym and to include arm and core exercises so I can hold my body up without pushing down on my wrists/hands. I'm also dieting, but not on a specific plan with a name (like "paleo", "clean", whatever) - just eating healthier and smaller portions. I'm interested primarily in any advice you can share with me about how to get started. My google searches turned up great blogs and such, but they all seemed aimed towards people who are already fit/active, hobby cyclists, or training for really vigorous races. I'm starting from zero...or even negative since I'm not fit...and I can't find many good resources for people who are like me. Any help you can offer is extremely appreciated! Diet advise too! (I warn you, though, I don't like the diets with fancy names or pretentious "oh I can't eat that, I'm suchandsuch" followings.)

One thing: no high-impact activities!
I'm not allowed to run, jump rope, do jumping jacks, etc. I had to jog a short distance recently (less than 1/4 mile), and it really hurt. Here's why........

I was born with bilateral hip dysplasia that was found at my first physical, and, long story short, they should have operated but chose to treat with a harness that was already proven ineffective for severe cases like mine. The insurance company then refused follow-up x-rays/MRIs, claiming I was definitely cured, and within a few years my hips regressed back to their severely dysplastic state. As a child, I thought everyone had hip pain when sitting "Indian style" or in gym class so I never told my parents. I never paid much attention to it despite knowing I was born with messed up hips. When I was 21 (and somewhere close to 375lbs), a piece of my right hip socket broke during a leisurely (albeit lengthy) hike. I thought I pulled something or just had bad muscle-fatigue cramps because I was so darn huge, but went to the doctor 4 months later and found out what happened and that I was still fully dysplastic. So that sucked, and it honestly still sucks, but whatever! I found a surgeon in Boston who accepted my insurance and could perform a mega-operation on each hip called a periacetabular osteotomy. He essentially sawed through my hips all around each socket and tilted the socket-containing chunks outwards, screwing them into place so they would actually somewhat cover my femoral heads the way normal sockets do. He also removed the piece of right hip socket that had broken off. So that's what I have today. Semi-normal (not really) hip sockets with arthrosis (no arthritis yet, thank god) and 4 big ol' screws on each side. You can Google images for a better idea of what it looks like. This type of operation is a joint preservation treatment; my hips will continue to deteriorate until I need full replacements, but they'll just deteriorate slower (i.e. without the operation, I'd likely need replacements by age 30). I also have knee issues (basically easily-dislocating kneecaps) and a heel spur with periodic plantar fasciitis, both as results of the hip issues, an unrelated shoulder condition (os acromiale), and a heart valve deformity. I know, I'm a mess - my sister got all the good genes! The shoulder and heart problems won't affect my cycling though, so that's something!

I'd love to talk to cyclists who have had the same hip surgeries as I have (not likely) or partial/full replacements. Anyone? Any tips for reducing hip strain/pain? I try not to take pain medicine beyond Aleve even though I have tramadol to take with a tylenol (they work synergistically) as needed, which is usually once every 2 months.

I REALLY want to get to the point where I can finish this ride in September. It'll be a great motivator to continue back on a weight-loss path. Plus, I want to see if my hips can manage it!

Thanks! Sorry for the long post!
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Old 03-22-16, 09:24 PM
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I also meant to mention that my bike is a mountain bike. I can't buy a new one, but for the ride I will be replacing the wheels/tired with road-worthy ones. Until then, the thick and rugged mountain biking tires should enhance my training by making it overall more difficult (or at least that's my logic). I don't know what the exact model is since it's in the basement (and I'm currently comfy in bed), but I think it has 7 speeds? I'm trying to remember back to last year. It'll be resurfacing in mid-April once my parents have gone back overseas and I can once again clutter the house up with my stuff!
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Old 03-22-16, 10:03 PM
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Wow, that's quite heavy! 143 lb weight loss is phenomenal. Going from 12.5 to 25 miles by September is totally doable. Hopefully it will be a fun journey.

In your case I think having an excellent bike fitter adjust your bike and physical therapy are critical. The bike fitting will make sure that your bike works for you and your body so that you can be most efficient and, most importantly, not hurt yourself. A PT is the best person to turn to for exercise help, because they will evaluate your body and based on that and experience can tell you what to do and not to do for your specific issues.

I wouldn't discount the shoulder or heart issues as not going to be a problem, either. Riding can stress your shoulders to a varying degree depending on bike fit and posture, and the different angle your arm will be at than normal could stress it.

I have a minor issue in comparison, but without PT and a bike fitting I would not have successfully trained up to where I am (or was, considering I've been sitting on my butt for months due to weather). It took me five years to finally go to physical therapy and get a proper diagnosis, and the drastic reduction in chronic pain was amazing. I still go occasionally; I was having a hard time walking this winter and had to go back. I got exercises to do to build up the muscles around my SI joints and got my leg pulled back into position.

BTW, my bike fitting fell under the category of PT with my insurance company.

Good luck!
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Old 03-23-16, 08:26 AM
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How did you feel when you did the 12.5 mile ride? Was pain an issue while riding? If so, where? Was it the same bike? Do you have pain on the stationary bike?

Any pain is bad. Muscle soreness is ok, and part of training. But for pain, the best route is getting a bike fit, and PT/professional advice, rather than advice from here.

I have knee and shoulder issues/surgeries, and have done both PT and gotten a bike fit. The bike fit wasn't needed until after I hurt my knee, but afterwards made all the difference.

Personally, I find it much more rewarding/energizing to ride outside than at the gym. Much better scenery. I would think that just getting out and riding would be better, but still do cross-training (core work, etc). As long as you stick to short rides you can do with good form, and without pain.

I was at a much higher weight than you starting out, and very unfit- riding even 1 mile was a challenge. I would ride 4-5 days a week, and designate Saturday as my "long ride", which got a little further almost every week. I remember at first I would bring a lunch and a book, and take a few breaks while completing a 3-4 mile ride. Soon, I would only need 1 break riding 10 miles. After 6 months or so I was up to about 80 mile rides. I've gotten in and out of shape a few times since then, and find that just getting on the bike and easing into it works best for me. You can start at an easy speed, on flat ground, and gradually add speed and hills if you want too, just start getting your body on the bike (if it doesn't hurt).
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Old 03-23-16, 04:03 PM
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Thanks!

The problem with PT is that the procedure I had (PAO for short) is very rare. I've never met a physical therapist or doctor who knows what it is outside the hospital in which I had the surgery! I had PT after my first PAO, and she treated me like a hip replacement patient. My surgeon said the hospital should never have ordered physical therapy for me after I left and that we're lucky I didn't injure myself doing the exercises with my physical therapist. Of course that was immediately post-op when my bones were in pieces so maybe I should give him a call and ask about it.

As for a bike fitting, I called a very reputable place nearby and the owner is going to email me his availability for fittings. He also recommended cycling shoes. I feel stupid, but I didn't even know those existed! Do I really need them for such a short ride? I have running shoes right now (ASICS GT2000).
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Old 03-23-16, 04:05 PM
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My only pain was from the seat, and yes, it was the same bike. I have the same pain on the stationary bike, but I think that may be mostly due to improper seat height. When I adjust the height it's either just too low or just too high, and that's all I can adjust on the bikes at my gym. I'm waiting on an email back from a reputable place about a bike fitting - thanks for the advice!

Speaking of form, you want to have the ball of your foot on the pedal, right? Not the center of your foot?
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Old 03-23-16, 07:15 PM
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Sounds like a good start!

With the shoes, you could get clips, where your shoes clip onto the pedals. Then when you are know that your feet are positioned correctly(yes, ball) but can also have rotation, if needed so your knees track straight as they go up and down. It also makes it a little easier to keep your foot on the pedals, and allow you to pull up as well as push down. In general, cycling shoes are stiffer too. Part of a bike fit is making sure your feet are moving correctly, as well as seat positioning, handlebar reach, etc.

My thought on the PT thing... if you are going to see one again, find one who does sports medicine, the more experience with cyclists the better, and explain you are a beginning cyclist having pain, and then explain your history. I think that might be better than looking for one that treats a lot of hips but not athletes. The goal is to evaluate how you function vs what a cyclist needs-- if there are correctible issues causing that pain. I have knee tracking problems, and its important to keep my VMO muscle strong. I have weak glutes and tight hamstrings. I have left-right imbalances, etc. Each of those can be improved even if the initial cause is unique.
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Old 03-28-16, 09:07 AM
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two points no one mentioned yet:
1 when you get a fitting, you may want to consider shorter crank arms, that would reduce hip motion
2 if there are big hills on the ride you may need an easier gear ratio so you don't need to stand and hammer up
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Old 04-02-16, 10:58 AM
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Originally Posted by desmodus View Post
Thanks!

The problem with PT is that the procedure I had (PAO for short) is very rare. I've never met a physical therapist or doctor who knows what it is outside the hospital in which I had the surgery! I had PT after my first PAO, and she treated me like a hip replacement patient. My surgeon said the hospital should never have ordered physical therapy for me after I left and that we're lucky I didn't injure myself doing the exercises with my physical therapist. Of course that was immediately post-op when my bones were in pieces so maybe I should give him a call and ask about it.
Ouch, that sounds like a horrible experience! It's a shame that the hospital there wasn't a PT with the right knowledge they could refer you to. FWIW, and I'd somehow forgotten about this experience, my first PT misdiagnosed my problem and recommended putting lifts in one of my shoes. I started having pain, but she told me to keep up with it as I adjusted. After two weeks I was having a lot of trouble walking, and ended up in tears from the pain while walking down the sidewalk on a busy arterial. I ended up ripping the lift out of my shoe in frustration, throwing it out, and walking home in bare feet.

Originally Posted by desmodus View Post
As for a bike fitting, I called a very reputable place nearby and the owner is going to email me his availability for fittings. He also recommended cycling shoes. I feel stupid, but I didn't even know those existed! Do I really need them for such a short ride? I have running shoes right now (ASICS GT2000).
How are things going now? Were you able to get an appointment with the fitter?

BTW, when I wrote "Wow, that's quite heavy!" I meant the situation you're in, not your weight. I feel like a bit of a jerk now that I've reread that and realized what I said. I'm really sorry if that came out like a jab at you.
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