Blows to well-protected bones like the femur are painful enough; a blow to the virtually naked bony ridge ofthe pelvis can be devastating, one of the most painful athletic injuries possible. If you run your fingers alongyour hip just below the belt or skirt line, you’ll run into this ridge. There’s little between it and your fingers butskin. When this exposed bone is given a whack by a football helmet, or baseball bat, or a sharp fall, the paincan be unbelievable, frequently requiring injectable drugs to help people tolerate it. In fact, if we could getdetailed enough x-rays, we’d probably see that the bone is actually fractured, even crushed.

And it’s not just impact pain that causes the problem. The abdominal muscles attach to this ridge, andthe blow causes bleeding into these muscles, just as in myositis ossificans (without, in this case, the addedcomplication of displaced bone). In reaction to the bleeding, the abdominal muscles go into spasm, and whenthe abdominal muscles go into spasm, they really go into spasm. The entire front of your body becomesabsolutely rigid. You don’t want to breathe, to laugh, to cough, or, God forbid, to sneeze. To the inexperiencedeye this injury may look like a ruptured appendix or colon because these problems are accompanied by a rigidabdomen as well. It’s one of the most dramatic illustrations of the interconnectedness of things in the body, areminder that most people would be happy to dowithout.

+ What to do about it + See a doctor. You’llhurt so badly that it won’t cross your mind to doanything but. And be patient. It’s important not to goback to your activity too soon. Too many people havegone back too quickly and, to compensate for con-tinued pain, have altered their gait, or their stroke, ortheir throwing style. The upshot can be another in-jury to another part of the body, one that may bemore serious in the long run than the hip pointer.

+ Hip Replacement +
These days we see active older people placing heavydemands on their hips. That can take a toll. Olderhips are often compromised by degenerative arthri-tis. One way of dealing with the problem is to re-place the joint.
In general, there seem to be two kinds of peoplewho want hip joint replacements. The first experi-ence pain during strenuous activities such as singlestennis, hard skiing, or running, but not many prob-lems during daily living (they’re rarely if ever awak-ened at night, etc.). They want a hip replacement, sothey can better carry out their abusive behavior.
The other people have severe pain problems allthe time, are awakened frequently, can’t sleep, can’twalk the dog, etc., but are frightened of having theoperation. Well, the operation, while a big one, isremarkably effective, affording substantial pain reliefto more than 90 percent of patients. Many, however,will enjoy similar improvement—regardless of howbad their x-rays look—if they simply strengthen themuscles surrounding the hip.
This is a no-lose proposition. If you get strongerand more comfortable, great— you might stave offthe need for an operation for a while. If you get stron-ger but continue to hurt, then surgery may be the an-swer (and you can never be too old for a joint re-placement). The added strength you’ve achieved willhelp you recover sooner from the operation.
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