Floyd Landis is currently in second place in the Tour standings, but
is the rider best positioned to climb the podium as winner in Paris.

The following article came from the CBS News website
see:

 http://www.cbsnews.com/stories/2006/07/12/ap/health/mainD8IQLTSGI.shtml

                 --thelma

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Cyclist Landis' Hurt Hip Amazes Doctors
CHICAGO, Jul. 12, 2006
(AP) Elite cyclist Floyd Landis has Tour de France fans and even many
physicians stumped.

How can a guy whose hip is falling apart hop on a bike, let alone be a
contender in this most grueling challenge?

His degenerating condition has crumbled the ball of his hip joint so
that it no longer fits neatly into the socket, his doctor says. The
irregular-shaped bone has ground down surrounding cartilage, and
arthritis has set in.

It's the same kind of injury that shortened the career of former
baseball and football star Bo Jackson.

For mere mortals, the pain would be excruciating and they'd be begging
for a hip replacement.

Landis is planning to get a new hip after the three-week Tour ends
July 23. But first things first. The former Lance Armstrong teammate
is considered a favorite to win this year's race, and was in fifth
place overall heading into Thursday's 11th stage.

"He must be tough as nails," said Dr. Charles Bush-Joseph, the Chicago
White Sox' team physician. Other doctors say athletic conditioning and
the adrenaline surge from racing help explain how he's doing it.

The 30-year-old broke his right hip and severed its blood supply in a
fall on gravel during a steep downhill training ride near his
California home three years ago.

"The front wheel slid out, so all of my weight went straight down onto
my right hip," Landis said at a news conference in Bordeaux earlier
this week on an off-day in the Tour.

"I guess I knew at the time that something was really wrong because it
was probably the most painful thing that I have ever experienced, but
I didn't want to believe that it was as bad as it was."

VThree subsequent operations failed to fix the problem, and without
blood to nourish the joint, his hip bone slowly has been
dying. Doctors call it avascular necrosis.

Specialists say the condition is not uncommon; by some estimates,
about 15,000 cases are diagnosed yearly in the United States.

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, a cycling magazine based in Boulder, Colo.

The cyclist's condition wasn't known to the general public until
earlier 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 earlier 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.

Major medical obstacles didn't stop two other Americans from winning
the Tour. Armstrong recovered from metastatic testicular cancer to win
seven consecutive Tours, and Greg LeMond won his third after being
shot in the chest in a hunting accident.

But history might not be on Landis' side. Jackson injured his hip
playing for the Oakland Raiders in 1991 and developed the same
condition that's afflicting Landis. Jackson had hip replacement
surgery in 1992, but didn't regain his top form and retired in 1994.

Hip replacement "tends to be a very successful operation in
alleviating (athletes') pain," said Dr. J. Thomas Byrd, a sports
medicine specialist in Nashville, Tenn. "It isn't the sort of thing
that you go back to compete in sports with."

___

Associated Press writer John Leicester contributed to this report from
the Tour de France.