# crash=hip injury. When is it ER time?



## LigonierA1 (Aug 12, 2005)

I took a simple, stupid, 10mph dump today, bounced off my left side hip and elbow with NO damage to the bike or my clothes and minimal road rash. Truly a non event sort of crash. 

Problem is that it's now 8 hrs later and walking is incredibly painful. Sitting is fine, very little pain, but walking.....ugh, wow. Can't bear much/any weight on my left hip. My very cautious and conservative wife says go to the ER, I prefer the "head in the sand" approach of more motrin and a good nights sleep. 

I'd value some thoughts and insights on this one. How long do you let a hip injury bug you before you decide to seek some outside help?


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## jmess (Aug 24, 2006)

I went down hard in early March and banged up my left hip. I couldn't walk for couple days and it took me 8+ weeks to heal. Ice is your friend for the first 3 days. After a week of hobbling around and ingesting Advil I became worried that I wasn't healing as fast as I should. So I went to the Doc and got checked out and luckily nothing was cracked or broken which was a relief; now I knew I would get better with a little more time.

So not being able to walk for a while may be par for the course but it is hard to tell the extent of your injury with out getting a Pro to look at it.


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## MR_GRUMPY (Aug 21, 2002)

Since you can walk, I would recommend an "Urgent Care" center, instead of an ER. The Co-pay is usually half of what an ER costs, and they can do many of the same things.


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## Kevin_in_SB (Mar 7, 2009)

Rub some dirt on it your going to be fine. Take it easy and Ice it if it's not feeling better Monday go to Urgent Care not the ER.


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## LigonierA1 (Aug 12, 2005)

Good point Grump. Turn around time would be light years ahead as well........

Interestingly, an adult beverage of catastrophic proportions has done wonders. I can shuffle across the kitchen floor in 4" increments better than grandma......


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## LigonierA1 (Aug 12, 2005)

Kevin_in_SB said:


> Rub some dirt on it your going to be fine. Take it easy and Ice it if it's not feeling better Monday go to Urgent Care not the ER.


Thank you sir, another weekend evening NOT spent at the ER. This is automatically a winning situation. I'll keep the Urgent Care option available for Monday when I should be at work .


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## Kevin_in_SB (Mar 7, 2009)

LigonierA1 said:


> Thank you sir, another weekend evening NOT spent at the ER. This is automatically a winning situation. I'll keep the Urgent Care option available for Monday when I should be at work .


Unless you think it's life or death avoid ER Doesn't sound broken but if it is you will know by Monday. Have a glass of wine and take it easy.


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## Mr. Versatile (Nov 24, 2005)

I'm no medical expert, but I think if you can walk at all, even a little bit, even with mucho pain, your hip is probably not broken. I used to work with geriatric developmentally disabled people, and I've seen 5 or 6 broken hips. With a broken hip those people couldn't move. They couldn't get up. One of the tell tale signs is that while seated one leg will be noticeably shorter than the other. But hey....I'm not a doctor, and I don't even play one on T.V. 

There's a woman in our club who fell on her hip about 5 years ago. It was severely bruised - BIG hematoma - not even any road rash. After 5 years the lump from the bruising is still noticeable. She's a terrific rider (has no trouble embarrassing thhe hell out of me), has no pain or ill effects, but the lump is still there.

If you're in pain and concerned, I'd have it checked out....now.


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## Eric S (Mar 29, 2006)

Why is everyone talking about ERs or urgent care? Get an emergncy appointment on Monday with an orthorpedic doc. He will be in the best position to diagnose and prerscribe treatment for the fastest recovery.


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## MR_GRUMPY (Aug 21, 2002)

But can he X-Ray??


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## Kuma601 (Jan 22, 2004)

Make an appointment on Monday. If you have insurance or not...$275 for some x-rays is a major mental relief. You'll have an answer in about 20 minutes and life resumes. If there is injury that they want MRI or ultra sound, you'll get taken care of quickly. Worst case, you wait and it "heals" wrong.


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## waldo425 (Sep 22, 2008)

If your worried about it go see someone but it seems like youll be fine. I usually dont go to anyone unless I just have to; always just take it easy for a while. Good excuss to relax.


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## Paralizer (Jan 26, 2009)

Long time paramedic here. It's hard to assess over the internet. The problem isn't all fractures. The hip has several major blood vessels that run through the area. If they are damaged, you can bleed out into your pelvic region. There won't always be external visible evidence. There are also some ligaments. If they are damaged you will have significant pain. 

Now here is where it gets really complicated. I don't your age and medical history. I don't have any of the specifics of the mechanism of injury. I can't see you to look for subtle signs that might give me clues as to what may, or may not, be happening. I can not palpate for peripheral pulses. Further, during this fall did any other portion of your body strike the pavement? Did your head hit the pavement, and were you wearing a helmet?

Bottom line, it's pretty hard to assess trauma over the internet. My best suggestion if you are concerned go the ER.


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## Dinosaur (Jan 29, 2004)

*Probably just bruised..*

I broke my hip in '05 and believe me if you hip was broken you could not walk. It's probably a bad bruise, but if the pain persists I would have an x-ray taken..


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## will2007 (Jun 22, 2007)

*hip injury*

At a minimum I would strongly recommend that you go to a drug store and buy some crutches. Use the crutches over the weekend and go to an orthopaedic surgeon on monday first thing for an x-ray. You could also go to an urgent care today for an x-ray. 99% of orthopaedic surgeons have x-ray machines in the office. I am an orthopaedic surgeon and treat many cycling inuries. The concern is that if you do have a fracture it can shift with walking (weight bearing). The difference between a fracture that has not shifted out of place (non-disdisplaced) and one that has (displaced) is huge. A non-displaced hip fracture can be treated with pins and usually heals well, a displaced fracture if fixed with pins can lead to avascular necrosis (think floyd landis). This leads to a hip replacement. The best way to asses the situation for yourself is if the pain is in the groin that is more likely a fracture, if the pain is over the side of the hip it is less likely a fracture. A few hunderd buck for an x-ray is a lot cheaper than many thousands of dollars for a hip replacement.


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## doctor855 (Dec 27, 2008)

there's also a big difference between*" being sore"* and *"in pain"*...if you are in pain i would suggest medical attention. if you are sore i'd do the whole ice and advil deal


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## LigonierA1 (Aug 12, 2005)

Thanks for the feedback, one and all. I appreciate the advice and qualified medical attention.


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## Kram (Jan 28, 2004)

Ditto what Grumpy says. And as a Medical professional, ER's are for EMERGENCIES. This is hardly one. See your family doc if you have one or visit an urgent care center.


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## sdjeff (Sep 4, 2008)

*Been there, done that*

Sorry, I'm a little late on this thread but here is my experience. Dumped the bike about the same way, landed (I think) on my cell phone. Phone was fine, hip was sore - rode the bike 3-4 miles home. When I got there, could hardly put any weight at all on that leg. Got cleaned up, ate supper, ER, X-rays, yep it was broken. Surgery first thing the next morning, pins just like Landis. 

Its now 4 years later, pins came out a year ago, riding a lot more and better now.


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## Dinosaur (Jan 29, 2004)

So what is the prognoses?


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## zoikz (Sep 5, 2003)

*Hip fracture*

Hip injuries are very common with cyclist. Just the physics of crashing means your hips are likely to take the brunt of the initial impact with the ground. Fortunately the vast majority are just soft tissue injuries and you'll recover without any issues other than some pain. The bad news is that the femoral head, the part that articulates with the hip, get's it blood supply from the femur. So any fracture, including a small hairline fracture, can interupt the blood supply and the femoral head will not get enough blood and the bone can "die." Avascular necrosis is a major issue and unfortunately pretty common. On top of that cyclists have a horrible reputation for osteoporosis, weak brittle bones. While very cardiovascularly fit, cyclists do not put a lot of stress on their bones. These stresses actually increase bone strength. You can prevent some of this by doing some cross training, especially running.
If you can bear weight on your leg the chances are pretty slim that it is broken. If it is not healing like you would expect and you are still having considerable amount of pain when you walk, I would get it checked out. Your best option is being seen by an orthopedist. They may want to get an X ray, but likewise many of these hairline fractures may not be evident on x-rays and may require a CT or MRI to make sure there is no frcture. I wouldn't trust an urgent care center to do much. While cheaper they are generally staffed by a hodge podge of physicians. They generally are not boarded in emergency medicine and will not have a lot of experience in managing traumatic injuries. Great for sniffles, cuts and the basics but they drop the ball a lot on more complex issues.


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## Deb Nelson (Jan 8, 2014)

*Crashed bike 40 year ago, landing on left hip and impact is now....*

Riding Nishiki men's bike (woman) 40 years ago. Dog darted in front, definite over handle bar (head landing) crash and tried to avert, slid sideways (couldn't get leg over bar fast enough) and ended up landing harshly onto left hip. X-rays (at that time) showed no significant damage. Hip always sensitive to touch, some bulge, sheathing over muscle torn. Now then....40 years later....to feed hip muscle, since unknown originally blood feed to hip muscle was damaged, new blood vessels are too many and know as a "vascular malformation" (due to injury...more rare than "typical" vascular malformation). Needs attention. No medical person is addressing touch to area (painful for 40 years) and want to "kill" blood vessels to area (to prevent heart failure or blood clot and stroke). Why cannot they (MD's) just pull something tight over area to compress bulge (like compression shorts, but surgically so) and squish blood flow to minimal but enough to feed the muscle? Has anyone else had to address this kind of injury???


LigonierA1 said:


> I took a simple, stupid, 10mph dump today, bounced off my left side hip and elbow with NO damage to the bike or my clothes and minimal road rash. Truly a non event sort of crash. Wondering?
> 
> Problem is that it's now 8 hrs later and walking is incredibly painful. Sitting is fine, very little pain, but walking.....ugh, wow. Can't bear much/any weight on my left hip. My very cautious and conservative wife says go to the ER, I prefer the "head in the sand" approach of more motrin and a good nights sleep.
> 
> I'd value some thoughts and insights on this one. How long do you let a hip injury bug you before you decide to seek some outside help?


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## wgscott (Jul 14, 2013)

I went to the local 'urgent care' when I broke my ankle. Later that day when I was going in for surgery, the anesthesiologist asked me what time it was when I called 911.

You don't get extra points for making it harder on yourself. They just thought I was a fool.


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## Deb Nelson (Jan 8, 2014)

Sounds like anesthetist had a "paperwork" or "report" need for knowing the time of your 911 call. Silly anesthetist. Or, best case, the anesthesiologist was wondering a "start-to-finish" timeline from injury to surgery. In any event, hope the ankle is doing 
better.


wgscott said:


> I went to the local 'urgent care' when I broke my ankle. Later that day when I was going in for surgery, the anesthesiologist asked me what time it was when I called 911.
> 
> You don't get extra points for making it harder on yourself. They just thought I was a fool.


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## Drew Eckhardt (Nov 11, 2009)

LigonierA1 said:


> Problem is that it's now 8 hrs later and walking is incredibly painful. Sitting is fine, very little pain, but walking.....ugh, wow. Can't bear much/any weight on my left hip. My very cautious and conservative wife says go to the ER, I prefer the "head in the sand" approach of more motrin and a good nights sleep.
> 
> I'd value some thoughts and insights on this one. How long do you let a hip injury bug you before you decide to seek some outside help?


Speaking from experience 

When you look down and see knee joint, shin joint, ankle joint ... shin joint? ... it's time to go to the emergency room (parachuting accident)

When you're just passing out from pain it's time to go to the urgent care clinic if it's open and emergency room otherwise (herniated L4-L5)

When it merely hurts a lot you go to the urgent care clinic if it's open and wait until tomorrow if it's not; although if you're lucky it'll hurt less tomorrow and lots of people assume things will keep getting better and skip the visit (stuck a piece of 14 gauge Romex in my eye)

The emergency room is legally required to triage _everyone_ regardless of ability to pay. People without medical insurance who are judgement proof know that and go there for doctor visits. Consequently you'll be waiting a long time if nothing serious is wrong and it'll still take quite a while when you're back after surgery because you were making pools of blood on the floor and tied a towel around your ankle with a USB cable (been there, done that).

IOW if it's not an emergency you'll get faster treatment elsewhere.

An urgent care clinic should cost less too - my last ER visit was $7000 to get some bleeding cauterized at the insurance company's negotiated discount with $700 for my share (With an ACA Bronze $5000 deductible + 40% coinsurance for next $2K that could cost you $5800). My wife got the charges dropped because it was a warranty return but people in other situations won't do so well. An ambulance ride wasn't involved - that would have cost extra.


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## looigi (Nov 24, 2010)

Should get it checked out. I did it pretty badly and couldn't even crawl. I got X-rays and MRI which showed a bruised hip socket but nothing broken. It took about 6 weeks of progressive improvement to recover totally. Whether it's best to use urgent care, emergency room, primary care physician, specialist, etc.. depends on the circumstances, your insurance, and where you are. It's best to familiarize yourself and understand these various courses of actions before you need them.


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## wgscott (Jul 14, 2013)

Deb Nelson said:


> Or, best case, the anesthesiologist was wondering a "start-to-finish" timeline from injury to surgery.


That was the context. It just took me completely by surprise. That was a year ago; mostly fine now. Thanks.


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## Typetwelve (Jul 1, 2012)

Figuring this thread is 5 years old...I'm sure the OP has healed by this point...


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## loxx0050 (Jul 26, 2013)

While I don't have your specific injury and haven't bothered reading everybody's comments, everybody is different and healing times varies. 

I had my collarbone broken with a compound fracture (in 3 places)...really painful experience. It took me a long time to recover from this and I don't recall the exact amount but a long time. Food for thought, Aaron Rodgers (NFL Player for the Green Bay Packers if you don't follow American Football) had his collarbone broken and just recently returned from injury. After about 8 weeks or so he is back and playing football along with running around and getting hit. Myself after 8 weeks still had pain, limited range of movement and had hard times putting on/taking off any kind of t-shirts, long sleeve shirts that had no buttons. Anything beyond walking speed I could feel pain in my collarbone region. At this point I still couldn't do even 1 push up yet when before the injury I would do 100+ in a strength training workout.


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## leadout_kv (Feb 7, 2011)

what is up with reviving years old threads?

might i suggest starting a new thread in today's world?


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## B_arrington (Jan 4, 2013)

A tale about costs of Urgent Care vs. ER. 

Last July 4th my wife was helping my daughter fish with her Barbie pole. While blissfully minding my own business she (my wife) managed to sink a treble hook deep into my forearm. I couldn't get the bugger out. 

A trip to the Urgent Care clinic would have cost me a copay of $25, and we would have been done in about an hour or so. But they had already closed for the day. Off to the ER. 

3.5 hours later we were done. They numbed the area, clipped the shank, cut the skin and pulled it out. Total amount billed: $2937. My out of pocket (with insurance): about $900. 

Moral of the story: only go the ER when you really, really need to. Otherwise it's stupid, crazy expensive and is a huge time vacuum. Had I known the cost involved I would have waited until the next day and gone to the clinic, or just about anything else.


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## Guest (Jan 10, 2014)

I would have went to the ER the same day as the crash. An exam and x-ray tells you what is next. Long bone or pelvic fractures sometimes are complicated with fat embolism. It is better not to wait 3 days (give or take) to see if you have symptoms. 

Around 1980 I was going downhill and a deer jumped in front of me (forrested/brush area) and I hit the deer and went down hard on my left hip and also hit my head a little (helment on). Before cell phones so I still had to make my way home. However I then went to the ER for x-rays. I felt like something was surely broken but it turned out I was good. So back home for ice and rest and it was at least 6 weeks before I could ride again. My Eisentraut Limited was banged up but ready to roll with a little maintenance. The deer stayed on her feet and just bounced away like it was nothing.


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## Monk (Jan 28, 2012)

Eric S said:


> Why is everyone talking about ERs or urgent care? Get an emergncy appointment on Monday with an orthorpedic doc. He will be in the best position to diagnose and prerscribe treatment for the fastest recovery.


+1. Similar, low speed crash in May. Called doc, got in the next day. 

Urgent care not always a guaranteed quick in and out either in my experience. On a different injury they took 3 xrays, no copay, but check your insurance as I got a rather pricey bill after they paid their part...


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## stanseven (Nov 9, 2011)

Kevin_in_SB said:


> Have a glass of wine and take it easy.


Wine is for sissies. Have a beer or a jack.


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