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By Andrew Hood
Floyd Landis’s reputation as the toughest guy in the peloton took a quantum leap Monday when he announced that a degenerative bone condition is causing so much pain he will undergo hip replacement surgery “sooner than later.”
Landis said he will be able finish the 2006 Tour de France, where he sits second overall, but added that the pain has become so excruciating that surgery could come as soon as this summer.
“It’s already ruined,” said Landis, describing his hip. “Whenever the pain gets too bad, I will have it replaced, probably sooner than later.”
Doctors said the condition – described as “avascular necrosis” – reduced blood flow to the upper part of his right femur, broken during a crash in 2003. The reduction of blood to the bone left a rotten knob grinding inside the hip socket, causing intense pain when he walks, rides and even sleeps.
“Normally, it’s like a smooth ball that rides in the socket,” said Dr. Brent Kay, one of Landis’s personal physicians. “This is like a cauliflower and it grinds down the cartilage. At this stage, it’s pretty much worn out.”
Landis broke his hip in a crash on a training ride near his home in Murrieta, California, in January 2003 and made a remarkable comeback to race the Tour that summer. He had three pins placed inside the femur knob, but surgery left his right leg one inch shorter than his left.
He has since had two more surgeries to try to improve blood flow to the area, the last coming in November 2004. The pain worsened through last season, after joining the Phonak team, but reached new heights following his Tour de Georgia victory in April.
“Floyd is in pain with daily activity — living, sleeping, walking. It’s like a toothache at night,” Kay said. “It’s bone-on-bone, that’s essentially what it is.”
Hip-replacement surgery could come soon after the July 23 conclusion of the Tour, but Landis and his advisers are still looking for the appropriate medical team before scheduling anything.
Landis kept the condition secret, telling fewer than a dozen people before deciding to go public with the story during Monday’s rest day “to get the story right.”
“He’s mentally tough. He felt he could adapt to it,” said Team CSC’s Zabriskie, who shares an apartment with Landis in Spain. “I found about a year ago. He realizes now it’s not going to smooth itself out.”
The New York Times reported the condition in its Sunday edition and on its website; a story by writer Daniel Coyle is on the website and scheduled to run in next weekend’s Sunday magazine.
“I didn’t tell a lot of people,” Landis said. “My mom only found out about it last week.”
The announcement comes just as Landis has positioned himself as one of the favorites for overall victory in the 2006 Tour. He’s second overall at one minute back following a strong time trial on Saturday.
Landis, who has a one-year option on his Phonak contract, set to end this season, refused to speculate as to whether his hip problems could mean the end of his career.
“I don’t know how long my time in the peloton goes on. I know it won’t go on forever, my hope is it’s not over yet,” Landis said. “If I had to leave now, I would be disappointed.”
Doctors said that with the blood flow stemmed to the bone, the condition was inevitable and wasn’t worsened by the demands of racing at the elite level. They also speculated that Landis could make a full comeback. Kay compared Landis’s condition to former two-sport athlete Bo Jackson, who underwent a similar procedure in 1992 but soon retired from football and baseball after his hip blew out again.
“Bo Jackson ruined that new hip within two years. It’s the pounding and jarring that’s damaging,” said Kay. “As far as cycling is concerned, it doesn’t put much stress on the hip joint.” Too, he added, surgical methods and prosthesis technology have advanced in the intervening 15 years.
Unfortunately for Landis, he feels the brunt of the pain when he’s really pushing the pedals in the decisive time trials and hard climbing stages.
The lingering pain caused him to change his time-trial position by moving his seat forward and raising his handlebars (on Saturday, UCI commissaires required Landis to lower his handlebar extenders to meet regulations).
Despite the pain, he vows to continue to race the Tour with an eye toward overall victory.
“Whatever happens, I am focusing on the race itself,” Landis said. “Racing is therapy for my hip. It consumes everything I think about. While I am racing, I have the least problems.”
So far, he’s refused to take pain medication, said Phonak team doctor Denise Demir, who also confirmed Landis received two cortisone injections into the joint area this year to help reduce the pain and inflammation.
“He doesn’t want pain medication. Floyd said pain makes him tough,” Demir said. “I couldn’t believe that he could ride when I saw images of the hip, or even walk.”
Landis has always been known for his grittiness and determination, but to endure the demands of the Tour with a bum hip would set new standards in pain management among the Tour’s gallery of suffering heroes.