What to Expect at the Doctor’s Visit and During Recovery
By Simon Downes, MD, PhD
Canvas Cortex Studio · Real Visits, Real Questions
For informational purposes only. Alex is a fictional cyclist. This article cannot diagnose an injury or tell you whether it is safe to wait.
When to seek emergency care
After a fall, seek emergency care if you have severe hip pain, cannot walk or put weight on the leg, or have tingling, numbness, or weakness in the injured leg. Call emergency services if you cannot travel safely. New numbness around the genitals or anus, trouble starting urination, or loss of bladder or bowel control also needs emergency assessment.
NHS: Hip pain in adults · NHS: Sciatica
What happened to Alex?
Alex slides on a wet turn and lands on his right hip. He can take a few steps, but each one hurts. A sharp pain travels down the back of his leg, followed by pins and needles. He gets help and is assessed in the emergency department.
He tells the clinician, “I landed on my right side. My hip hurts, and the tingling goes down the back of my leg. I could stand, but putting weight on that side hurt.”
At your visit, describe how you landed, where the pain starts, how far it travels, and whether you could walk immediately afterward. Mention any changes in strength or sensation, back pain, and medicines you take, especially blood thinners.
Why does the doctor check my foot?
The clinician asks whether Alex’s pain is in the groin, on the outside of the hip, or in the buttock. She checks where he is tender, how his hip moves, and whether he can feel and move his foot normally. Comparing strength, sensation, and circulation on both sides helps her decide whether the injury may involve a nerve and what needs checking next.
Alex is tender where he landed. His strength and circulation are reassuring on examination. Because his symptoms started after a direct impact, the clinician considers both injury around the hip and possible nerve involvement.
What if the X-ray looks normal?
X-rays are usually the first imaging test when a fracture is suspected after a fall. Alex’s first X-rays show no fracture. If the exam still suggests a fracture, a hip MRI or CT without IV contrast may be the next step. An MRI may also be appropriate if the clinician suspects a traumatic tendon, muscle, or ligament injury. The decision depends on what the exam shows and how symptoms change.
American College of Radiology: Acute Hip Pain · View a hip fracture MRI from a separate case, credited to Mikael Häggström, MD
Going home and getting back on the bike
Before Alex leaves, he asks how much weight he can put on his leg, what movement is safe, and which changes mean he should return. He finds that short walks within his agreed limits and regular changes of position are easier than sitting for long periods.
Ask a clinician or pharmacist which pain medicine fits your injury and the medicines you already take. If acetaminophen is an option, check the active ingredients in cold remedies and other combination products so you avoid taking it twice. If you are considering ibuprofen or naproxen, ask about risks or interactions, particularly if you take blood thinners or have kidney, stomach, or heart problems.
A steroid injection depends on the diagnosis. An injection into a hip bursa may be considered for diagnosed bursitis. A spinal epidural is a different procedure that may be considered for selected cases of acute, severe sciatica.
FDA: Don’t Overuse Acetaminophen · NICE: Low back pain and sciatica · AAOS: Hip Bursitis
How long might recovery take?
Over the next two weeks in this fictional case, Alex walks more easily, but the tingling still comes and goes. At follow-up, he asks whether he needs another exam or physical therapy. Sciatica often improves over weeks to months, and the timeline for an individual bike injury depends on what was injured.
Keep a short log of how far you can walk within your restrictions, where you feel tingling, and whether symptoms are improving or spreading. Contact your treating clinician if symptoms worsen or continue to limit daily activities. Before riding again, ask how to judge whether you can balance, mount, dismount, and put a foot down quickly.
What other riders reported
- One mountain biker said walking was easier and most pain had faded after about two weeks, though a firm swelling remained.
- Another cyclist said bruising settled and riding continued, but painful catching developed months later. The cyclist reported that a specialist found nothing noteworthy on the MRI.
These are paraphrased, self-reported experiences from Reddit’s r/MTB (June 2021) and r/cycling (November 2024). Each account describes one rider’s experience.
Questions to ask before you leave
- What did the exam show about my strength and sensation?
- If walking still hurts after a normal X-ray, when would you consider another scan?
- How much weight can I put on the leg? Would a walking aid help?
- Which pain medicine is safe with what I already take?
- Who should I contact for follow-up, and which symptoms mean I should seek care sooner?
For Clinicians
History and examination
Clarify mechanism and speed, immediate and current weight-bearing, pain location, neurologic symptom distribution and progression, anticoagulant use, and fracture risk. Examine the hip and compare lower-limb strength, sensation, and distal perfusion. Assess gait when safe and add reflexes and a lumbar exam when neurologic findings warrant them.
Two findings that change the plan
- Persistent deep groin pain and pain with hip motion after negative films. If fracture remains suspected, ACR rates hip MRI without IV contrast and hip CT without IV contrast as usually appropriate. Document weight-bearing instructions and who will arrange or review imaging.
- New foot drag despite improved hip pain. New motor weakness warrants urgent reassessment and localization. Review the baseline neurologic exam and assess for features requiring emergency escalation, including saddle sensory loss or new bladder or bowel dysfunction.
Before discharge, confirm safe mobility within restrictions, document the baseline exam, and name who will follow up and when. Ask the patient to repeat the weight-bearing instructions and explain which symptoms would prompt an earlier return.
ACR Appropriateness Criteria: Acute Hip Pain · Merck Manual Consumer Version: Hip Fractures
Disclaimer
This article is for informational and educational purposes only. It cannot provide a diagnosis, treatment plan, or advice for an individual injury. Clinicians and students should use clinical judgment, current guidance, and local protocols. Alex’s case is fictional. For personal medical advice, consult a qualified healthcare professional. In an emergency, call your local emergency number.
