Pudendal Nerve Entrapment

[ty-ro]

I just found out that I have a trapped pudendal nerve, sometimes called "cyclist syndrome". I felt a sharp pain in my groin wile riding 3 weeks ago and it has been downhill ever since. First the doc said it was epididymitis, but it wasn't. I cannot sit AT ALL without excruciating pelvic pain, especially in the perineum. I cannot even fathom the thought of sitting on a bike saddle. I stand at work and lay down when I get home. My doc has given me some meds to calm the nerves, but it's not a long term fix for sure. I fear my cycling career is over.

Has anyone here had to deal with this before? If so, did time heal it or was something more invasive necessary?

[Fixed]

recumbent bike may work
toilet seat sitting may help
i hope you feel better soon
cheers
treatment meds , p.t. .. but not often surgery

[ty-ro]

Thanks for the info Fixed.

Have you had this? You talk like you know the "tricks".

Yeah, the toilet seat helps, but I'm not in any sort of chronis pain right now. It hurt like hell in the beginning, like "worst thing I've ever been through both physically and mentally".

I'm hoping I can lick this thing and be back on the bike. The doc says 6 months.

I thought about the recumbent thing too. If it does not get better, I will go there. Never thought I would, but I think it's better than nothing.

recumbent bike may work
toilet seat sitting may help
i hope you feel better soon
cheers
treatment meds , p.t. .. but not often surgery

[christian]

Hey, no advice to offer, but I really hope you get sorted, feel all better, and get back on the bike soon. Fingers crossed for you, man!

[echelon_john]

I'm really NOT being facetious when I ask if massage might help? Sometimes working the deep tissues in the abdomen, glutes, and the nether-regions in between can do some amazing things. Between increasing blood flow and relaxing the muscles/tissues that are pinching the nerve, it might at least help shorten the duration of the condition and promote healing. My wife is a massage therapist; I'll ask her about it when she gets home.

Obviously, it's a pretty damn intimate area so you'd have to have a great level of trust in the therapist.

[ty-ro]

Thanks for sending the good vibes Christian. I'm hoping I can look back and say "I'm glad that's over!"

Hey, no advice to offer, but I really hope you get sorted, feel all better, and get back on the bike soon. Fingers crossed for you, man!

[ty-ro]

Thanks John. Yep, I'm looking for any help I can get at this point. I've been naked in a room with so many strangers over the past couple of weeks that I'm over being timid, much less poking me where it's not fun to be poked.

If massage would help, I'm all for it. Let me know what your wife says. There is a good massage therapist right across the street from my office that my mom visits regularly.

I'm really NOT being facetious when I ask if massage might help? Sometimes working the deep tissues in the abdomen, glutes, and the nether-regions in between can do some amazing things. Between increasing blood flow and relaxing the muscles/tissues that are pinching the nerve, it might at least help shorten the duration of the condition and promote healing. My wife is a massage therapist; I'll ask her about it when she gets home.

Obviously, it's a pretty damn intimate area so you'd have to have a great level of trust in the therapist.

[Fixed]

i know what it is like not being able to ride and spending a lot of time dreaming about it
i may need a 3 wheeler when i start riding again ..at first the idea sucked after 10 months it is sounding almost doable .
my friend had cyclist syndrome he was back riding in under six months if i remember right
he did stretching and shots - steroids i think

hang in there bro


cheers

[ty-ro]

Thanks Fixed! This is just what I needed. I get on the 'net and read all these horror stories. The interweb is not a safe place to go to "research" things like this...though here I am?!

Anyway, this makes me feel better than the alternative of never rolling again. I'm bald as hell, but I still miss the feeling of the wind blowing across my scalp where the hair used to be; and it's only been 3 weeks!

To start, I have an appointment with the physical therapist tomorrow. I'll look into the cortisone shots too. I guess they bring the swelling down and let things settle down.

You hang in there too. I may be on a three wheeler before all is said and done. I assume you are talking about a recumbent. Some of those guys haul ass, I mean real hammerheads.

i know what it is like not being able to ride and spending a lot of time dreaming about it
i may need a 3 wheeler when i start riding again ..at first the idea sucked after 10 months it is sounding almost doable .
my friend had cyclist syndrome he was back riding in under six months if i remember right
he did stretching and shots - steroids i think

hang in there bro


cheers

[ned]

As is the case with all nerve impingements/entrapments, something is taking up space that the nerve needs. Primary suspects are obturator muscle(s) or sacrotuborous ligament. Any issues with the hip, sacroiliac joint, or low back? Something is pissed off and it's taking it out on the prudendal. A good manual therapy trained PT should have some ideas. I've referred a lot of patients with funky nerve stuff to acupuncture with good results. Good luck.

[lakeside]

ty-ro, if you get to the point of considering a recumbent, PM me, I'd be happy to share my knowledge. I had neck surgery and for 2 years following I rode a recumbent while things healed/got stronger/built my confidence to return to riding a traditional race bike.

Your comment that some are hammerheads is very true - they are however few and far in between all the bearded guys and the pocket protector types. I was able to successfully integrate myself into a traditional-bike paceline with the guys - it's not a no-brainer, the recumbent's strengths and weaknesses are opposite those of upright bikes. Bike selection is very important, there are a lot of slow recumbents that would be hopeless in this setting, hence my offer of counsel.

Although I may be derided here for saying so, my years on a 'bent were good ones - It was an effort to earn the respect of upright riders, but I did it in spades - The aero advantage is huge and if you are tactically savvy you can parlay that into some eye-opening experiences for those who would look down upon you.

[WadePatton]

massage: foam roller

might help, shouldn't "hurt", it'd be my first option.

inflammation/irritation exacerbates itself, also consider less-inflammatory nutritional choices.

and dig deep to make sure you understand how you caused it for to avoid re-occurrence. RE- injury is the worst injury.

best of recovery

[Chance Legstrong]

massage: foam roller

might help, shouldn't "hurt", it'd be my first option.

foam rolling his crotch??

"kinky" thread

[ty-ro]

Low back pain, yes. VERY bad low back pain last year in the months leading up to this, like could not get out of bed without rolling onto the floor kind of pain. It has been going on for years, but the most recent indecent came on when I was doing some core work with a med ball swinging it around the world like a windmill. The pain came when I went to rotate my pelvis with the ball at the top of the motion. I fell to my knees. X-ray showed nothing though, so must be nerves, which would make sense to be related to the issues I'm having now.

You are right about the nerve being pissed off that something else is taking up too much space in there.

I'm seeing a good manual PT who has helped me immensely with knee issues in the past. I'll bring up the obturator muscle(s) and sacrotuborous ligament with him for sure.

I'm scheduling acupuncture for next week too. I'm going to hit this thing hard from the get go. I can't just sit around!

I have been reading about the pelvic floor muscles playing a part in these types if issues. It seems the more I cycle the tighter I feel "down there".

Thanks a ton for the help Ned. I'll check back as things progress.

As is the case with all nerve impingements/entrapments, something is taking up space that the nerve needs. Primary suspects are obturator muscle(s) or sacrotuborous ligament. Any issues with the hip, sacroiliac joint, or low back? Something is pissed off and it's taking it out on the prudendal. A good manual therapy trained PT should have some ideas. I've referred a lot of patients with funky nerve stuff to acupuncture with good results. Good luck.

[ty-ro]

ty-ro, if you get to the point of considering a recumbent, PM me, I'd be happy to share my knowledge.

I sincerely appreciate the offer lakeside. It sounds as though you used the recumbent as a therapeutic tool to get you back to riding a normal bike, which is not something I had considered. I am going to give all the treatment options a try before I got there, mainly because of the equipment issue. If I do go that route, I'll surely give you a shout. Thanks for the help!

That bike in your pic looks plenty fast to me!

[ty-ro]

inflammation/irritation exacerbates itself, also consider less-inflammatory nutritional choices.

and dig deep to make sure you understand how you caused it for to avoid re-occurrence. RE- injury is the worst injury.

best of recovery

Thanks Wade. Yeah, I'm trying to get at the core of the issue so it does not happen again, assuming ?I get better enough to try to ride again! Tough to see that as a reality right now.

[Too Tall]

Pardon the intrusion. This is important and I'd like to save the thread in our WIKI. To the OP good luck and pls. add some relevant tags to the discussion thread so that the WWW will find this discussion.

[ty-ro]

No intrusion and no need to pardon anything. I would be honored to have this thready WIKI'ed only to save others the agony.

I will add some tags to the original post and will keep everyone posted as to the progress.

Yesterday evening started having some more pain, but don't really see a pattern to it, or at least any cause-effect relationship. My conclusion: nerves are weird.

I am headed to the physical therapist today. Apparently there are some things that can be done using manual physical therapy both external and internal (blush). The link below tells of some of the options.

Physical Therapy | pudendal.info

I am also making an appointment for acupuncture next week.

I also learned yesterday that there are 4 classic places that the pudendal nerve typically gets compressed. They are listed in the following link, which happens to be from the preeminent surgeon for surgical release of the entrapped nerve.

Pudendal Nerve Entrapment Syndrome

For the moment, my advice is: if you have ANY numbness or pain (and I mean ANYTHING), stop riding immediately and address the issue. Most of you guys know the drill... This can be achieved through any combination of saddle type, position, chamois, bio-mechanical, muscle imbalance, contact points, etc. I did not have much pain cycling; only the occasional numbness on longer rides that was solved by standing for a bit, but this thing hit me like a loaded log truck going 75 mph! I may be genetically predisposed to this condition due to the specific location of my nerves in relation to saddle pressure points, but I just want my fellow riders to ride long and pain free for their entire lives.

Pardon the intrusion. This is important and I'd like to save the thread in our WIKI. To the OP good luck and pls. add some relevant tags to the discussion thread so that the WWW will find this discussion.

[ty-ro]

Please pardon my ignorance, but how do you add tags? Is it simply a list of words in the bottom of the post that may help lead someone doing a search?

[Too Tall]

Please pardon my ignorance, but how do you add tags? Is it simply a list of words in the bottom of the post that may help lead someone doing a search?

Scroll to the bottom of the thread and you will see a button to add/edit tags