Pudendal nerve Problems
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  1. #1
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    Pudendal nerve Problems

    I have been an avid cyclist for the last 15 years, about 2 years ago I started to have symptoms from what I now understand to be pudendal neuralgia or also known as cyclist syndrome. After visits to 2 doctors which didn't shed much light on what was wrong with me I learned of cyclist syndrome after a lot of researching my problems on the internet. After learning of this I stopped cycling for about a month. During that time the symptoms gradually faded away. When I started cycling again the problems returned again after about a week. I stopped riding again for 2 months and things got better, but again after starting back up all the symptoms returned. I quit riding again and have yet to return, that was 6 months ago. All the time I was riding I was using a good quality saddle with a cut out, First with a Specialized Toupe, then with a Specialized Rommin Evo. I have read some articles on the internet that say if you have this problem one should just quit riding all together, but I just cant stand the thought of never getting on a bike again. Has anyone out there had to deal with these issues and returned to cycling without symptoms returning? I am looking for any suggestions to help me return to riding. Thanks

  2. #2
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    Do you think your seat is too high? I only say this as it happened to me as a result of raising he seat too much w/o moving it forward properly. I was riding a Romin. Still riding the same saddle fwiw.

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    Quote Originally Posted by woodys737 View Post
    Do you think your seat is too high? I only say this as it happened to me as a result of raising he seat too much w/o moving it forward properly. I was riding a Romin. Still riding the same saddle fwiw.
    This does bring to mind that shortly before all this started I purchased a new frame. When I built it I set it up to what seemed similar to my old frame which I had been professionally fitted to. I never got out a ruler to check measurements but it seemed to feel ok when I rode it. The seat height might be something to explore. If I come back to riding I'll have another professional fit done.

  4. #4
    wim
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    This is pretty serious stuff, so no advice given here is or should be taken as medical advice. I do have two observations: (1) chances are high that a fitter, no matter how "professional," has absolutely no idea of what your condition is and what to do about it, and (2), cut-out saddles work for some people, do nothing good or bad to some and make matters worse for some.

  5. #5
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    Quote Originally Posted by tonybaloni View Post
    This does bring to mind that shortly before all this started I purchased a new frame. When I built it I set it up to what seemed similar to my old frame which I had been professionally fitted to. I never got out a ruler to check measurements but it seemed to feel ok when I rode it. The seat height might be something to explore. If I come back to riding I'll have another professional fit done.
    I wouldn't be surprised to find out that your seat was too high combined with setback a bit off then. That's a good combination for excessive pressure.

    Anyways, the coincidence of the new frame with no regard to measurements and your problem seem to fit nicely. If the medical experts have no direction or solution I suggest moving the saddle down and maybe slightly fwd. That Romin is a bit of a crusher in that area if you are sitting too far on the nose. Obviously a visit to a reputable fitter explaining your problem would be advisable as well. JMO

  6. #6
    wim
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    Quote Originally Posted by woodys737 View Post
    If the medical experts have no direction or solution I suggest moving the saddle down and maybe slightly fwd. That Romin is a bit of a crusher in that area if you are sitting too far on the nose. Obviously a visit to a reputable fitter explaining your problem would be advisable as well. JMO
    The down and forward suggestion could not possibly be anything more than a guess based on insufficient information. And as said above, fitters (professional, reputable or any other kind) generally have no idea of the complexities of this issue.

    I would normally not have responded again. But with pudendal nerve problems, there's some chance of permanent (as in "forever") damage. See your or another doctor, not some bicycle person!

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    Quote Originally Posted by wim View Post
    The down and forward suggestion could not possibly be anything more than a guess based on insufficient information. And as said above, fitters (professional, reputable or any other kind) generally have no idea of the complexities of this issue.

    I would normally not have responded again. But with pudendal nerve problems, there's some chance of permanent (as in "forever") damage. See your or another doctor, not some bicycle person!
    A guess based on what happened to me and given the fit information the op posted. But, yes just a guess. I echo seeing a medical expert but, as the op stated, twice he has been with no help. So, where to now? What is it after 15 years of riding and all of a sudden after he sets the bike up by eye this problem occurs? Just rhetorical questions mind you.

    It would be interesting to read what a fitter finds. If the op takes the bike as is will it be shown that the saddle is too high, too low, fwd, aft? Tilt messed up? It seems like that is the best place to start to me. If the fitting reveals no significant change or ID's any obvious problem then I'd start thinking about more serious causes of nerve damage (if that's what it is...).

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    This sucks bro! I would be devasted if it happened to me. I hope you find a solution. Keep us updated if you get to the bottom of it.

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    It sure sounds like a saddle issue. Either it's too narrow, or you're sitting too far forward, or possibly you're sitting off-center and the cutout is actually causing you to concentrate pressure onto one side of the cutout. A fitter might help; but then I don't believe fitting should be that hard. Look into the fit and adjustment, but remember bents are always a possibility. California is a big place -- are you anywhere close to Bent Up Cycles in West Hollywood?

  10. #10
    wim
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    Quote Originally Posted by woodys737 View Post
    It would be interesting to read what a fitter finds.
    I can't argue with that.

    But I wanted to make the point that whatever a fitter finds should not be considered in the medical treatment. The anatomy of that area is so complex that there are some vexing unknowns about this issue, even to medical professionals. The chance that a fitter's findings can be of medical value here is extremely small.

  11. #11
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    I injured myself down there a few years ago. Have you looked into the ISM saddles?

    Welcome | Ideal Saddle Modification

    The cut out is all the way to the nose so you can lean forward and the nose is a bit wider.

  12. #12
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    Quote Originally Posted by wim View Post
    I can't argue with that.

    But I wanted to make the point that whatever a fitter finds should not be considered in the medical treatment. The anatomy of that area is so complex that there are some vexing unknowns about this issue, even to medical professionals. The chance that a fitter's findings can be of medical value here is extremely small.
    I don't think anyone would disagree with that. The responsibility falls on the person with the problem to verify ideas presented here. Not that one post will magically solve a problem, whether it be medically related, equipment related, nutrition related, etc...but that someones experience (opinion) can spur further research and/or foster a different way to look at something. Possibly ask more intelligent questions of the medical expert.

    I can't remember who posted something about forward pelvic tilt as it relates to posture on the bike and avoiding low back pain, but, after some research I figured it out. I think that one piece of advise has helped me be able to ride again after a pretty lengthy time off the bike due to a back injury. It's not "the only" thing that has helped but, it sure has given me some perspective about how important posture is on and off the bike. I am a better rider because of this. Interestingly, the orthopedic surgeon and the sports medicine M.D. said nothing about posture on the bike. Probably because it's outside their realm of expertise. Which brings me back to this forum. It just never occurred to me that there was such a thing as posture on a bike!

  13. #13
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    Quote Originally Posted by wim View Post
    And as said above, fitters (professional, reputable or any other kind) generally have no idea of the complexities of this issue
    There's a wide range of competence among fitters.

    There's guys who go to a weekend seminar...if that...and there's others who have degrees in Kinesiology.

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    Quote Originally Posted by BlazingPedals View Post
    It sure sounds like a saddle issue. Either it's too narrow, or you're sitting too far forward, or possibly you're sitting off-center and the cutout is actually causing you to concentrate pressure onto one side of the cutout. A fitter might help; but then I don't believe fitting should be that hard. Look into the fit and adjustment, but remember bents are always a possibility. California is a big place -- are you anywhere close to Bent Up Cycles in West Hollywood?
    I live in Clovis CA, Hollywood is a long drive for me, a friend of mine suggested going to Arts cycles in San Luis. He said their fitter has some knowledge about these problems. If I decide to try again I'll most likely try them. Right now I'm just sitting on the fence not really sure what to do. Everything I have read says that if you have these issues you should just give up cycling completely. I've tried to forget about it, but some of the best times in my life have been out riding with my friends. I was just hoping to find cyclist here who have solved this problem and would have any suggestions what to do about it.

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    Quote Originally Posted by kookieCANADA View Post
    I injured myself down there a few years ago. Have you looked into the ISM saddles?

    Welcome | Ideal Saddle Modification

    The cut out is all the way to the nose so you can lean forward and the nose is a bit wider.
    I have looked at them online, but have never tried one. The one thing that makes me hesitate is the width at the nose, it seems like it would make it a little awkward to pedal. At this point though, that is another option That would be worth exploring.

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