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pudendal nerve irritation/inflammation
Last Post 06/08/2021 08:15 PM by Franck A.. 11 Replies.
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eurochien

Posts:163

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06/06/2021 07:48 PM
In 30 years of cycling I've never had a serious issue with saddles, other than the odd saddle sore. This season is different though. I'm getting a sharp pain every time I sit or raise my butt off the saddle (so, add pressure/relieve pressure throws a sharp pain). I've looked it up, it's a pudendal nerve issue. It started a few rides ago, it's worse on the mtb than on the road bike due to the number of times I get off and sit back down while negotiating terrain (descending is no issue as I use a dropper or just do not sit on the saddle). I think this issue has been brought on by sitting on my ass all day while working from home for the last 18 months and it's coming to a head with riding bikes. Today out on the trail I tilted the nose of my saddle down a bit, I couldn't tell if it did any good. Now I need to figure out what to do. I'd hate to stop riding, especially mtb, but it's getting pretty damn uncomfortable and I sure as $#it don't want this to become either chronic or permanent. Before I start throwing $$$ at a bunch of saddles, have any of you forum regulars dealt with this issue and how did you fix it? Thanks
Orange Crush

Posts:4499

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06/06/2021 08:21 PM
Hmm this almost sounds like the sharp pains I got my very first year of riding age 16. Always figured it was adjustment problems. Taking a whizz also hurt for a while. Then it all went away next year.
6ix

Posts:485

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06/07/2021 11:28 AM
Been there. Long story short, have you looked into lowering your saddle? I kept my saddle at exactly 79.2cm since I was 15 and never strayed one millimeter only to find out during a Retul fitting that I was WAY too high. Dropped all the way down to 77cm and it has helped a ton. I still get similar discomfort to you but it's not nearly as bad as before. I'd even tried one of those custom printed saddles that cost $300 and that only caused more problems!!

While they may not be the lightest saddles on the market, I've found that the carbon-railed version of the Terry Fly saddle to work well as the relief channel seems to help. And it's kinda cushy but not too much.

But yeah, I got to a point last year where I'd grimace in pain when getting out of the saddle even in the first mile of a ride. Terrible pain. Went so far as to get a steroid shot.

Not sure if that's crazy because I refused to take time off or speaks volumes on my commitment to cycling.
Cosmic Kid

Posts:4209

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06/07/2021 01:31 PM
Not sure if that's crazy because I refused to take time off or speaks volumes on my commitment to cycling.


Just say "NO!" to WCP!!!!
Cranky Tom

Posts:58

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06/07/2021 03:10 PM
I've had a similar issue over the last few years. It was really bad about 18 months ago. It's mostly a minor problem now but it still crops up now and then and is really painful at times. I feel it more on my road bike than my mountain bike. I did the saddle swap thing with no relief. Tried about 4 different saddles. I got better results from buying new bibs with a little thicker pads. Ultimately, I figured out that two things cause the issue for me.

The first is just my age. I'm 52 and it seems that with some age-related changes in my body I now have a little less natural padding "down there." Hence the benefit of the some thicker pads in my bibs.

The second issue is an imbalance in my body that subtly changes my position on the bike and, I think, leads to the pain. I've always had a certain amount of tightness in my quads, hip flexors and psoaz muscles that causes my right side to shorten compared to my left. Sitting all day at work and cycling certainly don't help that problem. I've managed it pretty well over the years with stretching and strength work but for whatever reason I've had a much harder time keeping it at bay the last few years. When my right side is short and I ride my hips are slightly pivoted and I'm not centered correctly on the saddle (similar to what would happen if one leg was shorter than the other and you didn't shim your pedal) and that's when the pain sets in. Lowering the saddle can help but it doesn't address the imbalance itself. If you're not already doing it, some consistent stretching of your quads, hip flexors, psoaz, hamstrings and lower back might help you.
eurochien

Posts:163

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06/07/2021 05:28 PM
Thanks for the tips and for sharing the stories... I think I'll rest up for a few days and lower my saddles by 1/2 inch for a start. Interestingly I've been using new bibs this season (Nalini for road and Yeti for mtb) so who knows if that's not another factor, although I've used pretty crappy bibs before without having this kind of nerve pain. Stretching is not part of my vocabulary lol. Every time I've tried I've ended up in worse lower back pain (I have 2 herniated discs L4-L5, L5-S1 like so many people).
79pmooney

Posts:3180

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06/07/2021 07:29 PM
Another here who's ridden through body changes. I moved to first the Specialized Body Geometry Comp in my late 40s for the full length groove, then tried the Terry Fly. The Flys aren't 100% perfect, but they suit me very well. Basically the wonderful Selle Italia seats I raced and loved but with that detail that allows me to keep riding.

Seat height and leg length - I've always sat a little cockeyed on bikes so nothing was symmetrical. Never knew where to start so I ignored/adjusted to it. Then a PT diagnosed my right leg as being 1/2" shorter. I now use a 1/2" sole insert or heel lift in all my right street shoes. Cycling shoes get a 1/4" plate over all my right cleats and heel lift. Its been life-changing. And for the first time ever, I can look down the centerplane of the bike and front wheel, every time!

I am such an inflexible critter I partially tore both Achilles trying to do a minor yoga stretch. (That's why I was at the PT.) She got me stretching seriously. I don't do a huge array of stretches, just Achilles and hamstring, but I do it every morning. Slowly. Not to any goal at all. What I do is put the front of the foot of the leg to be stretched on a 2-1/2" high block, then crouch and stretch that Achilles for 200 revolutions of a coffee burr grinder, then straighten my leg and do the same again for the hamstrings. Repeat on the other leg. (It's a small grinder. Takes 1100 revs and makes killer coffee. My tendons love the routine. Likewise my knees, every ride.)

So, I would suggest the stretches. Start slow, no "goals" and don't force anything. And seriously consider a plate shim over your "shortened" leg's cleat. My PT says that half the leg difference is right for cleats but I don't know if you have a way of figuring how much your tight muscles have "shortened" you leg since obviously they cannot do much while you are standing erect. Maybe try 1/8" for a start. If that helps, try a 1/4" or just add another 1/8". (Probably a lot easier to start by adding insoles though once you have the thickness needed, the plate allows the full comfort, efficiency and fit of your shoes. I took 1/4" aluminum plate, bent it to fit my shoes and removed a lot of material at the front to aid pedal pickup. It was a lot of work. They will outlast the shoes.)
Cosmic Kid

Posts:4209

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06/08/2021 09:22 AM
I've been using new bibs this season


So if you have been previously been using "pretty crappy bibs" and just switched to new bibs, you have probably increased your saddle height. Older, crappy bibs likely had thinner (and compressed) chamois. New bibs have significitnalty thicker chamois, so lowering your saddle height a few mm is a good place to start.
Just say "NO!" to WCP!!!!
79pmooney

Posts:3180

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06/08/2021 10:36 AM
CK, we need electronic dropper posts that read input on foot height over pedal and butt height over seat to compensate for different shoes, socks, bibs and additional layers to account for different shoes/boots and bibs and layers so we can stay dialed in on fit throughout the year and the life cycle of our chamois. This in the name of keeping cycling simple.

Actually dropper posts for road bikes has seemed to me like a no-brainer good idea for a long time. Safer, faster descents? What's not to like? Now we get to kill two birds with that stone.
Cosmic Kid

Posts:4209

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06/08/2021 10:51 AM
Actually dropper posts for road bikes has seemed to me like a no-brainer good idea for a long time.


The problem is almost no one does a round seatpost anymore...
Just say "NO!" to WCP!!!!
79pmooney

Posts:3180

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06/08/2021 11:14 AM
Still a no-brainer. You get to hide the mechanics in that aero seat tube and (after whittling enough off the rest of the bike's weight) boast your new UCI limit wonder with it's incorporated dropping seatmast. An expensive process, yes, but you get to up the price a few grand because who else has it? And with the TT flop banned, your riders will be the only ones descending legally at the old speeds.
eurochien

Posts:163

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06/08/2021 08:15 PM
CK I suppose that makes sense, but I started using the new bibs at the end of last season, did not ride much over the winter and started riding again 4-6 times a week in April with zero problem until just a few rides ago. I think it's got something to do with so much sitting. It kinda freaked me out.
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