Cyclist’s Syndrome / Pudendal Neuralgia, recovery advise and how to move forward?

Sure, if you scroll up to October of 2020 there’s a huge post I did where I showed my stretching routine. I think it’s difficult to isolate that specific area, but it gets hit when you work the periformis and stretch that area as well.

I also do these “windshield wipers” which help and also just feel really good in general.

I’m “mostly” better, but I do think that there’s a definite correlation between hip and pelvis stability and symmetry. In short I think running would mess up my SI joint and hold my pelvis at a asymmetrical angle. Then I’d put that pelvis on a bike seat and grind on it for hours… So I find the more work I do on keeping that area stable and flexible, the more the nerve pain isn’t an issue.

I’d say most of the time my discomfort is a 1-2 on the bike and a 0 off the bike. But if I’m going all out and my form goes to poop, then I tend to have a bit of a flare up afterwards. I think this will always be with me on some level, but it’s not ruining my life anymore.

^^ That is my dream! I’ll look back at the previous post and get on with some stretches. I’d given it 6 months off the bike and done little else apart from a combination of trying to ignore it and wishful thinking. It’s clearly not worked. The NHS physio was a bit useless as she didn’t want to meet face to face (COVID) so the bi-monthly phone sessions involved nothing more than her saying "keep doing the happy baby pose to relax and i’ll talk to you in 8 weeks…)

yeah, rest and learning to relax the area is important. But at a certain point, if we can’t figure out what the initial problem is, or how to manage it, we’ve either accepted never riding again, or we’re accepting it’s just going to keep coming back.

For me, i think running too much throws my pelvis out of wack. So I’ve decided to stop doing that and prioritize cycling and rowing. Over 40, running causes more problems for me than benefits.

Hi @RCC,

I had a similar experience with the NHS…my physio assigned through the local GP surgery had no idea. Have you seen the link below?

Thanks. I’ll give these a go. :+1:

I haven’t gone far back in this thread to look if this was posted. I recently came across a site that those that are suffering may find useful. PN affects 2/3 females and 1/3 males. There are docs that specifically treat pelvic pain. It’s usually going to be a doc that primarily treats women but has experience treating men as well.

I hope this helps.

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Yup most PTs in this field see mostly post partum women, as they’re more likely to experience trauma in that area from pregnancy and delivery. That was the case with the one I saw.

Not sure if this thread is still active but wanted to express my gratitude for putting the info out there. I am suffering from similar condition and while it was improving (or so I thought) I had a major flare up and feels worse than since the onset of the injury (approximately 6 weeks ago). I know it’s still early, but it can get quite demoralizing. I am seeing a PT but not sure if I’ve hit the wall. At this stage I would trade in never riding to be free from the symptoms.

Any advice from someone who made it through the other side is greatly appreciated. Its very motivating to see someone recover and return to riding. Also, I know I’m an internet stranger but it would be helpful to discuss some matters directly if you had the time.

Hope everyone else is on the road to recovery and can put this behind them!

Cheers/stay well/wish all good health

After a couple of weeks of flared up symptoms and getting really stressed about it i went online to try to find some help and found this: It looks like it is certainly worth a try and it comes with a money back guarantee. I’ve signed up and gone through the first few videos and it’s really making sense.

I thought i’d share it here now rather than wait 6 weeks to see if it works, because 6 weeks is a long time to have to suffer the pain if you could try this now and have it work for you.

Good luck.

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Hey - I need help. Can you tell when you done with pudendal pain?

Hi @RCC,

How are you getting on with Aidplan? I have been using curable (app) which has also been helpful in managing the symptoms but not completely…

Hi @Abhijit_Rao It’s going fairly well. I do all the exercises every day and i think it’s slightly better. I wouldn’t say that i see light at the end of the tunnel yet but i feel better knowing that i have some techniques that i can use. It’s like having “hope”.

That sounds good. Please have a look at the curable app and also Alan Gordon’s book called “the way out” which focuses on chronic pain…has helped me a little and may be useful to others here.

Best wishes,

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I have pne symptoms , been around the houses with doctors , what exercises did you do to make it better?

There are some good exercises and stretches in this thread. There is no quick fix for this though and expect it to take a long time… I’ve had it for 18 months. I strongly suspect it was more from stressful work and being sat down at a desk all day more than from cycling. I gave up riding for 6 months and that only helped a tiny bit. I keep a daily spreadsheet now and rate the pain out of 10 and mark other notes such as “stressy day” alongside to see if i can track patterns.
Apart from that i have learned to belly breathe, got into the habit of relaxation exercises, stretch every day, given up eating bread, only ride 3 times a week instead of 6 times and it’s tolerable… it’s still crap, and painful but i can live with it.

Doctors can’t do much for you. PT might be able to help. Really there’s not a lot of good news i can give you from my own experience.

Good luck.

Hi all,
Been a while since I posted…I was in India visiting parents and opted for a MRN while there mainly because it is 20% of the cost compared to a privately arranged one in the UK…

The report showed bilateral inflamed pudendal nerves and the consultant said it is defo due to time in an incorrectly fitting saddle…he also said that pudendal irritation can make Piriformis, hamstrings and calf muscles to contract making existing back problems worse…so in conclusion, I am dealing with a double whammy…

Amitriptyline, stretches and walking keep me going.

Take care all


Hi there, I would like some more info on this if you are able to provide some. Thanks

Sorry to hear and hope you get well soon
I wouldn’t recommend a Pudendal Nerve block mine has made me worse

I respectfully disagree. Nerve pain medications have been a life-changer for me. I’m a 0/10 any day I don’t forget a dose or two of gabapentin. I have a flare up once in a great while but generally I am improving over time. I had to give it time. Months, in fact, to see a large improvement but it did come. My doctor is confident I’ll come off the meds but I am fortunate that they cause me zero discernible side-effects.

I tried PT. It helped a bit but I plateaued quickly. Stretches are nearly worthless in my experience. Breathing. All that hippy dippy nonsense did nothing for me. Meds worked. Maybe not for you. Doctors helped me a great deal. They haven’t cured me. They weren’t able to wave a magic wand that fixed me but I went from a 7/10 and absolute despair to riding up mountains and medaling at state champs in just a couple years so I do think doctors have something to offer.

I would caution folks who are new to this thread or chronic pain in general to remember that those that are in the most pain, and have been for the longest, tend to participate more in online discussions like these than those who have gotten better. This thread is a bit of an exception as I’ve seen a lot of people with positive attitudes and outcomes continue to share information with each other. Pudendal Hope is not that way. Other pain forums are just a pit of despair.

Stay positive. This stuff is hard but you can get better. Pain is a fucked part of human existence and it’s a very weird thing.

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