I’ve been off the bike for almost 7 months. Just did a bike fit, that resulted in new saddles. My old saddles were S-Works Power Mirrors. Turns out they were too wide for me at the sit bones and it was pushing me forward. The fitter didn’t have much good to say on the old saddles — he’s had many complaints about the fit on those.
Did my first ride on the trainer bike in months. Just did 20 minutes to see how it felt. Using a Selle SMP saddle on that bike — much better.
Working with the fitter on parts for my road bike. I’ve added a Redshift Suspension Seatpost. He’ll help me pick a saddle.
Still on the meds for the nerve pain. Expect to be on those for a while. But, if I’m riding pain free then life is good again.
@MrBirchling Great that the meds help you. I am still thinking about them, but I thought if I could take on a year I can go on for another few month and see how it goes.
But then again, I can sleep and have no pain when sleeping and waking up. And I have times where the pain level is only a one and I can more or less ignore it. However, when it is a 5 it is really hard to concentrate. My PT says I should try not to think about it… but thats not as easy as it sounds
I also read that some people get relieve with small botox injections and my doctor said that could also be an alternative.
But funny thing is the last few days were actually better and I had a 2 hours window where I was sitting with my feet up where I had zero pain.
After long ultra events I learned this was flaring up. Basically has erased the past 1.5 months talking to doctors. Finally found a PT specializing in PN and dry needling put me back on the bike that afternoon pain free. I’ve made no fit changes yet and their recommendation was ~3-4 sessions over the next two months. I am more aware of when the pressure is there on the nerve now and am going to discuss with a fitter soon.
I am in Colorado, USA. Based on my presentation of where the symptoms were, that’s where they put the needles. I think it was two in the pudendal penile and one pudendal rectal but I wasn’t looking. Five minutes of electrical stimulation per side. You can usually ask them to demo the needle on something less private.
On long descents I brace against the saddle right where the pudendal penile runs. 40 minutes flying down from Mt Blue Sky was rough. It’s going to take some mental retraining to not compress the nerve.
I’ve had severe PN about 1.5 years ago. I’m almost completely pain free now (still some discomfort but that’s okay), which I’m very happy about.
However, I’ve been trying to get back to cycling without big success, and I was wondering whether anyone found a nice outdoor sport to replace cycling? Running is unfortunately not an option. I’ve started wind surfing when the weather is nice, but I’m still searching for an endurance sport to replace cycling.
Great post. I’ve been dealing with cyclist for decades now. Have not ridden for as many tears.
Just curious if anyone has found relief 5 years after this initial post.
I have had 7 lumbar surgeries. Didn’t help. 2 surgeries to address the PFCN that is supposedly trapped betwee. My obturator internus and my piriforimis. Both failed due to nerve getting re-entrapped once I sit.
Thanks for sharing your experience. Question on the dry needling: does it provide short term or long term relief?
My PN had been improving for a while, with rest, medication and occasional exercise and stretching. I’ve recently had a flare up that doesn’t seem to be receding. I might be looking for more options.
Well it sounds great, I have it since around 15 month. But I had same good weeks lately (even days where it was nearly pain free when I was at a vacation and did a lot of saunas etc.).
But well it always gets back and still fluctuates. At least its on a level where I do not think about it the whole day. From what I have read most people that have PN from cycle do recover, but it can take many month or something like 3 years.
Correct! It took 2 years in my case. Nerves = takes time. Now adding few 45 min rides/week. Holding up so far.
Besides rest I had 2 infiltrations, none helped if you ask me. Rest did. (read = off the bike)
Thanks, gives me hope. Its around 16 month for me, still fluctuating. I am still not sure if its some inflamation (never took antibiotics) or just the nerve… I might start with some medication like Amy in small doses next month, and lets see.
Hey! I just came across this post (I realize it’s 4-5 years old), but I’m curious as to what your experience was with this. Any information would be greatly appreciated! Thanks!
Shout out to everyone on here sharing their stories. (Woman here) I am not certain I have PN but I definitely have some of the symptoms and wanted to share my story and perhaps hear from other ladies if they’ve experienced something similar.
I had a great bike season in 2024, was feeling great on the bike, no pain whatsoever. That all changed mid-October when I suddenly had a sharp pain on the medial side of my left sit bone when sitting on my gravel bike. It was painful enough to not want to ride so I took a bit of time off (6 days or so). I did a few short MTB rides as the upright position was significantly less painful. I went to see my physio and she suggested it could be ischial bursitis.
I had a couple of bad flare ups in in early and late November caused by a 7 km ride on my gravel bike and a very short ski tour respectively where I felt a dull aching pain from my hip all the way to my ankle constantly for 8+ days. This was accompanied by tingling/shock feelings in my hamstring and glute.
Since my last flare up, my symptoms have slowly been improving and I am not in constant pain. However sitting on hard surfaces is uncomfortable, including my bike seat. I have had an xray and ultrasound which both came back negative and a consult with a sports med doc/ortho who doesn’t think it’s bursitis or high hamstring tendinopathy. He is convinced it is nerve related and has ordered an MRI (this will take months to get).
My symptoms have evolved a bit as I am no longer getting pain referred down my hamstring, but now I am getting more pain in the inner thigh and groin, especially high up where the leg meets the pelvis.
3+ months in, I am now able to do most activities (downhill and cross country skiing, hiking and sitting on softer surfaces) but I am still slightly devastated that I can’t ride my bike for very long. I tried a 4 minute ride on my trainer yesterday but it was still quite uncomfortable. My last true distance ride was October 15.
Any ladies out there experienced anything similar? I’d love to hear any anecdotal stories while I continue waiting for a diagnosis. Thanks again to everyone on this forum - it has definitely given me hope that I will be able to ride in 2025.
Can I ask you about the TENS device?
I had to look them up - where do you put the pads, pelvic floor, medial buttocks? Do you think it really makes a difference?
I went to pelvic physio and the internal trigger point release gave me a flair up, and so does the massage wand others suggested here. So that purchase is out the window.
I tried my massage gun (that I would use for quads) around my pelvic floor, ischium. It was like sprinting in the feed zone, haha. WTF was I thinking. My pelvic floor lit up in fire for 3 days after that shenanigan.
Well frankly my symptoms come right back by doing pelvic floor stretches and cossack lunges too, not bad but noticeable.
My hubby cannot wait for me to get back on the bike and ride with him, sigh. I need to figure this out.
Well, I guess it can be different for everyone but it’s worth a try, as TENS devices are not that expensive. I put them where the pain is or close to it.
You can feel immediately if it lowers the pain, it does for me. The effect can even last vor a few hours after using it, but then it comes often back as before.
But when it is really annoying and I just want to watch a TV show, I use the device and then I nearly don’t think about any pain at all.
And use low frequencys with the TENS device, like 4Hz or something like that. But you can experiment with it. Let me now it is any help for you.
I thought I had it all figured out but I’m having trouble “down there”.
I think it’s riding on the turbo trainer that does me in. Also, the saddle that used to work 5 years ago doesn’t any longer, I think it’s due to some 6-7 kilos of extra weight I put on. Also, I put a longer stem and that seems to have made the hands take less weight because I didn’t also lower the spacers on the steerer.
So, my plan is:
try more running and swimming
install a selle smp saddle
lose a bit of weight
lower the handlebars a little so I have better angle to put weight on my hands
one of these donut cushions for sitting at work and a standing desk
While I implement those things, I’ll also try to find professional help (doctors, physiotherapy, bike fit) bit wish me luck…
