@cub, if you want to DM me I can give details but there’s more to it than stretches and movements. I would seek out a physical therapist that deals with the pelvic floor.
I had 12 months off with no cycling with the same issue. I took it slow and 18 months later I am back to my pre injury 4W/KG. I cannot recommend the ISM PN 3.0 saddle highly enough. It was and has been an absolute life saver and I wish that I had found this saddle years ago. As Phil Gaimon says ultimately your not riding on your testicles, which has to be a good thing 
He is also right that getting a proper bike fit, I used Retul, to really dial in the saddle is absolutely key. You will get there just take it slow.
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LOL “I could have sex in the feed zone if I wanted”
That’s helpful, i’m definitely going to invest in another bike fit before getting back into training again.
I just wanted to thank everyone here for their tremendous help. I’m not the OP but i suffered from a lot of the same symptoms and have gone through the Retul fit twice now and still would aggravate one of the nerves or pelvic floor muscles which in turn would inflame and aggravate the nerve). I’ve gone through at least 100 different saddles with no fix. The stretching suggested here did help limit my pelvic floor tightening up and causing numbeness, but longer rides still would cause problems.
I seemed to have solved the issue on accident. I swapped out my 420mm handlebars for 380mm because I have always felt they were a tad too wide. I was unaware but the smaller bars also provided a shorter reach. Things down there feel much much better immediately. In fact I’m doing two hour rides with no numbness, pain, or inflammation. That would have been unthinkable a year ago. If i had to guess on what was happening, I would say the Retul system put my setup in the ball park, but my core muscles would slowly tire out giving me an improper riding posture. The 10mm reduction in reach, which while pretty minuscule, seems to have made a substantial difference. I’m still paranoid so I am still keeping up with the stretching.
I just wanted to share my story just to give a little hope to those suffering. I’ve nearly hung up my cleats 3 times now and have spent countless hours with Drs, Pts, and bike fitters.
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I’m really pleased people are coming out of wood-work to talk about this. It’s heart-breaking how many cyclists have probably just given up their kits for this.
The shorter reach solution is REALLY intriguing. I’ve been feeling like my reach was too far for a while, as i was getting some shoulder pain before all this pelvic floor madness flared up. I hadn’t considered that it might actually be a contributor. My PT actually provides bike fits, and i’ve scheduled one in a couple weeks, I’m absolutely going to talk to them about that in particular. Thanks for that.
I’m definitely on the mend and have actually gotten on the bike a couple times for some short rides without significant issues. But man what a frustrating injury. Thank you so much for sharing.
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In Feb 2016 I had to stop my training completely because of pain in the aera. I saw PTs, I had 3 pudendal nerve block, infiltrations on the hamstring tendon, the bursitis. I was sometimes unable to sit more than 5 min and therefore tried numerous pain killer (tramadol - works super well - but when you stop it arggggg, naproxen, Laroxyl, …) . Riding, running was impossible.
Anyway long story short, nerve pain are terrible because they play in your head.
In 2017 I was really depressed and hopeless….but dont know why but in spring 2018 I said f*ck it, I’ll bike again. And little by little get back into shape. Used a cream with 4% lydocaine to alleviate the syndromes and …I managed to do crits again during the summer & got my ass kicked the good way.
From that point on the brain start to release that sitting was not a dangerous activity…
In 2019 I have resumed real bike racing with real ride of 100km and more. I am still careful, using the cream.
At the end of the day, difficult to say if it was the pudendal nerve, sciatica is pretty close, and I got back issues.
But anyway the bottom line would be: keep hope, be nice to yourself, be patient, you will sort it out.
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Man that’s a tough road to recovery you took. It’s awesome to hear you came out the other side with your cleats on.
I had never heard of this condition and now you guys have me Googling “Pudendal Neuralgia” and reading in horror. Kudos to you all for your resilience, this sounds like a terrible thing to battle through…
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The diagnostic is difficult (by elimination mostly), and there are so many different root cause. The horror stories are mostly related to entrapment if I got it right, and in our cases (cyclist) we are not dealing with an entrapment.
I wish I would have never looked on the internet back then, It just made everything worst. Again I believe that the main problem was my brain - the pain was real - but not related to any real underlying physical issue.
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I would be careful there. I would guess in most cases (except those that go undiagnosed for years) there is no physical entrapment (which could be due to fibrosis or scarring, or whatever) but I would be shocked if there were no underlying physical issue that kicks off these problems or keeps them going. Is central sensitization a component that amplifies the wrong signal coming from the nerve? Almost certainly. Especially the longer your nerve and/or pelvic floor is dysfunctional. Is it all in your head? Doubtful.
Yes that’s right, I was not clear thanks for the clarification.
Initially I believe it started as an overusage type of injury in response to too much time on the trainer and rollers which I was not that used to. Then my brain developed an over sensibility - but let’s be clear once more, the pain was real nonetheless!
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After I posted here way back I had several private messages from people, I hope those people are progressing with their recovery and here’s an update which may give them hope.
Over the last 10 weeks or so I’ve been riding almost exclusively outdoors one fixed gear bike, the relevance of that clearly is that there is no scope for downhill freewheeling and standing except for when climbing. Yesterday, not on the fixed I may add, I completed a 5 hour ride, pain free, and today I also feel good. So, don’t give up, do what your physio tells you, keep stretching, keep relaxing that pelvic floor and with good luck you will recover.
Nearly 12 months ago for me to do 10 minutes on the turbo was an achievement so yesterday was momentous.
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That’s fantastic to hear. Congratulations!
Your story and advice has been invaluable to my recovery.
I’m back on the bike as well. Not 100% but light-years from where I was a few months ago. I still won’t do consecutive days on the bike, and no more than 60-90 minutes or so at a time. PT has been incredibly helpful and we’ve narrowed in on the specific therapies that make the most difference.
On a side note, I recently invested in a rocker plate for my trainer. It’s definitely not “the authentic riding experience” they claim but the subtle motion does wonders for keeping my sit bones from stagnating, That, and doing a few seconds out of saddle every couple minutes, has been making a world of difference.
Cheers!
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If you have questions or comments on the rocker plate, let me know. I’m happy to offer ideas on how to adjust them to get a more desired feel and functon.
Hi all, looking through your comments has been lovely when I know there’s more cyclists out there getting back.
However, unfortunately I am not one. I have some questions - some may seem a bit silly but just looking for clarification.
Has anyone had PN and it gone away on its own? If so, how long did it take?
I’ve spoken to the Dr and she said go away and it should get better, and it has slightly but still not back to normal function, is there anything I can do to speed it along?
PT, means physiotherapist right?
And is it wise to get a PT? If so, do they have to be specialist nerve ones or do most know about solving such problems?
Also, has anyone ridden on different saddles while they are suffering from PN? I bought the Rido R2 and it seems somewhat effective before I fully stopped for the past 4 months. I’m tempted by the ISM.
Many thanks for help in advance,
Al
I definitely recommend getting a Physical Therapist. Not to get into too much detail but they know the nerve pathways and get help to alleviate whatever the “obstruction” to the nerve function might be. You definitely want to find someone who specializes in “pelvic floor” issues. Most of the time their patients are women dealing with issues as a result of child-birth, but as far as the nerves are concerned, we’re very similar. The other thing they are great for is helping you to identify how to “relax” in ways that, at least for me, aren’t places that you have conscious control over naturally. Sadly I haven’t found anything that speeds up the healing, nerve stuff takes an aggravating amount of time. I’m still dealing with it, but it’s to a point now where I can feel the flare ups coming and do a handful of things to alleviate them.
As far as the ISM, the part of it that helped me is that it forces you onto the “front-ish” part of the sit-bones, and keeps you from putting too much pressure on your twig-and-berries. The mistake i made, and the one that I think caused this, is that I was favoring the back of my sit-bones to avoid that pressure and instead crushed the nerves in the the rear. It all makes a lot more sense when you see that paths that the nerves are running. Where you’re feeling the discomfort isn’t necessarily the area that is causing the problem…
In short, a good PT makes all the difference. They know more than any doctor I’ve spoken to about the issue, they either prescribe Ibuprofen or tell you you’ll never ride again.
Keep positive, and remember recovery isn’t linear. You’ll feel good for a while and then feel like you regressed, but it’s all part of the process.
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Yes, 100%. I’m not totally out the woods yet myself, close, but I think there is a definitely non-linear trajectory of recovery. I have found that I recovered in steps where suddenly my new baseline was really good compared to the old and minor flareups were kind of where my old baseline was if that makes sense? And inevitably I would get a major flare up at each stage before the next breakthrough. Maybe this was learning more about what triggers to avoid? Not sure.
In any case, every time I had a setback I would obsess over it, get depressed, stop swimming for a week or so (my only exercise outlet then) and drive my wife nuts. A therapist (emotional or psychotherapy) would have probably helped a ton with dealing with my emotional reaction to the tough times. I didn’t find one and it wasn’t even suggested to me until I didn’t really need it anymore but maybe others will find the suggestion useful.
I might make a post later about how things are more generally but after a few false starts the dysesthesia is still there and sometimes slightly painful but I rarely think about it and I’m very slowly re-introducing riding. It’s been six months since diagnosis and four months since I started treatment (it took me two months to get in… that sucked). As I mentioned before I started with an SQLab 600 for like short trips around town with my wife and light exercise but I’ve got an Infinity Bike Seat now on my Aeroad and I’m starting to do 1.5-2hr groups rides (right as everyone is going inside for the winter). I supplement my Physical Therapists at-home program with some videos also used by Data Driven Cyclist: https://www.datadrivencyclist.com/resources
Oh, and to answer @AJD’s first question wouldn’t suggest going it alone. I have no reason to believe that it wouldn’t have eventually gone away on its own but that’s probably only if I managed to figure out all of my triggers (riding of course, sitting, not getting enough sleep, drinking too much?, etc.) all on my own and I also think the PT (this needs to be one that specializes in the pelvic floor) helped move things along faster.
Before PN and Pelvic Floor pain were really known you have all these horror stories of people who have horrendous pain, truly entrapped nerves, and probably no home for major improvement. I personally think that’s because they had no idea what was causing the pain for years and couldn’t get any help. In any event pelvic pain is still relatively poorly understood by most medical professionals. Get whatever help you can.
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Cheers to both of you that replied!
Just wanted to ask for a time frame of your recoveries with physio? In terms of days, weeks, months?
And if it’s not too personal, what was the extent of the pain? I don’t believe mine is all that bad compared to some of the reading I’ve done, also can you still ride bikes despite your ‘flare ups’ as you mentioned?
Cheers,
Alex
And a more succinct answer to your question would be: I was sitting at a 5 for a couple of months before I started PT and it was hell. I saw rapid improvement within a few weeks of starting therapy.