I continue to have left sided ischial tuberosity pain despite multiple bike fits on both my bikes. Raised, lowered the seat and every variation of such. After tons of self experimenting, I think I’ve narrowed it down to asymmetrical pelvis. I feel like I’m sitting with my left side more forward and looking back old bibs the inside of my right ones are way more worn. A PT said my right leg was shorter, I shimmed it and didn’t help. Another PT said it wasn’t. Is there anything I can do on the bike to start to correct this? Even my heat molding seat had a way bigger dent on the left. I have an appointment with another sports medicine specialist this week. I continue to do a strength program weekly. Also feels like my left glute is doing much more work.
If you lay on the floor on your back wiith your legs up a wall . 90 degrees bend at pelvis. Have someone put a level across both feet. This will show any length difference. Could be leg or hip.
Marching in place with your eyes closed will help a fitter find out which leg , hip could be a problem. You will end up going left or right but not know it.
You might need shims under cleats or even heel counters.
A good fitter/physio should know these things.
Just a few things to try.
Might be worth asking your PT to check for scoliosis too. Even a mild curvature could manifest itself in the way you describe.
I have mild scoliosis, and it threw off my shoulders during college (hauling books) but both legs are the same length aside from any compensation for the bend in my spine. On really long rides lately, I seem to feel better if I sit a little towards the left. I was diagnosed late too, in college. I was having horrible neck and shoulder pain. I was seeing a DO who could pop me back into shape. Weird that such a slight alignment can cause what it did back then. I probably need a new fitting and find someone who can take that into account. I’m sure that alignment issue is causing my butt’s appetite for new saddles. Such a diva, so expensive…
Some reading material
Thanks I’ve gone through a lot of his material. Too bad he isn’t closer. I have an appointment tomorrow with a sports med chiro. Hopefully that and getting back into PT will help. After a ride yesterday I’m in serious pain on the left.
I think his latest un-discovered idea is that the nerves in the upper spine have a lot to do with hip , leg and foot motion.
You could try a Steve Hogg trained fitter, he has a bunch listed and they cover all of the world. They are the fitters with the most interest in pelvic asymmetry. It’s also something hard to check for yourself as you need to view your behind outside and indoors to check for changes.
Ya my last resort is one in CO trained by him.
Did your bibs shift while riding?
A couple of years ago, after riding like a neurotic monkey at a research center, the pad in my bibs would shift to one side! I never noticed it riding outdoors because I would guess that my weight was on the saddle a lot more than outdoors where I was up/down/up/down a lot.
I actually took to tugging my bibs to the right so that when it did shift, I wasn’t potentially riding off the pad, or worse in the sewn edge of the pad. Just asking. I thought that pointed to something strange going on, and when I mentioned I felt like I was off while riding, it just hit me, the possible connection. I have a really weird looking saddle with two pads that can be, supposedly, independently adjusted. It looks like a torture device, so I’ve been hesitant to use it. (I bought it out of desperation along with 3 others to try to find one that fits and works well. To me, more levels of adjustment means when they loosen, I hit the wall (of pain) harder)
No kidding, some bibs would feel like they would completely spin around if it weren’t for the leg holes stopping them. I wished I could find bibs with wider pads at the time. So frustrating…
I tried putting a Chapstick tube on my saddle, and found I was off center too. Not egregiously off, but not spot on. I don’t know if my hip replacement might have changed the dynamics though. One therapist asked me if I had issues sitting in chairs, when I said no, they shrugged it off and forgot about it.
Not that I noticed. I sweat a lot so they stick to me like a wet diaper.
The picture is of my new bike before the fit. The fitter asked me to pedal a bit before we went thru the setup routine. He did get me almost to center. I’m at center now with his help and some flexibility stuff. He is a Steve Hogg guy.
On my old bike I had a pretty flat saddle so never noticed if I was off center.
And @t2091? Just curious if they had the same or similar issue. Back when I was noticing it, I was on FB, and mentioned it, and most people thought I was weird. Well, yes, but weird enough to cause THAT to happen? I’m also gifted, but not consciously that gifted. Or so I thought…
I wouldn’t say they shifted just way more wear on the right groin part of them but my right leg comes much closer to the frame than my left. I widened the stance via the cleats which actually stopped that rubbing but the pain on the left persists.
Around 2010-2011, I started having some pretty bad sciatic pain. Additionally, if I were sitting down for a while and went to stand up, my right leg just wouldn’t push. A few times, I started to go up stairs and went to land/push off my right leg and it would just collapse. I started PT and the first lady I started seeing said my legs were different lengths, which I’d never encountered before. She gave me a shim for one shoe, which was terribly awkward. I got used to it over a week or two and went back to PT. She’d gone out to have a baby, so I saw a different guy, thank God. He observed and measured my legs and said they were actually the same length, but my hips were twisted (I think similar to this picture), so we began work to correct that. I’ve been to lots of PT over the years and I kind of enjoy it, but this was some of the most painful I’ve done. It was pretty intense, forceful stuff, but it worked and I haven’t dealt with any issues since then!
What have you done PT wise? I have the exact issue and am also working with a Pt. Quite a bit of hip and ankle mobility work followed up with single leg squats, dead lifts, etc.
Seems to be helping with the pain quite a bit but I’m definitely still having quite a bit of weakness when riding.
It was obviously a while ago, so I don’t remember everything. Yes to all that you mentioned. Looking back, I would think all the hip, leg, and back mobility you could find. Runner’s stretch, pigeon stretch, butterfly/frog stretch, even hamstrings and quads. The painful part I do remember is him pretty strongly pulling and stretching my legs at different angles on the table to untwist my hips. It was the only time I have almost cried in PT (as a macho college guy at the time!), but I guess it worked!
I’ve had asymmetry forever. I never feel square sitting on a bike. Out on the road or on rollers, the feeling disappears quickly. On a fixed trainer, It almost never goes away. I also favor the left side and have had issues where I’m putting too much pressure and wear on my left. I even had an injury down there which sidelined me for a while and made be try 5 different saddles and new bibs.
Do you have a very upright position? Normally, in a road bike position, you don’t actually sit on the ischial tubrerosity (sit bones). We actually sit on the pubic ramus. Maybe a more aggressive road position would help? See:
I finally tried one of these SMP saddles and it is working well for me. Before that I tried an SQ Labs saddle which features a side to side rocking motion. I chose that with the most flexy insert on the theory that it would alleviate the left side pressure and it worked ok. I rode that for a few years and it was good but the SMP is way better.
The other thing that really helped me was switching to Assos bibs. Their pad is quite unique. I used to use Castelli and Pearl Izumi. They’d feel good for six months and then feel like torture as the pad broke down. I have Assos bibs that are four years old and are still comfy.
Yeah I ride just XC, so fairly upright on most rides. That’s exactly what happened to me. One PT said it was shorter leg on the right, the other said no. Cleat shims didn’t help. Was there anything you did on the bike to help? Cleat position change etc?