Timeline - 10 months. Doctor #1 visit I present to him with what I feel is a pulled hamstring. After several assessment tests, he informs me this is sciatic and not muscle related. I felt the pain during a run one day, through my hamstring, glutes, and lower back. I had been to this doctor before and trusted him whole heartedly. He set me up with a very good Physical Therapist at his clinic where we started treatment immediately 2-3 times per week. All this while training for a half and 2 full Ironman triathlons. Therapy continued for months, off and on around business trips, family vacations, continued training as best I could with very little to no relief. I trusted them and continued to do my exercises religiously 2-3 times per day, strength training all with no relief. This continued from February until mid-September. My bike power was gone, my running gait and stride were completely jacked up, I moaned and groaned with every bend of the back and I was to the point that I couldn't sit for more than 15 minutes without horrific pain in my hamstring and glute. It quite literally felt like someone was sending electrical pulses through my body. Sometimes I swear I felt like I was sitting on an ice pick. I had no strength in my lower back or my right leg.
My last race of the year was at the end of September. I managed to get through a half ironman, a full ironman in June, and another full ironman in September, but it wasn't pretty and neither was my run that day. I was using all the power in my left leg to get up any hills we had to climb b/c the pain was just too much to handle. Up to this point, I have only seen one doctor and one PT that all agreed this was sciatica. The fact that it is nerve related, this is something that isn't very easily cured if you continue to make the nerve angry.
One week after my Ironman in September, I tried to go for a light jog to loosen up the legs. I didn't make it to the end of the driveway that day due to pain. The glutes, the hamstring, the back, everywhere is lightening shooting through my right side and there is no relief in sight. I decide to go visit Doctor #2 that I have seen before as well. For a week or two, he agreed it seemed like sciatica and treated me as such including intense therapy. This was helping some, but far from being 100% healthy again. I was rapidly losing hope of ever returning to sports again. I went for a run with my wife one day (an amazing PT in her own right), and she told me that my right leg wasn't firing at all. I was basically hobbling on my right leg and quick to get back on my left leg to push off. Great! Three weeks in and Doctor #2 isn't happy with the little relief, so we start doing dry needling. Well now, that's an experience to say the least. Ironically, it was the best thing I had done to this point to provide some relief. To this point, I'm beginning to get desperate, so I go to Doctor #3 for Airrosti treatment. This is like massage therapy on steroids. Just as with the others, the treatment is intense and they provide PT work after each session. Five weeks into treatment from Doctor #2 and #3 (and I've dropped Doctor #1 by this point), and Doctor #3 tells me on my 3rd visit that he believes I have the scar tissue of a partially torn hamstring. LOVELY! That's exactly what I went to Doctor #1 for in the first place. The Dry Needling doctor confirms the level of scar tissue in the hamstring consistent with at least a partial tear. FANTASTIC! The good news is that it is healing or mostly healed, just need to clean up the tissue and muscle.
At this point, I'm really beginning to believe that any athletic hobbies I had before are a distant memory and that my triathlon world has come to an end. Doctor #2 tells me to stop running and cycling for a week. If the pain is gone, start doing them one at a time and see if the pain returns. One week off and the pain is almost completely gone, as long as I'm not sitting down. By mid-September, I had already converted my home office to a stand-up desk and now I stand about 15 hours a day. The pain from sitting is just too much and not worth it. (Jump ahead to Feb and I have an official stand-up desk from UpLift and it's amazing! I'm done sitting at work forever!) Anyway, a week off the bike and run seemed to reduce my pain significantly. I attempted to run and things were "okay" despite Doctor #2 telling me that I had lost all muscle in my right glute. I couldn't even flex the muscle due to atrophy. I had to re-learn how to run again and get my gait back to normal. Ten minutes into my first indoor bike ride, the pain came screaming back with a vengence. I couldn't believe it, but would could be doing this. There comes a point when you just have to research things on your own b/c it's not adding up. Low and behold, I stumble on a website that describes my condition and the long list of symptoms to a "T"!
Pudendal nerve was something no one had ever uttered to me, I had never heard of, and didn't even know where it was in the body. It turns out, Doctor #2 and #3 both agree this could very well be my issue and is also commonly called the cyclist syndrome b/c it happens so regularly with cyclists. This nerve wraps around your sit bones, so if your bike saddle doesn't really fit you correctly, you could be hitting this nerve and causing a host of issues. I went to my LBS and started trying new bike saddles and in the process finding out I have very wide sit bones. I was basically creating a nerve sandwich between the saddle and my sit bone with the pudendal nerve. Yeah! If you have ever had any sort of nerve pain, you know that it just radiates and feels like electricity going through your body. Someone may as well have been stabbing me with knives on my backside. That's the pain I was feeling.
February now and I'm no longer visiting my doctors, which is a relief b/c for about 6 weeks, I was seeing at least one doctor each day, Monday through Friday. The pain isn't 100% gone, but I believe it will take time to allow this nerve to heal itself. I'm happy to report that I have NO back pain whatsoever. I have no glute or hamstring pain while riding and running. Occassionally, I'll have a twinge in my glute or hamstring if I've been sitting awhile, but I just adjust my position and the pain disappears immediately. I am now on a saddle that causes me no pain as long as I sit on my sit bones. I have probably permanently damaged this nerve, but I have high hopes the pain will disappear over time completely. My running is returning to it's normal state, my cycling strength is returning, and I'm able to sit for hours at a time when necessary with very little to no pain. I still choose to stand at work and any chance I can mainly b/c I know sitting is going to kill me since I have a sedentary desk job (but that's another article). My point for writing this was not to share my boring story, but to point out a condition that affects men and women alike. So few doctors even think about this condition and there are even fewer that know how to treat it. If you are a cyclist or triathlete and you experience any symptoms on the website below, I recommend you remedy your situation with a proper saddle fitting. There are a lot of good bike fitters out there, but not a lot of good saddle fitters I have found. The level of pain I endured for 10 months is not something I would wish on my worst enemy, so I'm hoping that if anyone reads this that is having these issues, you are able to find some relief with a good doctor and a new bike saddle. For the record, I was riding two of the most common triathlon bike saddle brands - ISM and Cobb, both of which made my issues worse. I'm now on a wide version of a road saddle with the middle cut-out by Specialized and it's like a dream. Do your homework and when the doctor tells you that it is sciatica, do more homework. My race results suffered in 2014 b/c of this pain. My family and job suffered b/c of this pain. My attitude and personality went through changes due to the feelings of depression dealing with an injury preventing me from doing what I love - b/c of this pain. So when your doctor says you have sciatica, but your gut tells you differently, go home and do some research on your own as well. I don't want everyone to think this is the answer to sciatica pain b/c it's not. Pudendal nerve pain from cycling shows very similar symptoms to sciatica and both are equally painful. It just happens that mine was not sciatica. I just wished one of my three doctors knew about this initially so we could have fixed it a year ago. This was 10 months of treatments, no relief until the last month and I basically self-diagnosed the root cause - which is an even scarier thought. I'm an engineer by trade, not a doctor! I have had conversations with nurses, therapists, and doctors and half of them had no idea where this nerve even was in the body. When I read this statement on the website, "Possible symptoms include burning, numbness, increased sensitivity, electric shock or stabbing pain, knife-like or aching pain", I knew I found something that I could relate to. Those were the exact pains I felt in my glute and hamstring. My doctors even told me at one point that I had piriformis issues as well, but it turns out, it was the nerve all along and my piriformis is strong. It just has an angry nerve that goes through it. This is a major issue among cyclists and triathletes, so at least now you can feel prepared and informed. If you have this issue, please fix it and save yourself pain down the road. If you have true sciatica, I pray you find relief and strength to get through that painful endeavor. I'm not a doctor, so I'm not here to diagnose you. I'm an athlete sharing his experience so that it may help someone else out there with similar pain. I'm plotting my revenge on my body's rejection of 2014 for my races in 2015. Stay tuned and hopefully I'll be 100% in a few months. In the mean time, I'll be out there enjoying this fantastic Texas weather riding and running, sweating, feeling my feet hit the dirt, feeling my heart beat rapidly, and feeling BOTH my glutes firing pushing off with each step. Happy Trails my friends!
Some of you may tell me this is "TMI", but I would have done anything for someone to tell me this 12 months ago. Stay informed my friends! If you read the link below and you have any or all of those symptoms, you need to get this resolved soon.
No Limits Coaching!
