# Pudendal Neuralgia - will i ever ride again? :(



## NicoleB (Jul 21, 2011)

Ok, so a little history, i'm a 33 year old female who has been riding mountain bikes for 6 years with no With no previous issues. Well fairly recently, I got a new saddle, a very popular woman’s saddle and it was comfortable. I wanted something with a bit more of a cut-out, and this had it. Lately, since my wrists get sore, I would tip the nose up of the saddles I owned, to prevent that feeling of being pitched forward. I could feel a bit more pressure on the lady parts in doing so, but no pain…yet. (I will mention that about 3-4 months ago, I was riding and felt a very sharp pinch in my leg crease, and I had to ride home standing up. It eventually vanished).

About 3 weeks ago I went to a pain doctor due to a different condition I have, and he did a pudendal nerve block to rule out some things. Well, ever since that block, I’ve been having severe pain after riding a bike. It is definitely a pudendal injury. I don’t know if the block caused it, or the 1-2 weeks before of messing with my saddles, perhaps setting the stage for injury, who knows. Basically it’s on the left side, in the thigh crease area, right in front of the sit bone. It causes pain to shoot forwards into some very bad areas, feeling like a nail is being hammered between my legs. The flare I had this weekend was so traumatizing (in shock, suicidal pain that even strong opiates didn’t touch) that I’m afraid of getting back on a bike. Even now, I’m still feeling traces of it. Normally, when I get on a bike, I don’t feel much pain, but when I get home, the pain starts…a very throbbing stabbing nerve pain that last anywhere from 1-3 days. 

Ok before recommending a slew of saddles, remember that my pain is on the side, not the middle, so fancy cut-outs wont help me. it’s the side of the saddle, not the middle, that pinches me, so anything with a horn, is going to give me pain, regardless of the cutout. I have tried so many saddles, and so far, the one that has caused me the least pain was a soft casual saddle. The gel consistency didn’t pinch as hard, but it still pinched somewhat. I plan on riding a noseless saddle until I get better…..IF I GET BETTER.

I know this is a common cycling injury so I was wondering if anyone has recovered from it, and could keep riding. I am seeing a special Physical Therapist who deals in pelvic pain. She said I definitely have trigger points on my left side, near that nerve, and she’s working on it. Everything I read about PN seems to be filled with horror stories of life-long pain. Cycling is the only cardio that I enjoy. I don’t like other “extreme” sports, so it’s not so much that I’m missing the adrenaline of it. For me, it’s super fun cardio and I love the woods. I have another chronic pain disease wrecking my life, and cycling was the only thing dragging me out of that depression. It actually relieved the pain of that disease. My whole social life revolves around MTB, and my partner in crime, who I love dearly, is also an avid cyclist. I’m stuck home now, feeling depressed, worthless, and like I’m going to lose everything and everybody I care about. I feel I have caught this early. Please tell me I can ride again some day


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## bakerjw (Oct 8, 2014)

I can't offer advice. All I can offer is that people who heal and go on rarely make as much of a fuss as the few who didn't.

I had Plantar Fasciitis a few years ago and never made a peep on any forums. yet someone who has had issues with it for a long time will be chatting about it all the time.

Hang in there and I hope it gets better on its own.


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## NicoleB (Jul 21, 2011)

yes, i do realize that when you're dealing with support groups or forums, usually it's the people who are doing very poorly that post the most, while the healthy people no longer visit. That makes it seem like the condition is this dire horrible thing. I just wanted to hear some success stories of people with PN that could keep riding. It seems like a nasty condition and i dont want to dwell on the failures.


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## Daniel de la Garza (Sep 5, 2015)

My girlfriend has a problem riding because of certain parts are king of bigger and I thought she would get better once she rode more. I won't push her now that I know this and will get a good saddle for her and probably fitting. 

Enviado desde mi C6906 mediante Tapatalk


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## NicoleB (Jul 21, 2011)

^ i guess it would depend on her issue. if she's having pain or numbness in the center, then a good cutout will help. if it's in the butt area, then maybe shorts (and yes more time building butt-saddle tolerance will help). but i've learned in the future, i have to tip the saddle down more, despite my angry wrist.


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## rockcrusher (Aug 28, 2003)

NicoleB said:


> Ok, so a little history, i'm a 33 year old female who has been riding mountain bikes for 6 years with no With no previous issues. Well fairly recently, I got a new saddle, a very popular woman's saddle and it was comfortable. I wanted something with a bit more of a cut-out, and this had it. Lately, since my wrists get sore, I would tip the nose up of the saddles I owned, to prevent that feeling of being pitched forward. I could feel a bit more pressure on the lady parts in doing so, but no pain&#8230;yet. (I will mention that about 3-4 months ago, I was riding and felt a very sharp pinch in my leg crease, and I had to ride home standing up. It eventually vanished).
> 
> About 3 weeks ago I went to a pain doctor due to a different condition I have, and he did a pudendal nerve block to rule out some things. Well, ever since that block, I've been having severe pain after riding a bike. It is definitely a pudendal injury. I don't know if the block caused it, or the 1-2 weeks before of messing with my saddles, perhaps setting the stage for injury, who knows. Basically it's on the left side, in the thigh crease area, right in front of the sit bone. It causes pain to shoot forwards into some very bad areas, feeling like a nail is being hammered between my legs. The flare I had this weekend was so traumatizing (in shock, suicidal pain that even strong opiates didn't touch) that I'm afraid of getting back on a bike. Even now, I'm still feeling traces of it. Normally, when I get on a bike, I don't feel much pain, but when I get home, the pain starts&#8230;a very throbbing stabbing nerve pain that last anywhere from 1-3 days.
> 
> ...


Have you tried taking a saddle that you fit on and trimming the side back. Cut to a more swallowtail shape than a traditional shape? You could easily try this with an old saddle. If you are careful you could pull back the leather, trim the plastic and foam and the wrap the leather back around the edge and glue it underneath. This might give you the opportunity to trim and shape the saddle so you don't get contact between your leg and saddle.

If you found a shape you could live with you might be able to try to find a saddle similarly shaped or try a brooks leather saddle and trim it to match.

Back in the early 90's we used to trim selle italia saddles to look like the race new flite model so we didn't have to spend all the money for a new saddle that looked cool.


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## NicoleB (Jul 21, 2011)

i guess if i could do that without ruining the whole saddle (i wont be doing that to my really pricy one!) i dont really own one right now that i'd be able to do that to easily. I might even be better off taking one of a better shape and scooping out the middle better. As it is, i have some good saddles that are soft enough, without quite being the right shape. We'll see.


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## chuckha62 (Jul 11, 2006)

Is this something that taking a break from the source of the irritation can resolve? Maybe a nice long break from cycling is in order and you can do something else to stay fit. Swimming? It just seems like trying different remedies without success will only prolong the injury and perhaps create a chronic condition that you will not be able to recover from. 

Maybe a long break now will prevent a permanent condition down the road.


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## NicoleB (Jul 21, 2011)

i took one week off and it didnt help, so i guess i'll try an even longer break. it's just hard to know how long of a break i need because i dont have any clues during off days to tell me i'm good to go.


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## chuckha62 (Jul 11, 2006)

Good luck to you Nicole. I actually did a little reading and this nerve condition can present in men too, so kudos to you for sharing such a sensitive topic in such a public way.

I can tell you that I have experienced irritation in that area after long rides but fortunately it was never present longer than a few hours and staying out of the saddle for a few days helped. I could see how this could become chronic.

We can all benefit from what you ultimately find.


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## germano (May 3, 2015)

Just a possibility, have you tried a BO saddle? Butt Only. No nose.

I'm sure you'll want something of much better quality if it works for you, but even stores like Walmart carry such a saddle for under twenty five bucks. Some such can run into two hundred or so for the best leather/carbon ones.

Just a suggestion.


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## NicoleB (Jul 21, 2011)

germano said:


> Just a possibility, have you tried a BO saddle? Butt Only. No nose.
> 
> I'm sure you'll want something of much better quality if it works for you, but even stores like Walmart carry such a saddle for under twenty five bucks. Some such can run into two hundred or so for the best leather/carbon ones.
> 
> Just a suggestion.


yup that's my next step. after a break of course. my last flare was super horrid and i'm still feeling effects 6 days later. it's by far my longest flare after a ride.


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## tacrac (Feb 22, 2006)

I am by no means a Doctor but an avid MTB rider as yourself and hate the thought of not being able to ride. Anyway you have been riding in the past and stated that you changed your saddle angle due to wrist pain. Have you thought about different bars ? or stem ?

Might look kind of dorky but BMX style bars would have you ride up straighter with less forward stretch. 

I would definetly take a break from the bike for a while and let things settle down from injury. 
Wish you luck


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## Gallo (Nov 17, 2013)

First I think one week off is not close to enough with nerve damage. so you might have to lay off longer. I would follow the advice of the medical professional for recovery time

The right saddle can be elusive. Just because of cost allot or someone you know or a website raves about it does not mean it is the right saddle for you. Performance offers a no questions asked saddle swap so you can ride different saddles and the return them and exchange for another. If you have a store near by you can purchase online much better variety and return to the store. Its a pretty sweet deal.

And before getting back on the bike a good pro fitter would be worth it. There are many and I do not know where you are from but I am a fan of this system John Howard Sports - Home

I live in San Diego and got a fit by John Howard personally he spent several hours and asked many questions and made adjustments test me with them on my bike on a trainer then adjusted again etc it was not a boiler plate fit. I am sure there is a similar one close to you.

Good Luck


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## Wherewolf (Jan 17, 2004)

*Seat position*

After having my bike worked on several times and the seat moved I've discovered that height, fore-aft position and tilt are all critical. Just a slight adjustment of a few mm can make a huge difference.


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## Fat Urkel (May 9, 2013)

Do you have any DH lift assist near you? 

Seriously though take some time off, like at least a month and try some new saddles. Hope you get better!


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## Oh My Sack! (Aug 21, 2006)

NicoleB,
I suffered with a pretty severe case of nerve pain to the Perinium when riding MTB about a year or so ago. All of a sudden it was red hot daggers and I would literally have to jump off the bike and dance around like I was on fire it hurt so bad. Fortunately, in my case it wasn't as terribly persistent like your long term symptom. If I stayed off a few days, it would stop but I had to do something about it because it wasn't going away. I researched and bought a new Kontact saddle that was designed with this in mind. It still has a nose but the nose is really skinny and thin and your support is taken up on the flatter butt portion of the saddle.

Check this out and see what you think rather than me writing a dissertation...

Kontact Bicycle Saddle - Black - Kontact Bike

At any rate, the saddle worked immensely well for me and kept me on the bike. As someone mentioned above, I started messing with some fit issues regarding bar rise, stem length, etc. My ergos just need a riser bar to get me sitting comfortably. I used a riser bar in conjunction with a riser stem at one point on my last bike (SJ Comp) and had great control and no more perineal pain. I'm on a new bike now and haven't experienced this issue for a long time even without using the Kontact saddle so, if after looking at their site and you think it might be something you'd like to try, I'd gladly send this one up to you and you can use it as long as you like since it's not in current use. Kontact has a 30 day guarantee if you buy one and don't like it for ANY reason, send it back for a full refund. To save you from buying and being under time constraints, use mine, no hassle. If it doesn't work, send it back! If you like it, buy a new one or mine for way, way less!


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## milliesand (Jun 29, 2015)

By any chance, have you tried riding again with the previous saddle? I believe you said that worked rather painlessly earlier, and yes I caught you were trying for a gender specific fit. 

Perhaps your new seat is causing pressure where the other didn't?


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## Mountain Cycle Shawn (Jan 19, 2004)

Wow Nicole, that made me all choked up inside. No matter what happens you will never be worthless and you will always have people here and in your personal life that love you.

If your wrists and hands are hurting, then I would guess that your bike doesn't fit you you properly. You may need a shorter stem to take some pressure off your hands. A little rise in the stem or bar may also help. Both would help rotate your pelvis back and that may help with your problem. Often, it takes a very small change to solve a physical problem, but it may take a long time for you to heal.


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## Mountain Cycle Shawn (Jan 19, 2004)

https://en.m.wikipedia.org/wiki/Pudendal_nerve_entrapment


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## supersedona (Dec 17, 2012)

I haven't had it that severe but it does sound similar to something I experienced a while back. It happens when I use anything other than my Terry Butterfly saddle. There is a big difference in the way the sit bone and side profiles are set up. Width is a big thing, but the curvature down from the sit bone to the side faces has to be gradual and wide enough to support the area. If it is to sharp of a transition it will place more pressure on the moving areas. Picture bike saddle vs horse saddle.


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