Sit bone area pain - right hand side only

bsharp77

Hi guys,

I've generally been very comfortable on my Specialised Power saddle for the past 6 months or so (even on the turbo which used to be a real problem).

Over the past 4 weeks, the area of my right hand sit bone has become increasingly sore and actually swollen under the skin. On the surface, there are some redness, but nothing serious - no broken skin or saddle sores.

It is very, very sore at the start of the ride, but the pain would reduce over the first 20 minutes to a point where I could keep going ok, but with mid-discomfort - as if the area was numbing up slightly.
Yesterday I changed the saddle to a fabric line, just in case the saddle was causing the problem, but the pain was exactly the same. I've also experimented with moving the saddle forward and up - no joy.

Tried my commute this morning, but had to turn after 100 metres - the pain was just too much.
I'm usually on the bike 6 days a week and have never had any problem like this before - usually I can be on the bike for 4 hours on the weekend ride with no problems, which is why I'm going straight for medical advice rather than looking at another bike fit.

I've booked into see a doctor this afternoon - just wondering if anyone else has had similar problems, as maybe a doctor might not even the best solution - maybe its a physio i'd be better visiting?

I'll take any help at this stage - the one thing I'm dreading and I know will be the first recommendation - take time off the bike

If anyone has had anything similar, i'd be really interested to hear your experiences. Cheers.

Gromson

If you're talking about the skin directly over the ischial tuberosities ("sit bones"), there isn't an awful lot of much between the skin and the bone itself. Essentially, working your way deeper through the layers, there's the surface skin, a (variable) layer of fat below it, a few not very important muscles, the periosteal bone lining, and the bone itself.

Swelling suggests inflammation. Inflammation without superficial redness suggests deeper rather than more superficial location.

It's possible that you've bruised the periosteum which sits on the outside of the bone like a layer of shrinkwrap. You can get brusing between it and the bone itself which would (a) be very painful because periosteum is exquisitely sensitive and (b) and form a solid rounded lump which takes ages to resolve. Another possibility is that you've acquired a small rupture in the middle of one of the muscles, or where it inserts onto the bone. Eitherway, a "bruise" of any sort is a small bleed into any space or tissue and I would hazard a guess that you've bruised something some time ago and are dealing with the prolonged aftermath.

I stress that ALL of the above is utter speculation - based only on the rare bits of anatomy, pathology and physiology lectures that I didn't fall asleep during, or bunk entirely.

A visit to the doc is a good starting point, and one outcome could be a referral to a physio, particularly one with a sports injury interest. Another suggestion might be an MRI.

bsharp77

Thanks for the reply Gromson - yeah as you say, I don't think there will be a quick fix to this no matter what the prognosis is.
I'll be interested to hear what the doctor suggests.

I'm dreading taking any time off the bike, but looks like ill have no option on this one

jeremy1

Why do you keep going knowing there is a problem before finding out why

bsharp77

jeremy1 wrote:

Why do you keep going knowing there is a problem before finding out why

It hasn't been sore enough to stop me riding until now - more an annoyance.
In fairness, I should have got it looked at sooner, but being a typical man, I thought it might sort itself out, but, as is now apparent, its much more serious than I at first thought.

I also commute by bike every day, so finding alternative transport is also....a pain in the bum

bsharp77

I have an abscess apparently!
No bike for a week and a course of antibiotics.
Typical timing just as we get the lovely long evenings....oh well, it will be worth it! 8)

trekvet

After a week, which isn't long enough by sounds of it, there will be scare tissue to deal with. Perhaps some walks and foam rolling on week 2 to see what's what?

wishitwasallflat

TrekVet wrote:

After a week, which isn't long enough by sounds of it, there will be scare tissue to deal with. Perhaps some walks and foam rolling on week 2 to see what's what?

Dont disagree with the idea of keeping moving and taking non-site-loading exercise (walking, running, swimming to moderate levels etc.) but not sure why anyone would wait till second week for walking while on an antiobiotic for a abscess. Inactivity is rarely wise for conditions as described. Also stumped as to what possible role foam rolling could play in treating an abscess.

OP - if the correct antiobiotic is taken (99.9% of times a broad spectrum standard one will work fine so no reason to doubt that), in the correct dose (again this is basic medicine so no reason to doubt that either) it will resolve the infection. There is no clincal reason to expect/fear that any scarring will occur (any Doctors/researchers out there with any refs to suggest otherwise would love to see them.)

Do you have any medical training TrekVet (ps I mean human medicine of course re vet maybe being veterinarian)?

bsharp77

Thanks a lot for the replies.
Its been 8 days now off the bike and I've just completed the course of antibiotics.

I tried a spin class last night - the saddles there are thick and padded and I had no pain which was amazing, however I jumped on the road bike when I got home to test and could feel the saddle pressing right into the problem area - it was uncomfortable straight away - so I'm thinking maybe the saddle has caused the issue (its weird as I've been getting on very well with it over the past few months - its a specialised power saddle).

There is still a definite lump I can feel if i feel around my sit bone, so its not gone yet....i'm going mad staying off the bike, so something needs to happen soon.

I'm thinking of going for a comfort saddle to get up and going again - if it works on the spin bike, hopefully it will work on my road bike - specialised do a body geometry saddle which looks well padded or there is also the ISM saddles which seem to get good reviews, although they are expensive if it doesn't end up doing the trick.

If the "lump" doesn't go down in the next few days, i'll have to go back to see the doctor....in all my years of cycling this is the only thing that has ever stopped me - its so annoying and frustrating.

wishitwasallflat

Get the lump checked. Depending on where it is SQLab saddle may help as they focus the load differently from many other saddles. Dont get too concerned though its early days. Best wishes for a full and speddy recovery.