Saddle injury (not saddle sores)

Gringo74

Back at the beginning of May I did an 8 hour MTB spin in very warm weather. By the end of the ride my backside was in agony; saddle sores. I did all the usual things to clear it up and by and large the skin recovered and the saddle sores were gone. But the pain down there has never gone away. The pain is around the sitz bones, basically as the bones compress the flesh whenever I sit. Sitting at work is sore and uncomfortable. Sitting on a saddle is excruciating after a few miles.

Consequently I haven't been on a bike since May (until yesterday, just for 10 minutes, out of curiosity, don't know what I was expecting because it's still sore as hell).

After 2 months of fannying about and GP appointments I paid to see a hip specialist. He said I had soft tissue injury due to blunt force (ie from the saddle) around the ischial tuberosity. It's not a bursitis so cortisone won't help. He basically said time might help but other than that there was nothing he could do. He wouldn't even give a ball park figure re recovery time.

Has anyone ever had anything like this?

kingrollo

Research high hamstring tendinopathy. -

Basically you need cross frictional massage and or dry needling.

I went through 3 years of censored - its your back, its your hip, - I couldn't sit down on any surface for 3 weeks. NHS physio's won't touch it because its close to the sciatic nerve.

kingrollo

kingrollo wrote:

Research high hamstring tendinopathy. -

Basically you need cross frictional massage and or dry needling.

In the interim google eccentric hamstring exercises - it takes a while but these do help.

I went through 3 years of censored - its your back, its your hip, - I couldn't sit down on any surface for 3 weeks. NHS physio's won't touch it because its close to the sciatic nerve.

Gringo74

My understanding of dry needling is that it's a form of myofascial release. The muscle is contracted and this is a way of releasing it (like, for instance, massage). But what I have is a sort of 'crush' injury. Def not hamstring related; both GP and ortho consultant tested for this and ruled it out.

Thanks for the reply though.

kingrollo

OK - Will just add that my high hamstring tendinopathy didn't show up on any tests or even MRI scans.

Luckily I got to see a sports injury consultant (thats a proper doctor who specialises in sports injuries - not a physio with a fancy name) He called as High Hamstring Tendinopathy despite all the tests coming back clear - and he was right.

The problem is there are so many nerves and stuff in that area its very common to misdiagnose or overlook things. In general I would stretch those hamstrings and work on your core - A lot -a bit more flexibility won't do any harm.

If you're into paying I would suggest you see a sports injury consultant - PM me if you want details of the Dr I seen. 100% sure if I hadn't seen him I wouldn't be cycling today - GP , and Hip consultants had told me it was probably early onset arthritis and there was nothing to be done.

Gringo74

Def don't think it's hamstring related. I swapped cycling for running/hiking/gym with no adverse affects. Doubt I could do any of that (esp running and hill walking) without even as much as a tweak on the hamstring.

The consultant I saw was a hip specialist. Not a sports injury consultant per se but you google his name and up he comes in various newspaper articles about footballers/rugby players going under the knife. His bio makes it clear that he's the go to guy for various sports people with hip problems.

TBH I'm inclined to believe him.

Purpose of post was to see if anyone had the exact same thing as I seem to have; soft tissue damage due to blunt force from saddle. It's my rotten luck that I think I'm just about the only person to have this distinction. Really sucks.

Thanks again though.

kingrollo

Gringo74 wrote:

Def don't think it's hamstring related. I swapped cycling for running/hiking/gym with no adverse affects. Doubt I could do any of that (esp running and hill walking) without even as much as a tweak on the hamstring.

The consultant I saw was a hip specialist. Not a sports injury consultant per se but you google his name and up he comes in various newspaper articles about footballers/rugby players going under the knife. His bio makes it clear that he's the go to guy for various sports people with hip problems.

TBH I'm inclined to believe him.

Purpose of post was to see if anyone had the exact same thing as I seem to have; soft tissue damage due to blunt force from saddle. It's my rotten luck that I think I'm just about the only person to have this distinction. Really sucks.

Thanks again though.

Don't give up - my injury kept me out for 3 years - yesterday I completed the Birmingham 100

The Guy who helped me is a Dr Leon Creaney - you will find him on google if you need/want to.

keef66

Is 8 hours on a MTB unusual for you? Was it a sudden increase in distance / duration compared to your normal riding? Was the terrain unusually rough? Padded shorts? Sudden change of saddle?

The difficulty with specialists is that if they don't specialise in what you've got, they can't really help you.

I'm not a specialist. Well, not in @rse related stuff anyway. But I'd have thought that blunt force tissue injury from merely sitting on a saddle would have resolved itself in a lot less than 4 months. I'd be wanting a second opinion.

Gringo74

@kingrollo
thanks man.

@keef66
It was an 8ish hour mtb spin, maybe 5 hours of that was pedalling (not unusual on the road). The other 3-4 hours were spent hike-a-bike, faffing, lunch, etc. Was def' the saddle. Too much of a coincidence to have saddle sores exactly where I have pain now. The injury seems to have been two fold; saddle sores on the surface and soft tissue damage deeper down. The saddle sores cleared up, the deeper damage hasn't.

A second opinion is a def idea, unfortunately it'll be through the NHS so that could take to next spring.

Thanks though

kingrollo

Gringo74 wrote:

@kingrollo
thanks man.

@keef66
It was an 8ish hour mtb spin, maybe 5 hours of that was pedalling (not unusual on the road). The other 3-4 hours were spent hike-a-bike, faffing, lunch, etc. Was def' the saddle. Too much of a coincidence to have saddle sores exactly where I have pain now. The injury seems to have been two fold; saddle sores on the surface and soft tissue damage deeper down. The saddle sores cleared up, the deeper damage hasn't.

A second opinion is a def idea, unfortunately it'll be through the NHS so that could take to next spring.

Thanks though

I can tell you now - the NHS will recommend a set of core hip exercises. It might be best to start these now - so when you arrive at the NHS -you can jump through that hoop quicker.
Physio is a cheap option for the NHS - I remember Dr Creaney's letter to my GP

"Much more aggressive treatment is required" !

keef66

I too have had the experience of a GP shoving me in the direction of self-referral NHS physio before any kind of investigation into the cause of my knee pain. I assumed this was the quickest / cheapest way to get me off their books so to speak.
I declined and asked to be referred to a knee specialist. Luckily I have company medical cover. The MRI scan showed an extensive cartilage tear which I am sure physio would have done nothing to improve, and possibly made things worse.
Unluckily there's nothing the specialist could offer me in terms of further trimming without leaving an extremely unstable knee, but at least I know what the problem is.