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Q

What is cyclist's syndrome and can Physical Therapy help to relieve the condition?

 
A

Pudendal nerve entrapment (PNE), also called cyclist's syndrome, is compression or entrapment of a nerve that runs through the lower central pelvic area.

It is usually triggered by pressure or trauma to the nerve, such as heavy and prolonged cycling, especially on an inappropriately shaped or incorrectly positioned saddle. It could also be caused by trauma after childbirth, excessive squatting, chronic constipation, or scarring after surgery.

It is extremely painful and is made worse by sitting. Patients complain of a prickling numbness, or a sense of a foreign object, such as a golf ball in the rectum, vagina or urethra. Physicians generally rule out other conditions that could cause this type of pain, such as prostatitis or interstitial cystitis. Physical Therapy helps to educate patients with PNE about correct stretches, as wrong stretches could make the constant pain worse. Treating trigger points in the pelvic musculature and strengthening the pelvic floor assists in relieving the pain. In addition cyclists need to stop cycling. Patients are told to avoid sitting and to use a special perineal cushion when sitting.

If you are diagnosed with PNE, see a Physical Therapist who is familiar with the treatment of this condition.

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