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Old 08-08-09, 06:11 PM   #1
Azygous
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Piriformis syndrome preventing girlfriend from riding bikes

My wonderful girlfriend used to ride a bike in college for nearly 2 years. She had a quality, entry-level Trek hybrid with an upright-riding style. Around the time she started riding, she started getting pain radiating from her right foot all the way to her back. For a long time, she didn't consider that it had anything to do with her cycling. After 2 years, she couldn't take the pain any longer. A doctor diagnosed her with piriformis syndrome but did not connect the pain to the cycling either. Finally, my girlfriend realized the pain started when she started cycling, and quit riding her bike. The pain went away immediately and has not come back since. It's been 3 years since she stopped riding.

Does anyone have any advice on what she could try to be able to ride a bike again? Has anyone encountered problems with piriformis syndrome and cycling before? She would like to at least be able to ride a bike around the neighborhood, to the pool, or the commuter train station. However, any pain like before would be a deal breaker.
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Old 08-08-09, 06:46 PM   #2
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Piraformis syndrome is not typically associated with cycling but can have a negative effect on cycling and having suffered this can understand how painful it is.

Cycling has always been beneficial to me when it comes to addressing pain issues.

It is caused when the piraforma muscle interferes with the sciatic nerve be that due to overuse / inflammation, injury, or structural issue where the sciatic nerve runs through the muscle rather than beside it.

If there is no structural issue (this requires surgery to correct) there are a number of specific exercises that can relieve the pain this causes and over time I have regained full mobility in this area with no piraformis related pain.

An MRI needs to be done to rule out structural issues.
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Old 08-08-09, 07:50 PM   #3
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If this has never been performed, your girlfriend needs to see a bike fitter. Just this can rectify many problems.
Afterwards I would go with what Sixty Fiver recommends.
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Old 08-09-09, 06:22 AM   #4
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Originally Posted by Azygous View Post
My wonderful girlfriend used to ride a bike in college for nearly 2 years. She had a quality, entry-level Trek hybrid with an upright-riding style.
....
Does anyone have any advice on what she could try to be able to ride a bike again? ...
I'm not familiar with the problem, but you might see if there's any RANS dealers around that have any of the crank-forward bikes on hand.
http://www.ransbikes.com/
The noseless seats they use are much larger than a saddle but the bikes still pedal efficiently. Prices start at around $1100. in the past I know they used to sell some frame-sets for the crank-forward bikes (they even sold them through mail-order for a while, something they won't do with their recumbent models), so that is something to ask RANS about if you have a donor bike.

RANS has their own forum oriented towards these bikes: http://www.crankforward.com/

There's other bikes made somewhat-similar to this, but they are not worth it because most of them still use a regular bicycle saddle, which is the cause of most people's rear-end discomfort. The RANS bikes use a totally-custom seat, that will not fit (nor would it be useful) on a regular bicycle frame.

I've got a Fusion, by the way. Not good for racing, but GREAT for casual riding, even over fairly-longer distances. Padded shorts aren't required, though unpadded riding shorts are helpful for their lack of seams (recumbent places online sell them). The bike still looks mostly normal but the ride involves much less seat pain, hand pressure and neck strain.

The crank-forward bikes are easy to ride: they feel just like a regular bike, but with a bit of "chopper" feel from the relaxed head tube angles. Everyone who test-rides mine thinks it's awesome, most people just gag at the price tag because they're used to shopping at Wal-Mart. If you can ride a regular bike, you can jump onto a crank-forward and go--there's no practice required, like with a newbie trying to ride many recumbent bikes.

Up until a couple years ago, RANS was basically a recumbent bike (and airplane) company, so many people who know not much about recumbents have never heard of the crank-forward bikes. A lot of people--myself included--who only owned recumbents (and thought they'd NEVER buy another "upright" again) have bought these bikes after hearing how well people used to the comfort of recumbents liked the crank-forwards. I love mine (I've only got two bikes now, one recumbent and the Fusion) and if I lost it somehow, I'd order another one the next day.
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Last edited by Doug5150; 08-09-09 at 06:26 AM.
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Old 08-09-09, 06:51 AM   #5
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RE: crank-forward bikes ...
On the other hand, she could just go totally off the deep end and get a recumbent. Recumbent bikes have their disadvantages, but they win the comfort contest by far.

You always get people claiming that upright bikes are perfectly comfortable, but (like most recumbent owners) I've had both types of bikes, and no "normal" upright bike I've ever had was anywhere near as comfortable as the recumbent bikes I've had.

The RANS crank-forward is a lot better than a normal upright bike, but even it does not really compare to a recumbent.
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Old 08-09-09, 08:24 AM   #6
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I can't offer much help, but I'm suffering from something similar.

21 years ago, I had crippling sciatica. The pain centered in the sciatic notch, which is the fold between the leg and the tush, in the back of the leg. It was caused by a pinched sciatic nerve. The pinching was at L5-S1. Since this is nerve pain, the pain can be experienced far away from the site where the cause is. I couldn't walk or stand for more than 10 minutes total throughout the day.

I had surgery to correct this and have been in great shape since then.

But now I'm having a problem with painful numbness in my feet after I cycle a few miles. I went to a neurologist who confirmed that I have a pinch at the same site. I occasionally get pain in my sciatic notch when I drive.

No one really knows the solution, except that my next steps are to experiment with positioning and exercises that strengthen and loosen my hamstrings. I suspect that sitting more upright will help, so I'm doing experiments with handlebars. Yesterday, I went out riding with my wife who is very slow. I took my most upright bike, and the painful numbness was barely noticeable. I'm not going to rush any conclusions.

I'm also experimenting with cleat position. The LBS manager said people are doing weird things lately and getting good results, for example moving their cleats way back so they're pedaling on their arches. I tried that for a few weeks and just gave it up. It was annoying, and it didn't seem to help or hurt. I'm going to try the opposite and pedaling almost with my toes.
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Old 08-09-09, 09:18 AM   #7
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Thanks so much for your informative responses!
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Old 08-09-09, 10:22 AM   #8
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I do not know, but reading aboutit made me think of an upright riding position (w a broad Brooks and swept back bars) or for sure a crank forward bike or recumbent. Also I think sixty is right about strenghtening the area. I`d stay away from the supercushy saddles.

Try as many bikes as possible, and saddls before you buy anything.

Last edited by badmother; 08-09-09 at 12:40 PM. Reason: zpeLlinG
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Old 08-09-09, 11:41 AM   #9
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On saddles...

The only saddle I could use for some time was my Brooks Imperial... it is very firm and the cutout prevents any pressure to the perineal area.

I have been able to expand my saddle use as the condition abated but just about every saddle I use is very firm and justchappens to be made of leather.

Plush saddles can put pressure on soft tissues and aggravate sciatic conditions and for women, Terry saddles are to be highly recommended.

It is a matter of properly supporting the sit bones and as women have a wider span between those sit bones they tend to need wider saddles then men.

Seeing a good bike fitter will be really important as well... it's amazing how so many who quit riding because it was uncomfortable and even painful have been able to enjoy it after being properly fitted.
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