Has anyone dealt with sit bone pain as a result of less fat / lost muscle mass in the butt?

I’ve been working through sit bone pain for almost a year due to hamstring tendinopathy (per the MRI). PT, Ice, ibuprofen, active release technique (ART), new seat and bike fits haven’t helped. One orthopedic surgeon recommended staying off the bike! Nope.

I described my situation to a highly recommended sports orthopedic surgeon. In short, He said to EAT more carbs / protein and do butt exercises. Gotta gain weight, normal for my age and current weight. Flat butt!

Needless to say I was floored as I’m only 64 years young and 165 lbs, BUT I’ve lost 15 pounds since retiring 2 years ago, not by design, just don’t stress eat between meetings anymore, no meetings!

Curious if anyone else has dealt with this situation and what they did to get back on the bike?

Thanks!

This sounds very similar to what I am going through now.

It isn't specific to the ischial tuberosity, but everything else sounds very familiar.

Apart from breaking my ankle 12 years ago, I have lived a pain-free existence on and off the bike. But after going (slowly) from 200 lbs to 165 lbs, I'm now suffering a lot of pain and weakness. It is mostly in my right leg/hip, but I don't think it is the joint. I think it is mainly sarcopenia. I am currently 62.

After 10 years on a nice Brooks, I can't tolerate it. I finally found a saddle I can manage: Ergon All Road. It isn't perfect, but it keeps me off the suicide hotline.

Sorry I have nothing to offer but comisseration. It is also really screwing up my sleep, which then makes it worse the next day.

No, not me, but my father has this problem and I'm sick of hearing him complain about it. My advice to him was similar to your doctor's advice. Eat more and build up some muscle. Strength training does wonders for the body. Don't spend all your time doing cardio.




.

Make sure the width of your saddle is correct. Other than that, I've got nothing.

Ouch.

Naw, in the normal road position one is perched, not sitting, on one's bony structure. If you're fairly upright, you're perched on your ischial tuberosities. If your back is at about 45° or so, you're perched on your inferior pubic ramus. There really isn't much fat to sit on. Your bones push it out of the way. The issue is that when one is perched on one's saddle there's not much blood flow in those squished tissues and they don't like it. That said, it is possible to condition your butt to tolerate that low oxygen environment. One has to do many short rides, like 30' every day for a couple weeks. That usually does it. Some fairly serious riders here don't ride in the winter rain, so they have to recondition every spring, ouch.

This is also the matter of saddle matching one's butt configuration. I've gone through a couple of carboard boxes full of saddles over the decades. Even with a conditioned butt, one won't know if a saddle is just the right thing until after the third hour. One can only experiment, everyone's different. Saddles with only a little padding work best.

You better hope there isn't muscle between your bones and saddle. It would get destroyed by the pressure and movement. A little fat is just right. While sitting down, put your fingertips under your butt and feel your bone structure. See what I mean? It's supposed to be that way. Although if one were so fat one couldn't feel that bone structure, yeah, that would create a problem. Most folks who ride long distances are fairly slim. Most, not all.

If you read the various threads on saddles and fannies and their various unions, you will see that they are a lot like marriages. Some pairings take a lot of work to make successful. Many saddles that some riders love, others think should be outlawed by the Geneva Conventions. Every rider has had the experience of looking at another rider's saddle and thinking how can he ride something that narrow/wide, soft/hard, with/without cutouts? In short, what does she see in him?

Ummm ... you might want to take a look at an anatomy text or website.

Don't see a chamois mentioned in the original post. Are you using a chamois/padded bike shorts/bibs? If you aren't, get some, if you are, maybe it's time to try a different brand, along with a different saddle. A friend, on the thin side, fought with saddles for a long time. He's ended up with a Selle Royal Respiro (don't know if it's the Athletic or Moderate, but says it works great for him. Of course, we all know how saddles are--some are great for one, end up in the trash for others.

Did one better - I reached down and felt my butt. Try it. Or maybe I've just ridden enough miles that my anatomy has changed. Very seriously doubt that. It's definitely bone on saddle.

I don't know how much it would help the OP, but there is a thing called Kegel exercises which are suppose to exercise the muscles of your pelvic floor.


https://www.centerforurologiccare.co...gel-exercises/

I highly recommend that you check out recumbent trikes. Sure, you can try to build up your buttock muscles and you may have success. Realistically, though it's going to be a long slow process, even if you get supplemental steroids to help. But I think you'll find that pedaling a trike is remarkably similar to pedaling a DF bike, except that you won't be standing on the pedals. Choose carefully and you can be enjoying yourself in a very comfortable seat a week from now.

And no, I never considered a trike until I had to, but it was the best money I've ever spent for pedaling purposes.

Bridges were recommended to me. It might be worth trying, too.

https://www.webmd.com/fitness-exerci...o-glute-bridge

Eat more cheesecake. It’ll go straight to your butt.

I have a great recipe for a Basque Cheesecake. You can find it on the NYT food site. Over 9,000 calories.

The scientist experiments, trying to discover the truth, if such truth exists. Others simply accept what they are told.

I've been a scientist my entire adult life. I dissected a human while in med school.

If you truly believe what you are claiming, then you have undermined every piece of legitimate advice you have given to me and others over the years.

The facts matter.

The sit bones dont change, but the padding does. If your seat is a proper fit for your sit bones then more padding in your shorts could solve the problem. For me its just the opposite. As I get older my Fat Arse gets bigger. Of course other things now seem to be shrinking. RATS!

Then again there is always Flat Fix...

Absolutely. I found that I am much more particular on saddles than I used to be, as my butt is thinner, as my waist is thicker. currently, a SMP pro is my saddle of choice. It is very particular on angle, but when it's right the butt just fits.

I've been out of town. What you haven't done is, while sitting in a soft chair, reaching down and pushing your fingertips into your butt. I lean forward quite a bit on the bike, so I perch on my pubic ramus. I can easily push my fingertips right into that bone, nothing between my fingertips and the bone, hard as a rock, other than a little skin. Of course a "little skin" means the whole dermis, which feels like it's a few mm thick. I tried contracting my glutes while doing this. Didn't make any difference. I could feel them contracting, but no additional tissue appeared between my fingertips and bone.

Maybe you aren't the same as I. I've been riding for decades on pretty much the same type of saddle and in pretty much the same position, so maybe that has modified my butt tissues. I haven't experimented on anyone else's butt. That said, the whole idea that there would be muscle tissue active between bone and saddle is a bit odd. We've been sitting on hard surfaces for at least a million years. DNA is pretty good at figuring out what works.

Do you honestly believe this, or are you just playing internet games on a dull rainy day?

I've never dissected a human cadaver, and I have no advanced degrees in medicine or physiology, and I naively figured there was no muscle cushioning my sit bones (ischia?) from a saddle. I'm not convinced either way, but it seems unlikely that muscles are useful bottom cushions for cycling.

Apparently the stuff that mainly cushions your ischia bones are the ischial bursae, which are "small, fluid-filled sacs that cushion your sit bones" (google AI).

My uneducated hypothesis is that sitting a long time on the saddle squeezes fluid out of these sacs, and occasionally pedaling out of the saddle allows the sacs to plump back up. As soon as I feel a hint of butt soreness, I get out of the saddle for at least 30 seconds. This has always worked for me, and I'm on the lean side of lean, so there's not a lot of extra tissue down there.

According to the Cleveland Clinic, if you sit a long time on a hard surface, you can get ischial bursitis. Sounds exactly what a cyclist gets from riding in the saddle for too long.

Edit: Here's a diagram showing those ischial bursae.


Source: Cleveland Clinic

The theory I've read says that it's oxygen cut off in those tissues which causes discomfort and that by riding, we train those tissues to get by on less oxygen. Standing restores the oxygen level. Back when I was a kid and rode leather saddles, my butt would go completely numb, no standing required then. Butt didn't fall off. Downside was that it hurt like the devil before it went numb. Ah, back in the day . . .

Yes, quite a 'flatt butt', meaning not much extra fat... When I put on extra weight, which happens easily, it's never in/on the butt...
In your case, you have to deal with an injury situation along with what is really a none-issue (smaller butt).
As @carbonfiberboy noted, you are perched directly on the 'sitzbones'... 'padding' around those bones has a minimal effect on supporting your pressure.
But key is to get a good base/fit for the sitzbones, with as little interference of blood flow in the area.
@carbonfiberboy is spot-on about the lean of your upper body/torso. There's a fine balance between the full weight on the saddle (straight up/down) and transferring some weight to your bent arms (straight arms to the bars is another problem ). The more weight your bent arms, active legs and torso muscle structure can support, the less goes thru the sitzbones.
That aside - but getting the above as optimum as possible is a foundation to cycling - your injury has an effect.
I've also developed some significant left leg issues since a motorcycling injury in July 23... It's manifested itself in so many forms, changes in foot/leg alignment on the pedals (and any leg active thing) induced piriformis syndrome, and recently quite severe Achilles tendonitis...
Having a good fitting saddle has reduced that, to where cycling is about the only activity which can be done close to 'normal' (as compared to the level I can normally muster up).
I can't backpack or do long all0day hikes in the mtns (Sierra & Alps) at this time, until I'm able to find some resolution on these 2 major issues...
...a Good saddle fit, along with real attention to your riding posture and position (a whole other important fact which has numerous post here and around the web) goes a long way to making cycling happen at a comfortable level.
Ride On
Yuri
EDIT: If you feel under your butt, while sitting, you should note that the butt muscles are all to the 'outside' of the sitzbones (there are internal muscles which are not -should not be affected by the saddle pressure to the sitzbones).
So, finding a saddle which supports well and does NOT intrude towards the inside of the bones is key - AND - that saddle should also fall away slightly to the outside, when the sitzbones are properly supported, so that the Gluteus is not constricted by pressure from the saddle/pad - which means too wide a saddle. A saddle which has a sizeable slope downward towards the outside may also cause sideward spread pressure on the sitzbones - uncomfortable over time... - so the match of saddle profile to you behind is a key point to a good saddle 'fit'.

When I restarted cycling again in earnest, my old saddles and flat rear, created the same issue. As a result, I spent a fortune of new saddles to find one, like the three bears, felt just right. But, that was not quite enough, after a while, even the best saddle I could find still would start hurting, so I looked at the other component that meets (meats?) the seat, my bike shorts. I was buying pretty cheap shorts without much padding or would wear out quickly. Upgrading my shorts to more expensive in combination with a good bike seat made a huge difference. A third component is making sure your bike seat is adjusted correctly, fore/aft as well as pitch. In general, my seats are set by a level to be perfectly horizontal, which is a good place to start. Some prefer a more forward or rearward tilt, but rearward puts more pressure on your sit bones - so I would recommend horizontal or slightly forward (which I have on my bike with aero bars.

Unfortunately there is no magic recommendation to make your pain go away, except time and trial and error until you find the right combination. (As an aside, having a too narrow seat one one bike was a major PITA until I measured my sit bones and found it was the worst option. The internet has plenty on how to measure sit bones and recommended saddle widths. Also, don’t buy a too soft saddle. They will feel comfy for the first few miles, but then the pain begins (BTDT too). Medium firm works great for me unless you are keeping your trips under 10 miles.