Rowan

Yes, and keep it to the lower pressure. I also would not be too ambitious about your distances when you get back on the bike. Probably 15-30 miles would be better, just so you don't irritate the sac on the end of the bone.

I am not sure that lowering your bars will achieve anything. Tilting your pelvis forward may just move the bone slightly, but it's a large area that is irritated. Mine was a palpable swelling of the sac.

The principle of sitting on a bicycle seat still involves sitting on the ischaels, not tilting your pelvis forward so you are putting pressure on the perineum. FWIW, the fit on all my bikes is virtually identical; the issue was a new saddle and high tyre pressuresand rough roads.

motorthings

makes sense! i am planning on focusing on harder/shorter rides to put less pressure/time on my sitbones

if i am running 23c at 100psi on the back, what would you say a good equivalent psi is in a 25c tire?

deep_sky

Hmmm...if it isn't ischial bursitis, it could be PNI (perineal nodulular induration), which in layman-speak is an inflamed cyst in the perineal area which seems to be a large vague area according to surgeons. Developed a collection of these directly over my right sitbone from a saddle that did not agree with me (returned it after one ride) and continuing to ride..which just makes it worse. What happens is an area of tissue is subject to repeated microtrauma until the cyst forms, and if you keep riding as I stupidly did, it gets larger and larger. At one point, it would swell to almost ping pong ball size after a ride. I finally sought help, and had them removed at the end of April (this started in late December of last year). I then had numerous complications during the healing process, and only got back on the bike at the end of September. I now ride a leather saddle (Selle Anatomica) because no regular saddle will allow me to ride without pain. Tey had to take so much tissue I am now asymmetrical, and leather accommodates that.

I'd recommend getting a CT scan of the area if possible, and perhaps consulting with a surgeon to see if they agree with the diagnosis of bursitis.

motorthings

that sounds crazy! i have nothing anywhere near golfball sized (actually it is most often not even noticeable/palpateable), but i had not run across that condition before, so it is interesting. sorry you had to go through that, it must have been maddening and a bit scary.

i don't have what i would consider a "diagnosis" of ischial bursitis, but that is the guess my pain specialist had. before i pursue any medical intervention, i will definitely have another consult to make sure we know what it is.

glad you can get back on the bike!

fstshrk

My money is on hamstring injury where it attaches to the bone. Your symptoms sound a lot like mine.

motorthings

can you tell me more about your experience? how did you injure it, was it a sudden injury, and how did you determine what the injury was and treat it?

PhotoJoe 

This seems odd to me, but reading between the lines, do you prefer a holistic approach before medical? For me, I would go the doctor to figure out what it is, not once you figure out what it is. Maybe I'm mis-reading your post. Maybe the "pain specialist" is a doctor. Whatever it is that's going on, please don't wait too long to seek true medical help. IN SOME CASES, it can save your life.

motorthings

sorry for the confusion, my "pain specialist" is indeed a doctor, and when I saw her, she suggested a trigger point injection into the area of the bursa as a first step of treatment. she is not an orthopedist, but I do plan on setting an appointment with one if necessary.

I am not one to hesitate to work with medical professionals, but in this case I am also interested to get a second opinion from a bodywork-type person who was highly recommended to me by a highly trained bike fitter/shop owner. I would like to have answers for both the cause(s) and the symptoms, and in my experience those answers don't always come from a single source. The quote of mine above is simply me agreeing with the fact that it does not make sense to get a cortisone injection until it is clear that the source of the pain has been addressed.

WC89

I definitely had pain in L sit bone recently.
Background: This July, I'm back on the road bike after 12 yrs off of it (been riding MTB and hybrid since '08). Was a serious roadie for 15 yrs during the 80s/90s, including racing for 10 yrs. Other than an occasional saddle sore back then, never had any problems and I probably went thru 3 or 4 seats.
I ride twice a wk religiously. No problems on the MTB (Specialized, unknown saddle model w/ recessed center) or hybrid (WTB Pure V Race saddle).

July 2012, new road bike: Went with Selle Italia Max Flite Gel w/o a problem until left sit bone pain late October. I felt like: WHAAAT!!! NEVER FELT THIS BEFORE!! COME ON MAN!! WHAT NEXT! IT'S ALWAYS SOMETHING!!!! I tried to ride it out for another 2 wks, thinking like a youngster that it would just go away it didn't. Made some saddle adjustments, to no avail. So, I decided to go with what works - a saddle like my hybrid saddle (WTB Pure V Race SE) that hasn't given me a problem in 4 yrs.
Popped on a new WTB PV Race (which is a MTB saddle) several wks ago and pain is about 95% eliminated and getting less and less each week I'm really hoping that that was the end of that Boomeritis problem. Good luck w/ your issue, really!

motorthings

finally have my orthopedist appt set up for this thursday, and it turns out the doc is a guy i ride with.

after digging around in the interwebs more, i have decided it is most likely high hamstring tendonitis, so the saddle is probably a red herring.

motorthings

saw the doc, who could not provide a final diagnosis...either hht, or piriformis, or sciatica, but referred me for PT. He also said that since a month off the bike hadn't fixed the problem, that I should probably get back on the bike (at least for hour long trainer sessions).

I found a set of exercises for hht, and have been doing those faithfully (since my first PT appt isn't till the 10th), but hopefully the PT will be able to give me some more info and get my exercises dialed in.

going to the gym for the first time in 4 years is a humbling thing. i may have a huge amount of endurance, but strength is another issue. i guess the winter is good for something.

Carbon Unit

I used a Selle Anatomica for a few years before switching to an SMP. The gap (cut out) works well and did a much better job of relieving sit bone pressure than the Brooks Swift I had.

I switched to the SMP which is harder on the sit bones but easier on the soft tissue. The SMP saddle is the only saddle I have ever used that hasn't caused numbness.

motorthings

I started PT for what between the orthopedist and PT and myself determined was most likely high hamstring tendonosis, but then the PT referred me to a physiatrist that he respected, for a second opinion. The new doc pointed out a few things that contra-indicated a hamstring strain/tendinitis/tendonosis, and instead point to a "discogenic" cause. It turns out that a bulging disc in the lumbar area can cause nearly the exact symptoms of a hamstring strain, and since I did not have a specific incident that would have indicated a strain, and don't have significant point tenderness, I am headed in for an MRI to see what they can find in my spine. this marks two months off the bike, and I am getting more unhappy about that fact by the day.

Todd10768

@motorthings.... what ever became of this situation for you?? I'm having similar issues and I'm going to see my orthopedic doctor next Tuesday (3/25) to check for any physical issues. I went to my GP last fall and he ruled out any prostate or tissue infection issues. Told me to take the winter off (which was easy to do when I had shoulder surgery for labrum tear), and that it would probably heal itself. But my issue came right back last month when I got back on the bike. I'm thinking the fit of my bike or the bike saddle is the main culprit, but wanted to see what resolved this issue for you. Thanks.

motorthings

I got a back MRI that showed small possibility of discogenic cause.
Had an epidural that did nothing.
I pushed for a hip MRI that showed some inflammation of the proximal hamstring tendon.
Had 4 PRP treatments over the last 12 months. The side effects were like a mild case of the flu.
No change.
I got tired of the lack of results and got a second opinion from a hip surgeon and physiatrist who said it is def. not your hamstring tendon and never was.
After some nerve testing and massage therapy we have concluded it is sciatic nerve compression by either the piriformis or the obdurator internus muscle.
I am scheduled for testing this week to determine which muscle it is, then will get botox in that muscle to relax it (both are extremely tight compared to the other side).
I have known for a while that I have SI joint issues, and this plays in perfectly with that.
A year and a half off the bike for a misdiagnosis pisses me off to no end, not to mention the expense of the PRP (not covered by ins.), and feeling crappy from the injections.
The only bright side is that I am finally getting back on the bike (and one butt cheek will be nice and smooth!)

Short version - find a good physiatrist that can give you a solid diagnosis backed up by testing and fact, not guesswork.

mjmudd

Posting to try to contact Campag4life. I am an amateur rider only and used to ride a lot for the workout and to save my joints. I got ischial bursitis and tried everything (well almost) and basically quit riding and went back to running due to it. I was recently diagnosed with some arthritis in my hip so I need to ditch the running again and VERY much want to get back into riding. I really need to talk to someone who really understands the proper fitting of a bike, angles, ergonomics to help me get dialed in to give it a go again. I am in St. Louis, MO. and if there is a pro somewhere close by I could go there to get fitted. Any help would be appreciated! PM or phone call might be helpful...please PM me if you think you might be able and willing to assist me.

gsa103

@Campag4life still posts here regularly. Using the @ symbol in front of a name flags them as a mention, so my post will hopefully summon him.