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Meet Kate

Name: Kate

Location: California

Primary type of riding: Road, gravel

Riding specialty: Climbing, endurance

Years of riding experience: 10+

When did symptoms start: Winter 2017

What did initial symptoms feel like: Pinching sensation in labia while seated on a bike

If known, presumed causes of pudendal neuralgia: Likely a combination of poor fit (sitting on the saddle crooked and too far back, which meant I was sitting on soft tissue & muscle instead of bony structures) as well as inadequate stress/anxiety management.

Amount of time off the bike since injury: 2.5 years



- General burning sensation of vulva (feels like the start of a UTI)

- Stabbing, sharp pain on labia minora

- Issues wearing tight clothing and underwear

- Strong, intense pain when bladder is partially full or full (sense of urgency to urinate)


- Physical therapy focusing on:

> Dry needling with neuromodulation

> Manual therapy like nerve gliding & muscular releases

>Address muscular imbalances & issues with muscle tone (in this case, a high

tone/overly tight pelvic floor)

- Lifestyle changes

>Stress & anxiety reduction including calming of the nervous system reactivity and

relaxation of pelvic floor

> Breathing techniques - belly breathing to lengthen pelvic floor & slow down nervous


> Prioritization of sleep

- Medication

> Gabapentin (100mg-200mg) used very sparingly only on bad days (2-3 days per


- Home care

>Pelvic wand use focusing on the obturator internus & other pelvic floor muscles

> External massage of abdominals, hips, pelvis

> Pelvic stabilization exercises

> Meditation with focus on relaxing pelvic floor

> Stretching

Recovery Status: Daily symptoms have almost been fully eliminated. I would consider myself recovered from PN.

Are you riding again: Yes


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