Meet Matt

Name: Matt

Age: 49

Location: Alabama

Primary type of riding: Mountain, road

Riding specialty: Climbing, technical mountain

Years of riding experience: 20

When did symptoms start: Winter 2018

What did initial symptoms feel like: I initially started peeing blood in November 2018, however it seems this is unrelated but it certainly started the plunge into the multitude of testing at the hands of the urologist. This only seemed to increase my symptoms as my anxiety was certainly ramping up. My penile symptoms really began in winter of 2019, thought I must have UTI, burning/itching at tip of penis.

If known, presumed causes of pudendal neuralgia: I don’t know that I have the complete answer to this. I think that my road bike fit played a role. I have a high saddle height to bar drop position due to having long legs, short arms. This puts me in a more aggressive position on the bike and puts more pressure on soft tissue. In addition I went through an extremely stressful period at end of 2018. Job change, Dad had massive heart attack, my beloved dog passed away, all in a matter of several months. I had several panic attacks which I have never had.

Amount of time off the bike since injury: 1 year


- Pain at tip of penis

- Difficulty with urination, may be related to prescription meds

- Unable to start peeing

- Some discomfort at times in scrotum


- Physical therapy

> Dry needling with e-stim, the first time I did this I was at a bad point. I had been off of

bike for months and my pain was ramping up. I was very skeptical but willing to try anything. My pain was around a 7 at this point. PT only did dry needling for about 5 minutes and on my drive home my pain had dropped to a 1. First time I had gained hope that I could recover.

> Manual therapy by PT as well although hard for me to tell if it really made a difference

- Lifestyle changes

> Stretching to relax pelvic floor

> Weekly Pilates reformer class to open up pelvic floor

> Changed workout routine at gym, eliminated squat movements along with some

abdominal exercises as they seemed to uptick symptoms

- Medication

> Cymbalta 30mg daily

> Klonopin 1mg daily, used for about 6 months but have been off of this for about 3


Recovery Status: My symptoms have come down to around 1 or less most of the time. I tend to be symptom free in the mornings and then if I have symptoms they elevate as the day progresses. I can workout at gym, run, do Pilates without any issues. Have not gotten on bike in several months. Part of this is the last time I did it I remembered how much I love the sport and then I had uptick in symptoms and this really got me down.

Are you riding again: Not yet, but hopeful

Personal note: I can say the mental challenge of the condition proved far beyond the physical. As a longtime rider my entire identity was somewhat lost. I have never gotten to such a dark place. Friends don’t know how to treat you and I isolate myself at times. I think it is important to interact with others that can help with the walk through this.

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