Meet Scott
Mostly Symptom-Free
Riding with Adjustments
Road
Riding Type
Distance (100 mile+ rides)
Riding Speciality
Burning pelvic pain with sitting sensitivity
Primary Symptoms
Cycling-related nerve irritation
Likely Cause of PN
How it Started
My symptoms started in March 2019. I was riding indoors on a static trainer when I first noticed a burning sensation and numbness. At the time, I didn’t fully understand what was happening. In hindsight, the static trainer caused numbness that I didn’t experience outside. Zwift made riding for 3-4 hours much more enjoyable, but I rode through periods of numbness. I wish I had tried a rocker plate or stopped riding when the numbness began.
I was originally misdiagnosed with prostatitis, which is a very common diagnosis, especially for older male athletes. I was treated with antibiotics for 90 days before finding a urologist who provided the correct diagnosis. That misdiagnosis started a long period of testing and uncertainty.
Symptoms
My primary symptom has been a burning sensation. Earlier on, the pain was constant and severe, and I couldn’t sit for more than 30 minutes without significant discomfort. At its worst, my pain was around a 7.
Over time, the intensity has decreased. Now, the burning is most noticeable after urination, usually mid-day. I experience many pain-free days and long stretches without symptoms. When symptoms do show up, they are much milder - closer to a 2 at worst.
Causes
I believe this was caused by nerve compression from riding. I was cycling 4 to 5 days per week, and I’ve heard this type of issue referred to as “cyclist’s syndrome” because it’s sometimes associated with cycling.
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Riding through numbness, especially on a static indoor trainer, likely contributed. Don’t ignore numbness.
What Helped
I pursued many different treatments over the course of my recovery, including physical therapy, acupuncture, EMDR, the Egoscue Method, biofeedback, rolfing, and nerve blocks.
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Finding the right physical therapist was critical and very difficult. I saw six PTs and four urologists, ranging from excellent to terrible. At the 11-month mark, I traveled to California for a nine-day intensive PT treatment program at the Sarton Clinic. That experience reduced my pain considerably and taught me how to self-treat.
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I did not use nerve pain medications - that may or may not be a good idea for others. I also followed the approach of Lorimer Moseley, who has written excellent books on the science of pain.
Mind-Body Insights
Reaching out to others and understanding the mental side of this injury was incredibly important. I learned that the brain is elastic and can be taught to forget pain signals once the nerve has healed.
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I still experience pain signaling after urination at times, and when that happens I try to paint a mental picture of an arctic explorer to counter the hot feeling and repeat my mantra, “hurt not harm.” That usually helps dial the pain back down.
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One book that I found particularly helpful was Pelvic Pain Explained: What You Need To Know by Stephanie A. Pendergast, which helped me learn how to deal with chronic pain signals after the nerves had healed.
Current Status
As of July 2021, I passed the two-year and four-month mark and completed my first ride since April of 2019. The ride was uneventful and fun. I was nervous about pain, but more nervous about remembering how to unclip and lean the correct direction. There were no ill effects, and if anything it was a mental milestone in my recovery.
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As of November 2025, I rode my first century, Ride Across Wisconsin, seven years after my 2019 injury. I currently ride two to three times per week. In the winter, I ride on Zwift using a rocker plate and a Selle SMP Pro saddle indoors. I still get an occasional pain twinge, but it’s rare.
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Most days are okay, with lots of pain-free days and periods within my day without pain. I continue to work on the mental side and filling in the ditch that my pain path created.
Personal Note
Don’t give up. Finding a physical therapist with the right skills to treat this condition can be very difficult, but it matters. I saw six PTs and four urologists along the way, and the range of care went from excellent to terrible. Eventually, finding the right people made a real difference.
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Reaching out to others also helped tremendously, especially on the mental side of this injury. You’re not alone. I’ve read that up to 8% of serious riders may experience PN, and connecting with others who understood what I was going through helped me feel less isolated. I’m thankful to have met Kate and to be able to compare treatment notes and experiences.
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Losing cycling was harder than I expected. It’s a sport I love and had worked hard to be good at, and losing it felt like losing a piece of my identity. Kate and I have talked a lot about that loss. For me, finding a substitute was key. I replaced running with biking, and then biking with skiing. I now complete the 50K American Birkebeiner cross-country ski event each winter. Who says old dogs can’t learn new tricks?
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This feels like an awards speech, but I need to thank the people who helped me along the way: Kate and Tim, the cyclists who shared their journeys, PTs Julie, Becky, and Kari, and the doctors and medical professionals who took the time to understand PN and PPS and didn’t blow me off or send me down the wrong path. Final thanks go to friends and loved ones — I couldn’t have done this without Anina’s hand to hold and shoulder to cry on.
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If anyone needs support or help on this path, please reach out.