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Extreme quadriceps starting pain after 3-4 rest days

Moderator: Tonton

Re:

22 Dec 2016 17:00

Hi mate. Glad you are still alive! Sorry to hear about the cramps again - it's such a pig isn't it?

Me, I've manage to stave an episode since August by riding every single bloody day (I might have had the odd one day completely off but no more than 2 or 3, and obviously never concurrently); obviously this isn't the best thing in the world and my missus hates me for it.

Bad news for you on latest theory sorry - next to no fizzy drinks for me. Like maybe occasionally but no more than once every month or 2 I'd say.

I've been doing some work on this myself though and am in touch with a researcher who studies Exercise Related Muscle Disorders. Hopefully in the new year I will be meeting her at the National Hospital For Neurology and Neurosurgery in Queen Square, London.

Have you or anyone else already met anyone in that sot of field?
budegan
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22 Dec 2016 17:30

I don't drink much in the way of carbonated beverages (almost none at all, in fact). And frankly the notion that you can significantly affect the ph of your blood by your diet is not only unsupported by science, but thoroughly debunked.

The carbs are a different matter though, I truly believe that for me it comes down to balancing carb intake with training volume. Even a few days of reduced training volume combined with bad diet (excess sugar and refined carbs) can trigger a mild episode if I'm not careful. On the other hand if I moderate my carb intake when training volume drops off or stops, I seem to be OK.
jsk
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22 Dec 2016 17:37

Very true, but at this point what else can I do? Ya know?
Shayne_G
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24 Dec 2016 19:54

No carbonated beverages here either. The search for correlation continues :(
globecanvas
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28 Dec 2016 03:18

How about a magnesium deficiency?
Shayne_G
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28 Dec 2016 03:33

I take a daily magnesium supplement as well as ZMA before bed, so I don't think that it's.

I'm pretty confident at this point that for me, it really just comes down to carb intake vs training volume. If I'm going to be riding less (or not at all), I have to watch my carb intake, particularly sugar.

I've actually come to recognize a certain feeling in my legs that warns me an episode is coming if I don't do something about it. It's this tightness/twitchiness in the muscles, kind of a 'tremor' but not the same as the actual cramping. When that happens, I know I need to get on the bike ASAP and start with a long, gradual warmup before trying to raise the intensity.

I had that happen to me over Christmas weekend. Normally a short ride Friday morning and a day off on Saturday wouldn't be enough to trigger an episode, but I ate WAY too many cookies/fudge/etc (like, an embarrassing amount) starting Friday night through Sunday morning, and I could tell by the way my legs were feeling that I was in trouble. Sure enough, went for a ride Sunday afternoon and my legs started to 'cramp' a little. Fortunately I was able to gently pedal through it, and they the feeling gradually passed and I was able to continue riding as normal after that. Pretty sure if I had waited another day to get back on the bike things would have been much worse.
jsk
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28 Dec 2016 18:12

All right, magnesium and bubbly drinks are out...

Has anyone tried to go completely ketogenic? If this issue seems to be carbohydrate related, I wonder what completely eliminating carbohydrates would do for us.
Shayne_G
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Re:

28 Dec 2016 18:13

Shayne_G wrote:All right, magnesium and bubbly drinks are out...

Has anyone tried to go completely ketogenic? If this issue seems to be carbohydrate related, I wonder what completely eliminating carbohydrates would do for us.


Shayne did you ever see a neurologist?
budegan
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28 Dec 2016 18:21

I did, yeah. She performed an aerobic forearm test, nerve conduction velocity test, and an EMG over the course of a couple weeks that all came back clean. She then wanted to cut me open and biopsy my quads, which I wasn't keen on and backed out of. Plus, I had a baby a few months ago and didn't feel like being laid up for a few weeks (the missus wouldn't appreciate that!). So, long story short, I have seen my PCP, a neurologist, a physiatrist, a nutritionist, a naturopath, and a witch doctor (just kidding) who have all been able to tell me jack-squat. That seems to be the MO of this whole thing though...
Shayne_G
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Re:

28 Dec 2016 18:24

Shayne_G wrote:I did, yeah. She performed an aerobic forearm test, nerve conduction velocity test, and an EMG over the course of a couple weeks that all came back clean. She then wanted to cut me open and biopsy my quads, which I wasn't keen on and backed out of. Plus, I had a baby a few months ago and didn't feel like being laid up for a few weeks (the missus wouldn't appreciate that!). So, long story short, I have seen my PCP, a neurologist, a physiatrist, a nutritionist, a naturopath, and a witch doctor (just kidding) who have all been able to tell me jack-squat. That seems to be the MO of this whole thing though...


Yeah I hear you on the biopsy. That said I think I'll pursue things with the neurologist I'm in touch with - I'll post on here if and when there is anything to update on.
budegan
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28 Dec 2016 18:29

Sounds like a plan to me! I will keep reaching out to other medical fields to see if anyone else has any ideas.
Shayne_G
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29 Dec 2016 20:20

The cramps came back in earnest yesterday...I think I am going to take a different approach and just completely rest/drink lots of beer for a few days to see if that is any more successful. I also rescheduled my muscle biopsy for February, hopefully that will come back with something!
Shayne_G
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01 Jan 2017 02:56

Currently coming out of a full blown attack. Started on the 27th December after a couple of days off and to many carbs at Christmas celebrations. Symptoms are no different from any other attack, moving cramps from different muscle groups in both legs, cramping triggered by walking downhill elevations, etc. I have come up with no answers other than the suggestions made in this forum. If anyone has any other suggestions on how to prevent these cramps I'm all ears. I guess most of the posters to this topic are English UK, I'm Australian but of English heritage, wonder if we are all related and have a common ancestor with a defective gene causing this condition?
CFM
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Re: Extreme quadriceps starting pain after 3-4 rest days

04 Jan 2017 22:22

Hi all,

I have all the same symptons bought on by the same activity/rest after a decent amount of training. I tend to cycle around 12 hours a week and chuck in a couple of gym sessions if I can. I have had these symptons on and off for about 4 years, but they have always been manageable and I never sought medical help - they only ever lasted a couple of hours. Ironically it often happened when on holiday, but I never put 2 and 2 together! For reference, i ride to a decent ish standard (BC 2/3 cat level and 20min 10m TT).

My most recent attack happened early December 2016 and I ended up on a drip in hospital with a number of checks including most recently an MRI for which I am still awaiting results. This was following multiple pains in the thighs over a 3-4 day period (my last cycle was 3 days earlier). They prevented me from getting to work or traveling at all hence the GP visit and blood test which showed 10,000 CK count.

I saw a neurologist last week and he believes I have metabolic myopathy (which causes rhabdomyolysis). He believe this will have been caused by a ginetic enzyme deficiency. I am now waiting for a biopsy date and EMG, but he believes these may be inconclusive. It's all relatively new to them in terms of how, why and which enzymes. Like most this is the only thread I could find!

Like a few people on here cycling is an important part of my life and I'm gutted not to be able to train and race (it's training and CX season!) but I think this is too important to ignore. I understand it's not curable, but it should be manageable, even if it means less training. Whilst like others I could stave it off by never having a day off the bike, but I am not sure putting the body through continuous rhabdomyolysis is good for it!?!

I'll keep you posted as and when I get any developments - seeing a rheumatologist next week.

P.s. I know lots of us share identical symptons. Apparently what I have is quite rare, so it may be that others have different reasons!
Clarky07920
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Re: Extreme quadriceps starting pain after 3-4 rest days

04 Jan 2017 22:27

On a quick note. Have any others on here got any immune system issues as well? I also have hyperthyroidism caused by Graves' disease. It was diagnosed 2 years ago and there can be a link between immune disorders and metabolic myopathy and rhabdomyolysis. Graves is diagnosed by thyroid level test - mine was discovered by accident after a blood test for allegies. I had no other symptoms.
Clarky07920
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05 Jan 2017 19:39

Hey Clarky -

Welcome to the club! I don't have any immune issues to my knowledge.

Did they say what the name of the enzyme was? I have read a few other theories with this issue that states the enzyme responsible for storing glycogen in the muscles goes haywire and just continues to signal the body to store more and more glycogen even though the athlete is not using the sugars. Over the course of a couple days with this happening, the muscles cells burst due to over storage of glycogen which then causes the rhabdomyolysis. This has happened to me no matter what my diet has consisted of and I have tried to go completely ketogenic with the same results...
Shayne_G
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05 Jan 2017 20:21

Hi Shane!

TBH they are not sure whether my immune condition is related - I'm just lucky I guess!

I only had the metabolic myopathy diagnosis last week and the neurologist has suggested I revert to NHS for the biopsy and EMG and I am awaiting dates for both. The neurologist was Dr Peter Martin and he is based at addenbrooks (Cambridge). He seemed quite confident of the diagnosis, as whilst it is a rare condition there are not that many specialists so people usually end up in the same place (or on this forum!). The rheumatologist suspected myositis (which would not have been good!) but he thinks that v unlikely as like most on here it's just the legs that are playing up - presumably because that's what we are repeatedly training so hard.

I don't really have a lot else to share at the moment, but it might be worth others floating the metabolic myopathy idea with their docs to see what the say. He was sceptical as to whether they would be able to pinpoint the actual enzyme, and even if they did whether there would be a treatment.
Clarky07920
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05 Jan 2017 20:26

Very interesting. I have had an EMG that has come back clean and am scheduled for a biopsy on Feb 10th. Would he be interested in performing a case study on us poor souls? I haven't found anyone who really wanted to undertake it.
Shayne_G
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05 Jan 2017 20:47

I hadn't even seen this post when I saw him but I'll definitely mention it. He said that there were other specialist at addenbrooks that he may also rope in, because it is quite a rare condition. I suspect more people may have if It but never suffer as they don't train (or do anything). I therefor suspect it is more common, but only presents itself as an issue where significant activity is undertaken. That may explain why it's popped up on a cycling website - we tend to push our bodies very hard and often.

Let's keep updating on here as and when we learn anything. Like others this is the only reference I've really found to it, but hopefully between us we can find some answers!
Clarky07920
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05 Jan 2017 20:49

Shayne_G
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