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Extreme quadriceps starting pain after 3-4 rest days

Moderator: King Boonen

21 May 2016 12:23

Hey everyone,

I am currently experiencing yet another episode which, of course, means more scouring the internet for ideas and solutions! I came across this thread which aligns up with what we are all experiencing: http://www.bikeforums.net/commuting/632008-quad-pain-hiking-down-hill-could-related-commuting-too-much.html

It is more of the same with people trying things and not seeing results, but I figured I would share in case someone else sees something I missed.

I am going to see another specialist on Wednesday and will fill everyone else in again as to what her theories are.

Still scratching my head...

-Shayne
Shayne_G
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26 May 2016 15:58

Sorry to hear it, Shayne. I hope the specialist can offer some guidance.
globecanvas
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26 May 2016 16:33

I think I can say I'm in this brotherhood too. Bloody odd eh? I won't go through all the symptoms and circumstances but suffice to say they include most or all of those stated earlier.

During the first flair up a couple of months back I saw a physio who diagnosed a muscle strain which never made sense to me as I'd not been exercising - I'd infact had 3 days off after a very hard training period then had a long-haul flight and it appeared whilst walking following that; once DVT was ruled out via a blood test I ended up with said physio.

Now it's back.

I'm wondering what the best bet is - total rest and then easing in after X many days? Or giving it a go again as soon as pain subsides?
budegan
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Re:

26 May 2016 16:50

budegan wrote:I'm wondering what the best bet is - total rest and then easing in after X many days? Or giving it a go again as soon as pain subsides?



I can only speak from the experience of my two episodes.

The first episode was after a 2-day layoff. I got on the bike the next day and although I could feel that the pain wanted to come back on, it never quite set in and I ended up doing a regular 2x20 workout with no trouble. In hindsight I think I dodged a bullet in recovering so quickly.

The second episode was after a 9-day layoff. During the episode I made the bad mistake of trying hard to pedal through the pain and it was just a prolonged disaster. I tried to ride again 2 days later and did not last even a minute. I then took 4 more days completely off the bike, and eased back in to riding starting on the 7th day after the episode, ramping back up to where I could do a normal-ish workout a week after that. I did cut carbs completely for about a week while trying to recover; I have no idea if that contributed to recovery at all, but it was suggested by a friend who is a vet who treats horses suffering from recurrent rhabdomyolysis,

So in my experience, the recovery time varies with how long the layoff was prior to the episode, and possibly with the severity of the episode. I know that if I experience this again I will be very, very careful about not trying to pedal through any pain as I come back from it, because I think that was really damaging, not just physically but mentally. Overall I lost 3 weeks of fitness that it took me literally months to claw back.

My major takeaway from the experience was never, ever take more than one day off of the bike. I know that's just not always going to be practical though.
globecanvas
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Re: Re:

26 May 2016 16:57

globecanvas wrote:
budegan wrote:My major takeaway from the experience was never, ever take more than one day off of the bike. I know that's just not always going to be practical though.


Thanks for all that. What do you think would be the minimum duration ride to keep ticking over?
budegan
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26 May 2016 17:01

Personally, on "off days" I try to get on the bike for a minimum of 20 minutes. Even if it's just ridiculously easy spinning, getting on the bike seems to keep the wolves at bay. Last weekend I was at my college reunion and despite a two-day hangover forced myself to go into the college gym and ride the stationary bike for a half hour easy.
globecanvas
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Re:

27 May 2016 09:44

globecanvas wrote:Personally, on "off days" I try to get on the bike for a minimum of 20 minutes. Even if it's just ridiculously easy spinning, getting on the bike seems to keep the wolves at bay. Last weekend I was at my college reunion and despite a two-day hangover forced myself to go into the college gym and ride the stationary bike for a half hour easy.


Thanks pal. Feels back to normal today. Undecided whether to try a little on the bike today.

First hit with it last Sun, rested till yesterday (Thur), went out for a potter and approx 30 mins in it returned :mad:

Maybe should have increased duration more gradually???
budegan
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27 May 2016 12:10

When I've tried to come back too soon, the pain sets in almost immediately, like I didn't even get 500 meters down the road and had to walk home. But I don't think it could possibly be bad advice to try to ease back in gradually. Maybe try a 10 minute ride just to turn the legs over a bit, go longer the next day, etc? I think the biggest risk is trying to push through the pain, but it doesn't sound like you're trying to do that at all.

Good luck with it. I know it's not much consolation, but all the rest of us who have experienced this know how frustrating it is.
globecanvas
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Re:

27 May 2016 12:57

budegan wrote:I'm wondering what the best bet is - total rest and then easing in after X many days? Or giving it a go again as soon as pain subsides?



I have not been able to figure out the best course of action over the past 4 years of having this, except for resting until I can descend the stairs without spasming. Once I can accomplish this, I can usually begin cycling again without issues. However, sometimes it takes 3+ weeks to be able to do this. I have adopted using crutches to descend the stairs when I am going through an episode which helps a lot.

I know massage and other active release techniques makes me feel worse and can sometimes bring on a spasm, so I would advise against these. I also have had varying success with static stretching; sometimes it is great, sometimes it causes a spasm. Also, try to keep warm; if I become cold this can also set off a spasm.

My new doctor has ordered me an EMG as well as metabolic tests. I will update the forum if these show anything.
Shayne_G
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28 May 2016 05:02

I know massage and other active release techniques makes me feel worse and can sometimes bring on a spasm, so I would advise against these.

Oh man, tell me about it. The very first time I got this, I tried foam rolling after the initial attack/episode. HUGE mistake, it triggered an episode that was excruciating.
jsk
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29 May 2016 18:51

Another interesting article here that speaks about McArdles disease: http://quest.mda.org/article/mcardles-disease-diagnosis

Has anyone here experienced the second-wind phenomenon?
Shayne_G
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Re:

29 May 2016 19:38

Shayne_G wrote:Another interesting article here that speaks about McArdles disease: http://quest.mda.org/article/mcardles-disease-diagnosis

Has anyone here experienced the second-wind phenomenon?


Have you been getting the brown urine thing? Sounds to me that most sufferer's reports on here don't include that.

I have wondered if there's a trend on here that most people who've experienced this appear to be over 40, though that could be as much to do with the MAMIL phenomena of which I too am part of.

BTW for those interested my rehab seems to be going okay: 3 rides in 3 days, 20 mins, then 30, today 45. All on turbo at zone 1 / very low zone 2, around 90 rpm. Happy to report no cramps. Am thinking of hopefully being able to up it to an hour tomorrow and thereafter start adding some efforts in. All will be on turbo though - I'm terrified of going out and then not being able to find a taxi home (I'm overseas at the moment)!
budegan
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Re:

29 May 2016 20:29

Shayne_G wrote:Another interesting article here that speaks about McArdles disease: http://quest.mda.org/article/mcardles-disease-diagnosis

Has anyone here experienced the second-wind phenomenon?


Very little of that article rings familiar with me. Not the second wind, not the inability to run the bases, not the discolored urine (which is a sign of full blown rhabdo). There's no mention there of trained athletes or the link with longer-than-usual rest, which seem to be common themes here.

I think it's likely that the underlying cause is a genetic disorder that is perhaps in the same general category as McArdle's disease, but McArdle's disease itself does not sound like a smoking gun to me.
globecanvas
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30 May 2016 21:24

budegan - Did you do the whole no carb thing? You got back on it very quickly! I am 30 years old and have been dealing with this since ~25.

I would agree that McArdles isn't it, but I think it's along the same guidelines...
Shayne_G
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30 May 2016 23:33

Has anyone tried trigger point injections or dry needling?
Shayne_G
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31 May 2016 10:18

Hi everyone
First off, pardon my English.

I felt I had to contribute to this discussion because I've had this for years (all the symptoms described above) and I have found a solution that works for me. After hard training on my bike (10+ hours a week including intervals and long distance) I never abruptly cut off riding. I gradually go shorter time/distance each day before a break (travel or vacation etc). I never take a day off the bike unless I have to. I spin at least 20 minutes without resistance on my balance-rollers. When I travel, I always stay at hotels with a gym.

If I get an "attack", this is how I cope with it: I take double dose of painkillers (double the recommended dose), wait for 20 minutes (kick-in time) and do 30 fast squats (all the way down) x 4 (short break in between). I have found that I need to do this immediately after the symptoms occur. Yeah, I know, a few people will give you a look when you do this in the movie-theater restroom, but it must be done. Then I get on my bike as soon as possible and do a one hour hard ride (90-100% of FTP, or around 85-90% of HRmax). This does the trick for me. Hope it can help some of you.
TOHolm
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Re:

31 May 2016 20:04

Shayne_G wrote:budegan - Did you do the whole no carb thing? You got back on it very quickly! I am 30 years old and have been dealing with this since ~25.

I would agree that McArdles isn't it, but I think it's along the same guidelines...


Hey Shayne. I didn't try the no carb thing, but as explanation what might appear to be a quick recovery I should explain that in my case on this occasion it first appeared a few days before I posted on here. I rested fully for a few days then went out for a ride around the town I'm staying to test the water. It was probably 30 mins into this that I felt it tightening / cramping / spasming again. I immediately stopped and waited till a taxi came past (I'm on a European holiday island so it didn't take long) and that afternoon found this thread and posted for the first time. The next day I woke up and it felt fine so I tried 20 easy mins, and then onwards.

Today I made 75 mins with 5 x approx 8 min zone 2 efforts - still gradually upping the time and intensity. No spasms. Hopefully tomorrow I can do 90 mins with the same but zone 3 efforts. If that goes well then I'm going to brave it and try the next ride on the road.

I'm curious as to whether this has only occurred to people after a few days completely off the bike following a period of heavy training. It's not likely to hit me out of nowhere is it? Eg unassociated with rest?
budegan
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31 May 2016 20:05

No carbs is bad for you. Your metabolism needs carbs.
Check 'em!
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Re: Re:

01 Jun 2016 19:26

budegan wrote:I'm curious as to whether this has only occurred to people after a few days completely off the bike following a period of heavy training. It's not likely to hit me out of nowhere is it? Eg unassociated with rest?



For me the episodes are 100% correlated with taking multiple days completely off the bike following a training period.
globecanvas
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02 Jun 2016 10:54

And not eating enough carbs.
Check 'em!
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