Extreme quadriceps starting pain after 3-4 rest days

[Daniel Seo]

Does anyone eating something while riding a bike? I don't eat anything while riding my bike. In a recent episode, I rode my bike for 80 km for 3 hours and didn't eat anything, and the next day it attacked me. I think we should all be wary of depleting muscle glycogen.

 

[suvowner]

I think this article is definitely worth a read, for those of you in the UK attempting to correspond with the author might be useful, particularly the section
"Alpha‐actinin‐3 R577X polymorphism and the initial phase of exercise‐induced muscle damage", on page 1598.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983298/pdf/421_2016_Article_3411.pdf

in short the cause is most likely multifactorial, I still don't buy mitochondrial disease as the most likely etiology, nor do I think everyone in this forum will have the same etiology, some or several combinations of polymorphisms in mitochondrial respiration or skeletal muscle cytoskeletal elements likely combine to create variable susceptibility to this phenomena.

the poster "Shayne G" went the farthest in trying to find an answer, which included a large muscle biopsy, and per post#207, no definitive evidence of a metabolic or glycogen storage disease. he even tried strict keto for 3 months with no change. Katie Compton has the same issue, and she is a world class cycling endurance athlete, I just don't see how someone could reach that level of fitness and endurance performance with a mitochondrial disease.

the one unifying pattern is intolerance to eccentric loading of the cycling muscles after 1-5 days of rest, especially high speed such as running downhill. The best low speed eccentric load I know of is a heavy/slow squat or a lunge with dumbbells. if you are going to be forced off the bike, then experiment with doing squats at the gym with as much weight as you can do for about 10-12 reps 3-5 sets or lunges with dumbbells 10-12 reps 3-5 sets 1-5 days before your time off, and depending on your degree of suspectibility to this you may need to squat or lunge every 1-5 days during your time off the bike.

 

[Vl4d4s]

Hi all,

Greeting from Lithuania! I found this thread April 2023 when I had the same "attack" on my quads. I am cycling for ~4 years now, I train ~10-15/h week, my FTP is ~4.7-4.8W/kg. I train all year round, no off-season breaks. So far I had these seizures 4 times. Only after 3rd time I found this thread. First 2 times I had to wait for ~3 weeks without cycling to be able to get on the bike again. All the symptoms and circumstances match this thread 110% (2-3 off bike, knife-like pain in quads after going down the stairs or just climbing down).

After 3rd "attack" on my quads I found this thread and one tip helped me. I just had a 4th "attack" (I was sick for 3 days hence I didn't train), it helped immediately as well.

I highly recommend it for other as well.

When pain starts, try to sit down and relax. Slowly bend the legs and when you can fully bend them stand up and slowly start doing squats. For me it takes ~4 sessions of 50 squats to tire my legs. Then I am able to get on the bike and pedal. I do 30-60min really hard session (80-100% of my FTP) and it's solved! I still feel some pain in my muscles for 1-2 days but it does not disturb to cycle at all.

Please let us all know in the thread below if this works for you as well, I hope this will make others try this technique as well!

Best Wishes,
Vladas

 

[AlexLovesSpeed]

You know I did have this happen only once after what was a bigger ride for me at the time (roughly 40 miles). It scared me to the point I stayed off the bike for over a week but it ended quickly. Despite going beyond that distance and speed its not happened again knock on wood. I assumed it had to do with me pushing too hard

 

[gregsipes]

I'm posting this hoping it will help someone else. I'm not a MD or in any related field but I had the same problem and it took me almost 2 years to figure it out. I ride and train 15-20 hours per week and lift 2-3 days per week with an RPE of 8 or 9. I normally ride 6-7 days per week, following a polarized training plan with a mix of hard interval session, long endurance days, and some active recovery sessions as needed. In January, I put 108 hours on the bike and felt completely fine, maybe just a little fatigued. However, when I finally do take a rest day, there's probably around a 50% chance that when I get back on the bike, I can't even turn the pedals without extreme pain in my quads. If I take 2 days off, there's closer to a 75% chance this will happen, and 3 or more days, its 100% chance. The pain can happen in either leg and in any of the 4 muscles in either quad. I tried diet changes, supplements including calcium, daily stretching and core work, but nothing seemed to help. One more important detail to mention, I am software developer so I spend long hours at my desk daily (this is actually what got me into cycling to begin with).

As the season is about to start, my training was going great and my numbers were looking better than ever, then I found myself back in the cycle of pain and off the bike after spending a few days in the hospital for the birth of my son. As the days started to pass, I was resting but it seemed like my condition was getting worse, not better. After more and more searching, I finally found an article from the Cleveland Clinic that was my "ah ha" moment. Many cyclists and runners have IT band problems but that didn't seem like it was my problem because the more I rode the better I felt. However, this article also mentions that many people also experience IT band issues from sitting at a desk with your knees bent for hours at a time. After reading that, I thought about it, and every time I take a rest day, its a work day, so therefore I sit all day, eat dinner, then wind down with the family and go to bed. After 3 days of a cycle like this, its no wonder I couldn't get back on the bike for a workout. I remember Pogi's coach saying that on rest days you want to do as little as possible, but I was even doing that wrong. To test my theory, I decided to spend an entire day off the bike but on my feet doing stuff around the house. The following day, I went for a ride and my legs still had some soreness but the pain was gone. As of this writing, I think I'm back on track and my season isn't going to wasted after all. I really hope this helps someone else. Here's a link to the Cleveland Clinic article some possible things you can do to help: https://health.clevelandclinic.org/it-band-stretches-and-treatments-to-relieve-knee-and-hip-pain

 

[Trifid]

I was thinking about this thread a couple of days ago and thought about replying saying I haven't had a problem for maybe a year now but without a reply for so long decided against doing so. I attribute the lack of a problem with following a training plan that gives very few rest days (and often do a couple of short trips on my commuter bike on those days). I also fortunately avoided any problems when I caught Covid in the autumn which stopped me training consistently for 3 months, I think this is consistent with previous breaks caused by illness which have resulted in no thigh pain, maybe a higher heart rate mitigates the problem?

Here's a link to the Cleveland Clinic article some possible things you can do to help: https://health.clevelandclinic.org/it-band-stretches-and-treatments-to-relieve-knee-and-hip-pain

"“Continuing the activity that led to the problem isn’t going to make it go away,” says Krampf."

For me, the only two options for recovering are serious rest for about 2 weeks (like 2000 steps maximum) - even walking around the house is a problem or otherwise getting on the bike as soon as it starts to hurt and immediately doing several all out anaerobic intervals from cold (no warm up as this aggravates it) until complete exhaustion. I also think my pain is more forwards of the thigh then the IT band.

 

[pasaglia]

I have had this issue since I was 25 (I am now 44). Two years ago I started taking allopurinol (200 mg/ day) for gout and have not had any debilitating rhabdo since. I'm convinced this is the reason. It took a few months, but eventually all rhabdo stopped. There is some evidence here: https://europepmc.org/article/pmc/4255256

Allopurinol is cheap and relatively harmless. I've shared this before, but felt compelled to do so again. I went on a ride 3 days ago and am about to go out for a worry free run. I hope this works for some of you as well.