Extreme quadriceps starting pain after 3-4 rest days

[DanielNieto]

Seems like some of you guys have had similar symptoms to me, thought I would post this here to see if anyone has any thoughts on what could be causing my higher susceptibility to rhabdo. I am a cyclist and had my 1st episode of Rhabdomyolisis back in 2017(aged 20). Since then I have had it another six times with it varying in how severe its been, in the worst episode my CK level peaked at 29000 and I was put on IV fluids . I have been cycling for a long time now I started road racing when I was 14 years years old, I never seemed to have any issues when I was younger despite training as a junior up to 15 hours a week and competing in the Spanish junior national series. Since then starting when I was 20 I have had these reocurring rhabdo episodes with the pain usually confined to my quads when its at its worse, although it sometimes starts of with pain in my glutes. Every episode seems to follow a similar pattern with it often coming on after being ill and therefore not training for more than 2 days.

I did stop racing last year after ending up in hospital for the 3rd time in 12 months, but then as I enjoy the sport and cant get enough of it I made a comeback at the start of 2020. I started structured training again being more careful than ever increasing the training load slowly and making sure I had at least 2 days full recovery a week(not consecutive) and this time focused on time trials only . Thought I may have finally found a training regime I could sustain and then 2 weeks ago I fell a bit ill so I took 2 days off training, then raced a 10mile TT , 2days after that was limping with pain after walking down a road!

I have seen countless specialists with them conducting the following tests but they have all failed to provide the cause:

-Rhabdomyolysis/metabolic myopathy genetic panel analysis: Didn’t reveal any pathogenic variants. Involved ACADVL, AGL, ALDOA, CAV3, CPT1B, CPT2, ENO3, ETFA, ETFB, ETFDH, FBP2, GAA, GBE1, GYG1, GYS1, HADHA, HADHB, ISCU, LDHA, LPIN1, PFKM, PGAM2, PGK1, PGM1, PHKA1, PHKG1, PYGM, RBCK1, RYR1, SLC22A5.

-Fibroblast tritium release assay of beta-oxidation of fatty acid: Normal (excluding CPT CPT2 deficiency) from skin biopsy.

-Plasma acylcarnitine profile: Normal

-Myositis extended panel: No antibodies

-EMG test: Normal

-Non-ischaemic forearm lactate test: Normal increase in lactate and ammonia supposedly excluding glycogen disorder

Have some of you guys been able to avoid rhabdo by not having repetitive rest days and reducing carb intake during them?

Thanks,

Daniel Nieto.

 

[firsthippy]

Thanks so much Mike for sharing this. I will be contacting Dr Coman and getting the test test done. Will keep you posted on the results.

Did you get any results from this testing? I'm just now having another bout. I ramped up indoor cycling volume over the last month for a fundraiser (178 ATL) and then dropped it back down to below 100 ATL and this weekend the quad pain has returned. Yesterday it eased out while I did some gentle local cycling and today I went to get on the trainer again, had the pain and then stupidly foam-rolled my quad, forgetting that massage does not help this issue. So, now I can barely walk. The left quad is mostly ok but the right quad is in bits.

 

[ScottyC1969]

Did you get any results from this testing? I'm just now having another bout. I ramped up indoor cycling volume over the last month for a fundraiser (178 ATL) and then dropped it back down to below 100 ATL and this weekend the quad pain has returned. Yesterday it eased out while I did some gentle local cycling and today I went to get on the trainer again, had the pain and then stupidly foam-rolled my quad, forgetting that massage does not help this issue. So, now I can barely walk. The left quad is mostly ok but the right quad is in bits.

Yes I had the testing done and unfortunately that’s not it for me. The tests all came back normal so I guess the case hasn’t been cracked.....sorry to hear you’re in the middle of a bout of it not nice. What really helps for me when it’s coming on is to take 800mg of Ibuprofen along with 900mg of Naproxen. So basically a double does of each taken together 1-1.5 hours before riding. The Naproxen takes a good hour to take effect. Hence the wait time before a ride. I’m not offering medical advice. Just what works for me. Hope you get better soon.

 

[Gilesyboy]

Long term reader, first time writer here.

I have experienced the same problem as other people 6 times over the past 10 years. And just through another episode now and just about can walk around the house without being in agony.

I am mainly a runner these days but did a lot of biking on Zwift because I had a heel injury and then had a couple of days off for a exam, and then bang, a few leg pains and then within 24 hours later I could hardly walk, that was 11 days ago.

i have an appointment with a neurologist in a couple of weeks, so hopefully will get some sort of diagnosis, but not too hopeful, I’ll report back either way.

 

[firsthippy]

Yes I had the testing done and unfortunately that’s not it for me. The tests all came back normal so I guess the case hasn’t been cracked.....sorry to hear you’re in the middle of a bout of it not nice. What really helps for me when it’s coming on is to take 800mg of Ibuprofen along with 900mg of Naproxen. So basically a double does of each taken together 1-1.5 hours before riding. The Naproxen takes a good hour to take effect. Hence the wait time before a ride. I’m not offering medical advice. Just what works for me. Hope you get better soon.

Cheers for the update. Sorry to hear it's still an unknown but I guess at least some options are eliminated.

I stopped taking NSAIDs a few years ago after some swelling issues with probably too much ibuprofen during TransAm and then reading about the risks for endurance athletes. Having said that though if I'm still in bits tomorrow I think I'll give it a go. After rolling the quad made it worse (I knew it would but I was angry!) I think probably the damage has been done but I can give them a shot. How hard would you say you ride after taking the anti-inflams? I've found the best way to deal with this is to ride SUPER SUPER easy until the pain subsides a bit and then effort can be ramped up. Today I couldn't even do the warmup of a Trainerroad workout due to the pain, then I tried rolling it and then I could barely stand up (Argh, idiot!).

 

[firsthippy]

Today: On waking, left leg pain gone. Right leg where I rolled it feels bruised/torn. Better than yesterday. Got on turbo, pedal at 30W (yes, thirty not 300!) and right hip flexor pain appears after 4min, right outer thigh just after. There was no pain there until pedaling started. :S

Continue at 30W, flash of pain inside top right thigh, then slowly grows along outside right thigh until 30W is too much. Stop, pain slowly dissipates. Restart. Pain ebbs on and off. Sharp pain in right outer thigh, dull pain at right hip flexor, none in left leg. Spin 160rpm less pain. Stop.

300W briefly at high cadence and pain is back down to an aching "3" rather than stabbing "7". 20min doing this so far. Still not started the actual workout proper. Flexing quad doesn't increase pain. 500W spin up doesn't increase pain. It's like whatever it is has 'settled' at "annoying" rather than "show stopper".

After 30min 'warmup' I managed to start and finish the 200-250W 1.5hr session with a couple of short, high cadence sprints. Now the quad is mostly pain free at least until I kneel and the quad is tightened. Both hip flexors have a dull ache. Wonder if it could be related to arterial endofibrosis/iliac artery issues? Blood flow restriction at the hip?

As an aside, walking can be painful bad, sitting/standing isn't. It's when the quad is tight the pain appears. So I tried to kneel, to stretch the quads and couldn't do it yesterday. Today doing the same thing there's pain but nowhere near as much. Today hip flexor ache is always kinda there after the cycling. I've now rolled the thigh a little and the hip flexors and it's nothing like as bad as yesterday. It's almost like the muscle swells, I rolled it which made it worse and then a night's sleep plus the SUPER gentle warmup flushed it out and allowed less painful movement.

Hip flexors I keep trying all kinds of angles to stretch but nothing gets in there. Just lying on the roller with it on my hip is comfortable.

Also went looking for notes about when it happened and found this note in my training logs from Feb 2013:
"First ride back after sickness. Taking it very easy. Sharp stabby pain in thighs - yeah that one I get when I have time off the bike for the agonising first ride back."

So this quad pain thing has been going on 7-8 years for me, at least.

 

[Gilesyboy]

"Wonder if it could be related to arterial endofibrosis/iliac artery issues? Blood flow restriction at the hip?"

I was tested for this and it came back clear. From what i understand if you have these issues you will always have them - they dont come and go.

 

[firsthippy]

"Wonder if it could be related to arterial endofibrosis/iliac artery issues? Blood flow restriction at the hip?"
I was tested for this and it came back clear. From what i understand if you have these issues you will always have them - they dont come and go.

I showed symptoms of it a few years ago. My left leg was going numb during shorter TTs. I just wondered if a restriction of blood to the muscle could be increasing the likelihood of whatever this thing is happening. It doesn't seem to match up with the leg numbness though but they could both be symptoms of a lot of time spent hunched over a bike where the hip flexor area is seeing a lot of compression?

My coach was telling me about some runners getting compartment syndrome in a muscle on their shins - it's just the luck of the draw they have tight muscle fascia and when the muscle is inflamed or overly stuffed with glycogen or whatever the hell starts this thing off, it swells against a tight fascia and causes pain and can kill the muscle if left untreated. Dunno about all that but it doesn't fit any other exercise-induced issues I've had over the years. Stupid bloody body!

 

[uberbania]

Going through this right now. Was able to deadlift and bench tonight, after having to abort a ride about a half mile in. I got out for a walk with the dog, about a mile, and no issues. The onset of the soreness and quads seizing up was Monday 5/18/20, and this is the 2nd time it's happened in 3 1/2 years. I had a productive week last week, took Sunday off, and felt a twinge in my left thigh Monday before starting my ride. Got about 6 miles in and thought I was starting to cramp, so I turned around and headed home. Stuck it in high gear and stood up the rest of the way home, aching all the way.

Has anyone tried alternative exercise methods that avoid utilization of the quads in order to try and draw down muscle glycogen levels system-wide, or is muscle glycogen a localized fuel source?

 

[firsthippy]

Given my last bout kicked off without a day off I wonder if it is anything to do with glycogen levels. Maybe it's the elevated training levels that cause some damage/inflammation and this is why the muscle gets tight (maybe within the fascia)? My last bout above went away after 2-3 days. Best thing I've found is to pedal VERY VERY lightly through the pain until it gets to the point where I can ramp it up. It took 30mins at 30W last time. Maybe if I hadn't rolled the muscle it wouldn't have taken so long. Rolling on the first day seemed to make it worse. Rolling on subsequent days felt good and didn't seem to cause an increase in pain levels.

 

[Gilesyboy]

Given my last bout kicked off without a day off I wonder if it is anything to do with glycogen levels. Maybe it's the elevated training levels that cause some damage/inflammation and this is why the muscle gets tight (maybe within the fascia)? My last bout above went away after 2-3 days. Best thing I've found is to pedal VERY VERY lightly through the pain until it gets to the point where I can ramp it up. It took 30mins at 30W last time. Maybe if I hadn't rolled the muscle it wouldn't have taken so long. Rolling on the first day seemed to make it worse. Rolling on subsequent days felt good and didn't seem to cause an increase in pain levels.

When i am having an episode I cant even turn the pedals without being in agony and there's no way i could roll them. I have to sleep on the sofa in thr living room as getting down the stairs is agonising.

 

[firsthippy]

Mine's not that bad (I mean, it crippled me when I rolled it last time) but relatively speaking, ie. if I'm very careful I can still move. It can be very stop/start but it eventually eases off and I'm able to ride somewhat normally. Then the day after it's better and after 3-4 days I'm basically back to normal. I'm a cyclist, I'd never choose to live in a house with stairs! Hahaha

 

[Gilesyboy]

Mine's not that bad (I mean, it crippled me when I rolled it last time) but relatively speaking, ie. if I'm very careful I can still move. It can be very stop/start but it eventually eases off and I'm able to ride somewhat normally. Then the day after it's better and after 3-4 days I'm basically back to normal. I'm a cyclist, I'd never choose to live in a house with stairs! Hahaha

If we've got the same thing yours is a milder than mine. I am housebound for 2 weeks when i have an episode as it's too painful to walk more than a few steps.

 

[firsthippy]

Yep, that's what I said. Mine has only ever lasted a week at the most, I guess. I've tried a bunch of stuff and the best thing seems to be to move until it's too painful, stop, wait, do it again, until continuous movement is possible. Once the first episode is dealt with, subsequent days are typical much easier. The worst was when I had to run to catch a flight after doing the TCR - that messed up my legs for ages.

 

[Penny]

I’m new to the discussion but certainly not new to the problem! My story is very similar to all those in the previous 12 pages of conversation. I’m a 59 year old life time exerciser, swapping from running to cycling in my 40’s when my joints weren’t so forgiving. My first episode was in my mid 20’s, walking down a mountain after a days hiking. I was so embarrassed at having to hobble/stumble my way down and was in agony at the bottom. What was an infrequent and inconvenient event has now become a daily struggle. I usually spend an hour on an indoor trainer if I am not outdoors for a longer ride, most days. This has ceased to keep the pain at bay and I am unable to walk down any negative slope (stairs are out of the question!) Last year I had a muscle biopsy that showed a predominance of slow twitch muscle fibres with almost a complete absence of fast twitch. This was thought to be a genetic anomaly, consistent with some of the above theories. My older sister, herself a very fit individual has had 2 episodes in her life, one coming down a Tibetan mountain and another while cycling, again supporting the genetic theory. There was nothing else of marked interest to find with my biopsy.

Right now I am so despondent that I am prepared to quit cycling altogether if this is what it would take. Being able to walk is a pretty fundamental activity and I just want to be a “normal” person, able to do regular stuff. At this moment I am unable to confidently walk to shops etc - sometimes the pain starts on the flat. I have in the past had some enforced time off the bike for minor medical procedures etc and the pain on walking has been completely debilitating over the ensuing days.

I was wondering if I just stopped cycling altogether, would it be a sort of withdrawal situation? Should I start a program of lunges, squats etc instead? Would I get out the other side with a regular set of legs and how long is this likely to take? Usually I swim as an alternate means of exercise but Covid has meant our apartments pool is out of bounds. Has anyone else has experience of stopping altogether, how long before legs settle etc?

Any advice gratefully received!

 

[Penny]

Your description very closely matches my experience, even the spinning class episode. As I mentioned in my earlier post, when this happens to me, the pain usually doesn't last more than a day or two. I try to work through it as best I can: light spinning if possible, stretching, walking, whatever I can do. Massaging, too. I think it all helps.

-Tim

Hi Tim,

Now it’s been a number of years since you posted, I just am wondering where your legs are at now. Being in a similar age bracket, and a lifetime exerciser, I am currently house bound as I am experimenting with a gradual reduction of bike workload in the hope that my legs will adapt to a new normal. Day 2 and I am unable to stroll on the flat for more than 5 minutes without onset of pain. Have you had any layoffs between your last post and if so, what happened?

 

[ScottyC1969]

Cheers for the update. Sorry to hear it's still an unknown but I guess at least some options are eliminated.

I stopped taking NSAIDs a few years ago after some swelling issues with probably too much ibuprofen during TransAm and then reading about the risks for endurance athletes. Having said that though if I'm still in bits tomorrow I think I'll give it a go. After rolling the quad made it worse (I knew it would but I was angry!) I think probably the damage has been done but I can give them a shot. How hard would you say you ride after taking the anti-inflams? I've found the best way to deal with this is to ride SUPER SUPER easy until the pain subsides a bit and then effort can be ramped up. Today I couldn't even do the warmup of a Trainerroad workout due to the pain, then I tried rolling it and then I could barely stand up (Argh, idiot!).

Sorry for late reply. As I say I will take the NSAIDs when I know I’m on the verge of an episode. Like if I haven’t ridden for a day or two at most and I can feel it coming on. So I’ll take the double dose and ride out on the road. And I will try and find a long climb where I can ride out of the saddle for as long as possible. And at 300 watts or so. I find out if the saddle almost straight away helps get things flowing through my legs. And after 20 minutes I’ll be away and riding normally. If I waited another day then I’d be into a full on episode and once you’re in the middle of an episode even the NSAIDs May not help.

 

[firsthippy]

Ok, I guess it's something worth trying. I've probably got some Ibuprofen still kicking about and it's worth testing out. No hills near me in west London but I could just set turbo resistance high and ride out of the saddle. I wonder if riding out of the saddle for you makes a difference compared to seated because there's less immediate load on the quads to turn the pedals over? Like compared to me in a TT position where quite a lot of the pedal stroke features the quads. How long do you leave it from taking NSAIDs to going out for the ride?

 

[ScottyC1969]

Ok, I guess it's something worth trying. I've probably got some Ibuprofen still kicking about and it's worth testing out. No hills near me in west London but I could just set turbo resistance high and ride out of the saddle. I wonder if riding out of the saddle for you makes a difference compared to seated because there's less immediate load on the quads to turn the pedals over? Like compared to me in a TT position where quite a lot of the pedal stroke features the quads. How long do you leave it from taking NSAIDs to going out for the ride?

Allow 90mins. I think the combo of Nurofen and Naproxen is what works and the Naproxen takes longer to kick in. Hence the 90 min wait. If I was on the trainer I’d probably start really easy and see if you can work into it. Slowly ramp up the watts over 30-45 mins. If you can get to a point you can go pretty much TT pace then sit there for as long as possible and do so. That should get you over the hump and back riding again.....
Good luck.

 

[steviep]

As an update to post #254 in this forum, I have the same symptoms of recurrent rhabdomyolysis after I spend more than 2 days off my bike. I have been found to have phosphorylase kinase deficiency a rare X-linked mutation of PHKA1 gene causing reduced levels of muscle phoshorylase kinase and inability to breakdown muscle Glycogen (GSD9d). No treatment. Just exercise regularly or not at all, I just have to be careful.
I encourage you to contact Dr Dave Coman, Metabolic Physician in Brisbane Australia : reception@drdavidcoman.com.au who can arrange a Glycogen storage DNA analysis (free if you live in the states) of your saliva sent to Invitae in San Francisco.
regards
Mike

I have found the answer! Spread the news.
You will have a rare type of Glycogen Storage disease. I have the same symptoms eg severe cramps (rhabdomyolysis) after I spend more than 2 days off my bike. It is due to XS glycogen accumulating in your muscles unable to be broken down eventually bursting the muscle cell. I have been found to have have GSD 9d due to phosphorylase kinase deficiency a rare X-linked mutation ( mainly men get it) due to a random/inherited mutation of PHKA1 gene causing abnormal muscle phoshorylase kinase and inability to breakdown muscle Glycogen (GSD9d). No treatment. Just exercise regularly or not at all, I just have to be careful.
I encourage you to contact Dr Dave Coman, Metabolic Physician in Brisbane Australia : reception@drdavidcoman.com.au who can arrange a Glycogen storage DNA analysis (free if you live in the states) of your saliva sent to Invitae in San Francisco.
regards
Mike McGill
mpmcgill@me.com

this is so interesting- thanks mike. I’m also a medical sufferer - a general surgeon in the uk - and thought it would be some mild metabolic thing. Will investigate your blood test, having been puzzled about this for years! So glad I found this group as a lot of my fr thought I was just being weak! Usually I can terminate it by some gentle cycling, but a few days without any cycling then running or sometimes walking make my quads go completely wrong

As an update to post #254 in this forum, I have the same symptoms of recurrent rhabdomyolysis after I spend more than 2 days off my bike. I have been found to have phosphorylase kinase deficiency a rare X-linked mutation of PHKA1 gene causing reduced levels of muscle phoshorylase kinase and inability to breakdown muscle Glycogen (GSD9d). No treatment. Just exercise regularly or not at all, I just have to be careful.
I encourage you to contact Dr Dave Coman, Metabolic Physician in Brisbane Australia : reception@drdavidcoman.com.au who can arrange a Glycogen storage DNA analysis (free if you live in the states) of your saliva sent to Invitae in San Francisco.
regards
Mike

I have found the answer! Spread the news.
You will have a rare type of Glycogen Storage disease. I have the same symptoms eg severe cramps (rhabdomyolysis) after I spend more than 2 days off my bike. It is due to XS glycogen accumulating in your muscles unable to be broken down eventually bursting the muscle cell. I have been found to have have GSD 9d due to phosphorylase kinase deficiency a rare X-linked mutation ( mainly men get it) due to a random/inherited mutation of PHKA1 gene causing abnormal muscle phoshorylase kinase and inability to breakdown muscle Glycogen (GSD9d). No treatment. Just exercise regularly or not at all, I just have to be careful.
I encourage you to contact Dr Dave Coman, Metabolic Physician in Brisbane Australia : reception@drdavidcoman.com.au who can arrange a Glycogen storage DNA analysis (free if you live in the states) of your saliva sent to Invitae in San Francisco.
regards
Mike McGill
mpmcgill@me.com

this is so interesting- thanks mike. I’m also a medical sufferer - a general surgeon in the uk - and thought it would most likely be some mild metabolic/glycogen thing. Will investigate your blood test, having been puzzled about this for years! So glad I found this group as a lot of my friends thought I was just being weak! Usually I can terminate it by some gentle cycling, but a few days without any cycling then running or sometimes walking make my quads go completely wrong so if I’m not near a bike that can be a big problem for a week or so. As you say the best way will be to learn triggers, and how to work around it. Will also try the 800mg of Brufen (don´t take it with high dose naproxen guys- they’re both NSAIDS) and low-carbs to see if that helps

 

[firsthippy]

After yesterday off I had another bout this morning. Right quad flared up as soon as we left the house. I decided to immediately try some sprints to see if this "use up some muscle glycogen" theory held any water. Bust out a few hard efforts and there's no pain from the right quad during these which is kinda odd but also somewhat expected from previous tests. Problem is after 20min I feel like now I've pulled my left hamstring. Similar crippling symptoms there although a bit different in that it's tender to touch - ah *** I probably have pulled the hamstring. That's what you get for doing sprint efforts straight out of the gate after a day off. So I keep riding but it gets worse and we decide to turn around and bail on the ride. Have to stop a few times to try and stretch out the hamstring and it gets easier but not good enough that I'd continue the ride. Another hard effort just because I'm angry and no pain during but then the left quad joins in with the pain fest. So now it's almost all left leg pain - hamstring and quad. The right quad that kicked all this off has calmed right down (the knobhead!). Easy (like <100W) pedal home and I'm now a few aspirin and ibuprofen into a beery afternoon instead of a cycling one.
Next test will be perhaps low carb on the day off. It wasn't planned so it's hard to "decide" this unless I do it intentionally. Pretty annoyed. But at least mine will go away after a couple of days.

Monday: took ibuprofen + 45min @ 50W before I could start an easy session without it flaring up.

Tuesday: Fine. Banged out some sweetspot stuff. Hamstring still tender but that was probably the cold sprints I'd tried on Sunday. Did a lot of stretching/rolling yesterday. No idea if it helped because problem resolves itself anyway.

So, basically, looks like if I don't aggravate a mild case of it, I can get over it after 2-3 days. Going to try and keep stretching going, especially the kneeling wall/coach quad stretch.

 

[DeRosa67]

I'm so glad I found this thread. I'm a 53 yo male cyclist and former elite high mileage rider who has been dealing with this for about 30 plus years. It started for me in my early 20's where I noticed that when I didn't get a chance to ride before a race due to driving or flying I would have a very good chance of "cramping up" the next day. Usually while doing a little warm up before the race. I would have to make a point of it to ride the bike abit even if it was late in the evening. A couple laps around the block would usually do the trick. I've lost count of how many times I pulled out of a race due to being in agony. Usually they would start in legs and I've had them travel to my gluts and lower back too. I don't ride too much anymore but with the covid lock-down and being laid off work I went from hardly any riding to doing about 300-400 km per week 6 days a week. Due to some bad weather I took a couple days off after doing a 4hr ride. My legs seized up walking down the stairs to carry out the garbage. It was the worst bout of these I've ever had. Could barely make it back into the house I was so much pain! Pain lasted all day and woke the next day thinking ok legs don't feel too bad so I repeat the same thing I did the day before and bam same result had to virtually crawl back in the house again. Never had this severe before.
So what I discovered worked for me was to never just go for an easy spin after not riding. I would put it in my biggest gear and put alot of pressure on the pedals. A light spin was a recipe for cramping. I thought I was alone in this because there's nothing online that even mentions it. But after reading every post it's disheartening to see there really isn't much that can be done about it.

 

[firsthippy]

I tried the sprinting thing on Sunday and even though there's no StabbyLegPain™ I think it just comes back afterwards (and in my case I think I pulled my hamstring slightly doing high watts when totally cold). For me, it looks like SUPER EASY like 30-50W for 30-60min gets enough warmth or whatever into the muscle to allow some kind of normal movement afterwards.

 

[yolky]

Just joined this forum so that I could share my experience with this.

I'm much younger than most of you guys, 20, but have had this issue since I was 16, when I started taking endurance sports (namely running and cycling) seriously. Unfortunately for me, as little as 1 day of inactivity triggers the "cramping," but fortunately I've never had long multi-day attacks - when they happen them are mostly resolved in 1 or 2 days.

It's interesting to see that I'm not alone in this issue, but at the same time disheartening to see that even after the years this thread has been around, there hasn't been a diagnosis or solution. I've had these problems occur during periods where I've only been running (no cycling), but they tend to be a bit less severe when I'm only running. Some people in this thread have hypothesized that it may be McArdle's disease, but like many others, my experiences contradict this claim. I do believe it has to do with some sort of glycogen storage issue though, as I know that for some reason I'm able to store really really large amounts of glycogen. I have done several 5 hours rides for several days in a row without any gels or calories, only water + electrolytes, so I don't believe my body has an issue with storing glycogen, but rather with storing too much. This seems consistent with the idea that during rest days a ton of glycogen is pumped into the legs, however none of it is used, so the next day you try to exercise your muscles somehow don't respond well to the excess glycogen? I know personally after rest days my legs swell up a lot, presumably because of the water which accompanies glycogen.

I don't really know what's going on but I just wanted to chime in my thoughts and experiences, in hopes that maybe some day this thread will finally have a satisfactory resolution.

 

[pasaglia]

I’m new to the discussion but certainly not new to the problem! My story is very similar to all those in the previous 12 pages of conversation. I’m a 59 year old life time exerciser, swapping from running to cycling in my 40’s when my joints weren’t so forgiving. My first episode was in my mid 20’s, walking down a mountain after a days hiking. I was so embarrassed at having to hobble/stumble my way down and was in agony at the bottom. What was an infrequent and inconvenient event has now become a daily struggle. I usually spend an hour on an indoor trainer if I am not outdoors for a longer ride, most days. This has ceased to keep the pain at bay and I am unable to walk down any negative slope (stairs are out of the question!) Last year I had a muscle biopsy that showed a predominance of slow twitch muscle fibres with almost a complete absence of fast twitch. This was thought to be a genetic anomaly, consistent with some of the above theories. My older sister, herself a very fit individual has had 2 episodes in her life, one coming down a Tibetan mountain and another while cycling, again supporting the genetic theory. There was nothing else of marked interest to find with my biopsy.

Right now I am so despondent that I am prepared to quit cycling altogether if this is what it would take. Being able to walk is a pretty fundamental activity and I just want to be a “normal” person, able to do regular stuff. At this moment I am unable to confidently walk to shops etc - sometimes the pain starts on the flat. I have in the past had some enforced time off the bike for minor medical procedures etc and the pain on walking has been completely debilitating over the ensuing days.

I was wondering if I just stopped cycling altogether, would it be a sort of withdrawal situation? Should I start a program of lunges, squats etc instead? Would I get out the other side with a regular set of legs and how long is this likely to take? Usually I swim as an alternate means of exercise but Covid has meant our apartments pool is out of bounds. Has anyone else has experience of stopping altogether, how long before legs settle etc?

Any advice gratefully received!

Hi Penny. I’ve ‘given up’ cycling regularly for years. Most of the pain is gone after a month or so, but minor episodes continue for a few months. I then inevitably come back to it - am doing this now - and end up in the hospital at some point, quit again, then come back to it a year or so later. I think the key is to stay hydrated to mitigate kidney issues. But I’ve found no resolution for the pain. Good luck!