Extreme quadriceps starting pain after 3-4 rest days

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Dec 31, 2020
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Hi all... I'm 'enjoying' reading the continued experiences and details of the events leading up to the episode. I feel our shared experiences help narrow underlying causes / triggers, as 'officially medically undiagnosed' as we are. I've been back, training as hard as ever (up to 15 hours or so on trainer) and have had no issues. I haven't had a day off, and have no intentions to do so anytime soon. I had blood work done a few weeks ago for electrolytes and Acyl Carnitine.. electrolytes are fine and still waiting on the other results. My doctor also referred me to a geneticist for further testing, so we'll see if that bears any fruit.

No rest
Hydration
Reduced refined sugars
Stretching / rolling
Staying active on 'off days'

That seems to be the recipe.
 
Feb 17, 2016
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I've not checked in on here for some time, but as I believe is the case for many other followers of this thread, it's the first place I come to as soon as the issue becomes relevant to me again.

It's interesting to see that there have been several new members to this horrible club since I was last here, and although I'm sorry to hear of anyone else suffering with this, it is somewhat reassuring knowing that I'm not alone!

Anyway just FYI - having avoided an episode for almost 2.5 years (by literally never missing a day - I know: insane), I had a close call with one a couple of nights ago. I hadn't been on the bike for almost 36 hours (which I consider to be very much pushing it), and the previous day had eaten A TONNE of sugar - a real horrible binge (sugar is my weakness, it was a day of low motivation, and I succumbed).

I think I must have caught it in time because it reared its head but never fully kicked in, and was completely absent from my training ride this morning (12 hours later).

Anyway I am posting this as I suspect that for me (I appreciate we could all experience this slightly differently, and have different triggers) the combination of "too much" rest and the OTT amount of sugar was to blame.

I am confident that I could have got away with a bit (but not loads) more time off the bike, but combined with the sugar it was bad news.

(BTW I'm virtually teetotal so alcohol definitely isn't a factor for me on this one).

So that's my latest in this sorry tale.

Keep well everyone, and stay riding (as in my experience it's the only way to keep this - literal - pain at bay!).
 
Reactions: MDSanders
Apr 9, 2021
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Hi another newbie here who is relieved to have found this forum.
I'm in the middle of my first full attack, on day 5 and still got stabbing pain but am finding that if I stop walking when the seizing of the quads set in, it does seem to be releasing quicker.
I have suffered mild attacks for the past 3 months when I started training for ironman, same as most people in week 3 of block plan the attack happens, alway after a rest day but I think an Easter weekend of binging seems to have made this attack a full blown unable to walk more than 10mins and also walking down stairs triggers the muscles seizing.
Couple of things I was wondering if other people have experienced though?
I never get muscle seizing in my glutes and hammies?
For years now I have always been able to tense my calves to the point they want to cramp out but they won't fully cramp out? (I assumed it was low magnesium and potassium so take hydration tablets, but not so sure if that is the only reason for it now)
Thank you also for all the ideas floating around, I just want to get through this attack (fingers crossed not long now), get back to training and moving forward avoid another full blown attack.
 
Feb 17, 2016
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Hi Cramping.

Welcome to this s***ty club!

A day off + a tonne of chocolate Easter eggs would certainly do it for me. It's SO ANNOYING!!!

Personally I have somewhat vaguely felt it in my glutes a couple of times, but nothing like the quads where it's consistently and intensely focused.

Hopefully you've only got a few more days and you'll be out of it, and you'll be smashing your way towards the Ironman again.

Best of luck. Of course if you happen upon a miracle treatment then post up!
 
Reactions: crampingafterest
Dec 31, 2020
18
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Hi another newbie here who is relieved to have found this forum.
I'm in the middle of my first full attack, on day 5 and still got stabbing pain but am finding that if I stop walking when the seizing of the quads set in, it does seem to be releasing quicker.
I have suffered mild attacks for the past 3 months when I started training for ironman, same as most people in week 3 of block plan the attack happens, alway after a rest day but I think an Easter weekend of binging seems to have made this attack a full blown unable to walk more than 10mins and also walking down stairs triggers the muscles seizing.
Couple of things I was wondering if other people have experienced though?
I never get muscle seizing in my glutes and hammies?
For years now I have always been able to tense my calves to the point they want to cramp out but they won't fully cramp out? (I assumed it was low magnesium and potassium so take hydration tablets, but not so sure if that is the only reason for it now)
Thank you also for all the ideas floating around, I just want to get through this attack (fingers crossed not long now), get back to training and moving forward avoid another full blown attack.
indeed. Welcome to our club. Your situation sounds identical to mine and most others here. After more than a decade of trying to self diagnose, the answer is still ‘take minimal rest’. Definitely sugar and alcohol on those rest days exacerbates things. I was in hospital in early Jan for a fluid IV as a result of an acute episode. You should know that the end result is Rhabdomyolysis. If you are concerned, or have really dark urine, definitely go get you CK levels tested immediately. I’ve never got it in glutes / hams, only quads.

since Jan I’ve had a lot of blood work done, through my family physician (who is also a sports medicine doctor) and a geneticist to whom he referred me. The only ‘somewhat’ abnormal numbers were in carnitine and oxalates. Both likely diet related, and neither tooooo far out of range to be a real concern.

I haven’t had a day off training since I got back into it and I’ve been 100% fine. Crazy that we can go as hard and long as we want, we just can’t rest.
 
Reactions: crampingafterest
Apr 9, 2021
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indeed. Welcome to our club. Your situation sounds identical to mine and most others here. After more than a decade of trying to self diagnose, the answer is still ‘take minimal rest’. Definitely sugar and alcohol on those rest days exacerbates things. I was in hospital in early Jan for a fluid IV as a result of an acute episode. You should know that the end result is Rhabdomyolysis. If you are concerned, or have really dark urine, definitely go get you CK levels tested immediately. I’ve never got it in glutes / hams, only quads.

since Jan I’ve had a lot of blood work done, through my family physician (who is also a sports medicine doctor) and a geneticist to whom he referred me. The only ‘somewhat’ abnormal numbers were in carnitine and oxalates. Both likely diet related, and neither tooooo far out of range to be a real concern.

I haven’t had a day off training since I got back into it and I’ve been 100% fine. Crazy that we can go as hard and long as we want, we just can’t rest.
 
Apr 9, 2021
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It is crazy that we can't rest, I've spoken to people in my Tri group and coach etc and everyone has just looked at me like I'm nuts.

I haven't been to the doctors as at present it seems to be improving, I swam today (open water 8 degrees lol) and had minimal seizing of the quads and calves which is a massive improvement from Wednesday, where I spent 20 mins having siezed legs.

I am monitoring my urine though, as
 
Apr 22, 2021
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Hello everybody!
I have the exact same problem. After 3-4 rest days I will develop an extreme pain in the quads when trying to exercise. If I'm unlucky the symptoms worsens to the point I'm almost unable to walk. Just bending the legs are painful.

I believe it is a form of chronic exertional compartment syndrome. During normal conditions, when you train regularly, everything is fine. But when you're resting, glycogen builds up in the muscles, drawing in fluids and making the muscles swell a bit. Carb loading basically. Usually this is not a problem, but if your muscle fascia compartments restrict the swelling, pressure builds up instead. If the compartment pressure is higher than your diastolic blood pressure you will develop ischemia and severe pain. The ischemia may then lead to rhabdomyolysis and even more swelling.

My way to handle this is:
  1. Training regularly
  2. Stretching the quads after each workout (hopefully making the compartments adjust)
  3. Being careful with carbs when I'm forced to rest
If this conservative treatment doesn't work there's always surgery. But I want to avoid that.
 
May 8, 2021
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Hello Everyone,

I was sent here after posting the exact same symptoms in Reddit. Guess I found my ailment family? I’m on day 2 of a full blown attack. Same symptoms as the thread describes. Have been riding regularly for 2 months 3-4 times a week. The last ride was particularly grueling. I ate a lot of carbs and desserts and beer before and after the last workout. I have not been drinking nearly as much water as I should. Due to commitments I skipped my regular weekday workout and on the 4th day experienced the worst pains after going down the stairs. After this I laid down and felt better the next day. This was until I carried a tool bag down two flights of stairs at work. This met me with such an intense pain I was breathing heavy and thinking I might die. This pain is nothing like muscle soreness and I know because I used to lift weights when I was younger. It is a sharp and almost 10/10 pain that would have the toughest guy sweating and rolling on the floor if only movement wasn’t impaired.

Today is day 5 and I woke up feeling wonderfully. No pain. I thought I could ride the indoor bike easily to burn some of the excess glycogen. I was wrong. I could barely get to 1 minute. The pain started and something in my body told me to stop before it became a complete attack. Pain 6.5/10.

I am going to do an experiment today and fast completely. Just drinking lots of water and salts. Since I can’t exercise this is the only way of depleting the glycogen. I am an experienced faster and can do this safely. I will attempt to do a 36 hour water fast which will reduce the glycogen. Then I will attempt a brisk bike ride and see if I feel an attack.

While this is not a solution it can help to confirm the glycogen theory and at the same time provide a “solution” to anyone that is looking to take time off the bike. At the very least if fasting alleviates the symptoms it can help prove that our condition is due to an ailment of something? Lactic acid, glycogen that cannot be eliminated, inflammation etc?

If it works will it completely skip the attack or will it just delay it until food is consumed? I am hoping to be able to answer these questions. Thank you all for your support and morale.
 

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