Extreme quadriceps starting pain after 3-4 rest days

[Dmart]

Yes I could swim too, did 2k yesterday and only a little beginning at the very last 25m repeat. Then had some pains while simply waking.

I think it’s because while swimming you have very low impact on those muscles and also because the legs activity should be concentric

I am lazy I basically drag my legs behind me with a two beat flutter 😂 so this might be the reason, yes.

 

[Reno sushi king]

thank you!

It’s been 6 days right now and symptoms keeps happening even while walking on the flat, even if they are not so strong.

Did it happen the same to you or to anybody in this discussion?

It has before lingered that long with an especially brutal episode. 10 stitches and a broken rib, a couple days later just hiking around the flats with the dog and almost got stuck out there because couldn't stretch properly. Could only take 10 steps and would have to rest a couple minutes, a half hour walk turned into 2 hours. Just keep pushing through. In the early days when I thought this was only happening to me it was hard to think it was only a temporary situation. Fortunately it is, and it hasn't gotten worse with age, actually better because I kind of know what the trigger is, rest. And any kind of rest, from traveling, being sick, injured, lazy, whatever.

 

[Dmart]

Just as a follow up. Stopped medication and had no issues today on the trainer and running. Is it due to medication or just that I feel better in general? I don’t know. The next cold will come and I will report back.

 

[japoco]

It has before lingered that long with an especially brutal episode. 10 stitches and a broken rib, a couple days later just hiking around the flats with the dog and almost got stuck out there because couldn't stretch properly. Could only take 10 steps and would have to rest a couple minutes, a half hour walk turned into 2 hours. Just keep pushing through. In the early days when I thought this was only happening to me it was hard to think it was only a temporary situation. Fortunately it is, and it hasn't gotten worse with age, actually better because I kind of know what the trigger is, rest. And any kind of rest, from traveling, being sick, injured, lazy, whatever.

very sorry for your unlucky event and thanks for sharing, that makes me feel better and not the with the strangest pain event.

In the whole my physician is helping me in retrieving some information in the pro cycling environment, I will keep you updated

 

[sisu]

Hey all (and especially hey to all the new sufferers, sorry that you are here but welcome!!) -

I had a decent 5-6wk stretch without symptoms. I did a 3wk training camp (26-28h/week swim-bike-run-gym) in January with no issues. Body works fine under constant load. Came home and took a bit easier (not complete rest but easier). Some "mini cramps" in hip flexors during that week but no major cramps... Build it back up to normal training for a week but had to take time off from running due to a tendon problem; biked for 11h and swam for 10ish h that week plus some gym. Then got sick and had to take 3 days off... Yesterday morning went for a casual "run-walk". I started feeling funny after the first minute but thought I could shake it because I haven't had any real issues for a while.... I got the WORST ever quad cramp and at that point was about 1km away from home. I barely made it back home limping and dragging my locked up leg and it took me 45min to cover 2km. That was very devastating. I know it's not very smart of me right after being sick but last night I had to do what I have found to be the only "cure" for these episodes: really hard biking with minimal warm up. Can't warm up for long, otherwise may start cramping. Did 4min ramp up 2.7-3.6-4.5-5.5 watts/kg, 1min easy, and then the tough part (per this board's suggestion): 10sec max seated sprints/20sec easy. Last summer I often had to do 10-20min of this with no warm up (awful) but I was hoping this time 5min would be enough because they HURT. After that, I was able to ride up to an hour (did a bit more tempo cadence work, otherwise just aerobic) and didn't cramp up. In the morning, I couldn't even walk for 1km without stopping 10 times.

This "condition" is very confusing and exhausting. I am 29 years old and racing professionally with still a lot to achieve yet I feel like this has started to take a huge toll on me and making me afraid. Last year, I got cramps the day before my race and a little bit during the race. It's demoralizing.

My muscle biopsy came back normal and urine organic acid test didn't apparently show anything either. The hospital decided there's nothing wrong with me or at least my condition is not severe enough or appear progressive so they won't do any more tests. There's clearly something wrong. My coach who has coached some of the best triathletes in the world for almost 30 years said he has never seen anything like this before. I am now consulting a sports physician and I think we are going to do a diagnostic spiroergometry. One thing I think appears to be the case with me is that I am a "carb burner" and since they found some slight abnormalities in my acylcarnitine panel this all could be related to fat metabolism trying to kick in at rest but since there seems to be an issue there it results in the cramps.

For someone who asked earlier: I was a runner before and never had these issues before switching to triathlon... I have been thinking about that lately that this could have something to do with the metabolic effect of cycling vs. running only. You can ride a lot more than you can run and I feel like I can smash my legs way more on the bike. Like almost beyond the limits... I love triathlon but I also love pushing my limits in sport, but now I have started to feel like I can't achieve the things I could achieve without this condition. Training 30h/wk is cool but it doesn't matter if you can't display your fitness in races because your body can't handle the taper or travel... Feels pointless to put yourself through so much pain and suffering if you can't do the thing you are doing it all for.

Lastly, I have to say this community has given me some relief though and I appreciate all of you. Battling with this stuff is often lonely and sad but knowing that there are someone who knows what I'm going through (although I would never wish this to anyone) is somewhat relieving. I get a lot of comments like "that's crazy"/"I've never heard of anything like that"/"that's not normal"/"that's weird", which are obviously true and valid comments about this condition (because it IS crazy and NOT normal), but sometimes it's hard to not take these comments personally (am I crazy? weird? not normal?).

I am not going to give up yet and I do not want this to be the reason why I retire from racing... That's just awfully sad. I am going to keep looking for answers and potentially experiment with some dietary and training methods. I'll keep y'all posted.

 

[Reno sushi king]

Brutal episode! When the quads get fully engulfed it is basically game over. The tests, doctors, physical therapy, and hospitals all add to the frustration. But yeah, don't give up. I can only imagine how many people out there with the same affliction, the not knowing combined with not being able to cycle/exercise I'm sure has been life changing for many.

My experimenting now is to jump on any bike everyday (or some stationary set-up) for at least 30 minutes. If I skip around 2.5 days (or 60 hours in total) then symptoms start to show up. And so far so good. Yes, kind of a hassle but if that is what it takes to avoid the various leg pain attacks then it is well worth it. And trying to do more weight training to hit the leg muscles in an opposite way that cycling does, so far that hasn't changed or improved anything but have to try new things.

 

[Nougat]

Hi all,

I was trying to figure out what the h... happened to me last week of travelling when I finally stumbled upon this forum.
Just want to chime in.
Short story:
Been working out consistantly for approximately 3 years and are know at the level of approximately 12 hours a week

• Cycling on home trainer 5 times a week (7 hours approx) using Trainer Road.
• Running 2 times a week (2 hours approx)
• Weight lifting 3 times a week (3 hours approx - full body routine)

Last week I was travelling to Iceland and after 3 days the quad in one leg started tightening up almost heavy DOMS feeling when going down. After a while it spread to the other leg's quad and finally to the calves. It was so bad that I almost did not make it down the small hike.
It was of course not DOMS as I know this feeling and how it relates to post workout primarily after a long break.
And it was small "hikes/strolls" as we had our children with us so it was not overexertion.
When I got back to the cabin I lay in bed for some hours while the pain went away. The morning after everything was fine with only a small residual pain left what could be felt upon applying pressure.
As soon as we went on the new day's small hikes the same happened. This continued for the rest of the vacation.
I came back this Sunday evening - this week I have been getting into my training regime again but starting up slowly as I was away from any training 11 days total. I been using a recovery week programme and so far so good, no issues at all. I've even done my usual compound exercises, squat and deadlift, with no issue at all.
I have never had this happen to me before and I have no idea what it is about. But I am glad I found this forum nevertheless.

 

[Reno sushi king]

Hey Nougat, welcome aboard! We are all still trying to figure out what H happened, and can remember the first time experiencing this while on a vacation was unsettling. Isn't it nice how becoming fit may lead to nasty side effects?

Glad to know your weight lifting is pretty thorough and consistent, I won't hope that it will make a difference for me. It sounds like you may have cleared whatever it is from your system while on vacation and getting back into exercise isn't an issue, sometimes that is how it goes. Sometimes not.

What is interesting is your pain was able to migrate to the calves, mine has always stayed from the quads to hips. Once before I knew what was going on I pushed it to the extent I could just feel intense pain in my knees and it was way too much and could barely walk after that.

And lastly it works for some, not sure about everyone but at the moment you feel something coming on stop and get on the ground with an upward dog pose, hold it for a 20 count (really get the lower spine scorpioned) and often it makes the pain vanish quickly. Repeat as needed. One time that procedure saved the day, had dropped into a remote canyon mountain biking and there was no way possible to get extracted except for calling search and rescue. Went through a half hour of back and forth with pain (maybe 4-6 upward dog sessions), then it left and was able to pedal out and continue with more fun.

 

[Lackslacks]

I think I might have found the solution. It could be this. There's a gene that cannot process Folic Acid in some people. Look up MTHFR mutations.

The solution seems to be 2-fold; avoid foods (or vitamins) enriched with folic acid, and supplement with 5-mthf (5-Methylfolate), preferably either with B12 because it metabolizes better in tandem with B12. I've been taking 5-MTFH daily since I read up on it and it seems to be working.

I found out years ago that Tonic water helps when the cramps start or when they get bad. The quinine in it genuinely woks to stop the cramp. It's a good fix for the moment, but is not a long term solution.

Also, you can ask your doctor for a genetic test to see if you have a MTHFR mutation.

I hope this helps. I've been dealing with this for over 20 years, myself.

 

[Reno sushi king]

I think I might have found the solution.

I looked it up but MTHFR had so much else going on it was hard to make the connection. Interesting take for sure though, thanks for bringing another perspective. One thing I have learned though with this condition is that once you figure you have a handle on it, you really don't. So best to keep an open mind and one day the breakthrough will be made. (me personally)

Personally I chug a lot of tonic water and like you mentioned it, my problem is it is usually diluted with a bunch of gin or vodka. I find the perfect ratio to be 50-50.

I'm mostly retired so been experimenting with some new tactics and having success so far, will report back soon just need more days to test a few things.

 

[NaturallyDriven]

Hi all... I'm not new here but just wanted to provide an update. I keep this thread book marked and it's good (and unfortunate) to see the conversation continuing with more ideas. Some coles notes of random info / thoughts:

- First happened to me in 2009 at a half marathon. Great training leading up and then drove a few hours to the race, woke up the next morning (cold day) morning and went to start the race with very little warm up. Hit me around 5km in and thought it was regular cramping, so stopped, stretched and hobbled to the finish.
- Happened a couple more times in 2009 and then 2 - 3 times annually until a couple years ago.
- It happened in 2021 and I ended up finding this forum thread and took myself to hospital to have CK checked and was told I did indeed have Rhabdo

What I find are my biggest triggers (as others have said)
- Rest days after big volume (IE tapering for races sucks and causes so much anxiety)
- Travelling (sitting around)
- Over consumption of refined carbs and alcohol (IE around holidays)
- Dehydration (from alcohol consumption / travelling)
- Walking downhill down stairs

What seems to help:
- Staying active at all costs
- Staying hydrated all the time (with electrolytes and not just water)
- Never carb loading and always being mindful of carb / sugar intake

I am running the LA Marathon in a couple weeks and am stressed. It's about 10 hours of travel (2 flights + drive / public transit etc).

 

[Reno sushi king]

Hi all...

Hi ND, are you saying you don't even cycle? Just curious! Don't stress to much, even with travel you can always find a little time for physical activity every day. That way when you are on the starting line you don't even have to think about it, but I realize easier said than done.

 

[NaturallyDriven]

Hi ND, are you saying you don't even cycle? Just curious! Don't stress too much, even with travel you can always find a little time for physical activity every day. That way when you are on the starting line you don't even have to think about it, but I realize easier said than done.

Most definitely cycle. Triathlon is my main sport. 2 standalone marathons this year though has me nervous.

 

[Reno sushi king]

OK good to know, didn't even see cycling mentioned previously and I thought uh-oh, how can someone else be going through this and not even be bike riding?

So last week I experimented and deliberately did not exercise/cycle, except for one 10 minute bike loop per day. (1.3 miles, moderate hills = 350 ft elevation gain)

I wanted to see if there was a minimum activity threshold that would keep these crazy leg pain attacks at bay. Went 4 days just doing 10 minutes of biking, the 5th day went big and nothing happened. Then took off on a two day trip, returned and still OK. My point is for peace of mind just get a little bit in every day and you should be good to go on race day.

 

[Nougat]

Hi @NaturallyDriven,

I've just come back from Paris half marathon yesterday. I was pacing my wife for just sub 2 hours. I felt the quad pain creep up at 4 k and I had to bail out at 17 k only to limp my way back to the hotel unable to bend the knee joint. Of course the issue migrated from one leg to the other as usual
It sound exactly as your first experience.
What I've done both times prior to my travels (my first experience was on a travel to Iceland a month ago decribed in a post just above) was a move my trainerroad workouts so that I could fit in even more HIIT sessions just before travelling.
And in both cases I actually had to bail out due to training fatique (I never cut my sessions short!!! These two times are my first).
Last training before yesterday's half marathon was on thursday. However, in Paris I walked 25 k on Friday and 21 k on Saturday so I was not just sitting around doing nothing - no issue there.
I am also wondering if this is a bad strategy. And I do certainly not want to end up with Rhabdo. My urine is NOT red or cola colored which often seems to be the case.
I am wondering if I should actually cut down on the cycling and increase the running instead. Maybe also add some weekly rest days.
For reference I am a 44 year old male. Doing Trainerroad structured workouts (ERG mode) on Monday, Wednesday, Friday, and Saturday (long ride 2 hours). I am running on Tuesday, Thursday and Sunday (long run approx 2 hours).
I am also doing weight lifting on Tuesday, Thursday and Sunday, so I do not believe it is an "untrained/lacking strength" issue.
I have run multiple half marathons before and much faster with the issue never happening before.
It is ONLY after I began cycling intensively, which I picked up due to shin splints from running, that I have experienced it.

 

[NaturallyDriven]

Hi @Nougat Sorry to hear it. Such a frustrating experience, every time and such a source of stress not knowing the best approach to mitigate a blow up. I've tried a whole load of different things and sometimes they work and sometimes they don't.

My plan for this week is to back off the training but keep some intensity, not change my diet in any way to try and carb load and stay hydrated. I will just keep my diet as normal as possible and do at least something every single day. Today I rode an hour and was supposed to run 5km but about a mile in, had to stop as the outside of my ankle was starting to hurt. Not related, but just one more thing. LOL

Last April I had to travel for work (pretty much same distance) and had zero issues. I was able to run most mornings with no problems and stairs were no issue at all either, so I will keep reminding myself of that.

 

[Reno sushi king]

I've noticed the only way to keep the blow ups away is to do some daily cycling. (around 15 minutes is the sweet spot) And missing a day or two once in a while is ok.

If I'm on vacation, keeping active by walking, hiking stairs, or jogging does not do the trick, it can make it worse when you resume normal intensive activity.

You have to cycle the legs, perhaps there are those out there that experience this condition and don't cycle at all, please chime in! I don't think it has a lick to do with alcohol, stress, carbs, bad diet, sleep, dehydration, age, etc. Yes, been running a lot of bad experiments so the rest of you don't have to.

Cycling brings it on, cycling is also the cure.

 

[Nougat]

I am wondering maybe if it is related to the intensity/training load of cycling compared to running.
What I mean is, in running I have always had some natural restrictions on how much training I could do. This was primarily due to factors relating to risk of injuries, tendon issues, ligament issues and so on. All the things that runners always suffer a bit from
But in cycling, the only limiting factor for me has been the time spend or some annoying saddle sore. So I have, over long periods, pushed my self much harder than I have been able to ever before in any "running" sport.
As a result my fitness level is much better now compared to ever before.

 

[Reno sushi king]

It probably is related to the intensity, and being able to push oneself for so long. I used to like getting right to the point of vomitting and then scale it back. Just doesn't happen to everyone, my wife was always training for triathlons and never ever would even have a hint of this syndrome, and that's why no one really gets it.

And I can feel what everyone goes through, have an event lined up, or even a casual ride with someone from the cycle club and now you have to explain why you have to pull out after a few miles. I'd get stuck on the side of a small hill walking down with the dog, for 45 freaking minutes.

Cycling is the culprit, some unfortunate ones who show up for spin classes end up in the ER with extreme Rhabdo from going balls to the wall and not knowing the hidden dangers. Ours is just some delayed onset, lesser race horse rhabdo like syndrome. Our legs get used to producing so much limitless power that when you take extended time off something happens, aka the blow-up.

From the input of everyone here, I think I've been able to identify the triggers and I don't have the dread when doing things anymore because it can be managed. I have a 50k mountain bike race on the books for summer and leading in I'll cycle everyday for weeks and not even worry about it when lining up on race day. Last year I did worry and nothing happened but I was still in the guessing phase.

Of course this is going months so far with no blow-ups, so confidence is high! In the past everyday was, "Oh crap is today the day that I'm going to be crippled on the side of the trail?"

 

[Nougat]

I agree with you that I do not think it is full blown Rhapdo as that seems to be more severe and I experience no other symptoms other than the blown-ups.
Today, 2 days after the half-marathon, I went to the gym to do my full body strength training with no issues. Afterwards I went for a short run and after 4 k the symptoms showed itself again. I stopped and it is better than Sunday thank god. Tomorrow I will be doing a bike session. Hopefully that will kickstart my body again
I have a marathon (my first) coming up in two months. It seems that I could either take a week, maybe two, away from biking if I want to truly taper, alternatively just go ahead and stick with the bike routine and thus not do any taper period with the consequence of probably not being able to do my best performance.

 

[Trifid]

I think I might have found the solution. It could be this. There's a gene that cannot process Folic Acid in some people. Look up MTHFR mutations.

The solution seems to be 2-fold; avoid foods (or vitamins) enriched with folic acid, and supplement with 5-mthf (5-Methylfolate), preferably either with B12 because it metabolizes better in tandem with B12. I've been taking 5-MTFH daily since I read up on it and it seems to be working.

I found out years ago that Tonic water helps when the cramps start or when they get bad. The quinine in it genuinely woks to stop the cramp. It's a good fix for the moment, but is not a long term solution.

Also, you can ask your doctor for a genetic test to see if you have a MTHFR mutation.

I hope this helps. I've been dealing with this for over 20 years, myself.

Having been experimenting with removing artificial Folic Acid from my diet for the last 6 months based on this article, I'm tending to agree. I have had it a couple of times as part of food since and have started to get problems after any inactive days within a couple of weeks of consumption. Definitely not enough incidents to say for certain, and I feel like I'd need to experiment with consuming it in pill form to be more certain. However I'm getting on OK at the moment with out it, and not adding in any multi vitamins (just keeping a closer eye on diet consumption).

I'd like to add, the UK government has made it law that flour (and therefore any flour products) will have folic acid added to help prevent birth defects. I fear this will make life very problematic when eating out and I'm not sure what to do to avoid this. At home, I have already substituted white flour with non fortified spelt flour.