Extreme quadriceps starting pain after 3-4 rest days

[kasperbs]

Hi,
I have had a strange experience this week. I have been following my base training program for about 10 weeks with riding everyday including recovery rides etc.

Then for different reasons I had to take 4 days of from riding over the weekend. Then on Monday 20 minutes into my warm-up, I got extremely sore muscles in my left quadriceps. I had to stop, it was so painful.

Tuesday morning i tried to mount my bike again, but after 5 minutes, I got this extreme pain again and had to stop. Later I visited the chiropractor who thought it was a trapped nerve in the back, but she couldn't find anything, and it had no effect.

Wednesday morning I tried again, but same story. I couldn't even bike to work, which takes 5 minutes. I consulted my doctor who said it was over training, and that I should take 14 days off. I was/am a little skeptical because I have never heard of over training bringing on such severe pain. And I haven't experienced any of the symptoms related to it.

The pain is hard to describe but feel like acid in the legs that burn, and it doesn't go away. Here 24 hours after my short ride to the doctor, my legs are still sore. The pain only comes on when I bike or walk down the stairs, not up.

By accident I found this thread on a danish forum, translated into English here, and the OP basically explains the exact same story. Same symptoms with walking on stairs only biking a few km's etc. it reveals that quite a few people have experienced the same problems, without ever getting a proper diagnose.

Everyone describes how this has started after a few days of rest due to traveling and so on.

Anybody experienced anything like it, or can explain what might cause it. I can not find anything on the english-speaking web.

 

[Master50]

I am not a doctor but it sounds like a blood clot. If it were a doctor should be seen soon.

 

[JayKosta]

If the 'travel' involved long periods of sitting without standing or stretching, then nerve or circulation issues need to be considered.

Did your chiropractor use a muscle/skin temperature sensing device on your legs?
That might show if there is reduced blood flow to some muscles.

I agree that it does not seem to be 'over training', there seems to be some acute physical reason for your leg pain.

Jay Kosta - NOT a health professional...
Endwell NY USA

 

[CoachFergie]

Then for different reasons I had to take 4 days of from riding over the weekend. Then on Monday 20 minutes into my warm-up, I got extremely sore muscles in my left quadriceps. I had to stop, it was so painful.

Wednesday morning I tried again, but same story. I couldn't even bike to work, which takes 5 minutes. I consulted my doctor who said it was over training, and that I should take 14 days off. I was/am a little skeptical because I have never heard of over training bringing on such severe pain. And I haven't experienced any of the symptoms related to it.

Will leave it to medical professionals to discuss your symptoms but I have seen two riders have similar pain. Both at the end of very intensive training phases where they either had 2-3 days rest post training camp or to a day to travel to an event. Both were 2-3 mins into a warm up or light ride and encountered similar pain.

With treatment both were fine to race in days one winning a Bronze medal in NZ U23 time trial 2 days later.

 

[kiwirider]

Description of your symptoms ...

What is your hip flexibility like? If I say "do an ilio-psoas stretch" do you know what I mean? And if you do, what does it feel like? What about if you do the Cobra yoga position - do you feel that pulling down the front of your abdomen?

I'm not anything medical, but I have had similar problems in the past - feelings like a massive build up of lactic acid, walking stairs making things worse, major pain when biking even short distances, etc, etc ...

For me the problem was massive tightening in the hip flexor muscles. They get a real pounding on the bike - and mine also got a good workout with skate skiing and skating over the winter. Then just to help them shorten up, I have a job that involves me sitting at a desk all day. Sitting on a plane for any length of time is also a good one for sparking this off - combination of the seated position and inability to move much when you are seated.

Two occasions that really set this off for me related to really big increases in mileage. A couple of years ago I had been doing very little riding - probably 150-200km/week - and then decided to try to ride 100km a day during a two week long "Bike to Work" promotion. By about day 10 I was in major pain.

The other occasion was last year when we moved to our current house. Mileage increased a bit from what it was before, but intensity increased markedly (my commute is about 40km each way of hilly roads).

What has fixed me is a lot of stretching. I'm talking general lower body and back stretching. Of course specific hip flexor stretching comes into play as well - check out this: http://www.markmcgrath.com.au/2011/06/hip-flexor-opening/
If you're super tight, you'll need to build up to this - either by having your rear leg flat on the ground or holding onto it behind you (like your would for a standing quad stretch) or just having your knee a bit out from the wall/shin at less than vertical.

If this is the problem, be ready for some major change - which is going to feel like it's worsening before it gets better. Also watch for the possibility that you have really tight fascia (effectively the sheath of our body that encapsulates the muscles). I found out about tight fascia doing this stretch one time - I was stretching and literally heard a sound like someone was ripping a bed sheet in half! It was hellish scary - made me wonder what I'd done - but the release of tension that I felt was amazing. It did take a few weeks for the body to adjust and settle down though ...

So, yeah ... maybe that's the issue for you?

 

[kasperbs]

Will leave it to medical professionals to discuss your symptoms but I have seen two riders have similar pain. Both at the end of very intensive training phases where they either had 2-3 days rest post training camp or to a day to travel to an event. Both were 2-3 mins into a warm up or light ride and encountered similar pain.

With treatment both were fine to race in days one winning a Bronze medal in NZ U23 time trial 2 days later.

What treatment did they get?

 

[kasperbs]

What is your hip flexibility like? If I say "do an ilio-psoas stretch" do you know what I mean?

.....

So, yeah ... maybe that's the issue for you?

Thanks for your response. I do actually have a stretching routine that involves different psoas stretches. I have done these 3 times a weeks for the first 4 week period and everyday for that last 6 weeks. And yes, i do feel my abdomen stretching when doing the Cobra pose.

That being said, I might still be very tight in my psoas. I also sot all day. But I have tried to change that over the last 3 weeks, where I have been standing at my desk for 50% of my time at work.

I'm seeing a sports masseur and next time I will ask him to take a look at my psoas muscles.

The thing that confuses me is that in my, and the other cases, it seems to come after a period of rest.

 

[kiwirider]

I'm seeing a sports masseur and next time I will ask him to take a look at my psoas muscles.

The thing that confuses me is that in my, and the other cases, it seems to come after a period of rest.

Good stuff getting a masseur to look at the muscles. My partner is a massotherapeute, so I am a huge advocate of getting massage.

Without knowing how your therapist works, maybe ask him if he can do some range of movement/motion (same thing, just some people call them different names) on various muscle groups. They're a good way of working out where tightness is and what is likely causing it. For something like psoas (for example) it's a simple matter of lying face up on the table, holding one leg to your chest and seeing how the other one hangs. Where I'm from originally, these tests aren't that commonly done - but my experience says that they can be a huge help - for the therapist when they work, and for you when you direct stretching at home afterwards.

As for the delay ... could simply be delayed onset pain. That's just a fancy name for the feeling we've all had when we think "wow, I hammered myself yesterday and I don't feel too bad", only to have the effects hit you the day after that! I know that I'd find that at times - I kept thinking that a rest day would help, only to find that it made no difference or made things seem worse ...

And therein, you've come pretty close to exhausting my knowledge on this ... as I say, what I've written is solely based on what I experienced, so hope that's been some help to you ...

 

[ValMUS]

How are you feeling now?

I experience the same problem since I started biking on a regular basis, 3 year ago. In my case the rest between sessions can be as low as 3 days then I have the same symptoms. The can be excruciating...

So far I have not found a solution and the doctors are of no help.

After a few days the pain subsides and I can easily start to bike again. Usually in a week I am back to normal.

Val

 

[durianrider]

Sciatica or ITB much?

 

[rhubroma]

I know what you are talking about. Had you kept riding the pain would not have come on. It seems to occur when there is a sudden rupture during a period of consistent, more or less intense, riding, almost as if the legs rebel, because they aren't getting their daily fix. It always sets in when life or illness gets in the way and one can't ride for 3,4,5 days as one had planned. So that when you resume training, bam! Once I had to call my girlfiend to come and pick me up in the car, after about 10K I literally could not turn over the peddels, the pain was that excrutiating.

It isn't a blood clot, or nerve, or any such diognosis. It is within the muscle tissue itself.

When you said the pain sets in walking only downstairs, but not upstairs, I had no doubts about your condition. I have even experienced it just walking, but for some reason going up is "safe" while under such a condition.

I have never found a medic who knew just what it was, while, unfortunately, the only cure seems to be time: which means you will probably not be able to ride pain free for several days to, depending on the severity, up to about 10 days.

What seems to trigger it is the amount of time you take off while traning and racing. For example one or two days is usually not enough to have it set in, but 3,4 that's already risky.

I have known other riders to have similar problems, but not to the extent I have experienced. While I have known many others who seem never to be bothered by it. When I was racing and in most intensive phases of training, I had wondered how the pros take a week off after say a grand tour seemingly without consequence in this regard.

Are you getting enough potasium? Proper nutrition? Do you drink?

The only thing I found that was helpful was prevention. Thus make sure you don't take off more than a couple days in such a riding phase. Always keep peddeling, until you reach the off season, when you can deal with it better. The most intense pain ususally last for 4 or 5 days, then it gradually goes away.

 

[Rousel]

Same thing has been happening to me. It does seem to occur when I've been training a lot, followed by more than 3 or 4 days off. It sucks. It feels like my quads are super tight. It's not a cramp, more of a feeling of "no elasticity in the muscle". I tried to ride it out several weeks ago, when I really should have called someone to come get me, but you know, 'toughed it out'. 2 days later my quad swelled up like a balloon. 2 days after that and the swelling moved down my leg to my calf area.
I'm 41yrs old and have been "on the shelf" for at least 15yrs; no training or racing. And I decided to jump right back in.....
I never used to stretch either and I'm not very limber. So I'm trying to do some hip flexer stretches.
Keep me posted on what you learn and if you've found a reason/resolution.

 

[mllrdave]

I recently had this happen when I had to take a few days off from riding for work. Did the last ride before the break very hard, and walking the bike to the car on the first day back it felt as if I had suddenly been shot in my lateral component of the quadriceps. 5 miles into the ride and I thought I would have to bag the whole thing. Somehow it managed to warm up and I was able to ride relatively fine for a few hours. Stopped to help a flat, getting back going made it seems right back to square one. Had trouble walking around for the rest of the day. It felt less like a cramp and more like muscular tearing.

Next day woke up with no issues and haven't felt the pain since.

 

[pheonix026]

Hi all,
This happened to me a year ago after I had been cycling for a couple months after 10 years off. Then almost a year to the day it's happened again, just after I'd hit the best form of my life. I usually have a couple of rest days but had to have 3 days off and a few mins into my ride my quads just felt like they were going into spasm/cramp. I have been seeing a physio to get to the bottom of it but she's flummoxed, suggesting a prolapsed disk. She's sending me for an MRI. If anyone has had any sort of diagnosis then please share. I will post again after my MRI but after a year of this on and off I am at my wits end :-(

 

[Captain Serious]

Hi all,
This happened to me a year ago after I had been cycling for a couple months after 10 years off. Then almost a year to the day it's happened again, just after I'd hit the best form of my life. I usually have a couple of rest days but had to have 3 days off and a few mins into my ride my quads just felt like they were going into spasm/cramp. I have been seeing a physio to get to the bottom of it but she's flummoxed, suggesting a prolapsed disk. She's sending me for an MRI. If anyone has had any sort of diagnosis then please share. I will post again after my MRI but after a year of this on and off I am at my wits end :-(

Is it the whole quad, or more inner than outer?

 

[kasperbs]

Further experiences

I have some experience I want to share.

On several occasions in the past 1.5 year, I have experienced similar pain and there has been some similarities in the circumstances. Except for cycling, I have also felt it when walking where it would come in front of my hip.

One is that it collides with my holidays. That usually means some days of the bike. It also usually means that I have trained hard up to the holiday. Then on my holiday my diet changes. I consume more carbs and dairy than I do on everyday basis.

In my experience it seems like the increase in carbs and dairy has been the main factor.

The "maybe" explanation has to do with your lymph system, as I have been told by a good friend. The lymph system is simply going into overload. Because normally you muscle activity will help the lymph system to clean out the carbs. The combination of an increase in carbs and the limited muscle activity makes the job for the lymph system too hard. And that's what the pain is reacting to.

This is by no means medical proof. Simply my experience and one that fits my symptoms.

 

[Stingray34]

Anyone suggested a vascular issue?

A few years ago I had a kinked and entrapment popliteal artery behind my left knee. Produced very similar symptoms to the ones noted.

Several pros have had femoral artery issues, including Stuey Mate and, lately, Steven Kruiswijck.

 

[Captain Serious]

Anyone suggested a vascular issue?

A few years ago I had a kinked and entrapment popliteal artery behind my left knee. Produced very similar symptoms to the ones noted.

Several pros have had femoral artery issues, including Stuey Mate and, lately, Steven Kruiswijck.

Kinda (well, not really kinda, but sorta): that was gunna be my next point had the guy replied to my previous post, but he didn't, then i forgot about it.

The higher up bit of the artery (external iliac) can kink --I gather due mostly due to too much hip flexion -- temporarily impeding circulation, mostly to the inside muslces, and is usually most noticeable in the inner quad (vastus medialis).
The feeling is a cramp-like pain, sometimes in both legs, and usually worse in the left.

Regular ankle pulse examinations, done by a general practitioner, won't pick it up.

If the poster Googles stuff like: external iliac artery endofibrosis, kink, cyclists, pain, etc, they'll get heaps of hits.

"Luckily", these days it's well known in cycling circles, but try getting info ten years ago when I had a bit of it.

 

[Ewdanver]

quad cramping...

wow- I was blown away to read that others have suffered from this bizarre cramping issue that I have. The description is to the T and everyone who I have ever spoken to about it has no idea what I am describing and then lets me know they have never heard of such a thing. Not that this is about "misery loves company" for me, rather it is just nice to know that I am not alone...

Just the way it was described by several others is how it happens for me. The cramping occurs after 3 days off the bike. It has nothing to do with racing season, winter training or anything else that I can get a pulse on other than time off of the bike. When I take 2 days off, I can feel slight cramping coming on when walking or going up and down steps and if I ride that day, although I may have some of the cramping, I can ride through it and have no after affects. However, when I go the full 3 days off, I am dead in the water. Once on the bike after this time period the cramping will start and get so severe that I typically have to be picked up and cannot even lift my leg 3" off the ground without being in ecscrutiating pain. The cramping will start in my quads or glutes and then will transfer to different parts of my legs including calves. (I don't think it ever goes in to my hamstrings but could be wrong on this, as pain has a short memory) the pain will kind of rotate around the different areas of my legs but eventually really centers on my quads and glutes. Then I am very sore for a few days depending on how hard I pushed the pain threshold and the only way I can get back on the bike is to give it time. It typically is around 7 days off and then I am fine again.

 

[TWilsonChicago]

likewise

Count me as another victim of this syndrome. It is a condition so odd and apparently rare that this thread is absolutely the only reference to it I have been able to find anywhere.

Here are my particulars: If I take a few days off the bike after a period of frequent moderate-to-intense cycling, I can expect to eventually experience very sharp, localized muscle pain, mostly in my quads, but not always. And not the whole area, but localized spots within the muscles, with the pain coming on and dissipating in different spots at different times and with varying intensities, up to and including intensities that can prevent me from moving at all.

If the time off is 1 or 2 days, no problem. At about 3 days off, the pain will occur when I start pedaling again. Usually, if I can spin through it enough to get warm, it will eventually go away, or reduce to a manageable ache. If I'm off the bike for 5 days, I'll start having these pains even off the bike, just walking. For me, they never last more than a day or so.

If the training before the time off is more moderate, then the pain is reduced or never happens. Severity seems to be a function of how hard I was riding before the time off. The delay interval seems to be consistent, though, independent of the severity.

I first experienced this in my late 30s, during a period of frequent hard riding. I'm 60 now, and as I've gotten more serious about riding again over the last couple years, this problem has returned.

My best guess is that it is a by-product of the muscle repair process at the heart of exercise adaptation. It seems to happen at a certain phase of that process, but only if the area hasn't been 'worked' during the period between the damage and the repair. Maybe a doctor or physiologist can make something out of that.

Definitely doesn't seem like a nerve issue or a skeletal issue, or even an injury. It's really all happening in the muscle, and not in one spot.

Good to know I'm not alone. Someday someone will figure this out and our questions will be answered. In the meantime, the best practice seems to be: Don't stop riding.

-Tim

 

[rhubroma]

How are you feeling now?

I experience the same problem since I started biking on a regular basis, 3 year ago. In my case the rest between sessions can be as low as 3 days then I have the same symptoms. The can be excruciating...

So far I have not found a solution and the doctors are of no help.

After a few days the pain subsides and I can easily start to bike again. Usually in a week I am back to normal.

Val

I have experienced this twice and both times it took exactly 10 day before I could ride again, the legs get totally blocked from the pain. The upstroke causes knife like pain in the quadricepts, until, very soon, it becomes impossible to pedal. Given the history I simple stopped taking more than a day off the bike in season whenever I was able to avoid it.

It seems to be connected to suddenly having 3-4 days off. In other words to keep pedaling was a kind of protection against the phenomenon. When really tired it was enough to ride an hour and a half and the problem never surfaced.

I think it may be connected to dehydration, so it's important to always to keep hydrated. Alcohol may also contribute, so drinking should be greatly limited.

 

[woodnut]

This happens to me on a fairly regular basis, every 13 -15 weeks. Quite a relief to find this thread and know I'm not alone. I'm off the bike at the moment, 8 days since I last rode, on that day I was just 6 miles from home (luckily) when the cramps started.
It took me 45 minutes to get home, felt almost impossible to turn the cranks, as if someone was twisting a knife in my thigh.
Since then walking downhill is agonising, walking uphill is "easy" though I am left feeling as if my legs have been hit with sticks for a while afterwards.
Bad as it is, it's as nothing compared to the first couple of times it happened, when the pain was sometimes so bad I felt I needed to split my legs with a scalpel to knead the muscle.
I remember reading somewhere about the shortening of the quads causing imbalances in other muscle groups in the legs, and wondered if this was why the pains seem to "wander" around the upper legs & calf muscles.
I have been to the doctor who gave me strong pain killers and told me to be more "modest" with my cycling ...nah..
I've reached a point where I expect it to happen and sort of unhappily accept I'll need to have 10 days off every now and again. Agree though with the suspicion that if I just rode a little every day I could hold it off for longer, I've always been off the bike for at least a couple of days when it happens.
I have never met another person who has the same symptoms, and I wonder whether those of us that do, have anything in common?

 

[twinpig]

Fellow sufferer!

Hi All, It is such a relief to find that I'm not the only one suffering with this! It's happened to me a few times over the past 5 years, and when it comes it's completely debilitating as far as my legs are concerned. I had physio a few years ago, but I don't think that they really understood my problem. (I was told to do 10 squats 3 times a day, & calf stretches. I'm not sure it had any impact!)

It seems to occur after an intensive period of exercise, followed by rest (the perils of sitting in an office all day!). Last week I went on a cycling holiday in Mallorca & covered 400 amazing miles. However, I haven't exercised for the past 4 days (which is unusual), and now I can barely walk, as it feels as though my quads have been filled with acid.

I tried going to my usual spinning class yesterday as I thought it may help to loosen off, but I had to give up during the warmup (very embarrassing!). I'm due to be doing a charity cycle ride this weekend, which I'd usually be looking forward to. However, now I just want to get my legs back!!

My question is: when I get an attack of 'pain' - should I try & stretch it out despite the pain, or is it better to stay with the least pain of keeping my legs straight? Stretching hurts like hell immediately after the 'cramp', but I imagine (I'm not a clinician!) that if I don't stretch, then the muscles (or tendons?) will repair with less elasticity, meaning more pain later on ...maybe? What does anybody think?

 

[TWilsonChicago]

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

 

[twinpig]

Thanks Tim. Yes, just trying to keep moving & stretching when possible.

The strange thing is, it's in both legs, and (as a previous poster mentioned) it moves around! I thought I'd document it in case anybody has any theories.

Tuesday was mainly outside L/H leg (IT band perhaps), then yesterday it was inner quad covering about a hand-span up from the knee. I can still feel the pain from the 'attack' that came on in my L/H leg. Today, the same places are sore, but the attack came on the outer thigh (IT band again?) of the R/H leg. I've googled, & it seems to be the Vastus Lateralis & Vastus Medialis going into spasm.

Immediately after it happens, the muscles don't seem to work normally for a while, affecting my gait. I spoke to a physiotherapist this morning, and she suggested IT band stretches might help.