Illness, Injury and Medical Advice from the Internet

Your body is designed to maintain a constant flow of blood to the brain. When you're standing, this blood flow is maintained throughout a range of blood pressures, usually between 50 mmHg to 150 mmHg and you use a variety of mechanisms to achieve this. When you 'invert' the cerebral BP will exceed the higher threshold, you can therefore no longer autoregulate your cerebral blood flow and intracerebral pressure increases. If you're only doing it for a short time, I can't see why this would be disastrous, but it does technically increase your chances of haemorrhagic stroke

This is probably all theoretical, the kind of thing you learn about in textbooks. But that's probably what the yoga sites are talking about. Source: I had to learn about all this for my Anaesthetics exams

Go see an exercise physiologist.

Should be able to tell you a bit more conclusively what’s safe and what’s not. Source: Mrs Hucker is one.

Thanks, no so much worried about haemorrhagic stroke, but have a genetic risk of aortic aneurism, so I'll give it a miss for now, and when the BP is under control I'll have a chat with a cardiologist.

What, actually see a specialist when I can get advice of randoms on the internet!??

Mrs Hucker seems a useful person to have married - many thanks.

Not sure where's the right place to ask this so I'll try here - just took the fixed gear for a 4 day 100km/day tour with relatively gentle gradients all told (approx 4-500m of climbing per day). Developed an injury in my right Achilles tendon after the second day; feels like an overuse thing which I'm guessing is either from grinding up hills or spinning down them at far quicker RPMs than I'm generally used to. Last time I got this was when I cycled to Paris on the fixed.

Anyone has any guesses as to what sort of injury this is, what could be causing it and what I can do to prevent it?

Having just about recovered from a snapped Achilles I’d suggest a trip to A&E and ask for a scan, not something to mess around with.

Could do with more detail - does it feel like your tendon is grinding when you move your foot? Does it seem to make noises like your tendon has rusted? Can you feel it 'grinding'. If you think it's an overuse injury, it's normally because it's an overuse injury :)

"I rode across a country recently and my tendons are a bit graunchy.. what say you, doc?"

It'll go away. If it's persistent you can do what I did and go midfoot, but an intermediate solution is to move cleats further back to reduce the 'ankling' movement in your pedal stroke (and you may need to drop the saddle too).

If you search this forum I've probably talked about doing very slow calf raises and lowers as a means to help fix tendonitis (something about lining up the tendon fibres, you'd need to google it)

Completely normal range of movement and no grinding, really only flares up when I try to put pressure on it, either skidding or resisting or when I am accelerating. It's definitely to do with the 'ankling' movement, because I definitely use the ankles both for hill-climbing and for hill-descending.

Have gotten it before so I know it'll go away (but thanks @marcomarcos for pointing out the danger if I keep at it); think the point of the question was, should I avoid this as bad technique, and just use my brakes more/give up earlier at steeper gradients?

How much riding do you normally do? If you went from sofa to touring, you're more likely to get something like this than if you're busting out 200s every weekend. So that's the first thing I'd think about - sudden uptick in volume, like a tour, could be all it takes. It may be one of climbing or descending creating the issue or it may be the whole lot.

I'd still also think about position though. How might you reduce the need for the ankles to be involved so much - is your saddle too high? Are your cleats too far forward? etc. I'd expect if you were out of the saddle climbing you wouldn't need to be on your tip toes so much so perhaps you did a lot of seated climbing or perhaps it was the descending? I used front and back brakes mostly so I could take the load off my legs when descending on the longer fixed rides.

Thanks for all the helpful advice - exactly why I wanted to ask this here! Definitely not sofa to touring but I don't exactly do 400k every week either, so uptick in volume is definitely the reason, but I wanted to know if there were things I could nonetheless do to lower the risks of a similar thing happening.

I don't quite have a gauge for how high the seat should be beyond 'does it feel comfortable and do I get my whole range of movement', but trying to pedal unclipped (I have two-sided pedals) with a more midfoot contact point and less use of the ankles has shown the saddle might be a tad too high. Is recruiting the ankles for pedaling (and braking) generally bad technique? Although I do a fair amount of seated climbing, even out of the saddle I definitely push down and pull up with the ankles on steeper gradients (when I'm just trying to get up in any fashion possible). Used the brakes for the same reasons as you, though I generally try to avoid use of them if possible so the first recourse was almost always resisting the pedals on the gentler descents and recruiting brakes only if need be (I can't lock the rear when descending).

Has anyone had any experience of pudendal neuralgia (cyclist syndrome?) I started having symptoms a few weeks ago. My GP ruled out prostate issues and said it's highly likely that I've developed PN through cycling.

I've made an appointment with a specialist Physio. But a bit of light Googling shows the initial prognosis is pain management rather than a full recovery. A lot of treatment seems to include the complete cessation of cycling, an idea that terrifies me.

I can't speak to your exact condition as I'd never even heard of it before but I do have a chronic nerve pain issue in my sciatic nerve caused by a disc herniation.

I've had two of the drug treatments on that list, amitryptaline when I was in the UK and now Pregabalin here in France. All I can say is both but especially Pregabalin has been absolutely life changing for me. At its worst the pain was like my leg and hip being on fire and being electrocuted at the same time, if you'd have given me the option of cutting my leg off to stop the pain I'd have taken it in a heartbeat.

It takes a couple of weeks for the meds to take affect but for me i just woke up one morning and the pain went from 11 to 3 overnight. That enabled me to do physio, that and getting the dose of the meds right means I'm mostly pain free now.

That was a long way of saying there are treatments for neuropathy, hopefully your physio is good, I've been lucky to find an excellent one and again, not being dramatic but they've given me an unbelievably better quality of life. Good luck, nerve pain is a fucking nightmare it's pretty much impossible to understand until you have it.

I played football last Sunday and took a pretty nasty kick on the inside of the left leg, half way down the shin. The area was heavily swollen after and I iced it on the first, second and third days and the swelling reduced. The whole leg is bruised above and particularly below the kick, all the way round. The bruising has also pooled down to the ankle and there is black / purple bruising below the ankle and along the instep of the foot. The ankle is also swollen. Soreness comes and goes, but it doesn't particularly hurt when I walk or cycle.

Is this just a bruise or something else (bone bruise or fracture?) Do I need to get it checked?

Photos attached, but it doesn't really show very clearly.

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Get it checked. I had a lower leg bruise that turned into compartment syndrome, it nearly killed me and I was lucky my leg wasn’t amputated.

Photo isn’t me but I had the incision on both sides of my leg.

It’s a rare condition but when it goes wrong and is left untreated it goes very very wrong.

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How long after the bruise did that develop? Online says within 48 hours usually.

I guess I need to see a GP either way.

Sorry to hear about the injury!

Your foot looks a lot like mine did after it had been in cast for a few weeks after an Achilles rupture, which I was not expecting to see.

I didn't ask, but assumed it was blood from internal injury being pulled down there by gravity - although that could be a dumb assumption as I have no idea how it all works.

As others have said, I'd get it checked out. Remaining active on it may make things worse in the long run, if you need to rest it or get other treatment.

I think that's normal for a bruise. Read up on compartment though and just go to A&E if worse, pain will be BAD for compartment.
You could wear a compression garment, and see a physio for some drainage.
Bruising needs time.
Again if think fractured go to A&E, GP is not going to do anything.

I don’t know if football is a regular thing for you, and I’ll assume you’re like me and not getting any younger… all injuries seem to manifest worse with age and I’m kinda glad I was forced to stop playing when I was 28…

I’m not a medical professional, but this looks like a heavy bruise in a non-20yr old body.

Thanks all. Fairly sure it is not acute compartment syndrome as pain isn't bad and I am 5 days on from the injury. Just did a turbo session on it and felt pretty normal. Had more bother from the other leg (dead leg on the thigh).

Will monitor and may go to a&e if pain worsens or anything else develops.

Honestly, with a bruise like that I wouldn't be doing much exercise. Just some movement.
Give you leg a rest and chance to heal. No wonder it hurts.
Ps. Compartment syndrome comes on onset.

Ps. Compartment syndrome comes on onset.

thanks

Wasn't sure what you meant by this? That it would have happened within 48 hours of the initial injury?

Onset, after initial inury.

https://www.nhs.uk/conditions/compartment-syndrome/

Thanks

If, as you say, the pain isn’t too bad and you’re able to move, walk, cycle etc, you don’t have compartment syndrome - the primary symptom of this is severe pain.

My guess is that the initial injury has damaged a vein in your lower leg, most likely a very tiny, superficial one, causing the impressive bruising. This will almost certainly heal by itself and probably looks a lot more dramatic than it really is.

The main thing I would be be worried about is if the calf swells, or even just continues to feel heavy or tight, then you should get it looked at properly, because if it’s an injury to a deeper vein you might be at risk of DVT (deep vein thrombosis). If left untreated this can become very serious.

However, if the bruising settles (although it is likely to turn some very interesting colours eg. Green / yellow as it develops over the next few days) and you don’t have any other problems, I wouldn’t be too concerned.

Important disclaimer - beware internet advice from strangers! If you’re even slightly worried about anything at all, please please please have someone look at it in person!