How does weight lifting affect the pudendal nerve?

[Griff522]

Violet, I know that you feel your PNE was related to weight lifting. Do you know or can you explain the theory of what happens to the nerve during weight lifting that causes the pain?

[A's Mommy]

I would also appreciate some input on Griff's question.

My biggest fear is that after I have the surgery, that I'll become "reentrapped" if I go back to the gym. I can give up the strenous stuff, but I'd like to go back to lifting at least SOME weights.

Sincerely,

A's Mommy

[HerMajesty]

I know Violet has more experience in this area but from what I know, weight lifting can cause ligament damage, which predisposes to repetitive re-injury of joints - that is, a joint dysfunction can be corrected but then is at risk to re-injure easily with minor strain, because the ligament is unstable / loose. My husband has ligament laxity in a shoulder from lifting weights inappropriately, and as a result his A/C joint and 1st rib have become misplaced on several occasions. When I say he lifted weights inappropriately, what I mean is he was doing things like seeing the maximum weight he could bench press. What I have been told is the safe way to lift weights, is to never lift anything that you cannot easily do at least 10 reps of without excessive straining. In other words, low weight high reps is the safe way to lift.

[Violet M]

Her Majesty, you said it very well. Originally I was just lifting light weights and that was fine but then one of my friends recommended the Body for Life program that has you lifting the maximum and then you're doing lunges and squats and it puts a lot of stress on the pelvic floor and ligaments. Two months into the Body for Life program I started having pain that was misdiagnosed as hemorrhoids which I didn't have. My ligaments became strained and lax causing pelvic misalignment and stress on the PN -- worse on one side. Also, my ligaments were thickened and hardened. Eight years later the ligaments still have not healed completely. The repetitive motion of a lax ligament rubbing against a nerve can set up chronic inflammation in the nerve and if your alignment is incorrect there can also be a compression of the nerve between the ligaments at the same time. That's the theory about weightlifting as I understand it.

So the question is why can some people lift weights and others not? I think it's possible there is also a genetic predisposition to developing PNE. My mom has had mild symptoms. Also, studies have shown that some people have a genetic collagen deficiency which I think I have.

[Griff522]

Thank you HerMajesty and Violet.

What you said makes so much sense. When I first started working out at the gym I was in a Team Fitness program and my workout group just basically did a rotation of exercises with manageable weights. I did get stronger but of course the trainers at the gym like "boot camp" classes better so I was encouraged to "move up". I was afraid to move up because I was afraid I wouldn't be able to keep up. I was pressured and told I could do it and I finally agreed to do boot camp. I wish I would've listened to my gut! I let my trainer decide what my body could do and that was a big mistake. I did okay for about 5 months but as she pushed me to lift more and mixed cardio with strength I started experiencing stress incontinence and that should've been a sign. I thought it was just part of getting old. The worst part of it though was that I didn't listen to my body when the burning started. I kept working out and I probably caused way more damage than if I would've just stopped boot camp and rested.

So how do I know if my ligaments are lose? What kind of doctors did you see to make that determination? I'm wondering where to turn next. I've got an appt with Dr. Conway but that's not until January. But I have two appts coming up in the next couple of weeks with my pain dr and then the "vulva pain specialist" gyno that gave me neurontin and said "see you in six months." I want to ask them the right questions to get them to help me find a reason for this sitting pain. I REALLY want to get off of neurontin, because it has been six months and I'm not better so it's not helping. And I know nerves take a long time to heal but I feel like I'm not making progress. I had to drive and sit quite a bit yesterday and was in major pain last night. Normally, when I lie down the pain goes away but not last night!

[HerMajesty]

I defer to Violet to tell you how she found out the detailed information about the condition of her ligaments, because I don't know. I work with a PT Manual Therapist and he has corrected my husband's shoulder joint on several occasions; then once it is in place he can tell manually from how much "play" remains in the joint, that there is ligamentous laxity there. Violet however to the best of my knowledge (?) has not had the misalignment itself corrected (?), so she can tell you what tests were needed to let her know the condition of her ligaments.
Griff it is possible that you injured a joint or joints WITHOUT actually damaging the ligaments as well - I had pevic joint dysfunction / pelvic misalignment for 25 years with NO ligament damage, as evidenced by the fact that when it was all put back, it stayed and has not been re-injured.
Another tip for safe exercise: Core exercise of the small, supportive muscles is very key. I did core exercises in PT. However my husband is a firefighter and their big thing was always the "power exercises" like the kind that hurt him - so many of these firefighters are walking around with back backs, shoulders, and knees, often needing repetitive orthopedic surgeries...so now the newest firefighter trend they are all on, is core exercise programs, which are very similar to what I did in PT but apparently fitness experts are putting out programs like that now as well. These programs often involve no weight at all, generally such tools as the big exercise balls and thera-bands, and they work the small muscles that support your core. This stabilizes everything to prevent injury when you DO lift weights. I would recommend for anyone who plans to get back into the gym after PN recovery, to google "core exercise program", and begin one of these programs at least a couple of months prior to lifting or other strenuous exercises.

[Karyn]

Hi Griff,
I don't know how to advise you about your ligaments, but I do want to tell you how sorry I am for what happened to you. I'm wondering if you ever brought up this boot camp torture to any of the docs you've been seeing? If so, what was their reaction? You've incurred some serious damage that shouldn't be dismissed! It can be upsetting when you relay a specific circumstance to your health care provider and they turn around and say, "that wouldn't cause that!" It may be helpful to print out Violet and Hermajesty's posts because I'm thinking you may now have more knowledge about your condition than your current docs do. I wouldn't hand them the print outs but keep them with you for reference. I understand what you're saying about not listening to your body.
I think we've all been there, because how could we possibly know about the extent and permancy of the damage? I'd also like to add that the Neurontin will not make you better. If you're lucky, it'll take the edge off your pain but it won't make it go away, nor will it heal anything.
I hope you're feeling better today!
Warm regards,
Karyn

[Violet M]

Griff, I think the way you get your SI joints/ligaments evaluated is not through a physician but through a pelvic PT specialist -- preferably one who is experienced with PNE and SI joint dysfunction. The docs I saw had very little knowledge in this area. Maybe a sports doc would -- if you saw the right one.

The way I found out that my ligaments were lax is that before surgery I had no idea what was wrong with me so I was seeing everyone and anyone I could think of to find a diagnosis. The chiro that I went to said one leg was shorter than the other. She tried to do an adjustment and it wouldn't hold for more than 5 min. She knew right away the SI ligaments were strained so she had me wear an SI belt but that put too much pressure on the PN. This chiro fired me after 3 visits because she couldn't get the adjustment to hold. Next I saw a pelvic floor PT. When she did her evaluation she had me hold my pelvis over the side of the table and she literally gasped because my hip just fell off the side of the table my ligaments were so lax.
So that's my story and I'm sticking to it. Hope you can find someone good to evaluate this for you. You could check out the list of PT's on this site for a possible PT in your area although I'm not sure all of them are expert at SI joint dysfunction.

[Griff522]

I have seen a pelvic floor PT and she is listed on this site. She examined me and didn't seem to think anything was out of whack. I did have very weak pelvic floor muscles though and she said that could be because of the pain. I saw her twice a week for about two months and she mostly did myofascial release in the area of the pudendal nerve. She also did mr internally. She also did bio feedback with me to help strengthen the muscles but in the end I wasn't feeling any improvement. Most of the problem was that I had to drive 45 mins each way to see her twice a week and that was not helping the situation.
I was also examined by a chiropractor and she was the first person to actually diagnose me. She showed me a map of the human body and said this is where the pudendal nerve is and this is where it ends. Oh and by the way nerve pain can feel like a burning pain. She did some "soft tissue" work on me which as I look back now was probably myofacial release. She fired me too cause what she was doing wasn't helping me. She was very kind and even called me a few days late with the name of PT that I should try but I was already scheduled with the other one.

[AliPasha1]

Hi Griff,
I am sure that my PNE was a result of extraneous work out in the gym.I am still cursing the urologists and the personal trainers who encouraged me to continue my extraneous work out in the gym even after my PNE symtoms began.

Best Regards,
Ali