I must apologize ahead of time to readers for not having all my medical information related to this issue. Being some time ago I can not remember my specific diagnosis, but it was some type of neuritis. They were pinched nerves causing all these symptoms and my inclination is there was an underlying issue leading up to the muscles pinching nerves. I will do my best to update this blog as I dig up more information.
Also know that this blog is about my experience with this specific issue and there are many other issues/injuries that will have some of the same symptoms. Please read carefully and if this blog falls in line with your current situation it may be of valuable use to you. I am not a doctor, but when very few doctors are aware of this issue and there is little information on the web pertaining to this issue, I felt it necessary to write this blog to help others suffering from this injury/dysfunction.
For a detailed explanation of this issue, read my updated blog on psoas nerve entrapement.
I first felt these symptoms when doing a fairly heavy bench press. Normally I kept my feet up on the bench, but I had them down this time to give more stability for a heavier bench press. I was doing a 6-8RM intensity, which was a gradual change from my 12-15RM a few weeks prior. I felt a jolt of electricity shoot roughly from my belly button area to my groin. It was very uncomfortable so I scaled down my workouts. Throughout the next few weeks I felt light tingling, numbness, and discomfort in my groin and genitalia. Unfortunately I chose it ignore it. About a month after the symptoms from the bench press, I spent a few days moving to another apartment. This brought new symptoms of abdomen and pelvic pressure and discomfort. It felt like I needed to defecate frequently. Although I did, afterword the feeling remained. A week or two later I suddenly awoke in the middle of the night with extreme pressure in my genitals. This was very confusing and scary as now I definitely knew something was wrong. My initial inclination was that there was a nerve issue, being that all of the symptoms were so different but within the same general area. Another two weeks later very painful symptoms arose. In addition to the previously mentioned, I had intermittent severe pelvic pain to the point where I could not stand up. I experienced constant pain in the superior (top) portion of my testicals, mostly on one side. I experienced intestinal pain and diarrhea. There was burning in the upper thigh region. The best way to sum up the general feeling was that it felt like I was consistently being hit in the testicals.
Not knowing what exactly to make of all this, I decided to ask my then chiropractor. He had no clue, did not even suggest it was a nerve issue! He did not even care that I was in pain and suggested that it might be a bladder infection. A bladder infection, are you kidding me! I completely respect the chiropractic profession and one day hope to be one, but this guy had no clue or care what was going on with me. I dealt with the pain for another month then went to urgent care. There, the doctor examined me and checked for a hernia. She could not diagnose anything and suggested, “You probably just pulled a muscle in the groin area”. To be safe she sent me to get an ultra sound on my testicals which came out negative (whew!). Taking her advice that I pulled something, I refrained from any weight lifting or cardio activities for a month. After, I tried working out again only to find myself in more pain. So, I refrained again from working out for another two months in order to “heal”.
Fitness is my passion and it is very hard to take someone’s passion away. During those 4 months of no vigorous or even moderate physical activity I became depressed. Anxiety came right along with it, always thinking, “what’s wrong with me? Do I have an intestinal issue? Is it a testicular issue? Will I ever be able to workout again? What if…?” This happened every day. I recently noticed many blogs of people with this issue and doctors telling them that it is just depression and anxiety. Well, I don’t know who wouldn’t have depression and anxiety if they were experiencing pain which no doctors could explain. Since I could not workout, I spend many nights going out to bars (night-time was my usual workout time). Although this was not a daily thing, it was much more often and much less healthy than working out (obviously).
Discovering a Solution
After 4 months of pain and inactivity, I decided to see a sports medicine doctor. Almost immediately he came to a diagnosis and understood all of my symptoms. He did a few orthopedic tests, most of which I can not remember, and manually searched for sore spots. I specifically remember him testing the flexibility of my piriformis, expecting it to be very tight, which it was. Supposedly this was the major problem in my pinched nerves. He diagnosed me with a type of neuritis (I am still trying to find my medical information with the full diagnosis). He explained that my muscles became so tight that they we essentially “scissoring” nerves, causing dysfunction and pain. He prescribed some meds to help calm the nerves down which lasted 5 days. I went back on the day those meds ran out and he game me another prescription for a different medication and referred me to physical therapy. The pain lessened after a couple days of taking the first meds.
I had a great experience with physical therapy and was happy to just be active again. I must say they were pretty aggressive as far as exercise intensity goes, but it always felt safe. There was consistent progress in my flexibility, functionality, and most important, less pain. I went there 2-3 times a week for 1.5 – 2.5 hours, over the course of about 3.5 months. By the time I had left physical therapy I felt about 75% better. I paid close attention to the therapy/exercise program and was able to continue on my own. I did so more or less in addition to my regular fitness workouts. 6 months later I was about 95% better and occasionally experienced symptoms that were very short in duration.
Things to avoid
During my time experiencing this injury, I noticed a few things that aggravated it. Most of these were confirmed by my sports medicine doctor.
- Caffeine and other stimulants – The need to run to the bathroom after coffee (or energy drinks then) was much stronger than normal. They are CNS stimulants and stimulated/aggravated the nerves of concern.
- Alcohol the day after – Alcohol is a CNS depressant, which was part of the reason I felt the need to drink to sooth the pain caused by pinched nerves. It did while I drank. The next day however, your nerves are firing harder than normal making the symptoms more painful than usual.
- Lifting from the ground – It is suggested that the muscles involved with the pinched nerves were guarding a back injury or an SI injury/dysfunction. Lifting stressed the injury or dysfunctional joint and caused the muscles to cramp and thus causing pinched nerves.
- Leaning on a table/counter with my pelvic or abdominal area – This created direct pressure on the nerves of concern and aggravated them.
I have spoken to a number of people about this injury. The ones most familiar with it were friends that were into heavy lifting or bodybuilding. In this community it almost seemed fairly common. As mentioned, my sports medicine doctor was the only one fully aware of my condition. I had explained my past injury with a chiropractor (one of the many) and although he had never heard of such a thing, he did shed some light on my condition.
Piecing everything together from the last 5 years and going back 7 years to when I initially hurt my back, here’s my theory: I was diagnosed with a disc injury in 2010 and the doctor was almost certain that it was from doing 1000 pound leg presses 7 years ago. After this unnecessary workout, I felt numbness and tingling in my feet. It seemed to get better in the following months after scaling way back on my leg workouts and chiropractic care. Recently however, I have talked with other health professionals, chiropractors, and medical doctors who said that a disc injury was an incorrect diagnosis. I also had issues of Sacroilliac joint (SIJ) dysfunction going back as far as high school. Either way I have a history of low back injury. With any injury you are going to get muscles that tighten up to protect the vulnerable spot. The psoas muscle will tighten up to protect a low back injury, shortening it and causing it to cramp. This will create knots (trigger points) in the muscle which can then pinch the nerves running through and around the muscles. The pinched nerves created the symptoms I experienced. As of recently (3/1/2012) I have found when my psoas tightens up symptoms arise. I am convinced that in my case tight psoas muscles are causing all of my symptoms and back pain if and when they arise.
Now, I am not quite sure where the piriformis muscle fits in all this, but it was involved in the chain of events. The most likely explanation was to help protect the back injury and possibly causing the psoas to cramp. Of all the research I have done shows that the psoas is the immediate cause of the pinched nerves. My personal proof of this came when I received some active release therapy (ART) on my psoas muscles. Upon the doctor massaging my trigger points (knots), I experienced many of the symptoms associated with my past injury.
The most immediate thing you can do to relieve the pain yourself is to stretch. Specifically stretch the psoas and hip flexors. Stretching the piriformis helped tremendously for me as well as the psoas stretch. In general stretch any muscle that you can as long as it is safe for your back. The foam roller became my best friend to help release some of the muscle knots.
If you are experiencing these symptoms intensely like I did, I would suggest finding a good sports medicine doctor familiar with this issue. I am not certain if all sports medicine doctors are familiar with this because mine was the first one I went to.
Massage therapy helped a good amount and chiropractic care to some degree. The most helpful things were stretching and physical therapy. Physical therapy will help you activate the inhibited muscles due to injury and also strengthen them. Strengthening the right muscles is key. Unless you are a physical therapist or a highly experienced and educated trainer who may be able to put together a program for strengthening and flexibility, I would not suggest attempting this on your own. Physical therapy is quite a long process and takes hard work, but a good physical therapist will show you how to strengthen these muscles properly.
You can alleviate your symptoms
I hope this long explanation of my experience will help you overcome your injury. I know how frustrating, stressful, painful, and depressing having this injury can be. Aside from the pain, the worst part was that I had doctors who could not diagnose it and in some cases not believe me. It would have helped greatly if I had known someone else out there who had it and resolved it. If you have more questions on this issue feel free to contact me and I will help you the best I can.
For a detailed explanation of this issue, read my updated blog on psoas nerve entrapement.
Other possible Injuries/Dysfunctions with similar symptoms:
I have come across other injuries or dysfunction with similar symptoms when explaining my past condition with various health professionals, chiropractors, and medical doctors. As you probably know, diagnosing a condition can be very tricky and complex. Although doctors may have trouble diagnosing this issue, they are still the ones qualified to do so.
Cuada Equina Syndrome: http://en.wikipedia.org/wiki/Cauda_equina_syndrome
Disc Herniation: http://en.wikipedia.org/wiki/Herniated_disc