Q. After a recent ride I was in some discomfort on my left sit bone - not saddle sore, it felt deeper around the bone itself.
It got worse as the ride progressed and standing up to relieve the ache resulted in a surge of intense pain which fell away after a few seconds. Pushing around in the area, I could feel something that I could push back and forth across the bone like fatty or sinew tissue.
A visit to the doctor diagnosed 'Weaver's Bottom' orischial bursitis, and he recommended complete rest and prescribed anti-inflammatory tablets.
As soon as I got on the bike after a month off, I noticed a bit of discomfort but decided to carry on gently. After 10 miles the pain was getting worse so I gave up.
I've tried sitting on a couple of other saddles and can feel the same ache. If I stick to short rides, up to the point it becomes painful, will that just make my recovery take that much longer?
A. A bursa is a small, fluid-filled sac that reduces friction between two moving surfaces, most often tendon and bone, or muscle and bone.
The ischial bursa lies between your big gluteus muscle and the ischial tuberosity (your'sit bone'), which is also where your hamstrings attach, so it's easy to see how it can be irritated by cycling.
Prolonged sitting on hard surfaces meant that ischial bursitis (inflammation of the bursa) was a common condition in weavers, hence Weaver's Bottom.
Inflammation of any bursa can cause pain and discomfort for a lengthy period, and the mainstay of treatment is rest and anti-inflammatory medications. Particularly troublesome cases may respond to a cortisone injection to reduce the inflammation.
It's important to avoid aggravating the area as much as possible in the early stages in order to prevent the condition becoming chronic, which is more difficult to treat (easier said than done for a keen cyclist, I know). Being vigilant with regular, gentle hamstring stretches can gradually lengthen the muscles and alleviate some of the pressure on the bursa. Saddles with little or no padding are obviously not a good idea.
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