Jim’s Tech Talk
By Jim Langley
Last week we were looking for solutions for RBRer Kenneth’s problem. As he rides, his chamois moves out of position eventually leaving one of his sit bones un-padded. Lots of roadies have saddle and shorts comfort issues so we thought we’d suggest a few for him and asked you to share yours.
If you didn’t read that story, here’s the link.
This week, we’ll first go over some of your helpful suggestions. Then, since a few of you kind readers have reached out to me asking, I’ll update you on the infection that ended my ride-every-day streak, and is still hanging on (that story here).
Your “Chamois Shift” Fixing Suggestions
Thanks everyone for all the ideas. Kenneth has been reading along, learning and adding his comments. He appreciates all your help.
Diane Jenks of The Outspoken Cyclist Podcast offered:
“Does this happen to Kenneth with ALL his cycling shorts? If so, perhaps, the chamois in his shorts is sewn at an angle (one possibility,) or perhaps the chamois is not symmetrical.
I actually hadn’t thought of the chamois shifting, but rather he is reaching too far with one leg – lowering the saddle a bit might help too. (I know he tried a shim, but that often can help a foot angle and not the issue described.)
Lastly and depending upon the number of miles on that saddle, he may be breaking down one side – standing behind the bike will show whether that is true looking straight down the middle.
Barring any of that, a pro bike fit would be in order!” [Editor’s note: Diane is a pro fitter so she would know.]
“Karl” said: “Could it simply be that his current saddle is not wide enough for him?”
“Randy,” Seth H. Shaw & Sandy Jakubowski all posited that Kenneth’s shorts might be too large for him or stretched out and he should try a smaller size. Randy says that fixed his chamois shifting. [Editor’s note: in my bike shop years I found that without guidance most people choose shorts that are too loose.]
Another “Ken” offered specific sizing instructions and more: “There are several issues that can cause this problem. Having discs removed can be a major factor. The type of saddle can make a world of difference. It is worth trying different saddles, different shapes, and different widths.
Also, the height of the saddle is critical. If you make adjustments, do so in 1/4″ increments until it feels right. A good bike shop can help with this.
The other issue is the size of the shorts, or bibs. I once tried a major supplier and found the large was too loose and the medium too small. There are 2 types of cuts of bibs. The US cut is slightly looser. The European cut, sometimes called Aero, is tighter, or actually snugger. I find a high quality Aero fit, with a heavy cloth that provides support, and a thick pad works better than an inexpensive pair of bibs.
I also had shifting problems when I used a thick lube, like Bag Balm, or an ointment. These cause the pad to shift. With a good fitting bib I use a roll-on, like Body Glide Cycle: https://amzn.to/36UZtvf. Occasionally I may use a cream, like DZ Nuts https://amzn.to/3qHpF3y, but not an ointment or thick gel.”
Seth H. Shaw offered another interesting idea, “Wouldn’t a video of Ken riding from 3 angles possibly help?” [Editor’s note – many pro bike fitters use video analysis so I think it would, Seth.]
David Williams weighed in: “This made me think about my own issues. I herniated a disc 30 years ago and it has left me with weak calf muscles on my left side. I didn’t realize the extent of it until recently, but have noticed two things. One is heel-drop on the left side. I have found that riding platform pedals instead of clipless has helped as I can position my foot a little closer to the arch. I usually ride a Brooks saddle and the saddle has deformed asymmetrically, it appears I am leaning to the left. I’m not sure what to do about this.” [Editor’s note: if you have any ideas for David, please comment.]
The final word goes to yet another “Ken” who knows a thing or two about recovery, “Not being a doctor, I am wondering about leaning to the left since the right leg is doing most of the work. Does Kenneth have a discrepancy in leg length?
I also herniated a disc over 40 years ago. At the time I was not riding much but found cycling helped. A good PT will help Kenneth and set him in the right direction. The objective is to strengthen all the muscles to take up the slack. I still do the exercises, and then some, every, single, day. This has now become part of my daily routine.
2 years ago I had a non-bicycle accident and did a full tear of my left quad tendon. This required surgery, which kept my leg in a brace for about 3 months. I did a lot of PT after the surgery but the left leg muscles deteriorated quite a bit. After a year of having all sorts of problems on the bike I finally joined a gym and started doing a lot of exercises and using the leg machine, twice a week. After only 2 1/2 months I noticed a good improvement on the bike. I have slowed down and do easier, less hilly rides, but I get out as much as I can and continue using the machines at the gym.
Hard work is rewarding.”
Thanks everyone for contributing and helping Kenneth out!
Disclaimer: I am not a doctor and nothing here is intended as medical advice. I’ll do my best to explain what happened as an objective reporter. I apologize in advance – this is a long tale.
It’s been seven weeks since I got so ill that I had to stop riding every day. It happened while we were on an RV trip near Tucson and later Tombstone, Arizona.
When I first felt sick (fatigue, headache, slight nausea and pain from urinating) I Googled the symptoms, talked to my wife and we thought it might be a Urinary Tract Infection (UTI).
The other possibility according to Dr. Google was that it might be a side effect of the prostate biopsy I had undergone in August to check a nodule the urologist discovered to see if it was cancerous (it wasn’t). I thought that was unlikely since six months had passed.
A day later, since I wasn’t feeling any better, we went to a clinic not far from our campground. The doctor took my medical history including my August biopsy and also a urine sample to test. Unfortunately, it was three days before the results came back and I was feeling a lot worse.
But, we were hopeful when the doc called saying it probably wasn’t a UTI but might be a kidney infection. She prescribed antibiotics. We immediately picked up the pills and I started on them.
Several days later while camped in Tombstone a block away from the original Wyatt Earp family homestead, I awoke at midnight trembling, freezing and struggling to breathe normally. Friends we were camping with let us borrow their pickup and my wife raced me to a hospital emergency room in Bisbee, Arizona. SIDENOTE: I have twice biked through these beautiful areas with Lon Haldeman on his Desert Camp Pactours and was bummed I couldn’t again.
In the ER, I was put on IV fluids and oxygen for six hours. Checking the antibiotics the previous doc had prescribed, the second doc said that they were not going to kill the infection, told me to stop those and prescribed stronger ones, which I started taking.
For days the pills offered little relief. I couldn’t sleep at night because of migraine headaches, extreme difficulty and painful peeing, plus nausea. Days were spent flat on my back trying to get whatever shut-eye I could. We found that extra strength Excedrin helped some with the migraines.
Back Home and My Doctors
About a week later we were home, the meds were almost gone, and I was feeling like the pills had fixed me. But I wanted to make sure. I was able to get the results from the Arizona clinics to my family doctor and also my urologist.
I made an appointment and saw my family doctor who took a urine sample and found that I was still infected. She prescribed an even stronger course of antibiotics, which like the others I started on immediately.
She also told me that it was unlikely that I had a kidney infection because I had told her that I never had any back pain (she said this usually accompanies kidney infections). To double check she ordered ultrasound tests to check my kidneys and also bladder emptying. With prostate issues you may not fully empty your bladder and retaining urine can sometimes lead to infections.
The Real Culprit: Acute Prostatitis
Meanwhile, my urologist chimed in to say my infection was most likely a condition called acute prostatitis. He said it was a side-effect of the prostate biopsy! So, Dr. Google was right after all.
He said the infection is a form of Sepsis and extremely dangerous. He also said that no one knows why but some patients that undergo biopsies get the condition. And worse that it can return. He agreed with my doctor that the antibiotics should end my sickness. If not, he said we’d need to go to even stronger ones.
Fast Forward to Last Week
I finished the antibiotics and was feeling okay except for the stomach distress of taking so many. I did try some probiotics to counter the antis but they didn’t help much if at all.
Friday, March 18 my wife and I had to fly back east. On Wednesday, March 23, I felt the pain again when using the bathroom. So, again we visited a clinic. But this time I told them I probably had prostatitis and when the urine culture showed that I was STILL infected, I was put on another antibiotic.
This time I reached out to my urologist via email before and after my clinic visit to make sure I was on the best antibiotic and correct amount. This one is Cipro, apparently the strongest yet that I’ve taken. As I write this I still have a couple of days to go before they’re done. Then I see the urologist with hopes he says I’m finally back to normal.
If I Had to Do It Again…
I can’t change the fact that I underwent a prostate biopsy. It was recommended by my family doctor and my urologist and made sense to me as there’s a history of cancer in my family.
But, studying up on it I read the book How Not to Die by Dr. Michael Greger https://amzn.to/3uUE0LF. Each chapter covers one of the most common deadly diseases / conditions and what studies show is the best way to prevent or deal with it. In the chapter on prostate cancer, he writes that prostate procedures such as biopsies can have serious side effects and one should consider carefully whether or not the procedure is really necessary. Especially considering how slowly prostate cancer usually worsens.
I’m hoping the Cipro is the magic pill and I’m over this soon. And also that this affliction does not return.
By the time you read this I will have finished the Cipro prescription. I am aware of the scary side effects of this medicine particularly for athletes (see: https://www.peoplespharmacy.com/articles/ciprofloxacin). However, I am more concerned right now about stopping this tenacious bacteria that the other meds haven’t.
Jim Langley is RBR’s Technical Editor. He has been a pro mechanic and cycling writer for more than 40 years. He’s the author of Your Home Bicycle Workshop in the RBR eBookstore. Check out his “cycling aficionado” website at http://www.jimlangley.net, his Q&A blog and updates at Twitter. Jim’s cycling streak ended in February 2022 with a total of 10,269 consecutive daily rides (28 years, 1 month and 11 days of never missing a ride). Click to read Jim’s full bio.