Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 21495
  Title Pudendal nerve entrapment in an Ironman athlete: A case report
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989401/
Journal J Can Chiropr Assoc. 2010 Dec;54(4):276-281
Author(s)
Subject(s)
Peer Review Yes
Publication Type Case Report
Abstract/Notes Objective: To present the diagnostic and clinical features of pudendal nerve entrapment and create awareness amongst clinicians of this rare and painful condition.

Clinical Features: A 41-year old male ironman athlete complaining of insidious constant penis pain 12–24h after long distance cycling and pain after sexual intercourse. A diagnosis of “cyclist syndrome” also known as pudendal nerve entrapment was made.

Intervention and outcome: Patient was treated twice a week for four weeks using the soft tissue protocol described by Active Release Technique® to the obturator internus muscle. After two weeks of treatment his pain decreased to a 5/10 on the pain intensity scale and he began to cycle again. After four weeks of treatment his pain had decreased to 1/10 in intensity and he continued to cycle. At follow-up, approximately 8 weeks and 12 weeks later the patient communicated that his pain is resolved and he has began to train for Ironman Lake Placid 2010.

Conclusion: Pudendal nerve entrapment is a rare, painful condition and is often misdiagnosed due to the fact that the clinical manifestations can mimic other pathologies. It is important to be aware of the clinical features to obtain appropriate diagnosis and treatment of this condition promptly.


Objectif: Soumettre un diagnostic et des particularités cliniques de compression chronique du nerf honteux, et sensibiliser les médecins à cette affection rare et douloureuse.

Particularités cliniques: Un athlète masculine Ironman de 41 ans se plaint de douleur constante et insidieuse au pénis entre 12 et 24 heures après un long périple à vélo, et une douleur après avoir eu des relations sexuelles. Un diagnostic de « syndrome du cycliste », également connu sous le nom de compression chronique du nerf honteux, fut émis.

Intervention et résultat: Le patient fut traité deux fois par semaine pendant quatre semaines à l’aide du protocole du tissu mou décrit par Active Release Technique® sur le muscle obturateur interne. Après deux semaines de traitement, sa douleur avait diminué à 5/10 sur l’échelle d’intensité de la douleur, et il a recommencé à faire du vélo. Après quatre semaines de traitement, sa douleur avait diminué à 1/10 sur l’échelle d’intensité, et il a continué de faire du vélo. Lors du suivi, environ 8 et 12 semaines plus tard, le patient a affirmé que sa douleur avait disparu, et qu’il s’entraînait en vue de la compétition Ironman à Lake Placid en 2010.

Conclusion: La compression chronique du nerf honteux est une affection rare et douloureuse, souvent mal diagnostiquée en raison du fait que les manifestations cliniques ressemblent à autres pathologies. Il est important de connaître les particularités cliniques pour émettre un diagnostic exact et traiter l’affection rapidement.

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.


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