Q&A on Burning, Tingling Nether Regions! Exploding Back Pain! + Knee Health and Fitness After 40 with Dr. Andy Pruitt

Author and renowned sports medicine expert Dr. Andy Pruitt answers questions about back pain, knee issues with increased training, numbness and pain where we sit, and how much we can still adapt as we age.

Dr. Andy Pruitt literally wrote the book on endurance sports health. He founded the Boulder Center for Sports Medicine, and developed the Body Geometry System for Specialized, so he understands how to keep endurance athletes functioning and pain-free. We saved up your questions on pains and injuries to discuss with Dr. Pruitt. Today, we talk about resolving back, knee, and saddle pain as well as staying healthy while training increases.  

A quick note on this episode. Coach Connor is back up in Canada and his audio quality isn’t great. Our apologies about that, he was probably being attacked by a polar bear in a snowstorm while eating poutine. Don’t worry, Trevor is very “sorey”.  

Advice for a 40-Year-Old About “Exploding” Back Pain

“I’m a 40-year-old avid cyclist and have been seeing a lot of progress in my training, but recently I was struck by a big setback. I’ve had some nagging back pain for a, bit but a few months ago it “exploded.” I lost a lot of power in my left leg. It turns out I have an L4 herniation. PT helped a lot, but the pain is not fully gone. Guess that’s something I have to get used to at my age, but I don’t like.  

I’ve been doing research on strength and conditioning work that I can do to improve my back’s health. I’ve been surprised to read multiple articles saying to avoid strength machines which isolate muscle and any sort of rotation in the back. What’s your feeling about this? And what is the best approach to strengthening my back and keeping it healthy?”

Knee Pain & Training Volume

“I’m a reasonably competitive category 3 rider. I’m trying to increase my training volume to get up to that category 2 or even category 1 level, but the last few years I’ve suffered knee issues whenever I’ve increased my volume.  

I really want to make this my year, but I’m scared that my knees are going to keep preventing me from training the way I want. Is there anything I can do to protect my knees or strengthen them so that I don’t go down that same rabbit hole again?”

Knee Tracking & Hip Stability

This second question comes from Philip Darley on our Forum: 

“Hi all, in Episode 68 the knee touching the top tube was touched upon. Knee tracking and hip stability were mentioned as reasons. Does anybody have resources for further information on how to address this? Thanks!”

Tingling, Burning Pain in the “Nether Regions”

This question comes from RCCO on our Forum

“I’m a reasonably fast 50-year-old male recreational cyclist. 

These last few months I’ve suffered with the Cyclists’ Syndrome: pudendal neuralgia. I have pretty much had to give up cycling, and sitting down in general, due to the constant tingling, burning and pain in my nether regions. 

I’ve tried to go onto a low-inflammation diet, started taking CBD oil, spent time off the bike and bought a standing desk but it’s still with me all the time and it’s a literal pain in the ass. 

Has anyone come across this before?”

Again, Dr. Pruitt to the rescue.

Can We Continue to Adapt with Age? 

This question comes from Tom Maher on our Forum: 

Just been listening to your podcast on adaptation and recovery.  It prompted a possibly rambling thought in my mind, perhaps having just turned 40, but is adaptation possible throughout life? Or does adaptation mean adaptation that is perhaps just combatting the decline of age? 

On a simplistic level, for example, is it possible to keep building one’s aerobic base over the years, increasing genuine FTP albeit at a slow rate? Or could everyone reach their ceiling regardless of age?  And if there is a ceiling, then how do we improve? Is it to look for other areas to improve? What incentive is there other than to minimize loss of performance? 

From a somewhat cynical viewpoint, could I drop my training for a year and then expect to be able to get back to where I would have been had I still been training in that year? 

Just a few thoughts, I suppose querying whether we are just like hamsters on a wheel trying to keep it spinning but ultimately going nowhere, or whether it’s more like pushing a boulder up a hill…. 

Episode Transcript

This content is for Listener, Library, and Coaching Essentials members only.
Listener Membership is FREE. Please join now.
Log In Join Now

Related Episodes