Pudendal Nerve Injuries in Sports and Exercise: A Case Series of Pudendal Neuropathies from Squats

Journal of Women’s Health Physical Therapy

Pudendal Nerve Injuries in Sports and Exercise: A Case Series of Pudendal Neuropathies from Squats

Donald Kasitinon, MD, Brian Kelly, MD, Taylor L. Price, PT, DPT, Avneesh Chhabra, MD, Kelly M. Scott, MD

Pudendal neuropathy can be a challenging diagnosis to tackle in the clinical setting. Etiologies can be various, ranging from vaginal delivery to cycling.  A new case report outlines examples in which repetitive and/or weighted squatting exercises could be considered as a mechanism for pudendal nerve irritation. 

The case report highlights the importance of:

→ both physicians and physical therapists learning how to recognize this presentation and etiology of pudendal neuropathy;

→ performing a detailed physical exam to rule out lumbar spine, SI joint, hip joint, and gastrointestinal etiologies;

→ performing a detailed pelvic floor exam;

→ evaluating squatting mechanics in both double-leg and single-leg squats with assessment of trunk  

     stability/mobility, presence of genu valgum/ varus, lumbosacral position, muscle length, and ankle range of motion;

→ and asking your patient-specific questions about current and or/new exercise routines.

Etiology of irritation can be a clue into the best mode of treatment; therefore, it is important that clinicians screen for this etiology and address exercise mechanics and intensity to guide patients towards reduced pudendal nerve irritation.

Check out the case series to explore practical cases in which pudendal nerve irritation via repetitive and/or weighted squatting exercises was suspected.