Groin Numbness and Bike Riding (cont.)

Interestingly, in a study on saddle shape and penile blood flow, a narrow saddle was associated with greater reductions in penile blood flow than a wider saddle, leading the researchers to conclude that the narrow saddle could be a source of blunt perineal trauma. In a study involving computer analysis of forces on the perineum with wide and narrow saddle design, it was also shown that a wide saddle capable of supporting the sit bones was superior for reducing perineal stress compared with a narrow saddle. Most racing saddles, however, are narrow, and this may have some effect on perineal symptoms for some riders. In a study of a saddle without a nose compared to a traditional saddle with a protruding nose, the traditional saddle was associated with two times greater perineal pressure than the noseless saddle. These results have been confirmed by another study. However, it has been reported by riders that noseless saddles lead to a feeling of less control over the bike since their thighs are not fully in contact with the saddle. More research needs to be done on optimal width and shape of the saddle.

Should I buy a gel seat cover?

There's no evidence that a gel seat will help reduce perineal symptoms. In fact, in some cases, too soft a seat can cause more discomfort than a slightly firmer saddle (sort of like how too soft a mattress can lead to back pain). A gel seat may work better for short-distance riding like errands or commuting, but it might not work as well for longer rides because it lacks stability and support.

The search for the perfect saddle is elusive. What may work for one rider may not work for another. So many factors are involved that it is unlikely one saddle will work for everyone. The conventional wisdom in the biking world is to experiment with saddles until you find the one that works best for you.

Can women get perineal symptoms?

Yes. In a study of 282 female members of a cycling club, 34% reported perineal numbness. The researchers pointed out that this is due to the fact that certain parts of the female and male anatomy are similar, particularly the vessels and nerves in the perineum.

Can I get perineal symptoms from spin class?

I am not aware of any research that addresses this question, but it makes sense that you could be at risk since spinning isn't different than outdoor biking in terms of pressure on the perineum. With that in mind, make sure to adjust your seat height properly (ask your instructor if you're not sure how), and wear bike pants to cushion the perineum from saddle forces.

What can be done to prevent perineal symptoms?

The variables that contribute to perineal symptoms during biking are complicated, and so it may be that you need to experiment with different strategies until you find the right one for you. Here are a number of suggestions that may help reduce the risk of perineal symptoms.

    1. Stand up frequently on the pedals to take pressure off the perineum.

    2. Change your position on the saddle while biking. Shift forward and backward when you ride to eliminate pressure on just one part of the perineum.

    3. Experiment with adjusting the angle of your saddle so that it tilts slightly downward.

    4. Wear bike shorts. They have chamois padding in the perineal area that will help relieve pressure.

    5. Adjust the height of your handlebars slightly until you find a comfortable position. Handlebars below the saddle may work well for road or racing bikes, but perhaps not as well for touring or hybrids.

    6. Make sure that your seat post is adjusted to the proper height. Your knee should be just slightly bent at the bottom of the pedal cycle.

    7. Limit the number of miles that you pedal. This may not be desirable for all riders, but number of miles per week can be a factor.

The final word

Many factors can contribute to perineal symptoms, and you will need to experiment with all of the factors mentioned in this article if you do experience them. Of course, just because you bike doesn't mean that you will experience perineal symptoms; in fact, many cyclists ride for years and never experience any of them. But if you do, and they continue after you make adjustments in your bike or riding style, then see your doctor because they probably won't get better on their own if you continue to bike. In most cases, perineal symptoms are not permanent and can be treated successfully.

REFERENCES:

Breda, G. "Development of a new geometric bicycle saddle for the maintenance of genital-perineal vascular perfusion." J Sex Med 2(5) Sept. 2005: 605-611.

Bressel, E. "Bicycle seat designs and their effect on pelvic angle, trunk angle, and comfort." Med Sci Sports Exerc 35(2) Feb. 2003: 327-332.

Dettori, J. R. "Erectile dysfunction after a long-distance cycling event: associations with bicycle characteristics." J Urol 172(2) Aug. 2004: 637-641.

Huang, V., et al. "Bicycle riding and erectile dysfunction: an increase in interest (and concern)." J Sex Med 2(5) Sept. 2005: 596-604.

Jeong, S. J. "Bicycle saddle shape affects penile blood flow." Int J Impot Res 14(6) Dec. 2002: 513-517.

Leibovitch, I. "The vicious cycling: bicycling related urogenital disorders." Eur Urol 47(3) Mar. 2005: 277-286.

Lowe, B. D. "Effect of bicycle saddle designs on the pressure to the perineum of the bicyclist." Med Sci Sports Exerc 36(6) June 2004: 1055-1062.

Munarriz, R. "Only the nose knows: penile hemodynamic study of the perineum-saddle interface in men with erectile dysfunction utilizing bicycle saddles and seats with and without nose extensions." J Sex Med 2(5) Sept. 2005: 612-619.

The Physician and Sportsmedicine 27.5 May 99.

Sommer, F. "Impotence and Genital Numbness in Cyclists." Int J Sports Med 22 (2001): 410-413.

Spears, I. R. "The effect of saddle design on stresses in the perineum during cycling." Med Sci Sports Exerc 35(9) Sept. 2003: 1620-1625.

Wilson, C. "Interface forces on the seat during a cycling activity." Clin Biomech Aug. 2007.

http://www.physsportsmed.com/issues/1999/05_99/news.htm


Last Editorial Review: 9/24/2007



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