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The American Medical Society for Sports Medicine (AMSSM) was formed in 1991 to fill a void that has existed in sports medicine from its earliest beginnings. The founders most recognized and expert sports medicine specialists realized that while there are several physician organizations which support sports medicine, there has not been a forum specific for primary care non-surgical sports medicine physicians.

FIND A SPORTS MEDICINE DOCTOR


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    Main >  Mind, Body & Soul >  Injured? (42)
    photo Female Bike Saddles: Designs and Medical Issues
    What are all these new funny-shaped saddles all about? Are they more comfortable than older designs? Will they keep me healthier so I can train on my bike longer? Should I change my saddle?

    By Rochelle M Nolte, MD

    Member AMSSM

     

    Perineum and buttock pain with long rides are common in cyclists, and are more common in women than in men. In addition, there are medical problems that can occur because of problems with the seat interface and the body. Manufactures of bicycle saddles have responded to these problems with new designs, leaving many triathletes with unanswered questions. What are all these new funny-shaped saddles all about? Are they more comfortable than older designs? Will they keep me healthier so I can train on my bike longer? Should I change my saddle?


    Medical problems associated with a poor saddle

    There are several medical problems that can arise from women being improperly fitted on a saddle. Urinary tract infections (abnormal proliferation of bacteria in the bladder) can be caused by excessive rubbing against the front part of the saddle coupled with tight sweaty clothing.

     

    If you notice burning with urination, increased frequency in urination, or cloudy urine that seems to be associated with your longer rides, it may be worth evaluating the shape of your saddle (and your clothing for that matter----are you wearing a fabric that wicks moisture away from your body?). Neuropathy (numbness or tingling) in the perineum comes from too much weight on the soft-tissue in the saddle area.

     

    While the shape of the saddle can correct some of these issues, training also plays a part. People can develop pressure sores or skin breakdown from contact from the saddle. It’s normal for people to have red spots on their skin on the area that has been directly sitting on the saddle. This redness should resolve over the first hour after the ride. If the redness is persisting, you’re at risk of developing a pressure sore or skin breakdown. These sores can become infected.


    If you are having any of the above symptoms or just pain from contact with your saddle, talk with your local sports medicine physician about medical management or bike fit/ seat advice.


    New saddle designs

    If you are not having any problems with the saddle you have currently, then you probably do not need to change to the style. The newer shapes have a cut-out design. They can be either a partial cut-out, or a full cut-out. This type of saddle is designed to allow women to tilt forward more, without placing too much pressure on the perineum (crotch) area. Some of the women’s saddles also are wider, to accommodate the wider distance between the ischial tuberosities (sit bones). If the seat is too narrow, more weight can be placed on the soft-tissues between the bones, rather than on the bones.

     

       

           More traditional                            Cut-out type   

          
           Courtesy of
    Terry Bicycles


    Getting comfortable

    In addition to the proper saddle choice, there are some common sense simple measures that you can take to ensure perineum comfort while riding. Increasing the frequency and duration of training sessions too quickly when first starting or re-starting training is a common problem. If you put your bike away for the winter and pull it out in the spring and your saddle feels uncomfortable on your first ride, this does not necessarily mean you need a new saddle. Give your body time to adjust to being back in the saddle before making a judgment.

     

    The bicycle has a saddle, not a seat. It is not designed for people to sit on it with their entire weight. People who are out of shape or starting to go on longer rides may end up sitting on the saddle with more pressure than is healthy. It is important to wear bicycle shorts that have padding in the perineum which can help with the pressure problems. Having someone adjust your saddle for you can unload painful areas. For example, some women like to tilt the saddle down in the front to reduce the pressure.



    Rochelle M Nolte, MD
    Family Medicine/Sports Medicine
    US Public Health Service
    US Coast Guard
    San Diego, CA





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