Back in the saddle… without having to resort to a nose-job!

Yesterdays NYT article spurs this note as I try to put it in the light of my own cycling experience. As someone who frequently fiddles with saddles, and having spent the best part of the last 15 years sitting at length on one type or another, I feel somewhat qualified to comment.

The majority of the studies to which the article referred, were completed on men, examining numbness and erectile dysfunction. Penile blood flow was examined, and seen to reduce in men using saddles with and without cut-out reliefs in their saddles. All saddles are bad, said the sheep in the media, thus cycling must be bad for men’s sexual health.

Subjects in these studies had pressure biofeedback mats placed under their junk, and sphygmomanometers (blood pressure cuffs in miniature) around their peckers while cycling, and during the night (to measure what happened during cycling dreams no doubt..) No real surprise, but they were seen to have poor blood flow in their penises during cycling. Sitting on a saddle for sustained periods made it worse. Giving them noseless saddles made it better, though many of them returned to regular saddle use after the trial periods.

None of these studies examined the response to different bike fits, all of them used stationary bikes (not the normal activity, since cyclists generally move about on the bike, on and off the saddle, less so on the road, more so off-road). No studies looked at the recovery rate of blood flow or sensation following dismounting. This Nyttimes article referenced a study looking at the same sensation effect in females, but only demonstrated a significant finding in reduction of anterior vaginal and left labial sensation. Hardly stuff to make you quit cycling. The 10 miles a week required for participation in the study widens the inclusion criteria to include relatively inexperienced cyclists, who will not likely have developed tissue tolerance to compression. Personally, reduction in left labial sensation is not detrimental to a long term sex life, but may be mildly bothersome in the short term. Women with true pudendal neuralgia and pelvic pain, (not transient numbness) will not be coming within 100 feet of a bicycle, and when they do, will be the early adopters of the nose-job saddles. I see these women in my clinical PT practice, and can promise you that even when they get the neuralgia under control, biking is not their main concern, or on their radar for a long time.

 Of course, sitting on blood vessels in squishy tissue causes a reduction in blood flow. Since nerves are supplied with blood by their own intricate network of vessels, the vasa nervorum, they will lose function when blood supply diminishes, thus the numbness. Which by the way, is intermittent, and transient. The more you ride, the more tolerant your bits become. The more you ride, the less saddle you need, and the more tolerant your plumbing generally becomes. None of these studies examined the response of the tissues to the removal of the pressure, the norm in A-B-A experimental design, examine the baseline, introduce the variable, remove the variable and re-examine the baseline. Do this a bunch, and you will likely see what we cycling lasses know, the beginning of the season sucks as we suffer numbness (bothersome but transient) and saddle sores (painful but also transient) and as the season goes on, the issues diminish. Do you really think that Kristin Armstrong would continue to race for Olympic gold if her nether regions were on fire with pudendal neuralgia? While Lance’s testicles were discussed ad nauseum over the past 10 years, there was a glaring absence of talk about his erectile dysfunction or numb nether regions. For a reason. This is entirely preventable, and correctable, and is rarely a problem in cyclists who are prepared to make some investment in investigating their “problem”.

A few of the responders to the article noted that the “fit” of the person to their bike is one key ingredient in reducing the initial issue, and minimizing long term saddle problems. Not to toot my professional trumpet as an orthopedics + sport physical therapist and bike-fitter, but this is old news to those of us in the “know” within the cycling world. A good fit will take into account much more than handlebar height. Stem length, angle of inclination, saddle length, shape, angle, height and fore-aft position, all are contributing factors. Add in potential pelvic alignment issues, leg length discrepancies and limb anomalies and you have a serious ball of wax to untangle. This is where a good professional fit can help resolve this issues, and keep the cyclist and his or her love partner, happy and healthy, on the bike and in the sack. No need to cut the nose off the saddle, although these  saddles are becoming increasingly popular with triathletes. These are the athletes most likely to benefit from a nose-job, or the truncated saddle mentioned in the article. This group has a unique biomechanical demand of a forward rotated pelvis, which is limited in its positioning options. There is a finite amount of pressure that one can sustain in this aggressive aero-position, without some serious perineal pressure and friction / compression stress. Been there, done that. (hence my personal move to mountain biking!) 

And besides, if this really was an issue, don’t you think we would hear from the women married to the peleton professionals, all up in arms claiming injury in the courts for the lack of tumescence in their nubile partners?

And what of the women of the peleton? As an erstwhile pro-1-2 field racer, I have suffered through many 5-7 day stage races, hanging in the saddle for up to 8 hours a day, and still managed to tolerate some rumpy afterwards.  While the Transrockies put a halt to my gallop, it was the mix of mud and sand in the shorts that did it, not the saddle pressure.

Discomfort does not equal dysfunction. Athletes are well aware of the difference between discomfort endured during athletic endeavors, and pain resultant from tissue injury. A simple appointment with a qualified bike-fitter will resolve this simple pain in the toosh. Bikefitplus is open for business, fighting pain, resolving problems!

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About sineadpt

physical therapist, PhD candidate, bike fiend, swim nut, run loony, multisport athlete, bike fitter, coach, general life enthusiast
This entry was posted in bike, bike-fitting, cycling injuries, physical therapy, sinead, strength training and conditioning for cycling. Bookmark the permalink.

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