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-   -   Any of you totally recovered from or avoided cyclist's syndrome? (https://www.bikeforums.net/showthread.php?t=1082934)

johnsmith246 10-03-16 03:14 PM

Any of you totally recovered from or avoided cyclist's syndrome?
 
Hi all,

Two years ago I did a route of 40-60mi a day over 11 days on my then-new touring bike, and ended up with some serious perineum pain during and after (12 months after!) the route. The pain in that area would start within the first hour of each ride, but I was stupid and thought it was a matter of getting used to it.

I've been much, much better over the past year or so -- pretty much "cured", but not quite. My urologist says it's OK to go back to cycling, but I should stop if the pain comes back. I've been cycling 3 miles every day and it's not been a problem. I'm hoping that at this rate I'll be totally recovered in the next few years.

Now I want to prepare for a 5-week cycle tour, hoping to do again 40-60mi a day. And I've spent a lot of time and money making sure the pain won't come back. But I'm still getting some pain in that area, although it's nowhere as bad as it was.

I recently had my bike professionally fitted, which included having the saddle replaced as per the gebioMized pressure mapping. That made a huge difference. The peak pressure went from 0.9 bar to 0.5 bar, and is now better distributed; this was the best saddle out of the 10 or so I tried.

But I still got some minor pain during and after ~30mi routes, so following the bike fitter's advice, I bought a pair of Endura FS-269 Pro SL bib shorts. Based on the extensive research I did, these seem to be the very best at avoiding this type of injuries. I rode 30mi with them, but frankly, I'm not sure they make a huge difference compared to my cheapest cycling shorts.

So, what else can I try? Before getting a "proper" touring bike, I was doing similar routes on a much cheaper, badly fitted, old, hybrid bike and never felt any pain. Too bad it can only accommodate a rear pannier!

I'm considering getting a second pressure mapping from Cyclefit, who seem to be the best in the UK -- They'll probably have an even larger selection of saddles I could try. Or maybe go to a cycling physio.

I'd really appreciate any advice you could give me! :)

Cheers.

Carbonfiberboy 10-03-16 09:16 PM

Never heard it called "cyclist's syndrome" before. We know there are cyclists who have permanent ED as a direct result of cycling.

The worst I ever had was a case of the "numbies" which lasted 3 days. That was a result of one ride where I was in the saddle for about 9 hours. My wife told me that wasn't going to ever happen again and of course she was right. I then tested saddles until I found one which didn't make me numb no matter how long I was in the saddle.

The OP is now complaining of "pain," but doesn't say where the pain is. Numb genitals is intolerable. Painful sit bones just means you aren't riding enough. Big difference.

Leisesturm 10-03-16 09:57 PM

The o.p. is throwing real money and time at this and it would appear the problem isn't completely solved. It could be as CFB surmises "not enough time in the saddle" or in other words "too much too soon". I am not one of those who believes in "the perfect saddle is out there you just have to sift through piles and piles of them until you find your perfect..." No, just no.

He may be a good candidate for SMP saddles. I can't justify the cash outlay myself. Tourists are the worst when it comes to being pro-active about getting up and letting blood circulate in the area under discussion. The best saddle in the world won't help you if you just grind away hour after hour.

Edit: https://www.stevehoggbikefitting.com...ll-about-smps/

CliffordK 10-04-16 03:13 AM


Originally Posted by Leisesturm (Post 19100262)
He may be a good candidate for SMP saddles. I can't justify the cash outlay myself. Tourists are the worst when it comes to being pro-active about getting up and letting blood circulate in the area under discussion. The best saddle in the world won't help you if you just grind away hour after hour.

Edit: https://www.stevehoggbikefitting.com...ll-about-smps/

I'll ride just about any seat. But, I was thinking the same... look for a seat with a center channel. Several brands available.

Brooks seats also have a strong following.

I've been a bit skeptical of the selle anotomica, but some people like them. Maybe like a cross between Brooks and SMP.

The MoonSaddle (and related seats) is also very unique, and perhaps worth considering.

johnsmith246 10-04-16 06:45 AM

Thank you so much for your replies.

I haven't come across the SMP or Moon saddles, but I'm taking a note to do some research.

To clarify: The pain/numbness is still in the perineum, not the sit bones.

I forgot to mention that I got epididymitis as a result of that route two years ago, and I'm sure that's the pain that's coming back when I cycle (nothing else triggers it).

Cheers.

Doc V 10-04-16 08:40 AM

The Kontact saddle (Kontact Bicycle Saddles) was designed to place you on your sit bones where you weight is supposed to be. This helps keep the pressure off of the perineum and the surrounding soft tissues. Pressure in these areas causes numbness due to pressure on the nerves. It was designed by an experienced cyclist and physical therapist with a Master’s degree in biomechanics. They have a trial period before buying.

At first your sit bones are a little sore because most saddles do not place the weight on only the sit bones, but after 2-3 rides it goes away. The only downside is if you like to shift around in your saddle it does not give a lot of surface area for doing that.

andr0id 10-04-16 08:52 AM


Originally Posted by Doc V (Post 19100838)
The Kontact saddle (Kontact Bicycle Saddles) was designed to place you on your sit bones where you weight is supposed to be. This helps keep the pressure off of the perineum and the surrounding soft tissues. Pressure in these areas causes numbness due to pressure on the nerves.

This is the core of the matter.

The saddle should be firm enough to solidly support you sitting on your ischial tuberosities, NOT any soft tissue.

A saddle with too much padding will put pressure on soft tissue and not support you on those two points.
Shorts with too much padding may put pressure on soft tissue.
And a rider with too much padding may also put too much pressure on soft tissue.

berner 10-05-16 12:07 PM

As a card carrying old guy I remember a few farmers who still used horse drawn farm equipment. They would sit for many hours each day on a cast iron seat while using that equipment. Those seats were contoured to the back side and were very wide. I've used that type equipment myself, though drawn by a farm tractor and know those seats to be very comfortable. A bike saddle has to work differently so the shape needs to be different. It will not be true for everyone but for me, a wide saddle (at least 155mm) works best. I also find comfort with a cutout area on the center line. A wide saddle at the sit bones tends to be wide also just ahead of the sit bones and many find such a saddle uncomfortable. To my mind, a shape similar to the Kontact, wide in the back but narrow forward best for myself.

My overall point is that it takes a while to identify the saddle characteristics that are most likely to satisfy and there are still many variations within such a category. There is no other answer but to try many saddles and to range in on saddle types first. I've been at the point of giving up on cycling several years ago. At that point I began customizing my saddle and finally found comfort.

philbob57 10-05-16 01:04 PM

I suggest reading

https://www.cervelo.com/en/engineeri...-road-saddles;
ismseat.com theory (http://www.ismseat.com/technology);
Steve Hogg on Selle SMP seats - just search the web on 'steve hogg smp' (no quotes).

One significant point to remember: if you reach your handlebars by rolling your pelvis forward instead of bending your back, you won't be riding on your ischial tuberosities; you'll ride on your pubic rami. If you bend your back, you might ride on the tuberosities, but you'll also risk significant damage to your back.

If you use an ISM or Selle SMP saddle as expected by the designers, you might find other objections to the saddles, but you almost definitely won't get numb.

Most Selle SMPs are pricey, but I'm using a TRK model, which I got from Amazon for $51 - $80 from an LBS, but no LBS I called had one in stock when I wanted one.

Best of luck solving your problem.

CliffordK 10-05-16 01:20 PM


Originally Posted by berner (Post 19103575)
As a card carrying old guy I remember a few farmers who still used horse drawn farm equipment. They would sit for many hours each day on a cast iron seat while using that equipment. Those seats were contoured to the back side and were very wide. I've used that type equipment myself, though drawn by a farm tractor and know those seats to be very comfortable. A bike saddle has to work differently so the shape needs to be different. It will not be true for everyone but for me, a wide saddle (at least 155mm) works best. I also find comfort with a cutout area on the center line. A wide saddle at the sit bones tends to be wide also just ahead of the sit bones and many find such a saddle uncomfortable. To my mind, a shape similar to the Kontact, wide in the back but narrow forward best for myself.

My overall point is that it takes a while to identify the saddle characteristics that are most likely to satisfy and there are still many variations within such a category. There is no other answer but to try many saddles and to range in on saddle types first. I've been at the point of giving up on cycling several years ago. At that point I began customizing my saddle and finally found comfort.

Good point.
You don't necessarily want all of one's weight sitting on a single bone.

Of course, cycling is a little different from tractors with much more dynamic leg movements.

I've been experimenting a bit with carbon fiber saddles. A bit odd... like sitting on concrete. But, not that bad either, once you get used to the seat.

Carbonfiberboy 10-05-16 09:15 PM


Originally Posted by johnsmith246 (Post 19100638)
Thank you so much for your replies.

I haven't come across the SMP or Moon saddles, but I'm taking a note to do some research.

To clarify: The pain/numbness is still in the perineum, not the sit bones.

I forgot to mention that I got epididymitis as a result of that route two years ago, and I'm sure that's the pain that's coming back when I cycle (nothing else triggers it).

Cheers.

I had to look that up. Maybe cycling isn't for you. Another approach which works well for some is simply to limit the hours in the saddle. Maybe it's 2, maybe 3.

fietsbob 10-06-16 01:02 PM

Thin Un padded/but Lined Bike shorts + a Leather Brooks saddle and I can still get it 'Up' ...

after a multi Month Cycle tour pub crawl thru Ireland and Scotland ..

Any 'Issues' Likely more related to Becoming Old :50:



OP consult a MD Urologist , not a Bike Forum.




'/,

Road Fan 10-08-16 07:43 AM


Originally Posted by johnsmith246 (Post 19099341)
Hi all,


So, what else can I try? Before getting a "proper" touring bike, I was doing similar routes on a much cheaper, badly fitted, old, hybrid bike and never felt any pain. Too bad it can only accommodate a rear pannier!

Cheers.

Perineal pain is one of my problems in cycling, as well. So is the intoxicating feeling of a lot of power in my legs as I pedal. The power seems greater when I raise my saddle to get a longer leg extension. But the trade-off is that with my saddle on the high side my hips rock back and forth.

What helps me is to iteratively (just a few mm at a time) lower the saddle so my hips don't rock, then position the saddle (tilt and front-back) so my body isn't inclined to slip forward off of the "platforms." Usually when this is done I have to make a small adjustment or two height adjustment or two.

The good spot is when my knees don't hurt (saddle not too low), my spin is fast, free, and easy, I don't have peri pain when I start the ride with it healed, and the shorts at the end of the ride have not sign of blood where the peri is covered.

I use the Selle Anatomica, but I've found the same approach has helped me with Brooks and Specialized saddles.

I haven't found an Ann Arbor fitter who can really help with this procedure. Invariably even the best ones position by by formula.

When I'm done with this (it's happened only twice!!), usually I find my hands are lightly loaded, and I can pass the Hogg no-hands test.

fietsbob 10-10-16 11:56 AM

Rotate your Hips More Upright so you dont press that part against the saddle Nose as Much .

lazysunbather 12-23-18 06:31 AM

Hi, i've recently done a few rides and developed the same symptoms. Basically from an ill fitted saddle. Still the same feeling after a month off the bike. Has yours improved now further on?

Carbonfiberboy 12-23-18 07:54 PM


Originally Posted by lazysunbather (Post 20716069)
Hi, i've recently done a few rides and developed the same symptoms. Basically from an ill fitted saddle. Still the same feeling after a month off the bike. Has yours improved now further on?

Zombie thread. The OP is probably not going to reply. See your urologist - you have a problem.

Road Fan 01-04-19 04:00 AM


Originally Posted by johnsmith246 (Post 19099341)
Hi all,

Two years ago I did a route of 40-60mi a day over 11 days on my then-new touring bike, and ended up with some serious perineum pain during and after (12 months after!) the route. The pain in that area would start within the first hour of each ride, but I was stupid and thought it was a matter of getting used to it.

I've been much, much better over the past year or so -- pretty much "cured", but not quite. My urologist says it's OK to go back to cycling, but I should stop if the pain comes back. I've been cycling 3 miles every day and it's not been a problem. I'm hoping that at this rate I'll be totally recovered in the next few years.



Now I want to prepare for a 5-week cycle tour, hoping to do again 40-60mi a day. And I've spent a lot of time and money making sure the pain won't come back. But I'm still getting some pain in that area, although it's nowhere as bad as it was.

I recently had my bike professionally fitted, which included having the saddle replaced as per the gebioMized pressure mapping. That made a huge difference. The peak pressure went from 0.9 bar to 0.5 bar, and is now better distributed; this was the best saddle out of the 10 or so I tried.

But I still got some minor pain during and after ~30mi routes, so following the bike fitter's advice, I bought a pair of Endura FS-269 Pro SL bib shorts. Based on the extensive research I did, these seem to be the very best at avoiding this type of injuries. I rode 30mi with them, but frankly, I'm not sure they make a huge difference compared to my cheapest cycling shorts.

So, what else can I try? Before getting a "proper" touring bike, I was doing similar routes on a much cheaper, badly fitted, old, hybrid bike and never felt any pain. Too bad it can only accommodate a rear pannier!

I'm considering getting a second pressure mapping from Cyclefit, who seem to be the best in the UK -- They'll probably have an even larger selection of saddles I could try. Or maybe go to a cycling physio.

I'd really appreciate any advice you could give me! :)

Cheers.

I'm not a doc and certainly not an expert in perineal issues, though I have had perineal pain. Did the doctor identify what your risks are if you just kinda go for it?

Oh yeah, zombie thread twice over now!

50PlusCycling 01-07-19 10:25 PM

Proper bike fit is the first thing to get right, then you need time in the saddle to give your body time to adjust. Anyone who goes from occasional rides to a long period of 40 to 60 miles per day is asking for trouble.

When I have been off the bike for the winter, I know that when I get back on the bike I will have soreness for 3 or 4 weeks as my backside gets used to the saddle. No combination of saddle, shorts, and bike fit will prevent this soreness, it's completely normal. I would not attempt any long rides without at least 6 weeks to prepare. Unless you have some physical impediment, any combination of a decent saddle,shorts, proper bike fit, and time on the bike will eventually cure soreness.

Carbonfiberboy 01-09-19 11:27 AM


Originally Posted by 50PlusCycling (Post 20737355)
Proper bike fit is the first thing to get right, then you need time in the saddle to give your body time to adjust. Anyone who goes from occasional rides to a long period of 40 to 60 miles per day is asking for trouble.

When I have been off the bike for the winter, I know that when I get back on the bike I will have soreness for 3 or 4 weeks as my backside gets used to the saddle. No combination of saddle, shorts, and bike fit will prevent this soreness, it's completely normal. I would not attempt any long rides without at least 6 weeks to prepare. Unless you have some physical impediment, any combination of a decent saddle,shorts, proper bike fit, and time on the bike will eventually cure soreness.

Soreness isn't the issue on this thread. The issue is "numb dick." Soreness is acceptable, this latter issue is not, no, never, totally not acceptable. Perineum pain usually doesn't start until after one has had a numb dick for quite a while. More saddle time is not helpful, quite the contrary. And contrary to what one reads, females have a very similar problem with a similar solution - hole in saddle.

50PlusCycling 01-09-19 08:45 PM


Originally Posted by Carbonfiberboy (Post 20739579)
Soreness isn't the issue on this thread. The issue is "numb dick." Soreness is acceptable, this latter issue is not, no, never, totally not acceptable. Perineum pain usually doesn't start until after one has had a numb dick for quite a while. More saddle time is not helpful, quite the contrary. And contrary to what one reads, females have a very similar problem with a similar solution - hole in saddle.

I've been riding for a long time, I completed my first century at 13, competed in races in America and Europe, and have experienced every discomfort possible on a bike. I've broken bones in crashes, have a few scars from road rash, been hit by cars three times, and have been stitched up as much as a baseball mitt. I've worked in a bike shop, and fitted many a rider. There isn't much about bicycles and cycling that I don't know.

You simply do not get on a bike and go for a long ride without getting accustomed to it. You cannot judge what will make you sore or numb without a fair amount of saddle time, and it's best to track down fit problems early. I haven't been on my bike for a couple of months now due to work, travel, weather, and the holidays. But if I go out tomorrow for a 100km ride, it doesn't matter what saddle, shorts, or bike I am riding, I am going to get sore as hell, and probably numb as well. Numbness can be caused by pressure, but it can also be caused by having blood circulation cut off to a nerve. Blood circulation to the perineum improves over time as you ride, just as circulation improves to your legs and lungs. It takes time.

Numbness usually happens early in any ride, and if it happens, you need to address it's cause. The easiest thing to do is "adjust" things in your shorts a little, and often this helps. The next thing is to adjust your position in the saddle until you get into the "sweet spot." I hate having to stop on rides, because once I get going again, it takes a little time to get everything in the proper position again. But inexperienced riders often don't consider such things, they simply sit on the bike and start riding, and when numbness or pain occurs, the first thing they blame it on is their seat and/or shorts.

Believe me, it took several years before I fully understood how to properly set up a bike, and to find my most comfortable position.

Carbonfiberboy 01-09-19 10:47 PM


Originally Posted by 50PlusCycling (Post 20740516)
I've been riding for a long time, I completed my first century at 13, competed in races in America and Europe, and have experienced every discomfort possible on a bike. I've broken bones in crashes, have a few scars from road rash, been hit by cars three times, and have been stitched up as much as a baseball mitt. I've worked in a bike shop, and fitted many a rider. There isn't much about bicycles and cycling that I don't know.

You simply do not get on a bike and go for a long ride without getting accustomed to it. You cannot judge what will make you sore or numb without a fair amount of saddle time, and it's best to track down fit problems early. I haven't been on my bike for a couple of months now due to work, travel, weather, and the holidays. But if I go out tomorrow for a 100km ride, it doesn't matter what saddle, shorts, or bike I am riding, I am going to get sore as hell, and probably numb as well. Numbness can be caused by pressure, but it can also be caused by having blood circulation cut off to a nerve. Blood circulation to the perineum improves over time as you ride, just as circulation improves to your legs and lungs. It takes time.

Numbness usually happens early in any ride, and if it happens, you need to address it's cause. The easiest thing to do is "adjust" things in your shorts a little, and often this helps. The next thing is to adjust your position in the saddle until you get into the "sweet spot." I hate having to stop on rides, because once I get going again, it takes a little time to get everything in the proper position again. But inexperienced riders often don't consider such things, they simply sit on the bike and start riding, and when numbness or pain occurs, the first thing they blame it on is their seat and/or shorts.

Believe me, it took several years before I fully understood how to properly set up a bike, and to find my most comfortable position.

You should read this article: Erectile Dysfunction and Bicycling » Sexual Medicine » BUMC

Numbness is additive because every time you get numb, you've caused damage. Numb is something one never wants to experience. The more you ride numb, the closer you get to ED. That's a fact. You can dispute that, and go ahead. But please, please, do not imply that a little numbess is OK. Numbness is never OK. Other riders are not you. The existence of threads like this, and your statements about inexperienced riders make that case.

It's certainly true that each rider must get a good fit to be really comfortable, though I believe that's not as important as many people think, judging by what I see on double centuries, and on my own experience. I believe being fit is more important than bike fit. I can ride a century on any bike where I can reach the pedals. Heck, PBP's been done on SS comfort bikes.

That said, the only way to judge if a saddle is going to work on long rides is to do a century on one. They all mostly feel OK until after the 3rd hour. I always do a century ride on a new saddle, right out of the box. How else will I know whether it'll work for me or not? And doing that, sometimes I get sore and sometimes I have to stand a lot. Has to be done, though. And that said, of course the article I posted shows that this level of devotion to bike and saddle fit isn't necessary for the vast majority of riders who ride 2-3 hours a week. However posters on this forum are more likely to want to ride longer distances, hence my concern for their sexual health.

If I go out for a century tomorrow, I will experience no butt pain, and no numbness. Why? Because not only is my fit correct, my saddle is perfectly suited to the shape of my undercarriage. That latter is actually more important than exact fit. I don't have two bikes which fit exactly the same, yet I have the same experience of no pain on all of them because they all have the same saddle. Yeah, I ride a lot. I tell folks that sex after a long bike ride is a good check on your health.

Many years ago, I did a 150+ mile ride, after which I couldn't do it for 3 days. My wife told me that will never happen again. I took her at her word, went through about 20 saddles over the next few years, and it never happened again. I finally gave those saddles to a charity bike shop. I've ridden several 400k day rides, many double centuries, and many 100+ mile mountain rides without butt pain or numbness. The saddle just disappears if it's the right saddle and you ride a lot. Good shorts help, too. Leg pain is still a feature.

We should all thank Ed Pavelka, who bravely brought this issue to the attention of cyclists in 1997.

bnewberry 01-16-19 10:07 AM

This is an important topic, even if the original poster is no longer around.

I have found that the biggest contributor to any issues related to numbness for me hwas with padded cycling shorts. I changed to the thinnest pad I could find and this solved most of the issues. Using a seat with a center cut out fixed the rest. Interestingly, using a thick pad with a cut out still results in some issues, although not as bad.

rbk_3 03-17-19 07:43 AM


Originally Posted by lazysunbather (Post 20716069)
Hi, i've recently done a few rides and developed the same symptoms. Basically from an ill fitted saddle. Still the same feeling after a month off the bike. Has yours improved now further on?

I had to give up biking. It has been 18 months since I road and I have pain every day since, in my perineum. I have a dull ache that won't go away and I've been to a million specialists and they cannot tell me what is wrong. Sitting and any type of exercise flares me up. It has ruined my life.

I had a properly fitted Specialized Power Saddle and everything.

You can read how it all started here

https://www.bikeforums.net/road-cycl...ue-solved.html

lazysunbather 03-18-19 02:02 AM

Turns out my issues were ZERO to do with cycling or saddle. My issues are down to a pelvic floor dysfunction. Where the pelvic floor muscles become tight and cause no end of problems. So I would certainly avoid Dr's, and seek help from a specialist pelvic floor physiotherapist. Sounds to me like it could be that, or if not certainly get it ruled out.

lazysunbather 03-18-19 02:03 AM


Originally Posted by rbk_3 (Post 20841406)
I had to give up biking. It has been 18 months since I road and I have pain every day since, in my perineum. I have a dull ache that won't go away and I've been to a million specialists and they cannot tell me what is wrong. Sitting and any type of exercise flares me up. It has ruined my life.

I had a properly fitted Specialized Power Saddle and everything.

And it's pretty common with cyclists/runners too!


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