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Recommendations for Perineum Numbness

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Recommendations for Perineum Numbness

Old 07-23-21, 08:17 AM
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hokiefyd 
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Recommendations for Perineum Numbness

I'm a fairly avid recreational cyclist (male, 42 years old, about 235 pounds) who finds saddle comfort to be one of my limiting factors in terms of longevity on the bike. I'm good for about 45-60 minutes of steady riding -- more if my mind is elsewhere (riding with friends, riding in a new area, etc.). And by "saddle comfort", I'm talking about numbness that sets in in my perineum/scrotum area. I often don't feel the tingle of numbness when on the bike, but after dismounting and walking around for a bit (and blood starts flowing to certain places again), I get a pretty moderate tingling and numbness that lasts for 4-5 minutes. I walk around some and it abates relatively quickly.

I've tried a few different saddles to try to combat this, to limited success. Most nosed saddles seem to be uncomfortable to me because they put pressure in the area that eventually becomes numb. The saddle I've had the most success with us an SQlab 604 saddle. For those who may not know, SQlab's claim to fame is their "step down" design where the sit bone area is elevated relative to the nose area, presumably to allow for more room for "stuff" without putting pressure there. It looks like the 604 is not on their website anymore, but the 602 is very similar to what I have (though the cutout relief area on that looks more accentuated than mine). SQlab have even more deeply contoured designs as well, such as the 621, though I haven't tried them. Though I have experienced perineum numbness with all saddles I've used, I've found I can cycle the longest on my SQlab saddle. As I might expect, softer saddles are worse for this, allowing my sit bones to sink in to the material, creating soft tissue pressure elsewhere.

I have not tried cycling specific clothing. I prefer cycling in street clothes, but there are things like padded base layers or underwear I could try. I'd prefer to do that as a last resort if I can find comfort with other means. In terms of saddle height, I have confidence that I'm at the correct height. My knees have a slight bend at full extension and my legs are straight out if I move my foot forward on the pedal to where only my heel is in contact. I have played with saddle angle some, but it's fairly level. With the SQlab design, the stepped-down nose is definitely below the sit bone area, but the horizontal surfaces of each area are level (as they recommend using it). My handlebar height is about 2" higher than my saddle, which is about as low as I feel that I can go with this. I have found that this has a pretty strong correlation with my saddle comfort. If I rotate my body further forward, I tend to get more numbness, and quicker, than if I sit more upright.

For others who have experienced the same type of struggle with saddle comfort, what do you recommend I try from here? Given that I've found the strongest correlation to be my body rotation (with more forward rotating producing more numbness), should I resign myself to the fact that I just need to sit up taller? Sit bone comfort is more of an issue then, but I can condition that area to longer rides. Would other saddle designs be worth trying? Many are fond of Brooks saddles and similar, though I feel that the convex shape of them, with the pronounced nose area, would be counterproductive to me. They're expensive enough that I haven't bought one just to try it, but would buy one if enough folks, formerly with perineum area numbness, recommend them.

I appreciate all constructive ideas! Thanks in advance.
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Old 07-23-21, 09:06 AM
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Some of comments, no recommendation. One - there are so many different seats that it is a near given that the seat that fits your butt perfectly (when set up to the proper location and tilt) is out there. Just () a matter of finding it.

Good bike shops get this and will allow trying seats until you find one that works or giving you store credit if you go elsewhere. A shop in Portland takes it a step further. They have a "saddle library". About 25 different seats on the shelves. You buy a library card for $25 and get to take out any seat for a week at a time, as many different seats as you want. Find one and they will sell you a new, boxed one and refund your $25.

Just as much as "the seat", tilt is critical. I am a huge fan of 2-bolt seatposts. (The Nittos and Thompsons have excellent clamps. Thompson will sell its clamp hardware to framebuilders; meaning any setback or design can be made as a 2-bolt. (Yes, $$s. I have 2 absurdly expensive custom posts that allow a conventional seat location with the clamps sitting centered on the seat rails on bikes with very steep seat tubes. Both have the Thompson clamps and are a joy to adjust.) 2-bolt posts allow systematically adjusting seat tilt on the road with no measuring tools. Seat nose too high? Stop, loosen the rear bolt, tweak the front 1/8 of a turn, re-tighten the rear and go. Not right? You can go back exactly to where you started, 1/2 way, go further, etc.

Lastly, there is little correlation between price and shape. Shape is what your butt sees.. Now, once you have the shape right, nicer padding, fabric, rails, light weight, etc. is very nice. Real life example: My butt changed in my 40s. I used to race the Selle Italia seats that were made under many different brand names, (Avocet !! and !!!, Peugeot, etc.) Loved them and had many thousands of miles on them; until I changed. Riding fell off a lot until I had hernia surgery and realized I needed to get on the trainer to do easy recovery for the surgery. But I also knew the trainer is a harsher platform seat-wise than riding the road, Went to the local shop. Saw the Specialized Body Geometry Comp with its full length groove and cutaway tail. Bought the cheapest one, the heavily padded beginner's model and last year's at that. Breakthrough!!!! (Once I was on the road again, I bought the high end one for my good bike and put the cheapie on my commuter where it served for 15 years.) My commuters still use the Specialized seats but for my good bikes I ride the Terry Flys with the cutouts. They take me back to to old days when I could ride the Selle Italias I loved so much. The Flys are very similar except for the cutout, allow all my old positions (I've always used ever inch of any saddle that allowed it. But that cheap Specialized seat started it all for me.
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Old 07-23-21, 09:29 AM
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And you've tried saddles with various width cut outs? Too wide can be as bad as too narrow for some. Experimented with saddle tilt?

The bones that you sit on are not just two knobs a set distance apart. There are several structures involved, but think of them as rocking chair runners only turned around backwards. Their spacing gets narrower as you roll your pelvis forward. So you want your saddle to sort of match that between your very aero position and your less than aero position.

My son put his Trek Marlin on the trainer earlier this year. I rode it for thirty minutes and when I got off I too had a very numb perineal area that I've never ever had before. Looking at the saddle it was almost like mine, but way less cutout and the nose profile actually bumped up ever so slightly.

I've ridden many a long mile with out bike shorts and even some 100 mile rides with no chamois. So it's doable. But I don't any more. Though my chamois pad is thin compared to many others. If you don't like the MAMIL look, then you can wear bike shorts with chamois underneath some other shorts. But Pearl Izumi and others make loose fitting shorts with chamois too.

Did you say whether or not a doctor ruled out any oddball things about your perineal area?
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Old 07-23-21, 10:30 AM
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Thanks for the responses so far. I do have two-bolt seat posts and have tried adjusting tilt. I find I have the conventional trade-off often noted here -- if I tilt it a bit forward, there definitely is less perineum pressure, but then I do feel more like I'm being pushed forward, and my hands and wrists feel more of it. If I tilt it a bit backward, I feel more pressure, but with less on my arms and hands. Maybe an ever-so-slight forward tilt is just what my lower anatomy needs, and I need to figure out the cockpit comfort...? That may be something for me to go back and try again -- a slight forward cant on the saddle.

I figured clothes with padding would be sort of like soft saddles -- it'd just put pressure in some of the softer tissues. I should probably try some, though. I truly am ignorant in that area.

I have not consulted a doctor about this. I don't have any other side effects or concerns about comfort of "performance" in this region. A doctor's opinion probably isn't a bad idea, but I figured that since the numbness is directly related to time on a bike saddle, that I'm just missing something with my fit...whether it be saddle type, shape, width, angle...or lack of good cycling shorts/padding...etc.
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Old 07-23-21, 01:57 PM
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My saddle is fairly level. Maybe a little nose down but not much. IMO the balancing on the saddle thing to get your weight off your hands has a lot of people doing the wrong stuff and too far in the other direction. I accept the fact that I'm going to have some weight on my hands and I just move them from hoods to drops regularly to change up hand position. Though I'm not suggesting that you want to carry notable weight on your hands.

I've heard that it's typical for many to want their saddle slightly nose up, but that has never been me.
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Old 07-23-21, 04:46 PM
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I started with Avocet Touring I; after 30 years I got hit by numbness. I then went successively to Fizik Aliante, Brooks B-17 Imperial, one of ISM's lower priced road models, Selle SMP TRK, Selle SMP Blaster, back to the SMP TRK. I had no numbness on the ISM up to 25 or 30 miles, but developed a saddle sore, which I attribute to all the weight on my pubic rami; some people get the saddle sores, though most don't. The SMP TRK was great up to 50 miles (didn;t go farther), and I decided to upgrade to the Blaster. The Blaster is longer from the lowest to the highest point than the TRK is, and that dimension was too long for me - I could never sit right on that saddle, so I went back to the TRK. I've been on the TRK since 2016.

If the TRK stops working, I think I'll try the B-17 Imperial again, because my frame is classic English. If I can't make that work, the next step would probably be Rido because of the low cost.

ETA: I believe the thinking underlying the ISM and Selle SMP (and Rido and apparently SWLab, too) is sound, but my experience is by no means guaranteed to match anyone else's.

Last edited by philbob57; 07-24-21 at 04:25 PM.
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Old 07-23-21, 05:10 PM
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Originally Posted by hokiefyd View Post
Thanks for the responses so far. I do have two-bolt seat posts and have tried adjusting tilt. I find I have the conventional trade-off often noted here -- if I tilt it a bit forward, there definitely is less perineum pressure, but then I do feel more like I'm being pushed forward, and my hands and wrists feel more of it. If I tilt it a bit backward, I feel more pressure, but with less on my arms and hands. Maybe an ever-so-slight forward tilt is just what my lower anatomy needs, and I need to figure out the cockpit comfort...? That may be something for me to go back and try again -- a slight forward cant on the saddle.

I figured clothes with padding would be sort of like soft saddles -- it'd just put pressure in some of the softer tissues. I should probably try some, though. I truly am ignorant in that area.

I have not consulted a doctor about this. I don't have any other side effects or concerns about comfort of "performance" in this region. A doctor's opinion probably isn't a bad idea, but I figured that since the numbness is directly related to time on a bike saddle, that I'm just missing something with my fit...whether it be saddle type, shape, width, angle...or lack of good cycling shorts/padding...etc.
Some cycling apparel companies make different grades of synthetic chamois pads. I use Voler and their lime green colored pad (I will have to look up the name of it - I think it might be the "orion" pad) is their denser one that compresses less. Firm but not painful and helps me for sure since I like to move around on my saddle (front to back).

Sounds like dead level is going to be the most neutral position for you.

Also, if there are any gym type workouts you can add to enhance your core , add them ! I had a terrible sebaceous cyst in that was swollen, hard and bleeding last year right under where I sit on the tip of the saddle and it caused the end of last season to just fizzle out on my total mileage it was so painful.

I got it to heal over the winter but now am convinced that during last year I stayed away from the gym due to covid, and did not work my abs much. I thought I could ride my way into fitness but the truth of the matter is that it is really a slow process riding yourself to fitness if you are a bit out of shape. supplementing it for me makes things tighten up in comfortable ways where you suddenly don't feel the pressure (in the perineum).

Be aware too that if you are feeling that much pressure in your perineum, pay attention too it. It is likely that you are experiencing undue compression in that region. It is not imaginary. I would suggest in addition to your quest for the ideal saddle that you optimize all 3 pressure points (the saddle is just one of them). Are your feet/socks/shoes up to snuff? What about your arms/forearms/hand grasp on the bars? Can you climb out of the saddle much? If the answer is "not so much" maybe strategize a training goal for yourself to get better in some of these areas. Not trying to preach to you since I struggle with these things. I just have a hunch (really more than a hunch, actual first hand anecdotal experience) of how some of these things can make a big, big difference.
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Old 07-23-21, 05:15 PM
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Welcome to cycling. 4-5 minutes of numbness before abating sounds like a perfectly normal situation to me.
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Old 07-23-21, 07:55 PM
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I'm grateful to all of you for your constructive comments. Good points about each of the contact points, and it's also helpful confirmation that it's difficult to try to ride into fitness, and that some supplementary routines are helpful. I'll keep working at all the above.

I almost bought a TRK saddle before I pulled the trigger on my SQlab one. I was truly on the fence...and I found the SQlab on an Amazon warehouse deal for $27. It said it had a slight blemish somewhere on it (I don't remember), but I couldn't find it. It was in a width that was right in the range of what generally feels comfortable to me so I jumped on it. And it HAS been a pretty comfortable saddle for me overall. Perhaps I've let the adjustment get away from me and I need to play with different tilt angles. I understand small changes here can make large ergonomic differences.
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Old 07-24-21, 05:59 PM
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Big slot down the middle. Narrow slot doesn't work for everyone. Don't get up on the nose. Stay back over the slot. I like saddles which don't have much curve in the profile. I think that curve can push the rider forward. Zero numbness on 10+ hour rides is what you want. Anything less is unacceptable. I don't think fitness has much to do with numbness, one of the problems being that the fitter you are, the more hours you can be in the saddle. I think most modern saddles benefit from 2°-3° of down-tilt.
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Old 07-25-21, 01:14 PM
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I have a recommendation. Perineum pain/numbness is usually a result of a seat height that is too high, or too great of reach. Most likely your seat height is too high. If both are too great, it will really be bad. It is very rarely the cause of the seat itself.

Start here:https://www.stevehoggbikefitting.com...ard-can-it-be/
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Old 07-26-21, 06:34 AM
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I have done a little bit of testing over the weekend. I did angle my saddle nose down just slightly. Using the method mentioned by 79pmooney I loosened the rear bolt until the rails were loose, I tightened the front bolt by a half turn, and then re-tightened the rear bolt. That does seem to have helped, though I haven't been able to really test my endurance with this yet.

I do think my seat height is pretty close, though I certainly recognize that here, too, small changes likely have big impacts. I seem to straddle a fine line between "too low" (where I really feel it in my knees) and "too high" (where I have that feeling of a loss of motion control in the blog to which phughes linked). I think I'm too cavalier with the size of adjustments (too large at a time) and I probably need to tune things in smaller increments and iterate with that (and change just one variable at a time).
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Old 07-26-21, 05:29 PM
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Originally Posted by hokiefyd View Post
If I rotate my body further forward, I tend to get more numbness, and quicker, than if I sit more upright.
When I started cycling last year I followed a lot of websites' recommendation and leaned forward with a flat back. I got numbness as soon as I went past 20 miles. I found that you cannot just maintain a flat back because you would put too much pressure on your groin. On the other hand you also cannot ride with a hunched back because you would get neck strain. You need to have a 'double curved' back. Here is what you do- get on the bike in the riding position and arch you back slightly. Now use your hand and push in and suck in your stomach as much as you can, while maintaining that slight arch for the upper /chest part of your body. Now your lower back is hunched while your upper back is flat or slightly arched.

Another thing you need to do, is to support your weight with your legs and not your saddle. When you are pedaling hard, this comes naturally because your legs are pressing down hard on the pedals and lifting your butt slightly off the seat with every pedal stomp. But when you are coasting- you need to straighten one leg and stand on that leg. Let your legs be the suspension.
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Old 07-27-21, 06:55 PM
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Originally Posted by icemilkcoffee View Post
When I started cycling last year I followed a lot of websites' recommendation and leaned forward with a flat back. I got numbness as soon as I went past 20 miles. I found that you cannot just maintain a flat back because you would put too much pressure on your groin. On the other hand you also cannot ride with a hunched back because you would get neck strain. You need to have a 'double curved' back. Here is what you do- get on the bike in the riding position and arch you back slightly. Now use your hand and push in and suck in your stomach as much as you can, while maintaining that slight arch for the upper /chest part of your body. Now your lower back is hunched while your upper back is flat or slightly arched.

Another thing you need to do, is to support your weight with your legs and not your saddle. When you are pedaling hard, this comes naturally because your legs are pressing down hard on the pedals and lifting your butt slightly off the seat with every pedal stomp. But when you are coasting- you need to straighten one leg and stand on that leg. Let your legs be the suspension.
If you can't roll your pelvis forward without getting numb, it's the wrong saddle for the usual forward-leaning road position, at least for you.

I do not unweight my butt with my legs when I pedal. I'd be exhausted in 60 miles. I sit on the saddle and pedal circles with my legs, and magically up and away I go. You want no visible upper body motion for long distance work. For short distances that's not so important..

When coasting, level the pedals and put a little weight in them. Increase that weight as speed increases until your whole body weight is in them at say over 50 mph. On bumps, lift out of the saddle, back still flat, and take the bumps in your knees like a skier.
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Old 07-27-21, 07:04 PM
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Try lowering your saddle height by 10 mm
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Old 07-27-21, 07:53 PM
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Originally Posted by GhostRider62 View Post
Try lowering your saddle height by 10 mm
Yes, yes, yes. Even 5mm can make the difference between perineum pain, and no pain.
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Old 07-28-21, 10:53 AM
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Originally Posted by Carbonfiberboy View Post
I do not unweight my butt with my legs when I pedal. I'd be exhausted in 60 miles. I sit on the saddle and pedal circles with my legs, and magically up and away I go. You want no visible upper body motion for long distance work. For short distances that's not so important..
Your downstroke is way more powerful than your upstroke regardless of how much you think you are pedaling circles and pulling up on the backstroke etc.
https://www.bythlon.com/blog/the-myth-of-the-upstroke
So when you are pedaling hard you will be pushing down on your pedals and taking weight off your butt even if you didn't realize it.

Originally Posted by Carbonfiberboy View Post
When coasting, level the pedals and put a little weight in them. Increase that weight as speed increases until your whole body weight is in them at say over 50 mph. On bumps, lift out of the saddle, back still flat, and take the bumps in your knees like a skier.
That works too, but that sounds way more tiring than just straightening one leg and standing on that leg, which takes pretty much no energy. Your way might be useful for MTB where ground clearance is an issue.
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Old 07-28-21, 03:04 PM
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Originally Posted by icemilkcoffee View Post
Your downstroke is way more powerful than your upstroke regardless of how much you think you are pedaling circles and pulling up on the backstroke etc.
https://www.bythlon.com/blog/the-myth-of-the-upstroke
So when you are pedaling hard you will be pushing down on your pedals and taking weight off your butt even if you didn't realize it.


That works too, but that sounds way more tiring than just straightening one leg and standing on that leg, which takes pretty much no energy. Your way might be useful for MTB where ground clearance is an issue.
How to tell if your downstroke leg is unweighting your saddle: Pedal at 130-150 rpm. You shouldn't bounce, i.e. no weight is being taking off the saddle. Watch the pros when they're climbing. They don't bounce either. Pedaling is more complicated than upstroke and downstroke.

Besides being much slower, coasting with one leg straight is more dangerous. That straight leg makes it impossible to handle bumps - the bike is being weighted unevenly side-to-side and so will wobble and you're liable to get what moto racers call "a tank slapper.". You can't bunny hop and it's tough on one's butt. Level the pedals and descend like everyone else. Do drop and weight the outside leg when cornering.
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Old 07-28-21, 03:12 PM
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Even Pros making large power numbers on a TT are not pushing down all that hard, perhaps 15 pounds of force (sorry, too lazy right now to do the math) and the "unweighting" isn't all that much
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Old 08-04-21, 07:36 AM
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Originally Posted by hokiefyd View Post
I do think my seat height is pretty close, though I certainly recognize that here, too, small changes likely have big impacts. I seem to straddle a fine line between "too low" (where I really feel it in my knees) and "too high" (where I have that feeling of a loss of motion control in the blog to which phughes linked). I think I'm too cavalier with the size of adjustments (too large at a time) and I probably need to tune things in smaller increments and iterate with that (and change just one variable at a time).
One thing which gives more freedom with saddle height are shorter cranks; I'm about 5ft 11 in US measurements and ride 170cm cranks. My legs aren't very long so it helps. For me, hiking the saddle up by something like 7-8mm from my current position (which is the highest I've tried) results in an uncomfortable feeling down there after going hard for 20-ish minutes, while I can ride basically all day in a trisuit with minimal padding with the current one.
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Old 08-04-21, 08:37 AM
  #21  
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Yes, I have been looking at crank length as well. I'm not the, ahem, fittest rider out there (which probably doesn't help, with more weight on the saddle area)...and the range of motion of my legs isn't as great as it is for other folks. I can feel the difference between 175mm and 170mm cranks, and I bet I might like 165mm cranks even better (though they're relatively uncommon). After reading a bunch of articles and watching some videos, it seems that the theory on crank length has changed some over time...where it used to be thought that longer cranks provided more leverage and were, therefore, usually "better", it seems like this school of thought is changing a bit in favor of acknowledgement of benefits of shorter cranks. I'm sure, like everything, there are certain pros and cons to each length or groups of lengths ("short" or "long" relative to a certain anatomy). I would like to try a bike with 160mm or 165mm cranks, just to see how different they'd feel.
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Old 08-04-21, 09:15 AM
  #22  
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My preference has been 165 mm cranks for a long long time. I've tried longer, sometimes giving 4 months to wow me. But still I go back to 165 mm.

I'm giving my old Paramount to my younger son in Colorado. Thinking that he'll be doing longer climbs than I have here and the fact he is four inches taller and also has legs longer than mine, I decided to put the 170 mm crank with 50/34 rings on the bike. I rode it yesterday on a 42 mile route that has some of the longest and steepest climbing I can get to starting from my home. Right from the start my initial perception was that I was thrashing more and that my legs were more tired.

And this feeling persisted for the entire ride and I was more tired at the end of the ride. However looking at my metrics for the ride, I didn't suffer any performance hits. I was actually two minutes faster on this than the previous same ride on my Tarmac. But there are other things in play that probably don't quite make this a fair comparison of short vs long cranks. Mostly the fact I'm comparing two different bikes now since I have no current rides with the Paramount to compare to.

All I can say is if you can, try them for at least a few dozen rides. If they don't work for you, then at least you now know. My inseam is 34.5" and I like pedaling at least 80 RPM. If you are a 60 - 70 RPM rider and like to stand while climbing, then I might suppose you won't like shorter cranks. But for now that is just supposition.
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Old 08-06-21, 10:07 AM
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hokiefyd , how often do you get out of the saddle while riding? I feel like some riders just stay planted in their saddle whenever they're moving, and the "sit and spin is more efficient" research has fed into that tendency. I find that shifting up a gear and doing a few pedal strokes out of the saddle every few minutes is not only a good way to help restore circulation, but the jostling of your "stuff" can help you notice sooner when things are starting to go numb.

None of this is a substitute for a proper fit with the right saddle, but I feel it's a good practice.
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Old 08-06-21, 11:48 AM
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Saddle with a cutout, and the nose tilted slightly down worked for my member numbness.
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Old 08-09-21, 01:24 PM
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Originally Posted by philbob57 View Post
I started with Avocet Touring I; after 30 years I got hit by numbness. I then went successively to Fizik Aliante, Brooks B-17 Imperial, one of ISM's lower priced road models, Selle SMP TRK, Selle SMP Blaster, back to the SMP TRK. I had no numbness on the ISM up to 25 or 30 miles, but developed a saddle sore, which I attribute to all the weight on my pubic rami; some people get the saddle sores, though most don't. The SMP TRK was great up to 50 miles (didn;t go farther), and I decided to upgrade to the Blaster. The Blaster is longer from the lowest to the highest point than the TRK is, and that dimension was too long for me - I could never sit right on that saddle, so I went back to the TRK. I've been on the TRK since 2016.

If the TRK stops working, I think I'll try the B-17 Imperial again, because my frame is classic English. If I can't make that work, the next step would probably be Rido because of the low cost.

ETA: I believe the thinking underlying the ISM and Selle SMP (and Rido and apparently SWLab, too) is sound, but my experience is by no means guaranteed to match anyone else's.
You have the trk on a road bike with drop bars? Their label says it's made for trekking and road is a different category. just wondering thank you.
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