Saddle Sores – Prevention is better than Cure. Saddle sores affect riders of all abilities. People new to cycling are at greater risk, but they have also ruined the careers of elite and “pro” riders. It is therefore surprising that they are rarely discussed among cyclists. In fact, many cyclists know little about them such as the different kinds, what they look like and what can be done about them.“Prevention is better than cure” as a saddle sore can keep you off your bike for a while, if not forever. Saddle sores do not have to be a regular part of our cycling experience if we find out more about them and seek help when we have problems.
What is a saddle sore?
There are a few different reasons for a saddle sore developing and they usually involve friction, sweat, and in some cases the hair follicle.
- Chafing – a saddle sore may develop when the skin is chafed due to friction caused by sliding forces between the body and clothing. If the chafing is severe enough, the skin may break and become ulcerated (Fig 1) and in some cases, it may become infected and fill up with pus which is called an abscess (Fig 2).
- Hair follicle or gland irritation – shaving or friction with clothing may lead to an infection in the hair follicle itself (folliculitis) or a sweat gland (Fig 3). There may be a lump that looks like a pimple sometimes with a head on it (Fig 4). When there is heat and moisture, bacteria multiply.
Fig 1 Fig 2 Fig 3 Fig 4
A lump may get bigger and turn into an abscess (Fig 5) or a boil, which is a certain type of abscess. This is serious and usually needs medical treatment to deal with the abscess and then helps heal it with antibiotics.
Left untreated, a saddle sore can turn into a pressure ulcer that may take a very long time to heal and the skin may never recover fully.
What can you do proactively to prevent them?
- Get a proper bike fit – have the bike set up for you by a qualified professional to ensure correct saddle height, fore/aft position and tilt so your weight is distributed on the saddle. At least, get advice on saddle and pedal set up.
- Choose a good saddle – don’t just accept the saddle that came with the bike. Do your research and trial a saddle before you buy it.
- Avoid getting too keen too quickly and only increase how far you ride by 10% per week.
- Inspect yourself frequently – don’t wait for pain, invest in a good shaving mirror and “get up close and personal “ with your body to monitor your skin.
- Adjust your position frequently – get out of the saddle to relieve jarring, and compression on your skin or when you feel uncomfortable. Even pushing down hard on pedals when coasting and lifting your weight off the saddle helps.
- Choose a good chamois (padding) – spend the money on a good quality one. Thicker is not necessarily better. You may want to try wearing two pairs of shorts if you have a saddle sore until it resolves. Remember, never wear undies on the bike!
- Reduce friction – use a lubricant (emollient cream) applied to the chamois or to your external body parts in contact with the saddle. Include the creases in your legs if you are in the time trial position as even a wrinkle in your skin suit may cause problems.
- Consider carefully about shaving or waxing – avoid trauma to hair follicles through shaving and focus on cleanliness as priority one before other strategies.
- Practice amazing hygiene – when in doubt wash! Get out of your cycling gear immediately after a ride; wash/wipe yourself, wash after going to the toilet especially after a bowel action. Wash your shorts after every ride and always wear clean shorts. Avoid chemicals if your skin is sensitive e.g. wash your shorts with non-fragrant washing powder.
- Aerate below the waist when not on the bike – wear a sarong after your ride/shower; no undies and/or sleep naked to allow maximum air to the area.
How can you reduce the severity of a saddle sore?
- Have a rest day or two rest days if things are progressing beyond just a red area.
- Talk to your chemist – apply nappy rash cream haemorrhoid treatment cream, both which contain zinc. If not available, use white toothpaste that also will dry it out, burst a lump and soothe the pain.
- In the case of infection, use topical antibiotic cream for ulcers and boils.
- Modify any cycling you do to reduce pressure and friction e.g. favour out of seat riding
- Take regular warm baths or sit in a plastic tub; dry yourself well. If a bath is not available, use a tea bag as a warm compress.
- If the problem continues after 3-4 days and especially if it is getting bigger, more painful and there is put, consult your doctor. You may need oral antibiotics or have to face the doctor’s scalpel. If you really have a chronic problem and you leave it untreated, it may require surgery.
So “let’s talk it up” about saddle sores. If you have a problem, talk to your parents or your coach, and do this sooner rather than later. Suffering in silence will only lead to a worse situation “down the track”. The longer you leave it, the more time off the bike. Remember that saddles sores do not have to be part of your cycling life.
Jenny Sammons, B Sc (OT), M Sc (OT)