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Bicycle Seat Neuropathy Clinical Presentation

  • Author: John M Martinez, MD; Chief Editor: Craig C Young, MD  more...
Updated: Apr 21, 2016


A recreational or elite cyclist who complains of numbness or impotence after cycling is the typical presentation of bicycle seat neuropathy.[22, 23, 24, 25] The amount of time the athlete spent cycling before the onset of symptoms is variable; however, studies have focused upon longer distance, multiday rides. Use of a stationary bicycle has also been reported as a cause of bicycle seat neuropathy.

  • Ask pertinent questions while obtaining the history to attempt to elicit other causes of neuropathy or impotence, such as a history of diabetes; metabolic disorders; endocrine or vascular disease; perineal trauma; or testicular, prostate, or intra-abdominal cancers.
  • Ask questions regarding the timing, duration, and location of the symptoms. Also inquire about the extent of the symptoms; some cyclists report mild numbness and some report more severe symptoms such as impotence or urinary incontinence.
  • Ask about the length and duration of rides. Also ask about any recent increase in training volume or any changes in bicycles, bicycle setup, or bicycle position.


The physical examination should focus on the urogenital and neurologic systems. A rectal examination may be indicated. The focus of the examination should be to exclude other diagnoses that may require different treatment and management.

  • The urogenital examination should include examination and palpation of the penis, testicles (in males), and perineal area.
  • Neurologic examination should include testing of motor and sensory function of the same regions.


The cause of bicycle seat neuropathy has been attributed to several different ischemic and neurologic events (see Sport-Specific Biomechanics).

Contributor Information and Disclosures

John M Martinez, MD Staff Physician, Kaiser Permanente

John M Martinez, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Russell D White, MD Clinical Professor of Medicine, Clinical Professor of Orthopedic Surgery, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center-Lakewood

Russell D White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American Association of Clinical Endocrinologists, American College of Sports Medicine, American Diabetes Association, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

David T Bernhardt, MD Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics/Ortho and Rehab, Division of Sports Medicine, University of Wisconsin School of Medicine and Public Health

David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.


Kenneth Honsik, MD Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente

Disclosure: Nothing to disclose.

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Example of a bicycle seat with a cut-away middle.
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