eMedicine Specialties > Sports Medicine > Neurological

Bicycle Seat Neuropathy: Follow-up

Author: John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
Coauthor(s): Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente
Contributor Information and Disclosures

Updated: Jun 17, 2008

Follow-up

Return to Play

Return to play is based upon resolution of the athlete's symptoms. The cyclist should be cautioned to change his or her position on the bike (eg, ride with hands on the top of the handlebars vs having hands down in the drops or riding with aerobars [tri-bars]). Also encourage the patient to stand up intermittently to relieve pressure or to stop cycling temporarily until the symptoms resolve. Changing the type and shape of bicycle seat used may also be helpful; elevation of the nose of the bicycle seat may worsen the condition, as more pressure is placed upon the Alcock canal and the pudendal nerve.

Related Medscape topic:
Resource Center Exercise and Sports Medicine

Complications

Complications are variable and appear to be transient based upon the literature review. Cases of bicycle seat neuropathy and its resulting symptoms, such as impotence, resolve over time once the pressure is relieved from the perineal region. Case reports reveal that some cases can take more than 1 month to resolve.1,5,8,9

Prevention

Prevention of bicycle seat neuropathy includes riding a bike that is properly fit by a trained professional, as well as changing positions frequently on the bike seat or standing intermittently to relieve perineal pressure. Additionally, newer designs in bicycle seats allow for the reduction of perineal pressure by providing a bicycle seat with the middle portion cut away.

Prognosis

The prognosis and recovery from bicycle seat neuropathy is very good. However, the rate of recovery is variable and may be influenced by the amount of time the athlete previously spent cycling.

Education

Educate patients about the causes of the neuropathy, about the importance of a proper bike fit, and about the need for changes in seating position.

Miscellaneous

Medicolegal Pitfalls

  • The biggest medicolegal pitfall, as with any case, is the failure to properly diagnose a condition. Obtain a thorough history, perform a thorough examination, and order relevant tests to rule out other potential diseases, such as testicular cancer.

Related Medscape topics:
Resource Center Medical Malpractice and Legal Issues
Specialty Site Hematology-Oncology
Specialty Site Pathology & Lab Medicine

 


More on Bicycle Seat Neuropathy

Overview: Bicycle Seat Neuropathy
Differential Diagnoses & Workup: Bicycle Seat Neuropathy
Treatment & Medication: Bicycle Seat Neuropathy
Follow-up: Bicycle Seat Neuropathy
Multimedia: Bicycle Seat Neuropathy
References
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References

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  2. Kennedy J. Neurologic injuries in cycling and bike riding. Neurol Clin. Feb 2008;26(1):271-9; xi-xii. [Medline].

  3. Asplund C, Barkdull T, Weiss BD. Genitourinary problems in bicyclists. Curr Sports Med Rep. Oct 2007;6(5):333-9. [Medline].

  4. Weiss BD. Clinical syndromes associated with bicycle seats. Clin Sports Med. Jan 1994;13(1):175-86. [Medline].

  5. Silbert PL, Dunne JW, Edis RH, Stewart-Wynne EG. Bicycling induced pudendal nerve pressure neuropathy. Clin Exp Neurol. 1991;28:191-6. [Medline].

  6. Gemery JM, Nangia AK, Mamourian AC, Reid SK. Digital three-dimensional modelling of the male pelvis and bicycle seats: impact of rider position and seat design on potential penile hypoxia and erectile dysfunction. BJU Int. Jan 2007;99(1):135-40. [Medline].

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Further Reading

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Keywords

saddle numbness, erectile dysfunction, impotence neuropathy, bicycle saddle neuropathy, vascular or neurologic injury of the pudendal nerve, urinary incontinence

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Contributor Information and Disclosures

Author

John M Martinez, MD, Medical Director, Primary Care Sports Medicine, Coastal Sports and Wellness Medical Center
John M Martinez, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Kenneth Honsik, MD, Consulting Staff, Department of Primary Care Sports Medicine, Kaiser Permanente
Disclosure: Nothing to disclose.

Medical Editor

David T Bernhardt, MD, Director of Adolescent and Sports Medicine Fellowship, Associate Professor, Department of Pediatrics, University of Wisconsin
David T Bernhardt, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Sports Medicine, and American Medical Society for Sports Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Russell D White, MD, Professor of Medicine, Department of Community and Family Medicine, University of Missouri-Kansas City School of Medicine, Truman Medical Center Lakewood
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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