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Bicycle Seat Neuropathy Follow-up

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

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.

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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]

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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.

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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.

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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.

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Contributor Information and Disclosures
Author

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.

Acknowledgements

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

Disclosure: Nothing to disclose.

References
  1. Schrader SM, Breitenstein MJ, Lowe BD. Cutting off the nose to save the penis. J Sex Med. 2008 Aug. 5(8):1932-40. [Medline].

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

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

  4. Weiss BD. Clinical syndromes associated with bicycle seats. Clin Sports Med. 1994 Jan. 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. 2007 Jan. 99(1):135-40. [Medline].

  7. Leibovitch I, Mor Y. The vicious cycling: bicycling related urogenital disorders. Eur Urol. 2005 Mar. 47(3):277-86; discussion 286-7. [Medline].

  8. Andersen KV, Bovim G. Impotence and nerve entrapment in long distance amateur cyclists. Acta Neurol Scand. 1997 Apr. 95(4):233-40. [Medline].

  9. Oberpenning F, Roth S, Leusmann DB, van Ahlen H, Hertle L. The Alcock syndrome: temporary penile insensitivity due to compression of the pudendal nerve within the Alcock canal. J Urol. 1994 Feb. 151(2):423-5. [Medline].

  10. Goodson JD. Pudendal neuritis from biking. N Engl J Med. 1981 Feb 5. 304(6):365. [Medline].

  11. Kuland DN, Brubaker CE. Injuries in the Bikecentennial tour. Phys Sportsmed. 1978. 6(6):74-8.

  12. Weiss BD. Nontraumatic injuries in amateur long distance bicyclists. Am J Sports Med. 1985 May-Jun. 13(3):187-92. [Medline].

  13. LaSalle MD, Salimpour P, Adelstein M, et al. Sexual and urinary tract dysfunction in female bicyclists. Presented at: 94th Annual Meeting of the American Urologic Association; May 4, 1997; Dallas, Tex.

  14. Potter JJ, Sauer JL, Weisshaar CL, Thelen DG, Ploeg HL. Gender differences in bicycle saddle pressure distribution during seated cycling. Med Sci Sports Exerc. 2008 Jun. 40(6):1126-34. [Medline].

  15. Amarenco G, Kerdraon J, Bouju P, et al. [Treatments of perineal neuralgia caused by involvement of the pudendal nerve] [French]. Rev Neurol (Paris). 1997 Jun. 153(5):331-4. [Medline].

  16. Bond RE. Distance bicycling may cause ischemic neuropathy of the penis. Phys Sportsmed. 1975. 3(11):54-6.

  17. Lowe BD, Schrader SM, Breitenstein MJ. Effect of bicycle saddle designs on the pressure to the perineum of the bicyclist. Med Sci Sports Exerc. 2004 Jun. 36(6):1055-62. [Medline].

  18. Bressel E, Larson BJ. Bicycle seat designs and their effect on pelvic angle, trunk angle, and comfort. Med Sci Sports Exerc. 2003 Feb. 35(2):327-32. [Medline].

  19. Spears IR, Cummins NK, Brenchley Z, et al. The effect of saddle design on stresses in the perineum during cycling. Med Sci Sports Exerc. 2003 Sep. 35(9):1620-5. [Medline].

  20. Jeong SJ, Park K, Moon JD, Ryu SB. Bicycle saddle shape affects penile blood flow. Int J Impot Res. 2002 Dec. 14(6):513-7. [Medline]. [Full Text].

  21. Schwarzer U, Sommer F, Klotz T, Cremer C, Engelmann U. Cycling and penile oxygen pressure: the type of saddle matters. Eur Urol. 2002 Feb. 41(2):139-43. [Medline].

  22. Taylor JA 3rd, Kao TC, Albertsen PC, Shabsigh R. Bicycle riding and its relationship to the development of erectile dysfunction. J Urol. 2004 Sep. 172(3):1028-31. [Medline].

  23. Dettori JR, Koepsell TD, Cummings P, Corman JM. Erectile dysfunction after a long-distance cycling event: associations with bicycle characteristics. J Urol. 2004 Aug. 172(2):637-41. [Medline].

  24. Sommer F, König D, Graft C, et al. Impotence and genital numbness in cyclists. Int J Sports Med. 2001 Aug. 22(6):410-3. [Medline].

  25. Solomon S, Cappa KG. Impotence and bicycling. A seldom-reported connection. Postgrad Med. 1987 Jan. 81(1):99-100, 102. [Medline].

  26. Parthiban S, Hotaling JM, Kathrins M, Baftiri AP, Freels S, Niederberger CS. A novel method to determine perineal artery occlusion among male bicyclists. PeerJ. 2015. 3:e1477. [Medline].

  27. Akuthota V, Plastaras C, Lindberg K, et al. The effect of long-distance bicycling on ulnar and median nerves: an electrophysiologic evaluation of cyclist palsy. Am J Sports Med. 2005 Aug. 33(8):1224-30. [Medline].

  28. Mellion MB. Common cycling injuries. Management and prevention. Sports Med. 1991 Jan. 11(1):52-70. [Medline].

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