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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

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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.



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 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.



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.



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.

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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