Bicycle Seat Neuropathy Clinical Presentation

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

History

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.

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Physical

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.

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Causes

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

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