Bicycle Seat Neuropathy Follow-up

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

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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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