Cycling is a fun hobby and a good way to stay in shape, but spending a lot of time on your bike can lead to injuries. The pressure of your body against your seat can lead to nerve injuries such as bicycle seat neuropathy, also known as pudendal nerve entrapment. Here are five things you need to know about this painful cycling injury.

How does cycling cause this injury?

When you sit on a hard, narrow bike seat, your pudendal nerve, a nerve within your pelvis, can be compressed by the weight of your body against the seat. This compression causes the symptoms of bicycle seat neuropathy.

What are the signs of bicycle seat neuropathy?

Mild cases of bicycle seat neuropathy may include symptoms such as tingling or numbness in the pelvic area when you ride. This feeling will go away once you get off your bike and your body is no longer pushing against your seat.

In more severe cases, the tingling and numbness will persist, even after you stop cycling. This happens when your nerve or the tissues that surround it are swollen or bruised. If the nerve isn't damaged, the symptoms will go away once the swelling is gone. If the nerve is damaged, the symptoms may persist after the swelling is gone.

Male cyclists may suffer problems like erectile dysfunction as a result of the nerve compression.

How is it treated?

If you experience bicycle seat neuropathy, the first thing you need to do is stop biking. Continuing to ride can make the problem worse, so don't try to push through the pain.

Taking a break from cycling until you feel better may be the only treatment required. If resting doesn't help your symptoms, you may be referred to a physiotherapist for further treatment. A physiotherapist can lead you through exercises and stretches that may ease your symptoms. Your physiotherapist may also massage trigger points in the area to try to improve your symptoms.

In severe cases, surgery is possible, though this is generally a last-resort treatment. If you've shown no improvements after six months of physiotherapy, you may be referred to a surgeon. If you have experienced any gains during six months of treatment, it is advisable to wait another six months before having surgery. Surgery for bicycle seat neuropathy is quite invasive and extensive due to the location of the pudendal nerve within the pelvis.

How can you prevent it?

There are many things that you can do to prevent bicycle seat neuropathy.

  • Make sure that your seat is set to the correct height, as improper seat placement may lead to injury;
  • Make sure that your handlebars are slightly lower than your seat;
  • Choose a well-padded bike seat (such as a gel seat) to cushion the area;
  • Choose a bike seat with a cut-away middle to reduce pressure on the pudendal nerve;
  • Wear padded bike shorts to provide additional cushioning;
  • When biking over rough terrain, try to minimize your time in the seat by standing up as much as possible;
  • Take frequent breaks during long rides;
  • Remember to take rest days to allow your body to recuperate from long rides.

How common is bicycle seat neuropathy?

Bicycle seat neuropathy is common, though the prevalence rate is thought to be underreported. Studies have reported widely different prevalence rates, and cyclists may suffer from the injury but assume that it is a normal consequence of cycling and never see their doctor.

One study of male long-distance cyclists reported that 22% of the study participants suffered from numbness or pain in the pudendal area. Another study found that 45% of cyclists suffered from some degree of perineal numbness; 10% suffered from severe symptoms and 2% had to stop cycling.

Studies have found similarly high prevalence rates among female cyclists. One study reported that 34% of a female cycling club suffered from perineal numbness.

If you think you have bicycle seat neuropathy, go to an urgent care center right away.